Board of Supervisors — 2014-05-06

Yeah. you ♪ ♪ ♪ Morning, ladies and gentlemen. We'd like to call to order the May 6 meeting of the Board of Supervisors for Santa Barbara County. Mr. Allen, can I get a roll call please?

Mr. Carbajal? Here. Ms. Wolfe? Here. Ms Farrer? Here! Mr. Adams? Here Mr. Lavagnino?

Can I get a motion to approve the minutes of the April 22nd meeting, please? Moved and seconded. All those in favor, aye. None opposed. Passes unanimously. It's time for public comment. Mr. Allen do we have any speakers?

We have no request to speak for public comment.

No requests to speak from the public. Okay, very good. Are there any changes to the administrative agenda you need to make us aware of?

Chairman Lavinino, members of the board, just a couple of quick announcements. We had a request from the Public Works Department to withdraw item A-17 from the agenda today that is regarding an acceptance of easements for public utility purposes. It's the Sierraville 4 in the second district and that item is going to be withdrawn from the agenda today. I also wanted to note that we did post an addendum on Friday which added item A31 to the agenda. It was from Supervisor Adam, and it was the appointment of Kenneth Bell to the Advisory Board on Alcohol and Drug Problems. Those are my two announcements.

Okay, very good. Can I get a motion to approve items A1 through A5? Moved and seconded. All those in favor? Aye. None opposed. They pass unanimously. We'll go to A1, Supervisor Carbajal.

Thank you, Mr. Chair. If I could have Paige Batson come forward, Sandra Copley, Linda Penny, Yvette Calhoun. I am honored to sponsor the resolution proclaiming May 6th as National Nurses Day. And the week of May 6, 2014 through May 12, 2014 is National Nurses Week in Santa Barbara County. I think most, if not all know the important work that our nurses provide to our healthcare system.

As I read this resolution, And I can't say enough about the important role that nurses play. I have a personal story, I immigrated to this country when I was five years old and about a year later, I don't even recall why but I ended up being hospitalized. For about a week and one of the most pleasant experiences, especially as somebody new to this country was just my interaction with the care I was getting from the nurses. So for me it left a very important memory in my life in terms of the role that nurses play and I just want to thank you for the important role that nurses play day in and day out in our healthcare system to helping Achieve the medical outcomes that we need to achieve and to help mend everybody who comes into your care. So thank you for your service, Mr.

Allen if you could read the resolution?

Chairman Labnino, members of the board. This is a resolution proclaiming the day of May 6th 2014 as National Nurses Day and the week of May 6-12 2014 as National Nurses Week. Whereas nurses are recognized for their contributions to the healthcare system both in their role as expert clinicians in diverse care settings and as leaders who can dramatically influence the quality of care and overall performance of the healthcare system. And whereas, nursing is the largest of the healthcare professions and continues to grow with more job growth projected in nursing than any other occupation between 2008 and 2018. And whereas, the nursing profession plays an essential role in improving patient outcomes, increasing access, and reducing healthcare costs.

And whereas every day nurses step forward embracing new technologies, resolving emerging issues and accepting ever-changing roles in their profession. They lead the way for their patients, colleagues, organizations and the healthcare industry as a whole. And whereas the theme for National Nurses Week 2014, Nurses Leading The Way highlights the dedication, commitment and tireless efforts of nearly 3.1 million registered nurses nationwide to promote and maintain the health of communities in the United States.

Now, therefore be it hereby ordered and resolved that the Board of Supervisors does observe the sixth day of May 2014 as National Nurses Day and the week of May 6th through May 12th as National Nurses Week in recognition of the contributions of all nurses working in our health care and educational settings and in the County of Santa Barbara. Passed and adopted today.

I just wanted to start off really quickly here and express my gratitude for your support, recognition of Nurses Day and Nurses Week. System change efforts, as well as just the day-to-day work that the nurses do within our system and our operations. Investigating outbreaks, doing home visits, operating in our quality program, emergency medical services, children's services. In our clinics obviously in both public health and alcohol drug and mental health. Inpatient settings like our PUF, working with the homeless, working in the jails. You can see that throughout the county, and all of our stakeholder partners in healthcare rely incredibly on nurses and their leadership and their talents. So I'm going to quickly turn it over now to some of our wonderful nurse leaders within the county first with Yvette.

Good morning, Chair, Supervisor Carbajal and members of the board. I'm Yvette Calhoun. I am Nursing Director of the Santa Barbara County Healthcare Centers. I am joined today by two of my colleagues that come closer, Paige Batson, Director of Public Health Nursing and Sandra Copley, Director Of Maternal Child Adolescent Health. I first would like to say thank you for your kind words, and they mean a lot. And those kinds of things are what's important for nurses to hear.

I'd like to start off first, we'd like to start off first by thanking you for acknowledging Nurses Week and the valuable contribution that nurses make it to the health care system. We also would like to take this opportunity to thank all the nurses that work at the Public Health Department as well as our communities for their efforts in health promotion disease prevention access to care as well as helping residents establish medical homes Nurses are recognized for their role as expert clinicians in diverse care settings and as leaders who can dramatically influence the quality of care and overall performance of the healthcare system.

In concert with this year's National Nurses Week theme, Nurses Leading The Way, nurses will lead the way and continue to play a critical role as healthcare reform continues to evolve. Thank you.

Supervisor

Carbajal.

Mr Chair, I know every time you provide this resolution or the immunization one, you usually come up with this very unique way of highlighting the day. You got an immunization last time- You're not trying to give me another shot at it. I was thinking of some way to best you but I couldn't so I just want you to know that I tried very hard.

Okay, very good. We'll go to A2 Supervisor Wolfe. Very special resolution.

Indeed. This is a resolution proclaiming the month of May 2014 as National Foster Care Month in Santa Barbara County and I'd like to call our Department of Social Services Director Daniel Nielsen, Deputy Director Delphine O'Neira, social services practitioner Don Manola, Kenneth and Yolanda DeWitt are Very special honorees and their two young sons who I have something to read, but I just want to say sitting up here and watching your beautiful family. I think it's just incredible and you boys are pretty amazing. You really are so I just want to thank you for being here. And as we read the resolution, I wanted to make sure that the kids look up here because they're going to see themselves on TV That's really going to be the TV. So

you

can wave to the TV. Yeah, there you go! May is National Foster Care Month and we celebrate the contributions of very special families who provide a safe place for our children in need. Every year we'd like to highlight one of our families as an example of the care and dedication Shown to our children every day by foster parents in Santa Barbara County. The DeWitts became licensed foster parents through Santa Barbara County after hearing about RJ. RJ, do you want to raise your hand? There's RJ. And his big brother, is it Devin? Okay.

The Dewitts began the licensing process hoping that he would be available when they were finished with the process. Unfortunately by the time they finished, he had already been placed with another foster family. They kept their license in the hope that something would work out for their family. Several months later, the Dewitts learned that RJ's form replacement didn't work out And they immediately agreed to bring RJ into their home.

When the social service practitioner arrived at their home with RJ, Mrs. DeWitt welcomed him with open arms, took his face in her hands and told him we've been waiting for you. The Dewitts reassured RJ that he was never leaving their home and that he would always be their child. They have followed through with their words and have worked diligently to make RJ feel loved and accepted Thank you for joining us today.

Kind, loving, accepting foster parents she has ever met. They adopted their son RJ a year ago on April 14th 2013. So thank you very much for allowing us to honor you and all the other foster parents in our county. Thank you. Who's going to speak first? I forgot, I have to go down there. What am I supposed

to

do? Mr. Allen. I thought she read that. Okay, go ahead. You threw me off, all right.

Chairman Labnino, members of the board. This is a resolution recognizing May 2014 to be National Foster Care Month. Whereas in Santa Barbara County, there are approximately 500 children in foster care who need and deserve a stable home where they're supported and nurtured in a safe environment. And whereas young people in foster care need the guidance, stability, and love that are essential for becoming successful adults from the significant people in their lives while they are in care.

The enduring and valuable contributions of relatives in foster and adoptive parents who open their hearts, families and homes to vulnerable children. And youth play a vital role in helping children and families heal and reconnect. And whereas there are many individuals public and private organizations who work to increase awareness of the contribution of foster parents as well as the need of children in foster care.

And whereas, thanks to these heroes, many formerly abused or neglected children and teens will safely reunify with their parents or form lifelong permanent connections and be supported into independent adulthood with relatives, foster, and adoptive parents. Now therefore, be it hereby ordered and resolved that the Board of Supervisors of the County of Santa Barbara recognizes May 2014 as National Foster Care Month in recognition of our county's foster children and foster parents and all county employees involved in the juvenile independency system Who care for children and families that watch over them. Passed and adopted today by the board.

Chairman Lavinino, members of the board it's I guess next year I won't write such a dramatic speech right? We want to thank you on behalf of the department and the foster parents For this recognition, it is probably one of the most if not the most important component of our child safety system. But I wanted to highlight today to everybody that every year we need about 100 new families for children that cannot safely reside with their natural families. This board and our department fully support families and children with their parents when at all possible but unfortunately we all know that's just not a realistic possibility for everybody so today we want to take the opportunity Not just the accomplishments of our foster families, but our continued need for foster families.

And if anybody there in the public that's interested they can contact our department at 866-892-4649 because every year we need 100 families like the DeWitts to help with this.

Thank you. Thank you very much. Thank you

for being here today. I hear the DeWitts are speechless right now so. Thank you.

Okay, Supervisor Farr, you get to try to top that, A3.

Well, I'm going to go back to our health theme that we started the resolutions with by honoring nurses. And ask, I see Vice Chancellor Michael Young in the audience, Debbie Fleming, Jim Caesar, also Dr. Mary Ferris and also Pam Lombardo's name listed here. They'd all come up and also Dr. Wada. The title of the resolution I'm going to present is accommodation honoring the University of California Santa Barbara for promotion of health in Santa Barbara County. But I think that doesn't really explain how important the actions of the university were beginning last fall.

As some of you might remember, read in the news there were four UCSB students that were diagnosed with meningitis and this was not the first time it had happened on a college campus, it had happened back east But it meant that not only the university, but our department of our county public health department with Dr. Wada at the head, the California State Department of Public Health, Centers for Disease Control all had to work together to contain the outbreak and to the point where the university was successful in obtaining a vaccine that was not generally available to the public And doing mass inoculations, not once but twice this spring because that was what was required of it to keep everybody safe. So an enormous effort fortunately very successful probably really good to know that the systems that we have in place do work and we all come together when something like this happens.

So the commendation is to thank you all for the wonderful work that you did. And Mr. Allen, would you go ahead and read it?

Chairman Labnino, members of the board, A3 is a resolution recognizing the University of California Santa Barbara for promotion of health in Santa Barbara County. Whereas in November of 2013 four students at the University of California Santa Barbara became ill with meningococcal disease, a serious and incommunicable disease. And whereas the university collaborated with the Santa Barbara County Health Department, the California Department of Public Health and the Centers for Disease Control to respond in a protective and proactive manner to prevent the spread of disease and protect the health of the community.

And whereas the university secured a vaccine that has only been used in one other setting nationally, coordinated massive vaccine campaign for thousands of students and monitored every single student who received the vaccine. Now therefore be it hereby ordered and resolved that the Board of Supervisors of Santa Barbara County does hereby recognize the outstanding leadership by the University of California, Santa Barbara to protect the health of the university community and promote wellness in our county. This pass is adopted by the Board of Supervisors today.

Good morning chair, members of the board. Again thank you for this recognition I'd like to first start by offering well wishes to the students and families that were affected. Of course this was a tragic event but in terms of the response and the leadership and coordination from UC Santa Barbara working with the county and our lead Dr. Toman from the public health department they really do need to be recognized and commended We always have some cases of meningitis in the county, but to have a concentrated number and one close proximity was certainly something that needed to be acted on quickly and very effectively. And we had at one point almost daily conference calls with the university as well as the Centers for Disease Control. I remember conference calls on Christmas Day and the evenings and weekends.

And when CNN and Al Jazeera are in town you know it's a big deal But throughout the entire effort, UC Santa Barbara and their leadership was amazing in coordinating these efforts again to secure an unlicensed vaccine. There was an incredible number of approvals and of course administrative issues that had to be worked through. And coordinating their mass vaccination efforts was amazing and should be a model that can be used elsewhere. So I certainly want to thank them as excellent partners in keeping our community safe And I'll turn it over to UC Santa Barbara for a comment. Thank you.

Thank you very much, Dr. Wada and Supervisor Farr. I'm Dr. Mary Ferris, the Director of Student Health at UCSB and the campus physician. And we just want to also thank the Santa Barbara County Public Health Department for the extraordinary collaboration that this has required in the fast response to protect our students and our community. And now we've given over 17,000 shots of the special vaccine that we brought to campus, and it's required an extraordinary Volunteer spirit from both public health as well as from our campus employees and the students themselves.

In this case, our students really rose to the challenge spread the message of prevention as well as coming in for a painful shot series of two shots and they rose to that challenge and we are grateful to them all thank you very much.

Thank you. Thanks. All right, we'll go to our next resolution that I'll be handing out and that is if I could get Dr. Wada please to come forward this is adopting a resolution claiming the month of May 2014 as a mental health month. Oh sorry yeah. Chairman please come forward and you know I just wanted to say that when I came on this board four years ago this isn't an issue I really knew too much about my eyes have really been open to the extent that mental illness plays in the lives of so many people in our community.

It was very sobering for me to get a phone call from a mother who had a teenage son at home that was starting to hear voices and he was saying you know, he's getting violent thoughts. And as a you know being called and asked if you could Find out what services are available for a situation like that is very scary and it you start realizing what some people have to go through on a daily basis. And what I've come to realize is we are lacking in services and we are lacking capital.

The buildings that that we need in the beds that we need and it's just amazing how this issue really Kind of bleeds over into a lot of other areas in our homelessness and our social services. The effects in our jail, and I'm very excited that I think this is an issue that's really elevated in the last year here. I think we're all, this board is very committed to working with all of our stakeholders in this area to really do whatever we can to try to make this better place for those who are suffering Not only the folks that are suffering, but their families as well. So with that Mr. Allen if you could please read the resolution.

Chairman Labnino and members of the board, item A4 it's a resolution proclaiming the month of May 2014 is Mental Health Month. Whereas the US Surgeon General has found that one in every five Americans experiences a mental disorder in any given year and half of all Americans have such disorders at some time in their lives. Mental health is essential to everyone's overall health and well-being. And whereas mental illnesses are far more common than cancer, diabetes, heart disease or arthritis and are real treatable diseases that can affect anyone regardless of age, ethnicity or gender. Prevention is an effective way to reduce the burden of mental health conditions.

And whereas, there's a strong body of research that supports scientific tools that all Americans can use to better handle challenges and protect their health and well-being. The Santa Barbara County Alcohol, Drug, and Mental Health Services Department recognizes the importance of promoting mental wellness for all members of the community. And whereas, Santa Barbara County Mental Health Commission supports proactive community collaborations to maximize the mental health of all people. And with effective treatment those individuals with mental health conditions can recover and lead full productive lives.

Now therefore be it hereby ordered and resolved that the Santa Barbara County Board of Supervisors does hereby proclaim the month of May 2014 as Mental Health Month, and calls upon all Santa Barbara County citizens to fight stigma associated with mental illness. And reaffirm a commitment supporting the mental health of all people in Santa Barbara County. Passed and adopted today.

Thank you Chair and members of the Board. As stated in the resolution, one in five Americans are affected by mental illness in any given year and half of the population here in the United States have mental illness at some point in their lives so it certainly is An issue that touches many of us in our communities, in our own personal families. And our efforts to increase awareness are so important to help reduce stigma and lead towards new treatments and effective partnerships to make our system better for all the people affected and their families. And so with me is Mr. James Road, he's chair of the Mental Health Commission as well The Alcohol and Drug Advisory Board, and also a member of our Behavioral Health Steering Committee. So I will now turn it over to him for some comment.

Thank you.

Good morning Chair Lavinino and members of the board. Again, as always I'm speaking for clients, consumers, family members, people affected in our community by mental health issues. And Chair Lavagnino what you shared is exactly the crux of the issue for me is the awareness. I want to raise the awareness of the mental health issues that we have throughout this country and in this county of course so that was really rewarding for me to hear you say that It's, we see it all the time in the news in different ways. What I'd like to see is the day come when we can be more on the preventive side and stop crises and stop tragedy in our society before it reaches that point. And if we all work together, we can accomplish that here at home and throughout the nation.

So thank you again for this, awesome.

Great, thank you. All right, our next resolution is A5. And I'm going to go out on a limb and I'm going to say I think it's one of our supervisors' favorite resolutions of the year because we get a goody. So if we could have Bob Engel from Engle & Gray come forward. This resolution is proclaiming May 5th through the 11th as Compost Awareness Week. And we're always looking for creative ways to reduce what's going into our landfills And to improve our soils and promote sustainable communities. And what better way to do that than to get an education on how to compost?

And I think you're going to make me go home and try to grow that. Do you want to see what happened to the plants you gave us last year? Mr. Allen, can you read the resolution please?

Chairman Labnino, members of the board, this item A5 is a resolution proclaiming the week of May 5 through 11 2014 as Compost Awareness Week. Whereas the composting councils of Canada, Ireland, Australia, United Kingdom and the United States have declared the first week of May to be the annual International Composting Awareness Week And whereas, organic materials suitable for composting represent up to 70% of materials that can be landfilled each year. And composting is an effective form of waste reduction, reuse and recycling.

And whereas, compost improves the soil structure, reduces erosion and runoff, supplies soil with a variety of macro- and micronutrients, enables compost cemented soils to use less water. And whereas, using sustainable soil enriching composts help prevent erosion and valuable topsoil without depleting valuable wildlife habitats. And whereas community sustainability is enhanced by composting green waste biosolids and other organic materials and promoting the use of renewable resources in landscaping, horticulture, and agriculture. And whereas, returning composted organic resources to the soil is a method of decreasing the dependence on chemical fertilizers, decreasing erosion, reducing water consumption and non-point pollution. And whereas, the county of Santa Barbara has initiated green waste collection programs with its franchise haulers to aid in the efforts of environmental sustainability.

And whereas England great regional composting facility in Santa Maria has been successfully composting organic material for sustainable agricultural practices. Now therefore it be hereby ordered and resolved that the Board of Supervisors, in recognition of the efforts of the Composting Councils Extension agents, households, landscapers, farmers, recyclers, public workers, composters, gardeners and plant growers everywhere along with Engle and Gray Week and Harvest Blend Compost hereby proclaim the week of May 5 through 11 as Compost Awareness Week. Pass it adopted today.

Supervisor Adam? Did you want to say yours first and then I'll just ask you. I got a couple of comments

Well, I just wanted to say Chair, fellow supervisors. I'd like to thank you again on behalf of the International Composting Council to recognize International Compost Awareness Week and it's kind of lightened in light of all the heavier stuff that you have going on during the day but I'd just like to bring awareness to that it all starts with the soil and compost is building healthy soil. And in light of the drought that we have going on right now, the water savings capability of putting compost into soil and how much more water that soil can absorb with the compost is great so we really appreciate you taking your time out of your day to recognize us.

So my first comment is there's a lot of great pumice in here. Is there not?

Yes, there is.

Well you might consider throwing in a bottle of wine to make this a really stunning gift The other thing is I want to talk about a little bit agricultural uses of compost Have you been working on, is there anybody working on getting the food safety issue dealt with with the word compost?

That is a good question and a big issue because compost has Been kind of thrown in with manures and other things. And that's what our facility specializes in is killing all the pathogens, all the bad things that are in all of our feedstocks that come in. We go through a very rigid production protocol to make sure we get temperatures up and we kill all the pathogens and stuff. But no there is a big misconception in the food industry especially customers yours like the bag salad industry where they'll just come out and say they don't want any compost applied to a farm field. And it's an education issue that we're trying to address at a national level, but it's a slow process.

Right. Well, keep going because I really like compost. I've got some compost that I've used in the past and I'm barred from using it now because the food safety issue won't allow it just to tell everybody there's a you know we'd like to use more compost but at this time in the veg industry at least it's a taboo right?

Well, by some growers because their customers are telling them not to use it. We do sell a lot into the ag industry. It's just that in some of the growers' customers are saying hey if you've applied compost to your field we're not going to buy your produce and it's a problem like Red Lobster, Olive Garden, that chain of food restaurants they have one of their protocols their buyers goes out and says did you apply compost? And how that got in there, I have no idea. Well

it's not really their buyer, it's their third party food safety auditors and just so everybody knows we get audited all the time by third party food safety providers who tell Darden who owns those restaurants that they shouldn't buy our produce if compost is used in our fields. So just so everybody knows.

All right. So thanks for doing this on the first week, so we don't want to make sure anybody gives these as Mother's Day gifts if your wife sees this she's going to be a big you're in big trouble

Miriam if you're watching this this is this should not be your mother's

day gift from Mr. Lagunito maybe mother-in-law we can go there thank you very much just kidding Hopefully she's watching Family Feud instead of the Board of Supervisors. All right, so we're going deeper all right So we're gonna move on to the rest of the administrative agenda Do we have any speakers from the public on any of the agenda?

We have requests to speak on items a 6 and 8 10

a 6 and 10 And do any of my colleagues wish to push them pull any items Yeah, I would like to have a 10 and a 22 10 and 22. Okay, let's start with the public. Mr. Allen?

Chairman Lavignino, members of the board, we'll start with item A6. We have five requests to speak. Item A6 is from Alcohol, Drug and Mental Health Services. The request that the board consider recommendations regarding agreement with traditions behavioral health. Start with Dr. Mark Koffler to be followed by Peter Tilton.

Board of Supervisors, Chair, CEO and the public. My name is Dr. Mark Koffler. I've worked for ADMHS for over 20 years as a board-certified civil service psychiatrist. I'm here also today representing UAPD which is also known as the Union of American Physicians and Dentists. The union opposes the contract which seeks to fill Up to five civil service union positions with independent contractors supplied and employed by a third party, TBH, Traditions Behavioral Health.

They will also remain in the employ and beholden to TBH and not directly employed by the county. The TBH contract, which is for almost $5.8 million for four years, is unnecessary and not financially prudent on the part of the department in the county. Dr. Peter Tilton who will follow will speak in more detail about alternatives and less costly approaches the county can take in finding and hiring psychiatrists.

Lack of recruitment is at the heart of the predicament that we're in and why we have these vacancies. As to the recruitment efforts made by the department or claimed by the department, they are spelled out on the bottom half of the second page of the board letter which I'm going to reference. If you look at the third paragraph from the bottom on page two, the last line it states These recruitment efforts resulted in the hiring of 19 psychiatrists over an eight-year period.

Well, let's talk about what's relevant to these six vacancies. Not one permanent psychiatrist has been hired over the last two and a half years from approximately October of 2011. When you go on to the next paragraph, the claims made by the department were not done by administration Or the county, they were done by staff psychiatrists volunteering their time.

And coming up with the ways and the approaches that we've been advocating and pushing for two years while these vacancies have existed. And they were not given the proper attention they need. That's why we're in this predicament. The union is asking that the contract not be approved and at a minimum table to give alternative approaches as spelled out by Dr. Tilden, a chance to succeed with less upfront costs. So what's the rush? And he'll explain to you why I think we should be more prudent and take a little additional time. Thank you.

Peter Tilden to be followed by Steve Cook

Good morning, I'm Dr. Peter Tilton. I'm another one of the civil service full-time psychiatrists in Santa Barbara County and no one knows better than I the impact of not having enough psychiatrists because there's a shortage. I drive from Santa Barbara to Santa Maria three days a week. I also work at Care South and experience firsthand the delays in treating patients. But also let me address the misleading information in the agenda letter regarding recruitment.

Of the 19 psychiatrists cited, most that were hired were locum tenens or temporary psychiatrists. In fact none of the full time psychiatrists were recruited through any efforts by our administration. In fact, only last month were we told that one company our department uses is only used to hire locums not full-time doctors. In short, our administration has failed miserably in its attempt to recruit psychiatrists but that does not mean the TBH is the answer. Had the department come to us sooner to seek our collective knowledge what we as a group started Could have been implemented much sooner, obviating the need for this proposed contract.

We have formed our own recruiting committee in the last several months. One of our psychiatrists, Dr. Luniansky has been to a job fair in LA and visited UCLA and other programs in LA County to recruit residents graduating from programs. Another psychiatrist, Dr Peter Garcia is going to Reno, Fresno, and Sacramento to do the same. I myself have been in contact with several national recruiting companies including Alliance, D&Y, Psychiatry's Only, St. John's and Comp Health. Not one of these companies was aware of our need for a psychiatrist but were all willing to assist us in finding permanent civil service psychiatrists and provide us with locums in the interim.

All without the need for a long-term contract. And last week, Dr. Berenstain, our medical director informed me that the county was now negotiating with two other national recruitment companies. FCS to hire civil service psychiatrists and Jackson & Cook for locums. These companies all use the same pool of doctors seeking employment as does TBH. The only unique thing about TBH is the proposed almost four year $5.8 million contract.

These other companies can do the same work without the need for this kind of a contract and at a lesser cost to the county. There is no guarantee that TBH can fill our vacant positions or do a better job than any of the other companies mentioned. Therefore, I strongly urge you to reject this contract or at a minimum postpone it for six months. Allow our efforts that we have as concerned members of our department put in place a chance to succeed and save the county money that could be better spent elsewhere.

Thank you.

Steve Cook and then Jan Winter.

Good morning honorable board, my name is Steve Cook I'm a business representative with UAPD the union that represents the doctors As stated in the board letter, this is a long-term solution. And this is why the, as you heard, psychiatrists are against this. Long term means the replacing of civil service psychiatrists with contractors degrading the UAPD bargaining unit which at this time has been challenged with an unfair labor practice.

The cost of the TBH contract would be better used in recruiting the psychiatric workforce for the County of Santa Barbara. Research done, as was talked by the prior doctor, by the UAPD psychiatrist has shown that the last eight years, the recruitment efforts have been half-hearted at best. This is an example of a contract where Santa Barbara County could have enlisted many recruiting firms throughout the state in the nation. They only did basically local recruitment through ads, etcetera.

And we're unsuccessful obviously. At the cost of that recruitment is like three times what it would be normal recruitment costs for a psychiatrist coming in. $40,000 versus about 10 to 15 or 10 to 12 thousand something like that. The difference in cost between the civil service psychiatrists and the TBH contractors is enough to hire these recruiters, to get these people. It's going to cost the county much more money to go forward with this contract.

UAPD believes this could be an attempt to start a continual degradation of the UAPD bargaining units, and again that's why the unfair labor practice was followed. For these reasons, UAPD opposes the contract and would request the board to reconsider the way the County of Santa Barbara hires a psychiatrist and to not approve this contract. Thank

you. Jan Winter to be followed by James Road who is our final speaker.

Chair Lavanino and supervisors, I am Jan Winter. And I'm here representing NAMI which has a membership of over 300 families. And I like to think I represent families with mentally ill loved ones throughout the community even those who are not currently clients of the county system. We thank you for agendizing the traditions contract. ADMHS has been short between five and seven psychiatrists for many years.

Research shows that timely treatment can prevent further damage, and early intervention is a very important concept throughout medical care. We want and we hope to have additional psychiatrists so that we can treat all of our family members in a timely way and a consistent way. Excuse me. With the consistency that can build trust and build compliance with mental health treatment, which is always an issue or oftentimes an issue. Thank you for your attention. And we hope to see the approval of the contract and the quick hiring of fine new psychiatrists. Thank you.

James Road? Mr. Road is our final speaker.

Chair Lavinino, members of the board again it's great to be here. I always want to make sure that you know that I represent, again, clients, consumers, family members, anyone affected by mental health issues in this county. I think it's important that we fill these positions as soon as possible because the need is there and it would help to relieve the delay that we're well aware of in clients having these psychiatric needs met At the moment, that delay is unacceptable and we're all working together to try to bring that time delay down.

The idea of a six month time period to look at this is not acceptable in the sense that we have this crisis now. We have this need now. These positions need to be filled. So again, I urge you to do what's best for the clients that we serve here in the county. And to consider their needs and to try to lower the time wait to be met properly and with respect concerning their situation.

Thank you for this time. Thank

you. Supervisor Wolf?

Thank you Mr. Chair, I just have a few comments. First of all when this item first came to us it was apparent after the information we had been studying about mental health that we needed to move and hire more psychiatrists. The contract was for this particular, for TBH was given to us. And I had raised some concerns about the contract. The contract was subsequently revised and Then, as of yesterday there were a few just minor changes.

I think that the contract now is a good contract for the county and I do believe that we should move forward and get these psychiatrists on board. But I also want to mention the issue of future recruitment and I think that the county can do a better job in working with our psychiatrists in developing a plan for recruitment. We've got psychiatrists that are apparently going out on their own time trying to do this, and we're talking about hiring a recruiter to do this.

It seems that at some point, a meeting of the minds needs to occur. And so that we can all be on the same page as we go forward because it is my understanding that we're going to be needing to hire additional psychiatrists. But I think for the time being, I will support this.

Okay, very good. Do we have any other additional speakers?

We have no further requests to speak. I just wanted to note for the record that yesterday we did receive two documents that were distributed as late distribution. There was a memorandum from Alcohol, Drug and Mental Health as well as a revised copy of the contract. Those were distributed to the board and placed online for the public and also are available in the back of the room. I just wanted to note that.

Okay. Supervisor Carbajal?

Thank you, Mr. Chair. I raised a number of questions in advance with Dr. Wada and the staff report pretty much covered and addressed all the issues that I've raised. One of them dealt with civil service recruitment, cultural competence issues, and all of those issues have been addressed in the staff report. Really appreciate Dr. Wada addressing those issues.

Very good. Supervisor Adam, I think we go to A10 next Mr. Allen can you read 810 please?

Chairman Lavagnino, members of the board item 810 is from the County Executive Office. The request that the board consider recommendation regarding the transient occupancy tax increase ballot measure for the November 2014 general election ballot and this is the second reading of the ordinance we have three requests to speak we're going to start with George Thompson followed by Seamus McManus

Mr. Chairman members of the board I'm George Thompson, I'm an owner of a vacation rental in the county and I spoke to you the last time this issue came up And argued to maintain the tax at 10% rather raising it to 12 and The argument at that time was it gave me a competitive advantage as an owner in competing with other vacation rentals in municipalities that charge more tax.

The board listened to that and you did not increase the tax at the time. However, I understand the budget crisis is still a problem. And so this time I feel an increase is inevitable and So I've given up my former position However, I'd like to point out that I feel that twelve and a half percent is excessive It's going to harm the county rentals and my reasoning goes like like this It puts me now at a competitive disadvantage versus municipalities that are at 12% Our revenues may well go down And if our revenues go down the tax revenue to the county will also go down. I My feeling is at worst the county may not get the revenues that they presently do if we if our business is impacted severely.