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A
And
hutchinson
assistant,
director
of
the
department,
Patty
Durham
who's,
the
division
chief
for
administration
and
Quality
Assurance,
dr.
John,
Palmeri
who's,
the
division
chief
for
behavioral
health,
Brian,
Vickers,
who's,
a
management
intern
with
us
and
Michael
Dharma
Aaron
who's,
our
Quality
Assurance
Manager.
Anyone
I
miss.
A
A
So
just
to
set
the
the
stage
we
have
a
vision
of
providing
support
to
create
a
community
of
healthy,
safe
and
economically
secure
children,
adults
and
families,
and
our
mission,
which
we
really
embody,
is
to
strengthen,
protect
and
empower.
Those
in
need.
I
wanted
to
give
you
a
brief
overview
of
the
kinds
of
programs
we
have.
Dhs
serves
over
50,000
residents
in
five
main
service
areas
or
divisions.
You've
just
met
the
division
Chiefs
and
the
following.
Two
slides
show
the
largest
program
by
service
areas.
A
The
numbers
represent
unduplicated
clients
in
each
program,
so
you
can
see
our
largest
programs
in
aging
and
disability
or
with
nursing
case
management
in
behavioral,
health,
psychiatric
services
and
emergency
services
and
children
and
family
child
protective
services.
We
do
have
some
trends
of
growth,
for
example,
people
former
slide
people
coming
to
emergency
services,
which
is
24/7
service
for
people
who
are
often
in
a
very
critical
suicide
or
homicidal
crisis,
have
increased
by
17
percent
for
the
over
the
last
two
years.
So
we
are
seeing
many
more
people
coming
to
us
for
services.
A
The
next
slide
shows
the
trends
in
two
of
the
larger
divisions,
which
is
economic
independence
and
public
health.
School
clinic
visits,
keep
going
up,
Medicaid
recipients
keep
going
up
and
I
just
want
to
say
that
as
a
large
department
and
a
department
that's
responsible
for
really
supporting
clients
who
are
living
in
poverty
or
with
serious
mental
and
physical
illness.
We
rely
on
a
staff
of
professional
nurses,
social
workers,
psychiatrists
mental
health
professionals.
A
They
are
the
backbone
of
our
organization
and
it
is
very
important
to
us
to
be
able
to
recruit
and
retain
those
professionals
and
it's
becoming
harder
because
we
are
not
always
very
competitive
in
those
areas.
Our
salaries
cannot
always
compete
with
the
surrounding
jurisdictions
and
the
private
sector
jobs,
but
in
order
to
have
a
robust
and
fully
functioning
Department,
we
need
to
have
top-notch
professionals
in
the
health
sector
next
slide.
Okay,
I
wanted
to
focus
the
next
two
slides
on
the
initiatives
we're
working
on.
A
The
reason
is
is
that,
even
though
this
is
a
time
of
scarcity,
budget
scarcity,
social
problems,
don't
go
away.
Okay,
and
we
can't
we
don't
have
the
luxury
of
saying
oh
opioid
crisis.
Well,
we
don't
have
money
for
that.
You
know
lack
of
childcare.
Sorry,
we're
too
busy
I
mean
our
department
is
charged
with
leading
the
community
in
addressing
some
very,
very
difficult
social
issues
that
are
on
the
horizon,
and
we
have
addressed
all
of
these
initiatives
and
are
running
and
managing
these
initiatives
by
utilizing
existing
staff
and
budget
resources.
A
We
have
not
requested
any
additional
FTEs
or
any
additional
non
personnel
for
these
initiatives,
even
though
they
are
very
extremely
labor
intensive,
starting
at
the
top.
The
childcare
initiative,
which
you
know,
is
a
priority
of
this
board
and
this
community.
We
are
convening
over
30
organizations
to
create
an
integrated,
affordable
quality,
accessible
care
childcare
system,
and
we
have
a
very
robust
community
engagement
process
where
we've
already
received
over
500
comments
from
the
community
on
our
action
plan,
which
is
nearing
its
final
form
and
will
be
come
to
you
in
the
next
month
or
so.
A
With
regard
to
the
opioid
response,
we
have
over
20
entities
at
the
table.
We
are
leading
together
with
the
police,
an
effort
to
make
the
community
more
aware,
expand
treatment,
services,
disseminate
naloxone,
enforce
better,
safe
prescribing,
reduce
supply
and
we
were
used
an
existing
FTE
that
was
vacant
and
we
repurposed
it
for
an
opioid
manager.
A
Who's
coming
on
board,
hopefully
soon
destination,
2027,
that's
an
initiative
that
occurs
every
10
years.
We
do
a
very
thorough
assessment
of
our
healthcare
system,
led
by
the
public
health
department.
We
have
over
35
entities
who
are
convenient
healthcare
providers.
We
have
the
schools,
we
have
universities,
foundations,
law
enforcement,
the
hospital
to
understand
what
our
current
health
care
system
provides
and
what
it's
lacking
and
we
went
out
and
had
a
did-
a
survey
to
collect
community
health
information
and
we
got
over
2,500
responses.
A
This
is
we
don't
have
special
staff
to
do
this.
These
are
people
who
already
have
full-time
jobs
who
work
on
these
special
initiatives,
because
we
believe
we
must
continue
to
address
these
issues
and
we
have
to
do
it
in
a
way
that
involves
in
all
of
the
stakeholders
in
the
community.
Next
next
slide
we're
working
on.
You
may
have
heard
people
talk
about
bridges
out
of
poverty.
A
Ac
works.
The
manager
has
asked
us
to
look
at
how
employment
and
workforce
development
services
are
conducted
in
the
county
and
to
do
a
multi-year
effort
in
order
to
eliminate
redundancies
and
create
efficiencies.
So
we're
working
on
that
and
then
same-day
access,
which
is
a
best
practice
across
really
the
nation
and
now
Virginia
has
adopted.
It
means
that
we
now
and
starting
in
November,
see
people
the
very
day
that
they
feel
they
need
to
see
someone
in
them
in
the
behavioral
healthcare
division.
There's
no
more
wait
time.
A
People
walk
in
and
can
be
seen
the
very
same
day
that
has
meant
that
our
numbers
have
increased,
but
it
also
means
much
better
service
to
the
clients.
The
bridge.
A
lot
of
these
initiatives,
I
just
want
to
say,
are
getting,
are
coming
together
and
converging
around
the
issue
of
social
equity
and
social
determinants
of
health
and
you'll.
Hear
more
about
that
as
you
meet
with
nonprofits.
A
It
is
very
clear
that
although
Arlington
overall
is
a
well-off
community,
we
have
pockets
of
extreme
disadvantage
that
can't
be
ignored
when
we
go
down
Columbia
Pike
on
one
side
of
the
Columbia
Pike
people
have
a
life
expectancy
of
75
and
on
the
other
side
of
Columbia
Pike
people
have
a
life
expectancy
of
85
and
there's
a
study
out
from
the
Virginia
Commonwealth
University's
dr.
Steven
Wolfe,
published
with
the
Northern
Virginia
health
foundation.
A
A
Our
net
change
in
staff
is
a
negative
thirteen
point.
Seven,
although
you'll
see
on
the
next
page
that
we're
taking
sixteen
FTEs
as
part
of
our
reduction,
but
we've
added
some
FTEs
as
part
of
the
state
grants.
So
that's
the
net
change
something
I
should
highlight,
because
you
were
interested
in
hearing
about
fees.
There
are
no
fees
that
are
being
collected
as
a
result
of
the
state
asking
us
to
ask
for
client
fees
for
testing
of
sexually
transmitted
infections.
A
A
We
worked
to
select
reductions
based
on
where
we
could
create
efficiencies
where
we
could
merge
functions
where
we
could
outsource
work
and
still
have
work
done
where
services
had
the
client
demand
had
decreased,
and
so
the
staffing
could
decrease
and
basically
where
we
could
do
the
least
harm
or
the
and
have
the
least
negative
impact
on
client
services
that
led
us
to
propose
a
2.2
million
dollar
reduction
that
includes
16
FTEs.
Eleven
are
currently
filled
and
five
are
vacant.
A
The
first
one
is
an
administrative
staff
reduction.
There
are
two
FTEs,
both
are
filled.
One
is
a
Public
Health
Division
office
supervisor,
whose
direct
reports
will
be
transferred
to
another
supervisor,
and
one
is
an
administrative
technician
who
helps
with
record
delivery
and
retrieval,
and
those
functions
will
be
contracted
out
to
a
private
company.
The.
A
Second
reduction
is
$80,000
non-personnel
from
a
some
contingency
funding
that
we
had
for
residential
behavioral
healthcare
services.
Typically,
we
have
not
needed
to
rely
on
this
contingency
funding
to
meet
our
our
service
delivery,
and
so
we
are
eliminating
that
funding.
Although
if
we
do
come
to
a
point
where
we
do
think
that
we
need
that
additional
funding
for
residential
services,
we
will
come
back
to
the
county
manager
to
see
how
we
can
fund
those
pharmacy.
A
A
We
have
looked
into
a
private
pharmacy
company
that
is
used
by
neighboring
CSPs,
to
estimate
the
costs
of
service
delivery
and
contracting
out
this
service
to
a
private
company,
and
it
is,
it
is
very
doable.
It's
a
model,
that's
practiced
by
CS
B's
across
the
Commonwealth,
and
the
pharmacy
pays
for
the
cost
of
the
bill
down
and
their
own
personnel,
and
so
this
will
allow
us
to
eliminate
four
positions.
A
A
So
we
have
are
proposing
a
reduction
of
six
positions.
Five
are
filled
and
one
is
vacant,
one
to
our
administrative,
a
program
manager
and
a
management
specialist
whose
duties
will
be
transferred
to
another
to
other
management.
People
were
eliminating
a
supervisor,
leaving
one
supervisor
and
then
eliminating
three
employment
services
specialists.
Those
are
the
direct
workers,
two
of
those
are
filled
and
one
is
vacant.
The
other
reduction
associated
with
this
section
is
reap.
A
A
We
have
supported
reap
to
the
tune
of
over
eight
hundred
thousand
dollars
and
over
the
last
few
years
because
of
the
increase
in
their
own
salaries
and
other
expenses
which
are
not
on
the
county's
salary
system.
But
on
the
school
system
we
have
had
a
decline
in
the
number
of
ESL
slots
because
of
the
rising
costs
of
administrative
side
of
the
house.
A
We
had
our
own
personnel
sit
down
with
the
head
of
reap
and
look
at
how
reap
was
structured,
administrative
Lee
and
came
up
with
a
hundred
and
seventy
one
thousand
dollars
worth
of
administrative
reductions.
That
will
not
impact
any
of
the
number
of
ESL
slots
available
or
the
tuition
that
people
pay
for
it's
strictly
administrative
and
we
applied
the
same
principles
of
creating
efficiencies
that
we
used
internally
to
our
own
department
to
this
grant.
A
A
Why
are
my
notes
in
there?
That's
not
good
okay
public
assistance.
We
are
proposing
the
elimination
of
one
eligibility
worker
because
of
declining
caseloads.
In
snap
and
TANF,
we
have
approximately
seventeen
thousand
individuals
who
receive
public
assistance.
This
caseload
of
seven
hundred
has
already
been
reassigned
to
other
workers,
and
this
position
is
vacant,
we're
proposing
$300,000
to
be
eliminated
from
our
developmental
disability
residential
services.
A
This
does
not
mean
that
we're
reducing
the
services.
What
it
means
is
that
we
have
managed
to
obtain
state
funding
in
the
form
of
Medicaid
waivers
to
replace
this
local
pot
of
money
of
$300,000.
Every
year
the
state
has
been
giving
us
more
and
more
waivers,
we're
lucky
to
say
we
in
18.
We
have
138
waivers.
This
is
all
part
of
the
DOJ
settlement
that
Virginia
went
through
a
few
years
ago,
and
so
this
does
not
impact
the
ability
for
people
with
disabilities
to
receive
residential
services.
A
We
have
one
or
we're
one
of
two
locality's
left
who
have
their
own
laboratories
within
their
public
health
departments,
Arlington
and
Fairfax.
So
we
are
closing
this
laboratory
down
keeping
two
laboratory
assistants,
who
will
still
be
able
to
help
with
lobotomy
and
some
in-house
tests,
but
the
laboratories,
section,
supervisor
and
three
laboratory
technicians
would
be
eliminated.
Those
are
all
filled.
We
will
be
using
private
companies
such
as
LabCorp
or
some
other
company
to
conduct
our
tests.
A
A
Just
to
let
you
know
there
are
some
requests
from
nonprofits.
The
next
two
slides
I
want
to
inform.
You
I
will
tell
you
that
I
do
not
support
these
requests.
People
have
come
to
me
directly.
I
can't
in
good
conscience,
provide
extra
money
to
nonprofits
when
we
have
our
own
internal
reductions.
A
spam
would
like
a
hundred
and
ten
thousand
dollars
of
additional
funding
for
the
homeless
services.
A
Next
slide.
Arlington
thrive
is
requesting
$50,000
increase
in
emergency
financial
assistance,
which
typically
goes
for
rental
assistance,
utilities,
medical
bills
etc,
and
the
Arlington
Community
Foundation
nonprofit
Resource
Center,
which
helps
convene
the
23
nonprofits
around
bridges
of
poverty,
is
requesting
$25,000
next
also
I
want
to
make
you
aware
that
the
Community,
Services,
Board
and
I
believe
they're
represented
here
is
requesting
three
additional
items,
and
we
have
an
under
Debra's
leadership.
A
I
must
say,
done
a
very
good
job
at
trying
to
reallocate
all
of
the
vacant
FTEs
that
could
be
repurposed
for
other
types
of
predominant
needs,
such
as
outpatient
treatment
for
people
addicted
to
opioids,
peer
health
navigators
and
we've
also
gotten
additional
monies
from
the
state.
Nevertheless,
this
area
still
is
an
area
of
demand
for
our
community.
There
are
increasing
mental
health
needs.
The
Community
Services
Board
is
interested
in
a
young
adult
mental
health
therapist
another
peer
specialist
and
then
a
two-pilot,
a
developmental
disability,
a
program
of
employment
for
developmental
people
with
disabilities.
A
A
May
I
pass
these
two
housing
grants,
as
you
remember,
that
was
historically
on
the
rise,
but
over
the
last
three
fiscal
years,
so
I'm
talking
about
starting
in
seventeen
not
actually
really
starting
in
16
17
18,
and
it's
going
to
level
off
in
nineteen,
we're
projecting
that
has
been
declining
and
it's
declining
in
terms
of
applications.
There's
about
a
decline
of
5.2
percent
from
FY
16
to
FY
17.
We
discussed
this
last
year
in
my
budget
presentation.
It
really
is
connected
to
the
lack
of
a
available,
affordable
units
in
the
community,
especially
larger
ones.
A
The
cost
per
rent
continues
to
go
up
because
of
the
pressures
of
the
rent
in
Arlington.
Our
maximum
allowable
rent
has
not
gone
up
since
2010,
so
more
people
are
spending
more
and
more
of
their
own
income
beyond
30%
of
their
income,
more
like
40
or
45
percent
of
their
income
in
order
to
be
able
to
live
in
an
affordable
unit.
A
A
A
Permanent
supportive
housing,
as
you
know,
is
one
of
the
premier
programs.
We
have
that
supports
people
with
living
with
permanent
disabilities,
both
mental
and
physical,
fifty
percent
of
which
have
been
homeless
in
the
past
and
has
really
enabled
us
to
bring
the
numbers
of
homeless
down
in
Arlington
right
now,
as
of
today,
we're
projecting
for
FY
19
that
will
have
two
hundred
and
fifty
six
units
filled.
Those
are
all
locally
funded.
A
We
also
have
just
you
know.
These
are
the
locally
funded
256
units
represents
the
local
funded
units.
The
Department
of
Behavioral,
Health,
Care
and
Developmental
Services
gives
us
an
additional
pot
of
money
where
we've
gotten
40
more
units
and
a
span
and
VOA
and
New
Hope
housing
have
combined
about
an
additional
hundred.
C
Thank
you
very
much.
We
appreciate
it.
We
are
joined
by
a
few
commissions
actually
today,
which
we
appreciate
very
much
and
I.
Think
what
we're
going
to
do
is
ask
you
to.
Please
join
us
two
at
a
time,
if
that's
possible,
since
we've
got
the
two
spots
for
you
and
we'll
conclude
with
our
FAQ,
who
we
always
appreciate
your
ability
to
stay
at
the
table.
If
you
don't
mind,
although
for
all
of
our
Commission's,
if
you
could
stay
on
hand,
my
colleagues
and
I
may
have
questions.
So
why
don't
we
begin?
C
We
have
from
the
disability,
Advisory
Commission
the
chair
bill
state
ermine,
welcome!
Thank
you
for
joining
us
and
Carl
Brooks
from
the
Commission
on
Aging.
If
you
could
join
us
as
well,
thank
you
very
much.
So,
as
you
all
are
making
your
way
I'll
again,
just
reiterate,
I
I
know
we
sprung
this
early
on
you
this
year
you
usually
have
a
little
more
time
with
the
managers
proposed
budget
and
I
know.
C
It's
not
always
easy
to
convene
your
Commission's
in
time
to
give
us
feedback
when
we,
when
we
ask
you
to
do
it
on
a
short
timetable,
so
we
really
greatly
appreciate
any
comments
you
want
to
provide
with
us
today
and
remain
very
open
to
continuing
the
conversation
so
mister
state
Herman.
Would
you
like
to
begin
my.
D
D
First,
is
that
I
know
was
a
point
a
couple
years
ago
in
the
budget
and
history
of
forgotten,
after
publish
call
saying,
captives
of
these
were
in
temped
of
lap
having
the
same
program
same
old
facility,
where
they
will
think
to
write
at
the
Edit
office
of
these,
which
seems
to
be
happening
more
and
more.
A
particularly
I'll
talk
about
visitors
and
schools.
They
are
often
beaten,
Delta,
a
great
expense,
great
frequency
and
for
very
similar
purposes.
D
Why?
The
the
original
idea
was
to
have
programs
within
one
facility,
then
building
two
facilities,
but
now
this
to
be
each
Duke,
you
into
center,
of
which
there
not
quite
sure
what
there
so
many
pleaded
in
there
are
new
scores,
which
obviously
are
because
more
students
are
objected,
but
the
facilities
being
built
for
the
community
center
can
also
use
the
scruffs
of
these
and
I.
Don't
understand
why
Butterbean
felt
and
they've
rebuilt
so
expensive,
as
I
was
put
my
robe
on
the
DC
I
muscle
liaison
with
police
review
question
I
plan
a
fusion.
D
D
That
being
said,
there's
been
enough
chances
that
new
traffic
study
the
rather
especially
into
that
you
are
up
in
the
air.
These
have
temporary
fire
station
to
tom
quarter,
herb
tea
which
to
a
something
of
loop.
But
what
it
appears
is
that
the
chef
program
which
I
cannot
stand
by
even
weitfeldt
there
is
the
program
form
save
children.
D
C
I
very
much
appreciate
these
comments
and
I
know:
it's
been
an
ongoing
conversation
with
the
school
board.
I
think
we
can
commit
to
you.
We
have
a
meeting
mr.
Dorsey
and
I
do
with
our
school
board
counterparts
on
Friday.
If
you
think
we
can
commit
to
bringing
up
some
of
those
conversations
about
the
building
Zion
I
might
try
to.
If
we
can
refocus
a
little
on
the
budget.
Yeah.
D
D
Well:
okay,
really
like
come
over
right
now.
Well,
I
was
wondering
point
that
it
in
point
their
their
traditional
ice.
All
these
issues,
and
then
it
just
a
few
puts
for
this-
is
extremely
for
an
issue
in
Arlington
is
greatly
renowned
for
their
for
the
star
program
and
roughly
so,
however,
him
being
very,
it
will
be
involved
and
a
user.
This
travel
room
a
very
where
that
they
are
out.
It's
just
ly.
D
D
D
Snow
that
accumulates
and
curve
cuts,
these
things
need
to
be
stinkers
and
they
don't
have
a
direct
funding
line.
So
this
descriptive
and
I'll
just
conduct
that
I
don't
know
what
they
were
really
could
be
called.
There
would
be
good
funding
source
to
have
funds
available
for
these
fearful,
inevitable,
train
set
costs.
D
C
You
so
much.
You
also
are
such
a
model
for
how
we
bring
commissions
in
with
the
department
they
may
be
most
loosely
associated
with.
But
of
course
you
cover
so
much
of
our
built
environment.
So
I
think
great
questions
here
for
pay.
Go
funding,
transportation,
cab,
the
capital
budget,
as
well
with
regard
to
public
facilities.
So
thank
you
so
much
and
thank
you
for
your
ongoing
leadership.
Q.
E
My
name
is
Karl
Brooks
and
I'm.
The
chair
of
the
Budget
Committee
for
the
commission
of
aging
I'm
joined
by
my
vice
chair
of
the
board.
Jim
Feaster
and
I've,
been
on
the
board
for
a
year
and
a
half
that
in
Arlington
since
2001
after
retiring
and
serving
as
a
corporate
executive
at
Boeing
and
general
public
utilities,
and
later
as
the
president
and
CEO
of
the
executive,
Leadership
Council,
the
organization
of
the
most
senior
African
Americans
in
corporate
America.
E
We
celebrate
your
continued
focus
and
contributions
to
affordable
housing
and
housing
grants
while
continuing
to
explore
land
use
and
other
tools
to
further
increase
the
supply
of
affordable
units.
We,
however,
are
concerned
about
any
potential
increases
to
residential
utilities,
electric
gas,
water
fees
and
rates
which
propose
a
northern
in
pack
when
our
community,
most
of
which
are
working
with
fixed
incomes.
Finally,
we
are
concerned
with
any
budget
impacts
to
the
aging
matters
program,
which
is
a
weekly
interview
program
on
Arlington
community
radio
focused
on
senior
issues,
and
the
impact
on
that
could
be
very
major.
E
The
Commission
on
Aging
is
invested
in
continuing
to
partner
with
the
Aging
and
Disability
Services
Division,
to
ensure
that
our
seniors
have
the
opportunity
to
thrive
through
accessibility,
affordability,
choice
and
opportunity.
We
recognize
their
contribution,
strengths
and
value
and
we're
committed
to
continuing
to
partnership
there.
Thank.
C
You
very
much
mr.
Brooks,
so
for
both
of
you,
if
you
wouldn't
mind,
staying
close
by
I'm,
going
to
ask
that
we
bring
up
the
next
round
of
commissioners
to
your
seats,
but
we
appreciate
your
comments
very
much
and
may
have
further
questions.
Thank
you.
Thank
you.
So
I'd
like
to
invite.
We
have
as
well
the
Community,
Services,
Board,
Chair
and
Herman
I
believe
is
with
us
and
Stephanie
Clifford,
who
is
the
chair
of
the
Commission
on
the
status
of
women.
Thank
you.
So
much.
F
Need:
okay,
okay,
so
I'm
Ann
Herman
and,
as
you
said,
I'm
chair
of
the
Community
Services
Board.
First
I
want
to
thank
you
for
the
many
ways.
You've
supported
the
vulnerable
residents
whom
we
represent,
and
secondly,
I'd
like
to
take
just
a
moment
to
review
the
CS
B's
mission
to
talk
about
how
our
requests
are
hand-in-hand
but
separate
from
the
DHS
request.
So
cfb
is
imported
by
the
county
board
in
accordance
with
virginia
statute.
F
We
serve
as
both
an
advisory
body
to
you
and
an
oversight
body
for
the
combined
federal
state,
local
resources
that
support
community
services
for
mental
health,
intellectual
and
developmental
disabilities
and
substance
abuse.
As
you
saw
on
the
DHHS
presentation,
we
have
three
requests
we
are
coming
to
you
with,
but
I'd
like
to
give
you
a
little
background
on
that.
F
Another
is
the
growing
number
of
young
adults
with
autism
who
have
graduated
from
the
school
system
where
they
had
a
lot
of
support
but
deteriorate
when
they
no
longer
have
the
services
they
need.
Change
is
also
driven
by
policy
decisions
made
outside
Arlington.
Those
include
the
Department
of
Justice
settlement
I,
think
most
of
you
are
familiar
with
with
the
Commonwealth,
which
requires
that
individuals
with
developmental
disabilities
be
integrated
into
the
community,
including
having
the
opportunity
for
competitive,
integrated
employment
for
the
mental
health
and
substance
abuse
populations.
We
have
been
working
working
since
November.
F
This
is
something
we
have
long
wanted
to
do
and
the
results
have
been
very
positive,
but
we
need
more
therapists
to
support
these
individuals.
Confronted
by
these
challenges,
the
CSB
and
DHHS
staffs
have
collaborated
to
reconfigure
staffing
and
services
to
better
serve
these
clients
and
to
seek
alternative
resources.
These
efforts
are
resulting
in
an
opioid
Nader
position:
security
for
our
crisis
crisis
intervention
center,
improve
nursing
services
for
Mary
Marshall
residents
and
an
additional
adult
mental
health.
F
Therapist
we've
also
found
an
outside
source
to
assist
with
the
study
we
requested
last
year
on
needs
and
services
for
young
adults
with
autism.
Even
so,
we
have
substantial
needs.
We
cannot
meet
and
are
bringing
you
three
priority
requests
one
for
each
of
our
populations
for
mental
health,
one
FTE
mental
health
therapist
for
young
adults
for
substance
abuse-
and
you
saw
this
on
the
list
which
was
up
on
your
slide
before
one
FTE
peer
outreach
specialist
for
hard
to
engage
opioid
clients
and
for
intellectual
and
developmental
disabilities,
a
three-year
pilot
to
support
competitive
integrated
employment.
F
We
can
commend
th,
DHHS
leadership
and
also
CSB
leadership
for
the
work
that
they've
done
to
reorient
and
meet
these
challenges,
but
it
is
not
within
the
parameters
of
what's
available
to
do
to
meet
these
three
needs.
So
if
it's
possible,
this
is
what
we're
bringing
to
you
and
we
will
discuss
it
more
at
a
later
date.
Okay,.
C
G
The
status
of
Whitman
I'm
Stephanie
Clifford
I'm,
the
chair
of
the
Commission
on
the
status
of
women.
Thank
you
very
much
for
presenting
this
thoughtful
budget
and
giving
us
a
chance
to
respond
to
it
as
you
introduce
this
discussion,
since
it
is
early
in
the
process.
I
do
apologize
that
lots
of
what
I'm
raising
are
questions
and
concerns
more
than
any
solutions.
I
just
wanted
to
put
this
all
on
the
table
as
we're
at
this
early
point
in
the
PowerPoint
that
was
used
to
introduce
the
budget.
G
We
also
would
be
interested
in
knowing
what
services
would
be
provided
to
employees
who
are
leaving
the
county's
employment,
whether
you
have
severance
outplacement
services
issues
like
that
to
support
those
employees
that
are
leaving,
especially
since
those
we
mentioned,
the
some
cuts
are
proposed
to
employment
services.
We
do
have
screen
concerns
there
as
well,
because
we
have
been
partnering
with
employment
services
on
a
project
last
year
at
how
people
work
the
way
through
job
fairs.
We
know
there
are
a
lot
of
needs
there.
G
Even
though
unemployment
is
low,
there
are
needs
for
people
in
different
transitionary
states.
Maybe
people
want
to
move
from
a
customer
service
job
to
a
job
worth
more
advancement
potential
concerning
women,
specifically
the
women
who
returned
into
the
workforces,
maybe
after
raising
their
children
after
a
divorce.
Other
changes
in
life
circumstances
so,
even
though
the
unemployment
is
low,
we
want
to
see
there's
some
way.
We
might
reimagine
these
employment
services
to
make
them
more
useful
to
the
population
to
move
into
better
jobs
and
more
high-paying
jobs.
G
We
do
have
some
concerns
on
some
of
the
public
health
issues
under
DPR.
There
is
a
proposal
to
eliminate
the
Office
of
Community
Health
and
that
some
of
those
tasks
would
then
go
to
the
HS
and
since
you're,
also
facing
cuts
and
are
kind
of
overwhelmed
with
tests
already
how
those
health
and
wellness
services
would
be
assumed,
whether
they're
already
being
duplicated
in
any
departments
or
whether
those
would
be
lost
or
what
are
the
plans
are
since
that's
an
elimination
of
four
people
and
significant
programs
how
those
wellness
services
would
still
be
provided
under
DHS.
G
We
also
do
have
concerns
about
the
elimination
of
the
management,
specialist
and
community
health
position,
since
a
work
concerns
mentioned
that
it
does
involve
family
planning
and
maternity
care
clinics
and
very
likely
would
increase.
Those
cost
is
in
efficiencies
and
areas
of
ineffectiveness
that
you
and
we
also
did
question
the
cost
for
STI
testing.
I
know
you
did
touch
on
that
briefly,
that
it
was
a
state
request,
so
we're
just
curious
if
that's
a
request
or
mandate
or
where
that
came
from
since
it
did
only
involve
$12,000.
G
The
childcare
initiative
we're
of
course
curious
to
see
the
outcomes
on
that,
and
also
since
there
was
made
mention
of,
is
that
resources
would
be
needed,
but
no
allocation
on
those.
If
there's
any
plan
to
make
sure
there's
so
many
available
to
implement
those
recommendations,
I
do
have
some
questions
on
fostering
adoption
services.
I
might
save
those
for
later
expand
went
in
to
looking
some
tomorrow
she's
there,
but
which
is
concerned
whether
you
had
all
the
resources
you
need
to
promote
those
services.
G
Also,
I
just
want
to
make
sure
that
whatever
we're
looking
at
that,
we
do
make
sure
there
are
resources
and
funds
available
for
communication
services.
For
all
of
these.
You
know
we
had
discussions
last
year
on
especially
sexual
assault
services,
and
thank
you
very
much
for
all
the
work
that
was
done.
Any
video
just
website
to
make
sure
the
you
corrected
all
the
errors
on
numbers.
You
cleaned
up
that
made
it
very
obvious
where
people
can
go
to
find
those
resources
easily.
G
C
Very
helpful,
thank
you,
I
think
a
lot
for
a
discussion
with
DHS
and
then
a
few
too
I
think
that
we'll
want
to
dig
into
with
compensation
which
will
come
later,
but
thank
you
both
so
much
I'm
going
to
ask
Miss
Peterson
to
come.
Join
us
for
the
Fakher
port
is
our
final
item.
But
again,
if
our
commission
chairs
are
able
to
stay
close
you've,
given
us
a
lot
of
great
food
for
thought
and
I
think
we
may
have
follow-up
questions
for
you
as
Peterson.
H
You
so
much
my
name
is
Tenley
Peterson
I'm,
the
chair
of
the
fiscal
affairs
Advisory
Commission
for
Arlington
County.
Thank
you
very
much
chair
crystal
and
board
members
Dorsey
Garvey
gut
Shaw,
and
vice
that
for
giving
me
the
opportunity
to
present
this
report
today.
Thank
you
as
well
to
miss
Friedman
Director
of
Human
Services
and
her
staff
for
meeting
with
our
Commission
and
giving
us
the
chance
to
dig
deep.
This
report
was
prepared
by
my
fellow
commission
members,
Anthony
Perez
and
Connie
Flippo,
who
are
here
today.
H
The
county
managers
proposed
FY
19
budget
for
the
Department
of
Human
Services
is
based
on
sound
fiscal
principles,
strategic
spending
and
prioritizing
program
efficiencies
to
minimize
the
impact
of
cuts.
Despite
a
1%
increase
over
the
FY
18
adopted
budget,
there
are
budget
reductions
of
2.2
million
dollars,
which
includes
the
elimination
of
16
full-time
employees,
11,
which
positions
are
filled.
H
The
department
has
assured
us
that
they
will
be
able
to
meet
their
department
goals
under
this
budget
and
that
the
reductions
should
have
minimal
impact
on
the
services
provided
by
the
department,
primarily
because
a
lot
of
the
efficiencies
have
been
realized
by
contracting
out
services.
In
fact,
the
county
manager
relayed
that,
regarding
laboratory
services,
we
will
likely
see
an
increased
service
performance
at
a
lower
cost,
so
we
were
excited
to
hear
about
that
and
we
applaud
the
DHHS
for
their
meticulous
process
and
finding
increased
efficiencies
within
the
department
without
cutting
services
to
the
community.
H
We
also
wanted
to
applaud
them
for
finding
increased
efficiencies
with
schools
in
the
administration
of
the
Arlington
Education
Employment
reap
program.
As
miss
Friedman
mentioned,
they
were
able
to
provide
some
technical
assistance
to
the
schools
and
save
money
without
affecting
the
slots
or
the
fees
charged
to
students,
and
so
we
think
this
is
a
great
example
of
County
and
schools
working
together
in
order
to
save
money,
and
we
encourage
future
technical
assistance
that
may
be
provided
across
departments.
To
do
more
of
that,
our
recommendation.
H
The
fact
recommends
that
the
County
Board
adopt
the
county
managers
proposed
budget
for
FY
19
for
the
Department
of
Human
Services.
This
was
passed
unanimously
with
eight
votes
and
we
have
the
following
additional
comments:
where
appropriate
faq
encourages
the
county
to
transfer
the
11
county
ploys,
employees
whose
positions
are
being
eliminated
to
the
county's
200
plus
vacancies,
and
for
those
who
cannot
be
reassigned
to
county
positions.
We
encourage
the
county
to
assist
in
providing
opportunities
elsewhere
in
the
county
or
beyond.
H
If
we
find
that
they
are
actually
occurring
for
future
considerations,
we're
looking
at
the
impact
of
a
possible
Medicaid
expansion
to
able-bodied
adults
on
the
DHS
budget,
increased
staffing
would
be
needed
to
determine
the
eligibility
and
the
state
will
reimburse
us
for
some
of
that,
but
only
it
to
a
certain
percentage
and
also
the
future
budgetary
impact.
On
the
continuing
rise
in
the
opioid
addiction
treatment.
We
recognize
that
DHS
was
able
to
leverage
some
state
funds
and
reassign
a
position
this
year,
but
if
this
epidemic
continues
we're
going
to
need
to
look
at
increased
funds.
C
Thank
you
all
right
lots
to
discuss
that's
to
chew
on
I'm
gonna.
Just
reiterate
again,
what
I'd
like
us
to
do
is
see
if
we
can
begin
with
a
round
of
questions
focused
on
changes
to
this
year's
budget,
because
there
are
quite
a
few
and
we've
gotten
some
good
feedback
in
questions
from
our
commissioners
on
them
and
then
we'll
circle
around
to
another
round
of
questions
on
the
long-run
future
of
this
department
or
program
in
the
department
or
related
questions.
I
know.
C
I
You,
madam
chair
appreciation
to
everyone:
miss
Friedman
and
the
department,
all
of
our
commissions,
for
really
quality
questions,
advice
and
perspective.
I
want
to
focus
on
a
couple
of
areas
just
with
most
of
the
positions
that
have
been
designated
for
elimination.
You
know,
roughly,
are
in
the
administrative
support
or
office
management
space
or
a
great
many
of
them
not
going
to
necessarily
say
the
majority
and
overall,
the
assertion
is
articulated
by.
The
fact
is
that
we
don't
expect
that
this
will
have
a
negative
impact
on
service
delivery
to
clients.
I
However,
part
of
what
our
job
is
to
make
sure
that
the
organization
there
is
no
impact,
no
worsening
of
the
risk
or
exposure
to
risk
by
not
having
adequate
records,
kept
being
able
to
be
in
compliance,
which
is
a
huge
deal
for
your
agency.
Can
you
give
us
a
sense
of
how
you
assess
the
impact
of
losing
particularly
the
administrative
and
management
positions
on
those
other
larger
issues,
not
direct
day-to-day
services,
but
exposure
to
risk
to
the
organization.
A
Well,
I'm,
a
in
with
regard
to
public
health
call
on
dr.
Varughese,
because
we
really
prioritize
direct
service
delivery.
Many
of
these
cuts,
as
you
acknowledge,
are
on
the
back
end
in
terms
of
the
staff
that
are
doing
administrative
functions,
managerial
oversight,
Quality,
Assurance
and
I
cannot
tell
you
that
there's
no
impact,
obviously,
if
you're
working
with
16
fewer
individuals
there's
an
impact,
but
we
have
carefully
tried
to
assess
where
we
could
transfer
duties
of
those
individuals
we're
not
giving
up
any
of
those
functions.
A
We're
merely
transferring
those
Fung
to
people
who
already
have
other
duties,
and
so
yes,
their
workloads
will
increase,
but
compliance
is
something
that
our
department
takes
very
seriously.
You
know
that
we
have
a
very
robust
internal
performance
measurement
planning
system
and
we
are
regularly
audited
internally
and
by
the
state
and
the
federal
government.
So
I
can
assure
you
to
the
best
of
my
ability.
We
will
do
our
best
to
always
meet
those
regulatory
standards,
but
there
will
be
some
additional
burden
to
existing
staff.
A
I
Gonna
have
a
bunch
but
I
think
for
my
other
one,
if
there's
time,
I'd
like
to
introduce
a
question
about
reap,
unless
anybody
feels
it's
more
natural
to
take
the
conversation
in
a
different
direction.
So
you
know
with
reap
we've
heard
testimonials
letters
from
people
who
are,
you
know
either
been
teachers
for
the
program
or
understand
its
impact
on
students
and
from
what
I
understand
and
from
you
know
how
a
fact
is
assess
it
as
well,
really
don't
expect.
There's
gonna
be
in
a
program
impact
to
the
changes.
I
In
fact,
as
I
look
through
your
proposal,
it's
really
about
making
Rieff
a
much
more
efficient
and
effective
organization,
and
in
order
for
it
to
be
sustainable
in
the
future,
is
there
a
plan
in
place
that
we've
worked
out
with
ApS
to
make
sure
that
basic
things
such
as
salaries,
not
outpacing?
The
rates
of
available
funding
and
contributing
to
the
high
cost
of
overhead
are
not
a
part
of
its
future
because
it
seems
like
if
those
are
not
really
addressed
in
a
in
a
proactive
way.
We're
not
necessarily
going
to
have
a
very
successful
program.
A
A
The
way
that
we
operate
with
reap
is
similar
to
other
grants
that
we
provide
to
nonprofits.
We
provide
them
the
funding.
We
indicate
what
the
outcomes
are
expected
and
the
number
of
clients
to
be
served,
and
then
they
internally
have
a
budget
that
guides
the
expenditures,
because
we
are,
we
can't
control
the
salary
growth.
A
We
looked
at
the
other
areas
of
their
administrative
expenditures,
like
the
number
of
administrative
assistants,
like
the
number
of
coordinators
that
were
coordinating
work
at
different
sites
and
that's
how
we
determined
the
hundred
and
seventy
one
thousand
dollars
efficiency
as
well
as
some
additional
revenue.
They
have
been
providing
English
as
a
second
language
tutoring
to
private
citizens,
who
are
preparing
for
the
TOEFL
test,
which
they
previously
had
not
been
charging
for
or
very
minimally,
and
so
because
those
are
citizens
who
can
pay
they
plan
on
paying
charging
more.
For
that.
A
I
A
J
Garvey
yeah
my
sort
of
about
changes,
but
also
sort
of
I
guess
bigger
picture
ones.
One
more
specific.
The
opioid
manager,
who's
coming
on
I
said,
is
some
of
that
person's
work
going
to
be
in
prevention,
because
you
know
what
we
see
a
lot
is:
there's
a
lot
of
treatment,
which
is
great
and
important.
Are
we
going
to
try
to
start
because
it
just
keeps
growing
and
growing
yeah.
K
J
It'll
be
interesting
to
see
if
we
can
start
making
a
dent
in
it,
which
would
be
really
good,
slow
down
the
increase,
and
then
it's
occurred
to
me.
I
think
probably
your
department,
more
than
any
other,
maybe
leverages
nonprofits.
So
would
you
talk
a
little
bit
about
how
because
so
we
was
reading
about
you
know
getting
people
back
out
of
jail
and
it?
So
that's
a
are
from
that.
J
Then
there's
of
course,
the
homeless
services
center,
which
I
know
you
work
closely
with
and
then
the
last
one
I
was
sort
of
interested
in
was
a
FAQ
I
know:
we've
got
cuts,
but
I
was
seeing
how
we,
because
of
state
I,
think
it's
state
law.
People
can't
stay
on
TANF,
very
long.
They
can't
stay
on
snap,
and
so
where
do
they
turn
I
suspect
they
turn
to
a
fax,
so
they're
kind
of
backstopping?
So
it
feels
like
it's.
These
groups
are
partners.
If
you
just
talk
a
little
bit
about
how
that
works.
A
Well,
we
have,
depending
on
the
different
areas.
You
know
the
safety
net
services
have
been
a
prime
area
for
where
we've
had
the
most
collaboration
with
nonprofits,
starting
with
the
10-year
plan
de
and
homelessness
and
the
collaboration
between
the
county
and
the
nonprofits
around
that,
but
really
I
think
we.
A
Really
became
close
to
working
with
the
nonprofit's
when
we
had
the
recession
and
we
had
to
determine
how
to
support
people
in
the
community
who
were
not
able
sometimes
to
access
all
the
resources
from
the
county
where
they
or
the
nonprofit's
were
more
agile.
So,
in
the
case
of
a
FAQ,
the
majority
of
their
referrals
do
come
from
us,
but
a
fact
just
provides
the
food.
They
don't
do
the
case
management.
A
A
Are
people
who,
for
whatever
reason,
do
not
qualify
their
SNAP
benefits
may
have
ended?
They
may
just
have
some
food
insecurity
and
similarly
with
jail
reentry,
you
were
talking
about
them.
So
there's
a
we
have
services
in
the
jail,
mental
health
and
substance
abuse
the
jail
has
social
workers,
but
once
the
person
leaves
the
jail
and
they're
out
in
the
community,
it's
up
to
our
department,
together
with
the
nonprofit's,
to
support
those
individuals
in
their
reentry
journey.
That
may
mean.
Oh,
we
are
doing
a
piece
of
it.
A
That
may
mean
the
employment
center,
helping
them
find
a
job
that
may
mean
going
to
behavioral
health
care
for
ongoing
mental
health
support,
and
we
have
always,
as
long
as
I've
been
here,
worked
very
closely
with
the
nonprofit's
to
determine
who
is
best
suited
to
do
what
portion
of
the
of
the
work
and
most
agile,
II
and
efficiently.
Thank.
J
J
Is
great
and
great
leveraging
and
then
we
come
to
a
FAQ,
and
this
just
you
know,
cuz
looking
down.
Are
we
depending
on
them
to
pick
up
with
a
safety
net,
yet
not
supplying
them
with
the
support
that
they
maybe
need
so
which
I'm
sure
we'll
be
hearing
from
them?
Do
you
have
any
views
on
that
that
you'd
like
to
share
at
the
moment?
Well.
A
The
you
know,
the
cost
of
food
does
go
up.
The
money
that
we
provide
to
to
a
FAQ
is
only
for
food.
We
cannot
provide
any
support
for
any
of
their
administrative
costs.
They
do
have
to
purchase
some
of
the
food
sort
of
the
meats
and
things
like
that,
a
milk,
and
so
their
costs
do
go
up
and
they
feel
that
they
do
a
lot
of
fundraising
and
they
would
like
the
county
to
support
them
to
a
certain
extent
beyond
what
they
are
currently
being
supported
in
the
tune
of
$50,000.
That's
okay,.
C
I
have
a
couple
of
questions
about
some
of
the
changes,
one.
Actually,
that
I
think
may
be
one
of
the
more
positive
changes
in
the
budget,
which
is,
if
I'm
reading,
right
I'm
looking
at
web
506
of
the
proposed
budget
and
I
think
actually,
our
CSB
chair
maybe
have
mentioned
this
too,
which
is
the
increase
of
a
mental
health
therapist
and
an
increase
of
a
psychiatrist
position.
C
C
Really
helpful
but
I
wondered
if
you
could
say
a
little
bit,
I
think
you
all
brought
up
as
a
trend
and
I
know
at
least
a
couple.
Our
commenters
did
is
well.
Youth,
mental
health
and
I
wondered
if
you
could
speak
to
any
thoughts
around
the
roles
of
these
two,
not
new
FTE,
but
new
professionals
right
in
in
their
garden
and
how
they
might
be
serving
the
youth
population
or
the
adult
population.
Sure.
K
One
of
the
FTEs
is
is
being
shifted
from
what
was
called
out
what
is
called
our
job
Avenue,
which
is
employment
specifically
for
persons
with
serious
and
persistent
mental
illness
to
our
adult
outpatient
program,
because
the
caseloads
have
increased
to
an
average
of
46
clients
per
therapist
and
that's
just
unacceptably
high.
With
regard
to
the
request
for
the
young
adult
mental
health
therapist
position
that
the
CSB
has
has
indicated,
we
are
the
caseloads.
We
have
a
young
adult
unit,
a
team
and
they're
doing
great
work.
K
We
have
a
number
of
young
people-
young
adults
that
are
seen
by
our
adult
serving
staff
and
if
we
could
shift
those
to
the
young
adult
team
that
might
help
alleviate
some
press
and
in
addition,
we
have
soft
launched
our
same-day
Access
Initiative,
which
means
people
can
walk
in
and
get
an
assessment
and
get
an
appointment
for
to
see
a
therapist
within
a
week,
but
that
because
the
number
of
mental
health
and
substance
abuse
intakes
have
gone
up,
they
have
doubled.
That's
putting
increased
pressure
again
on
the
treatment
staff.
K
So
you
see
it's
a
ripple
and
so
that's
part
of
what's
going
on
there.
The
other
piece
that
was
mentioned
is
that
seeing
a
number
of
persons,
young
adults
with
co-occurring
autism
and
mental
health,
behavioral
health
concerns-
and
we
are
really
struggling
with
how
to
address
those
needs,
because
traditionally
we
have
not
received
any
funding
through
the
State
Department
of
Behavioral,
Health
and
developmental
services.
For
this
population
at
all
and
staff
are
not
trained
to
handle
this
population.
K
They
tend
to
be
trained
in
either
developmental
disabilities
or
behavioral
health,
and
so
we're
trying
to
figure
out
how
to
address
that
population,
but
we're
seeing
them
typically
in
their
early
20s,
typically
male
desperate
parents
who
really
really
need
support
from
our
department.
So
that's
part
of
the
press
for
that
position
can.
A
I
just
say
something
about
the
psychiatrist.
This
is
not
a
new.
This
is
it.
This
is
a
new
FTE,
but
it
was
we
used
to
have
and
I
think
we
discussed
this.
Maybe
two
or
three
years
ago,
when
we
first
launched
this
initiative
right
John,
we
had
only
contracted
psychiatrists,
9
or
10
of
them,
and
they
were
on
with
10
hours,
here's
15
hours,
they're
coming
and
going.
A
It
was
hard
to
deliver
quality
services,
so
we
proposed
to
you
all
I
think
it
was
two
years
ago,
maybe
to
convert
the
contract
money
into
FTEs
and
have
permanent
staff.
In
fact,
we
changed
some
of
the
psychiatrists
to
nurse
practitioners
because
they
are
less
expensive
right,
and
so
that's
where
this
FTE
comes
from,
it's
not
additional
money.
It's
just
moved
from
the
contracted
line
item
to
the
FDA
and.
C
J
Follow-Up
I
had
a
quick,
follow.
I'm
sorry,
so
this
intersection
with
autism
and
mental
health
that
you're,
seeing
with
the
young
adults
I
think
what
the
CSB
is
saying
is
that
the
students
get
through
school
and
they
get
treated
for
the
autism
and
they're
doing
okay
and
then
they
just
drop
off
the
edge
and
that
I
think
what
they're
arguing
is
that
you
know
and
I'm
wondering.
J
J
K
A
One
of
those
areas
that
has
typically
fallen
through
the
cracks
because
our
behavioral
health
care
staff
has
does
not
feel
prepared
to
deal
with
autism
and
yet
in
the
developmental
disability.
Community
autism
is
not
often
regarded
as
a
full-fledged
disability,
because
many
of
those
individuals
have
extremely
high
IQs
and
they're
very
high-functioning.
So
it's
one
of
those
sort
of
falling
through
the
cracks
and
when
they're
co-occurring
the
mental
health
and
the
autism,
then
there
are
really
complicated
cases.
If.
K
C
Thank
you.
No
I
appreciate
that
I
have
one
more
question
about
cuts
and
then
I'll
go
to
mr.
Vyse
hat
as
we
work
our
way
through
the
more
specific
questions
about.
What's
before
us
in
FY
19,
there
are
a
couple
of
points
of
Nexus,
I
think
between
the
human
capital
or
human
resources,
side
and
DHS
here
right
in
part,
because
you
are
taking
so
many
of
these
cuts
and
we
recognize
that,
but
in
part
because
we
might
in
otherwise
times
send
transitioning
staff
to
the
employment
services.
C
But
if
you
could
speak
to
a
little
bit
what
the
practice
of
the
county
has
been
in
terms
of
helping
individuals
whose
positions
might
be
terminated,
find
employment
elsewhere
in
the
county,
as
I
think
our
fact
mentioned,
we
have
200
vacancies
and
also
if
there
is
anything
that
you
all
might
illuminate
for
us
from
the
perspective
of
the
employment
services
center
or
thinking
about
helping
people
find
new
employment
within
the
Department
of
Human
Services.
So.
B
What
I'm
gonna
hand
it
over
to
Anita,
but
first
let
me
speak
more
broadly.
What
our
approach
is,
each
of
the
individuals
that
have
been
affected
have
we've
met
with
I've
met
with
each
of
them
and
as
the
departmental
leadership,
each
of
them
have
been
assigned
a
specific
Human
Resources
counselor
employment
specialists
that
works
with
them
and
for
many
of
them
who
haven't
been
in
the
workforce
for
quite
a
long
time,
the
actual
experience
of
putting
together
a
resume
and
going
into
our
Neoga
system
and
filling
that
out.
B
B
Employee
is
able
to
look
over
them
to
the
extent
they
have
an
interest
there.
We're
alerting
the
hiring
staff.
On
the
other
end
and
saying
here's
someone
that
you
want
to
come
in
and
have
a
conversation
with
and
see
if
we
can
make
that
connection
immediately,
rather
than
waiting
for
the
longer
process
to
take
place.
That
happens.
A
So
we
also
have
our
DHS
as
it's
on
HR
mini
unit
and
those
11
people
are
being
in
their
resumes
and
applications
are
being
individually
reviewed
by
our
Human
Resources
bureau
chief,
and
we
are
looking
for
matches
both
internally
to
the
department
as
well
as
within
the
county.
If
some
of
those
cannot
be
matched
because
of
the
unavailability
of
non
availability
of
position
that
are
appropriate,
the
employment
center
is
available,
even
in
spite
of
the
fact
that
they
are
taking
cuts.
A
L
L
I
know
that
in
the
in
the
context
of
our
work
with
app
on
Fisher
House
and
Westover
I
had
understood
that
there
will
be
some
permanent
supportive
housing
units
in
Westover
and
I
didn't
see
in
fiscal
19.
It
just
says
Columbia
Hills,
so
I'm
just
wondering
where
Westover
might
be
or
am
I
thinking
of
something
further
out
than
fiscal
2019.
I
think.
M
L
Thing:
okay,
terrific
thank
you
and
then
Ms
Clifford
from
the
Commission
on
status
of
women,
raised
the
question
about
the
impact
on
patients
or
prospective
patients
for
sexually
transmitted
diseases
in
terms
of
the
fee
hike
mandated
by
the
state.
Do
we
have
any
observations
as
to
whether
or
not
this
could
potentially
discourage
folks
from
seeking
testing
and
therefore
treatment,
I'll.
N
Good
afternoon,
this
was
a
requirement
actually
that
CDC
had
of
the
Virginia
Department
of
Health,
and
so
this
was
applied
throughout
the
Commonwealth.
Having
said
that,
yes,
whenever
you
put
fees
in
place
for
these
sorts
of
services,
that
potential
is
there
and
probably
is
more
skittish
for
the
folks
who
are
concerned
about
sexually
transmitted
infections,
there
is
a
sliding
scale
and.
L
N
That
is
the
same
scale
that
is
used
in
all
the
services
on.
Fortunately,
because
of
the
nature
of
sexually
transmitted
infections
diseases,
people
are
less
willing
in
general
to
show
up,
so
any
barriers
sometimes
can
tip
people
from
not
showing
up
we're
hoping
that
won't
happen,
but
unfortunately
this
is
something
we
cannot
prevent,
but
we
try
to
make
it
as
D
stigmatized
as
possible
when
they
do
come.
C
L
So
my
question
really
is
for
the
manager
in
terms
of
how
are
we
going
to
prepare
our
procurement
folks
for
having
a
new
set
of
services
that
we're
going
to
be
going
out
into
the
private
sector
for
and
what
what
can
you
say
there
in
terms
of
both
the
ability
of
our
procurement
folks
to
manage
this,
and
also
the
identification
of
of
private
providers
who
are
or
perhaps
public,
conceivably
here
and
there
who
are
ready,
able
and
willing
at
the
right
price
to
take
those
that
service
delivery
responsibilities?
Thank
you.
B
So
in
some
of
these
cases-
and
maybe
Anita
can
comment
or
Deborah
that
there
are
contracts
pre-existing
contracts
with
other
providers
in
the
Commonwealth,
and
it's
certainly
not
easy,
but
it's
easier
if
those
pre-existing
contracts
exists
for
our
procurement
staff
to
ride
those
contracts,
and
so
our
DHS
staff
is
aware
of
that
and
communicated
with
their
counterparts
in
the
Department
of
management
of
Finance.
So
that
is
sort
of
the
general
approach
we
try
to
take
on
that.
B
As
far
as
how
our
procurement
staff
is
handling
that
you
know,
I
don't
have
any
specific
knowledge
one
way
or
the
other,
but
I
do
know
that
they
there's
been
a
number
of
instances.
They
have
a
heavy
caseload
and
they're
dealing
with
procurements
all
the
time,
and
so
this
will
simply
I
can't
speak
to
whether
it
jumps
up
to
the
top
of
the
list.
But
if
it's
something
we
need
to
have
in
place
by
July,
we'll
make
sure
that
it
happens.
Ok.
L
Terrific,
mr.
Friedman,
you
had
an
interesting
slide
where
you
discuss
destination
2027,
which
is
kind
of
a
broad.
What
prospective
look
at
where
we
might
be
in
ten
years.
So,
but
what
my
question
is?
Did
we
so
did
we
do?
Did
we
do
a
destination
2017
in
2007,
yes,
okay
and
and
so
looking
back
over
that
decade-
and
maybe
you
can't
speak
to
this
now,
but
I
think
it
would
be
informative
for
us
when
we're
talking
about
big
picture
and
strategic
directions.
A
Well,
I
can't
say:
I
have
all
the
details
off
the
top
of
my
head,
but
Rubin
probably
does,
but
every
10
years
our
health
system
takes
a
deep
dive
into
to
look
at
our
internal
systems,
the
factor
the
health
of
the
community.
All
the
data
that
we
know
about
the
health
of
the
community
does
a
very
extensive
community
survey
to
identify
what
the
perceived
needs
are
of
the
community
members,
as
well
as
what
the
partners
agencies
determined
to
be
our
community
needs
and
all
that
data
is
compiled.
A
And
then
we
have
a
steering
committee,
which
is
a
cross-section
of
everyone,
from
the
hospital
law
enforcement
to
marymount,
right
neighborhood
health,
and
they
are
then
combing
through
on
a
very
systematic
way
under
dr.
Varughese
leadership,
to
lead
us
to
conclude
what
our
future
needs
are
now
dr.
Varughese
can
speak
about
what
we
implemented
during
the
last
ten
years.
N
So
any
decided
what
happened
in
just
a
Columbia
Pike.
Also,
if
you
look
at
Rosslyn
to
Boston
at
those
ends
depending
on
the
neighborhood
there's
a
10
year,
difference
as
well,
it
doesn't
necessarily
mean
there's
a
problem,
but
at
the
same
time,
it's
really
highly
unusual
to
see
that
much
difference
and
ask
the
question:
what
are
their
systemic
reasons
that
our
system
of
how
we
organize
ourselves
could
contribute
to
this
or
not?
So
that
is
where
we're
being
intentional
and
looking
at
that.
N
This
is
also
a
requirement
of
the
Virginia
Department
of
Health
we're
one
of
34
health
districts,
and
we
do
ten-year
reviews
to
see
what
could
the
community
come
up
with
and
say?
What
can
we
work
on
collectively
in
2007,
the
community
was
more
interested
in
disease,
specific
interventions,
but
we've
seen
also
a
difference
over
time
that
the
same
people
at
the
table
now
we're
saying
mm.
N
While
we've
made
some
progress
on
some
of
the
disease's
they're,
not
as
robust
as
we'd
like,
and
is
it
because
we
didn't
focus
on
the
systems
that
are
in
place,
and
can
we
organize
ourselves
in
a
different
way
to
and
pilot
more
things
to
see
how
things
are
going,
so
that's
I
think
we're
seeing
a
refinement
and
how
the
communities
looking
at
how
to
approach
these
problems.
If
that
helps
okay,.
L
I
think
that's
that's
really
interesting
and
I
think
at
least
for
my
part,
I
wouldn't
mind
seeing
something
of
a
follow
up
and
writing,
because
so
often,
when
we
do
these,
you
know
X
years
out
and
and
and
studies
and
so
for
with
multi
years.
They
just
kind
of
sit
on
the
shelf
and
gather
dust,
and
we
really
don't
take
the
time
to
go
back
and
check
the
value
of
that
of
that
study.
So
it'd
be.
A
N
Were
able
to
get
traction
to
have
the
community
to
focus
on
it,
because
it
was
a
difficult
issue
even
for
schools
to
think
about,
because
they
had
the
data
and
unfortunately,
sometimes
people
put
all
the
onus
on
the
schools
and
we
help
them
remind
them,
we'll
let
you
know
you
know
when
it's
kindergarten,
entry
level
data,
they
were
not
involved,
creating
that
and
we
had
to
help
and
but
they
were
very
cooperative.
We
helped
them
see.
It's
really
sad.
N
When
you
see
on
kindergarten
entry
that
arlington
children,
it's
20
to
25
to
30
percent,
start
off
overweight
or
obese,
and
that's
at
kindergarten
entry.
So
this
is
not
something
that
can
be
solved
in
eight
hours
in
the
day
and
they
have
primary
responsible
for
education.
However,
their
willingness
to
share
that
data
was
a
way
to
start
getting
the
traction
to
get
it
to
the
partnership
for
children,
youth
and
families
to
start
working
on
it.
Unfortunately,
there's
no
silver
bullet.
It
really
requires
thoughtful
planning
about.
N
How
are
we
going
to
get
this
behavior
change
to
occur?
An
earther
instead
of
just
individuals?
Are
there
things
we
can
do
as
a
community
to
support
the
family
so
that
their
default
choices?
Health?
It's
not
the
easiest
thing
to
do,
given
how
many
things
families
have
to
do,
and
yet,
if
we
don't
make
it
easier
for
them,
our
kids
are
going
to
have
that,
carry
what
they
learn
here
elsewhere.
So.
L
So
that's
actually
a
perfect
segue
into
my
third
strategic
question,
so
we
talked
about
partnerships
all
the
time.
We
talk
about
partnerships
between
the
schools
in
the
county.
We
talk
about
partnerships
between
the
county
and
the
private
sector,
and
we
know
in
particular
that
the
opioid
crisis
is
is
gathering
momentum.
We've
been
working
with
the
Community
Services
Board
on
on
mental
health
issues
and
in
particular
discussions
with
Virginia
Hospital,
Center
VHC
on
mental
health,
and
now
dr.
L
You
know
maternal
health
programs
and
just
a
range
of
community
health
opportunities
and
I'm
just
wondering
do
we
is
there
more
room
to
leverage
Virginia,
Hospital
Center
and
getting
the
word
out
for
what
VHC
itself
offers
to
help
kind
of
bridge
these
gaps
that
that
we
may
not
be
able
to
quite
accommodate
as
aggressively
as
we
might
like
in
the
public
sector.
Sure.
N
I'll
be
happy
to
VHC
is
at
the
table
as
well
as
anova
in
our
destination
20:27
process,
one
of
the
things
we
have
to
know,
and
it's
not
that
we
don't
support
our
Hospital,
but
most
of
our
residents
get
their
care
outside
of
Arlington.
So
we
have
to
take
a
broader
approach
to
make
sure
that
we
involve
groups
outside
of
Arlington,
because
our
health
care
system
is
broader
than
just
within
Arlington.
N
It
goes
into
DC
and
so
and
that's
why
we
even
have
Kaiser
at
the
table,
because
there
are
large
insurer
to
get
a
broader
perspective,
so
we're
trying
to
have
people
more
integrated
and
figure
out
a
way
to
help
them
get
their
message
out
further.
But
what
sometimes
happens
is
we've
gotten
to
the
point
where
we
just
focus
on
diseases,
and
now
we
need
to
try
to
take
a
step
back
further.
As
someone
has
mentioned,
it's
almost
like
when
people
say
was
it
the
lack
of
health
care
that
causes
problems?
N
Well,
that
the
equivalent
of
saying
the
lack
of
aspirin
caused
fever
symptoms
occur
because
of
other
problems,
and
so
what
we
need
to
figure
out
is.
Are
there
commonalities
one
step
back
that
connect
the
dots
among
the
diseases?
How
are
we
organized
and
do
people
have
the
time
and
energy
to
be
able
to
make
those
default
choices,
so
Virginia
Hospital
centers
at
the
table
and
no
is
at
the
table?
Others
are.
We
have
to
actually
ask
the
question:
can
we
do
something
even
more
radically
different?
N
L
J
On
this
again
don't
go
away.
Mr.
McGee's
actually
I
really
appreciate
I.
Think
it's
the
first
time
I've
really
heard
people
say
as
many
times
have
you
had
in
a
short
period
of
time
from
that
we
have
to
make
it
easy
for
people
I
mean
that's
part
of
what
we're
dealing
with
in
so
many
different
things
it's
out.
So
so
thank
you
for
that,
and
so
on.
General,
Health
and
I.
J
Don't
know
if
this
is
your
department,
so
it
that
I'm
looking
at
the
dental
clinic
information,
so
we
treat
children
up
to
age,
19
and
adults
60
and
over
and
I
know.
We
know
that
people
between
the
age
of
19
and
60
sometimes
need
to
see
a
dentist
and
in
fact
it's
my
understanding
that
dental
care
actually
affects
overall
health.
Quite
a
bit,
we
I
think
worked
out
some
cooperation
I'm
remembering
some
years
ago
with
maybe
a
clinic.
Could
you
fill
me
in
where
we
are
on
dental
care.
N
N
Having
said
that
you're
absolutely
right,
it
would
be
difficult
to
say
that
dental
health
isn't
an
important
part
of
overall
health
care
and
it's
actually
one
of
the
sadnesses
for
even
my
medical
training
that
dental
school
is
separate
from,
and
it's
really
that
whole
body
sort
of
perspective.
So
what
we've
done
in
the
past
years
has
been
to
turn
over
our
dental
chairs
when
we're
not
using
them,
so
that
both.
N
Free
clinic
and
neighborhood
health
has
have
now
come
in
and
basically
they're
there
most
every
day
that
we
don't
use
the
other
chair
and
they're
filling
in
the
gaps
so
that
their
clients,
which
are
really
adult
clients,
mostly,
although
neighborhood
health,
see
some
children,
they
can
provide
additional
services.
So
that's
added
to
the
safety
net
protection.
That's.
J
Excellent
love
that
cooperation
do
we
have
a
sense
of
how
many
underserved
people
there
are
with
you
know.
People
have
dental
needs
that
are
unserved
because
they
can't
get
them
here.
Lots,
okay,
and
how
much
does
that
affect
people?
And
we
have
a
sense
of
how
much
that
affects
the
public
health
I
mean
that
they
then
get
other
diseases.
They
get
her
two
other
problems,
I,
don't.
N
I,
don't
think
we
can
quantified
here
in
Arlington,
but
we
do
know
that
if
you
do
not
seek
dental
care,
it
affects
your
work
productivity.
It
can
lead
to
other
diseases.
This
is
one
of
the
reasons
why
at
least
we're
very
happy.
We
have
the
services
for
children.
If
you
remember
it
was
about
ten
years
ago
there
was
an
unfortunate
case
of
a
child
who
died
in
Prince,
George's
County.
If
I
remember
correctly
from
untreated
dental
abscess,
dental
care
can
save
lives
and
I.
J
A
One
thing
I
did
want
to
highlight,
which
I'm
not
sure
the
board
has
front-and-center
is
that
neighborhood
health
opened
up
a
five
day
a
week
clinic
in
our
Department
of
Human
Services
open
to
the
public.
So
that's
an
example
of
a
partnership
where
we
work
with
a
non-profit,
federally
qualified
health
center
who
raise
money
for
the
cost
of
the
doctor
and
the
nurse.
A
A
C
I
You
so
I
think
a
couple
of
strategic
questions.
First,
one
should
be
fairly
easy
on
web
551
and
just
looking.
This
is
going
back
to
the
sexually
transmitted
infections
conversation,
but
I
notice
that
we're
expecting
the
number
of
cases
to
slightly
increase
the
number
of
clinic
visits
to
substantially
decrease,
meaning
we're
having
fewer
clinic
visits
per
infected
case.
Is
this
the
result
of
efficiencies,
or
are
we
somehow
leading
to
lowering
the
standards
for
the
quality
of
care
for
people
with
sti's.
I
Just
an
aggregation
of
the
FY
2016
actuals
to
the
17
actuals
and
that
carries
forward
for
18
and
19
projected.
We
have
fewer
your
cases
or
we
have
slightly
larger
number
of
cases,
but
a
lot
fewer
visits,
meaning
in
FY
2016.
We
had
about
1.8
clinic
visits
per
case.
Now
it's
going
down
to
1.4.
Is
that
a
good
news
story,
we're
more
efficient
or
are
we
degrading
the
quality
of
care
for
people
with
sti's.
N
Let
me
see
how
I
can
best
answer
that
I
think
it's
a
commission
of
all
of
that:
okay
attentionally,
because
we
are
partly
anticipating
the
concern
about
with
the
change
in
general
of
requiring
people
to
go
through
eligibility
and
so
on.
We
are
anticipating
that
there
may
be
a
decrease
in
just
general
access
to
clinics,
because
it's
not
that
we
don't
have
the
ability
to,
but
people
may
be
dissuaded
from
showing
up.
So
we
don't
want
to
project
that.
We
don't
think
that
that's
a
possibility.
N
Having
said
that,
the
number
of
cases
will
always
remain
a
certain
level
because
there's
a
faked
infection
rate
and
unfortunately,
given
our
region,
we
actually
have
a
higher
rate
of
sexually
transmitted
infections
than
most
areas
and
part
of
it
can
be.
If
you
aren't
always
keep
it
in
your
forefront
of
your
mind.
Most
places
have
a
population
pyramid,
Arlington
has
a
population
diamond
and
our
bulging
is
between
20
and
44
I'll.
Leave
it
at
that,
and
so
we've
seen
we've
had,
we've
had
outbreaks
of
syphilis
in
the
region
and
Arlington
sometimes
has
been
the
epicenter.
N
So
what
we
try
to
do
is
get
outreach,
but
sometimes
it's
only
as
comfortable
as
people
are
willing
to
go.
Some
people
will
go
to
other
jurisdictions
and
we
see
theirs
as
well.
For
more
than
anything
else,
we
want
to
make
sure
people
feel
comfortable
someplace.
Even
so,
we
may
see
more
Fairfax
residents,
we're
happy
about
that.
If
our
folks
will
go
to
Fairfax
or
DC,
let's
make
sure
they
get
the
treatment
they
need,
so
we're
just
the
cases
will
always
be
there.
N
We're
afraid
that
the
visits
may
go
down
and
we're
hoping
that
they'll
go
to
the
private
sector,
which
we
won't
then
see
their
visits.
We
will
still
get
their
case
information
because
that's
part
of
the
communicable
disease
reporting
system,
because
then
we
will
try
to
follow
up
with
those
clients
to
find
out
who
their
sexual
partners
were
to
get
them
into
treatment.
Thank
You,
dr.
I
I
Ideally,
the
theory
is
the
county
leverages
some
dollar
or
put
some
dollars
in
at
the
nonprofit,
leverages
they're
able
to
produce
more
resources,
but
this
is
all
aligned,
because
it's
helping
us
deliver
a
service
more
efficiently
than
we
could
otherwise
and
we're
producing
client
outcomes
that
we
desire
that
are
part
of
our
plan,
so
I've
desired
to
have
us
come
up
with
a
way
for
evaluating
all
the
service
requests.
Funding
requests
that
we
get
from
nonprofits
based
on
that.
How
is
it
helping
us
do
what
we
could
not
otherwise
do
as
efficiently?
I
We
have
a
standard
way
of
evaluating
them
and
considering
funding
levels,
and
it
just
seemed
from
your
presentation
miss
Friedman
that,
because
of
our
just
tough
budget
year,
the
nonprofit
requests
were
just
put
in
a.
We
can't
do
that.
We've
we've
had
to
make
other
reductions.
We
can't
even
consider
that
you
know,
however,
I
would
like
for
us
to
get
to
a
place
where
we're
evaluating
not
based
on
those
macro
budget
principles,
but
really
how
does
this
nonprofit
align
with
our
goals?
How
are
they
helping
us
deliver
our
program?
Does
this
make
sense
to
pursue?
I
So
hopefully
we
don't
lose
sight
of
that
level
of
rigor
with
evaluating
the
nonprofits.
It's
not
really
a
criticism
for
what
we
may
not
have
done
this
year,
but
just
really
a
hope
that
we
do
it
in
future
years,
because
you
know
quite
frankly,
I
don't
want
our
board
to
be
in
the
position
of
just
deciding
who
we
like
and
who
we
should
give
money
to.
I
I
want
to
have
a
very
clear,
consistent
way
of
evaluating
how
they're
helping
us
meet
our
needs
so
that
we
transparently
can
then
be
making
decisions
about
whether
or
not
this
is
furthering
our
goals
as
an
organization
or
whether
we're
in
the
business
of
giving
money
to
people
simply
because
we
like
them
or
not.
Mr.
A
I
A
A
C
I
am
recognizing
at
some
point.
We
do
need
to
move
into
the
second
half
of
our
work
session
day,
which
is
revenue
overview,
but
I
cannot
resist
asking
one
kind
of
long
strategic
longer
answers.
You
question
my
own,
although
maybe
not
that
long
run,
because
we
are
of
course
looking
at
at
least
one
of
our
two
houses
of
the
General
Assembly
having
passed.
C
Medicaid
expansion
as
part
of
their
budget
and
I
would
not
want
DHS
or
any
of
our
staff
to
spend
too
much
time
preparing
for
the
impacts
of
something
that
is
as
live
of
a
question
as
whether
that
will
be
part
of
the
budget.
But
I
wondered
if
you
could
respond
even
at
a
high
level.
I
can
see
that
heating
Arlington
County
in
a
lot
of
different
ways.
On
the
one
hand,
you
know
access
to
health
care,
for
our
residents
is
a
wonderful
thing.
We've
been
able
to
successfully
use
Medicaid
waivers
to
pay
for
great
services.
C
On
the
other
hand,
I
know
we're
discussing
a
potential
or
the
General
Assembly
is
discussing
a
potential
education
or
training
or
work
requirement,
which
soon
would
fall
to
our
eligibility
workers
to
modern
it
or
determine.
Do
you
have
any
sense
at
a
high
level
of
how
this
what
could
become
policy?
Effective,
July
right
and
the
Commonwealth
could
could
affect
your
budget.
Our
budget,
the.
A
Numbers
that
we
are
are
hearing
about,
there's
an
estimated
7,000
individuals,
Arlington
residents,
who
could
potentially
qualify
from
Medicaid
if
it's
expanded,
and
that
would
mean
that
those
7,000
individuals
they
could
apply
online.
But
eventually
their
paperwork
would
come
to
the
Department
of
Human
Services
and
we
would
have
to
determine
their
eligibility
and
set
up
their
accounts
that
the
benefits
are
issued
to
them.
If
there's
a
work
requirement,
that
would
be
something
similar
to
what
we
currently
do
with
TANF
recipients.
A
What
length
of
time,
what
kinds
of
sanctions
there's,
often
sanctions
that
are
imposed
when
people
don't
reach
the
level
of
work
requirements
that
they're
supposed
to
so
now
for
most
positions
that
come
through
the
Department
of
Social
Services,
the
county
does
receive
I.
Think
it's
58
percent
fifty
seven
percent
reimbursement
from
the
state
and
then
we
chip
in
the
other
part.
So
there
is
some
compensation
also
for
people
who
would
receive
any
kinds
of
additional
Medicaid
eligible
services
through
our
Department,
like
behavioral
health.
A
C
O
You
know
I'm
gonna
violate
that
rule
of
I
could
just
keep
my
mouth
shut
and
and
not
look
dumb
and
I'll
just
open
my
mouth
and
eliminate
that
potential.
Whatever
that's
saying
is
so
I'm
gonna
ask
them
what
might
be
dumb
questions
is
what
I'm
about
to
say
so
first
off
I
do
want
to
associate
myself
with
mr.
Darcy's
comments
about
how
we
the
opportunity
to
evaluate
and
kind
of
a
more
dispassionate
view.
O
O
A
O
And
so
it's
no
surprise
to
you
that
that
they
have
come
to
board
members
and
expressed
that
they
feel
that
there
are
parts
of
the
contract
that
we'll
certainly
get
get
discussed
and
borne
out
in
the
RFP
for
the
new
contract.
But
parts
of
the
existing
contract
that
they
feel
were
just
sort
of
is
brand
new
contract
not
exactly
accounted
for
and
without
looking
taking
the
look
back
into
what
is
or
what
was,
but
looking
forward
in
this
RFP.
O
A
That
the
homeless
services
Center
contract
is
very
generously
funded
to
the
tune
of
1.5
1.4
million
dollars,
as
well
as
an
additional
hundred
and
thirty
four
thousand
dollars
of
repair
of
building
utilities
and
security
services
that
the
department
pays
for.
On
top
of
that,
so
it's
almost
a
1.6
million
dollars.
I
have
all
the
costs
of
the
other
shelters.
A
Of
course,
the
homeless
services
Center
does
do
outreach
and
has
a
day
program,
but
the
areas
that
were
identified
by
a
span
for
for
additional
needs,
such
as
increasing
their
administrative
overhead
from
6
to
10
percent,
increasing
cleaning
and
some
of
the
other
items.
I
don't
share
in
the
view
that
those
are
as
critical
as
a
span
views
them
to
be,
and
I
do
believe
that,
with
some
realignment
internally
of
their
resources,
those
could
be
covered.
Well,.
O
A
O
I
C
J
Actually,
I'd
really
I
was
gonna.
Just
tell
mr.
Gatchell.
Don't
worry
about
asking
dumb
questions.
I
never
do
is
anyone
who
listens
to
my
questions.
Quill
attest
I,
like
prefer
better.
The
only
dumb
question
is
the
one
you
don't
ask.
That's
right,
then
you're
probably
gonna.
Thank
this.
This
was
just
a
really
impressive
presentation.
This
is
really
impressive
here.
I
have
a
daughter
who's
like
all
over
me
these
days.
What
are
we
doing
for
what
I'm
gonna
just
take
this
and
give
it
to
her
to
look
at?
Thank
you.
Thank
you.
Thank.
C
You
all,
and
just
thank
you
to
your
staff
for
the
work
that
you
do
exactly
is
Miss
Garvey
was
saying
we're.
We
appreciate
you
tremendously.
This
is
there's
a
reason.
This
is
one
of
our
largest
departments
in
the
county.
It's
the
most
some
of
the
most
important
work
that
we
do
literally
matters
of
life
and
death.
So
we
appreciate
you
very
much,
thank
you
and
you
got
out
of
here
without
any
board
member
asking
to
do
a
comparison
between
Arlington
and
17
surrounding
jurisdictions.
We
know
are
your
favorite
kind
of
questions
so.
C
B
So
I
I
think
that
it's
either
Emily
Hughes
or
richard
stephenson
or
it's
Emily
Hughes
is
going
to
walk
us
through
the
revenue
overview,
which
will
be
a
an
excellent
summary
of
the
revenue
section
you
find
in
the
budget.
If
you
haven't
had
a
chance
to
read
it
yet,
but
I
still
would
encourage
you
to
read
it
in
your
spare
time.
P
So,
just
to
start
off,
just
a
pie
chart
giving
us
a
summary
of
the
general
fund
revenue
by
source,
local
taxes
make
up
84
percent
of
our
budget.
We
also
have
charges
for
services
license
permits
and
fees,
miscellaneous
state
and
federal
funding
within
our
local
tax
revenue.
68%
of
that
is
made
up
by
real
estate
taxes.
35%
of
that
is
on
the
residential
side
and
33
percent
is
on
the
commercial
side.
Personal
property
is
our
second
largest
source.
P
That's
11%
of
all
local
tax
revenue
that
our
vehicle
personal
property
tax,
as
well
as
our
business,
tangible
property
tax
and
on
this
slide
you'll
just
see
a
summary
of
proposed
budget
changes.
We
have
real
estate
taxes
going
up
because
of
the
assessment
change.
We
saw
personal
property
tax
going
up
based
on.
Basically,
the
pattern
of
actuals
we've
been
seeing
and
what
we
anticipate
seeing
in
growth
business
license
tax,
the
same
kind
of
basis
and
sales
meals
and
t
ot,
also,
all
because
of
growth
were
seeing
in
those
revenues.
P
Other
taxes,
it's
primarily
driven
by
the
increase
in
the
utility
taxes
which
we'll
get
into
more
detail
on
later
on.
There
are
a
number
of
tax
and
fee
changes
proposed
in
the
FY
19
budget.
This
was
part
of
the
budget
balancing
strategy.
So
we
looked
at
to
those
revenue
sources
where
we
could
make
changes.
We
do
this
on
an
annual
basis.
P
The
Ballston
bid
has
requested
that
we
consider
an
increase
to
their
tax
rate,
but
Rosslyn
and
Crystal
City
are
not
requesting
or
an
increase.
There
is
a
proposed
increase
to
both
the
commercial
and
residential
utility
taxes.
On
the
commercial
side,
the
proposal
is
to
increase
rates
by
approximately
5%
and
on
the
residential
side.
P
It's
an
increase
designed
to
take
each
taxpayer
up
to
the
3
dollar
monthly
max
on
both
the
gas
and
electric
side,
other
increases
that
are
proposed
or
to
parking
rates,
we're
increasing
a
25
cent,
an
hour
increase
and
extending
the
hours
from
6
p.m.
to
8
p.m.
there's.
Also,
a
proposal
to
increase
the
fines
for
exceeding
the
time
limit
on
parking
meters
from
35
to
$40
per
infraction.
P
Other
fees
that
are
proposed
for
changes
are
primarily
due
to
cost
recovery.
Looking
at
where
we
might
be
able
to
just
make
adjustments
based
on
changes
in
expenses
over
the
years.
One
good
example
of
that
is
the
fire
inspection
fee,
where
we
were
just.
We
just
got
a
little
bit
behind
because
of
what
expenses
were
so
bringing
that
up,
DPRs
doing
their
normal
review
of
all
their
fees
and
making
a
few
Changez
DHS.
You
just
heard
about
the
STI
fees.
P
C
PhD
and
des
are
both
looking
at
permit
fees
with
some
inflationary
increases,
we're
proposing
a
credit-card
convenience
fee
to
recover
the
cost
of
people
who
come
in
and
want
to
pay
for
services
with
the
credit
card,
actually
just
charging
them
at
2.5%
fee,
so
that
we're
not
paying
for
that.
Solid
waste
fees
are
going
up
two
dollars
a
year.
Recycling
inspection
fee
is
being
restructured
a
bit.
P
P
This
is
just
our
normal
summary
of
the
tax
and
fee
burden
on
our
mythical
average
homeowner
real
estate
taxes
are
going
up
solely
due
to
the
3.8%
increase
in
the
average
single-family
home
personal
property
is
going
up
due
to
and
anticipated
increase
in
the
value
of
vehicles.
So
that's
not
a
rate
change
in
any
way.
It's
just
that
we
expect
vehicle
value
as
it
does
every
year
to
increase
the
refuse
fee
going
up.
P
We
did
see
this
year
a
bit
of
a
shift
in
the
percentage
of
residential
versus
commercial
value
that
soap.
That's
due
to
the
changes
we
saw
in
assessments
again.
Overall
assessments
were
up,
1.9
percent
residential
grew
three
point:
nine
percent
and
commercial
was
down
0.2
percent,
so
we
went
from
a
51/49
split
to
a
52-48
split,
so
just
a
little
bit
more
of
the
burden
going
onto
the
residential
side
this
year.
P
Within
that
residential
category,
you
have
houses
in
town
houses
at
38.3%
condos
at
13.7.
This
just
shows
you
this
the
breakdowns
of
those
and
on
the
commercial
side
we
have
apartments
at
21%
office,
17.6,
general
commercial,
6.2%
and
hotels
at
3.2
percent,
just
to
chart
to
show
you
what
is
happening
with
the
average
single-family,
with
with
the
assessment
going
up
to
640
thousand
nine
hundred
dollars
and
then
just
a
few
details
on
other
taxes.
P
P
You
might
have
also
noticed
in
the
proposed
board
reports
that
you
saw
that
the
treasurer
is
proposing
one
change
on
vehicle
personal
property
billing.
In
the
past.
When
a
vehicle
came
into
the
county,
we
waited
to
bill
for
that
vehicle
personal
property
on
october
fifth,
which
made
compliance
a
bit
more
difficult
than
it
could
have
been
they're
proposing
to
change
that
so
that
they
can
bill
for
that
vehicle
within
thirty
days,
so
that
we
see
that
that
revenue
come
in
a
little
bit
sooner.
P
Just
a
slide
showing
the
expected
change
in
the
average
vehicle
value
going
up
to
ten
thousand
two
hundred
and
thirty
five
on
vehicle
personal
property.
We
offer
personal
property
tax
relief
that
we
get
from
the
state.
We
spread
that
across
all
vehicle
owners,
clean
fuel
vehicles
and
vehicles
equipped
to
transport,
the
physically
disabled
get
a
hundred
percent
exemption
on
the
first
three
thousand
values.
P
Fifty
percent
exemption
on
values
from
three
thousand
one
dollar
to
twenty
thousand
and
the
no
exemption
on
twenty
thousand
are
above
the
same
structure
exists
for
conventional
vehicles,
its
100%
exemption,
the
first
three
thousand
and
then
we're
proposing
again
doing.
Twenty-Eight
percent
on
that
three
thousand
one
to
twenty
thousand.
We
do
is
in
analysis
basically
on
how
far
the
money
can
spread
and
then
base
the
percentage
on
that.
P
P
Our
third
largest
tax
sources,
business
professional
occupational,
license
tax.
This
is
the
gross
receipts
tax
on
businesses.
We
expect
that
revenue
to
be
up
about
four
percent,
then
a
look
at
sales,
meals
and
transient
occupancy
sales
weeks
to
be
up
about
3%
meals,
up
4%
t
ot
up
2.2%,
the
Commissioner
of
Revenue
has
a
proposal
for
changing
making
a
slight
change
in
T
ot,
where
those
t
ot
providers
who
are
like
air
B&B
type
providers
have
been
under
the
same
requirement
to
file
monthly
as
hotels.
P
That's
been
a
bit
of
a
burden
for
them,
and
so
the
Commissioner
is
proposing
that
they
be
able
to
file
quarterly
instead
of
monthly.
So
that's
one
of
the
the
board
reports
that
you
saw
in
February
utility
tax
changes-
and
this
is
just
a
summary
of
the
proposal
to
change
those
commercial
rates
up
5%
and
the
residential
rates
to
go
up
to
that
3
dollar
monthly
max.
This
is
going
to
generate
500,000
on
the
commercial
side
and
2.7
million
on
the
residential
side,
and
that
money
is
shared
with
schools.
P
Other
tax
revenue
communications
tax
continues
to
go
down.
This
is
just
a
formula
at
the
state
level
that
spreads
the
money
similar
to
how
it
was
done
when
the
legislation
was
first
put
in
place
ibly,
it
was
2011.
So
when
the
overall
state
revenue
goes
down,
our
revenue
goes
down.
Recreation
text
continues
to
do
pretty.
P
Well,
this
we're
expecting
to
increase
that
a
bit
recreation
tax
has
been
at
this
level
for
the
past
five
years,
and
so,
but
it
really
depends
on
kind
of
commercial
transactions,
because
those
are
the
larger
dollar
value
transactions
going
on
carbinol.
We
continue
to
see
growth
so
we're
taking
that
up.
Just
a
little
bit
cigarettes
we're
seeing
the
first
increase
since
FY
12.
This
is
mainly
due
to
state
enforcement.
P
Non-Tax
revenue
we
have
our
tax
and
fee
compendium
that
we've
updated
as
we
do
every
year
so
that
you
can
go
in
and
look
at
the
summary
of
all
the
taxes
and
fees
that
the
county
has.
So
you
can
see
that
at
that
link
the
major
changes
in
non
tax
revenue
in
charges
for
services,
mainly
due
to
feed
changes,
the
parking
meter
went
being
the
biggest
one
and
the
household
solid
waste
rate.
P
The
credit
card
convenience
fee
falls
into
this
category
and
we've
also
seen
a
reduction
in
revenue
due
to
the
increased
utilization
of
dpr
sv
reductions,
they're
getting
out
there
and
promoting
the
the
program.
This
is
the
program
where
there's
a
means
test
for
how
much
you
have
to
pay
for
their
programs,
and
you
can
apply
to
get
a
reduced
fee
to
take
part
in
DPR
programs
and
fines
interest
in
rents.
P
We
have
an
adjustment
to
interest,
and
then
we
have
the
increased
revenue
for
parking
meter
violation,
finds
the
restructured
recycling
inspection
fee
and
under
license
permits
and
fees.
We
have
those
des
development
services
fees
increasing
in
the
fire
systems,
testing
fees,
increasing
state
and
federal
revenues.
State
revenues
up
about
3%,
mainly
due
to
mental
health
and
intellectual
disability,
funding
going
up
and
highway
Aid
going
up
slightly.
We
have
law
enforcement
aid
going
up
based
on
the
governor's
budget.
The
FY
19
level
has
made
it
through
both
Senate
and
the
house.
P
At
the
current
level,
the
Senate
did
take
down
the
20
estimate,
but
the
19
estimate
made
it
through.
So
we
shouldn't
have
to
make
any
adjustment
to
that
just
a
reminder
of.
What's
going
on
in
the
General
Assembly
I,
don't
anticipate
us
having
to
make
any
adjustments
to
FY
9
estimates.
Every
19
estimates
in
third
quarter,
just
from
what
we've
seen
in
legislation
and
then
federal
revenue
is
up
7.5%,
mainly
due
to
social
service
revenue.
P
Just
to
give
you
a
snapshot
of
how
we're
comparing
to
other
jurisdictions
on
tax
rates
and
tax
burdens
and
assessments.
So
our
assessments
were
a
bit
lower
than
our
neighboring
jurisdictions.
Alexandria
saw
very
similar
changes
in
their
assessments.
They
also
saw
some
downward
pressure
on
offices.
Fairfax
and
Loudon
are
much
more
residential,
so
you
just
see
very
different
patterns
there,
Falls
Church
isn't
out
yet
and
here's
how
we
compared
in
terms
of
how
much
of
our
our
assessments
are
residential
compared
to
our
jurisdictions,
we're
always
down
at
the
bottom.
P
Axe
rates,
it's
just
snapshot
of
what's
been
proposed
and
advertised
in
our
neighboring
jurisdictions,
again
false
churches
and
out
till
March
12th.
So
we
just
don't
have
their
information,
but
it
compared
to
other
jurisdictions.
Alexandria
is
staying
flat
like
us,
at
least
in
their
proposed
budget.
Fairfax
has
proposed
an
increase.
They've
also
proposed.
A
half
cent
increase
to
their
stormwater
rate
and
Loudoun
is,
is
proposing
a
decrease
on
the
tax
burden.
P
P
Just
to
give
you
a
snapshot
of
FY
18
mid-year.
We
don't
have
it
ready
for
you
yet,
but
just
so,
you
can
kind
of
see
what's
going
on
on
the
revenue
side
for
real
estate,
we
always
include
that
in
the
FY
19
proposed
budget,
but
for
vehicle
personal
property,
we're
coming
in
right
at
budget
business,
tangibles
we're
running
a
bit
higher
than
budget,
which
is
good
people.
We
never
know
until
mid-march,
because
those
revenues
mainly
come
in
in
February
and
March.
We
do
have
a
refund
risk.
P
There
there's
one
case
that
the
Commissioner
of
Revenue
is
still
working
out,
but
it
could
be
a
large
refund
that
hits
us,
and
refunds
have
generally
been
higher
this
year.
Males
males
t
ot
all
coming
in
about
budget
utilities
below
budget
recordation
above
budget
there's
always
some
puts
and
takes
on
these
other
taxes
right
about
it.
Budget
and
non
tax
revenue
is
running
a
little
bit
below
budget
right
now
and
that's
all
I'm
happy
to
take
any
of
your
questions.
Thank.
C
I
Gonna
start
off
and
I'm
gonna
be
that
guy
with
all
due
apologies,
so
we've
talked
about
it
for
years.
Mr.
manager,
you
always
know
that
there
are
no
average
Arlington
homeowners.
Yet
we
continue
to
describe
it
that
way
and
just
to
make
sure
I'm
understanding
it
correctly.
When
we
talk
about
the
average
Arlington
homeowner,
it's
based
on
the
average
assessed
value
of
an
Arlington
home.
So
why
don't
we
just
say
that
instead
of
referring
to
the
homeowner
as
average,
why
don't
we
talk
about
homeowners?
I
I
Thank
you
I'm,
sorry
to
be
that
guy,
but
I
am
but
I
am,
and
then
we
talked
the
other
day
about
the
use
of
the
word
tax
burden
and
I
noted.
As
we
went
through
a
lot
of
these
in
many
ways,
a
simple
one-to-one
substitution
of
burden
to
distribution
could
work
just
to
associate
myself
with
mr.
gut
Shaw,
who
I
think
raised
it
and
MS
Garvey
who
seconded
it,
but
then,
in
terms
of
a
substantive
question,
I
think
I
did
have.
One
did
I
get
so
excited
about
being
perspicacious.
I
I
forgot,
oh
just
really
is
a
comment,
because
I
think
this
is
also
very
educational
for
our
community
at
large.
He
may
be
watching
and
who
you
know
believes
that
Arlington
is
a
place.
That's
always
got
cranes
and
processes
developing
probably
in
many
cases,
far
too
much
for
their
tastes
and
appetites,
but
to
see
the
chart
on
page
26.
Six
that
gives
us
a
comparison
to
the
other
jurisdictions.
I
think
highlights
just
exactly
why
we
are
in
the
position
that
we're
in
this
year,
with
the
tough
budget
year
coming
becoming
realized.
I
You
know
when
we
and
in
times
of
abundance,
it's
a
great
thing
for
a
community
that
we
have
for
a
residential
community,
that
the
tax
base
is
split
with
the
commercial
interest
at
some
high-water
marks
contributing
half,
but
the
downside,
of
course,
is
when
they
go
into
a
cyclical
downturn.
That
means
that
the
burden
will
or
the
distribution
will
fall
on
the
residential
side,
and
that
puts
us
where
we
are-
and
we
don't
see
that
everywhere
else
where
the
distribution
is
altogether
very
different,
and
you
know
with
Loudoun
being
the
extreme
outlier.
I
That's
just
experiencing
huge
growth
in
both
the
other
jurisdictions
are
just
going
to
be
in
better
budget
years
when
they
have
a
much
higher
residential
distribution,
and
that's
really
why
Arlington,
despite
having
otherwise
sound
financials,
is
in
a
position
where
we
actually
have
to
be
a
little
bit
prudent
with.
You
know
how
we
figure
out
how
to
how
to
put
together
the
budget
I
would.
C
Q
It's
difficult
as
a
leading
indicator
on
the
commercial
side,
because
the
especially
with
the
new
construction
we
it's
there's
such
long
lead
times
and
what
a
commercial
developer
may
have
anticipated,
and
you
know
five
years
ago,
when
they're
going
through
a
extended
site
plan
process
and
bringing
it
to
market
and
leasing
it
up
and
the
macroeconomics
change.
It's
I'm
not
sure
it's
a
leading
indicator
because
of
some
of
the
dynamics
there
around
the
commercial
market,
but
I
don't
thought
anybody
else
has
a
observation
on
that.
It.
J
G
L
So
so
speaking
of
empty
office
buildings,
one
one
question
that
we
often
hear
from
the
community
is
how
our
empty
office
buildings,
assess
for
property,
tax
purposes
versus
fill
or
full
or
partly
full
office
building.
So
in
other
words,
there's
an
anxiety.
That's
been
expressed
by
some
getting
to
your
point
of
you
know
where
we're
continuing
to
new
new
office
buildings
are
coming
online
and
taking
a
lot
longer
to
fill
so
some
people
have
the
reaction
number
one.
Why
are
they
being
built
in
the
first
place,
number
two?
How
are
they
being?
L
How
are
they
being
taxed
and
if
they
were
taxed
at
a
higher
rate
that
would
the
argument
goes
discourage
speculative
office
buildings
from
being
built
in
the
first
place.
So
this
may
be.
You
know
a
conversation
that
that
might
be
helpful
to
have
with
with
Victor
Hoskins
RA
IDI
director
and
maybe
a
Oba
and
the
Chamber
of
Commerce
and
and
a
number
of
other
folks,
but
on
the
narrow
question
of
how
these
office
buildings
are
assessed,
empty
versus.
Not
can
you
speak
to
that
at
all
or
or
get
back
to
us.
Q
L
Q
Q
Is
they
discount
that
value
for
the
loss
of
income
for
for
the
year
sort
of
below,
though
generally
I'm
speaking
below
the
below
the
line?
They
value
the
the
building
it
at
market
and
then
give
a
deduction
for
the
lack
of
income
in
the
year
because
you're
valuing
it
the
building
into
perpetuity?
You
know
that
income
stream,
essentially
so
the
Department
of
real
estate
assessments,
takes
into
consideration
based
on
the
the
properties
submitted,
income
and
expense
information
very
individualized.
Q
L
Right,
okay,
yeah!
You
were
talking
assessments
yet
completely,
so
mr.
Stevens,
it
might
be
helpful
to
just
have
have
some
written
feedback
on
that,
or
maybe
even
some
some
paragraphs
that
might
be
something
suitable
for
public
consumption,
because
it
is
a
very
common
question
and
I
think
it's
gonna
be
even
more
so.
This.
Q
L
Think
again,
you
know
every
year
is
new,
and
that
is
when
people
you
know
they
see
their
neighbor
building
a
big
addition
on,
and
they
wonder
you
know,
when
is
the
assessed
value
gonna
catch
up
and
when
are
they
going
to
be
paying
the
fair
share
for
an
addition
that
where
they
maybe
had
to
cut
down
trees
or
they're
blocking
my
son
or
it's
a
little
big,
you
know
I
wanted
to
I
want
to
make
sure
that
you
know
they're
paying
more
than
I'm
paying
in
my
modest
little
bungalow.
L
J
You
can
we
put
up
slide
29
again
and
I
appreciate
mr.
Dorsey
bringing
up
the
issue
of
tax
burden
with
it's.
It's
occurred
to
me.
We
could
say
taxes
due
because
I
then,
and
we'll
probably
play
with
this
for
a
while,
but
it's
occurred
to
me.
Taxes
are
like
dues,
you
got
membership
dues
to
live
here
and
we
do
it
on
a
sliding
scale
anyway,
and
you
get
a
lot
back
for
what
you
what
you
put
in
and
dues
the
reason
I
had
this
up.
J
Do
we
I
know
we
always
compare
in
Virginia,
there's
probably
a
good
reason
for
that,
but
we're
closer
like
to
DC
than
we
are
at
a
Loudoun
County.
You
know
if
you
wanted
to
really
compare
so,
do
we
think
sometimes
about
comparative
putting
up
comparisons,
also
for
Maryland
DC
at
least
I.
Don't
know.
That's!
Oh.
J
C
C
C
You
know
the
the
value
we're
seeing
the
physical
manifestations
of
the
increased
value
in
the
residential
market
when
people
are
in
their
neighborhoods
and
I
think
it
can
be
hard
for
some
members
of
our
community
to
wrap
their
heads
around
what
we
mean
when
we
say
we're
looking
at
reduced
revenues
and
we're
making
cuts
and
so
forth
and
I
think
the
the
way
you've
taken
care
to
present
the
various
contributors
and
trends
here
has
been
really
helpful.
I'm.
I
Sorry,
madam
chair,
if
I
could
one
more
question
so
about
the
increase
in
credit
card
fees
across
the
across
the
organization?
Are
we
prepared
and
I'm
in
no
way
predicting
this,
but
it
certainly
could
happen
that
people
in
order
to
avoid
the
fee,
will
want
to
make
in-person
payments
or
process
more
checks
that
we
kind
of
considered
what
might
be
some
of
the
fiscal
offsets
if
an
increased
number
of
people
move
away
from
using
credit
cards
to
process
county
transactions,
the.
P
I
C
O
J
P
J
In
the
weeds
question,
I
think
American
Express
charges
more
for
a
fee
than
do
the
other
credit
cards.
If
this
is
this
true
that
there
we
go
mr.
Dorsey
says
it's:
oh,
it
must
be
so
so
did
they
get
a
cut,
so
we
don't
charge
more,
we
don't
charge.
Actually
we
have.
We
have
a
set
percentage,
no
matter
what
credit
card
is
being
used
and
it's
probably
too
hard
to
break
it
out,
but
I
do
there
are
places
where
they
well.
They
just
don't.
Take
American
Express,
that's
what
they
do
so
I
thought.
Thank
you.
C
L
Crystal
maybe
we
should
we,
maybe
we
should
just
point
out
I,
don't
know
if
you
folks
have
been
checking
your
machines,
but
I
got
an
an
email
or
a
text
from
Patrick
hope
and
Pat.
Carroll
sent
something
as
well
that
we
just
have
word
from
Richmond
that
the
House
of
Delegates
approved
the
t
ot
tax
renewal
for
three
years
by
a
bipartisan
vote
of
82
in
favor
17
against.
So
now
that
legislation.