►
Description
Briefing of the Buncombe County Board of Commissioners on April 4, 2023. The briefing is a chance for Commissioners to review agenda items before the meeting. No motions will take place during the briefing.
B
Good
afternoon,
commissioners,
yes,
we
have
a
slide
deck
here
we
go
all
right,
so
this
is
a
big
day,
I
think
in
the
life
of
HHS
and
for
our
community,
because
it
looks
like
we're
finally
going
to
get
to
expand.
Medicaid
I
do
want
to
just
give
a
little
bit
of
background
for
those
who
maybe
have
not
been
following
this
as
close
in
the
community.
But
just
so
folks
know,
Medicaid
is
a
federally
funded
program,
it
is
State
administered
and
then
it's
delivered
in
counties.
B
It's
a
very
County
specific
program,
so
you
apply
in
the
county
in
which
you
live.
You
receive
your
benefits
in
the
county
that
you
live.
We
determine
your
eligibility,
make
sure
you
keep
your
benefits
and
in
North
Carolina
it
has
always
primarily
been
for
lower
wealth,
children
and
adults,
elderly
adults
and
adults
with
disability.
B
Each
state
has
a
unique
Medicaid
plan,
so
Medicaid
would
not
look
the
same
in
every
state.
If
you
were
receiving
Medicaid
in
New,
York
or
Florida
moved
to
North
Carolina,
there
will
be
certain
pieces.
That
would
be
exactly
the
same,
but
it
wouldn't
all
the
benefits
may
not
match,
and
you
would
certainly
need
to
reapply
in
North
Carolina.
B
So
while
it's
a
federal
program,
very
State
specific,
the
Affordable
Care
Act
actually
called
to
expand
Medicaid
Nationwide,
it
was
a
big
feature
of
the
Affordable
Care
Act
and
in
2012
the
Supreme
Court
ruled
that
states
could
not
be
forced
to
expand
their
Medicaid
programs
as
a
part
of
ACA.
So
it
became
you
know
a
state-by-state
decision
about
whether
they
would
expand
Medicaid
or
not.
You
know
in
2014
it
was
available
in
26
States
in
D.C,
so
a
lot
of
States
jumped
in
right
off
the
bat.
B
Other
states
were
very
reluctant
to
move
and
North
Carolina
was
a
little
slower
to
move
and
to
warm
up
to
the
idea
of
Medicaid
expansion.
But
now
you
know
in
March
of
this
year
we
became
the
40th
state
to
pass
into
law,
Medicaid
expansion.
So
I
really
just
want
to
stop
there
a
minute,
because
there's
so
many
questions
about
it,
but
I
really
think
we
just
need
to
stop
a
second
and
celebrate
this.
B
So
for
many
of
us,
we've
advocated
for
many
years
for
Medicaid
expansion,
because
the
beauty
of
that
is,
it
really
offers
health
insurance
to
a
whole
lot
of
folks
in
our
community
who
have
not
had
health
insurance
in
a
long
long
time
which
opens
up
access
to
health
care.
So
I
just
want
to
stop
a
minute
and
celebrate
whatever
you
want
to
celebrate.
B
That's
how
I
like
celebrating,
let's
put
that
on
there
for
record
people,
probably
watching
this
presentation
for
years
to
come
and
where?
Where
are
we
now
so?
What's
our
current
timeline,
so
House
Bill
76
passed
the
Senate
and
the
house
pretty
overwhelmingly,
you
know
nonpartisan
lines
and
then
was
signed
into
law
by
the
governor
on
March
27th.
So
it
is
law.
It
is
in
effect
law
in
North,
Carolina,
Medicaid
expansion,
but
two
more
things
have
to
happen
before
residents
can
actually
enroll
in
the
program.
B
One
is
we
have
to
pass
a
state
budget,
so
Clause
was
put
in
this
law
that
says
until
the
state
budget
passes.
Medicaid
expansion
cannot
be
enacted,
so
we're
all
going
to
have
to
wait
for
the
state
budget
to
pass.
Hopefully,
that'll
be
sooner
than
later,
so
that
that
we
can
get
started.
We
also
have
to
get
North
Carolina's
plan
approved
by
the
federal
center
for
Medicare
and
Medicaid
services,
so
they
have
to
approve
North,
Carolina's
expansion
plan
and
I'll
be
honest
with
you.
B
B
But
if
it's
seen
as
a
mandated
work
program,
it
will
not
have
be
so
bold
to
say
it
will
not
pass
CMS,
because
other
states
have
attempted
this
and
the
federal
government's
been
very
clear
that
you
cannot
force
a
person
to
work
to
receive
this
benefit
to
receive
health
coverage.
So
when
I
talk
to
Folks
at
the
division
of
health
benefits,
they're
really
predicting
a
go
live
date
anywhere
between
July
1.
If
we
were
to
get
a
budget
to
pass
pretty
quickly,
We
Believe
CMS
will
work
really
quickly.
B
Then
we
could
begin
to
take
applications
as
soon
as
July
1st.
If
the
budget,
you
know
drags
on
a
bit
and
it
moves
a
little
bit
slower,
it
could
be
as
late
as
December
1.
To
be
quite
honest
with
you.
If
a
budget
doesn't
pass,
it
could
be
the
whole
next
biennium.
We
saw
that
happen
last
time,
but
I
do
want
to
say
that
that
December
first
date
is
worth
paying
attention
to
Because
unless
I'm
mistaken.
If
we're
not
in
place
by
December
1st,
we
will
not
get
the
1.8
billion
dollars
from
the
federal
government.
B
The
bonus
for
expanding
Medicaid
I
cannot
imagine
that
our
lawmakers
would
miss
out
on
that
that
money,
but
it's
beyond
my
influence
to
say
so.
What's
it
going
to
mean
locally
I
think
the
good
news
is.
We
start
here
we're
talking
about
15
over
15
000.,
current
members
of
our
community,
who
will
have
access
to
health
care,
and
so
these,
it's
primarily
for
people
19
to
64,
who
are
living
below
133
of
the
federal
poverty
level,
so
oh
I
might
have
to
lean
on
Philip
for
for
a
single
person,
it's
a
little
over.
B
We
do
need
to
recognize
that
it
doesn't
mean
that
every
person
in
Buncombe
County
will
have
health
insurance,
I
think
there's
still
a
couple
of
populations
that
could
still
sort
of
fall
through
the
cracks
a
little
bit.
So
if
you're
over
65
you'll
have
you
can
get
Medicare.
You
know
if
you're
at
this
poverty
level
and
now
from
birth
to
65
you'll
be
able
to
get
Medicaid.
B
We
also
have
the
ACA
so
folks
that
are
working
they're
above
that
they
can
afford
to
get
in
the
marketplace.
You
can
have
that
and
then,
of
course,
there's
the
folks
in
our
community
that
have
private
insurance,
whether
they're
self-insured
or
their
employer,
but
our
our
members
of
our
community,
who
are
undocumented
aliens,
will
still
not
have
access
to
health
coverage,
so
we'll
still
have
have
some
some
gaps
there
and
then
there's
always
those
people
that
are
just
above
that
poverty
rate.
B
So
maybe
they're
at
135
of
poverty
and
they
have
access
to
the
ACA,
but
they
still
might
not
be
able
to
afford
to
purchase
health
insurance
or
they're
at
a
stage
in
life
where
it's
by
health
insurance
or
pay
rent,
they're
28
years
old.
You
know
you're,
probably
going
to
pay
your
rent,
so
we'll
still
have
a
few
people
that
may
benefit
from
the
safety
net
approach
in
terms
of
what
it
means
for
us
operationally.
We
certainly
curb
serve
almost
61
000
members
of
our
community
with
Medicaid.
B
This
additional
15
5
will
represent
about
a
29
increase
in
our
in
our
caseload
in
the
folks
that
we
will
serve
so
we've
done,
the
math
we've
looked
at
what
we
would
have
to
do
to
support
that
additional
population,
and
we
believe
that
it
will
take
us
about
38
additional
positions
to
in
operating
costs,
which
would
amount
to
about
3.4
million
dollars.
B
The
good
news
for
that
is
in
this
bill
is
included
provisions
for
counties
to
be
able
to
expand
their
reach
with
no
County
dollars.
So
they're
going
to
take
some
of
these
Medicaid
additional
Medicaid
funds
pass
those
along
to
counties.
So
that
counties
won't
have
to
bear
the
expense,
as
you
rightly
know,
Medicaid
already
pays
75
percent
of
the
cost
of
administration.
The
federal
government
does
so.
B
B
After
State
fiscal
year
25
there
will
continue
to
be
funding,
but
I
think
it's
something
worth
this
commission
and
the
County
Commissioners
Association,
keeping
an
eye
on
to
make
sure
that
those
costs
don't
revert
back
to
counties
in
a
few
years,
because
there
should
be
ample
funding
to
to
fund
counties
to
do
this
work
so
I
lay
that
out
there
for
something
for
you
guys
think
of
in
the
future
and
our
Advanced
planning.
These
are
our
assumptions.
B
We
do
believe
that
this
will
create
simplified
eligibility
rules,
so
in
some
ways
it'll
make
it
a
little
bit
easier
to
determine
whether
people
can
receive
Medicaid
or
not,
because
they'll
basically
be
one
Medicaid
Program.
Instead
of
what
we
have
today,
which
is
many
programs
based
off
your
age,
your
stage,
your
disability
and
things
like
that,
it
will
require
us,
however,
to
retrain
our
entire
staff,
so
not
everybody's
working
in
that
model,
so
we'll
have
to
basically
start
from
scratch:
train
all
the
all
of
our
current
staff
train
these
38
additional
staff.
B
So
we
have
a
little
bit
of
a
ramp
up
process
here
and
we
will
need
to
provide
some
pretty
extensive
quality
control
for
just
a
little
while
because
but
a
lot
of
folks-
probably
don't
realize,
is
you
know
if
you
make
a
mistake,
if
the
county
staff
make
a
mistake
and
do
not
determine
eligibility
correctly,
and
then
that
person
goes
to
the
doctor
and
racks
up
pretty
serious
medical
bills
and
then
an
audit
you're
found
to
you're
that
error
is
found.
The
county
is
responsible
for
the
payback
of
those
medical
bills.
B
B
Other
things
that
we're
looking
at
doing
I
think
the
Big
Challenge
in
this
market
will
be
to
find
38
staff
fast
enough
to
get
them
trained
and
ready
to
receive
these
people.
But
we've
been
working
with
HR
they've,
been
really
good
about
helping
us
come
up
with
some
ideas
and
we're
reviewing
our
job
description.
The
qualifications
we're
work,
our
working
titles
we're
looking
at
like
doing
sort
of
like
a
rebranding
of
these
positions,
so
they
really
demonstrate
what
we
do.
B
We're
asking
to
be
able
to
start
recruiting
our
staff
as
soon
as
the
go
live
date
is
set.
So
we
don't
want
to
wait
to
the
date
it
starts
to
recruit.
We
want
to
be
ahead
of
it
so
that
we
can
be
ready
for
people
we're
going
to
advertise
differently,
expand
that
and
actually
go
to
a
continuous
recruitment
process.
So
we'll,
basically
just
have
open
recruitment
where
people
can
apply
for
these
jobs.
B
A
C
I
I
do
just
to
wrap
my
mind
around
what
this
will
actually
look
like
when
it
rolls
out.
Are
we
working
with
Community
Partners
to
fill
any
gaps?
I
know
it's
hard
to
find
employees
right
now,
it's
very
difficult
to
get
38
people
overnight,
even
if
you're
paying
significantly
higher
wages
than
it's
probably
possible
in
any
part
of
the
state
at
this
point,
but
are
there
any
programs
that
we
can
jointly
operate
with
to
fill
that
need
because
you're
going
to
get
hit
with
at
least
15
000?
C
B
B
Then
we'll
start
hiring
the
masses
of
the
workers
that
we
need,
so
we
can
run
them
through
this
training.
All
together
we
have
had
Community
Partners
rise
up
and
ask
us
hey:
is
there
any
way
we
can
help
you
in
the
way
of
like
getting
people
enrolled
into
the
Medicaid
Program?
So
a
lot
of
our
community-based
organizations
are
already
working,
so
these
aren't
one
way
I.
Think
about
is
these
aren't
people
that
are
moving
into
Buncombe
County?
B
B
We
can
access
more
service,
I,
think
the
bigger
challenge,
while
it'll
be
a
big
challenge
to
hire
and
train
38
people
before
this
goes
live,
especially
if
it's
July
1st
but
I
think
the
long-term
challenge
for
us
really
is
the
provider
Network
you
know
do:
do
we
have
a
provider
Network,
that's
ready
to
take
on
an
additional
fifteen
thousand
people
with
health
needs,
and
some
of
them
with
untreated
Health
needs
for
quite
some
time
and
I
guess.
B
C
D
I
guess
just
one
question
and
thanks
Tony
I
certainly
was
worried.
I'd
never
see
this
day
coming
to
North
Carolina,
so
I'm
very
excited
to
to
see
it.
It's
going
to
help
a
lot
of
people
and
save
save
lives
across
the
state,
especially
over
time.
Can
you
give
us
an
example
of
you
mentioned?
There's
still
be
a
gap
of
some
kind.
Can
you
kind
of
give
me
an
example
of
what
yeah.
B
So
I
think
the
situation
most
glaring
Gap
to
me-
and
we
already
see
this
at
times-
would
be
someone
who
is
not
a
citizen,
so
they
reside
in
Buncombe
County.
They
may
have
you
know
behavioral
health
or
physical
health
needs,
but
there
is
no
payer
source
for
them.
We
see
it
sometimes
we're
going
to
talk
about
child
welfare.
B
Tonight
we
see
it
sometimes
at
our
child
welfare
population,
where
maybe
I
have
a
child
in
foster
care
who
is
undocumented
but
has
severe
and
persistent
Behavioral
Health
needs
where
we
have
to
pay
100
percent
of
the
cost
of
those
Behavioral
Health
needs
which
can
get
pretty
expensive
pretty
fast.
So
I
think
that
that
would
be
one
population
that
will
still.
We
will
still
need
a
safety
net
for
and
the
only
encouraging
thing,
I
guess
about
that
in
Western.
B
North
Carolina
is
really
you
know
our
fqhc
model
in
Western,
North,
Carolina,
really
in
some
way
started
as
migrant
health,
and
so
we
have
Deep
Roots
there
and
we
have
a
really
strong
provider
Network.
We
really
have
three
fqhcs
in
Buncombe
County
now
and
an
fqhc
look-alike
in
mayhec,
so
our
safety
net
system
is
strong,
but
I
just
don't
want
to
send
the
message
that
everyone
will
have.
There
will
still
be
small
pockets
of
our
community
that
will
need
safety,
net
services
to
be
healthy
and
well.
B
Yeah
the
provider
Community
does
so
a
lot
of
that
service
is
provided
through
our
federally
qualified
Health
Centers,
who
receive
different
Federal
funding
to
provide
Health
Care
Services.
The
county
very
graciously
also
participates
in
what
I
call
the
Assurance
model
to
make
sure
people
do
have
access
to
primary
care
services,
so
that
would
be
our
major
provider.
Abccm
also
has
a
long
history
of
providing
some
services
to
the
uninsured
and
they
still
provide
some
Services
there.
B
The
free
clinic
model
has
all
but
gone
in
Western
North
Carolina,
however,
like
abcmcm
still
has
medical
services
available
to
folks
we're
on
Pharmacy,
and
things
like
that.
So,
like
I
say,
we
are
really
in
a
better
position
than
other
places
in
Western
North
Carolina
because
of
our
history
of
serving
the
underserved
and
how
I
would
look
at
this
is
now
there
will
be
a
payer
source
for
the
majority
of
folks
that
are
already
being
served
which
will
free
up
those
non-profit
dollars
to
really
focus
on
the
small
population
that
remains
okay,.
A
B
F
Thank
you,
so
I'm
here
today
to
talk
a
little
bit
about
the
North,
Carolina
Child
and
Family
specialty
plan,
and
so
this
is
a
small
cohort
of
folks
that
would
be
eligible
for
this
specific
plan
and
it
would
be
a
single
Statewide
plan
designed
to
serve
child
welfare
involved.
F
Children
and
families,
and
the
purpose
of
this
presentation
is
really
to
just
share
some
information
about
what
this
plan
would
look
like
what
is
happening
right
now
at
the
North
Carolina
legislation,
legislative
level
and
just
talk
a
little
bit
about
what
we're
facing
here
locally
as
it
pertains
to
the
mental
health
system
and
its
impact
on
our
child
welfare
system.
F
So
the
North,
Carolina,
Child
and
Family
specialty
plan
would
be
a
Statewide
plan
where,
regardless
of
a
member's
geographic
location,
the
plan
would
provide
members
with
access
to
a
broad
range
of
physical
health,
Behavioral,
Health,
Pharmacy
long-term
services
and
supports
intellectual
developmental
disability
services
and
resources
to
address
unmet
health-related
needs.
The
Statewide
plan
would
enable
the
members
to
have
access
to
treatment
plans
and
a
robust
Care
Management
System.
So
that's
just
a
quick
kind
of
overview.
F
F
So
there
is
current
pending
State
legislation,
it's
Senate,
Bill,
156
and
House
Bill
340,
and
the
bill
would
really
mandate.
F
The
special
population
that
would
be
eligible
for
these
Services
would
be
Children
and
Youth
in
foster
care.
Currently
in
Buncombe
County
we
have
about
320
Youth
and
about
50
or
so
young
adults
that
would
qualify
children
receiving
adoption
assistance.
That's
a
much
larger
group
of
children
here
in
Buncombe,
County
former
foster
care
youth
under
the
age
of
26.
F
So
even
those
youth
that
do
not
opt
into
the
extended
Foster
Care
Program
through
the
age
of
26,
they
would
still
be
eligible
minor
children
of
individuals
eligible
for
cfsp,
enrollment,
so
siblings
of
those
children,
the
parents,
Guardians
and
custodians
of
those
children.
That's
a
huge
part
of
this
is
allowing
those
adults
to
remain
involved
and
to
be
a
part
of
this
Specialized
Care
and
then
another
huge
one
for
me.
Is
families
receiving
Child,
Protective
Services
in-home
services.
F
F
So
just
an
overview
of
the
benefits
of
the
plan.
It
would
be
like
I
just
said:
prevention
focused
adults
being
able
to
receive
treatment
as
well
as
children.
It's
something
that
we
really
struggle
with
now
is
is
really
making
sure
that
we
can
access
high
quality
services
for
the
parents
involved.
If
we
can
and
we're
able
to
support
parents
in
a
different
way,
we
might
be
able
to
prevent
children
from
entering
foster
care,
which
would
be
really
helpful.
F
Children
and
DSs
directors,
so
on
behalf
of
foster,
children
would
be
able
to
opt
out
of
the
plan
if
they
prefer
the
tailored
plan
or
standard
plan.
So
just
that
flexibility
care
managers
will
be
available.
24
7,
to
assist
with
child
emergencies.
Care
managers
will
assist
with
the
transition
out
of
foster
care
so
working
over
to
another
plan.
If
a
family
is
no
longer
eligible
and
then
medication
management
being
a
course
service.
F
F
F
We
are
worried
that
a
Statewide
plan
may
not
be
able
to
work
with
us
at
the
same
degree
that
our
current
partnership
with
our
local
management
entity
works,
and
we
may
lose
some
of
the
more
individualized
attention
that
we
currently
have
a
loss
of
local
collaboration
and
real-time
response
may
happen,
and
Regional
providers
having
a
regional
provider
would
allow
for
that
that
real
partnership
to
happen,
if
that
was
if
that
was
ever
to
come
to
fruition,
and
we
were
able
to
have
a
regional
model,
a
regional
option.
F
So
again,
this
really
is
a
call
for
Action
in
terms
of
something
needs
to
be
done.
Something
needs
to
happen
differently
to
better
support
the
children
and
their
families
that
are
involved
in
our
child
welfare
system.
Currently,
we
are
facing
a
crisis
with
many
of
these
children.
We
have
a
lack
of
adequate
access
to
therapeutic
level
placements
willing
to
accept
older
children,
sibling
sets
and
children
with
complex
trauma
needs.
We
have
long
wait
lists
for
outpatient
services
and
enhanced
Services
through
our
local
providers.
F
Some
of
the
impacts
of
the
the
worries
and
concerns
with
our
system
are
that
parents
and
caretakers
are
frustrated
with
the
mental
health
system.
We're
seeing
parents
throw
up
their
hands,
drop
their
kids
at
hospitals
and
walk
away.
This
is
happening
not
just
once
every
few
months
is
happening
daily.
F
Our
children,
our
Buncombe
County
children,
are
being
placed
all
over
the
county,
all
over
the
state
and
sometimes
out
of
state,
and
when
that
happens,
because
the
resources
aren't
here
available
locally,
we
are
it's
really
hard
to
manage
their
care
right.
It's
hard
to
check
in
on
them
it's
hard
to
just
stop
by
and
see
how
they're
doing,
if
they're,
four
or
five
hours
away,
and
unfortunately,
we
really
feel
like
the
trauma
and
harm
cost
to
these
children
and
families
is
being
exacerbated
by
this
problem.
F
So
some
of
the
things
that
are
currently
going
well
with
our
via
partnership.
We
wanted
to
share
this
because,
whatever
direction,
we
end
up
going,
whether
it's
a
single
Statewide
plan,
a
regional
plans,
we
want
to
make
sure
and
not
lose
the
things
that
are
going
well
now
and
and
then
we
want
to
build
on
those
things,
and
so
we
just
wanted
to
share
that.
We
do
have
access
to
timely
and
trauma-informed
clinical
assessments
for
our
youth
and
for
our
parents
through
Partnerships
with
via
and
local
providers.
F
F
F
F
So
our
local
management
entity,
via
Health,
has
been
working
across
the
counties
that
they
serve
to
ensure
that
there's
co-location
in
the
DSs
offices
they
have
worked
to
implement
Statewide
to
standardized
policies,
enhance
their
Network
adequacy
and
then
coordinated
response
protocol
with
the
DSs
and
we're
in
the
middle
of
finalizing
ours.
At
this
time,
they're
asked
via's
ask
has
been
letters
of
support
from
both
County
management
and
County
Commissioners,
and
so
you
know,
with
this
information,
that's
been
provided.
G
Thank
you,
and,
and
before
diving
in
I,
just
want
to
thank
you
for
taking
the
time
to
do
this.
I
I'm
new,
relatively
newly
appointed
to
the
Via
board
and
even
more
newly
appointed
to
the
HHS
board.
G
So
still
learning
a
lot
in
both
those
spaces,
but
before
we
dive
into
this,
I
just
do
want
to
take
a
moment
to
recognize
what
you
and
your
team
are
and,
and
many
many
others
at
Via
and
HHS
are
doing
each
and
every
day
to
serve
families
and
and
kids
who
are
among
the
most
vulnerable
in
our
community
and
I
know,
that's
a
24
7.,
that's
not
work!
G
You
walk
away
from
at
5
PM
and
just
want
to
take
a
moment
to
to
recognize
that
and
express
appreciation
for
that,
and
also
just
appreciate
the
perspective
that
staff
is
providing
as
we
kind
of
Wade
through
this
request.
G
G
The
fourth
bullet
item
says
that
you
can
that
children
and
DSs
directors
can
opt
out
of
the
plan
if
they
prefer
the
tailored
or
standard
plan,
and
that
I'm
just
trying
to
get
my
head
around
that
is
is,
is
a
tailored
plan,
something
that
we
would
that
Buncombe
would
have
the
opportunity
to
develop
with
the
state.
Or
do
we
know
yet
what
that
means.
F
The
tailored
plan
is
the
plan
that
the
lmes
are
currently
working
on
rolling
out
and
I.
Believe
they've
said:
they've
named
the
date
of
September
of
2023
as
the
rollout
date,
and
that
is
a
plan
not
just
for
Children
and
Family
and
Child
Welfare,
but
a
plan
to
meet
the
the
needs
of
children
and
adults
who
have
high
specialized
needs
that
are
outside
of
kind
of
your
typical
Outpatient
Care
needs.
F
And
so
I
might
have
to
ask
for
some
help,
but
I'll
try.
So
my
understanding
is
that
tailored
plans.
F
My
understanding
is
that
the
tailor
plan
is
really
meant
for
the
larger
population,
and
this
is
a
really
specialized
population
that
would
be
served
by
this
Statewide
plan.
Okay,.
G
That
would
not
be
inconsistent
with
participating
in
a
tailored
plan
later
on
or
am
I
jumbling.
This
up.
Okay,
thanks
for
helping
me.
H
It's
kind
of
an
either
or
kind
of
thing
where
you
know
if,
if
they
roll
out
of
Statewide
plane-
and
you
don't
like
it,
you
can
change
plans
to
a
tailored
plan
that
exists
and
the
tailored
plans
have
been
in
the
works
for
a
long
time.
They
were
supposed
to
roll
out
in
December
pushed
back
to
April.
Now
October
1st,
it
looks
like
it's
the
tailored
plan
to
start,
but
that's
for
a
group
of
folks
that
don't
just
need
regular
care
that
come
under
Managed
Care
under
a
standard
plan
for
Medicaid
purposes,.
I
G
I
F
F
The
folks
that
I
think
about
are
the
ones
that
are
on
our
care
coordinators,
via's
care,
coordinators,
current
caseload
as
being
in
a
like
a
level
two
foster
home
or
group
home
psychiatric
Residential,
Treatment
Facility,
those
high
level
of
needs.
Those
are
the
folks
that
would
be
in
a
tailored
plan,
whereas
the
entire
child
welfare
population
and
family
in-home
population
and
their
parents
would
be
in
the
child
and
family
specialty
plan.
A
Why
that
why
you
feel
that
we
should
look
at
the
regional
aspect
with
via
because
we
received
a
letter
from
from
the
state,
and
it
was
pretty
strongly
urging
everyone
to
to
go
with
this
state
plan.
So
I
want
to
give
you
an
opportunity
to
just
kind
of
speak
to
that
more
directly,
because,
basically,
in
the
letter,
one
part
of
it
said.
Despite
these
challenges,
we
have
a
shared
obligation
to
do
better
for
these
children.
The
status
quo
is
not
acceptable
and
I
appreciate
your
efforts
to
begin
making
changes
with
this.
F
Yes,
I
can
try,
so
what
I
will
say
is
I.
Don't
think
that
the
Statewide
plan
will
fix
the
problem
that
is
being
identified
through
that
letter.
What
I
see
as
the
problem
in
in
my
day-to-day
experience
is
that
there
are
not
enough
provider
resources
available
in
our
community
or
across
the
state
to
meet
the
need.
We
do
not
have
enough
Therapeutic,
Foster,
Homes
level,
two
and
level
three
group
homes
or
psychiatric
residential
treatment
facilities
to
meet
the
needs
of
the
children
across
the
state
of
North
Carolina.
F
The
plan
is
not
going
to
impact
that
there
needs
to
be
something
that
is
targeted
toward
building
up
those
resources,
and
the
plan
is
whether
it's
a
local,
a
regional
or
estate
plan.
If
you
don't
focus
on
those
resources,
the
plan
is
not
going
to
fix
that
problem,
and
so
we
can
blame
via
or
the
lmes
across
the
state,
for
this
problem.
I,
don't
think
that
gets
us
to
a
solution.
F
I,
don't
I
I
believe
what
I
see
every
day
working
with
via
is
that
they
are
working
right
alongside
us
every
day,
day
and
night,
I'm
on
the
phone
with
via
at
8
pm
9
pm
midnight.
Talking
about
these
kids,
trying
to
figure
out
where
they're
going
to
go
in
the
middle
of
the
night,
while
they're
being
discharged
from
the
emergency
room,
I,
don't
know
if
we
get
away
from
a
local
or
a
regional
solution.
F
I
don't
know
who
I'm
going
to
be
talking
to
at
those
times
of
night
trying
to
figure
out
these
Solutions.
So
for
me,
boots
on
the
ground
day
to
day
I
value
the
partnership
with
via
I
trust
them.
They
are
working
really
hard.
They
have
grown.
They
are
in
the
middle
of
a
lot
of
growth,
a
partnership
with
benchmarks,
which
is
a
provider
entity
like
a
umbrella
Organization
for
providers
to
try
to
figure
out
how
to
lift
up
additional
provider
entities.
F
You
know,
and
so
I
agree
that
the
there
is
a
huge
problem
and
our
kids
are
caught
in
the
crossfire
of
that
problem.
I,
just
don't
know
that
a
Statewide
plan
is
going
to
get
us
to
the
solution
that
I
hope
for
I
do
think
that
there
have
been
ideas
out
there
shared
that
through
collaborative
work.
F
You
know
as
one
option
and
opening
up
additional
facilities
that
would
be
more
targeted
towards
serving
the
children
in
the
foster
care
system,
and
so
I
don't
know
if
I
fully
answered
your
question,
but
that
that
is
that's
kind
of
my
point
of
view
in
in
in
in
some
of
my
worries
related
to
having
an
entity
that
doesn't
have
as
much
close
connection
to
to
the
work
that
we're
doing
here
in
Buncombe
or
in
Western
North
Carolina.
C
F
C
Guess,
I
I
would
probably
I'd
be
interested
to
follow
up
with
that
and
see
a
little
bit
more
of
what
this
looks
like
in
practice.
I
understand
nothing's,
perfect,
especially
around
the
system,
but
when
you
have
something
that
requires
proximity,
the
way
that
a
lot
of
these
specific
plans
are
going
and
the
impact
that
they're
going
to
have
on
families,
locally
relationship
building
is
key
and
we've
spent
a
lot
of
time
building
relationships
from
from
what
I've
seen
in
the
courthouse
days.
C
There's
a
lot
of
trust
there
between
some
of
the
workers
and
the
families
that
are
serving
our
community,
so
not
not
to
take
away
from
anything.
The
state
might
have
in
mind,
but
I'd
be
curious
to
get
some
honest
feedback
about
what
that
looks
like
going
forward,
because
that
is
a
very
delicate,
Community,
specific
issue
and
that's
not
easily
regained.
If
we
lose
that.
G
County
Manager
Pender,
as
we
think
about
the
request
that's
come
in,
which
is
a
legislative
level
of
support.
The
content
of
that
essentially
be
a
synopsis
of
what
Rebecca
just
shared,
which
is
that
these
are
the.
This
is
what
we're
experiencing
on
the
ground,
and
these
are
the
concerns
we
have
or
issues
we'd
like
to
see
addressed
as
this
moves
forward.
Does
that
feel
like
a
play
to
kind
of
steer
the
conversation
a
little
bit.
I
It
does
a
we
can
draft
a
letter
if
you
guys
are
interested
in
this
on
a
letter.
We
believe
the
plan
is
going
to
pass,
but
we
do
want
to
register
Our
concern
because
we
are
seeing
to
Rebecca's
Point
Daily
need
for
our
kids
in
our
community
so
and
we
want
to
make
sure
it
is
just
not
a
Statewide
insurance
agency
and
that's
what
this
feels
like
that:
they're
going
to
issue
an
RFP
to
get
an
insurance
company,
that's
going
to
administer
claims,
and
what
we
are
saying
is:
when
that
happens.
I
Locally
we
lose
out,
especially
in
the
west,
are
the
far
Northeast
where
a
network
is
not
as
big
as
it
needs
to
be,
and
we
want
our
Focus
to
be
on
building
a
network
building
a
place
where
our
kids
can
go
and
not
be
discharged
from
a
hospital
and
we're
done
trying
to
find
a
place
across
our
state
for
our
kids
to
go
they're,
not
always
here
in
Buncombe
County.
We
have
to
ship
kids
all
over,
because
we
don't
have
the
resources
here.
I
G
I
F
I
G
A
One
final
thing,
while
Rebecca's
here
I,
would
also
be
on
this
agenda
item.
We're
asking
I
would
really
appreciate
at
some
point
her
coming
back
and
us
having
more
information
so
that
we
have
a
better
grasp
of
what
all
is
going
on
with
our
most
vulnerable
population,
because
I
just
think
you
know
she's
talking
about
different
resources
needed
and
ideas
around
this,
and
so
I'd
really
like
to
have
a
better
grasp
of
what
all
is
going
on.
I
A
Community
I
grew
up
calling
this
General
Mountain
Area
Spivey,
though
technically
I,
believe
the
mountain
may
also
be
known
as
deaverview.
So,
regardless
of
what
you
call,
it
applaud
Southern
Appalachians
initiative
to
conserve
this
valuable
Community
Asset,
with
its
proximity
to
a
significant
portion
of
our
community.
A
This
Mountain
Forest
has
tremendous
potential
to
provide
our
community
with
recreational
and
educational
opportunities
and
I,
especially
love
that
with
Public
Access.
Anyone
will
be
able
to
enjoy
the
most
spectacular
view
in
Asheville
and
this
will
be
an
enduring
Legacy
for
our
community
and
now
Allison
Danes.
Our
Parks
and
Recreation
director
will
provide
a
quick
overview
of
this
opportunity
and
then
we'll
ask
Carl,
Silverstein
and
Jay
lutzy
with
Southern
app
to
also
share
more
specifics
about
the
project.
J
Great
thank
you.
Thank
you
very
much
appreciate
the
opportunity
to
come,
speak
to
you
Commissioners
this
afternoon,
so
I'm
going
to
get
a
quick
overview
of
the
property
that
we
were
talking
about
here.
So
you
can
see
here
from
this
first
slide.
This
is
Spivey
mountain
or,
as
commissioner
will
say
it
often
known
as
Diva
view.
J
Mountain
is
located
in
the
deaverview
community,
we're
looking
at
approximate
5.2
miles
from
downtown
Asheville
3.6
miles
from
West
Asheville
7.5
from
Lister
7.9
from
Candler,
and
the
pictures
that
you
see
here
are
live
photos
from
the
top
of
the
mountain
where
there
is
a
large
clearing.
The
picture
on
the
left
that
shows
the
grassy
area
looks
out
over
the
city
of
Asheville,
as
well
as
Biltmore
Estate,
whereas
the
lower
right
hand
picture
where
the
trees
are
over.
There
is
a
direct
view
to
Pisgah
Mountain
so
highlight
an
overview
here.
J
This
is
where
the
property
lands,
if
you
zoom
out
I,
do
want
to
take
the
opportunity
to
recognize
right
now.
We're
all
very
aware
that
there
was
a
fire
this
past
weekend
at
Spivey.
Mountain
I
do
want
to
acknowledge
the
firefighters,
First,
Responders
and
volunteers
that
responded
to
that
and
and
did
such
an
excellent
job
of
taking
care
of
that
and
and
getting
that
fire
under
control.
J
That
is
north
of
this
piece
of
property.
So
you
can
see
the
outline
here
in
blue
of
the
piece
of
property
that
we're
looking
at
so
that
fire
was
north
of
this
property
and
did
not
affect
this
piece
of
property.
You
can
see
it's
about
342
acres
and
you
can
see
its
relevant
location
to
the
the
highway
there
to
the
north,
Patton
Avenue
and
then
I-40
to
the
South.
J
So
the
property
status
is
that
this
piece
of
property,
as
of
March,
is
currently
owned
by
a
single
conservation-minded
individual.
Who
is
interesting
in
preserving
this
area
in
this
location,
they're
working
with
sac
in
order
to
give
a
three-year
option
for
the
purchase
of
this
property
as
a
potential
for
raising
funds
to
make
it
a
piece
of
property
for
the
county
and
what
the
southern
Appalachian
Highlands
Conservancy
has
done.
Is
they
have
applied
for
a
grant
through
the
land
and
water
conservation
grant
funding
in
the
amount
of
a
little
bit
over
four
million
dollars.
J
The
piece
of
property
is
with
a
three-year
option
to
purchase
that
Sac
has
would
be
approximately
8.8
million
dollars,
and
so
there
would
be
a
variance
of
approximately
4.4
million
dollars
that
would
need
to
be
raised
for
funds
in
order
for
the
purchase
of
this
property
and
through
that
Grant,
what
it
would
do
is
it
would
preserve
this
piece
of
property
for
more
than
95
percent
of
it
would
be
under
a
conservation
easement,
and
what
that
means
is
here
in
this
slide,
which
is
that
it
would
allow
for
minimal
development,
including
multimodal
unpaved
trails.
J
What
we're
looking
at
is
the
southern
Appalachians
Highland
conservacy
is
expected
to
meet
that
deadline
of
within
three
years
raised
enough
funds
for
the
purchase
of
that
property
and
County
donation,
which
would
come
in
early
2026.
J
K
Thank
you,
Commissioners
and
thank
you,
commissioner
Wells
for
summarizing
the
project.
You
really
summed
it
up
beautifully.
This
is
a
place
that
we
have
an
opportunity
to
conserve
for
wildlife,
Scenic
Beauty,
perhaps
more
importantly,
a
place
that
people
can
get
to
and
access
and
that's
both
for
you
know,
enjoyment
just
getting
out
in
nature,
taking
a
walk
so
good
for
our
health
and
well-being
and
then
also
education
for
young
people
to
be
able
to
have
class
experiences,
learn
about
Wildlife
forest
habitat.
K
So
it's
a
terrific
opportunity
and
we
value
the
opportunity
to
work
with
the
county
on
on
conserving
the
property
and
and
hopefully
con
converting
it
to
a
park,
and
we
are
sensitive
to
the
need
for
master
planning
feasibility
study.
We
really
as
an
organization
we're
in
the
forever
business,
and
so
we
know
that
the
outcome
for
the
future
is
is
best
if
we
carefully
plan
that
and
take
it
slow
and
and
are
thoughtful
about
about
the
facilities
that
would
be
there
and
the
feasibility
and
and
all
those
details.
K
K
Federal
sources
also
additional
State
sources,
and
then
we
would
approach
private
philanthropic
donors
for
money
to
to
be
able
to
meet
the
the
overall
cost
of
the
project
so
happy
to
try
to
answer
any
questions
you
might
have
about
details
of
the
conservation,
easement
or
other
aspects
and
I
know.
Jay
will
have
some
some
insights
to
share
too.
L
Thanks
Commissioners
I
know,
several
people
in
the
room
have
been
to
this
place,
which
is
great,
and
we
certainly
want
everybody.
That's
interested
to
to
come
out
and
have
a
have.
A
good
experience
with
us.
I
would
just
add
to
what
Carl
said
that
this
property
was
listed
on
the
real
estate
market,
and
this
is
often
a
position
that
we
find
ourselves
in
in
the
local
Conservancy.
L
Well,
the
national
Conservancy
movement
property
gets
listed
and
then
you're
in
sort
of
a
panic
mode,
and
so
we're
really
excited
that
we
have
this
opportunity
at
all.
The
property
was
listed
for
10
million
dollars,
and
the
only
thing
I
would
add
is
that
the
more
quickly
we
can
move,
the
less
the
property
will
cost
at
transfer,
because
the
calculation
that
you
saw
on
your
screen
of
8.8
million
dollars
is
a
calculation
above
the
contract
price
that
the
property
was
purchased
for
by
the
conservation-minded
buyer.
So
moving
quickly
is
in
all
of
our
benefits.
D
I've
got
one
I
think
this
is
for
Carl
or
Jay
or
both
you
know
your
organization.
Does
this
a
lot
or
I
presume
tries
to
do
this
kind
of
thing
a
lot
so
I
I,
think
I
know
in
the
back
of
my
head.
What
I?
How
I
would
answer
this
question,
but
I
want
to
hear
hear
from
you
guys.
L
So
at
our
founding,
our
organization
was
created
to
protect
a
corridor
for
the
Appalachian
Trail
through
the
highlands
of
Rhone
in
a
area
of
extreme
ecological
sensitivity,
and
sometimes
it's
hard
to
share
places
that
have
extreme
ecological
sensitivity
with
the
public.
We
see
right
now,
especially
during
covid
places
that
are
being
loved
to
death
and
those
are
the
extremely
beautiful
places
that
are
Scenic
and
instagramable,
and
we
are
very
excited
about
this
project
in
particular,
because
Roan
Mountain,
where
our
founding
was
is
about
an
hour
and
a
half
from
here
and
deaverview
mountains.
L
Spivey
mountain
is
about
10
minutes
from
here,
and
the
other
thing
we
saw
during
covid
was
people
without
cars.
People
who
have
limited
Transportation
options
had
a
very
difficult
time
getting
outside
and
having
the
mental
health
and
physical
health
benefits
of
spending
time
outside,
which
is
what
doctors
said.
We
should
all
be
doing.
L
We
should
all
be
outside
more
during
a
pandemic
and
an
upper
respiratory
pandemic
in
particular,
and
that
was
really
hard
for
a
lot
of
people
and
when
this
property
came
on
the
market-
and
we
saw
the
accessibility
off
of
deaverview
Road
and
the
proximity
to
the
place
where
our
office
is
located
Asheville,
we
got
very,
very
excited
because
it
so
far
we
have
not
found
a
lot
of
rare
plants.
G
Kind
of
building
on
that
a
question
for
Allison,
could
you
share
some
some
thinking
about
sort
of
equity
and
access
and
how
a
sort
of
a
a
park
or
resource
like
this
could
be
made
as
it
could
be
made
accessible
to
folks
who
might
not
otherwise
be
able
to
access
Wilderness
areas
or.
J
Yeah
most
definitely
I
appreciate
the
question,
because
I
would
say
that
Equity
is
really
at
the
core
of
what
we're
doing
as
we're
looking
to
offer
services
to
the
community,
recreational
and
educational
opportunities.
We're
currently
undergoing
getting
ready
to
undergo
a
master
plan
for
the
recreation
department
and
being
able
to
reach
out
to
the
community
and
find
out
what
it
is
that
they
would
like
to
see
in
recreational
opportunities
in
their
areas.
What's
important
to
them.
J
It
would
definitely
be
something
that
we
would
be
focusing
on
having
groups
where
we're
specifically
reaching
out
to
the
immediate
neighborhoods
in
particular,
to
see
what
it
is
that
those
folks
would
like
to
see
from
this
type
of
a
piece
of
property
and
how
they
would
like
to
see
it
come
to
fruition
and
then
also
looking
outside
of
that
throughout
the
county,
for
what
kind
of
amenities
that
they
would
like
to
see
from
this
type
of
an
asset.
In
order
to
be
able
to
enjoy
the
beauty
and
pristine
of
what
it
currently
is.
I
E
Fine,
okay,
one
of
the
questions
I
have-
and
you
know
you
I've-
been
I-
was
born
and
raised
to
have
always
lived
in
the
hills
and
I've
been
up
the
spot
of
him
out
in
a
diva
view.
Whatever
we
call
it,
I
went
the
first
round
and
it's
beautiful
the
land
and
all
and
I
think
for
what
we
want
to
do
with
it.
But
one
of
the
questions
I
have
is:
did
we
approach
the
state
about
this
and
the
reason
I
asked
that?
E
Let
me
tell
you
why
I'm
asking
you
know
when
I
look
on
the
other
end
when
we
start
this
matter
of
fact,
I'll
be
off
the
commission
then,
but
as
a
taxpayer,
when
I
look
at
what
we're
getting
into
something
that
Buncombe
County
has
not
done
before,
and
this
is
going
to
be
expensive.
We'll
need
a
ranger
we're
going
to
need
a
lot
of
others,
but
my
deal
is
my
question
is:
would
it
have
been
cheaper
if
we
talked
to
the
state
about
this?
Who
already
have
the
structure
to
do
it?
E
J
K
We
we
are
working
with
the
state
to
help
raise
funds
for
the
project
and
the
state
parks
division
would
be
supporting
our
effort
to
apply
for
federal
funds
for
the
park,
and
you
know
I
think
we
could
talk
with
the
state
about
whether
they
would
consider
having
a
state
park
unit
there.
The
state
is
currently
creating
a
state
park
in
hominy
Valley
at
pisk
of
you
state
park
and
I.
K
Think
as
we
approached
the
project
thought
that
the
scale
of
the
size
of
the
property
and
the
fact
that
the
state
is
creating
another
state
park
in
the
county
led
to
us
thinking
that
a
locally
created
and
controlled
Park
might
be
a
more
workable
solution.
But
the
you
know
we
we
do
have
a
great
relationship
with
our
partners
at
the
state.
L
Yeah
I
think
the
we
we
talk
to
the
same
individuals
about
this
project,
whether
it's
a
county
park
or
a
state
park,
because
the
funds
that
the
state
directs
are
through
the
land
of
water
conservation
from
Stateside
assistant
grants
program
and
they
sort
of
give
guidance
for
where
they
think
the
money
ought
to
flow.
And
so,
when
we
approached
them
about
this
project,
they
thought
of
it
as
a
local
park
that
would
be
paid
for
in
part
by
State
Park
dollars.
L
So
we
we
gave
them
the
opportunity
if
they
wanted
to
have
a
state
park
on
deaverview
mountain
and
they
recommended
that
they
help
us
raise
the
money
for
for
a
county
park.
Since
the
county
was
also
expressing
interest.
C
A
Thank
you
all
and
I'll
share
just
a
few
additional
comments,
so
we
we
know
Green
Space
is
now
widely
viewed
as
a
health,
promoting
characteristic
of
residential
environments
and
has
been
linked
to
Mental.
Health
benefits,
as
well
as
reducing
mental
fatigue
and
stress
and
parks
are
Central,
are
a
Central
Community
infrastructure,
bringing
people
and
families
together
and
additionally,
with
this,
this
potential
project.