National Association of Counties
Washington, D.C.

 Workshops explore cutting-edge issues for counties



A work group considers how to communicate approval of new landfill for coal ash from power plants during an exercise at the Staying on Point: It’s the Message workshop.

NACo’s Annual Conference: County Solutions and Idea Marketplace provides excellent workshops for learning timely and relevant information about issues important to county government. The following report highlights educational sessions from the Tarrant County, Texas conference.  

(Several of the workshops were recorded with audio and slides from the presentations available at NACo’s website — free to conference attendees, or for a fee to non-attendees. Visit

Saturday, July 20

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Sunday, July 21Monday, July 22


• LEAN County Government

Who spoke?

  • Laurie Klupacs, interim executive director, Association of Minnesota Counties (AMC)
  • Toni Smith, education director, AMC 

G.K Maenius, Tarrant County, Texas administrator, learns how to apply LEAN principles to improve government efficiency.

What participants learned:

How to do more with less. Finding a county that hasn’t had to face this reality can be harder than quelling fears among staff that talk of efficiency studies is a code word for layoffs.

Glenn said Tarrant County participates with several other counties in a Public Employee Benefits Cooperative (PEBC) created in 1998. It developed a common plan design for all medical and dental benefits for its members, including Dallas, Denton and Parker counties.

"It’s not about laying off staff,” Smith said. “It’s about figuring out how what you do adds value and eliminating anything in the process that doesn’t add value.”

That said, after an efficiency analysis, such as the waste-busting LEAN process favored by AMC, employees can find themselves reassigned, if that promotes an organization’s product and reduces waste.

She added that too much of problem-solving involves time spent brainstorming a nebulous issue, time that could be better allocated to identifying the problem that could be resolved and effect improvement.

They identified waiting, defective processes, unclear objectives and wasted movement as four of the key opponents of an effective office. The two have done LEAN training in counties across Minnesota.

Successfully analyzing processes and making them more efficient could lead to dramatically reduced backlogs, reduced lead times, improved consistency in work.

“Sponsors must be open-minded and willing to accept the results, or else it will be a waste of time,” Klupacs said.

(Staff contact: Laurie Klupacs and Toni Smith,, 651.789.4335)

• Modernizing Health Plans

Who spoke?

  • John Bass, vice president, United Healthcare
  • Thomas Diaz, M.D., medical director, United Healthcare
  • Tina Glenn, HR director, Tarrant County, Texas

What participants learned:

Glenn and the United Healthcare officials shared innovations that are lowering the costs of employee health care for Texas counties.

Glenn said Tarrant County participates with several other counties in a Public Employee Benefits Cooperative (PEBC) created in 1998. It developed a common plan design for all medical and dental benefits for its members, including Dallas, Denton and Parker counties.

Thomas Diaz, M.D., United Healthcare, makes a point about how the Affordable Care Act will affect county employee benefits as Tina Glenn, Tarrant County HR director, looks on.

“Diabetes is something that we’re grappling with,” she said. The PEBC has a disease-management program for people with such chronic conditions. “These individuals are closely monitored; there’s a lot of good outreach.” Their supplies are covered at 100 percent, which helps to ensure better compliance in taking their medications.

An employee without diabetes could cost a county $3,000 a year, according to Diaz. That doubles for someone with controlled diabetes, and a person with uncontrolled diabetes could cost $10,000 to $22,000 a year.

Bass said half of what counties spend on health care is preventable. Based on his company’s data, 40 percent of health care costs can be linked a single statistic: elevated blood sugar levels. Wellness and prevention programs, like the PEBC’s, can make a difference. He added that if a diabetes-prone person can lose 5 percent of their body weight, they cut their risk of developing full-blown diabetes by more than 50 percent.

Bass said one way counties can rein in their health benefit liabilities is by providing incentives, such as lower insurance premiums. Though they have upfront costs for employers, in the long run, they reduce such factors as hospital admissions and costlier readmissions, and give employees a stake in managing costs.

(Tarrant County liaison: Natalie Plunk, 817.884.1041.) 

Sunday, July 21

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Saturday, July 20Monday, July 22 


• NACo Town Hall on Preventing Community Violence

Who spoke?

  • Ron Mandersheid, Ph.D., executive director of the National Association of County Behavioral Health and Developmental Disability Directors
  • Bill Pribil, sheriff, Coconino County, Ariz.
  • Michelle Morgan, director, One Safe Place, Fort Worth, Texas

What participants learned:

After a violent act, whether it is a mass shooting or a troubled relationship that went too far, one of the first questions is invariably, “why?”

Panelists including a behavioral health scientist, a law enforcement official and a social worker agreed substance abuse, particularly alcohol, is a catalyst, especially when combined with serious mental illness.

“If they have a severe mental illness and substance abuse, there’s a high probability they’ll become violent,” Mandersheid said. “Most people with behavioral health conditions are not violent, and are, in fact, four-to-seven times more likely to be victims of violence.”

Pribil said although Coconino County has a relatively low crime rate, alcohol causes a lot of assaults.

“We struggle with it in our community, how to overcome it,” he said.

Often, that violence takes place at home, and it’s repeated.

“(There are) typically seven reported incidents to law enforcement before [victims] leave,” said Morgan, who directs a domestic violence resource center in Fort Worth. “They have the same intervention each time but don’t understand the nature of domestic violence.”

Mandersheid added that violent video games and media are an influence in enabling violent behavior, noting some games allow a player to “kill” thousands of people in an hour.

“It greatly devalues life,” he said. “If you get addicted to it, it influences your subsequent behavior.”

Mandersheid did, however, mention that the Affordable Care Act would establish a good framework for mental health treatment.

(Staff contact: Paul Beddoe,, 202.942.4234)

• Educational Forum: Solutions for Shale-impacted Counties

Who spoke?

  • Dick Gardner, Center for Rural Entrepreneurship, Lincoln, Neb.
  • Don Macke, Center for Rural Entrepreneurship, Lincoln, Neb.

What participants learned:

Gardner and Macke facilitated this highly interactive educational forum, in which participants frequently broke up into small groups. Counties as diverse as Potter County, Pa., Forrest County, Miss. and Trumbull County, Ohio joined with counties better known for their involvement in the shale gas and oil industry to learn from each other. Improved hydraulic fracturing techniques have enabled drilling in areas once deemed inaccessible or too costly.

Glenn said Tarrant County participates with several other counties in a Public Employee Benefits Cooperative (PEBC) created in 1998. It developed a common plan design for all medical and dental benefits for its members, including Dallas, Denton and Parker counties.

Richard Gardner, Center for Rural Entrepreneurship, Lincoln, Neb., tells attendees at the Solutions for Shale-impacted Counties forum that increased housing demand is typical during resource booms.

More experienced counties, from states like North Dakota and Colorado, offered advice while all participants benefited from the facilitators’ expertise. They outlined four phases of past natural resource booms: planning, development, production and reclamation.

Counties new to the game can expect to deal with land use planning, infrastructure and social issues — such as friction between newcomers and old timers, and increases in crime and domestic violence, among others.

However, participants from counties with longer track records with the industry said benefits can outweigh perceived risks. Officials from Pennsylvania touted working with the industry to obtain funding to improve first responder training for gas emergencies. In Sublette County, Wyo., gas companies helped local officials construct an emergency medical facility closer to the gas fields, which also serves local residents.

Tarrant County, Texas Judge Glen Whitley, a NACo past president, offered his county’s expertise in working with the shale gas industry — which is firmly established in the Fort Worth area — to counties where the industry is emerging. “We’ll be glad to set up a workshop,” he said. “We’ll sit down and we’ll plan an agenda that will bring folks from the cities, from the oil and gas companies, the pipelines, all of that, and we’ll help.”

Gardner and Macke said partnerships, sooner rather than later, can make all the difference. The keys to a successful experience, they said, are to take the potential boom seriously; get organized; think strategically; and to stay ahead of the curve.

(Staff contact: Therese Dorau,, 202.942.4224)

• Post-Adjudicated Programs and Smart Justice

Who spoke?

  • Brent Carr, judge, Tarrant County, Texas Criminal Court
  • Cynthia Velasquez, program manager, Tarrant County, Texas Drug Impact Rehabilitation Enhanced Comprehensive Treatment (D.I.R.E.C.T.)
  • Kathryn Omarkhail, professional staff, Tarrant County, Texas Family Court Services
  • Courtney Young, program manager, Tarrant County, Texas Veteran’s Court
  • Jim Sinclair, assistant director, Tarrant County, Texas Felony Alcohol Intervention Program (FAIP)

What participants learned:

Tarrant County, Texas has several post-adjudication programs currently in operation. The panel included representatives from these programs and examined phases of specialty court programs. 

Glenn said Tarrant County participates with several other counties in a Public Employee Benefits Cooperative (PEBC) created in 1998. It developed a common plan design for all medical and dental benefits for its members, including Dallas, Denton and Parker counties.

Judge Brent Carr, Tarrant County, Texas Criminal Court, gives an overview of jail diversion programs as Courtney Young of the county’s Veterans Court listens.

Carr gave an overview of the different programs the county uses to help prevent non-violent offenders from being put in jail. How the programs are funded and how much counties saved was also addressed. County jails cost 500 percent more than the most expensive adjudication program ($10 per day).

“There are more startup funds for these programs than sustaining (funds),” Carr said. “These programs sell themselves but need local partnerships to withstand the costs.”

Non-violent offenders have two options in Tarrant County when it comes to supervised treatment according to Velasquez. D.I.R.E.C.T. Diversion and D.I.R.E.C.T. Drug Court offer non-violent offenders a judicially supervised treatment regimen in three or four phases over 12 months. The program has a 62 percent completion rate and 21 percent recidivism rate.

Omarkhail focused on the issue of mental health and how Tarrant County designed its diversion program to keep mentally impaired offenders out of the traditional criminal justice process and direct them into appropriate rehabilitation options.

Young said veterans who are currently facing prosecution for one or more criminal cases can find appropriate rehabilitative options.

“Most vets with mental health issues have them as a result of years in the field of combat,” Young said. “The veteran’s court helps rehabilitate them back to a normal life with their families.” 

Sinclair concluded the workshop by talking about how the FAIP program helps high-risk repeat DWI offenders with enhanced supervision and individual accountability when it comes to alcohol abuse.

(Tarrant County Liaison: Kathryn Omarkhail,, 817.884.3755.) 

• Staying on Point: It’s the Message

Who spoke?

  • Todd McGee, moderator, communications director, North Carolina Association of County Commissioners (NCACC)
  • Jessica Beyer, communications director, Blue Earth County, Minn.
  • Lori Hudson, communications director, Hillsborough County, Fla.
  • Dave Rose, communications director, El Paso County, Colo.

What participants learned:

The workshop offered quick tips from seasoned public information officers (PIO) on how to craft and deliver messages to the media.

 Workshop moderator McGee, National Association of Counties Information Officers president, briefly discussed how to construct a message, treat the media and prepare for an interview.

The best advice when delivering a message, the PR experts said, is to stick to the three main points you deem most important, and reinforce them as often as possible. Research has shown that when presented with a litany of facts, most listeners can only reliably recall about three of them. So don’t waste an interview opportunity by trying to cram in too much information. Don’t be evasive, but stay on-message.

Participants then broke into four groups, with each group given a controversial decision that needed to be communicated to the media. The group was to craft a message and select a leader who would participate in a mock news conference. The PIOs acted as reporters, while all audience members were invited to play reporter as well. After the news conference, the groups critiqued their spokespersons and messages.

There was time for questions and answers after the presentations with many participants interested in how to handle the media during major disasters or incidents.

(Staff contact: Jim Philipps,, 202.942.4220)

• Health Reform Impacts to County Employees’ Health Benefits

Who Spoke?

  • Rick Johnson, senior vice president, public sector health practice leader, Segal Consulting
  • Susan Meholic, head, business operations and product, public and labor segment, Aetna
  • Robin Vincent, benefits administrator, Harris County, Texas

What participants learned:

The speakers offered their advice and perspectives on issues counties will face during fuller implementation of the Affordable Care Act this year and next.

Glenn said Tarrant County participates with several other counties in a Public Employee Benefits Cooperative (PEBC) created in 1998. It developed a common plan design for all medical and dental benefits for its members, including Dallas, Denton and Parker counties.

Robin Vincent, benefits administrator, Harris County, Texas, explains potential impacts of the Affordable Care Act on her county’s employees’ health benefits.

Johnson said, “We now have something that is changing the entire playing field. First off, there are new and many more stringent requirements that public sector plans have to meet that they’ve never really had to meet before…. Importantly, the federal government is now a player in every one of your plans, whether you want it or not, or whether you like it or not.”

He added that the state health exchanges — now called marketplaces — that go online Jan.1, 2014 will be another major change. “Keep in mind you’re going to have not only your usual competitors or vendors out there to deal with in terms of benefits but also perhaps even more cost-effective approaches through these exchanges.”

Johnson and Harris County’s Vincent both stressed that counties will have consider how to deal with variable-hour and seasonal employees who are not classified as fulltime.

“What do you do with those people you hired to mow the grass, to be lifeguards and others where they may be working fulltime for parts of the year?” Johnson asked. “You’ve got to figure out whether now they should be offered coverage as well” — and how that will affect county budgets.

Vincent called this the biggest challenge her county has faced thus far in implementing the ACA, and sorting it out can’t be accomplished in a human resources vacuum. Other departments such as the county attorney and IT need to be involved as well.

Vincent advised counties to provide feedback to the U.S. Department of Health and Human Services on what’s working and what’s not — and to use NACo as a resource to bridge information gaps. “We got in contact with our representative from NACo who actually got us on the phone with somebody from Health and Human Services, and they listened to us,” she said.

(Staff contact: Maeghan Gilmore,, 202.942.4261)

• Data to Dollars: Energy Tracking Best Practices for Decision Makers

Who Spoke?

  • Dustin Knutson, director of energy services, Institute for Building Technology and Safety (IBTS)
  • Brian Bell, vice president for strategy, Facility Dude

What participants learned:

Knutson pitched his organization’s energy use intensity database and explained that more participation would make the benchmarks it calculates more statistically relevant.

The measure IBTS uses divides energy consumed over a year by the total floor space in a building to yield “use intensity.” Use intensity is then indexed by type of building: office, warehouse, mixed-use.

“There are obvious differences in the way buildings are used,” he said. “Firefighters are focused on doing their jobs, and whether the garage bay door was closed when they left on the way to fight a fire is the last thing on their minds.”

He said the best way to frame energy-efficiency improvements is to reassure employees that despite the abstract purpose of reducing energy use, it would not end with cold people working in dark office buildings.

“Let them know that the money the county saves will go to keeping jobs or providing equipment,” he said.

He added that a basic inventory of building stock could make a good first step to recognizing how much energy was used in various county facilities.

“You’d be amazed how many people don’t have a list of their buildings,” he said.

He also said it is important to establish energy savings goals with appropriate context.

“You can’t set a standing goal to cut energy use by a static number each year, like 20 percent,” he said. “The total gets smaller every year, and that 20 percent gets bigger and harder to realistically accomplish.”

Bell introduced the scientific method his organization follows when analyzing energy efficiency which includes the following:

  • Organization
  • Validation —  finding billing errors
  • Normalization —  taking into account weather swings when comparing yearly data
  • Classification —  comparing appropriate building categories
  • Investigation —  pursuing discrepancies to find problems
  • Justification —  demonstrating value in the process, and
  • Verification —  determining if something was accomplished

(Staff contact: Therese Dorau,, 202.942.4224) 

Monday, July 22

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Saturday, July 20Sunday, July 21

 • Have an Impact: Effective Grassroots Strategies

Who Spoke?

  • Deborah Cox, legislative director, NACo
  • Lisa Nolen, outreach coordinator, North Carolina Association of County Commissioners (NCACC)
  • Alissa Willett, legislative grassroots coordinator, NCACC

What participants learned:

Workshop speakers explained how counties can step up their game to get their message through to state and federal officials.

Glenn said Tarrant County participates with several other counties in a Public Employee Benefits Cooperative (PEBC) created in 1998. It developed a common plan design for all medical and dental benefits for its members, including Dallas, Denton and Parker counties.

Board Chair Fred McClure, Davidson County, N.C., participates in the Q&A session during the workshop on grassroots advocacy strategies.

Willett said, “The strongest communications we can have is elected leaders to elected leaders.” She proceeded to outline several tools and strategies her association has used to engage with state legislators and members of Congress.

She focused on the importance of having outreach and grassroots efforts closely aligned. For example, her association uses two former county managers as emissaries who serve as its “eyes and ears” throughout the state’s 100 counties. A staff advocacy team, which usually focuses on lobbying at the state capitol, visits counties during breaks or lulls in the legislative session. The lobbyists contact county managers and offer to meet with them about their issues and concerns.

“We want to encourage them [that it’s] their meeting; they come up with the agenda,” she said. “We ask them to invite county commissioners. We’ve had some counties invite every single department head in the county.” They are also asked to invite the state legislators who represent their area.

She also mentioned the association’s success in getting a former county commissioners’ caucus officially recognized by the state’s General Assembly. Twenty-seven ex-commissioners meet biweekly. They comprise a pool of lawmakers that counties can potentially tap to sponsor bills of concern to counties.

“I think the more that we can be viewed as educating and not lobbying, I think we’re really doing a service for counties of North Carolina,” Willett said.

Cox encouraged attendees to get to know their legislators in Washington — know their likes and dislikes, which committees they serve on, how they’ve voted in the past on key issues.

“It’s also very important that NACo, the state associations, individual counties know what the legislators can do for us, whether it’s to introduce or cosponsor legislation, sign ‘Dear Colleague’ letters and circulate those….”

She asked attendees to let NACo know of relationships they have with members of Congress as a source of potential connections that NACo can leverage.

(Staff contact: Tom Goodman,, 202.942.4222)

• Infrastructure Financing in the 21st Century

Who spoke?

  • Gary Fickes, commissioner, Tarrant County, Texas
  • Victor Vandergriff, member, Texas Transportation Commission
  • Michael Morris, transportation director, North Central Texas Council of Governments

What participants learned:

Morris has shepherded several regional transportation projects in North Texas, and he said leadership is crucial to creating opportunities for public-private partnerships to fund infrastructure projects.

Glenn said Tarrant County participates with several other counties in a Public Employee Benefits Cooperative (PEBC) created in 1998. It developed a common plan design for all medical and dental benefits for its members, including Dallas, Denton and Parker counties.

Police Juror Major Coleman, St. Helena Parish, La., takes in a presentation on infrastructure financing.

He said, “The number one ingredient to our success is the leaders, especially from the public sector, standing up and saying ‘we’re going to do something different; we’re not waiting on Congress; we’re not waiting on our State Legislature, we’re going to partner with our department of transportation and build projects.’”

Local governments, though, should treat exploring such partnerships with the same long-term commitments when deciding to work together.

Vandergriff went as far as to say the Legislature’s decreasing funding was leaving local governments in Texas without an alternative.

Morris also suggested toll roads could help defray the cost of maintenance for some roads and bridges.

“So often, those of us in the public sector are facing infrastructure costs without adequate revenue to rebuild that infrastructure,” he said. “If we had a toll or user fee on that particular facility, those revenues self-generate for reinvesting.”

Fickes discussed the use of toll-managed lanes, a type of congestion pricing that allows drivers to pay tolls adjusted by the amount of traffic in the lanes, which sometimes involves adding lanes to existing roadways.

“We’re adding capacity but giving drivers a choice,” he said.

(Staff contact: Michael Belarmino and Robert Fogel,, 202.942.4254 and, 202.942.4270.)

• FirstNet’s Nationwide Public Safety Broadband Network

Who spoke?

  • Wellington Webb, FirstNet board member

What participants learned:

Webb presented a workshop on FirstNet and what counties, whether large or rural, need to work on before the system goes live in 3–5 years.

The Middle Class Tax Relief and Job Creation Act of 2012 created the First Responder Network Authority (FirstNet), an independent authority within the U.S. Department of Commerce’s National Telecommunications and Information Administration. FirstNet is charged to create a nationwide interoperable wireless broadband network dedicated to public safety. This will enable police, firefighters, emergency medical service professionals and other public safety officials to more effectively communicate during emergencies and to use cutting-edge technologies.

“This will be the first high-speed, broadband wireless data network dedicated to public safety,” Webb said. “Involving the states, local and tribal jurisdictions early in the consultation process is critical to FirstNet’s ultimate success.”

He added that FirstNet will need to balance its goal to develop the nationwide public safety broadband network quickly against the need to conduct meaningful consultations at the regional, state, local, territorial and tribal levels.

While the act provides a basic framework for this process, it does not specify how state and local consultation should occur.

“It is imperative that counties engage in the consultation process and actively seek out the designated state coordinator(s),” Webb added. “This ensures existing local broadband and infrastructure assets are identified and included in the new network.”

(Staff contact: Yejin Jang,, 202.942.4239.)


Supervisor Peggy Romo West, Milwaukee County, Wis., shares work-life balance tips during a professional development workshop. Also pictured (l-r) are Board Chair Marina Dimitrijevic, Milwaukee County; Commissioner Alisha Bell, Wayne County, Mich.; and Councilmember Stalney Chang, Honolulu City and County.

• Finding the Work/Life Balance

Who spoke:

  • Alisha Bell, commissioner, Wayne County, Mich.
  • Stanley Chang, council member, Honolulu City and County, Hawaii
  • Marina Dimitrijevic, supervisor, Milwaukee County, Wis.
  • Peggy Romo West, supervisor, Milwaukee County, Wis.

What participants learned:

How four county officials keep their lives in order when the demands of public service and the responsibilities of their personal lives meet.

Glenn said Tarrant County participates with several other counties in a Public Employee Benefits Cooperative (PEBC) created in 1998. It developed a common plan design for all medical and dental benefits for its members, including Dallas, Denton and Parker counties.

Chang reserves time each evening to exercise and Sundays to spend with his family.  He also said it’s just impossible to do everything you’d like.

“Accept you’ll miss out on some things,” he said.

Romo West added a little flexibility to her life by routing her office phone to her cell phone while she’s out and about. Bell was single when she was elected, but her family has grown with a husband and two children in the years since. She admits she has had to miss a few performances, but makes those the priority because you can usually delegate or reschedule other things, not your kids’ performances, she said.

“Choose what you accept to be involved in, based on the issues you care about,” she said. “I’m into human services and women’s health, so what I do supports that.”

Dimitrijevic said hiring the right staff and trusting them to do their jobs is crucial to focusing her energy on the tasks she is most qualified to handle.

“Many people don’t hire the right staff,” she said. “You have friends and alliances, but in this environment, you need someone you can trust and rely on.”

As busy as she gets, she reserves the lion’s share of her time for constituents, though she tries her best, when she sees them at the grocery store on weekends, to reschedule them for Monday morning, so she can get her shopping done.

(Staff contact: Ryan Hurst,, 202.467.2361)