Conference workshops span the wide range of county interests

There were more than three-dozen workshops scheduled at the conference. Many materials and pre­sentations from these educational sessions are available to view or download from NACo.org. Use the “Media Type” filter and select “Workshop.” Following are highlights from several sessions.

Health Coverage in Jails: Important Provisions and Strategies

Who spoke?

• Glen Matayabas, chief depu­ty, Buncombe County, N.C.
• Jay Shannon, CEO of the Cook County, Ill. Health & Hos­pitals System

What participants learned:

Officials from large and small counties shared how they handle inmate medical care.

Matayabas, said his approach was to provide medical care 24 hours a day, seven days a week, though he acknowledged such service might not be feasible for all counties.

“As soon as they come in the jail, they have access to complete medical care, including prescrip­tions, dental and mental health,” he said of his 604-bed facility that processes 13,825 inmates a year. “You need to figure out what your obligation is and what is morally right. What is your philosophy?”

He said his jail has developed relationships with local hospitals to ease transitions to the care inmates will receive when they are released, and because state law allows, the county only suspends an inmate’s Medicaid coverage, rather than eliminating it.

Medicaid played a big part in Cook County’s strategy, and given the scale that a county of its size operates on, it paid off.

Shannon said that in 2012, Cook County, by virtue of Illinois’ embrace of Medicaid expansion, was able to reach out to half of the 330,000 uninsured adults in the county and sign half up for Medicaid.

“It’s completely inverted our pyramid, from one that was major­ity uninsured to one in which the majority is insured,” he said. “It was a game changer. It shrunk our uninsured population; Medicaid revenues have gone way up and dropped the amount of coverage that is uncompensated.”

That lowered the uncompen­sated total to $340 million in FY14, compared to $500 million in FY13.

Shannon agreed that the rela­tionships with community care providers was crucial to cutting down on recidivism.

“It doesn’t help to just get them coverage, you have to get them care,” he said. “Get them linked up with a primary care provider. We don’t want to lose that momentum. When you get them what they need, chances are they won’t be back.”

Staff Contact: Emmanuelle St. Jean, estjohn@naco.org, 202.942.4267

Putting the “Community” into Veterans’ Community Reintegration Efforts

Who spoke?

• Pete Buttigieg, mayor, South Bend, Ind.
• Jim Golgart, president, Na­tional Association of County Veterans Services Officers
• Nick Macchione, director, Health and Human Services, San Diego County
• Bill York, CEO, 2-1-1 San Diego
• Doug Wilson, co-founder, Veterans Community Connections

What participants learned

Vets’ Community Connections (VCC) was looking for places to pilot its community-based ap­proach to helping veterans and their families. VCC co-founder Wilson considered San Diego but initially ruled it out — because it already excelled at serving its large military community, where 170,000 active-duty military are based.

But Macchione, the county’s director of health and human services, convinced him otherwise. While the county and service agencies were connecting with vets, there was a missing link: getting the community involved in helping veterans and military families reintegrate into the com­munity. That’s a goal VCC wants to achieve in counties nationwide.

Wilson moderated and Mac­chione was one of the panelists for the workshop.

“Not every veteran coming back from the military has PTSD or has mental health issues,” Golgart said. Vets without those issues still need help to reconnect with the communities that they return to.

San Diego County is addressing the issue with its Courage to Call initiative. It’s an adjunct to the county’s 211 call line, according to York who oversees 211. “It’s partly through 211, but it’s a partnership with multiple agencies, boots on the ground.” Callers get to speak with peer specialists who are veterans about resources available in the community.

Golgart likened such programs that provide entry points into the community to “stone soup.” “We bring the stone; you make the soup,” he said. “We bring the idea, and you do it the way your community needs to have it done.”

Staff Contact: David Keen, dkeen@naco.org, 202.942.4206

Pros and Cons of Body Cameras for Law Enforcement

Who Spoke?

• Carmen Facciolo, policy advi­sor, Bureau of Justice Assistance
• Jered Shofner, sheriff, DeWitt County, Ill.

What participants learned

A year before a spate of deadly incidents involving law enforcement prompted widespread calls for body-worn cameras use by police, DeWitt County, Ill. already had its sheriff ’s office using them.

“When I worked in narcotics, we always wanted to get things on film,” said Sheriff Jered Shofner. “When I became the sheriff and saw that convictions were down, I knew there was a role for video in what we were doing.”

After the August 2014 incident in Ferguson, Mo., Shofner reported his department had a spike in interest from other agencies. And he saw the change in the criminal justice system that body-worn video was effecting.

“Civil and criminal juries re­ally expect to see video,” he said. “I’m not sure what I say as a law enforcement officer means as much, because cases are up to the jury.”

But video can also help avoid ju­ries from coming into the equation.

“If what you have is enough to convince a defendant to take a plea, that’s saving the county money because there’s no need for a trial,” he said.

Shofner’s department spent $21,000 in 2013 on 30 cameras — nearly half of what he had figured to spend on buying new cars, with another $2,000 going to upgrade storage capacity.

Shofner and Facciolo warned that storage costs are likely higher than the equipment cost for the cameras.

“I urge you to think, long term, about cost effectiveness in regard to storage,” Facciolo said. “And whether a judge will be able to access the video if it’s in the cloud.”

She said 3,500 law enforce­ment agencies in the United States were in some stage of adopting or using body-worn cameras, 45 states had pilot projects and 37 states had legisla­tion pending regarding their use.

He promoted the BJA Na­tional Body-Worn Camera Toolkit, available at www.bja.gov/bwc.

Shofner also advised counties not to abandon vehicle-mounted cameras as body-worn cameras proliferate because they could catch footage that the small, pager-sized cameras could not.

Staff contact: Jacob Terrell, jterrell@naco.org, 202.942.4236

Stepping Up Summit: Reducing Mental Illness in Jails

Who spoke?

• Nneka Jones Tapia, executive director, Cook County, Ill. Jail
• Donny Youngblood, sheriff, Kern County, Calif.

What participants learned

Mental illness has become a given in jails, but counties are on the road to change that through their engagement in Stepping Up initiative. By finding ways to divert and treat the mentally ill, counties are aiming for lower recidivism rates and lower cost per inmate as a result of not providing expensive general care that is less effective than conditions require.

“We have inmates that end up costing us $1 million a year,” Sheriff Youngblood said. “If someone in my jail needs to go to the state hospital, they’re going to be waiting for 50-plus days until a bed opens up. In the meantime, there’s only so much we can do for them.”

Hear Dr. Nneka Jones Tapia, executive director of the Cook County Jail, talk about serving inmates with mental illnesses.

Youngblood was among the experienced correctional profes­sionals who spoke at the Stepping Up Summit.

Jones Tapia described the tran­sition center within the Cook County Jail that provides cognitive behavioral treatment and follow-up attention for nonviolent offenders. Providing a smooth landing by set­ting up post-incarceration care can be eased by suspending Medicaid coverage while the inmate is in jail, rather than disenrolling them, according to Pat Fleming, retired director of Behavioral Health Ser­vices for Salt Lake County, Utah.

“Medicaid will be the payer for their services when they get out of jail, and starting them up again will take forever,” he said.

Staff Contact: Nastassia Walsh, nw­alsh@naco.org, 202.942.4289

Demographic Changes and New Mobility Patterns are Reshaping Transportation Investments and Land Use

Who spoke?

• Doug Dickerson, state director, AARP, North Carolina
• Bridget Massengill, project manager, THRIVE2055
• Beth Osbourne, senior policy advisor, Transportation for America
• Dan Saieed, director of devel­opment, Hamilton County, Tenn.

What participants learned:

Counties would do well to follow the millennials, because that’s what businesses are doing as they aban­don suburban office parks for dense, vibrant, walkable downtowns. The millennials, ages 18–34, comprise 34 percent of the workforce, the largest cohort of any age group, Massengill said.

These trends are expected to continue influence how counties grow and develop over the next several decades, speakers said.

Massengill cited a recent report, Why American Companies are Mov­ing Downtown for examples of the corporate mindset. She quoted a Rolls-Royce executive in India­napolis who said the company’s old suburban headquarters was “a liability in recruitment.”

“It is a calling card now in our recruitment efforts, that we are in the middle of downtown,” the executive said. “A lot of students coming out of engineering school, they’re not looking for suburbia. They’re looking for the downtown living environment.”

The good news for counties is that this type of development is cheaper and pays dividends, Massengill said. “Traditional downtown development costs 10 times less in terms of the provision of services, especially in terms of the deployment of infrastructure, and it generates 10 times more tax income.”

AARP’s Dickerson said the U.S. population of millennials and baby boomers — 80 million in each category — will influence land use and transportation planning trends.

He noted that one-third of millennials don’t own a car, and 25 percent of them don’t have a driver’s license — opting instead for walking, biking and transit modes of travel. And increasing numbers of people over the age of 75 no longer drive.

“That suggests that we need to relook at our transportation,” he said. “It’s not just a car-friendly environment, but more friendly to people of all ages.”

Staff contact: Kathy Nothstine, knoth­stine@naco.org, 202.661.8807

Reducing Fatalities and Serious Injuries on County Roads

Who Spoke:

• Brian Roberts, executive direc­tor National Association of County Engineers

What participants learned:

Roberts celebrated a turning point in the Toward Zero Deaths roadway safety campaign — the January endorsement by U.S. Trans­portation Secretary Anthony Foxx.

“We embrace the vision of Toward Zero Deaths,” Foxx said at the time. “It provides an overarching and common vision that drives and focuses our efforts to achieve our shared goals to eliminate injuries and fatalities on our roadways.”

Roberts was thrilled when he heard that.

“This was huge,” he said. “When the secretary of transportation said that all of his agencies were on board, so we had local, state and federal buy-in.”

Some national organizations, Roberts said, were leary of endors­ing the plan because they viewed “zero” as a statistic, rather than an idealized vision.

“We’ll never get to zero, but we’re working toward it,” he said. “Every county can take steps to get closer. The bottom line is that if you asked elected officials what number of roadway deaths was acceptable, they would all say zero.”

He outlined the measures that counties could take in getting closer to that target. Chief among them were education and enforcement efforts to cut down on distracted driving, intoxicated and impaired driving, seatbelt misuse and exces­sive speed.

“As our technology increases in our cars, there will be transponders on dangerous curves that will send a message to cars to tell them they’re going too fast,” he said. “The ques­tion will be who will be responsible for those transponders.”

He also stressed the need to protect vulnerable users, including pedestrians and bicyclists. He ac­knowledged that there are tradeoffs between road safety measures, like rumble strips, and growing con­stituencies such as bicyclists who don’t want them because it makes bicycling more difficult.

Staff Contact: Brian Roberts,broberts@naco.org, 202.393.5041