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HomeMy WebLinkAbout2019/01/28 - ADMIN - Agenda Packets - City Council - Study Session (2)AGENDA JANUARY 28, 2019 5:30 p.m. CLOSED EXECUTIVE SESSION – Westwood room Discussion items 1. 5:30 p.m. City manager performance evaluation 6:30 p.m. STUDY SESSION – Community room Discussion items 1. 6:30 p.m. Future study session agenda planning 2. 6:35 p.m. Climate action plan update 3. 8:05 p.m. Emergency medical services/community health management 8:35 p.m. Communications/updates (verbal) 8:40 p.m. Adjourn Written reports 4. Fourth quarter investment report (Oct. – Dec. 2018) 5. Senior Community Services Annual Report 6. Crime/drug free rental housing workgroup process Auxiliary aids for individuals with disabilities are available upon request. To make arrangements, please call the administration department at 952/924-2525 (TDD 952/924-2518) at least 96 hours in advance of meeting. Meeting: Closed Executive Session Meeting date: January 28, 2019 Discussion item: 1 Executive summary Title: City manager performance evaluation Recommended action: Consultant Scott Morrell from Rebar Leadership will facilitate a discussion with the city manager and council regarding feedback collected from the performance evaluation. City council and City Manager Tom Harmening will review the information and set general direction for 2019. Policy consideration: Not applicable. Summary: The city council and city manager will discuss the city manager’s performance evaluation in a closed executive session. The information will be sent to city council under separate cover. Once completed, final documents will be presented for formal approval at the next regular council meeting. In accordance with Minnesota open meeting law, this meeting will be audio taped. The law states: “All closed meetings, except those as permitted by the attorney-client privilege, must be electronically recorded at the expense of the public body. Unless otherwise provided by law, the recordings must be preserved for at least three years after the date of the meeting.” Financial or budget considerations: Not applicable. Strategic priority consideration: Not applicable. Supporting documents: None Prepared by: Ali Timpone, HR Manager Reviewed by: Nancy Deno, Deputy City Manager/HR Director Approved by: Tom Harmening, City Manager Meeting: Study session Meeting date: January 28, 2019 Discussion item: 1 Executive summary Title: Future study session agenda planning Recommended action: The city council and city manager to set the agenda for the regularly scheduled study session on Feb. 11, 2019. Policy consideration: Not applicable. Summary: This report summarizes the proposed agenda for the regularly scheduled study session on Feb. 11, 2019. Also attached to this report is: -study session discussion topics and timeline -Proposed topic for future study session discussion: Accessory dwelling units/home- based businesses - proposed by councilmember Rog Financial or budget considerations: Not applicable. Strategic priority consideration: Not applicable. Supporting documents: Tentative agenda – Feb. 11, 2019 Study session discussion topics and timeline Study Session proposal - Accessory dwelling units/home-based businesses Prepared by: Debbie Fischer, Administrative Services Office Assistant Reviewed by: Maria Carrillo Perez, Management Assistant Approved by: Tom Harmening, City Manager Study session meeting of January 28, 2019 (Item No. 1) Page 2 Title: Future study session agenda planning Feb. 11, 2019. 6:30 p.m. – Study session – Community room Tentative discussion items 1.Future study session agenda planning – Administrative services (5 minutes) 2.2019 bonding overview and financial model update – Administrative services (90 minutes) Staff and Stacie Kvilvang from Ehlers and Associates (municipal advisor) will review the 2019 bonding and we will review our long range forecasting. 3.Elections outreach and education – Administrative services (45 minutes) An overview of our planned and ongoing efforts to educate residents on ranked-choice voting and elections generally. Demonstrations of presentations, tools and materials that will be provided to residents along with a detailed review of our outreach timeline. Communications/meeting check-in – Administrative services (5 minutes) Time for communications between staff and council will be set aside on every study session agenda for the purposes of information sharing. Written reports 4.Open to Business annual report 5.Proposed allocation of 2019 Community Development Block Grant (CDBG) funds 6.Smart City building ready ordinance End of meeting: 8:55 p.m. Study session meeting of January 28, 2019 (Item No. 1) Page 3 Title: Future study session agenda planning Study session discussion topics and timeline Discussion topic Comments Date Scheduled Finalize Council Norms Reviewed on 5/7/18; adoption postponed on 5/21/18. To be discussed at Jan. Retreat Feb. 2019 Firearm sales Discussed 5/21/18 & 7/23. Written report provided at 9/24 study session. PC currently reviewing ordinance options. Policy on city facilities adopted 10/15 1st Qtr. 2019 Zoning guidelines for front-facing buildings with windows not papered Discussed 7/9/18. Referred to PC for review & recommendation. 1st Qtr. 2019 Design guidelines - New home construction Discussed 7/9/18. Referred to PC for review & recommendation. 1st Qtr. 2019 Retail/service/liquor stores size Discussed on 6/11/18; referred to PC. Discussed 11/26/18 Ongoing Crime free ordinance/affordable housing strategies Discussed 5/14/18. 1st reading housing trust fund 10/1/18; Other affordable housing strategies/Crime Free Ordinance – Nov/Dec, 12/10/18 crime free ordinance letter suspension Ongoing Revitalization of Walker Lake area Part of preserving Walker building reports: 8/28/17, 9/25/17, 1/22/18, design study 2/12/18, update 4/23/18, design study update 8/27/18 Ongoing Immigration & supporting families Discussed 8/6 and referred to HRC. HRC held comm. mtg. in Oct. Council/HRC discussion on 12/10; referred back to HRC for refinement of recommendations. TBD Discuss and evaluate our public process TBD STEP discussion: facilities Discussed on 1/14/19 TBD Easy access to nature, across city, starting with low-income neighborhoods TBD SEED’s community greenhouse/resilient cities initiative TBD Community center project TBD Utility pricing policy TBD Establish a local housing trust fund Completed 10/15/18 Board and commission work plan process Completed 11/26/18 Study session meeting of January 28, 2019 (Item No. 1) Page 4 Title: Future study session agenda planning Meeting: Study session Meeting date: January 28, 2019 Discussion item: 2 Executive summary Title: Climate action plan update Recommended action: The purpose of this report and study session is to provide an overview of recent actions and initiatives in support of the Climate Action Plan (CAP) as well as proposed and recommended actions for 2019. Policy consideration: Does the city council support continuing efforts in the area of energy efficiency, renewable energy, outreach, engagement, and new policy ideas such as adopting a benchmarking disclosure ordinance? Summary: In February 2018, the council adopted a Climate Action Plan for the community of St. Louis Park. The plan was developed through partnership with the Environment and Sustainability Commission (ESC) and with youth from the Roots and Shoots Environmental Club (RSEC). This plan includes an ambitious overarching goal of carbon neutrality by the year 2040. Carbon neutrality, having a net zero carbon footprint, refers to achieving net zero carbon emissions by balancing a measured amount of carbon released with an equivalent amount sequestered or offset, or through buying carbon credits to make up the difference. The CAP is a roadmap that includes mid-terms goals, initiatives, and actions that are considered necessary to achieve the overarching goal over time. The baseline year for the data is 2015, which was the most complete and recent data available for the entire inventory during 2016-17 when the plan was being developed. Comparisons to how we are doing will usually be compared to the baseline year of 2015. The environment and sustainability commission has been a strong supporter in the CAP development and will continue to provide outreach and education in the upcoming years in our continued journey with CAP implementation. Study session presentation: Staff understands there is a large amount of information summarized in this report and it is expected there are many questions and ideas regarding CAP, sustainability and progress. At the study session, staff and consultant will have a presentation and will provide additional information on the data/charts in the report along with additional information on CAP progress, data and future considerations. We will also have time for council discussion and questions. Financial or budget considerations: No specific budget item to consider at this time. Strategic priority consideration: St. Louis Park is committed to continue to lead in environmental stewardship. Supporting documents: Discussion Prepared by: Shannon Pinc, Environment and Sustainability Coordinator Reviewed by: Nancy Deno, HR Director/Deputy City Manager Approved by: Tom Harmening, City Manager Study session meeting of January 28, 2019 (Item No. 2) Page 2 Title: Climate action plan update Discussion CAP 2018 Actions – Municipal It is important that the city leads and inspires others to act. It is equally important that we educate while also removing barriers to participation. The city has started and completed many actions listed in the CAP. Below is a summary of ongoing work in our journey in CAP implementation. Three Kick-Start Projects 1)Supporting youth initiatives to increase energy efficiency and renewable energy in the community •Climate Action Plan kickoff event. •Supporting their business climate pledge efforts in identifying businesses who are interested in learning more about how they might participate. •Working with the youth and school district to align goals from the CAP with the projects the district is working on. •This work continues and will be ongoing. 2)Develop Climate Action Plan Resource Hub •New pages and content have been developed to help everyone in the community learn more about the plan and resources that pertain to them. •This hub will be constantly updated as needed, and as new programs and resources are developed or identified by city staff, consultants, and members of the ESC and RSEC. •One unique tool recently developed this year, in partnership with the Great Plains Institute, is a solar suitability map that helps any building owner in the city assess the solar potential for installing solar photovoltaic energy systems on their roof. Study session meeting of January 28, 2019 (Item No. 2) Page 3 Title: Climate action plan update 3)Install electric vehicle (EV) charging infrastructure in public parking lots Expanding EV charging capabilities is important to encourage and support transitioning to a lower carbon automobiles option. However, before expanding electric vehicle supply equipment (EVSE), it was critical for other actions related to EV expansion were addressed first. •Staff worked on creating an ordinance requiring levels of ESVE as part of building readiness. This ordinance was worked on throughout 2018 in partnership with the planning commission and is close to adoption. •Throughout 2018 various city staff participated in a larger cohort of cities exploring all aspects of EVs facilitated through the GreenStep Cities program. The program, Cities Charging Ahead, allowed staff to learn from experts as well as share knowledge with each other. Webinars, in-person meetings, and sharing of best resources were the main offerings of the program. However, in addition, because of our participation, we were able to receive a partial fleet analysis at no cost to the city, using FleetCarma. Xcel Energy sponsored the cost of this analysis that will be used to help determine appropriate city vehicles for replacement to EV or hybrid models. Results of this study are forthcoming. •EVSE was included as a requirement for the Westwood Hills Nature Center project even though the ordinance wasn’t final at that time. •In 2019, city staff will focus on which city-led projects are required to include EVSE based off the ordinance, while also looking at what additional features we should consider for these projects. Other Activities In addition to completing and continuing work on the kick-start projects, other more recent efforts help contribute to the other goals, initiatives, and actions listed in the plan. Here is a partial list: Study session meeting of January 28, 2019 (Item No. 2) Page 4 Title: Climate action plan update •Successful Climate Action Plan Kickoff Event on Earth Day in partnership with ESC and RSEC and hosted or attended other events such as Ecotacular and Solar Power Hour Bulk Buy •Energy efficiency projects in several city buildings have been completed and more are scheduled in 2019, including Rec Center •New Westwood Hills Nature center design and construction to be zero energy •Solar installations and Renewable-Connect accounts at city buildings •Switching a large number of gas powered hand tools/equipment to electric •Reanalysis on fleet and shifting of planned purchased to more energy efficient equipment/vehicles •Planning and replacing LED lighting in buildings and street lights •Piloting improved deconstruction methods on properties owned by the city to reduce/reuse waste and reduce emissions •Purchase of a home in the city to retrofit for energy efficiency and use as an education piece for our community •REC Center will be undergoing an energy analysis with the Center for Energy and Environment (CEE). This analysis will provide staff with an outline of best next steps for improvements and will allow us to plan and budget as needed •Street projects in engineering department is using Living Streets and Complete Streets principles reduces emissions •Worked together with Hennepin County and partner cities to develop pilot program for county-wide benchmarking ordinance, securing technical and facilitation assistance (at no cost to city) for working through the development and engagement process of such an important policy •Hired and trained intern to support sustainability efforts, development of communication/education materials and data collection •Hired consultant in 4th quarter 2018 to develop and implement CAP initiatives in 2019 and also develop a timeline on projects, initiatives and estimated outcomes/target dates for CAP 2019 to 2040 •Expanding solar at the MSC in 2019 and with the reroof at the Rec Center it is solar ready and is being reviewed for future consideration. •Moving staff support of ESC meetings to principal planner in January 2019 to allow more time for the environment and sustainability coordinator to develop strategic plans, programs, education and outreach for continued CAP implementation •Formalizing a partnership with the school district on the CAP and presenting to school board (scheduled for February 2019) •Mayor Spano is now part of a national network called Climate Mayors. Climate Mayors (aka the Mayors National Climate Action Agenda) is a Mayor-to-Mayor network of US Mayors collaborating on climate action Municipal Energy Use and Emissions – B3 Benchmarking data source (B3) B3 stands for Buildings, Benchmarks, and Beyond. This tool is available for all public buildings in Minnesota and is managed by The Weidt Group and funded by the MN Department of Commerce. Using basic building and meter information, the online tool summarizes energy consumption, costs, and carbon emissions for reporting purposes. Study session meeting of January 28, 2019 (Item No. 2) Page 5 Title: Climate action plan update Eight key municipal buildings are tracked historically in B3: City Hall, Police Station, Fire Stations 1 and 2, Rec Center (including the addition of the ROC in 2017), Westwood Hills Nature Center, Municipal Service Center and Hamilton House. This does not include all metered accounts attributable to municipal use. Street lights, park buildings, pump stations are not included in B3 but adding remaining municipal meters, including water, is an important next step to better manage all our use and associated emissions. Annual energy use for key buildings dropped slightly in 2016 attributed to warmer than average winter temperatures. Note condensed scale above Study session meeting of January 28, 2019 (Item No. 2) Page 6 Title: Climate action plan update Renewable Energy Solar Production- 2 Buildings Municipal Service Center Fire Station #2 55,232 kg = 55.232 metric tons 31,464 kg = 31.464 metric tons A megawatt is 1 million watts of power. Electricity generators are often measured in megawatts of peak power generation capacity. A megawatt hour is one million watts of electrical power used for 1 hour. It refers to an hour of electrical energy equal to this amount. Solar power plays an important role in our energy supply, providing the clean energy that our community wants and values. We have installed municipal solar arrays on two buildings thus far and could consider expanding projects to show the leadership and value of the emissions reductions from using renewable energy. The solar production in 2018 helped reduce emissions approximately 10% from 2017 levels. Expansion of solar on the Municipal Service Center is proposed for 2019. Renewable-Connect Subscriptions – 4 Buildings Xcel Energy’s Renewable-Connect is a newer renewable energy option offering a convenient way to meet sustainability goals using dedicated wind and solar resources. The first offering of this program provided monthly, 5 year, and 10 year subscription options with a pricing plan. The program price, which varies by agreement length, automatically replaces the fuel surcharge on our bill and is shown as a credit that partially offsets the subscription price. Although this is an additional cost, the payoff is that it achieves a reduction of 100% emissions from electricity sources for participating buildings during the life of the subscription. Pricing and options for the second round of Renewable-Connect is not yet known but should be considered for expanding to additional buildings and/or extending or entering into new, longer subscriptions for buildings already on the program once the program details are shared by Xcel Energy. In the case of City Hall and the Police Dept, this program has helped reduced emissions by approximately 66% and 74%, respectively. Study session meeting of January 28, 2019 (Item No. 2) Page 7 Title: Climate action plan update Renewable-Connect Costs (2018 and projected) Building 2018 Fees Expected total over 5 year contract * City Hall $ 3,035.01 $ 15,175.05 Fire station #1 $ 1,627.70 $ 8,138.50 Police Dept $ 3,011.45 $ 15,057.25 Fire Station #2 $ 648.28 $ 3,241.40 Total All 4 Buildings $ 8,322.44 $ 41,612.20 * Assuming same amount of energy use at each facility for remaining 4 years. All municipal accounts to Xcel Energy cost $1,214,561 in 2017. Renewable-Connect is an increase premium of about 0.7% for one year. For these eight buildings, overall energy consumption is down almost 5% while emissions are down by 27% against the baseline year of 2015. Reduced consumption across many buildings and renewable energy invested in four buildings, along with Xcel Energy cleaning their grid, has contributed to these reductions. Rec Center Our largest user of energy, the Rec Center, has undergone several efficiency improvements in recent years. More work is starting in 2019 to continue this trend of optimizing equipment and examining potential changes in order to reduce emissions. Study session meeting of January 28, 2019 (Item No. 2) Page 8 Title: Climate action plan update Note condensed scale above The scope of work includes analyzing existing boiler consumption and recommend options for replacement as well as a review of the new building automation system to ensure it is operating as expected and develop recommendations for improved control. The roof at this facility is now solar ready and projects should be explored after additional energy efficiency projects are completed. As stated earlier in the report, we are currently in the process of the energy efficiency study with CEE for the Rec Center and that information will be incorporated in a strategy plan for improvements (more to come). Study session meeting of January 28, 2019 (Item No. 2) Page 9 Title: Climate action plan update Community-Wide Energy Use and Emissions– Regional Indicators Initiative data source (RII) Despite an increased use of natural gas, reduced emissions community wide are mainly due to Xcel Energy cleaning up their grid. St. Louis Park is below the RII average (about 38 cities). Community wide data for 2018 is not yet available. Study session meeting of January 28, 2019 (Item No. 2) Page 10 Title: Climate action plan update St. Louis Park Community Reports Summary from Xcel Energy- Electricity Only Xcel Energy in SLP 2015 2016 2017 Consumption (kWh) Business 344,571,005 335,269,110 307,374,170 Consumption (kWh) Residential 140,165,535 142,240,272 136,656,071 Carbon Emissions (metric tons) Business 139,896 122,373 114,343 Carbon Emissions (metric tons) Residential 56,907 51,918 50,836 WindSource # customers / kWh 1,080 / 2,544,631 1,151 / 2,926,607 1,297 / 3,432,739 On Site Solar Installation # of installations / capacity kW 2 / 49 kW 7 / 76 kW 7 / 110 kW Total SLP Community Revenue Billed $ 48,823,883 $ 51,164,834 $ 49,014,692 (Total SLP Municipal Accounts) $ 1,174,793 $ 1,130,613 $ 1,214,561 Total solar installations overall history = 30. Renewable Connect data community wide for 2018 not yet available. One kilowatt-hour (1 kWh) is equal to the amount of energy you would use if you kept a single 1,000-watt appliance running for one hour. Electricity usage is measured in kilowatt-hours (kWh). kW means kilowatt which is 1000 Watts. It is a measure of power. The size of a solar system is defined by its peak power. e.g. a 1 kW system can produce 1 kW of power on a really sunny day. Consultant – Lotus Engineering and Sustainability Lotus Engineering and Sustainability is a certified Women-Owned business (M/WBE), Emerging Business Enterprise (EBE), Small Business Enterprise (SBE), and Disadvantaged Business Enterprise (DBE) located out of Denver, CO, with a subcontractor located in Minneapolis. Since 2012, Lotus has delivered responsible and progressive sustainability solutions for public and private sector clients. The city hired LOTUS in 4th quarter 2018 to assist staff with development of strategies, concepts and timeline to meet CAP targets. Their consulting services combine the technical and pragmatic approaches of engineering and finance with the holistic and innovative approaches of efficiency and sustainability. Lotus will focus on these areas in 2019 in partnership with city staff, the ESC and the RSEC: •Track sustainability initiatives •Maximize use of resource hub and outreach •Engage community groups for residential education •Develop and recommend programs, outreach, communication, education and future opportunities for staff to review in further development of specific strategic plans for 2019 to 2040 Study session meeting of January 28, 2019 (Item No. 2) Page 11 Title: Climate action plan update Next Steps: Efficiency and Renewable Projects We are seeing reductions at the municipal level because of our commitment to energy efficiency and renewable energy. We can continue to expand our efforts in improving efficiency across the organization while also increasing our use of renewable energy. A focus on reducing natural gas consumption community wide should be explored further. Municipal-owned utility meters not currently tracked in B3 should be added. Data collection is key to help us measure our community progress as it relates to CAP targets. Additionally, continuing to build resources, content, and programs that helps educate all members of the community in order to drive participation is crucial to achieving the goals of the CAP. Members of the Environment and Sustainability Commission and the youth from the Roots and Shoots Environmental Club have and continue to play an important role in education, outreach and engagement with the community. Note: As we are in the strategic planning process, there are many concepts and possibilities in the area of climate action and sustainability. In order to get the best outcome, staff is working with our consultant on strategies and concepts that will give us the best opportunities to meet targets in the CAP. As you are aware, we hear of many good ideas and it is important to be strategic to make sure the work we are doing at the city and in our community have the best outcomes. We also understand programs and technology continues to change in this area and our journey will be modified as we move along with our community. Below are several concepts in the study process and if recommended to move ahead, staff will have further discussions with council. Building Benchmarking Disclosure Ordinance concept for study A building energy disclosure ordinance is a policy tool that uses market forces to increase building energy performance and motivate building owners and operators to invest in energy efficiency improvements. Drafting and then adopting such an ordinance will allow the city to see how energy is used among its largest buildings, lead to accelerated energy reductions, and strengthen relationships between the city and the business community through more active engagement. Our CAP suggests the city adopt a building energy disclosure ordinance for all public buildings and all commercial buildings greater than 20,000 square feet, but we could look at other building types and sizes to include as well. Benchmarking ordinances have reduced energy use and emissions between 0.5 and 3.5% in just 3-5 years for cities like Minneapolis, Chicago and New York. In 2018, St. Louis Park, joined the Hennepin County Benchmarking Collaborative as a pilot city, along with St. Paul, Edina, and Eden Prairie. St. Louis Park’s Environment and Sustainability coordinator represents the city in this collaborative. This collaborative is meant to provide services for cities seeking to adopt and implement an energy benchmarking policy in the near future. The initial steps are to understand the circumstances within each community and embark on a process to establish roles, timeline, engagement plan, and implementation plan. Pilot cities will receive technical and facilitation assistance for developing the ordinance at no cost. Program education, outreach, and ordinance development should be a focus in 2019 for St. Louis Park. Study session meeting of January 28, 2019 (Item No. 2) Page 12 Title: Climate action plan update Energy Stretch Code Adoption concept for study In March 2017, Fresh Energy, a non-profit energy policy team, convened a meeting to discuss a strategy to petition the Governor’s office to direct the Department of Labor and Industry to allow for the use of the Sustainable Building 2030 program as an optional stretch code for municipalities. Although a number of groups were interested, they weren’t able to assemble a large enough of coalition to move forward with their efforts at that time. Now with a new governor and legislative makeup, the City of Minneapolis has expressed interest in pushing for this option at the Legislature. Fresh Energy will convene another meeting for Minneapolis to share their ideas and strategy for this process with St. Paul and St. Louis Park and ask for feedback. The city cannot currently exceed the State’s energy code. However, if the State were to add a green building code as an appendix (stretch) code, local authorities would be able to adopt it to increase their standards. It is listed in our CAP to support the State’s adoption of a green building stretch code and also to collaborate with other communities, industry, and state agencies to support the State through legislation or rule-making in adopting a green building stretch code. Point of Sale/Truth in Sale of Housing in Minneapolis St. Louis Park will monitor the progress and impact of the Minneapolis pilot study regarding point of sale and energy audits. As with any initiative, we would look at this through a racial equity and inclusion lens along with the possibility of how it may fit with the CAP. The City of Minneapolis hired CEE to perform a pilot study of how an energy disclosure could be incorporated into their Truth in Sale of Housing (TISH) program for homes. This is being studied as part of the Minneapolis Climate Action Plan. Five independent home inspection companies completed 38 inspections for sellers which agreed to participate. Basic criteria reported included amount of insulation, type of heating system, and window type were included with a recommendation to improve energy efficiency. Due to the limited access in many homes, estimations of type and R-value were made when the roof or wall insulation was not visible. Only 5 of the homes had a more extensive energy audit including a blower door evaluation due to inspection companies feeling this was beyond their business scope. This study is in addition to Minneapolis underwriting the entire cost of Home Energy Squad audits to eliminate any cost for homeowners, which increased the number of annual audits by 45% to nearly 900. The TISH program change being considered would require the sellers of 4000 homes a year to pay for an audit with the inspection. Due to inspectors needing to guess on the amount of wall insulation in certain homes, a suggestion being discussed is for drilling a 2" hole in the wall of the home from the inside. The potential damage/liability of hitting an electrical wire, or creating a repair when the house is offered for sale, is of concern to inspectors and realtors. Staff will monitor the program and ordinance changes now developing in Minneapolis. In contrast to a home disclosure report prepared by independent home inspectors in Minneapolis, the Property Maintenance Certificate program (PMC) in St. Louis Park is a minimum code compliance inspection completed by city staff on all buildings being offered for Study session meeting of January 28, 2019 (Item No. 2) Page 13 Title: Climate action plan update sale. The same basic code standard applies to all houses, apartments, commercial, industrial properties, and licensed rental properties. Most property transactions are completed with a Temporary Certificate, allowing the buyer to correct any deficiencies. This is generally preferred as they then control the type and quality of any repair or improvement. An example of this is when a buyer may choose a high efficiency furnace, rather than the lowest cost option a seller may select. Program enhancements are possible to increase the number of buildings receiving energy audits, especially for the over 1000 offered for sale each year in SLP. The buyer of any property will always be more interested in learning about possibilities for making energy improvements than the seller. Direct communication by the buyer with an auditor rather than a report or rating number provided by the seller may be more helpful in producing an action that results in higher energy efficiency. Considerations could include added communication, incentives, or a requirement that an energy audit be completed within a specified time after a property transaction. Meeting: Study session Meeting date: January 28, 2019 Discussion item: 3 Executive summary Title: Emergency medical services/community health management Recommended action: Staff desires to update the council on a transition being experimented with on pilot basis whereby the fire department would shift from the more traditional emergency medical services (EMS) approach to one with a much greater emphasis on community health management. Policy consideration: Does city council support the transition in the way the fire department provides EMS services in the future? Summary: The fire department will present its Community Health Management program and discuss the Business Plan (see attached) which is directed toward: • Improving equity and access to healthcare • Reducing the high utilization of 911 calls • Improving the quality of life and resiliency of St. Louis Park residents • Revenue that builds sustainability • Capitalizes on the trust of the community in its fire department Financial or budget considerations: The city/fire department currently receives no revenues or reimbursement for the EMS services it provides. The transition to a community health management approach provides opportunities for accessing funds that have not otherwise been available. The expense for this new approach is planned to be at least cost neutral. Strategic priority consideration: St. Louis Park is committed to creating opportunities to build social capital through community engagement. Supporting documents: Discussion Business plan Prepared by: Steve Koering, Fire Chief Approved by: Tom Harmening, City Manager Study session meeting of January 28, 2019 (Item No. 3) Page 2 Title: Emergency medical services/community health management Discussion Background: As city council is aware, the St. Louis Park Fire Dept. has been working on a variety of pilot projects directed at addressing the health challenges of our residents, particularly seniors, by connecting people with needed resources, reducing over utilization of the 911 system and partnering with a variety of community partners. Each pilot has shown the challenges that exist in four key areas. 1.Seniors are struggling to remain independent and to live at home 2.Patient’s families are struggling to manage their loved one’s care 3.The 911 system has become the default path toward managing healthcare needs 4.The healthcare system including primary care physicians, healthcare nurses, social workers etc. are likely not aware of all of the issues their patients are facing. The design of this program that the fire department, along with its partners have created, systematically builds awareness, action, measurable outcomes and revenue. It does so through the following steps: 1.Identifies high utilization of 911 patients during response and introduces them to services 2.Builds an electronic healthcare record that initiates a referral to the primary care physician 3.It connects all care team members and allows the primary care physician to create orders for additional services including the fire department Community EMT 4.It creates a path for the Community EMT to update the electronic patient record 5.It allows the fire department to bill for these services within the framework of the healthcare system i.e.; Medicaid and Medicare 6.It creates a feedback loop that allows the team to measure outcome improvements and to adjust care as needed. The fire department facilitates the navigation of the care coordination process through its partnership with Care Resource Connections, a nonprofit organization that specializes in these services. Care Resource uses its broad base of providers to address the unique needs which might arise for any resident. This group of providers has also shown promise in providing a solution for the rising mental health demands that our police department is faced with as well. In addition, the Primary Care Physician Group that is part of Care Resource, Twin City Physicians (TCP), has agreed to act as the Medical Director for the fire department’s program, which allows us to work under their medical license. TCP also manages all areas associated with billing. The city manager requested that the fire chief submit a business plan for this unique approach to meet the needs of residents and that business plan is attached for your review. 1 Business Plan Community Health Management Strategic Plan Initiative 6 Care Navigation and Mobile Integrated Healthcare “Building a more resilient St. Louis Park” Study session meeting of January 28, 2019 (Item No. 3) Title: Emergency medical services/community health management Page 3 2 Table of Contents Chapter Page Executive Summary 4 Improve Community Health 5 Patient Demographics 6 Patient Stories 8 Outcome Based Accountability 13 Build Collaborative Partnerships 14 Ensure Sustainability 18 Financials 19 Appendix A Leadership Team 24 Appendix B Macro Healthcare Environment 25 Appendix C Promis Survey Form 26 Appendix D Definitions 27 Appendix E Assumptions 29 Study session meeting of January 28, 2019 (Item No. 3) Title: Emergency medical services/community health management Page 4 3 Personal Experiences THIS IS WHY WE DO THIS We are so grateful to the Fire Department for connecting us to much needed help.”---Connie We are lucky to have the Fire Department and Care Resource Connections Care Team working with Dr. Lehman.---Linda I sometimes feel the only people that hear my calls for help are the Fire Department and I thank God for them and Amy every day.” ---Tammy We feel lucky that we live in a community that everyone was looking out for me and my husband.”--- Eileen Because of this program with the St. Louis Park Fire Department, I was able to collaborate with every member on the patients care team and advocate alongside CARE Resource Connection for the need of a safe discharge plan. Jessica- Study session meeting of January 28, 2019 (Item No. 3) Title: Emergency medical services/community health management Page 5 4 Executive Summary I would like to start by telling a story about Leo. Leo is an 87 year old male who is living independently and wishes to remain as independent as possible. Leo has been treated for a number of chronic health related issues and has struggled to maintain that independence. Over time he has been prescribed as many as 18 medications at a time. You might be asking yourself how I would manage that many medications. Leo met a fire department CEMT as part of a pilot during his discharge from a transitional care unit (TCU) and shared with us, that because of that support, for the first time he understood his medications and had confidence in his ability to manage his care. He would call directly to the CEMT instead of 911 twice over the next week, and since that time remained independent and free of 911 dependence. What Leo experienced represents the core values that our work is intended to address. First we need to have a focus on improving the overall health of our community. Our population continues to age and the projected growth of that population will demand creative solutions to meet their needs. The solutions we provide need to be measurable and accountable and appropriate for the patients we serve. It is important to understand that healthcare is complex and it requires a collaborative approach to meeting the ongoing needs of the patients, the fire department and the community we serve. Building lasting connections with providers and resources provides for a quicker more appropriate response. Lastly whatever the solution we need to remain adaptable and innovative to ensure sustainability. The very personal nature of healthcare requires that patients feel good about their care. They trust that the care will be available when they need it and that it will be delivered at the high level of quality they have come to expect. Sustainability builds confidence and improves resilient thinking. Leo’s story really isn’t that much different than many of our patients. Maybe you have personally experienced these challenges while caring for a loved one. This plan outlines a solution that centers on those three priorities, improve the health of our community, maximize collaborative partnerships, and ensure a sustainable approach. Through this work we can build on the unique trust that exists between the fire department and the community it serves. I think Leo would approve. Study session meeting of January 28, 2019 (Item No. 3) Title: Emergency medical services/community health management Page 6 5 Improve Community Health The St Louis Park fire department is actively engaged at improving community health by reducing risk and enhancing resiliency within the City of St Louis Park using a patient centered approach for community health management. Our all hazards approach to the challenges that confront this community places the fire department on the front lines of what is a fast changing environment across much of our service delivery. Examples of that, are the challenges of an aging population, increased density of senior population, and an evolving diversity which are driving a need for innovation in how we approach day to day healthcare response. Residents need assistance with navigation of resources and gaining access to the healthcare system. The changes to healthcare as a result of both economic and political impacts have made that a difficult journey for many. Because the fire department is on the frontlines and sees firsthand the resource gaps that exist, it is imperative that we leverage the opportunity we have to significantly impact community health and become the catalyst for improving the delivery model. The Patient Centered Approach Initial patient population Study session meeting of January 28, 2019 (Item No. 3) Title: Emergency medical services/community health management Page 7 6 This chart shows the distribution of the initial referrals based on where they live, their age and their gender. While a majority of the referrals have come from within managed senior care locations there is still a significant number of residents living independently who are in need of assistance. Study session meeting of January 28, 2019 (Item No. 3) Title: Emergency medical services/community health management Page 8 7 Building meaningful stories about improved health Firefighters remain the one of the most trusted service providers and are in an excellent position to gain the trust necessary to build lasting relationships with the community. It is with this in mind that the department proactively began a process of identifying, understanding, innovating, and solving this sizable challenge for the residents we serve, in order to connect them to the resources and care they require at the lowest possible cost to the system. How many of us have been confronted with this daunting process for a parent or spouse? How would you wish to be treated if you were faced with these challenges? What is known is that patients who are connected to resources begin to flourish and their quality of life improve and their dependency on 911 diminishes. The following are examples of patients who were considered high utilizers of the 911 system. Their story and the feedback from their family reinforces why we feel this approach makes sense. Study session meeting of January 28, 2019 (Item No. 3) Title: Emergency medical services/community health management Page 9 8 Patient Story 1 Study session meeting of January 28, 2019 (Item No. 3) Title: Emergency medical services/community health management Page 10 9 Patient Story 2 Study session meeting of January 28, 2019 (Item No. 3) Title: Emergency medical services/community health management Page 11 10 Patient Story 3 Study session meeting of January 28, 2019 (Item No. 3) Title: Emergency medical services/community health management Page 12 11 Patient Story 4 Study session meeting of January 28, 2019 (Item No. 3) Title: Emergency medical services/community health management Page 13 12 Measuring Improved Community Health; Outcome Based Accountability Study session meeting of January 28, 2019 (Item No. 3) Title: Emergency medical services/community health management Page 14 13 Since the advent of the Patient Protection Affordable Care Act in 2010 healthcare has been in a constant state of flux. The Triple Aim which was established in 2007 by the Institute of Healthcare Improvement became the guidepost for measuring the health of the population, the quality of the healthcare system and the cost of healthcare. Holding healthcare providers accountable for the quality of their care by establishing financial penalties brought a very sharp focus on the area of hospital readmissions. Keeping the patient out of the hospital for at least thirty days opened up the concept of mobile integrated healthcare; in other words meet the patient where they live, and keep them out of the hospital. To address the requirement of the Triple Aim the fire department has adopted a validated feedback tool that was developed by the National Institutes of Health called the PROMIS Survey (Appendix C). The PROMIS Survey Global Health Scale measures patient response to questions related to how they feel about their health, their security, their emotional and physical wellbeing along with other key questions. The survey is completed during the initial visit and is subsequently completed in 30 day increments to measure patient response to interventions. The chart below shows the average improvement of 78 % in PROMIS scores across all patients to date, following fire department CEMT and care navigation interventions over a 90 day period. Build Collaborative Partnerships Study session meeting of January 28, 2019 (Item No. 3) Title: Emergency medical services/community health management Page 15 14 A recognized weakness in the current healthcare process is the lack of connectivity and collaboration within the provider network. Community EMTs (CEMT) represent one element of the potential solutions because they are the first to identify the patient and they provide the most appropriate care at the lowest cost. The goal of the Triple AIM is to build solutions through partnerships that identify the gaps, explore options with those entrusted with the patients care, and deliver those resources in a timely, professional, respectful, and cost effective manner while working under physicians orders. Key external stakeholders Healthcare and Senior Care Providers Health Partners/Methodist Hospital https://www.parknicollet.com this community partner remains a significant support system for the expansion of CEMT and mobile integrated healthcare. The work which started as a post discharge visit has now developed into a bigger discussion around food security, mental health and care coordination. The Park Nicollet Foundation supports our visits through financial support towards visits and visit supplies. We are expanding the conversation to primary care physicians and care coordinators. Care Resource Connections https://careresourceconnections.org/home CARE Resource Connection is a nonprofit 501(c)(3) organization made up of a network of healthcare, public service and business professionals that are dedicated to “bridging the gaps between our communities & the resources they need.” Executive Director Amy Lucht has over 20 years of healthcare experience as a care integration coordinator and social worker. Amy from the very beginning recognized the importance of this work and has set out to help build a sustainable solution. Her vast connections have created a collaborative team of professionals who are driven to provide solutions. Twin Cities Physicians https://mytcp.org/index.php This organization of health care professionals will act as our medical director for our community health management program. State statute requires that a CEMT work under medical direction and the optimum choice is to partner with the field of primary care. Twin Cities Physicians provides primary care services with a number of facilities in St Louis Park. By specializing in geriatric care they can adapt easily to this growing segment of our population. Dr. Clemencia Rashquinha MD and Steve Atkinson PA-C, MS have been involved from the beginning and are helping us build a sustainable solution. Twin Cities Physicians will also be managing all of our billing to ensure compliance. Study session meeting of January 28, 2019 (Item No. 3) Title: Emergency medical services/community health management Page 16 15 Sholom www.sholom.com This community of senior living facilities accounts for a majority of the EMS calls which could benefit from a CEMT visit either as part of a discharge from the transitional care unit (TCU) or in the independent and assisted living residence areas. Sholom has been meeting with the fire department and Care Resource Connection to design a process that meets the needs of Sholom and creates a sustainable revenue stream for fire EMS operations. We have been successfully delivering CEMT services as part of a DHS grant that has shown to have positive impacts on reducing readmissions. This represents one of the largest opportunities to improve outcomes in our community. Fire Departments Most metro fire departments are sitting back waiting to see how this plays out and whether or not there is a way to integrate it into their work. The St Louis Park Fire Department continues to be a leader in the development of this process and we continue to field questions from across the country about what we are doing. The State of Wisconsin is finishing up on a Community Paramedic/Community EMS program and they are mirroring what we developed here. We have presented at numerous local and regional meeting including Hennepin Chiefs, Metro Chiefs, and State Fire Chiefs. We have presented at the Minnesota Hospital Associations Annual Care Conference and the Stratis Health West Metro Coordination of Care meetings. We are scheduled to present at Fire Rescue Med 2019 and the 2nd Annual National Community Paramedic Conference about our program. The sustainability of our program does not rely on other jurisdictions jumping in, however the overall concept would benefit from a larger pool of engagement. Key internal stakeholders Dispatch and 911 PSAP- Initially the goal is to reduce the over utilization of the 911 system which will relieve some workload for the on duty staff. High volume 911 callers stop calling because they are connected to resources. This frees up both dispatch and law enforcement staff that would be otherwise be tied to the call. Long term as the program matures we can see the potential for these calls to enter the dispatch through a non-emergent line where they would assign a mobile integrated health unit. Overall fire and EMS call volume continues to grow which might create an opportunity to consider a fire focused dispatcher who could handle both fire and EMS emergent and non-emergent response. Finance- We have had several meetings with City Finance to discuss revenue collection and revenue reporting for these various mobile integrated healthcare programs. The goal is to track Study session meeting of January 28, 2019 (Item No. 3) Title: Emergency medical services/community health management Page 17 16 each program to evaluate the sustainability and business needs required. Currently all revenue is being reported in the fire department operating budget by individual program. By design the billing for these services will be managed by our medical direction partners as part of the medical direction contract. Police Department- The police department responds in support of the fire department, to most medicals. This program will reduce the number of calls that police are dispatched to for non- emergent response. In addition this program will support the additional mental health programs that the police department is considering. This offers additional resource considerations for residents that police are repeatedly called to instead of Hennepin County. The Police Chief and the Fire Chief have discussed the advantages of this idea. Inspections- A prevalent problem particularly in independent living is the common issue of hoarding. Moving patients out of this living environment or getting them services will take a combined effort of the inspection department, the CEMT, and the social worker. There needs to be education and shared expectations developed to meet the goals of the program. It will be important to bring inspectors along as part of the team so that they can help drive the goals of whatever the intervention. Future collaborations impacting growth Currently the work of a Community EMT is billable to Medicaid only. Once we start to bill on a regular basis additional billing codes can be added which will provide additional billing options including commercial insurance coverage. This next legislative session in Minnesota a bill will be offered that would allow telemedicine as a billable event for CEMT. Other states are now working towards CEMT type programs which will support the expansion of services and billing options. As more outcome data is collected healthcare payers will offer reimbursements for private or conventional insurance. The department will continue to explore other pilot project opportunities that build on the current model with insurance providers, healthcare systems and service providers that can add value. When collaboration creates connections Study session meeting of January 28, 2019 (Item No. 3) Title: Emergency medical services/community health management Page 18 17 Meeting the needs of the patient that is underserved or in need of additional resources depends on the collaboration of the fire department staff, the care coordinator and the primary care physician. Once this care team is aligned the connection to a variety of resources can be explored or updated. It is the role of the CEMT to build relationships with the patient and the other members of the care team so that everyone stays informed. Ongoing meetings with providers and care navigation ensures the needs of the patient are being met. The immediate impact of the CEMT visit is measurable. The following graph details to date, the specific instance an additional service was ordered for a patient by their care team as a result of the report given by the CEMT following a visit with the patient. Ensure Sustainability 19 51 19 4 8 0 5 10 15 20 25 30 35 40 Mental Health Home Health/Hospice Long Term Care/Skilled Facility County Agenies/Vulnerable Adult Specialty Care Teams Study session meeting of January 28, 2019 (Item No. 3) Title: Emergency medical services/community health management Page 19 18 Sustainability by using the right resource at the right time A key component of sustainability is the very idea that the fire department is the lead agency that identifies the patients. During the growing number of EMS calls every year fire personnel connect with residents/patients that are in need of additional help. These patients who self-identify as wanting help to the responding fire personnel are immediately referred to the fire department CEMT and the Care Coordinator. The fire department remains involved in every step of this engagement to ensure consistency and quality of care for each resident. As long as the fire department is responsible for EMS first response there will be a way to ensure that patients are being identified and served. Sustainability through trust Protection of patient data is a critical part of sustainability. Once the referral is logged, a follow up appointment is made with the patient by the CEMT. The purpose of this visit is to spend time with the patient so as to better understand their needs, their safety, food security, medications and family or support system. This patient visit is captured in the fire department Electronic Health Record (EHR). This new system protects patient information and builds reports that validates outcomes. The patient signs a HIPPA release that is sent to the Care Coordinator, who will then begin the process of consolidating all facets of the care team that might be providing for the patient. This ensures patient confidentiality is met and it brings all entities up to a level playing field on what is going on and how they can collaboratively build solutions. Sustainability through revenue For years the fire department has been responding to these high utilization 911 callers without any reimbursement. The systems in place provided little or no opportunity for the firefighter EMT to intervene. This volume of calls has continued to increase and it creates a strain on resources and while impacting the reliability of the department. This new program now positions the department as a relevant provider of healthcare services, and an ongoing resource for patient care. The fire department can now bill for many of these services tied to patient support. The attached 3 year financial plan shows a conservative forecast of growth of patient numbers and revenue types. It is our assertion that this program will create opportunities for new revenue streams and patient types once the patient outcome data is more widely shared. Financial Plan Study session meeting of January 28, 2019 (Item No. 3) Title: Emergency medical services/community health management Page 20 19 As part of this financial plan we will present comparisons for FY 2019 of three different assumptions. Each of these plans offer revenue in excess of expenses. They vary in the number of patients and hours which are billable. Included in this plan is the long term financial plan for 2020 and 2021. The fire department will continue to explore available grants that target this type of outreach. We are currently awaiting on the status of our grant application to the Otto Bremer Trust. This grant would be used to offset the year one initial startup costs and year two capital costs. YEAR ONE CONSERVATIVE Study session meeting of January 28, 2019 (Item No. 3) Title: Emergency medical services/community health management Page 21 20 Study session meeting of January 28, 2019 (Item No. 3) Title: Emergency medical services/community health management Page 22 21 Study session meeting of January 28, 2019 (Item No. 3) Title: Emergency medical services/community health management Page 23 22 Study session meeting of January 28, 2019 (Item No. 3) Title: Emergency medical services/community health management Page 24 23 Study session meeting of January 28, 2019 (Item No. 3) Title: Emergency medical services/community health management Page 25 24 YEAR ONE EXPECTED Study session meeting of January 28, 2019 (Item No. 3) Title: Emergency medical services/community health management Page 26 25 YEAR ONE AGGRESSIVE Study session meeting of January 28, 2019 (Item No. 3) Title: Emergency medical services/community health management Page 27 26 Study session meeting of January 28, 2019 (Item No. 3) Title: Emergency medical services/community health management Page 28 27 YEAR TWO Study session meeting of January 28, 2019 (Item No. 3) Title: Emergency medical services/community health management Page 29 28 YEAR THREE Study session meeting of January 28, 2019 (Item No. 3) Title: Emergency medical services/community health management Page 30 29 Appendix A Leadership Team Steve Koering; Fire Chief-Chief Koering is a 30 year veteran of the fire and EMS services. Chief Koering has immersed himself in this challenges of mobile integrated healthcare locally, regionally and nationally. Chief Koering sits on the EMS Section of the International Association of Fire Chiefs and was a contributing author for the Mobile Integrated Handbook produced by the Affordable Care Act Task Force of the IAFC. The fire departments strategic plan completed in 2018 outlines community health management as a strategic priority. John Wolff; Deputy Chief- D.C. Wolff is a 32 year veteran of the fire and EMS service. He holds a degree in business management from the University of Massachusetts Eisenberg School and brings a strong business and financial acumen to the team. Before joining the St Louis Park fire department he had a successful career in the insurance and financial industry particularly in the healthcare space. John’s creativity and innovation in the areas of business strategy and planning are essential to this venture. He is the lead on the implementation of a new electronic patient care record system that interfaces with our 911 Center and a key architect in how we might operationalize this model in the field. Hugo Searle: Assistant Chief EMS/Training/CEMT A.C. Searle was part of the inaugural class of CEMT and currently holds the State Certification of Community EMT. AC Searle holds a masters of Education from Northern Illinois University. Chief Searle brings decades of in field experience to the discussion and understands both the opportunities and the barriers to success that exist with this model. He brings significant management experience to the program including 10 years as an executive with the Boys and Girls Clubs of the Twin Cities. A.C. Searle is an accomplished risk taker and explorer including leading teams to the summit of Mt Everest. Study session meeting of January 28, 2019 (Item No. 3) Title: Emergency medical services/community health management Page 31 30 Amy Lucht; Founder/Director/Care Coordinator- Care Resource Connections- Amy has 20 Years of experience in healthcare industry with a primary focus on care coordination, a role she served for both the Fairview and North Memorial medical systems before leaving to start the non-profit Care Resource Connection. Amy has a degree in Healthcare Management and has worked as a licensed Social Worker. Amy’s role as the Care Coordinator is pivotal to the success of the operation. Her vast experience and industry connections in the healthcare market allow her to facilitate solutions and build sustainable partnerships that serve the patients. Appendix B Macro Healthcare Environment In order to meet the criteria created as part of the Triple AIM the concept of a patient centered system was viewed as the best approach. Over the last decade various approaches to this idea have flourished nationally, and a number of programs have shown significant outcome improvements. The most successful approaches follow this patient centered approach. The New England Journal of Medicine defines patient centered care as follows; Patient- and family-centered care encourages the active collaboration and shared decision-making between patients, families, and providers to design and manage a customized and comprehensive care plan. •The health care system’s mission, vision, values, leadership, and quality-improvement drivers are aligned to patient-centered goals. •Care is collaborative, coordinated, and accessible. The right care is provided at the right time and the right place. •Care focuses on physical comfort as well as emotional well-being. •Patient and family preferences, values, cultural traditions, and socioeconomic conditions are respected. •Patients and their families are an expected part of the care team and play a role in decisions at the patient and system level. •The presence of family members in the care setting is encouraged and facilitated. •Information is shared fully and in a timely manner so that patients and their family members can make informed decisions. Study session meeting of January 28, 2019 (Item No. 3) Title: Emergency medical services/community health management Page 32 31 It is the intent of the SLPFD Community Health management program to align with a patient and family centered approach to improve community health and resiliency. Appendix C PROMIS SURVEY FORM Study session meeting of January 28, 2019 (Item No. 3) Title: Emergency medical services/community health management Page 33 32 Appendix D Definitions Study session meeting of January 28, 2019 (Item No. 3) Title: Emergency medical services/community health management Page 34 33 CEMT/Community Emergency Medical Technician; this is an Emergency Medical Technician who has completed approved additional training, and is certified by the State of Minnesota to deliver this care. Care Coordinator/Navigation this person works directly with the CEMT to coordinate and identify the appropriate resources and specializes in the coordination of all components of the care team. COPE Community Outreach for Psychiatric Emergencies a Hennepin County service available to any adult who is experiencing symptoms of a mental health crisis and needs crisis intervention or assessment. CRC Care Resource Connections a 501C3 nonprofit that acts as a resource navigation specialist in partnership with the fire department. D/C Discharge DHS State of Minnesota Department of Human Services EHR Electronic Health Record is a digital version of a patient’s paper chart. EHR These are real-time, patient-centered records that make information available instantly and securely to authorized users. While an EHR does contain the medical and treatment histories of patients, an EHR system is built to go beyond standard clinical data collected in a provider’s office and can be inclusive of a broader view of a patient’s care. One of the key features of an EHR is that health information can be created and managed by authorized providers in a digital format capable of being shared with other providers across more than one health care organization. EHRs are built to share information with other health care providers and organizations – such as laboratories, specialists, medical imaging facilities, pharmacies, emergency facilities, and school and workplace clinics – so they contain information from all clinicians involved in a patient’s care. MD or Medical Director is the medical professional who is a Primary Care Physician (PCP) oversees the programs quality, care plan, and provides the oversight through their medical license to ensure that the training and the care align. They are the conduit to the patients PCP and act on their behalf when writing orders for needed services. Study session meeting of January 28, 2019 (Item No. 3) Title: Emergency medical services/community health management Page 35 34 PCP or Primary Care Physician A potentially qualified primary care physician or NPP, as defined in Section 1833 (x) of the Social Security Act, is a physician with a Medicare specialty designation of family medicine, internal medicine, geriatric medicine, or pediatric medicine or an NPP with a specialty designation of Nurse Practitioner (NP), Patient is any resident of this community who is challenged with accessing healthcare and providing for their own safety and security. This can include those living in a variety of living arrangements including single family homes, senior independent living, assisted and skilled nursing, and multi-family residential, and f left underserved they will likely transition into a high utilizer of the 911 dispatch center. PSAP Primary Service Answering Point this is the classification of our police and fire 911 independent dispatch center. PT/OT Physical therapy or occupational therapy STEP St Louis Park Emergency Program a local resource for a variety of solutions including food TCU- the Transitional Care Unit TCU is a skilled nursing facility that assists patients as they transition from a stay in the hospital to home or another level of care. Appendix E Resource assumptions identified in the 3 year financial projections Study session meeting of January 28, 2019 (Item No. 3) Title: Emergency medical services/community health management Page 36 35 Staffing The 2019 staffing plan anticipates using a combination of sub-contractors, career and part time firefighters. We will sub-contract with Twin Cities Physicians for medical direction and insurance billing services. We plan to contract with Care Resources Connection for care coordination/navigation services, program development and ongoing CEMT training and development. Community EMT services will be provided by our trained career and part time firefighters. Based on anticipated volume, we project our 2019 human capital costs at $80,000. Office space We anticipate the need to revise our current office floor plan to provide an area for MIH staff and interns. In 2020, the chief’s office will be sub divided into 4 cubicles. Using 2 existing computer set ups and cubicle set ups in the intern/FPS office and adding 2 more. The adjoining conference room will serve as a small office for the Care Navigator and/or health care providers when they are at SLPFD. The chief will move to the current intern/FPS space. Expected cost for this move is $10,000 for equipment, cubicles and office furniture. Vehicle At this time the CEMT staff is using a retired chief’s squad. This is a high mileage vehicle (with ongoing service needs.) In 2020 we are recommending to lease a hybrid SUV similar to the unit demo’s last spring by Fleet Services. Fuel and leasing fees are anticipated at $7500/year. EMS & Home Safety Inspection Supplies We are estimating costs to be less than $1,000/year for EMS equipment and home safety inspection supplies. These expenses will be absorbed by the fire department budget. Training Ongoing training for our credentialed CEMT staff will be delivered by the care navigator and covered under human capital costs outlined above. Training for new CEMT staff was anticipated and is projected at $2500. We plan to absorb this cost in our 2019 fire department training budget. Study session meeting of January 28, 2019 (Item No. 3) Title: Emergency medical services/community health management Page 37 Meeting: Study session Meeting date: January 28, 2019 Written report: 4 Executive summary Title: Fourth quarter investment report (Oct. – Dec. 2018) Recommended action: No action required at this time. Policy consideration: Reporting on investments quarterly is part of our financial management policies. Summary: The quarterly investment report provides an overview of the City’s investment portfolio, including the types of investments held, length of maturity, and yield. Financial or budget considerations: The total portfolio value at December 31, 2018 was $64.9 million. Approximately $36 million is invested in longer term securities including U.S. Treasury notes, Federal agency bonds, municipal debt securities, and certificates of deposit. The remainder of the portfolio is held in money market accounts and commercial paper for cash flow needs between property tax settlements. The overall yield to maturity is at 2.08%, up from 1.92% at the end of the third quarter. Strategic priority consideration: Not applicable. Supporting documents: Discussion Investment portfolio summary Prepared by: Darla Monson, Accountant Reviewed by: Tim Simon, Chief Financial Officer Nancy Deno, Deputy City Manager/HR Director Approved by: Tom Harmening, City Manager Page 2 Study session meeting of January 28, 2019 (Item No. 4) Title: Fourth quarter investment report (Oct. – Dec. 2018) Discussion Background: The City’s investment portfolio is focused on short term cash flow needs and investment in longer term securities. This is done in accordance with Minnesota Statute 118A and the City’s investment policy objectives of: 1) Preservation of capital; 2) Liquidity; and 3) Return on investment. Present considerations: The portfolio value increased in the fourth quarter to $64.9 million from $50.9 million at September 30, 2018. Money market balances increased due to the receipt of the second half property tax and tax increment settlements from Hennepin County on December 3 and the closing on the first phase with PLACE for purchasing the former McGarvey Coffee property on December 28. The overall yield of the portfolio increased to 2.08%, compared to 1.92% at September 30 and 1.33% one year ago. This is the combined yield including both cash held in money market accounts and long term investments. As more of the older investments with lower yields mature or can be replaced with new higher yielding securities, the overall portfolio yield should continue to rise. Cities will typically use a benchmark such as the two year Treasury (2.48% on December 31, 2018) or a similar measure for yield comparison of their overall portfolio. There was approximately $26.7 million in money market accounts at the end of the quarter. This includes bond proceeds of about $6.2 million from the 2017 and 2018 bonds. Money market rates continued to increase in the fourth quarter to between 2.09% - 2.18% from 1.75% - 1.85% last quarter. One year ago, money market rates were only at about 1%. A large amount of cash will be necessary early in the first quarter of 2019 for the February 1 debt service and TIF note payments, and the first payment of nearly $2.9 million for SWLRT will also be due in January. The next property tax settlement will be a 70% advance of the first half tax payments in June 2019. It is necessary to keep adequate cash available for on-going expenses for payroll and operating expenses until that time. In addition to the cash held in money market accounts, the portfolio also has $2.4 million of commercial paper. Commercial paper are promissory notes with short maturity periods issued by financial institutions and large corporations, and usually have higher rates than money market accounts for investing cash in the shorter term. Commercial paper with a rate of 2.17% matured in November 2018 and was replaced with 9 month commercial paper at a rate of 2.97%. Approximately $3.1 million of the portfolio is invested in certificates of deposit. None matured during the quarter so there are still 13 CD’s in the portfolio, each with a face value of $245,000 or less, which guarantees that each CD is insured by the FDIC up to $250,000. The maturity dates range from 5 to 22 months and rates of up to 2.3%. The remaining $32.8 million of the portfolio is invested in other long term securities which include municipal bonds ($5.4 mil), Federal agency bonds ($10.1 mil) and U.S. Treasury notes ($17.3 mil). Municipal bonds are issued by states, local governments, or school districts to finance special projects. Agency bonds are issued by government agencies such as the Federal Home Loan Bank and Fannie Mae and may have call dates where they can be called prior to final maturity. Trades that were made during the quarter exchanged securities with rates of Page 3 Study session meeting of January 28, 2019 (Item No. 4) Title: Fourth quarter investment report (Oct. – Dec. 2018) 1% – 1.25 % with new securities with rates between 2.78% - 3%. Nothing with a maturity date out more than 4 years is owned at this time in order to take advantage of rising interest rates as much as possible. This table is a summary of the City’s portfolio at December 31, 2018: Next steps: None at this time. 9/30/18 12/31/18 <1 Year 46% 55% 1-2 Years 12% 13% 2-3 Years 28% 21% 3-4 Years 13% 11% >4 Years 1% 0% 9/30/18 12/31/18 Money Markets/Cash $13,094,151 $26,728,299 Commercial Paper $3,475,845 $2,376,488 Certificates of Deposit $3,064,911 $3,065,108 Municipal Debt $5,398,076 $5,423,634 Agencies/Treasuries $25,894,947 $27,344,809 City of St. Louis Park Investment Portfolio Summary December 31, 2018 Institution/Broker Investment Type CUSIP Maturity Date Yield Par Value Market Value at 12/31/2018 Estimated Avg Annual Income Citizens Indep Bank Money Market 0.10%1,472 1,472 1 4M Liquid Asset Money Market 2.09%1,928,830 1,928,830 40,313 4MP Liquid Asset Money Market 2.15%15,025,173 15,025,173 323,041 4MP 2017A Bonds Money Market 2.15%2,173,890 2,173,890 46,739 4M 2018A Bonds Money Market 2.09%98 98 2 4MP 2018A Bonds Money Market 2.15%4,053,868 4,053,868 87,158 23,181,859 UBS Institutional Money Market & Cash 2.18% 3,544,968 3,544,968 77,280 PFM Comm Paper - ING Funding 4497W1Q82 03/08/2019 2.55% 800,000 795,896 20,400 PFM Comm Paper - JP Morgan 46640QQR5 03/25/2019 2.63% 800,000 794,728 21,040 PFM Comm Paper - BNP Paribas 09659CV62 08/06/2019 2.97% 800,000 785,864 23,760 2,376,488 PFM CD - Cit Bank UT 17284CH49 06/04/2019 1.90% 240,000 239,352 4,560 PFM CD - Amer Exp F UT 02587CAC4 07/10/2019 1.95% 240,000 239,285 4,680 PFM CD - Capital One Bank 14042E4S6 07/15/2019 1.95% 240,000 239,119 4,680 PFM CD - First Bk Highland IL 3191408W2 08/13/2019 2.00% 240,000 239,138 4,800 PFM CD - Webster Bk NA CT 94768NJX3 08/20/2019 1.90% 240,000 239,088 4,560 PFM CD - Capital One Bank 140420PS3 10/08/2019 2.10% 240,000 239,018 5,040 PFM CD - State Bk India IL 856283XJ0 10/15/2019 2.10% 240,000 238,997 5,040 PFM CD - Goldman Sachs Bank NY 38148JHB0 01/14/2020 2.20% 240,000 238,682 5,280 PFM CD - Amer Express UT 02587DXE3 01/30/2020 1.95% 240,000 237,972 4,680 PFM CD - Camden Nat'l Bank ME 133033DR8 02/26/2020 1.80% 240,000 237,984 4,320 PFM CD - Private Bank & Tr IL 74267GVA2 02/27/2020 1.75% 240,000 238,116 4,200 PFM CD - World's Foremost 9159919E5 08/06/2020 2.30% 200,000 196,504 4,600 PFM CD - Comenity Cap Bk UT 20033AND4 10/13/2020 2.00% 245,000 241,852 4,900 3,065,108 PFM Muni Debt - Williamston Mich Sch 970294CN2 05/01/2019 1.46% 2,000,000 1,995,060 29,200 PFM Muni Debt - New York City 64971WUX6 08/01/2019 1.33% 2,000,000 1,987,200 26,600 PFM Muni Debt - Connecticut St 20772JKN1 10/15/2020 1.78% 1,000,000 991,770 17,800 PFM Muni Debt - California St 13063DGA0 04/01/2021 2.80% 450,000 449,604 12,600 5,423,634 PFM FNMA 3135G0H63 01/28/2019 1.03%350,000 349,724 3,605 PFM FHLB Global 3130A9EP2 09/26/2019 1.04%625,000 617,444 6,500 PFM FHLMC 3137EAEF2 04/20/2020 1.49%1,000,000 984,860 14,900 PFM FNMA 3135G0T60 07/30/2020 1.60%1,250,000 1,229,338 20,000 PFM US Treasury Note 912828L32 08/31/2020 0.89% 675,000 662,263 6,008 PFM US Treasury Note 912828L32 08/31/2020 1.09% 700,000 686,791 7,630 PFM FHLB 3130ACE26 09/28/2020 1.48% 575,000 563,374 8,510 PFM FHLMC 3137EAEJ4 09/29/2020 1.69% 530,000 521,706 8,957 PFM FHLMC 3137EAEK1 11/17/2020 1.91% 800,000 790,040 15,280 PFM US Treasury Note 912828N48 12/31/2020 1.02% 150,000 147,861 1,530 PFM US Treasury Note 912828N48 12/31/2020 1.12% 750,000 739,305 8,400 PFM Freddie Mac 3137EAEL9 02/16/2021 2.47% 800,000 797,224 19,760 PFM Fannie Mae 3135G0U27 04/13/2021 2.55% 500,000 499,590 12,750 PFM US Treasury Note 912828Q78 04/30/2021 1.86% 250,000 243,828 4,650 PFM US Treasury Note 912828Q78 04/30/2021 1.87% 675,000 658,334 12,623 PFM US Treasury Note 912828R77 05/31/2021 2.02% 1,600,000 1,558,880 32,320 PFM Fannie Mae 3135G0U35 06/22/2021 2.76% 700,000 703,927 19,320 PFM FHLB Global 3130A8QS5 07/14/2021 1.25% 750,000 724,320 9,375 PFM Freddie Mac 3134GSWC5 08/27/2021 2.90% 775,000 775,000 22,475 PFM US Treasury Note 912828D72 08/31/2021 1.86% 600,000 592,548 11,160 PFM US Treasury Note 912828D72 08/31/2021 1.73% 1,200,000 1,185,096 20,760 PFM US Treasury Note 912828D72 08/31/2021 1.93% 850,000 839,443 16,405 PFM US Treasury Note 912828D72 08/31/2021 1.85% 1,150,000 1,135,717 21,275 PFM FHLB 3130AEXV7 09/20/2021 3.00% 750,000 751,875 22,500 PFM FHLB 3130AF5B9 10/12/2021 3.02% 750,000 759,570 22,650 PFM US Treasury Note 912828T67 10/31/2021 1.72% 1,100,000 1,063,304 18,920 PFM US Treasury Note 912828T67 10/31/2021 1.64% 575,000 555,818 9,430 PFM US Treasury Note 912828T67 10/31/2021 1.85% 200,000 193,328 3,700 PFM US Treasury Note 912828X47 04/30/2022 1.96% 700,000 686,602 13,720 PFM US Treasury Note 912828X47 04/30/2022 2.12% 850,000 833,731 18,020 PFM US Treasury Note 912828X47 04/30/2022 2.18% 800,000 784,688 17,440 PFM US Treasury Note 912828X47 04/30/2022 2.69% 1,300,000 1,275,118 34,970 PFM US Treasury Note 912828TJ9 08/15/2022 2.76% 1,050,000 1,018,710 28,980 PFM US Treasury Note 912828N30 12/31/2022 2.86% 500,000 492,950 14,300 PFM US Treasury Note 912828N30 12/31/2022 3.00% 950,000 936,605 28,500 PFM US Treasury Note 912828N30 12/31/2022 2.78% 1,000,000 985,900 27,800 27,344,809 GRAND TOTAL 64,938,338 1,352,396 Current Portfolio Yield To Maturity 2.08% Study session meeting of January 28, 2019 (Item No. 4) Title: Fourth quarter investment report (Oct. – Dec. 2018)Page 4 Meeting: Study session Meeting date: January 28, 2019 Written report: 5 Executive summary Title: Senior Community Services Annual Report Recommended action: None; for information only. Policy consideration: Does the council support the services that Senior Community Services (SCS) is providing to seniors in St. Louis Park? Does the council wish to continue to provide an annual financial contribution to assist in funding SCS? Summary: SCS is a nonprofit organization with a mission to develop, coordinate and provide services that help meet the needs of older adults and support their caregivers. Services are provided through a combination of paid staff and volunteers. SCS served 75 senior residents in St. Louis Park throughout the year providing 1423.25 hours of service with the following: • Minor repair 36 jobs 85.5 hours • Seasonal outdoor 51 jobs 611.5 hours • Mowing 156 jobs 168.5 hours • Snow removal 185 jobs 198.5 hours • Cleaning 159 jobs 359.25 hours The pilot program for shoveling sidewalks was not continued after the 2017-18 season due to lack of participation. Seniors in St. Louis Park utilize the full service snow removal, but there was little interest in the sidewalk only service. SCS’s recently completed annual survey indicated an overall client satisfaction rate of 95%. Clients responded to the question, did HOME services help you to remain in your home? Seventy-five percent reported that it helped very much, 21 % that it helped somewhat and 4% that it did not help. In another measure of satisfaction, 98% of SCS’s HOME clients would recommend the HOME Program to other seniors. Client referrals remain a top way that new clients hear about the HOME Program. Financial or budget considerations: The city provided SCS with a $10,000 funding contribution in 2018 to assist in funding the services they provide to St. Louis Park seniors. SCS has requested a $10,000 contribution from the city for 2019. Funds have been allocated in the 2019 Housing Rehab Fund. Strategic priority consideration: Not applicable. Supporting documents: None Prepared by: Michele Schnitker, CD Deputy Director & Housing Supervisor Reviewed By: Karen Barton, Community Development Director Approved by: Tom Harmening, City Manager Meeting: Study session Meeting date: January 28, 2019 Written report: 6 Executive summary Title: Crime/drug free rental housing workgroup process Recommended action: : The purpose of this report is to provide an overview of the revised process for convening a crime/drug free rental housing workgroup that would conduct an advanced review and evaluation of the crime free ordinance as outlined in this report. Policy consideration: Does the city council support the proposed process to establish a workgroup of key stakeholders to review and evaluate the crime/drug free ordinance as outlined in the report, and to present to council the workgroup’s conclusions and recommendations regarding the ordinance? Summary: The crime/drug free rental housing ordinance took effect in 2008 in response to concerns from residents who lived in or adjacent to rental properties experiencing disorderly or criminal activity. Discussions were held by council on the crime/drug free housing ordinance in May and on December 10, 2018. At the December 17, 2018 council meeting, council adopted a resolution to suspend sending notices of violations of city code Section 8-331 to the owners of rental properties to allow time for further study. The council also gave direction to staff to prepare a report with recommendations from community development/housing staff regarding the convening of a workgroup of key stakeholders to review and evaluate the crime/drug free ordinance for the purpose of providing recommendations to the city council on possible modifications to the ordinance. Staff presented an outline of a proposed process for convening the workgroup at the council’s January 14, 2019 study session meeting. Staff has revised the workgroup process to incorporate comments and suggestions received from the council. Financial or budget considerations: No specific budget for the study has yet been developed. However, it is estimated that meeting facilitation and miscellaneous expenses including transportation, daycare and refreshments for the workgroup process should not exceed $5,000. The funding resource for this expense will be the Housing Rehab. Fund. Strategic priority consideration: St. Louis Park is committed to providing a broad range of housing and neighborhood oriented development. Supporting documents: Discussion Prepared by: Michele Schnitker, Housing Supervisor Karen Barton, CD Director Approved by: Tom Harmening, City Manager Study session meeting of January 28, 2019 (Item No. 6) Page 2 Title: Crime/drug free rental housing workgroup process Discussion Background: The city council first discussed the concept of a crime/drug free ordinance in 2006 in response to a growing number of rental tenant behavior complaints. Property managers and residents in the rental community were being negatively affected by disorderly behaviors of other tenants. The purpose of the proposed ordinance was to enhance the rental business licensing section of the city code to assist in reducing crime and improving the quality of life within the community. The city council approved a crime-free ordinance in 2007 that took effect in 2008. The program was designed to be an effective and efficient tool in partnering with rental property owners to maintain crime- and drug-free housing in the city and to provide a safe, livable community for all St. Louis Park residents. When the program was first adopted in 2008 there were 8,316 rental units; today there are 11,284 licensed rental units. The council discussed the crime free ordinance at study sessions in May 2018 and again in December 2018. At the December 17, 2018 council meeting, council adopted a resolution to suspend sending notices of violations of city code Section 8-331 to the owner or property manager of a rental property to allow time for further study of the ordinance. Council directed staff to develop a process for convening of a workgroup composed of key stakeholders to review and evaluate the crime/drug free rental housing ordinance. At the January 14, 2019 study session, staff presented a draft process for convening a workgroup to council for review and comment. The workgroup process outlined below has been revised to reflect input and suggestions provided by the council. Revisions have been highlighted. Workgroup outline: •Purpose The workgroup’s purpose is to 1) conduct a comprehensive review and evaluation of the impact of the crime/drug free ordinance; 2) determine the effectiveness of the ordinance; 3) identify any unintended consequences or concerns; and 4) make recommendations to the council on possible modifications to the ordinance, up to and including possible repeal, to help promote safe, livable rental properties that are responsive to the needs of tenants, property owners/managers and the community. •Workgroup composition Staff proposes that workgroup representatives include key stakeholders. Key stakeholders are defined as those groups most affected by the ordinance, including rental property owners/managers, tenants and other members of the community. •Workgroup size To allow for productive, positive interactions among members, staff proposes the workgroup include a maximum of 10 members. •Meeting facilitation Staff proposes using an outside, impartial party to facilitate the workgroup, so as to conduct the process in an unbiased manner. Staff recommends Cathy Bennett, Bennett Study session meeting of January 28, 2019 (Item No. 6) Page 3 Title: Crime/drug free rental housing workgroup process Community Consulting, for this role. Cathy facilitated the city’s NOAH preservation workgroup discussions, works with the Urban Land Institute MN, is a former community development department staff person for the City of Roseville, and is a facilitator for both the Southwest Light Rail Transit (SWLRT) housing committee and the regional NOAH preservation workgroup. Having an impartial party facilitate the meetings will also allow for confidential communications between the facilitator and the participants to then be shared anonymously with the work group, if needed/desired by the work group members. Meetings will be held at times and locations in the community that are responsive to the needs of the workgroup members. • City staff role St. Louis Park housing staff will oversee the workgroup process. At the discretion of the workgroup, city staff representing housing, inspections and the police department will attend the workgroup meetings to listen, answer questions and provide requested data. Workgroup meetings will be conducted in a manner to encourage member participation and involvement in an environment where workgroup members feel safe to express their thoughts, opinions, ideas and experiences or knowledge related to the impacts of the ordinance. • Workgroup member application process An application process will be created for individuals interested in serving on the workgroup. Applicants will be asked which stakeholder group they identify with, to describe the reason they would like to serve on the workgroup, and to specify if and how they have been directly affected by the ordinance. The final workgroup roster should include demographic diversity and an equitable representation from each of the various stakeholder groups. Staff will work with communications and the community engagement workgroup to develop a broad and inclusive public process for seeking member applications. Once the application process is complete, staff will present the applications to the council for final selection and confirmation of the workgroup members. • Workgroup meeting process o Facilitated workgroup meetings will be held at least monthly, and more often if workgroup member’s schedules allow. Meeting agendas will include review of data related to the ordinances impact, identification and analysis of unintended adverse impacts, a presentation and discussion session with a panel of industry experts, and development of conclusions and recommendations for potential modifications to or repeal of the ordinance. o The workgroup will host two public listening sessions. Early in the process, the workgroup will host a session that will offer an opportunity for special-interest group representatives and community members to provide testimony to the workgroup related to the crime/drug free ordinance. The public testimony will provide an opportunity for the workgroup to be informed on the benefits and effectiveness of the ordinance as well as concerns and issues. Later in the process the workgroup will host a 2nd public listening session at which the workgroup’s preliminary conclusions will be presented. The 2nd session will provide an opportunity for the workgroup to receive input and comments on the draft Study session meeting of January 28, 2019 (Item No. 6) Page 4 Title: Crime/drug free rental housing workgroup process conclusions and recommendations. Testimony from this listening session will be considered by the workgroup prior to finalizing the conclusions and recommendations. o The workgroup has the discretion to decide if holding additional listening sessions, seeking input from a focus group or seeking information from a specific resource or expert is needed for a comprehensive evaluation of the ordinance. • Workgroup report conclusions and recommendations Once the workgroup has finished its review and evaluation of the ordinance, its conclusions and recommendations will be presented to the council. Racial equity and inclusion will be taken into account as part of the workgroup’s activities. This process is expected to take approximately six to eight months. Next steps: Absent additional direction from the council, staff will finalize the process for convening the crime/drug free rental housing workgroup. Staff will work with the city’s communication staff and community engagement workgroup to develop an outreach process to inform the community that the council is seeking interested members to serve on a crime/drug free rental housing workgroup, with an emphasis on seeking members most affected by the ordinance. Staff will work with various community groups, industry groups and individuals in an attempt to encourage applications from individuals representing demographic diversity and to ensure a balanced number of representatives from each of the various stakeholder groups. Once the application process is complete, staff will present the applications to the council for final selection and confirmation of the workgroup members.