Bangor council restores Bangor Public Health to opioid grant slate

[0:35] Susan Hawes: Good evening, welcome to the special city council workshop. It is Monday, March 2nd. Yay, we're going tomorrow. That's a start. We are in the council chambers and it's 5:15. Around the table we have Councillor Carson, Council Back, City Manager Carollynn Lear, Councillor Walker, Councilor Fuling, Councilor Fish, Councilor Wenner, Councilor Mallar, and I am Councilor Haas, and I'll try to keep us on track here for this. We do have also in the audience committee members that were part of the Opioid Advisory Committee, and if you could introduce yourselves, that would be much appreciated. It some need know for you whatever you want to do Shillian Koski Alice as well. Okay, so that's three out of the committee that are here tonight to hear. Now this is for the purpose of our committee's recommendation to council, so with that I'm going to turn it over to City Manager where she has her or memo there as well as the proposed awards. [1:52] Angela Walker: Yes, so I picked up the Opioid Advisory Committee for its first meeting. I think it was maybe a week after I started, so I've seen the whole process through. So in April, council established the Opioid Advisory Committee and then shortly thereafter appointed members. Members. The committee met a total of 15 times to complete its work. To start, the committee completed a letter of interest process whereby the public was asked to submit letters expressing how they felt the money might be best used, and then held a number of a couple of listening sitting sessions. The committee then decided to inform its recommendations to counsel for how to spend the opioid money through a grant application process and spent a good amount of time many, weeks creating a grant application process for that purpose. That grant application process closed on December 1st, and then over the course of several additional weeks, the committee members scored those grants. The end result was we received 32 grant applications and with the money remaining to allocate, there were 19 grant awards that the committee ultimately is recommending to council. Again, with nine voting members, two members resigned for reasons unrelated to their work on the committee. And then an additional member recused themselves from the vote on the ultimate award recommendation. They felt that because they were employed by an organization that had applied for a grant, they shouldn't participate in the process. On the meeting date where the final vote on this recommendation was held, one member was absent, which meant that five members were present and voting on the recommendation. And the final recommendation that's before you passed by a vote of three to two. It seems like the split vote on this deserves explanation. And so I included that in the memo, but sort of the crux of the disagreement on the recommendation was the committee's decision to not award a grant to Bayward Health and Community Services. Services. Their grant application scored sixth highest of the 32 proposals to receive a grant award of $50,000. Sorry, it's going to be a struggle because I'm not feeling very well. So they scored the sixth highest. Their proposal was to fund a per diem nurse for 12 to 15 hours a week to be located at the Wabanaki one-stop shop and provide medical services to individuals taking advantage of Wabanaki services. The final recommendation that was ultimately moved was to remove Bangor Public Health from the list because those making the motion felt that because the Bangor Public Health had stepped up and took on the HIV case management program, they didn't want to fund an additional ask from Bangor Public Health. I think the folks who voted no felt that if we were going to not fund applicants who had already received opioid money, that it should have been a criteria as part of the application process, and that similarly we should have reviewed all applicants to determine whether they had received opioid settlement development funding. We have some of the no votes here. So I don't know if they want to add anything to that. [Susan Faloon: If I've] characterized it properly. [6:40] Daniel Carson: So we're specifically talking about? Yes. So I was a no vote and I'll explain. We had off early in the process there was clearly an issue developing our community involving HIV issues, and the committee unanimously decided that we needed to fund public health to get some services up to those that desperately needed it quickly, so we did needed. Fast forward to the process of application. The two don't align. I voted no because we were disallowing an applicant based on who they are, not on the content of the application. Excuse me, I'm struggling with the same thing. It's the room. It might be. So I feel like the HIV funding to the provider in the application to provide a embedded individual with Wabanaki for needle exchange don't align. We disallowed public health solely because of who they are and not because of the content of their application, and we were following the law center guidelines which was vetted by the city solicitor's office. I feel like we had a good process, we followed the process, and I disagreed with disallowing an applicant at the 11th hour. [8:12] Michael Beck: If the committee said yes to them, were they taking another applicant off the table, or was that just saying no money to them? In other words, were they saying yes to one thing and no to public health, or was this just saying we'll take everything else but them, well another applicant [8:27] Angela Walker: and moved out because of this? Okay, yes, so it would have been the 19th applicant that hadn't scored [8:34] Daniel Carson: high enough then. But I feel like the list was developed through careful consideration by all committee members. We were all assigned a certain number of applications, and I'm pretty confident that everybody did their due diligence. I know I carefully reviewed each applicant, and I'm sure all of the committee members did. We developed a lift based on that careful consideration, and to change it at the last minute. I disagree with it. [9:02] Carolyn Fish: Thank you. So it's still passed from what I saw. It's still passed. You're a new vote just because of the process changed and it was sort of because of who they were, but it's still passed correct to give Bangor help? No. So the final vote was to remove that? Yes. And so if we went back and reconsidered and felt it was in the best interest to include them, would be in violation of the process you're concerned about? I think that's that might be a better [9:50] Angela Walker: question for the city solicitor. Yeah, I think I would say if you were to add them back, that would be more aligned with the grant application process as originally contemplated by the committee, but it would be counter to the recommendation of the committee. So that's certainly something that you would need to contend with, whether you thought it was appropriate to do something different than what the committee ultimately recommended. But in my mind, the split vote on a committee like this was notable enough to explain to you, particularly in light of the fact that there were only five members voting on the ultimate decision. [10:35] Carolyn Fish: And this was the only thing we were concerned about. About, ultimately, we were fine with everything else, it would be that we would be accepting the majority of the recommendation. But I, know for myself, I have the same concern. [10:53] Wayne Mallar: The final decision is up to the council as opposed to the board. [10:59] Angela Walker: 100%. There's, there's just a recommendation. Yes. So, ultimately, I guess when I'm here, you have my memo of a page and a half, but then you have probably two, I guess, two pages of the actual organization. Oh, I'm sorry, Alison, did you want to say something before? Well, Chief Hathaway said I was coming up to say something. I just wanted to, thank you, I wanted to reiterate what he said, and I think the piece that I didn't hear that really cemented me in the no vote was that this was an ongoing point of contention among the committee there was a very profound belief that this money did not belong to the city by a couple members of the committee and so throughout the entire that was known to be an intent and that intention never made it into our application process and so it definitely came back up at the very last minute as kind of an either or it was a pretty compelling application that the city had I think I identified it as being something that would require a larger entity to be able to pull it off because it was very nimble and flexible in the funding and fit a need but it yeah it was not at any part of our process to say that somebody couldn't be awarded and then awarded again and the original award to the city actually took place before we even began developing the application process that was clearly a very emergent need I think that was when the encampment was just closed the Ryan White contract which was funding the HIV case management had just left state it was a mess and the city was identified as being in public health as being best able to meet that need and so that happened and then we started our process of so it was two different things and it popped back up at the end unfortunate way I think that's it kind of closing out the meeting but had I been there I believe it would Have been a tie because I actually didn't think that was very fair. I watched the meeting afterwards on YouTube and I, it didn't sit right for me that someone who ranked sixth would get pulled out and someone who ranked 8, 19 would come up. Everybody needs that money, and so that's why we have this process to determine who need, who was capable of using it the best way, and then we set up that process of grading, and that's how they graded. So I like she said and like Chief said, it's, it's two different things. Each of, I think each of these things done and over, and then we started the process. So I don't think they should be, you know, excluded because they said they, you know, stepped up and did the HIV thing, and then, you know, now they don't get the money from a nurse, which is two totally different things. Thank you so [14:29] Michael Beck: Wabanaki Public Health was the one that moved up. Yes, which is interesting because they too also received opioid settlement money. You know, let's, I guess I'm not following why it was okay for one but [14:41] Angela Walker: not the other on that. Yeah, and I think in, you know, evaluating whether anyone had already received opioid funding wasn't part of the application process, so we didn't even, I mean, I personally knew because obviously that money flows through the city. The committee itself didn't undertake a review of whether any of the other applicants had received money from the city or any other municipality or sub recipient. What [15:14] Michael Beck: was the ask for Public Health that got denied? It [15:18] Angela Walker: it was just short of 50,000, and it was for a per diem nurse practitioner to provide 12 to 15 hours of weekly health care services at the one-stop shop at Wabanaki. The project came to expand access to primary and preventative care for individuals in Bangor who experience social and physical barriers to health care and who are affected by substance use and [15:47] Michael Beck: cold current mental health. This is a follow-up, so through 2038 we've got, still got over two million dollars to allocate. So realistically this doesn't have to be an either-or, this could be a both-and, honor the slate that was given to us, and if there's enough support on the council, we could also grant the [16:07] Angela Walker: the Public Health the money for their project. I think we have, we have the 650 in the bank today that we're able to allocate. I'm not sure, and Dave probably doesn't know, when we expect the next check in the mail. I don't know that it comes on a predictable schedule. [16:28] David Szewczyk: I have, I have to check that out. I don't know, right, I mean, the AG estimates of this year [16:33] Michael Beck: Will receive 214 000, yeah, when it comes we don't know, but yeah, I mean, if there's enough support for it, I hate to throw it out based on that, because again, you know, if you're saying we can't give public health more money if they receive some, but then the 19th moves up and they've already received some, it does seem a little unfair. [17:02] Angela Walker: If we did [17:08] Carolyn Fish: go with their recommendation, but like Councilor Beck said, we knew that we're getting another 200, could we kind of amend this and say, well, phase one is to do as you recommended, however, the caveat would be for the first primary consideration would be we'd already want this, so you know, in the pipeline, it's sort of an amendment we go, and if you know what I'm saying, I make myself clear, where we can, once that other funding is in, or we know when it's coming in, if we can already put that aside, that this is what we would like to see happen, because they were already scaled, already, you know, in sixth place, well I [17:53] Angela Walker: think that begs probably what I think is the fundamental question here, is does council wish to move, or how does council wish to proceed with this recommendation? Is your wish to move the whole slate as one through the council process? Or is your wish to go proposal by proposal and have the opportunity to sort of ask questions and consider each one as a standalone? Because I think that will sort of then answer your question. Dr. [18:33] Wayne Mallar: I'm concerned about the fact that who's coordinating the services that we're providing by giving them the money. Do we have, you know, I hate to see that five of these are doing the same thing and providing services to the same person, so who's coordinating this, and for my money, I'd rather do them individually. Okay and [19:00] Susan Faloon: I have a question about one of them specifically, like, I don't know if you can answer it or not, but related to the Bangor Y1, I was wondering, and I don't know, maybe someone from the committee could answer this, but like the child care piece of it, I was questioning whether or not that fit within the scope of what that money should be used for, and how do we know? So like I get, you know, yes, you can have child care so you can, you know, attend these services. Like I get that. But how do we know specifically that someone isn't just using that for their child care for whatever reason? [19:42] Angela Walker: Yeah. So I'll say the this is the memorandum of understanding that outlines how the money can be used. It's pretty extensive and it includes, you're nodding, it includes offering services to people who are in recovery, including childcare, other healthcare, housing. So it's pretty broad so long as your target for those support services are part of the target population. Population, we will have a contract with each of these grant recipients that will come from the city solicitor that will require reporting back to us on the well first they'll have to you know sign off saying we will use this money in support of the purpose that we applied for it but they'll also be required to report data back to us so that is some check and think the data being reported back to us is going to be incredibly important because we're getting so much more money I think that would Be a fundamental tool for the city to determine how we'll spend additional amounts of money. [20:59] Daniel Carson: Yeah whatever oh go ahead I my preference would be to answer your question managerly. My preference would be if we could get to the point where we could move these as a slate rather than us digging through each and every one, but to get there, I sort of need to know a little bit more about this, like removing public health, adding Wabanaki public health there. They were 19th. I'm counting 16 awards. Oh, did I miss? I've counted a few times just to make sure because I'm exhausted, but I'm counting 16. So where did 17 and 18 go for my stream? [21:39] Angela Walker: I'm so glad you asked that. So there were a couple of applicants that were removed and that is my error because I just counted the lines on the Excel spreadsheet. There are a couple of applicants that were removed because they scored very high, but then we did an extensive review of the applicants against the MOU and we determined that a couple their projects did not qualify for funding and so they were removed. [22:11] David Szewczyk: David Sepchik city solicitor I just wanted to clarify something that I heard the idea that this isn't the city's this shouldn't be for the city I mean these are funds that came from the city's inclusion in the opioid litigation and they are funds that have to be spent on approved uses pursuant to the memorandum of understanding but How which approved uses that you spend the money on is up to the city. It's the city's settlement money and the process that was set up for the committee. The committee was formed to make recommendations, but Ultimately, it's the City Council who gets to decide what? The funds are spent on and the process for scoring that was set up was set up in a fair way everybody agrees on that. And so the idea that I just I just I don't think that there's anything to stand on when you're talking about the idea that this shouldn't be funds for the city. It's the city's money that is has to be spent on approved uses. And that's just what I wanted to add in there. [23:28] Susan Hawes: That was a comment made by one of the committee members in the course of the conversation, looking at one. It wasn't the whole committee. It was made in committee. [23:47] Joseph Leonard: Hello so I have a question for maybe counselor Hawes you can answer this or Andrew you can answer this. Were there out of all the other applicants were there any other major discussions or issues that came up regarding the other applicants besides Wabanaki and Bangor Public Health? [24:15] Susan Hawes: I don't recall any. A lot of these applicants were, it was a new program, new to the area. There was one that was discussed because when we looked at it, was new to the area, but it actually was housed in Florida or someplace else. But no, I don't think we had extensive questions on any of them. [24:40] Angela Walker: And we just to be clear we did not fund the program that our grant application made clear that the applicant needed to be located in Maine so we determined that was not a qualifying [24:50] Joseph Leonard: Application all right with that in mind I definitely am in the same boat as a counselor Carson where I would prefer to see a slate of these go through. I don't really want to see council be mired through work that other people have already done especially since we have a our own slate of agenda items are coming up this year. If this Council does want to continue on the discussion regarding whether a bank or public health should be what we should do regarding that subject, I'm completely okay with if Council wants to go forward with amending that item in some way, shape or form. But I don't wanna see each of these individual items going forward. I trust the committee doing their work and I think it would just be an erroneous waste of our time. [25:50] Susan Hawes: Yeah, Councilor, I don't know if Sandra's up first. [25:54] Carolyn Fish: I agree, I'd like to move these. That's an entire slate, and I'd kind of like to amend my suggestion, obviously with the council input, but I would like to amend to, in fact put Bangor Public Health back into their position, and then perhaps move Wabanaki as the amended first person, the first non-profit up in the slate for the next distribution of funds. I don't think that where they were eliminated by the rules in the beginning to go all that far and come into the sixth place to see them repositioned and included, but to also be respectful to the recommendation may be amended that Webnaki is next with the funding that comes [26:47] Angela Walker: in. That's all. I should have gone for you because you said everything that I was saying. What I was gonna say was I think that we trusted, we trusted that when the committees were built that they had the ability to go over every application individually and come up with their scoring, and they scored these applications, and I think it would be an incredible waste of time and doing them individual instead of getting like we need to get these, we need to get this funding out now, like it's for the OUA crisis that we had in the lives that have lost, that we've lost, like we definitely need to get these out, and I think that would be a complete waste of time to go individual because my myself, I trust that the committee members for these applications very thorough and scored them appropriately, and I also in favor of placing Bangor Public Health back in their position that they were because I think that's unfair to say that they had gotten the funding before because that wasn't in the application process, which is a huge thing, and that we place Wabanaki on the next that they would be guaranteed to get this money as well, and I definitely think going through it individually is not a good idea. You should do that's a whole big slate of it and approve it and get it out immediately. [28:21] Wayne Mallar: That's amount. I still would like to know what type of coordination we have between the people receiving the grants. We've been through this before and it hasn't worked well. We've had five groups providing services to the same person and that's not productive, so if we don't have a coordinator, I'm going to vote no for all of them, because I think you need coordination. The secret to a successful program is if you have someone that's coordinating all the arms, and we're not doing that. [28:54] Angela Walker: You mean coordination within the applicants? [28:58] Wayne Mallar: I mean, yes, I don't want to see the same group of people same, you know, I don't want to see five applicants providing the same services to conceivably could be for the same person. person. So that's a duplication of effort. So we need a coordination to know what 's going on. [29:16] Angela Walker: An individual person in our community getting services from all these people that have already been the applications have already been reviewed, like we have to trust that process. [29:26] Wayne Mallar: I'm not saying that they're not qualified. I'm saying I don't want a person that's receiving services from five different groups for the same thing. Well, [29:37] Angela Walker: I would strongly, I'm against that because I feel like people that are looking for these services, it could sometimes take one time, ten times, a hundred times, a thousand times, it wouldn't matter. It's recovery and it's like it doesn't just happen one time we're giving these services that this organization one time and not this organization another time, like it takes a thousand times if that's what it takes and services are often duplicated. [30:04] Wayne Mallar: That's the problem we spend too much money we need to consolidate the money and get the best bounce for the buck and I don't think we're doing it I have no problem with someone going 100 times to the same person but if you're the group that's providing the service you're better prepared to handle them when they come back the second time as going to a new person starting all over again [30:29] Carolyn Fish: I think I can understand where council mail is coming from in a way I mean when I've looked at the last two or three years of the money that we've got received either in grants or other funding and then it comes through the city and it's allocated out it's about five million dollars a year there about and it's grown exponentially the last three or four years and yet the problem seems to be also growing so there's the question of why isn't our monies being more effective so I think it's just a Misunderstanding or miscommunication or maybe lack of education to us that we don't understand whether or not more collaboration working with all of the service providers and then you know and here we are again allocating all this money that we're hoping gets a positive result but we haven't seen positive results even though the funding has grown and grown and grown it's gotten worse so I understand the question I just don't know that the you know I don't know if we're connecting really what The concern is, and that this is going to just continue what we've been doing, yeah. I too appreciate [31:49] Daniel Carson: in counselor maler's concern i sort of see these as two different pieces we're being asked right now to award money the homeless committee that we 've been talking a lot about i know that there's at least i feel like there's consensus across council that one of the main things that we need in that is collaboration the ability to actually foster that environment and i think that is where we're going to be able to answer that question i don't think we have the capability at this point in time to think that we're going to award funds and actually be able to do that second piece yet but i definitely think that 's that's an important part and i think i hope that we get to that quickly with establishing a homeless committee yeah [32:42] Wayne Mallar: By now, with all the monies we've given out in the past years, there should have been some coordination and who was receiving what. I believe we've been told that everyone that we service fills out a card and it goes to the next, you know, they know who's taking care of them. I asked for the report of that and I got an unreadable report from our department. So I question who is doing the coordination, or if we're doing any coordination, it appears to me we're not. And that's not prudent. We have to know what's, I don't care who the people are, it's not important to people that the process is what's important. I want to put the person in the proper slot or have them getting the type of service they need. I don't care if it takes two groups to do it, but I don't want them to going to five groups and accomplishing nothing, and that's what I see happening. You [33:41] Susan Hawes: mentioned that attorney Subject is going to be drawing up contracts with these organizations that get this amount of money in there. I thought we had discussed that there would be checkpoints as to what are they using it for, what have their, what were their wins with the money, what did they gain from that money, and how is it not helpful. You need all of that. Once we start doing that with everything that we give as a grant or have anything to do with it and ask them to take some ownership and accountability of how they're spending it, getting back to us on regular updates, dates, or however it's set up, will be spelled out, I would assume, in the contracts. And that will give us the base of what you're looking for, coordination. [34:38] Wayne Mallar: That also brings up the point, are they getting the money in advance or as they use? [34:44] Angela Walker: I think it will largely depend on what they've asked for money for, but for the most part, it will be in repayment for costs. That they've been heard second. [35:03] Wayne Mallar: Some of it, okay, we'll see how the coordination goes. I haven't been happy with it thus far. We have to start somewhere. [35:13] Susan Hawes: Well, yes, but anything else? Next step, some actions? Yeah, it's an action. [35:26] Michael Beck: We need lots of that. Well, I guess I see this as a motion, two parts. The first motion would be, I would move that we amend this slate to replace Wabanaki Public Health with Bangor Public Health's application and then disperse the money that way. It's been moved and double. [35:52] Susan Hawes: Seconded. Then we're going to take the slate and put Bangor Public Health second. Well, that. [36:07] Michael Beck: With my second motion would be then that I consider them discussion. [36:14] Wayne Mallar: Quick question, do I see somewhere else in the work tonight that Bangor Public Health is looking for 550,000 to help HIV? Is any of this duplication? Are they applying for a grant? [36:32] Angela Walker: There is a grant application in here from public health. Yes. [36:38] Wayne Mallar: That be a duplication of effort? Or is that additional money to what they thought they were going to get here? [36:44] Angela Walker: Here, so the one here is not HIV related services, they're not addicted discussion. Is that one motion you made or did you slide it into this one? That's just the one you start. [37:08] Susan Hawes: All right, so I moved and seconded to put public health back in, okay. Any other discussion? No, he goes, well, I'll vote on this, okay, to be honest, roll call vote. Council Carson, yes, that's about yes. Council Walker, yes. Council Flu, yes. Council Fish, yes. Council Leonard, yes. And that will be a yes. Oh, I don't know, it's actually important, yeah. [37:45] Michael Beck: I mean, you're. [37:46] Angela Walker: Member of the council, you would vote on it. Okay, so what is that, eight of us? [37:53] Michael Beck: Seven in favor, one opposed. And then my next motion is that we would consider Wabanaki Public Health their application first when the next round of funding decisions are made. That's it. [38:10] Wayne Mallar: Second. Well, yeah, discussion. Just because they're going to be their 19th now, we may have 20 others come in that are way above our 18 and that are above them, so you're giving them a leg up to start with. Is that how I understand this? I would see this more as we're just moving the grant. [38:31] Michael Beck: Application forward to that process, so they're going to get considered, so it doesn't guarantee it. [38:35] Wayne Mallar: Okay, so they're not going to be autumn. It's not an automatic. It's going to be thrown into the pot because the way you stated it, they were going to receive the next grant money. Well, they would get first consideration generation, but that gives them a leg up as opposed to the people that are applying for the grant. And I don't find that act, you know, you got to treat everyone the same. So if you're having a new grant round of grants, they all start off on the same footing. And if you say that about Wabanek, that means they're already receiving the grant. Yeah. [39:10] Michael Beck: I mean, I, to me, the word consideration is the key. So, you know, they may not, you know, they're going to be considered, but they may not. [39:17] Susan Hawes: They would still have to apply for that grant for the next round. They have to put an application in [39:28] David Szewczyk: like all of the others. Chair, sorry, Dave Stepchick, city solicitor. I would just wonder how whether in the context of this motion, if it could be clarified what first consideration means. [39:43] Michael Beck: Well, if they're going to have to comply anyway, I would just withdraw the motion and then just let them align. [39:48] Susan Hawes: Just encourage them to come back. We may have others that will also apply. [39:57] Michael Beck: Yeah, with the permission of the second, I'd like to withdraw my motion. [40:02] Susan Hawes: Is there a permission from the second? Okay, so that's what you had your hand up relevant now. Okay, so we've got the items that are going to be going ahead, so I'll work those into a an order for the next council meeting. Sounds good. If there's nothing else for this workshop, yes. [40:34] Michael Beck: Just a question in a future workshop where we have a discussion on the actual how the committee went and whether or not we would consider having a standing committee going forward. [40:44] Susan Hawes: I think that would be prudent because we had, I think the committee did good work. It's not a simple project, and it was a lot of discussion, and there was a lot of extra time that needed to be spent. But I think we do need to decide how do we go forward for the next round of money, and is it the same process, having that grant process hammered out before too soon into the committee was good because we really needed to know what the parameters were going to be. So I would say it would be another Workshop discussion, and we could even do that after budget because I have a feeling our time is going to be pretty well spent here pretty soon with budget, so but yes, we would have another discussion about how it went, what the process. So is there anything else? If not, we can adjourn the workshop up 5 56. We are adjourned. Coming up with the assignment committee, give them a couple of minutes because they do need to make them.