Board of County Commissioners on 2020-04-09 9:00 AM - COVID-19 Update

BOARD OF COUNTY COMMISSIONERS FINAL MINUTES 4/9/2020 9:00 AM MINUTES JOHN F. ARMSTRONG WING OF THE BLAKE LIBRARY 2351 SE MONTEREY ROAD, STUART, FLORIDA 34996 Taryn Kryzda, County Administrator Sarah W. Woods, County Attorney Carolyn Timmann, Clerk of the Circuit Court and Comptroller COUNTY COMMISSIONERS Harold E. Jenkins II, Chairman Stacey Hetherington, Vice Chair Doug Smith Sarah Heard Edward V. Ciampi COVID-19 Update CALL TO ORDER 5 - Chairman Harold E. Jenkins II Vice Chair Stacey Hetherington Commissioner Doug Smith Commissioner Sarah Heard Commissioner Edward V. Ciampi Present: 1. MOMENT OF SILENCE 2. PLEDGE OF ALLEGIANCE 3. APPROVAL OF AGENDA A motion was made by Vice Chair Hetherington, seconded by Commissioner Smith, to approve the agenda. The motion carried by the following vote: 5 - Chairman Jenkins II, Vice Chair Hetherington, Commissioner Smith, Commissioner Heard, and Commissioner Ciampi Aye: Page 1 of 44/9/20 FINAL MINUTES

COMMENTS 1. PUBLIC - PLEASE LIMIT COMMENTS TO THREE MINUTES. None at this time. 2. COMMISSIONERS Commissioner Smith spoke about a friend of Martin County up in Tallahassee who was gravely ill and asked that everyone keep that person in their prayers. Commissioner Hetherington thanked our medical professionals, who are on the front line, and our first responders, our school district, and our teachers. She also offered our thoughts and prayers to our first victim of COVID-19. Commissioner Heard reminded everyone that daily COVID-19 updates can be seen on MCTV at 4:30 p.m. 3. COUNTY ADMINISTRATOR None at this time. DEPARTMENTAL ADMINISTRATION DEPT-1 CORONAVIRUS (AKA COVID-19) UPDATE The Board of County Commissioners will hold a special meeting to discuss County efforts relating to the Coronavirus. Staff will provide an update on local efforts and coordination that is taking place. Agenda Item: 20-0630 COVID-19 UPDATE Emergency Management Director Michele Jones provided an update to the Board on the County's efforts. Fire Rescue Chief Bill Schobel informed the Board that all first responders were responding without delay and that five to six suspected COVID-19 patients were being transported per day. He assured the Board that ample personal protection equipment was available for emergency response personnel. He also praised the 9-1-1 dispatchers for the job they were doing. Martin County Health Department Administrator Carol Wegener-Vitani announced the first reported death in Martin County. She informed the Board that there were currently 108 confirmed cases (105 residents and 3 non-residents) and that the Health Department staff continue contact tracing, seven days a week, of all the positive individuals. Cleveland Clinic Martin Health President Rob Lord informed the Board that they Page 2 of 44/9/20 FINAL MINUTES

continue to operate under their Emergency Operations Plan and currently have adequate supplies. He announced that the hospital is collaborating with health care officials and estimated that their surge capacity was 350 to 450 beds, with alternate care sites identified that could add an additional 250 beds, if that became necessary. He also updated everyone on their testing program (triage #772-419-3360). United Way CEO Carol Houwaart-Diez updated the Board on the activities of the non-profit community. PAYCHECK PROTECTION PROGRAM Business Development Board Executive Director Joan Goodrich introduced Seacoast Bank Chairman Denny Hudson, who provided the presentation to the Board. PUBLIC COMMENT House of Hope CEO Rob Ranieri updated the Board on food distribution and mental health support. GOLF COURSE DISCUSSION The following members of the public spoke in opposition to closing the golf courses: Attorney Bob Raynes (The Dye Preserve Golf Club), Kevin Murphy (MacArthur Golf Club), Michele Reilly (Willoughby Golf Club), Nancy Lopez Russell (Piper's Landing), Brian Rich (Piper's Landing), Colleen Katterheinrich (Champions Club at Summerfield), and E.J. Ewing (Sailfish Point). Assistant County Administrator George Stokus updated the Board on staff's efforts in contacting local golf courses. County Administrator Taryn Kryzda (through communications with the Sheriff) confirmed that each open golf course had a plan in place to comply with CDC recommendations. County Attorney Sarah Woods informed the Board that they could direct an emergency order requiring compliance with best management practices. MOTION: A motion was made by Commissioner Smith to adopt the golf course owner's best management practices as our guiding principles. The motion failed for lack of a second. Agenda Item: 20-0630 MOTION: A motion was made by Commissioner Smith, seconded by Chairman Jenkins, to direct staff to work with the Sheriff to create an order [for golf courses], under the Emergency Powers Act that we operate under, to create a rule for existing members, Martin County residents, and no guests on either side of that equation, in coordination with the Sheriff's Department. The motion carried by the following vote: 3 - Chairman Jenkins II, Vice Chair Hetherington, and Commissioner Smith Aye: 2 - Commissioner Heard, and Commissioner CiampiNay: Agenda Item: 20-0630 Page 3 of 44/9/20 FINAL MINUTES

PARKS DISCUSSION Parks and Recreation Director Kevin Abbate provided a Parks Status Update to the Board. Mr. Abbate presented the Board with a list showing the status of the County's various parks and facilities. MOTION: A motion was made by Commissioner Smith, seconded by Commissioner Heard, to approve the language that Mr. Abbate has given us with the various edits. The motion carried by the following vote: 5 - Chairman Jenkins II, Vice Chair Hetherington, Commissioner Smith, Commissioner Heard, and Commissioner Ciampi Aye: PUBLIC - PLEASE LIMIT COMMENTS TO THREE MINUTES. None at this time. ADJOURN The Board of County Commissioners COVID-19 Update meeting of April 9, 2020 adjourned at 12:09 p.m. _________________________ _________________________ Carolyn Timmann, Clerk of the Harold E. Jenkins, Chairman Circuit Court and Comptroller Board of County Commissioners /mkv Minutes approved: _________________________ This document may be reproduced upon request in an alternative format by contacting the County ADA Coordinator (772) 320-3131, the County Administration Office (772) 288-5400, Florida Relay 711, or by completing our accessibility feedback form at www.martin.fl.us/accessibility-feedback. Page 4 of 44/9/20 FINAL MINUTES

>> welcome all to our April 9 th board of county commissioners special meeting. If we could stand for a moment of silence and remain standing for th pledge. I pledge allegiance to the flag of the united states of america and to the republic for which it stands one nation under God indivisible with liberty and justice for all. >> okay. We are going to have our update s first and then we will take public comment. We have a 9:30 preset with the bdb. With presentation on the ppp. Can you hear me. Yes, I am working on that. >> move to approve the agenda. >> second. >> we have a motion and second to approve the agenda. All in favor. All opposed. Motion carries unanimously. >> I believe we are going to start with michelle jones from emergency management. And chief schobel. Will follow, I guess. >> yes, sir. >>. >> good morning, commissioners. >> we have provided you a hand out tha has the latest situation report, daily report and communication statistics. Since our last update we have also launched a new dashboard, its has developed for us that has county specific covid-19 data and age distribution. And new cases by day. That can be found at martin.Fl.Us/coronavirus/doosh board. And and 772-287-1652. it is open daily. 7:00 A.M. To 6:00 P.M. It had be closed on sunday April 12th. They are fielding 100 calls a day and have fielded over 1600 calls since opening on March 18 th. Frequent questions that they are getting asked are about the boat ramps. Essential, nonessential businesses. As a reminder. >> michelle. Can you either. Speak a little bit into the mic >> it is just. >> very hard to hear. I am sorry. Speak more slowly if possible. >> can you speak with an accent >> maybe on one leg. >> can you stab on 1 foot. >> talented but not that talented. All right. So I apologize. Good morning. Wove provided each of you with a handout situation report. Daily report and communication statistics. We have also launched a new dashboard, a valentine --- covid-19 dashboard and new cases by day and that can be found on the coronavirus web page and also be found at martin.Fl.Us/coronavirus dashboard. >> you are our its developed that. And it doesn't require you to go in and find martin county. It is a nice snapshot of where we are at. Community information center fields calls at 772-287-1652. they are open daily from 7:00 A.M. To 6:00 P.M. But they will be closed on sunday April 12th. They are currently fielding 100 calls a day to date have field ed over 1600 calls since opening on March 18th. Some of the frequent questions they are getting asked are about boat ramps. Parks. Essential and nonessential businesses. As a reminder to the public, boat ramps will be open for activities on week days and close at 8:00 P.M. On friday night and reopen monday except to state licensed commercial marine activities who May operate out of the boat ramps in san sandsprit park and jensen beach. Department of environmental protection has closed all we haves and sand bars including the sand bars located in the intracoastal waterway. The fish and wildlife commission has directed all vessels shall have no more than 10 people on board and maintain a 50-foot distance between each vessel. >> reemployment applications, those have been provided to the nonproperties when sharing food assistance, and those are also available at fed. Ex. Locations and once completed can be drop ped off at fed. Ex. Locations and who will ship them free to the office of economic opportunity for processing. >> we are also creating a resource card for nonprofits and this is financial assistance sites. for any individuals that might need continuing service assistance. We work closely with cleveland clinic to plan for the incident and how that May impact the healthcare system. We have worked with the department of health on a hand out for those who are asked to self isolate or quarantine with information on what to do and when they are sick and where to go for add driggal help if needed. We are continuing our regular efforts. Martin county update videos are releasing every week day with our star Miss Kryzda and released three so far and yesterday get toured taryn and our sheriff. They start at 4:30. Each week day and will be post ed and e-mailed out. We are taking questions from the public on four of those to be addressed in the videos. They can e-mail the questions at covid-19 questions at martin.Fl.Us. >> then the weekly wrap up version. Daily report is e-mailed out each night and posted on social media in the website. Our website maintains constantly updated throughout the day. We continue with the social media platforms, facebook. Twitter and you tube. And notifications. Folks can register by texting alert martin to 888777. Our e-mails are sent out weekly and we continue with the news releases and media contact. We are asking our community to take this very seriously. Take this time to stay home and if able, stay home if able and connect virtually with family and friends. Next week the public safety telecom miewpt kate tore week and you heard from the sheriff's office and the herculean evident about the dispatchers. 911 responders and thank them for all their efforts and telecommunicators from fire rescue and the sheriff's office fo all their efforts to keep our first responders safe. With that, we ask the community to stay home. Stay safe. Stay connected. So that we can all stay together. Martin strong. Any questions for you me -- for me. All right. Thank you. >> thanks michelle. >> chief. >> can you hear me okay. Bill schobel. Fire rescue. I am here to tell you all of our first responders this martin county continue to respond without delay to normal 911 calls and also covid-19 patients. We transport about five to six covid suspected patients a day. It doesn't mean they have it but they meet the criteria of a high suspicion and we allow the testing. Cleveland clinic martin health will make further determination once they get in there. It is relatively, like I said. We are responding without delay i want to assure the community. There are no issues. We just received another shipment yesterday with ppevent , so, we have ample personal protective equipment to do our jobs and also, a shout out to our 911 dispatcher s. Obviously, it is their week and we are kind of shut down. So, it is a little bit bittersweet here. I want to give a shout out to them. Do an awesome job. We have taken extra precautions to protect them and they are safe. They are doing their jobs and thank you for everything they do. Any questions. >> no. Thank you, sir. >> thank you. >> okay. Now, we are going to get an update from the department of health car rog wagner vitani. Carol vitani. >> you are going to have to point it down a bit. There we go. >>. >> good morning, commissioners, thank you for allowing me the opportunity to give you an update on the covid-19 situation here in our community we are grateful for your support as we work in partner ship to take all available and necessary actions to stop the spread of this virus in our community. Sadly, the florida department of health is reporting its first keith from covid-19 in -- first death from covid-19. in martin county. Our condolences go out to his loved ones and friends. As of last evening, there are 108 confirmed cases of covid-19 in martin county. 105 residents. And three nonrose dents -- non residents. Health department staff continues contact tracing seven days a week of all the positive individuals. This is critical to decreasing the spread of the virus. Health department staff is in daily contact with our long-term care facilities urgent cares. Dialysis centers and rehabilitation facilities. We continue to work with our emergency management. The hospital to discuss and plan hospital surge as well as for alternative care sites. We realize this situation is difficult and stressful. But it is essential that everyone take action to protect themselves and prevent the spread of the virus. Which includes good handwashing staying at home when you are sick. Frequent cleaning and disinfect ing of high touch suffer fasts and social distancing. The positive impact of social distancing has been seen in other states as well as other countries. That social distancing measures have been effective and will dramatically alter the progression of the pandemic of allowing the communities to distribute resources more effectively and ultimately save lives. This will help prevent our healthcare system from becoming overwhelmed. So, we must stay the course. We encourage everybody to follow the governor's safer at home directive. Especially if you are over 65 and have a chronic health condition such as compromised immune system. Hypertension. Diabetes. Heart or lung disease. Face coverings. As you know, cdc recommended wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain such as the grocery store. Pharmacies, those trips of settings. Especially in areas of significant community based transmission. Cloth face coverings should not be placed on young children under the age of two. The cloth face covering recommended are not can you recall masks or I-95 respirator s. Those are critical supplies that must be in reserve for our healthcare workers and medical first responders. As recommended by the cdc, department of health just launched a community action survey called stronger than c 19. This short two minute on line survey will help the department identify and predict covid-19 trends in the state and reinforce prevention efforts. The survey and the dashboard with case counts by county is available on florida health covid-19.Gov. One last thing. You are becoming sick, call your healthcare provider for evaluation and to rule out other illnesses and stay home. Doh call center, as you heard before, the department of health in martin county has established a local call center to answer questions. That number is 772-221-4000, option nine. That line is active monday through friday. # A.M. To 5:00 P.M. Then we have an on call service for the weekends. That will allow you to speak to one of the staff. The department of health call center at the state level has a 24/7 to answer any questions. That number is 1-866-779-6121. Residents can also e-mail covid-19 at flhealth.Gov and last thing I would like to say, thank the many people in our community who are working above and beyond to respond to this virus, the medical staff, the first responders and the public health staff at the florida department of health in martin county. Especially during this week. National public health week. We thank you all for your support as we work together as a community to stay healthy and to stop the spread of this virus. Thank you. >> thank you, carol. >> any questions. >> yes, commissioner heard. >> do you have enough tests? >> well, the testing, you know, all the testing is being done at the hospital and we have a small supply of testing capability at the department of health and that is specifically earmarked for our long-term care facilities. Okay. I know the testing in the past, and at present is taking up to two weeks to get results back and there are some speculation about the duration the virus that hopefully most patients, it doesn't last that long. What about the reliability of testing from the the time that the person is tested and the time that they receive results. If the results take 14 days toe get back. How reliable can we assume that the testing is, if the gap time between the swabbing and the test results is two weeks or more. >> well, the test results have been coming back a lot more frequently. Much quicker now since we have more testing capability available in the community. And the, by the time, I know that some of the situation has been when someone has gotten the results. Ten or 11 days later, they are passed the incubation period or the time that the virus lasts 14 days. >> thanks. >> any other questions. >> go ahead. >> I am sorry. >> I have a couple of questions on testing. Are we using the same criteria that we were using weeks ago. When someone calls up they have to meet the cdc and can you describe what that is. >> for the testing. Yes. The testing at this is still following the cdc guidelines and the priority one, hospital ized patients, healthcare facility workers with symptoms and then patients and long-term care facilities with symptoms and patients 65 years of age and older with symptoms. And patients with underlying symptoms and first responders with symptoms. Critical infrastructure workers with symptoms. Individuals who do not meet above categories with symptoms May be, that might be through their physician who is recommending it. Individuals with mild symptoms in communities ex experiencing high number of covid-19 hospitalizations. >> then, I also understand just from people in the community, that now, because some folks are getting confused, there is the swab tests and then there is a separate test that tests for antibodies. Can you describe a little bit about that. >> yes. >> so, there is, there has been a lot about the testing, yes. >> the department of health will only accept fda approved tests. And the swabbing is the one that is the approved one. >> so, you can do a rapid test which will give you a good preliminary and we recommend do ing a follow up. >> are you seeing and I heard this just yesterday. From somebody that they had calls to get tested or family member of the person and said they were getting quoted upwards of $300 for a swab test is that something that primary care physician. >> I am not aware of that and the testing should be covered by most insurances or free. >> so, if a person doesn't have insurance, it should be free. >> okay. >> then, finally. You mentioned that the department of health was collecting. And doing that survey. When would we expect to see they compile the survey into data that filters back down locally and would help us with decision making. >> I don't have a date for that but I will difficult of definitely bring it up on my call today and get back with you. Thank you. >> is that legal? Is it private to make money off of this? >> I guess I can't speak about that. I don't know. >> can you on the call. Ask to see what the, I find that hard to imagine actually. But. >> yes. >> okay. >> any other questions. Thank you very much. >> thank you. >> Mr. Rob lord from the cleveland clinic. >> you are going to have to tilt it back up. So. >>. >> Mr. Chairman, commissioners. thank you so much for the opportunity to be here. It is a privilege. We continue to operate under our emergency operations plan. I have been on that plan since March 13th. And with the supplies and we get a lot of questions about that. We do have adequate supplies. Doesn't mean we have all that we node through this event. We have to be mindful of the fact that supplies rp limited as the -- supplies are limited as the world knows. We are trying to protect caregiverrers and be conservative in the use of the supplies. We continue to follow cdc and w ho guidelines on utilization. We are also wearing cloth masks in our facility. That is optional with the colleagues. At this time. Closely collaborating with our public health officials and the health department and the county. We have a great partnership in this community. I think we are fortunate in that regard and the county and carol and her team. We are working very well together. We are looking at a number of contingences ourselves. Expanding patient care areas within the hospitals and in the event of a surge. Have a little bit of information on that. We can share with you and the community. Capacity at north and south hospitals resist somewhere in the vicinity of 350 to 450 beds we can add. That is less than ideal. Staffing that is challenging for us. We can do that and we have alternate care sites identified that could add an additional 250 beds if that became necessary. We are assisting emergency management in the department of health as they plan this. With regard to drive through testing. There have been questions. No charge for our testing. >> I want everybody to know that. I want everybody in the community to know that. I don't care if you don't have a dime. Come symptom. If you have symptoms. We will test you. We have waived co-pay on Dr. Visits. >> we have gone to one location in martin county at north hospital because the volume did not support having two. We can open up again and have two if the volume picks up. But right now, that is not the case and for the public, they must first call a triage line. That number is (772)419-3360. If that patient meets criteria and we are using the cdc criteria that we mentioned a minute ago, they will get an appointment for the drive through facility. As of yesterday, we had screen ed more than 10,000 people by phone on that line. We have tested 780 martin county residents. And then an additional 300 persons through our martin county based drive throughs. Through this process, the reason this is important, it protects the patients. Caregiver and community. Patient can come up. Sit in the car. Have the seam am take be. Never get out of the car. Never have to come into direct contact with the caregiver at the window. We think that is the best for everybody involved and it reduces exposure. Test results, commissioner heard's question. Be able to fill in some information. My information May not mesh exactly with what carol ann presented. I am talking about martin county residents. I wanted to give a specific report here with you with regard to that. We tested a total of 1,016 residents. Of that, we received 958 result s now. So, that is a completely different situation we were in the last time we spoke with you we have 68 and essentially, we went from about 30% of our test results had been received. The last time I spoke with you. We are at 88%. The commercial lab is turned around and we have testing capabilities. So, there has been considerable improvement this that. And we continue to push and do everything we can. And get quick results and we have limited supplies of test kits and we can run the sephi test and abbott test locally now. They are limited and we are using them for the inpatients and caregiverrers. Where there is an urgency and using the lab and we have a five day turn around time. That is a considerable improvement. Virtual health. That continues and that's is the way to get your healthcare today. Hope that continues into the future after this is over. We have implemented processes for them to contact providers and using face time and other apps to communicate with patients. In person visit resist still necessary. But most likely try to set up a video visit with you today and wanted to see your doctor. That is to protect the patient as well as the caregivers and I will repeat. We are waiving co-pays and deductibles. There is some confusion about this in the community. Postponed. All elective cases. No nonessential procedures are being performed. If you have an emergency, we will take care of you. But, that conserves protective equipment. And increases the capacity as well in our hospitals and minimizes exposure. For our care caregivers. We have a housing program and provide being accommodations at no cost who have cared for punishments and tested positive and then something else, i think I am very proud of our partners and colleagues and law enforcement and fire rescue to know this. We have established a regional fill land thrown pick program to benefit first responders on the treasure coast who are the front line of this covid war and front line caregivers and they will provide financial support to first responders who are experiencing a financial hardship due to covid and wish to request consideration. This program will be available to our own caregivers. We have a parallel program. But, we want to express our gratitude to our colleagues that are where there is only one jersey in this battle. I also want to indicate and commissioner smith and I spoke about this. I think last week. Overwhelmed by the outpouring of support. And for our organization. They have contributed supplies. Cloth masks. Food, other items. They have come out and cheered at change of shift. Put tears in my eyes. And so, we are all impacted by my situation. My message to the community would be. There is talk about flattening the curve. We should try to crush this curve. To do that. We need to double down on social distancing. And limit as much as possible going to public places going to the grocery store and other essential businesses. finally. I am extremely proud of our dedicated caregivers and they are doing everything we can and doing our part to prepare for for what May come. And local churches have done so much. Large and small businesses are delivering food to the care I haves at the hospital. And to express their gratitude. I just want everybody in this community to know how very grateful I am with the support of the organization. That it means so much to them. I will be happy to answer any questions. >> yes, ma'am. >> I have an observation. That is, that we are so fortunate to live in martin county and so fortunate that our medical facilities resist under your leadership. You have done a traffic job. So grateful to hear that the testing turn around times have decreased by 2/3 and we are in so much better shape than any other county that I know of in florida and it is in large part due to the coordination between your cleveland clinic and the county and health department and know that social difference tansing and staying at home is really important. >> yes, ma'am. I could not agree more. And particularly with the comment about the cooperation. Locally. It is so key in this and so, thank you for that observation very much. >> commissioner smith. >> yes, thank you. I wanted to share a little bit. following commissioner heard. I did talk to rob last week. Following our meeting, I had four or five calls, different people calling for different issues. And I want to echo sarah's comments relative to the local folks. To the person that I talked to last week, all of them said when rob got up to the microphone and started speaking on behalf of the cleveland clinic, they were assured that our relationship, that our coordination, that our hospital and that our people that we recognize and under as leaders in our community, how important that was to everybody. So, rob, thank you thank you for being here and continuing to be here. It really means a lot to have that local face that people know and trust and it really makes a difference. Thank you very, very much for all you are doing personally. >> thank you very much. I appreciate your kind words. >> commissioner ciampi. >> thank you very much. Can you do a favor and explain the visitor policy. Some folks are not coming to the hospital for covid issues might be coming to the emergency room and might be admitted. Can you explain before they get to the hospital what the visitor's policy is. >> yes, sir. At this time we found it, fortunately found it necessary to strictly limit visit tores -- visitors. >> a patient is not allowed any visitors. >> in labor and delivery, one person is allowed to accompany the expectant mother and end of life issue, we address the family. And people need to understand that. This past week, there was a circumstance where I had a family member who required healthcare. And the young lady at the door told me. You know, sir, you are not allowed to enter the building with this patient. That applies to everybody. It is for the protection of the patients. And our caregivers and the person who could be entering the building. This is a very difficult condition to deal with. We believe they are a symptomatic people walking around that has the illness. You just don't know who is and who is not. We