MACON COUNTY BOARD OF COMMISSIONERS SEPTEMBER 10, 2013 AGENDA 1. Call to order and welcome by Chairman Corbin 2. Announcements A.

Awarding of the Certificate of Achievement for Excellence in Financial Reporting to the Macon County Finance Department 3. Moment of Silence 4. Pledge of Allegiance 5. Public Hearing(s) – 6:15 p.m. – Rural Operating Assistance Program (ROAP) application for Macon County Transit NOTE: Consideration of the ROAP Certified Statement will immediately follow the public hearing 6. Public Comment Period 7. Adjustments to and approval of the agenda 8. Reports/Presentations A. Proclamation regarding Constitution Week 9. Old Business A. Resolution Making Donation of Ambulance to Southwestern Community College B. Revised Agreement to Provide Recreation Opportunities with the Scaly Mountain Historical Society, Inc. C. Resolution regarding Nikwasi Mound 10.New Business A. Consideration of supplemental contract with NCDOT regarding purchase of new vehicle – Kim Angel, Transit Director B. Changes to Macon County Public Health Fee Schedule – Public Health Director Jim Bruckner

C. Consideration of resolution regarding the National Incident Management System (NIMS) – Emergency Services Director David Key and County Attorney D. Consideration of matching funds for airport grant – County Manager and Airport Authority representatives E. Consideration of License Agreement with the Town of Franklin and Franklin 111/C Flyers – County Manager and County Attorney 11.Consent Agenda – Attachment #11
All items below are considered routine and will be enacted by one motion. No separate discussion will be held except on request of a member of the Board of Commissioners.

A. B. C. D.

Minutes of the August 13, 2013 meeting Budget Amendments #25 through #29 Tax Releases Monthly ad valorem tax collection report

12.Appointments 13.Closed session – Attorney-client privilege -- NCGS 143-318.11(a)(3) 14. Adjourn/Recess

MACON COUNTY BOARD OF COMMISSIONERS AGENDA ITEM
MEETING DATE: September 10, 2013 DEPARTMENT/AGENCY: Finance SUBJECT MATTER: Reporting Certificate for Excellence in Financial

DEPARTMENT HEAD COMMENTS/RECOMMENDATION: The Certificate for Excellence in Financial Reporting has been awarded to the Macon County Finance Department by the Government Finance Officers Association (GFOA) of the United States and Canada for its comprehensive annual financial report (CAFR). This is the highest form of recognition in the area of governmental accounting and financial reporting.

COUNTY MANAGER’S COMMENTS/RECOMMENDATION: This marks the 18th consecutive year that Macon County has achieved this accomplishment. Congratulations to Finance Director Lori Hall and the staff.

Attachments ______ Agenda Item 2A

Yes

_X_

No

MACON COUNTY BOARD OF COMMISSIONERS AGENDA ITEM
MEETING DATE: September 10, 2013 DEPARTMENT/AGENCY: Transit SUBJECT MATTER: Public Hearing on the Rural Operating Assistance Program (ROAP) application DEPARTMENT HEAD COMMENTS/RECOMMENDATION: Please see the attached public hearing notice, which gives a brief description of the programs included within ROAP along with the individual program totals. This hearing is scheduled for a 6:15 p.m. start. Once the public hearing has been conducted, the board can consider approval of a certified statement regarding the program, a copy of which is also attached. COUNTY MANAGER’S COMMENTS/RECOMMENDATION:

Attachments ___X__ Agenda Item 5

Yes

___

No

Public Hearing Notice
This is to inform the public of the opportunity to attend a public hearing on the proposed Rural Operating Assistance Program (ROAP) application to be submitted to the North Carolina Department of Transportation no later than September 16, 2013 by the county of Macon. The public hearing will be held on September 10, 2013 at 6:15 p.m. at the Macon County Commissioners meeting in the Commissioner’s Board Room of the Macon County Courthouse located at 5 W. Main St., Franklin, NC. Macon County will provide auxiliary aids and services under the ADA for disabled persons who wish to participate in the hearing. Anyone requiring special services should contact Kim Angel, Transit Director at 828-349-2222, as soon as possible so that arrangements can be made. The programs included in the Rural Operating Assistance Program application are: 1. Elderly & Disabled Transportation Assistance (EDTAP) Program provides operating assistance for the public transportation of elderly and disabled citizens.

2. Employment Transportation Assistance Program provides operating assistance for the public
transportation of persons with employment related transportation needs. 3. Rural General Public (RGP) Program provides operating assistance for the public transportation of persons living in non-urban areas of the county. The period of performance for Rural Operating Assistance Program funds is July 1, 2013 through June 30, 2014. The FY2014 ROAP individual program totals are: PROGRAM EDTAP EMPL RGP TOTAL TOTAL $60,667 $8,765 $71,183 $140,615

This application may be inspected at the Macon County Transit office located at 36 Pannell Ln, Franklin, NC from 8:00 a.m. – 4:30 p.m., Monday - Friday. Written comments should be directed to Kim Angel, Transit Director, 5 W. Main St., Franklin, NC 28734, before September 15, 2013.

CERTIFIED STATEMENT
FY2014 RURAL OPERATING ASSISTANCE PROGRAM County of MACON
WHEREAS, the state-funded, formula-based Rural Operating Assistance Program (ROAP) administered by the North Carolina Department of Transportation, Public Transportation Division provides funding for the operating cost of passenger trips for counties within the state; WHEREAS, the county uses the most recent transportation plans (i.e. CTSP, CTIP, LCP) available and other public involvement strategies to learn about the transportation needs of agencies and individuals in the county before determining the sub-allocation of these ROAP funds; WHEREAS, the county government or regional public transportation authorities created pursuant to Article 25 or Article 26 of Chapter 160A of the General Statutes (upon written agreement with the municipalities or counties served) are the only eligible recipients of Rural Operating Assistance Program funds which are allocated to the counties based on a formula as described in the Program Guidelines included in the ROAP State Management Plan. NCDOT will disburse the ROAP funds only to counties and eligible transportation authorities and not to any sub-recipients selected by the county; WHEREAS, the county finance officer will be considered the county official accountable for the administration of the Rural Operating Assistance Program in the county, unless otherwise designated by the Board of County Commissioners; WHEREAS, the passenger trips provided with ROAP funds must be accessible to individuals with disabilities and be provided without discrimination on the basis of national origin, creed, age, race or gender (FTA C 4702.1A, FTA C 4704.1, Americans with Disabilities Act 1990); and WHEREAS, the period of performance for these funds will be July 1, 2013 to June 30, 2014 regardless of the date on which ROAP funds are disbursed to the county.

NOW, THEREFORE, by signing below, the duly authorized representatives of the County of Macon, North Carolina certify that the following statements are true and accurate:
 The county employed a documented methodology for sub-allocating ROAP funds that involved the participation of eligible agencies and citizens. Outreach efforts to include the participation of the elderly and individuals with disabilities, persons with limited English proficiency, minorities and low income persons in the county’s sub-allocation decision have been documented. The county will advise any sub-recipients about the source of the ROAP funds, specific program requirements and restrictions, eligible program expenses and reporting requirements. The county will be responsible for invoicing any sub-recipients for unexpended ROAP funds as needed. The county will monitor ROAP funded services routinely to verify that ROAP funds are being spent on allowable activities and that the eligibility of service recipients is being properly documented. The county will maintain records of trips and services for five years that prove that an eligible citizen was provided an eligible transportation service on the billed date, by whatever conveyance at the specified cost. The county will be responsible for monitoring the safety, quality and cost of ROAP funded services and assures that any procurements by subrecipients for contracted services will follow state guidelines. The county will conduct regular evaluations of ROAP funded passenger trips provided throughout the period of performance.

The county will only use the ROAP funds to provide trips when other funding sources are not available for the same purpose or the other funding sources for the same purpose have been completely exhausted. The county assures that the required matching funds for the FY2014 ROAP can be generated from fares and/or provided from local funds. The county will notify the Mobility Development Specialist assigned to the county if any ROAP funded services are discontinued before the end of the period of performance due to the lack of funding. No additional ROAP funds will be available. The county will provide an accounting of trips and expenditures in a semi-annual report and a final year-end report to NCDOT – Public Transportation Division or its designee. Any interest earned on the ROAP funds will be expended for eligible program uses as specified in the ROAP application. The County will include ROAP funds received and expended in its annual independent audit on the schedule of federal and state financial assistance. Funds passed through to other agencies will be identified as such. The county is applying for the following amounts of FY2014 Rural Operating Assistance Program funds:
State-Funded Rural Operating Assistance Program

 

 

Allocated $60,667 $8,765 $71,183 $140,615

Requested $60,667 $8,765 $71,183 $140,615

Elderly & Disabled Transportation Assistance Program (EDTAP) Employment Transportation Assistance Program (EMPL) Rural General Public Program (RGP)

TOTAL WITNESS my hand and county seal, this day of

, 20

.

Signature of County Manager/Administrator

Signature of Board of County Commissioners Chairperson

C. Jack Horton
Printed Name of County Manager/Administrator

Kevin Corbin
Printed Name of Chairperson

State of North Carolina County of
Signature of County Finance Officer

County Seal Here

Lori Hall
Printed Name of County Finance Officer

MACON COUNTY BOARD OF COMMISSIONERS AGENDA ITEM
MEETING DATE: September 10, 2013 DEPARTMENT/AGENCY: Governing Board SUBJECT MATTER: Proclamation regarding Constitution Week DEPARTMENT HEAD COMMENTS/RECOMMENDATION: Please see the attached proclamation in regard to Constitution Week 2013, and Chairman Corbin will have comments to share at the meeting. COUNTY MANAGER’S COMMENTS/RECOMMENDATION:

Attachments ___X__ Agenda Item 8A

Yes

___

No

           

PROCLAMATION   
CONSTITUTION WEEK 2013   
WHEREAS,    September  17,  2011,  marks  the  two  hundred  twenty‐fifth  anniversary  of  the  drafting  of  the  Constitution  of  the  United  States  of  America  by  the  Constitutional  Convention;  and    WHERAS, it is fitting and proper to accord official recognition to this magnificent document and  its  memorable  anniversary;  and  to  the  patriotic  celebrations  which  will  commemorate  the  occasion; and    Whereas,   Public  Law  915  guarantees  the  issuing  of  a  proclamation  each  year  by  the  President  of the United States of America designating September 17 – 23, as Constitution Week,    NOW,  THEREFORE,  IT  IS  PROCLAIMED  by  the  Macon  County  Board  of  Commissioners  that  September  17  –  23,  2013,  is  hereby  designated  as  Constitution  Week  and  all  citizens  are  encouraged  to  reaffirm  the  ideals  the  Framers  of  the  Constitution  had  in  1787  by  vigilantly  protecting  the  freedoms  guaranteed  to  us  through  this  guardian  of  our  liberties,  remembering  lost rights may never be regained.    IN WITNESS WHEREOF, I have hereunto set my hand and cause the Seal of Macon County to be  affixed on this tenth day of September, 2013.            ___________________________        _____________________________ 
C. Jack Horton, Clerk to the Board              Kevin Corbin, Chairman 

MACON COUNTY BOARD OF COMMISSIONERS AGENDA ITEM
MEETING DATE: September 10, 2013 DEPARTMENT/AGENCY: Governing Board SUBJECT MATTER: Community College Donation of Ambulance to Southwestern

DEPARTMENT HEAD COMMENTS/RECOMMENDATION: Please see the attached resolution regarding this matter. Also attached is the notice that has been posted and published regarding the board’s intent in donating this surplus vehicle to the community college’s Public Safety Training Center.

COUNTY MANAGER’S COMMENTS/RECOMMENDATION: Recommend donation.

Attachments ___X__ Agenda Item 9A

Yes

___

No

RESOLUTION OF THE MACON COUNTY BOARD OF COMMISSIONERS MAKING DONATION OF AMBULANCE TO SOUTHWESTERN COMMUNITY COLLEGE THAT WHEREAS, Macon County owns a certain ambulance being described as a Ford E350 Ambulance, VIN # 1FDKEJ0LXDHA53339; and WHEREAS, Macon County does not presently have a use for the same and has heretofore declared the same surplus; and WHEREAS, Macon County desires to donate said ambulance to Southwestern Community College in accordance with the provisions of N.C. Gen. Stat. § 160A-280 for use by the Southwestern Community College - Public Safety Training Center in Franklin, North Carolina; and WHEREAS, Macon County has duly posted the public notice of intent to adopt a resolution approving such donation at least five days prior to this September 10, 2013, Regular Meeting of the Macon County Board of Commissioners as required by the provisions of N.C. Gen. Stat. § 160A280. NOW THEREFORE, upon Motion of Commissioner _________________________, seconded by Commissioner __________________________________, and duly approved, be it hereby resolved by the Macon County Board of Commissioners as follows: RESOLVED, that Macon County Board of Commissioners does hereby donate its Ford E350 Ambulance, VIN # 1FDKEJ0LXDHA53339 unto Southwestern Community College in accordance with the provisions of N.C. Gen. Stat. § 160A-280 for use by the Southwestern Community College - Public Safety Training Center in Franklin, North Carolina. Adopted at the September 10, 2013, Regular Meeting of the Macon County Board of Commissioners.

__________________________________________ Kevin Corbin, Chairman of the Macon County Board Commissioners ATTEST: _____________________________________ Clerk to the Board ( Official Seal )

MACON COUNTY BOARD OF COMMISSIONERS AGENDA ITEM
MEETING DATE: September 10, 2013 DEPARTMENT/AGENCY: Governing Board SUBJECT MATTER: Revised Agreement with the Scaly Mountain Historical Society DEPARTMENT HEAD COMMENTS/RECOMMENDATION: Per the County Attorney, the agreement approved by the board at its August 13, 2013 meeting should have been with the Scaly Mountain Historical Society, Inc., not the Flats Township Historical Society as indicated. The County Attorney advised that the agreement from the August meeting should not be executed, that a replacement agreement could be properly approved and executed, and then the funds could be paid. The County Attorney can provide additional details as well as a revised agreement at the meeting.

COUNTY MANAGER’S COMMENTS/RECOMMENDATION:

Attachments ______ Agenda Item 9B

Yes

__X

No

MACON COUNTY BOARD OF COMMISSIONERS AGENDA ITEM
MEETING DATE: September 10, 2013 DEPARTMENT/AGENCY: Governing Board SUBJECT MATTER: Resolution regarding Nikwasi Mound DEPARTMENT HEAD COMMENTS/RECOMMENDATION: Per the board’s directive from the August 13, 2013 regular meeting, the County Attorney is preparing a resolution regarding the Nikwasi Mound, stemming from the presentation on that date by Principal Chief Michell Hicks of the Eastern Band of Cherokee. That resolution will be available at the meeting on Tuesday. COUNTY MANAGER’S COMMENTS/RECOMMENDATION:

Attachments ______ Agenda Item 9C

Yes

_X_

No

MACON COUNTY BOARD OF COMMISSIONERS AGENDA ITEM
MEETING DATE: September 10, 2013 DEPARTMENT/AGENCY: Transit SUBJECT MATTER: vehicle Supplemental contract for purchase of new

DEPARTMENT HEAD COMMENTS/RECOMMENDATION: Please see the attached letter, supplemental agreement and sample resolution regarding this matter. According to Transit Director Kim Angel, the state is requiring this agreement in regard to a vehicle that did not get ordered in Fiscal Year 2012-13 because the state Department of Transportation did not get it procured in time, and the cost was greater than anticipated. Mrs. Angel will be at the meeting to provide additional details and to answer questions. COUNTY MANAGER’S COMMENTS/RECOMMENDATION:

Attachments ___X__ Agenda Item 10A

Yes

___

No

STATE OF NORTH CAROLINA

DEPARTMENT OF TRANSPORTATION
PAT MCCRORY
GOVERNOR

ANTHONY J. TATA
SECRETARY

August 27, 2013

Mr. C. Jack Horton, County Manager Macon County 5 W. Main Street, Courthouse Annex Franklin, North Carolina 28734-3005 Dear Mr. Horton: RE: Project No. WBS Element No(s). WBS Element No(s). Agreement No. Agreement No. 13-CT-027 36233.68.14.1 36233.68.14.3 2000000860 2000000861

Your request for a budget amendment has been approved; and originals of the supplemental agreement to be executed between Macon County and the North Carolina Department of Transportation are enclosed. The resolution authorizes the County Manager to enter into this agreement on behalf of your agency. Please follow the enclosed instructions for execution and return of the agreements. The project, purchase order, and WBS Element numbers referenced above have been assigned to your project. Please refer to these numbers on all correspondence. If you have any questions, please contact Annette R. Hicks at (919) 707-4671 or Charlie Wright at (919) 7074674 in the Financial Management Unit. Sincerely,

Teresa Hart, PE, CPM Director TH/arh Enclosures

MAILING ADDRESS: NC DEPARTMENT OF T RANSPORTATION PUBLIC T RANSPORTATION DIVISION 1550 MAIL SERVICE CENTER RALEIGH, NC 27699-1550

T ELEPHONE: 919-707-4670 FAX: 919-733-1391
WWW.NCDOT.GOV/NCTRANSIT

LOCATION: T RANSPORTATION BUILDING 1 SOUTH W ILMINGTON STREET RALEIGH, NC

STATE OF NORTH CAROLINA COUNTY OF WAKE

NONURBANIZED AREA PUBLIC TRANSPORTATION SUPPLEMENTAL AGREEMENT FOR PUBLIC BODY ORGANIZATIONS COMMUNITY TRANSPORTATION PROGRAM – SECTION 5311 CFDA NUMBER: 20.509

DEPARTMENT OF TRANSPORTATION PROJECT NO. and WBS ELEMENT NO: 36233.68.14.1 36233.68.14.3 MACON COUNTY 13-CT-027

******************************************************************
THIS SUPPLEMENTAL AGREEMENT entered into this the day of 20 by and between MACON COUNTY (hereinafter referred to as the "Contractor"), and the NORTH CAROLINA DEPARTMENT OF TRANSPORTATION (hereinafter referred to as the "Department"), witnesseth that:

WHEREAS, the Contractor heretofore entered into an agreement with the Department to implement, carry out capital projects funded with Federal Transit Administration 5311 grant program funds administered by the State; and WHEREAS, the said agreement dated OCTOBER 22, 2012 sets forth the purpose of the Agreement and the public transportation capital projects and services as described in the project application (hereinafter referred to as “Project”) properly prepared, endorsed, approved and transmitted by the Contractor to the Department, and states the terms and conditions as to the manner in which the Project will be undertaken; and WHEREAS, the Agreement allows for the Contractor and the Department to revise or amend the agreement when there is a change in project circumstances or information causing an inconsistency with the terms of the Agreement and requires said agreement to be signed by the original signatories or their authorized designees; and WHEREAS, the Contractor and Department find it necessary to revise the Project Agreement to correct language in Section 3: Cost of Project/Project Budget;
That language appearing in Section 3. of the agreement and reading as follows:

Section 3. Cost of Project/Project Budget. The total cost of the Project approved by the Department is TWO HUNDRED THIRTY-EIGHT THOUSAND ONE HUNDRED THIRTY-TWO DOLLARS ($238,132) as set forth in the Project Description and Budget, incorporated into this Agreement as Attachment A. The Department shall provide, from Federal and State funds, the percentages of the actual net cost of the Project as indicated below, not in excess of the identified amounts for eligible administrative, operating, and capital expenses. The Contractor hereby agrees that it will provide the percentages of the actual net cost of the Project, as indicated below, and any amounts in excess of the Department’s maximum (Federal plus State shares). The net cost is the price paid minus any refunds, rebates, or other items of value received by the Contractor which have the effect of reducing the actual cost.

Administration WBS 36233.68.14.1 Agreement #2000000860 Capital WBS 36233.68.14.3 Agreement #2000000861 Project Total

Administration Total $189,531

Administration Federal (80%) $151,624

Administration State (5%) $9,476

Administration Local (15%) $28,431

Capital Total $48,601

Capital Federal (80%) $38,880

Capital State (10%) $4,859

Capital Local (10%) $4,862

Project Total $ 238,132

Project Total Federal $ 190,504

Project Total State $14,335

Project Total Local $33,293

Be, and hereby amended and revised to read as follows:

Section 3. Cost of Project/Project Budget. The Project Capital budget is increased by $1,751 in consideration of the increase on the bid award that exceeded the contract price for the Conversion and Lift Vans. The project budget is amended as follows: Federal: $1,401 State: $175, Local: $175 as set forth and incorporated in the NCDOT August 8, 2013 Board of Transportation Agenda, Public Transportation Division, Community Transportation Program (Item I-1-3), Division 14: Macon County dated August 8, 2013. The project budget as set forth in Appendix A – North Carolina Department of Transportation, Public Transportation Division Approved Budget Summary, Effective Date August 8, 2013 and Approved Project Budget is hereby amended to incorporate the total cost of the Project approved by the Department as TWO HUNDRED THIRTY-NINE THOUSAND EIGHTY HUNDRED EIGHTYTHREE DOLLARS ($239,883) The Department shall provide, from Federal and State funds, the percentages of the actual net cost of the Project as indicated below, not in excess of the identified amounts for eligible administrative, operating, and capital expenses. The Contractor hereby agrees that it will provide the percentages of the actual net cost of the Project, as indicated below, and any amounts in excess of the Department’s maximum (Federal plus State shares). The net cost is the price paid minus any refunds, rebates, or other items of value received by the Contractor which have the effect of reducing the actual cost.

2

Administration WBS 36233.68.14.1 Agreement #2000000860 Capital WBS 36233.68.14.3 Agreement #2000000861 Project Total

Administration Total $189,531

Administration Federal (80%) $151,624

Administration State (5%) $9,476

Administration Local (15%) $28,431

Capital Total $50,352

Capital Federal (80%) $40,280

Capital State (10%) $5,034

Capital Local (10%) $5,038

Project Total $239,883

Project Total Federal $191,904

Project Total State $14,510

Project Total Local $33,469

3

IN WITNESS THEREOF, this Supplemental Agreement has been executed by the Department, an agency of the State of North Carolina, and Macon County, the Contractor, by and through a duly authorized representative, and is effective the date and year first above written. By reference, this Supplemental Agreement incorporates and extends all of the provisions of the attached “Agreement” dated October 22, 2012.

MACON COUNTY

BY: TITLE: COUNTY MANAGER

(SEAL)

ATTEST: TITLE:

NORTH CAROLINA DEPARTMENT OF TRANSPORTATION

BY: TITLE: DEPUTY SECRETARY FOR TRANSIT

ATTEST: TITLE: SECRETARY

4

SAMPLE RESOLUTION AUTHORIZING (APPLICANT AGENCY) TO ENTER INTO AN AGREEMENT WITH THE NORTH CAROLINA DEPARTMENT OF TRANSPORTATION

A motion was made by (name and title) and seconded by (name and title) for adoption of the following resolution, and upon being put to a vote was duly adopted. WHEREAS, the (applicant agency) has requested the North Carolina Department of Transportation to assist in the funding of (brief description of project); and WHEREAS, the (applicant agency) will provide (percentage) of the cost of the above described project; NOW THEREFORE, BE IT RESOLVED that the (authorized official’s title)* is hereby authorized to enter into a contract with the Department of Transportation and execute all agreements and contracts with the North Carolina Department of Transportation, Public Transportation Division. ........................................................................................................................................... I, (name and title)* do hereby certify that the above is a true and correct copy of an excerpt for the minutes of a meeting of the (applicant agency’s governing body) duly held on the _____ day of _______________, 20_____.

_____________________________ Signature of Certifying Official

* the official authorized to enter onto agreement SHOULD NOT sign the resolution.

MACON COUNTY BOARD OF COMMISSIONERS AGENDA ITEM
MEETING DATE: September 10, 2013 DEPARTMENT/AGENCY: Public Health SUBJECT MATTER: debt write off Changes to fee schedule, billing guide and bad

DEPARTMENT HEAD COMMENTS/RECOMMENDATION: Please see the attached documents for more details. Per an e-mail from Tonya Hodgins at Public Health, the entire fee schedule needs to be approved as well as the billing guide. As part of the fee schedule, there are revised Environmental Health fees for the board’s consideration. Finally, there is a request for the board to approve bad debt write off in the amount of $10,636. Health Center Director Jim Bruckner will be here to present.

COUNTY MANAGER’S COMMENTS/RECOMMENDATION:

Attachments ___X__ Agenda Item 10B

Yes

___

No

Macon County Public Health Fee Schedule
Modifier

Final Approval

Proposed Changes Description Current
(Red = Increase Blue=Decrease) 07-23-13

Code

FY 13/14 J1055 J1050 J2790 J3490 J7300 J7302 54050 54065 56501 56515 57170 57452 57454 57455 57456 58300 58301 59025 59425 59426 59430 69210 86580 86580P G0008 G0009 G0010 Q2037 Q2038 Q2039 90471 90471 90472 90472 90474 90632 90633 90636 90645 90646 90647 90648 90649 90657 90658 90660 90662 90669 90670 90675 90676 FP Medroxyprogester1 Acetate for Contraceptive use, 150mg, Injection (DepoFP INJECTION, MEDROXYPROGESTERONE ACETATE, 150 MG, 150 units Rho(D) Immune Globulin (RhIg), full dose,300mcg 17P Injection FP Intrauterine copper contraceptive device, Paragard T380A FP Levonorgestrel-releasing intrauterine contraceptive system, 52 mg (Mirena) Destory Penis Lesion(s) - Simple Chemical Destruction Penis Lesion(s) - Extensive Cryosurgery TCA Vulva Destroy Vulva Lesion(s) - Complex Diaphragm fitting with instructions Colposcopy of the cervix including upper/adjacent vagina Colposcopy of the cervix including upper/adjacent vagina w/biopsy of cervix or endocervical curettage Colposcopy of cervix including upper/adjacent vagina w/biopsy of cervix Colposcopy of the cervix including upper/adjacent vagina w/endocervical curettage Insert intrauterine device Removal of IUD Fetal Non-Stress Test Prenatal visits: 4 to 6 visits Prenatal visits: 7 or more visits After Delivery Care Remove impacted ear wax TB Test TB Test - Patient Pay Administration Fee - Flu Shot (Medicare) Administration Fee - Pneumonia Shot (Medicare) Administration Fee - Hep B (Medicare) Flu Virus Vaccine (Fluvirin) Medicare Flu Virus Vaccine (Fluzone) Medicare Flu Virus Vaccine (Unspecified) Medicare Vaccine Administration Fee EP Vaccine Administration Fee Vaccine Administration Fee-Each Additional EP Vaccine Administration Fee-Each Additional Intranasal Administration Fee Hep A - Adult Hep A - Pediatric Twinrix Vaccine Hib - child Hib - Adult Hib Hib - child Gardasil (HPV) Flu Shot (6-35 months) Flu Shot (3 yrs & >) Flumist - State Supplied Fluzone High Dose (65 & >) Prevnar Prevnar Rabies Vaccine - Exposure Rabies Vaccine - Preventive 50.00 .34/unit 134.00 21.00 428.00 528.00 228.00 387.00 229.00 394.00 91.00 191.00 269.00 253.00 239.00 132.00 169.00 62.00 1,000.00 1,300.00 121.00 86.00 10.00 10.00 19.00 19.00 19.00 6.00 6.00 6.00 19.00 14.00 19.00 14.00 20.00 46.00 30.00 90.00 26.00 26.00 26.00 137.00 6.00 6.00 26.00 116.00 116.00 211.00 211.00

FY 13/14 50.00

Macon County Public Health Fee Schedule
Modifier

Final Approval

Proposed Changes Description Current
(Red = Increase Blue=Decrease) 07-23-13

Code

FY 13/14 90680 90691 90700 90707 90713 90714 90716 90715 90717 90732 90733 90734 90736 90744 90746 92552 92567 92587 96110 96372 97802 97803 99172 99173 99201 99202 99203 99204 99205 99211 99212 99213 99214 99215 99381 99382 99383 99384 99384 99385 99385 99385 99386 99386 99387 99391 99392 99393 99394 99394 99395 99395 99395 Rotateq Typhoid Vaccine DTAP MMR IPV Td Varicella Vaccine Tdap Yellow Fever Vaccine Pneumonia Vaccine Meningococcal Menactra Zostavax (Shingles Vaccine) Hep B - Pediatric Hep B - Adult Hearing test Tympanometry Evoked otoacoustic emissions; limited (single stimulus level, either transient) Developmental Screening Therapeautic Injection Medical nutrition therapy; initial assessment and intervention, individual, Medical nutrition therapy; re-assessment and intervention, individual, Visual Acuity Screening Test - Color Visual Acuity Screening Test Office Visit (OV) new patient (pt) minor-phys time approx. 10 minutes OV new pt, moderate-phys time approx 20 minutes OV new pt, moderate-phys time approx 30 minutes OV new pt, complex-phys time approx 45 minutes OV new pt, severe-phys time approx 60 minutes OV established (estab) pt, minimal w/wo phys, time approx 5 min OV estab. pt, minor-phys time approx 10 min. OV estab. pt, moderate. phys time approx 15 min. OV estab. pt, severe. phys time approx 25 min. OV estab. pt, severe. phys time approx 40 min. EP New Patient (NP) physical exam: < 1 year EP NP physical exam: 1 to 4 Years EP NP physical exam: 5 to 11 years FP NP physical exam: 12 to 17 years EP NP physical exam: 12 to 17 years NP physical exam: 18 to 39 years FP NP physical exam: 18 to 39 years EP NP physical exam: 18 to 39 years NP physical exam: 40 to 64 years FP NP physical exam: 40 to 64 years NP physical exam: 65 years and over EP Established Patient (EP) physical exam: < 1 year EP EP physical exam: 1 to 4 years EP EP physical exam: 5 through 11 years FP EP physical exam: 12 to 17 years EP EP physical exam: 12 to 17 years EP physical exam: 18 to 39 years FP EP physical exam: 18 to 39 years EP EP physical exam: 18 to 39 years 76.00 56.00 29.00 56.00 31.00 26.00 95.00 39.00 100.00 70.00 113.00 111.00 171.00 27.00 56.00 39.00 18.00 63.00 13.00 20.00 45.00 22.00 5.00 5.00 83.00 124.00 180.00 280.00 326.00 43.00 72.00 121.00 209.00 262.00 211.00 227.00 226.00 249.00 242.00 242.00 242.00 242.00 287.00 287.00 310.00 200.00 200.00 200.00 216.00 216.00 217.00 217.00 217.00

FY 13/14

60.00

Macon County Public Health Fee Schedule
Modifier

Final Approval

Proposed Changes Description Current
(Red = Increase Blue=Decrease) 07-23-13

Code

FY 13/14 99396 99396 99397 99406 99407 99408 99409 99420 99412 EP physical exam: 40 to 64 years FP EP physical exam: 40 to 64 years EP physical exam: 65 years and older Tobacco Education (3-10 min) Tobacco Education over 10 min Substance Abuse Substance Abuse over 30 min Additional Assessments Preventive medicine, group counseling, appx 60 minutes 242.00 242.00 250.00 12.00 23.62 31.00 63.00 9.00 91.00

FY 13/14

DENTAL
D0120 D0140 D0145 D0150 D0160 D0170 D0210 D0220 D0230 D0240 D0250 D0260 D0270 D0272 D0273 D0274 D0330 D1110 D1120 D1201 D1203 D1204 D1205 D1206 D1208 D1351 D1510 D1515 D1555 D2140 D2150 D2160 D2161 D2330 D2331 D2332 D2335 D2336 D2391 D2392 D2393 D2394 Periodic oral evaluation Limited oral evaluation - problem focused Oral Evaluation, pt < 3yrs Comprehensive oral evaluation - new or established patient Detailed and extensive oral evaluation - problem focused, by report Re-evaluation - limited, problem focused (established patient; not post-op) Intraoral - complete series (including bitewings) Intraoral -periapical first film Intraoral - periapical each additional film Intraoral - occlusal film Extraoral - first film Extraoral - each additional film Bitewing - single film Bitewings - 2 films Bitewings - 3 films Bitewings - 4 films Panoramic film Prophylaxis - adult Prophylaxis - child Topical Fluoride w/ Prophylaxis Topical application of fluoride (prophylaxis not included) - child Topical application of fluoride (prophylaxis not included) - adult Topical Fluoride w/ Prophylaxis Topical fluoride varnish; therapeutic application for moderate to high caries risk Topical application of fluoride (prophylaxis not included) Sealant - per tooth Space maintainer - fixed - unilateral Space maintainer - fixed - bilateral Remove Fix Space Maintainer Amalgam - 1 surface, primary or permanent Amalgam - 2 surfaces, primary or permanent Amalgam - 3 surfaces, primary or permanent Amalgam - 4 or more surfaces, primary or permanent Resin-based composite - 1 surface, anterior Resin-based composite - 2 surfaces, anterior Resin-based composite - 3 surfaces, anterior Resin-based composite - 4 or more surfaces or involving incisal angle (anterior) Resin based composite - 1 surface pstr perm Resin-based composite - 1 surface, posterior Resin-based composite - 2 surfaces, posterior Resin-based composite - 3 surfaces, posterior Resin-based composite - 4 or more surfaces, posterior 38.00 66.00 48.00 69.00 100.00 44.00 141.00 30.00 24.00 32.00 42.00 35.00 22.00 36.00 50.00 63.00 116.00 81.00 56.00 82.00 35.00 32.00 82.00 51.00 35.00 44.00 283.00 395.00 51.00 95.00 123.00 149.00 181.00 118.00 150.00 184.00 217.00 138.00 138.00 180.00 223.00 275.00

Macon County Public Health Fee Schedule
Modifier

Final Approval

Proposed Changes Description Current
(Red = Increase Blue=Decrease) 07-23-13

Code

FY 13/14 D2751 D2910 D2920 D2930 D2940 D2950 D2951 D3220 D3310 D3320 D3330 D4211 D4341 D4342 D4355 D4910 D5110 D5120 D5130 D5140 D5211 D5212 D5213 D5214 D5410 D5411 D5421 D5422 D5510 D5520 D5610 D5640 D5650 D5660 D5730 D5731 D5740 D5741 D6930 D7111 D7140 D7210 D7220 D7230 D7240 D7250 D7310 D7311 D7320 D7321 D7410 D7510 D7530 Crown, non- precious metal (porcelin) Recement inlay/onlay or part Recement Crown Prefabricated stainless steel crown - primary tooth Sedative filling Core buildup, including any pins Pin retention - per tooth, in addition to restoration Therapeutic pulpotomy (excluding final restoration) Root canal therapy - anterior (excluding final restoration) Root canal therapy - bicuspid (excluding final restoration) Root canal therapy - molar (excluding final restoration) Gingivectomy or gingivoplasty 1 to 3 contiguous teeth/quadrant Periodontal scaling and root planing 4 or more contiguous teeth Periodontal scaling and root planing 1 to 3 teeth/quadrant Full mouth debridement to enable comprehensive evaluation and diagnosis Periodontal Maintenance Complete Denture - Maxillary Complete Denture - Mandibular Immediate Denture - Maxillary Immediate Denture - Mandibular Maxillary Partial Denture - Resin Base Mandibular Partial Denture - Resin Base Maxillary partial denture - cast metal framework resin base Mandibular Partial Denture - cast metal framework resin base Adjust Complete Denture Maxillary Adjust Complete Denture Mandbular Adjust Partial Denture Maxillary Adjust Partial Denture Mandibular Repair Broken Complete Denture Replace Missing or Broken Tooth Repair Resin Denture Base Replace Broken Teeth Add tooth to existing partial denture Add clasp to existing partial denture Reline Complete Maxillary Denture Reline Complete Mandibular Denture Reline Maxillary Partial Denture Reline Mandibular Partial Denture Recement bridge Extraction, coronal remnants - deciduous tooth Extraction, erupted tooth or exposed root Surgical removal of erupted tooth Removal of impacted tooth - soft tissue Removal of impacted tooth - partially bony Removal of impacted tooth - completely bony Surgical removal of residual tooth roots (cutting procedure) Alveoloplasty in conjunction with extractions - 4 or more tooth spaces, per Alveoloplasty in conjunction with extractions 1 to 3 tooth spaces Alveoloplasty not in conjunction with extractions - 4 or more tooth spaces, per Alveoloplasty not in conjunction with extractions - 1 to 3 tooth spaces, per Excision of benign lesion up to 1.25 cm Incision and drainage of abscess - intraoral soft tissue Removal of foreign body from mucosa, skin, or subcutaneous tissue 1,000.00 25.00 28.00 223.00 85.00 194.00 48.00 138.00 572.00 700.00 869.00 182.00 198.00 488.00 146.00 98.00 1138.00 1138.00 1234.00 1234.00 844.00 844.00 1230.00 1230.00 62.00 62.00 62.00 62.00 150.00 128.00 150.00 128.00 156.00 234.00 264.00 264.00 258.00 258.00 88.00 92.00 123.00 217.00 271.00 354.00 424.00 234.00 223.00 190.00 364.00 308.00 177.56 241.00 250.00

FY 13/14

Macon County Public Health Fee Schedule
Modifier

Final Approval

Proposed Changes Description Current
(Red = Increase Blue=Decrease) 07-23-13

Code

FY 13/14 D9110 D9940 Palliative (emergency) treatment of dental pain - minor procedure Occlusal Bite Guard 97.00 400.00

FY 13/14

OTHER SERVICES
LU002 LU018 LU101 LU102 LU114 LU117 LU118 LU119 LU120 LU121 LU122 LU123 LU124 LU201 LU202 LU203 LU204 LU206 LU208 LU209 LU212 LU216 LU231 LU232 LU235 LU240 LU249 LU262 LU263 LU264 LU265 LU266 LU267 LU268 LU269 LU270 LU271 LU272 LU273 LU274 LU400 LU402 G0431 H0049 S0280 S0281 T1002 Lice Treatment Copy of Medical Records HIV Post-Test Results TB Screening Form PPD given, high risk (State Supplied) PPD, positive result, contact PPD, negative result, contact PPD, positive result, low risk PPD, negative result, low risk TB Directly Observed Therapy (DOT) TB Directly Observed Preventive Terapy (DOPT) PPD, not read, contact PPD, not read, low risk Repeat Pap (report only) International Travel Employment Physical; Limited ** DOT Physical; Limited ** Day Care Physical; Limited ** Sports Physical; Limited ** Foster Care Physical; Limited ** College Physical; Limited** County Employee Physical; Limited ** Pap Smear and/or Clinical Breast Exam (Non-BCCCP Eligible) Test/Lab Results Only Replacement Pill pack Non-billable TB LPN Contact Breast Exam Only PPD, positive result, high risk PPD, negative result, high risk PPD, not read, high risk Treatment of LTBI initiated, high risk Treatment of LTBI, initiated, low risk Treatment of LTBI, initiated, contact Treatment of LTBI completed, high risk Treatment of LTBI completed, low risk Treatment of LTBI completed,contact Treatment of LTBI incomplete Treatment of LTBI incomplete, low risk Treatment of LTBI incomplete, contact PPD given, contact Miscellaneous Services (ex. Medical records payment from Disability Medicaid Co-Payment Hair Drug Testing Expanded Hair Drug Testing Medical home program, comprehensive care coordination and planning, Initial Med home prog, comp care coord and planning, main. of plan (postpartum) RN Services fee based on service 10.00

25.00 70.00 90.00 35.00 35.00 35.00 35.00 50.00 83.00 10.00 40.00

15.00 3.00 100.00 110.00 50.00 150.00 19.50

** Limited Physical Exam Fees do not include Laboratory Testing Fees. Lab Testing

Macon County Public Health Fee Schedule
Modifier

Final Approval

Proposed Changes Description Current
(Red = Increase Blue=Decrease) 07-23-13

Code

FY 13/14 Fees are charged seperatly.

FY 13/14

HEALTH EDUCATION SERVICES
G0108 G0109 97802 97803 S9465 S9470 DSMT (Individual) 1/2 Hour Units DSMT (Group) 1/2 Hour Units MNT Individual/Initial (15 Min Units) MNT Re-Check/Individual (15 Min Units) Diabetic management program, dietician visit (BCBS) Nutritional counseling, dietician visit (BCBS) Baby Think It Over 4 Classes Body Fat Monitor & Calipers Body Fat Testing by Calipers Body Fat Testing by Monitor BTIO Keys Challenge Course CPR Breathing Barriers Adult 1st Aid / CPR / AED CPR w/AED (Adult & Child) - ELIMINATED Adult CPR/AED Adult & Pediatric CPR/AED Pediatric CPR/AED CPR w/AED (Child) + Infant CPR + FAB - ELIMINATED CPR w/AED (Adult & Child( + FAB - ELIMINATED Adult & Pediatric 1st Aid/CPR/AED First Aid-Basic Healthy Heart Screening Individual Health Education Life Worksite Wellness (A) Life Worksite Wellness (B) Life Worksite Wellness (C) Life Worksite Wellness (D) Life Worksite Wellness (E) Locking Clips Face Shield 53.23 18.18 24.51 21.44 34.50 34.50 350.00 10.00 7.00 5.00 6.00 10.00 6.00 90.00 60.00 70.00 90.00 70.00 55.00 75.00 110.00 70.00 35.50 20.00 40.00 37.50 35.00 32.50 30.00 1.00 2.00

LABORATORY 36415 ROUTINE VENIPUNCTURE 36416 CAPILLARY BLOOD DRAW 80048 BMP- METABOLIC PANEL TOTAL CA 80050 GENERAL HEALTH PANEL 80051 ELECTROLYTE PANEL 80053 CMP - COMPREHEN METABOLIC PANEL 80055 PRENATAL - OBSTETRIC PANEL 80061 LIPID PANEL 80069 RENAL FUNCTION PANEL 80074 HEPATITIS PANEL- ACUTE (A,B,C) 80076 HEPATIC FUNCTION PANEL 80100 DRUG SCREEN, QUALITATE/MULTI w/ confirmation 80101 DRUG SCREEN SINGLE 80152 AMITRIPTYLINE 80156 CARBAMAZEPINE, TOTAL- TEGRETOL

9.00 4.00 27.00 41.00 25.00 29.00 109.00 44.00 28.00 56.00 27.00 50.00 73.00 168.00 27.00

Macon County Public Health Fee Schedule
Modifier

Final Approval

Proposed Changes Description Current
(Red = Increase Blue=Decrease) 07-23-13

Code

FY 13/14 80157 80158 80162 80164 80178 80182 80184 80185 80188 80195 80197 80198 80299 81001 81002 81003 81025 82024 82040 82043 82055 82075 82085 82088 82103 82104 82105 82131 82140 82150 82157 82164 82175 82232 82239 82247 82248 82274 82306 82310 82330 82340 82374 82375 82378 82380 82384 82390 82435 82436 82465 82491 82542 TEGRETOL, FREE CYCLOSPORINE - BLOOD DIGOXIN VALPROIC ACID (DIPROPYLACETIC ACID) LITHIUM NORTRIPTYLINE PHENOBARBITAL DILANTIN - PHENYTOIN, TOTAL PRIMIDONE- MYSOLINE (W/PHENOB) SIROLIMUS(RAPAMUNE) BLOOD TACROLIMUS THEOPHYLLINE QUANTITATIVE ASSAY DRUG URINALYSIS, AUTO W/SCOPE" URINALYSIS NONAUTO W/O SCOPE (P&G) URINALYSIS, AUTO, W/O SCOPE" URINE PREGNANCY TEST ACTH ALBUMIN MICROALBUMIN / CREAT RATION - RANDOM URINE ALCOHOL - BLOOD (ETHANOL) ALCOHOL- BREATH ETHANOL ALDOLASE ALDOSTERONE ALPHA-1-ANTITRYPSIN, TOTAL" ALPHA-1-ANTITRYPSIN, PHENOTYPE ALPHA-FETOPROTEIN, SERUM" AMINO ACIDS, SINGLE QUANT" AMMONIA AMYLASE ANDROSTENEDIONE ANGIOTENSIN I ENZYME TEST ARSENIC BETA-2 MICROGLOBULIN SERUM BILE ACIDS, TOTAL BILIRUBIN, TOTAL" BILIRUBIN, DIRECT" FECAL OCCULT BLOOD,IMMUNOASSAY VITAMIN D CALCIUM CALCIUM- ionized CALCIUM IN URINE CARBON DIOXIDE-BLOOD CARBON MONOXIDE-BLOOD CEA-CARCINOEMBRYONIC ANTIGEN CAROTENE, BETA THREE CATECHOLAMINES CERULOPLASMIN CHLORIDE-BLOOD CHLORIDE- URINE CHOLESTEROL-BLD/SERUM CHROMOTOGRAPHY, QUANT, SING" LAMOTRIGINE (LAMICTAL) SERUM 155.00 161.00 26.00 27.00 27.00 150.00 71.00 27.00 200.00 174.00 187.00 69.00 137.00 22.00 16.00 17.00 19.00 192.00 36.00 35.00 109.00 40.00 80.00 161.00 63.00 132.00 45.00 59.00 77.00 25.00 183.00 102.00 147.00 125.00 32.50 36.00 36.00 45.00 54.00 36.00 35.00 37.00 36.00 109.00 43.00 108.00 172.00 53.00 37.00 36.00 25.00 154.00 154.00

FY 13/14

Macon County Public Health Fee Schedule
Modifier

Final Approval

Proposed Changes Description Current
(Red = Increase Blue=Decrease) 07-23-13

Code

FY 13/14 82507 82523 82530 82533 82550 82552 82553 82565 82570 82575 82595 82607 82627 82668 82670 82672 82677 82705 82710 82728 82731 82746 82784 82785 82941 82947 82950 82951 82952 82952 82955 82977 82985 83001 83002 83010 83020 83021 83036 83090 83498 83516 83520 83525 83527 83540 83550 83615 83655 83690 83695 83701 83704 CITRATE - urine 24 hour COLLAGEN CROSSLINKS CORTISOL, FREE - URINE 24 HOUR CORTISOL- TOTAL CPK TOTAL CPK ISOENZYMES CPK, MB FRACTION" CREATININE CREATININE- URINE 24 HOUR/RANDOM CREATININE CLEARANCE TEST CRYOGLOBULIN- semiquant, REFLEX VITAMIN B-12 DEHYDROEPIANDROSTERONE- DHEAS ERYTHROPOIETIN ESTRADIOL ESTROGEN ESTRIOL FATS/LIPIDS, FECES, QUAL" FECAL FATS, QUANTITATIVE FERRITIN FETAL FIBRONECTIN FOLIC ACID SERUM GAMMAGLOBULIN IgA, IgD, IgG, IgM, each GAMMAGLOBULIN IgE GASTRIN, SERUM GLUCOSE, BLOOD QUANT" O'SULLIVAN GLUCOSE TEST GLUCOSE TOLERANCE TEST (GTT) 2HR GLUCOSE TOLERANCE TEST -ADDITIONAL specimen GTT-ADDED SAMPLES G6PD ENZYME- QUANT GGT GLYCATED PROTEIN FSH- GONADOTROPIN (FSH) LH - GONADOTROPIN (LH) HAPTOGLOBIN, QUANT" SICKLE CELL TO STATE LAB HEMOGLOBIN CHROMOTOGRAPHY A1C Hgb - GLYCOSYLATED HEMOGLOBIN TEST HOMOCYSTINE HYDROXY-PROGESTERONE, 17-d alpha IMMUNOASSAY NONANTIBODY IMMUNOASSAY RIA INSULIN INSULIN-FREE IRON IRON BINDING TEST LACTATE (LD) (LDH) ENZYME LEAD (adult) LIPASE LIPOPROTEIN(A) ELECTROPHORETIC SEP & QUANT WITH HR REFRACTION LIPOPROTEIN PARTICLES-QUANTITATION 188.00 255.00 106.00 100.00 25.00 94.00 158.00 25.00 41.00 39.00 50.00 31.00 48.00 132.00 104.00 48.00 125.00 101.00 146.00 26.00 188.00 29.00 65.00 68.00 99.00 18.00 28.00 31.50 10.50 10.50 107.00 25.00 44.00 36.00 31.00 69.00 0.00 86.00 29.00 59.00 148.00 119.00 181.00 37.00 55.00 25.00 10.00 37.00 38.00 42.00 120.00 42.00 124.00

FY 13/14

Macon County Public Health Fee Schedule
Modifier

Final Approval

Proposed Changes Description Current
(Red = Increase Blue=Decrease) 07-23-13

Code

FY 13/14 83718 83721 83735 83825 83835 83874 83874 83880 83883 83891 83894 83898 83900 83901 83909 83912 83914 83921 83930 83935 83945 83970 83986 84066 84075 84100 84105 84132 84133 84134 84144 84146 84153 84154 84155 84156 84165 84166 84207 84244 84295 84300 84305 84402 84403 84425 84436 84439 84443 84445 84446 84450 84460 HDL- DIRECT LIPOPROTEIN LDL DIRECT - LIPOPROTEIN MAGNESIUM MERCURY METANEPHRINES- TOTAL - 24 HOUR URINE MYOGLOBIN- SERUM QUANT MYOGLOBIN- URINE QUANT BNP- T-TYPE NATRIURETIC PEPTIDE NEPHELOMETRY NOT SPEC MOLECULE ISOLATE NUCLEIC MOLECULE GEL ELECTROPHOR MOLECULE NUCLEIC AMPLI, EACH" MOLECULE NUCLEIC AMPLI 2 SEQ MOLECULE NUCLEIC AMPLI ADDON SEPARATION+ID BY HIGH RESOLUTION GENETIC EXAMINATION MUTATION ID OLA/SBCE/ASPE ORGANIC ACID, SINGLE, QUANT" OSMOLALITY- BLOOD OSMOLALITY- URINE OXALATE -24 HR URINE PTH- PARATHYROID HORMONE-INTACT BODY FLUID ACIDITY Nitrazine paper PROSTATE ACID PHOSPHATASE ALKALINE PHOSPHATASE PHOSPHORUS- INORGANIC -SERUM PHOSPHORUS- INORGANIC - URINE POTASSIUM- SERUM POTASSIUM- URINE PREALBUMIN PROGESTERONE PROLACTIN PSA, TOTAL PSA, FREE PROTEIN - TOTAL/REFLECT SERUM PROTEIN, URINE RANDOM or 24 hour PROTEIN ELEC-PHORESIS, SERUM QUANT PROTEIN ELEC-PHORESIS/URINE/CSF VIT B6 - PLASMA RENIN SODIUM- SERUM SODIUM- URINE 24 HOUR SOMATOMEDIN TESTOSTERONE- FREE TESTOSTERONE- TOTAL VITAMIN B-1 THIAMINE T4- TOTAL THYROXINE T4- FREE THYROXINE TSH- THYROID STIM HORMONE TSI-THYROID STIMULATING IMMUNG VIT E - SERUM AST (SGOT) TRANSFERASE ALT (SGPT) ALANINE AMINO 25.00 29.00 25.00 137.00 200.00 130.00 130.00 204.00 133.00 55.00 32.00 32.00 15.00 1.50 15.00 41.00 1.00 222.00 52.00 52.00 94.00 100.00 9.00 28.00 36.00 37.00 37.00 25.00 37.00 67.00 85.00 49.00 30.00 116.00 36.00 60.00 51.00 100.00 179.00 135.00 36.00 37.00 71.00 186.00 37.00 119.00 23.00 27.00 28.00 253.00 103.00 25.00 25.00

FY 13/14

Macon County Public Health Fee Schedule
Modifier

Final Approval

Proposed Changes Description Current
(Red = Increase Blue=Decrease) 07-23-13

Code

FY 13/14 84466 84478 84479 84480 84481 84482 84484 84520 84540 84550 84560 84585 84590 84591 84597 84630 84681 84702 84703 85002 85004 85007 85014 85018 85025 85041 85045 85048 85049 85060 85220 85240 85250 85300 85301 85302 85303 85305 85306 85307 85379 85384 85610 85613 85651 85660 85670 85705 85730 85732 86038 86060 86140 TRANSFERRIN TRIGLYCERIDES T3 or T4 UPTAKE or THBR T3- TRIIODOTHYRONINE (T3) T3-FREE ASSAY (FT-3) T3- REVERSE TROPONIN, QUANT" BUN -UREA NITROGEN UREA NITROGEN -24 HR URINE URIC ACID- BLOOD URIC ACID- URINE VMA- URINE 24 HOUR VITAMIN A Vitamin B7 - Biotin VIT K - 1 ZINC C-PEPTIDE HCG- QUANT SERUM HCG-QUAL SERUM BLEEDING TIME TEST WBC DIFFERENTIAL -AUTOMATED WBC DIFFERENTIAL- MANUAL bld smear HEMATOCRIT HEMOGLOBIN CBC W/AUTO DIFF WBC RBC COUNT AUTOMATED RETICULOCYTE COUNT AUTOMATED WBC-COUNT - BLOOD (LEUKOCYTE ) AUTOMATED PLATELET COUNT AUTOMATED BLOOD SMEAR INTERPRETATION FACTOR V ACTIVITY FACTOR VIII ACTIVITY FACTOR IX ACTIVITY ANTITHROMBIN III TEST ANTITHROMBIN III ANTIGEN TEST PROTEIN C ANTIGEN PROTEIN C ACTIVITY PROTEIN S, TOTAL PROTEIN S FREE ACTIVATED PROTEIN C (ACP) RESISTANCE FIBRIN DEGRADATION, QUANT" FIBRINOGEN PT / INR PROTHROMBIN TIME RUSSELL VIPER VENOM, DILUTED" SED RATE, NONAUTOMATED" SICKLE CELL TEST-RBC REDUCTION-reflex fraction. THROMBIN TIME PLASMA THROMBOPLASTIN INHIBITION PTT- THROMBOPLASTIN TIME, PARTIAL" THROMBOPLASTIN TIME, SUBSTITUTION EA ANA- ANTINUCLEAR ANTIBODIES-DIRECT ANTISTREPTOLYSIN O, TITER" C-REACTIVE PROTEIN 59.00 25.00 23.00 75.00 112.00 217.00 153.00 25.00 38.00 25.00 37.00 96.00 112.00 227.00 204.00 94.00 115.00 40.00 24.00 40.00 17.00 16.00 18.00 18.00 26.00 34.00 29.00 34.00 34.00 24.00 238.00 195.00 238.00 150.00 200.00 65.00 65.00 55.00 59.00 155.00 170.00 95.00 26.00 110.00 20.00 100.00 90.00 100.00 26.00 100.00 32.00 45.00 49.00

FY 13/14

Macon County Public Health Fee Schedule
Modifier

Final Approval

Proposed Changes Description Current
(Red = Increase Blue=Decrease) 07-23-13

Code

FY 13/14 86141 86147 86160 86162 86200 86215 86225 86226 86235 86255 86256 86300 86300 86301 86304 86308 86334 86335 86340 86359 86360 86376 86382 86431 86480 86580 86592 86593 86611 86617 86618 86632 86644 86645 86663 86664 86665 86677 86689 86694 86695 86696 86701 86703 86704 86705 86706 86707 86708 86709 86735 86747 86757 C-REACTIVE PROTEIN, HS - CARDIAC CARDIOLIPIN ANTIBOD, each class COMPLEMENT, ANTIGEN" COMPLEMENT, TOTAL (CH50)" CCP-CYCLIC CITRUL…PEPTIDE AB DNASE (DEOXYRIBONUCLEASE) ANTIBODY DNA ANTIBODY- NATIVE OR DOUBLE STRAND DNA ANTIBODY, SINGLE STRAND" NUCLEAR ANTIGEN ANTIBODY-EXTRACTABLE FLUORESCENT ANTIBODY, SCREEN" FLUORESCENT ANTIBODY, TITER" CA 15-3 -IMMUNOASSAY TUMOR, CA 27.29 -IMMUNOASSAY TUMOR, CA 19-9- MMUNOASSAY TUMOR, CA 125- MUNOASSAY TUMOR, MONO- HETEROPHILE ANTIBODIES-QUALITATIVE IMMUNOFIX E-PHORESIS, SERUM" IMMUNFIX E-PHORSIS/URINE/CSF INTRINSIC FACTOR ANTIBODY T CELLS; TOTAL COUNT CD4 / CD8, ABSOLUTE COUNT/RATIO" MICROSOMAL ANTIBODY NEUTRALIZATION TEST, VIRAL"(rabies titer) RA -RHEUMATOID FACTOR, QUANT" TB- INTERFERON GOLD TEST TB INTRADERMAL TEST RPR- BLOOD SEROLOGY, QUALITATIVE" RPR-TITER BLOOD SEROLOGY, QUANT BARTONELLA ANTIBODY CAT SCRATCH LYME DISEASE ANTIBODY-CONFIRMATORY WB LYME DISEASE IGM ANTIBODY CHLAMYDIA IGM ANTIBODY CMV ANTIBODY- IGG CMV ANTIBODY, IGM" EPSTEIN-BARR ANTIBODY-EA EARLY ANTIGEN EPSTEIN-BARR ANTIBODY-EBNA NUCLEAR AG EPSTEIN-BARR ANTIBODY-VIRAL CAPSID(VCA) HELICOBACTER PYLORI - IGG QUANT HTLV/HIV WB CONFIRMATORY HERPES SIMPLEX TEST- TYPE 1 & 2 IGM HERPES SIMPLEX TYPE 1 IGG HERPES SIMPLEX TYPE 2 HIV-1 HIV-1/HIV-2, SCREENING HEP B CORE ANTIBODY, TOTAL" HEP B CORE ANTIBODY, IGM" HEP B SURFACE ANTIBODY- QUALITAtive HEP BE ANTIBODY HEP A ANTIBODY, TOTAL" HEP A ANTIBODY, IGM" MUMPS TITER - IGG ANTIBODY PARVOVIRUS ANTIBODY-B19 IGG-IGM RICKETTSIA AB-ROCKY MTN SPOTTED FEVER 52.00 60.00 109.00 123.00 104.00 135.00 124.00 131.00 114.00 121.00 111.00 38.00 38.00 140.00 42.00 50.00 40.00 189.00 135.00 177.00 177.00 59.00 55.00 27.00 69.00 10.00 20.00 20.00 236.00 300.00 133.00 125.00 112.00 112.00 108.00 108.00 108.00 51.00 103.00 100.00 94.00 127.00 33.00 33.00 28.00 67.00 28.00 81.00 29.00 29.00 36.00 207.00 141.00

FY 13/14

Macon County Public Health Fee Schedule
Modifier

Final Approval

Proposed Changes Description Current
(Red = Increase Blue=Decrease) 07-23-13

Code

FY 13/14 86762 86765 86777 86780 86787 86790 86800 86803 86804 86850 86870 86880 86900 86901 87045 87070 87075 87077 87081 87086 87088 87168 87172 87177 87186 87205 87207 87209 87210 87230 87324 87338 87340 87350 87390 87425 87490 87491 87491 87517 87521 87522 87590 87591 87621 87880 87902 88175-90 89055 89321 99000 99070 G0328 RUBELLA ANTIBODY TITER IGG RUBEOLA ANTIBODY TITER IGG TOXOPLASMA GONDII IGG ANTIBODY TP-PA SYPHILIS CONFIRM TEST VARICELLA-ZOSTER ANTIBODY TITER VIRUS ANTIBODY NOS THYROGLOBULIN ANTIBODY HEPATITIS C AB TEST HEP C AB TEST, CONFIRM" ANTIBODY SCREEN- RBC ANTIBODY IDENTIFICATION- RBC COOMBS TEST, DIRECT" BLOOD TYPING, ABO" BLOOD TYPING, RH (D)" STOOL (FECES) CULTURE to State Lab CULTURE, BACTERIA, OTHER" CULTURE ANAEROBIC BACTERIA, EXCEPT BLOOD" CULTURE AEROBIC ORGANISM IDENTIFICATION CULTURE SCREEN ONLY URINE CULTURE/COLONY COUNT URINE BACTERIA CULTURE MACROSCOPIC EXAM ARTHROPOD (nits-lice) PINWORM EXAM OVA AND PARASITES SMEARS-concentration SUSCEPTIBLE - MICROBE , MIC" GRAM STAIN- SMEAR, SMEAR, SPECIAL STAIN" SMEAR, COMPLEX STAIN- richrome, iron etc WET MOUNT, SALINE/INK" C.DIFFICILE B TOXIN - (QUAL) CLOSTRIDIUM difficile toxin A and B, EIA HELICOBACTER PYLORI, STOOL ANITGEN, EIA HEPATITIS B SURFACE AG, EIA" HEPATITIS BE AG, EIA" HIV-1 AG, EIA - STATE LAB ROTAVIRUS AG, EIA" CHLAMYDIA TRACH BY DNA PROBE CHLAMYDIA TRACH, DNA, TO State Lab CHLAMYDIA TRACH, DNA, LabCorp swab or ua HEPATITIS B, DNA, QUANT - PCR HEPATITIS C, RNA, AMP PROBE - QUAL HEPATITIS C, RNA, QUANTISURE (IU) N.GONORRHOEAE, DNA, DIR PROB" N.GONORRHOEAE, DNA, AMP PROB-STATE LAB HPV, DNA, AMP PROBE" STREP A ASSAY W/OPTIC HEPATITIS C GENOTYPE, DNA, " PAP COLLECTION FEE WBC - STOOL SEMEN ANAL, SPERM DETECTION"-AMC HANDLING FEE - Paps MATERIALS AND SUPPLIES-each container HEMOCCULTS X 3 (MEDICARE) 30.00 38.00 94.00 67.00 51.00 143.00 105.00 38.00 406.00 28.00 107.00 56.00 25.00 38.00 0.00 25.00 88.00 25.00 25.00 18.00 22.00 17.00 15.00 25.00 23.00 18.00 119.00 50.00 15.00 140.00 127.00 204.00 27.00 83.00 0.00 137.00 32.00 0.00 129.00 541.00 368.00 406.00 84.00 0.00 105.00 32.00 582.00 16.75 69.00 30.00 15.00 7.50 18.00

FY 13/14

Macon County Public Health Fee Schedule
Modifier COC DRUG COLLECTION FEE COC PATERNITY COLLECTION

Final Approval

Proposed Changes Description Current
(Red = Increase Blue=Decrease) 07-23-13

Code

FY 13/14 LU305 LU306 15.00 15.00

FY 13/14

July 23, 2013

Macon County Environmental Health Fee Schedule FY 2013-2014
On-Site Waste Water Fees
Description
Improvement Permit (IP) Only Authorization to Construct (AC) Only IP/AC

Gallons Number Per Day Bedrooms
240 - 360 240 - 360 240 - 360 2-3 2-3 2-3

FY 14 Fee
$500 $500 $500

Improvement Permit (IP) Only Authorization to Construct (AC) Only IP/AC

480 - 600 480 - 600 480 - 600

4–5 4–5 4–5

$1,000 $1,000 $1,000

***Residential Rates for Bedrooms 6 and above see Commercial Rate Below***

Commercial – IP Commercial – AC Commercial – IP/AC

$1.65 per gal $1.65 per gal $1.65 per gal

***NOTE: If two (2) or more homes a single system, commercial rate applies***
RV Permit Only Addition to System (Per Bedroom) IP/AC/RV Renewal of Permit before Expiration Relocate Tank Consultative Visit Mobile Home Reconnect-Site Visit Additions to Structure Return Visit Fee Residential Repair Permit Commercial Repair Permit 0 - 120 0 -120 $250 $250 $250 $225 $125 $125 $125 $125 $125 $.42 per gal

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July 23, 2013

Private Drinking Water Well Fees
Description
Private Drinking Water Well (PDWW) Permit Consultative Visit Return Site Visit Fee Abandonment of a Well (no chage if done in conjunction with a PDWW permit) Renewal of Permit before Expiration (No Changes in Permit)

FY 14 Fee
$375 $125 $125 $125 $175

Water Testing Fees
Test Requested
Collection of Sample Bacterial Analysis Private Public Quanti-Tray Inorganic Chemical Analysis Nitrate Pesticide Analysis Petroleum Analysis Volatile Organic Compounds Analysis

Water System Type

FY 14 Fee
$50 $20 $20 $30 $20 $30 $45 $45 $250

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July 23, 2013

Food & Lodging Fees
Description
Food Service Establishment Plan Review New Existing New Existing Food Stand Plan Review Temporary Food Establishment Permit Tattoo Parlor Plan Review Per Event New Existing Tattoo Parlor Permit - Owner/Operator (Annually) Tattoo Parlor Permit - Each Additional Artist (Annually) Pool Plan Review Yearly Pool Application Fee Additional Pool or Spa DEFINITIONS: Improvement Permit (IP) On-site Waste Water System (OSWW) An improvement permit shall include: 1. For permits that are valid without expiration, a recorded plat or, for permits that are valid for five years, a site plan. 2. A description of the facility the proposed site is to serve. 3. The proposed wastewater system and its location. 4. The design wastewater flow and characteristics. 5. The conditions for any site modifications. 6. Any other information required by the rules of the Commission. Authorization for Construction (AC) OSWW The Authorization for Construction shall be issued by an authorized agent for the installation of a wastewater system when it is found that the Improvement Permit conditions and rules in this Section are met. The Construction Authorization shall contain conditions regarding system type, system layout, location, and installation requirements. It shall be the legal responsibility of the property owner to ensure that a valid Authorization for Construction is issued prior to the construction or repair of a septic system and the construction, location, or relocation of a residence, place of business, or place of public assembly.

Seats
<24 <24 >25 >25

FY 14 Fee
$200 $150 $200 $200 $100 $75 $200 $150 $700 $500 $200 $100 $50

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July 23, 2013 Private Drinking Water Well (PDWW) A private drinking water well as defined in G.S. 87-85 (10a) Repair Permit PDWW According to 15A NCAC 02C .0302 the definition of a “repair” is work involved in deepening, reaming, sealing, installing or changing casing depths, perforating, screening, or cleaning, acidizing or redevelopment of a well excavation, or any other work which results in breaking or opening the well seal. This definition is supported by the NC Division of Environmental Health (DEH) whose comments at a recent meeting included that deepening or hydrofracturing the well are considered repairs. However, though the definition of a “repair” is very clear it does not differentiate the amount of work involved in actually permitting these activities and therefore should not be used in determining fee structure. Fee structure is determined by the actual direct and indirect costs involved in conducting an activity. Note: These repair activities require an application by the owner/agent and a Construction Permit issued before any of these drilling activities can proceed. 15A NCAC 02C .0304 requires Environmental Health staff to conduct a field investigation to evaluate the property before issuing any permit. The level of time and effort required to perform the site evaluation for the above repair activities is no different than for a new construction permits. It is possible that a permit would be denied because of existing site conditions or inability to meet set back requirements. This is why in the current fee schedule we do not differentiate between these repair activities and placement of a new well.

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MCPH Billing Guide FY 14

MACON COUNTY PUBLIC HEALTH

FY 13-14
Billing and Collection Policies And Fee Schedules
Effective August 1, 2013

Presented to and Approved by Board of Health on July 23, 2013 Presented to and Approved by Board of Commissioners on _________

MCPH Billing Guide FY 14

Effective August 1, 2013
MACON COUNTY PUBLIC HEALTH BILLING AND COLLECTION POLICIES

RATIONALE North Carolina law1 allows a local board of health to impose a fee for services to be rendered by a

local health department, except where the imposition of a fee is prohibited by statute or where an employee of the local health department is performing the services as an agent of the State.
 Fees may be based on a plan recommended by the Health Director;  The plan must be approved by the Board of Health and the Board of County Commissioners;  And, fees collected under the authority of this subsection are to be deposited to the account of the local health department so that they may be expended for public health purposes in accordance with the provisions of the Local Government Budget and Fiscal Control Act. The State requires local health departments to provide certain services, and no one may be denied these services. It is in the best interest of our community for the Health Center to:

 Assure that all residents can get all legally required public health services.  Provide as many other recommended and needed health services as possible, within the resources we
still have available to use. The purpose of charging fees is to increase resources and use them to meet residents’ needs in a fair and balanced way. Fees are necessary to help identify and cover the full cost of providing public health services. As much as possible, fees are based on the true cost of providing a particular service (calculated as direct costs plus indirect costs). Throughout the year, ongoing cost analyses are performed and fee schedules shall be adjusted by the Health Director, with approval from the Board of Health and the Board of Commissioners in the amount of the increased cost for prevision of said services. A list of Health Center fees is available upon request. The information in the document below is the fee plan for FY 14, effective on July 1, 2010. This Billing Guide for FY14 replaces all earlier plans. COST OF SERVICE DETERMINATION Costs for services received through the Health Center are firstly based on the current Medicaid rate and then adjusted according to the actual cost of the service. If there is no Medicaid rate then fees are determined through cost analysis. Cost analysis takes into account all of the resources associated with providing a particular service and calculates the actual cost to provide that service. Cost analysis includes the calculation of direct and indirect costs for services and then adding these figures together to determine the actual cost of the service. Calculating direct cost: Direct costs are expenses that can be easily related to the provision of a specific service, i.e., physician and support staff salaries and benefits, medical supplies, lab tests, and other resources consumed at the time of the service. Calculating indirect costs: Indirect costs involve resources that are not directly consumed during the provision of a service, but without them the provision of that service would not be possible, i.e., administrative staff salaries and benefits, training costs, facility costs, insurance premiums, office equipment and supplies, and recruiting and marketing expenses.
1

North Carolina General Statue 130A-39(g) Page 2 9/5/20137/23/2013

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PAYMENT BY CONSUMER Fees are charged for services and collected at the Health Center. See attachment for fee schedule. All fees are the responsibility of the patient, consumer or responsible party and may be subject to the sliding fee scale. No consumer will be refused services solely on their inability to pay for said services. All fees may be paid by cash, check, or major credit card. Full payment is expected at the time of service. Consumers will be informed of their account status at each visit. An itemized receipt will be provided to individuals at time of payment. Fees for adult dental services will be collected before the service is rendered. Prepayment of co-pays for all services in which co-payments apply will be required and collected when services are rendered. Fees will be charged to individuals in families with annual gross incomes exceeding specified levels of a scale based on current Federal Poverty Income Guidelines. Verification of income and family size must be provided to determine a patient’s eligibility status. Verification (proof) of income may be provided for Family Planning services; however, if the patient has no proof of income, the patient’s declaration of income shall be accepted and any charge shall be based on what he/she declares. Falsification of this information will permanently disqualify consumers from using sliding fee scale. except for Family Planning services. Eligibility will be reevaluated as patient’s income and household status changes or at least annually. If income cannot be verified at the time of screening, the charge for all services except Family Planning will be at 100% pay and a Payment Agreement will be presented to the consumer for signature until verification is provided. If verification of income is received within thirty days of a service, the charge will be retroactively adjusted to reflect percent pay based on verification received. Verification received after thirty days will be applied only to future services. Eligibility of Medicaid will be determined where applicable. Individuals will be required to provide all social security numbers and names used for employment purposes. If an individual refuses to provide information to verify income, they will not be eligible for the sliding fee scale and will be at 100% pay. Customary visit services for mandatory childhood immunizations, community outreach, Tuberculosis (TB), TB related X-rays, Sexually Transmitted Disease control (STD), and other epidemiological investigations are provided at no cost to the consumer but may be billed to Medicaid or other third party agent. Separate fees may be charged for drugs, supplies, laboratory services, X-rays and other technological services, if appropriate. The costs of services performed by providers not affiliated with the Macon County Public Health Center are the responsibility of the patient/consumer. Fees may be charged or waived for educational services provided to individuals or groups, such as orientation, preceptorship, field training or classes. Charges not eligible for sliding scale discount include: a. Environmental Health services b. Non-mandated immunization services c. Miscellaneous/general services (see Miscellaneous/General section below) d. Out-of-county residents (see Out-of-County Service Restrictions section below) e. Specific insurance situations (see Insurance section below for details) Bills will be mailed monthly to individuals who have not paid charges in full for services rendered (exception Family Planning for those that request no mail be sent to their home). All bills will show total charges, as well as any discount that may have been provided. Arrangements may be made for payment plans when required for good cause. PAYMENT BY THIRD PARTY Verification of enrollment under Medicare, Medicaid, insurance or other third party payment plan is required by presentation of a valid card at the time of service. The Health Center is required to bill only
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Comment [t1]: Received notification from state DHHS June 18, 2013 regarding change to take effect August 1, 2013.

MCPH Billing Guide FY 14

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participating third party payers for services rendered. Services that are billed to third parties are billed at 100% of the total charge with no discount applied. When the claim is returned from the third party payer all discounts are applied at that time. (i.e., any applicable sliding fee scale adjustment) For services rendered to consumers with insurance where the Health Center is not a participating provider, the consumer will be responsible for full payment of service when the service is delivered. The Health Center is currently participating with Medicaid, Medicare, Blue Cross Blue Shield, Crescent, Tri-care, United Health Care and NC Health Choice for medical services. The consumer is responsible for charges not covered by third party payers. Co-pay amounts must be paid at the time of services and are not subject to the sliding fee eligibility scale. Sliding fee scale discount does not apply in the following situations: a. Consumers with insurance in which MCPH is not participating provider. b. Consumers with any insurance who choose not to use their coverage. c. Insurance co-payments (when MCPH is a participating provider) ACCOUNT COLLECTIONS AND BAD DEBT The Health Center will issue all consumers a monthly statement of fees that have been incurred and are due. Consumers are expected to make payment at the time services are rendered. If a balance is carried forward consumers who have not made a payment on their account for any service(s) received from Macon County Public Health for 120 days shall be required to pay their past due balance before another service shall be rendered (see Service Denial for further information). The Health Center may use the following resources to pursue collection of patient accounts: billing statements, past due notices, collection agencies or credit bureaus, and the NC Local Government Debt Setoff Clearinghouse (ref: NCGS 105A-1 et seq.) as administered by the NC Department of Revenue Accounts will be reviewed annually for bad debt status, and at that time with the approval of the BOH and the BOCC’s the amounts may be written off for accounting purposes if no further collection is anticipated. Any payments received for write-off debts will be accepted and credited to appropriate accounts. At no time will a patient be notified that the account has been written off as a bad debt. Bad debts, which are determined uncollectible (i.e. bankruptcy, death), will be written off permanently upon notification. CONSUMER DONATION POLICY A consumer may choose to make a donation to the agency. The consumer will never be asked to make a donation, but if offered the donation is accepted. Donations are not required, and are not a prerequisite for the provision of any service. Billing requirements set out above in the Payment by Consumer section are not waived because of consumer donations. (ref: Donation Policy 101.9) RETURNED CHECK POLICY A $25.00 fee will be charged for a returned check written to Macon County Public Health (MCPH). The consumer will be notified via telephone, if possible, of the returned check. If a telephone number is not available, a written notification will be sent certified letter. All returned checks will be made good via cash, money order, and/or certified check. If a consumer has two returned checks within a one-year period, he/she will be required to pay for services in advance via cash, money order, or certified check for the period of one year. After the one-year period expires, if another returned check occurs, all future bills must be paid with cash, money order, or certified check prior to the provision of services.

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REFUNDS In the event that a consumer or other third-party has overpaid their responsible charges, the credit balance is either: applied to future charges or refunded to the payer within thirty (30) days of discovery or request. Refunds for Environmental Health services are determined by attached policy and procedure.

SERVICE DENIAL No individual may be denied Health Center mandated services e.g. communicable disease services (STD/TB). These services are provided at no charge to the consumer. Individuals who do not meet program guideline criteria may be denied specific services. Consumers covered by Medicaid who fail to make required co-payments will not be denied services. Individuals who have not paid proper charges for previous services (unless state and federal program rules prohibit services restriction or denial) may be required to pay fees beforehand, be denied access to services (see Account Collections and Bad Debts), or be denied subsequent services pending demonstration of a good faith effort to make payment within the past ninety (90) days. OUT OF COUNTY SERVICE RESTRICTIONS Macon County supports its low-income citizens by subsidizing the cost for certain health care services. To assure that Macon County citizens have maximum access to Health Center services only those services mandated by North Carolina General Statues or approved in this plan will be provided to nonMacon County residents. If an individual moves out of Macon County, they must obtain services from another provider. Consumers are required to report any change of address at time of service. COMPLIANCE WITH TITLE VI AND VII, OF 42 US CODE CHAPTER 21 The MCPH complies with Title VI and Title VII of the Civil Rights Act of 1964 and all requirements imposed by or pursuant to the regulations. Staff will not discriminate against any clients because of age, sex, race, creed, national origin, or disability. Staff will ensure consumers with LEP are provided adequate language assistance so they have meaningful access to the agency’s services. PROGRAM SPECIFIC INFORMATION ADULT HEALTH Provides limited health screening services for adults. Services provided through this program are not eligible for sliding fee scale payment or third party billing. Exception: Colposcopies may be billed to third parties. Eligibility:

 Must be a resident of Macon County; Exception: Colposcopies.  Must be 18 years and older.  Adult Health Services are not eligible for sliding fee scale payment. Services will be paid for
prior to any service being rendered. Any additional fees associated with a visit will be added to the clients account and paid in full at checkout.

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MCPH Billing Guide FY 14
COMMUNICABLE DISEASE CONTROL

Effective August 1, 2013

Deals with the investigation and follow-up of all reportable communicable diseases. Testing, diagnosis, treatment, and referring as appropriate, of a variety of STD’s. Provides follow-up and treatment of TB cases and their contacts. No fees are charged directly to clients for these services as stated in Program Rules (exception Medicaid or other third party agent can be billed with the patient’s permission). Eligibility:  No residency or financial requirements BREAST AND CERVICAL CANCER CONTROL PROGRAM (BCCCP) Provides pap smears, breast exams and screening mammograms, assists women with abnormal breast examinations/mammograms, or abnormal cervical screenings to obtain additional diagnostic examinations. Eligibility:       Must be a resident of Macon County; uninsured or underinsured; without Medicare Part B or Medicaid; between ages 40 - 64 for breast screening services and 18 - 64 for cervical screening services; have a household income at or below 250% of the federal poverty level. No charge for those who qualify for the program; family size shall be determined as follows: Client, spouse of client and all children under 18 years of age, including step-children who live in the home.  Proof of income must be provided.

WOMEN’S HEALTH Provides limited health screening services (pap smears and/or breast exams) for women who do not meet the qualifications of the NC BCCCP Program. Grant funds may be available to cover the cost of repeat pap smears for women below 250% of federal poverty level when funding is available. Services provided are not eligible for sliding fee scale payment or third party billing. Eligibility:

 Must be a resident of Macon County; 18 years and older.  Women’s Health Services are not eligible for sliding fee scale payment. Services will be paid for
prior to any service being rendered. Any additional fees associated with a visit will be added to the clients account and paid in full at checkout

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MCPH Billing Guide FY 14
CHILD HEALTH

Effective August 1, 2013

Well child exams conducted by (appropriate provider); exam includes medical, social, development, nutritional history, lab work, and physical exam. MCPH accepts sliding fee scale; some Private Insurances; Health Choice; Medicaid Eligibility:  Residents of Macon County; Birth to 20 years; Residents of other surrounding NC Counties if client has Medicaid or Health Choice

IMMUNIZATIONS Provide all required and recommended vaccines that are available for infants, school aged children and college bound individuals. Also provide a wide range of vaccines for adults to include foreign travel vaccinations. MCPH accepts some Private Insurances, Health Choice, Medicaid, and Medicare. In some instances charges do not apply (e.g. state supplied vaccine). Sliding fee scale does not apply to immunizations. Eligibility:  No residency or financial requirements for immunizations. CARE COORDINATION FOR CHILDREN (CC4C) Case management assists families in identification of and access to services for children with special needs that will allow them the maximum opportunity to reach their development potential. MCPH accepts Medicaid Eligibility:  Macon County children birth to age three who are at risk for developmental delay or disability, long term illness and/or social, emotional disorders and children ages birth to five who have been diagnosed with developmental delay or disability, long term illness and/or social, emotional disorder may be eligible for the program. FAMILY PLANNING Clinic designed to assist women in planning their childbearing schedule; detailed history, lab work, physical exam, counseling and education given by (appropriate provider). MCPH accepts sliding fee scale; some Private Insurances; Medicaid or potentially Medicaid eligible. Eligibility:      This can be a “confidential service” Women of childbearing age Residents of Macon and other surrounding North Carolina Counties Proof of income must be provided. Family Planning (Title X) patients who present for services without proof of income will be assigned to the sliding fee scale based on information shared verbally regarding income and sources. Unless the information warrants, they will never be charged at 100% as this would be considered a barrier to service. Proof of income may be requested, but cannot be required
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Comment [t2]: Received notification from state DHHS June 18, 2013 regarding this change to take effect August 1, 2013.

 A Family Planning patient will never be refused a Family Planning service, or asked to meet with the Health Director due to a delinquent account; however they may be referred to Debt setoff. MISCELLANEOUS/GENERAL SERVICES Include: daycare, DOT, foster care, employment or other specialty physical exams; laboratory services, etc. Eligibility:  Residents of Macon County (exception, pregnancy tests)  These services are not eligible for sliding fee scale payment. Services will be paid for prior to any service being rendered. Any additional fees associated with a visit will be added to the clients account and paid in full at checkout. MATERNAL HEALTH Prenatal care is medical care recommended for women during pregnancy. The aim of good prenatal care is to detect any potential problems early, to prevent them if possible (through recommendations on adequate nutrition, exercise, vitamin intake etc), and to direct the woman to appropriate specialists, hospitals, etc. if necessary. Visits are monthly during the first two trimesters (from week one to week 28 of pregnancy), every two weeks from 28 to week 36 of pregnancy and weekly after week 36 (until the day of delivery that could be between week 38 and 40 weeks). MCPH accepts sliding fee scale; some Private Insurances; Medicaid or potentially Medicaid eligible. Eligibility:  Residents of Macon - eligibility policy and residency requirements attached  Maternal Health clients will be required to have 2 proofs of residency  Proof of income is required. OB CARE COORDINATION MANAGEMENT (OBCM) Case manager assists pregnant women in receiving needed prenatal care and pregnancy related services. MCPH accepts Medicaid or potentially Medicaid eligible. Eligibility:  Residents of Macon County WOMEN, INFANTS, AND CHILDREN NUTRITION PROGRAM (WIC) Supplemental nutrition and education program to provide specific nutritional foods and education services to improve health status of target groups. Eligibility: WIC is available to pregnant, breastfeeding, and postpartum women, infants, and children up to age 5 who meet the follow criteria:     Be a resident of Macon County; Be at medical and/or nutritional risk; Have a family income less than 185% of the US Federal Poverty Level; Medicaid, AFDC, or food stamps automatically meet the income eligibility requirement
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CHILDRENS DENTAL PROGRAM The Macon County Children’s Dental Clinic (Molar Roller) provides comprehensive general dental services to children from birth to 20 years of age. Eligibility:  Resident of Macon County. Exception: Residents of other surrounding NC Counties if client has Medicaid or Health Choice.  Services eligible for sliding fee scale with a maximum discount of 75%.  Charges not eligible for sliding fee scale discount include: Services not covered by Medicaid or Health Choice and those covered by insurances which MCPH is not a participating provider. ADULT DENTAL PROGRAM The Macon County Adult Dental Clinic provides comprehensive general dental services to adults 21 years of age and above. Eligibility:     Residents of Macon County. Exception: Residents of other surrounding NC Counties if client has Medicaid. Services eligible for sliding fee scale with a maximum discount of 50%. Charges not eligible for sliding fee scale discount include: Services not covered by Medicaid or Health Choice and those covered by insurances which MCPH is not a participating provider. Fees for adult dental services will be collected before the service is rendered.

HEALTH EDUCATION/HEALTH PROMOTION Health education/health promotion services are provided to individuals and/or groups. The focus is to promote health and prevent disease, disability and premature death through education-driven voluntary behavior change activities; and is designed to enable people to increase control over, and to improve, their health. Details, policies and fees are specific to each program or activity offered. Fees for these programs and activities are subject to change and appropriately adjusted throughout the year. Eligibility:  Residents of Macon and other North Carolina Counties Worksite Wellness Employee health services are available for all employers in Macon County. Employee health services are available on a per program basis or under and annual contract arrangement. Individual program fees will vary and are based on salary expense to prepare and deliver the program; current mileage rates if travel is required; as well as any materials, laboratory, or medical supplies costs. An administrative supplement of 10% is added for each individual program. Comprehensive worksite wellness programs are available under contract for organizations with at least 50 employees. This program, also known as the LIFE program, provides employee health screenings followed by customized programs and consultation services to address the health needs of the employees. Fees for the LIFE program range from $30 to $50 per employee per year depending upon the cost to provide
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the services, the number of programs provided, as well as the organization’s ability to provide in-kind assistance. CPR/AED and First Aid Training: Various components of American Red Cross Standard First Aid and/or CPR/AED for lay responders are offered on-site at Macon County Public Health’s location at Lakeside Drive in Franklin. Classes are offered for a fee approximately every month. The specific educational components offered may vary from month to month to best suit the current needs of the public. Pre-registration and pre-payment are required. A maximum of twelve individuals may be enrolled in a single instructor class. Fees for the specific educational components are based on current American Red Cross pricing and are subject to change. NUTRITION SERVICES: DSMT Services: Macon County Public Health offers Diabetes Self-Management Training services provided by a Registered Dietitian through American Diabetes Association approval/recognition. The registered dietitian is credentialed and a certified provider with Medicare, Medicaid and BCBS NC. For clients with these insurances, physician referral and medical diagnosis of diabetes the insurance will be billed and costs covered accordingly. For clients without these insurances a sliding fee scale based on annual gross income that is at or below 250% of poverty is used. The scale slides to a minimum discount of 20% in which the client is responsible for payment to the health center prior to service being rendered.

MNT Services: Macon County Public Health offers Medical Nutrition Therapy services provided by a Registered Dietitian. The registered dietitian is credentialed and a certified providers with Medicare, Medicaid and BCBS NC. For clients with these insurances, physician referral and covered medical diagnosis the insurance will be billed and costs covered accordingly. For clients without these insurances a sliding fee scale based on annual gross income that is at or below 250% of poverty is used. The scale slides to a minimum discount of 20% in which the client is responsible for payment to the health center prior to service being rendered.

ENVIRONMENTAL HEALTH Fees for Environmental Health Services are collected at time of application. by the Macon County Building Inspections Department. REFUND POLICY: Attached

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Guidelines for Determining Elements of the Sliding Fee Scale Eligibility screening is required on all new clients or when family size and/or income changes occur, or at 12 month intervals. A client’s percentage of pay is documented on the Financial Eligibility Application in the client’s medical record and in HIS. Definition for Family Size and Countable Gross Income for the following clinics: Adult Health, Child Health, Prenatal, Family Planning and Dental A family is defined as a group of related or non-related individuals who are living together as one economic unit. Individuals are considered members of a single family or economic unit when their production of income and consumption of goods are related. An economic unit must have its own source of income. Example: consumer with no income must be considered part of a larger economic unit that provides support to the household. Groups of individuals living in the same house with other individuals may be considered a separate economic unit. For example, if two sisters and their children live in the same house and both work and support their own children, they would be considered a separate household. EXCEPTIONS TO ECONOMIC UNIT A. Un-emancipated minors and others requesting confidential services will be considered a family unit of one, and fees will be assessed based on their own income. A foster child assigned by DSS shall always be considered a family of one.

B.

Determination of Gross Income: The dollar amounts represent gross annual income; they refer to total cash receipts before taxes from all sources. Household income sources include: Salaries and wages, earnings from self-employment (deduct business expenses, except depreciation); interest income, all investment and rental income; public assistance, unemployment benefits, worker’s compensation, alimony and child support, military allotments; Social Security benefits, VA benefits; retirement and pension pay; insurance or annuity plans; gaming proceeds and any other income not represented here that contributes to the household consumption of goods. This list is not all inclusive. Documents acceptable for income verifications: Current pay stub (noting the pay timeframe i.e.: weekly, bi-weekly etc.) Signed statement from employer indicating gross earnings for a specified pay period, statement must include the business name, address and phone number and must be legible. W-2 Forms Unemployment letter/notice Award letter from Social Security Office, VA or Railroad Retirement Board 1099’s received from IRS For Self-employment: Accounting records or income tax return for the most recent calendar year, entire tax return must be provided in order allow deductions for business expenses.

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Sliding Fee Scale ‐ Adult Dental ‐ 200% of Proverty   Family Size  1  2  3  4  5  6  7  8  9  10  11  12  50%  11490  15510  19530  23550  27570  31590  35610  39630  43650  47670  51690  55710  75%  11491 22979 15511 31019 19531 39059 23551 47099 27571 55139 31591 63179 35611 71219 39631 79259 43651 87299 47671 95339 51689 103379 55711 111419 100%  22980 31020 39060 47100 55140 63180 71220 79260 87300 95340 103380 111420

Sliding Fee Scale ‐ Molar Roller ‐ 250% of Poverty  Family Size  1  2  3  4  5  6  7  8  9  10  11  12  25%  11490  15510  19530  23550  27570  31590  35610  39630  43650  47670  51690  55710  50%  11491 15511 19531 23551 27571 31591 35611 39631 43651 47671 51691 55711 75%  20108 28724 27143 38774 34178 48824 41213 58874 48248 68924 55283 78974 62318 89024 69353 99074 76388 109124 83423 119174 90458 129224 97493 139274 100%  28725 38775 48825 58875 68925 78975 89025 99075 109125 119175 129225 139275

20107 27142 34177 41212 48247 55282 62317 69352 76387 83422 90457 97492

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Bad Debt Written Off by BOH Date October 14, 1998 October 13, 1999 September 11, 2000 July 26, 2001 June 11, 2002 May 19, 2004 March 10, 2005 March 14, 2006 February 12, 2008 April 9, 2009 July 23, 2013 Approved By BOH BOH BOH BOH BOH BOH BOH BOH BOH BOH BOH Date of BOH Mtg Carried Forward October 13, 1998 October 12, 1999 September 11, 2000 June 12, 2001 June 15, 2002 May 11, 2008 March 8, 2005 March 14, 2006 February 12, 2008 April 9, 2009 July 23, 2013 September 1, 1998 June 30, 1999 June 30, 1999 December 31, 1999 December 31, 2000 December 31, 2002 December 31, 2003 December 31, 2004 December 31, 2006 May 31, 2008 August 30, 2010 $ $ $ $ $ $ $ $ $ $ $ 4,166.86 1,369.79 153.90 5,278.18 5,398.58 10,978.57 8,053.52 7,298.21 15,825.66 20,111.77 10,636.00 Cut off Date for Debt to be Amount to be Written Written Off Off Balance of Bad Debt Written Off $ 3,859.61 $ 8,026.47 $ 9,396.26 $ 9,550.16 $ 14,828.34 $ 20,226.92 $ 31,205.49 $ 39,259.01 $ 46,557.22 $ 62,382.88 $ 82,494.65 $ 93,130.65

MACON COUNTY BOARD OF COMMISSIONERS AGENDA ITEM
MEETING DATE: September 10, 2013 DEPARTMENT/AGENCY: Emergency Management SUBJECT MATTER: National Incident Management System (NIMS) DEPARTMENT HEAD COMMENTS/RECOMMENDATION: Per Emergency Services Director David Key, the County Attorney is working to prepare a resolution in regard to the National Incident Management System (NIMS). Documents indicate that the county initially approved this plan in July of 2006. Mr. Key and the County Attorney can provide more information at the meeting. Attached for your information are (1) a copy of the implementation plan dated June 23, 2006 and (2) a sample NIMS ordinance.

COUNTY MANAGER’S COMMENTS/RECOMMENDATION: Recommend approval.

Attachments ___X__ Agenda Item 10C

Yes

___

No

MACON COUNTY

National Incident Management System (NIMS) IMPLEMENTATION PLAN
June 23, 2006

Due to the compilation of potentially sensitive data, this NIMS Implementation Plan is marked FOR OFFICIAL USE ONLY (FOUO) when completed. Also, this information may be exempt under the provisions of the Freedom of Information Act, 5 U.S.C. § 552. As such, anyone wishing to disseminate this document outside of the Federal Government should contact Warren Cabe for disclosure review.

PRIVACY STATEMENT

The disclosure of information in this plan could compromise the security of essential equipment, services, and systems of Macon County or otherwise impart Macon County’s ability to carry out essential emergency responsibilities. Distribution of this NIMS Implementation Plan in its entirety is limited to those associates who need to know the information in order to successfully activate and implement the plan. Portions of this plan contain information that raises personal privacy or other concerns, and those portions may be exempt from mandatory disclosure under the Freedom of Information Act. See 5 U.S.C. §552, 41 C.F.R. Part 105-60. Any decision to disclose information in this plan outside Macon County or to withhold information in this plan from a non-county requester must be coordinated with Macon County Legal Department.

RECORD OF CHANGES
Change No. Copy No. Date Entered Posted By

Recommended changes to this document should be addressed to the Macon County Emergency Management Coordinator

Macon County National Incident Management System (NIMS) Implementation Plan

TABLE OF CONTENTS
Foreword........................................................................................................................................ Section I: General ........................................................................................................................ Section II: Concept of Implementation ...................................................................................... Section III: Staff Training ............................................................................................................. Section IV: Modification of Plans, Procedures, and Policies................................................... Section V: Emergency Operations Plan (EOP) ......................................................................... Section VI: Glossary of Key Terms ............................................................................................ Section VII: Acronym List ........................................................................................................... LIST OF FIGURES Figure I-1. Figure II-1. Figure III-1. Figure III-3. Figure IV-1. Figure IV-2. Figure V-1. Figure V-2. Figure A-1. Identification of Key Personnel ................................................................................. Expected NIMS Implementation Timeline ................................................................. Training Requirements for All Employees................................................................. Current Training Programs ....................................................................................... Identification of Plans, Procedures, and Policies ...................................................... Strategy and Schedule for Developing an Inventory of Resources .......................... Contact for EOP ........................................................................................................ Checklist for a NIMS-Compliant EOP ....................................................................... General Comparison of the NIMS and the NRP .......................................................

ANNEXES Annex A – Relationship Between the EOP and the NIMS .............................................................

Macon County National Incident Management System (NIMS) Implementation Plan

FOREWORD
In Homeland Security Presidential Directive (HSPD)-5, Management of Domestic Incidents, the President directed the Secretary of Homeland Security to develop, submit for review to the Homeland Security Council, and administer a National Incident Management System (NIMS). This system will provide a consistent Nationwide approach for Federal, State, local and tribal governments to work effectively and efficiently together to prepare for, prevent, respond to, and recover from domestic incidents, regardless of cause, size, or complexity. The NIMS enhances the management of domestic incidents by establishing a single, comprehensive system for incident management and will help achieve greater cooperation among departments and agencies at all levels of government. Aside from the requirements of the HSPD, this department possesses significant responsibility as a signatory to the National Response Plan (NRP). Implementing the NIMS strengthens each department’s capability and resolve to fulfill its responsibilities to the American people in times of emergency. The following NIMS Implementation Plan will help ensure that Macon County has fully incorporated the NIMS into our emergency response plans, procedures, and policies. This plan also provides guidance for all divisions to ensure that all personnel are appropriately trained in the NIMS and prepared to effectively and efficiently execute the department’s duties under the NRP at all times.

_________________________________ Warren Cabe, Coordinator Macon County Emergency Management

SECTION I: GENERAL
I-1 Purpose

This document establishes the Macon County NIMS Implementation Plan in order to ensure compliance with HSPD-5, Management of Domestic Incidents. HSPD-5 requires all federal, state and local agencies to adopt the NIMS and use it in their individual domestic incident management and emergency prevention, preparedness, response, recovery, and mitigation activities. This plan also illustrates the intended methods of incorporation of the NIMS into the County’s plans, procedures, policies, and training programs. I-2 Authorities a. Proclamation dated May 11, 2005 issued by the Governor of North Carolina directing all counties and departments to adopt and integrate the National Incident Management System (NIMS). Emergency Management Ordinance for the County of Macon adopted 9-121977.

b.

I-3

References a. b. c. d. Homeland Security Act of 2002 HSPD-5, Management of Domestic Incidents HSPD-8, National Preparedness DHS, National Incident Management System, March 1, 2004

I-4

Definitions Relevant definitions and terms are provided in Section V.

I-5

Scope a. b. This document outlines how Macon County plans to implement the NIMS. The provisions of this document apply to all Macon County plans, procedures, policies, and training programs, including the procedures and annexes under the Macon County Emergency Operations Plan.

I-6

Responsibilities a.  The County Manager and Town Administrators To adopt the principles and policies of the National Incident Management System (NIMS) that will ensure the complete and efficient utilization of all resources to combat disaster resulting from enemy actions or other disasters. To ensure NIMS principles and policies are adhered to by all emergency management forces and across all functional disciplines To institutionalize the use of the Incident Management System (ICS) to enhance command, control, and communications capabilities Macon County Emergency Management       c.    d.   County lead for coordinating, monitoring, and reporting the progress on NIMS implementation Incorporate NIMS into the Emergency Operations Plan Institutionalize the use of the Incident Command System (ICS) during EOC activations and real time events Establish a timeframe and develop a strategy for NIMS implementation Establish a baseline to determine which NIMS requirements the agency has met Coordinate and provide assistance to local and regional entities regarding NIMS Macon County Fire Departments Responsible for ensuring Unit implementation of and compliance with Institutionalize the use of the Incident Command System (ICS). Incorporate NIMS into existing procedures, plans and policies, training programs, and exercises. Franklin and Highlands Police Departments Responsible for ensuring Unit implementation of and compliance with NIMS. Institutionalize the use of the Incident Command System (ICS). Incorporate NIMS into existing procedures, plans and policies, training programs, and exercises.

 

b.

e.
   f.    g    h.  

Macon County Sheriff’s Office Responsible for ensuring Unit implementation of and compliance with NIMS. Institutionalize the use of the Incident Command System (ICS). Incorporate NIMS into existing procedures, plans and policies, training programs, and exercises. Macon County Emergency Medical Services Responsible for ensuring Unit implementation of and compliance with NIMS. Institutionalize the use of the Incident Command System (ICS). Incorporate NIMS into existing procedures, plans and policies, training programs, and exercises. Macon County Fire Marshal Responsible for ensuring Unit implementation of and compliance with NIMS. . Institutionalize the use of the Incident Command System (ICS). Incorporate NIMS into existing procedures, plans and policies, training programs, and exercises. Macon County Public Health Responsible for ensuring Unit implementation of and compliance with NIMS. Institutionalize the use of the Incident Command System (ICS). Incorporate NIMS into existing procedures, plans and policies, training programs, and exercises.

Figure I-1 Identification of Key Personnel

Position Title County Manager Emergency Management Fire Marshal EMS Director Macon County Sheriff Health Department Franklin Administrator Franklin Police Dept. Franklin Mayor Highlands Administrator Highlands Police Highlands Mayor

Point of Contact Sam Greenwood Warren Cabe Warren Cabe Warren Cabe Robert Holland Ken Ring Mike Decker Terry Bradley Joe Collins Richard Betz Bill Harrell Don Mullin

Office Telephone 828-349-2025 828-349-2067 828-349-2067 828-349-2067 828-349-2104 828-349-2081 828-524-2516 828-524-2864 828-524-2516 828-526-2118 828-526-9431 828-526-2118

E-mail address

sgreenwood@maconnc.org wcabe@maconnc.org wcabe@maconnc.org wcabe@maconnc.org sholland@maconnc.org kring@maconnc.org

SECTION II: CONCEPT OF IMPLEMENTATION
II-1 The Phases of NIMS Adoption

NIMS adoption will include four distinct phases. The first phase will be initial staff training, which will include completion of FEMA’s IS-700 Emergency Management Institute Independent Study Course, additional training which has been identified for personnel in supervisory or key positions, and the enhancement of training programs that are currently in place. All supervisors with responsibility over operational assets will be accountable for ensuring that all employees are fully trained in the NIMS. The second phase will include evaluation of existing plans, policies, and procedures that are in need of updating to become NIMS compliant. In particular, the Emergency Operations Plan (EOP) must be evaluated for NIMS compliance. The third phase will be modifications of existing plans, procedures, and policies to reflect NIMS adoption. This includes modification of any emergency response plans in support of the EOP and any internal emergency plans such as COOP Plans. The fourth phase will verify achievement of the NIMS Integration Center’s standards, including certification and credentialing of employees (further guidance on both forthcoming) as well as conducting exercises to demonstrate compliance with the standards of the NIMS Integration Center. It is anticipated that the implementation phases will overlap in order to speed and strengthen the process. Phase I – Initial Staff Training……………………………………….………. 12 months a. b. c. EMI IS-700 – National Incident Management System Other relevant courses as determined by supervisors Internal training and new employee orientation

Phase II – Identification of Relevant Plans, Procedures, and Policies….12 Months a. Plans, procedures, policies, and training programs that will require augmentation

Phase III – Modification of Existing Plans, Procedures, and Policies……12 Months a. Emergency response plans, including those that fulfill procedures and annexes of the EOP and internal response plans, such as COOP Plans, must be modified to adopt NIMS principles and language Enhance/modify training programs to institutionalize NIMS Process includes modification, testing, refinement, and implementation

b. c.

Phase IV – Supporting NIMS Integration Center Standards……………………TBD a. b. Credentialing and certification of personnel and equipment Conducting validation exercises

Figure II-1. The following chart illustrates the NIMS implementation timeline
Jan 2006 Phase I Staff Training Phase II Identification of Relevant Plans, Procedures & Policies Phase III Modification of Plans, Procedures & Policies Phase IV Credentialing Feb 2006 Mar 2006 Apr 2006 May 2006 June 2006 Jul 2006 Aug 2006 Sept 2006 Oct 2006

 T B D

SECTION III: STAFF TRAINING
III-1 Training Requirement for All Employees

The following table illustrates the additional training all employees within the Towns and County will receive relevant to NIMS implementation.

Figure III-1. Training level requirements by organizational structure IS100 IS200 IS700 IS800 IS300 IS400
Agency Director Command Level Personnel Field Level Supervisors Group or Task Supervisors Field Level Personnel Administrative Personnel

SECTION IV: MODIFICATION OF PLANS, PROCEDURES, AND POLICIES
IV-1 Identification and Modification of Plans, Procedures, and Policies

The following chart identifies plans, procedures, and policies requiring enhancement/modification to reflect full adoption of the NIMS. The strategy for NIMS implementation will be to change the terminology, organizational structure and roles and responsibilities, as appropriate, to reflect NIMS terminology of key management components. Figure IV-1. Identification of Plans, Procedures, and Policies
Position Title & Point of Contact Emergency Management Director Warren Cabe Macon County Fire Departments Municipal Police Departments Franklin & Highlands Macon County Sheriff’s Department Plan, Procedure or Policy Emergency Operations Plan Continuity of Operations Plan Implementation Date

Standard Operations Guidelines

Standard Operating Procedures

Standard Operating Procedures

Macon County Emergency Medical Service Warren Cabe Macon County Fire Marshal’s Office

Standard Operating Guidelines

Standard Operating Guidelines

Macon County Public Health Ken Ring

Standard Operating Procedures

IV-2

Resource Management

The NIMS emphasizes the importance of maintaining accurate and up-to-date information on resource management and use as a critical component of incident management. Refer to FEMA’s National Mutual Aid and Resource Management Initiative for the basis to type, inventory, order and track Federal, State and local assets to support equipment and personnel compatibility required for mutual aid agreements. Resource typing definitions for 120 of the most commonly requested response resources are available at: www.fema.gov/nims/mutual_aid.shtm The following chart indicates the strategy and timeframe for developing or updating a comprehensive inventory of response resources. Figure IV-2. Strategy and Schedule for Developing an Inventory of Resources
Strategy for Resource Inventory Development

Unit Macon County Emergency Management Macon County Fire Marshal Macon County Fire Departments Franklin & Highlands Police Departments Macon County Sheriff’s Department Macon County Emergency Medical Services Macon County Public Health Department

Timeline for Completion

SECTION V: EMERGENCY OPERATIONS PLAN (EOP)
V-1. Identification of Emergency Operations Plan

For Macon County all procedures for any emergency operation is detailed in the Macon County Emergency Operations Plan (also known as the EOP). Figure V-1: Contact for the Emergency Operations Plan
Unit, Program, Section Macon County Emergency Management Point of Contact Warren Cabe Office Telephone E-Mail Address

828-349-2067

wcabe@maconnc.org

V-2.

NIMS Guidance

The following checklist was adopted directly from the NIMS (NIMS, Chapter III, Section B-2-a-1, page 35) and illustrates the status of NIMS incorporation into the County EOP.

Figure V-2. Checklist for a NIMS-Compliant EOP
EOP Title Defines the scope of preparedness and incident management activities necessary for the jurisdiction. Describes organizational structures, roles and responsibilities, policies, and protocols for providing emergency support. Facilitates response and short-term recovery activities. Is flexible enough to use in all emergencies. Describes the EOP purpose. Describes the EOP situation and assumptions. Describes the EOP concept of operations. Describes the EOP organization and assignment of responsibilities. Describes the administration and logistics of the EOP. Describes EOP development and maintenance. Describes the EOP authorities and references. Contains functional annexes. Contains hazard-specific appendices. Checklist Adoption Date

Contains a glossary. Designates jurisdictional and/or functional area representatives to the Incident Commander (IC) or Unified Command (UC) whenever possible. Includes pre incident and post incident public awareness, education, and communications plans and protocols. Plan has been promulgated by the approving authority

SECTION VI: GLOSSARY OF KEY TERMS
Agency: A division of government with a specific function offering a particular kind of assistance. In ICS, agencies are defined either as jurisdictional (having statutory responsibility for incident management) or as assisting or cooperating (providing resources or other assistance). Agency Representative: A person assigned by a primary, assisting, or cooperating Federal, State, local, or tribal government agency or private entity that has been delegated authority to make decisions affecting that agency’s or organization’s participation in incident management activities following appropriate consultation with the leadership of that agency. Area Command (Unified Area Command): An organization established (1) to oversee the management of multiple incidents that are each being handled by an ICS organization or (2) to oversee the management of large or multiple incidents to which several Incident Management Teams have been assigned. Area Command has the responsibility to set overall strategy and priorities, allocate critical resources according to priorities, ensure that incidents are properly managed, and ensure that objectives are met and strategies followed. Area Command becomes Unified Area Command when incidents are multi-jurisdictional. Area Command may be established at an emergency operations center facility or at some location other than an incident command post. Assessment: The evaluation and interpretation of measurements and other information to provide a basis for decisionmaking. Assignments: Tasks given to resources to perform within a given operational period that are based on operational objectives defined in the IAP. Assistant: Title for subordinates of principal Command Staff positions. The title indicates a level of technical capability, qualifications, and responsibility subordinate to the primary positions. Assistants may also be assigned to unit leaders. Assisting Agency: An agency or organization providing personnel, services, or other resources to the agency with direct responsibility for incident management. See also Supporting Agency. Available Resources: Resources assigned to an incident, checked in, and available for a mission assignment, normally located in a Staging Area. Branch: The organizational level having functional or geographical responsibility for major aspects of incident operations. A branch is organizationally situated between the section and the division or group in the Operations Section, and between the section and units in the Logistics Section. Branches are identified by the use of Roman numerals or by functional area. Chain of Command: A series of command, control, executive, or management positions in hierarchical order of authority. Check-In: The process through which resources first report to an incident. Checkin locations include the incident command post, Resources Unit, incident base, camps, staging areas, or directly on the site. Chief: The ICS title for individuals responsible for management of functional sections: Operations, Planning, Logistics, Finance/Administration, and Intelligence (if established as a separate section).

Command: The act of directing, ordering, or controlling by virtue of explicit statutory, regulatory, or delegated authority. Command Staff: In an incident management organization, the Command Staff consists of the Incident Command and the special staff positions of Public Information Officer, Safety Officer, Liaison Officer, and other positions as required, who report directly to the Incident Commander. They may have an assistant or assistants, as needed. Common Operating Picture: A broad view of the overall situation as reflected by situation reports, aerial photography, and other information or intelligence. Communications Unit: An organizational unit in the Logistics Section responsible for providing communication services at an incident or an EOC. A Communications Unit may also be a facility (e.g. a trailer or mobile van) used to support an Incident Communications Center. Cooperating Agency: An agency supplying assistance other than direct operational or support functions or resources to the incident management effort. Coordinate: To advance systematically an analysis and exchange of information among principals who have or may have a need to know certain information to carry out specific incident management responsibilities. Deputy: A fully qualified individual who, in the absence of a superior, can be delegated the authority to manage a functional operations or perform a specific task. In some cases, a deputy can act as relief for a superior and, therefore, must be fully qualified in the position. Deputies can be assigned to the Incident Commander, General Staff, and Branch Directors.

Dispatch: The ordered movement of a resource or resources to an assigned operational mission or an administrative move from one location to another. Division: The partition of an incident into geographical areas of operation. Divisions are established when the number of resources exceeds the manageable span of control of the Operations Chief. A division is located within the ICS organization between the branch and resources in the Operations Section. Emergency: Absent a Presidentially declared emergency, any incident(s), human-caused or natural, that requires responsive action to protect life or property. Under the Robert T. Stafford Disaster Relief and Emergency Assistance Act, an emergency means any occasion or instance for which, in the determination of the President, Federal assistance is needed to supplement State and local efforts and capabilities to save lives and to protect property and public health and safety, or to lessen or avert the threat of a catastrophe in any part of the United States. Emergency Operation Centers (EOCs): The physical location at which the coordination of information and resources to support domestic incident management activities normally takes place. And EOC may be a temporary facility or may be located in a more central or permanently established facility, perhaps at a higher level of organization within a jurisdiction. EOCs may be organized by major functional disciplines (e.g., fire, law enforcement, and medical services), by jurisdiction (e.g., Federal, State, regional, county, city, tribal), or some combination thereof. Emergency Operations Plan: A comprehensive emergency operations plan encompassing all hazards that pose a significant threat to the community.

Emergency Public Information: Information that is disseminated primarily in anticipation of an emergency or during an emergency. In addition to providing situational information to the public, it also frequently provides directive actions required to be taken by the general public. Emergency Response Provider: Includes Federal, State, local, and tribal emergency public safety, law enforcement, emergency response, emergency medical (including hospital emergency facilities), and related personnel, agencies, and authorities. See Section 2 (6), Homeland Security Act of 2002, Pub. L. 107-296, 116 Stat. 2135 (2002). Also known as Emergency Responder. Evacuation: Organized, phased, and supervised withdrawal, dispersal, or removal of civilians from dangerous or potentially dangerous area, and their reception and care in safe areas. Event: A planned, nonemergency activity. ICS can be used as the management system for a wide range of events, e.g., parades, concerts, or sporting events. Federal: Of or pertaining to the Federal Government of the United States of America. Function: Function refers to the five major activities in ICS: Command, Operations, Planning, Logistics, and Finance/Administration. The term function is also used when describing the activity involved, e.g., the planning function. A sixth function, Intelligence, may be established, if required, to meet incident management needs. General Staff: A group of incident management personnel organized according to function and reporting to the Incident Commander. The General Staff normally consists of the Operations Section Chief, Planning Section Chief, Logistics

Section Chief, and Finance/Administration Section Chief. Group: Established to divide the incident management structure into functional areas of operation. Groups are composed of resources assembled to perform a special function not necessarily within a single geographic division. Groups, when activated, are located between branches and resources in the Operations Section. (See Division). Hazard: Something that is potentially dangerous or harmful, often the root cause of an unwanted outcome. Incident: An occurrence or event, natural or human-caused, that requires an emergency response to protect life or property. Incidents can, for example, include major disasters, emergencies, terrorist attacks, terrorist threats, wildland and urban fires, floods, hazardous materials spills, nuclear accidents, aircraft accidents, earthquakes, hurricanes, tornadoes, tropical storms, war-related disasters, public health and medical emergencies, and other occurrences requiring an emergency response. Incident Action Plan: An oral or written plan containing general objectives reflecting the overall strategy for managing an incident. It may include the identification of operational resources and assignments. It may also include attachments that provide direction and important information for management of the incident during one or more operational periods. Incident Command Post (ICP): The field location at which the primary tactical-level, on-scene incident command functions are performed. The ICP may be collocated with the incident base or other incident facilities and is normally identified by a green rotating or flashing light.

Incident Command System: A standardized on-scene emergency management construct specifically designed to provide for the adoption of an integrated organizational structure that reflects the complexity and demands of single or multiple incidents, without being hindered by jurisdictional boundaries. ICS is the combination of facilities, equipment, personnel, procedures, and communications operating within a common organizational structure, designed to aid in the management of resources during incidents. It is used for all kinds of emergencies and is applicable to small as well as large and complex incidents. ICS is used by various jurisdictions and functional agencies, both public and private, to organize field-level incident management operations. Incident Commander (IC): The individual responsible for all incident activities, including the development of strategies and tactics and the ordering and the release of resources. The IC has overall authority and responsibility for conducting incident operations and is responsible for the management of all incident operations at the incident site. Incident Management Team (IMT): The IC and appropriate Command and General Staff personnel assigned to an incident. Incident Objectives: Statements of guidance and direction necessary for selecting appropriate strategy(s) and the tactical direction of resources. Incident objectives are based on realistic expectations of what can be accomplished when all allocated resources have been effectively deployed. Incident objectives must be achievable and measurable, yet flexible enough to allow strategic and tactical alternatives. Initial Action: The actions taken by those responders first to arrive at an incident site.

Initial Response: Resources initially committed to an incident. Intelligence Officer: The intelligence officer is responsible for managing internal information, intelligence, and operational security requirements supporting incident management activities. These may include information security and operational security activities, as well as the complex task of ensuring that sensitive information of all types (e.g., classified information, law enforcement sensitive information, proprietary information, or export-controlled information) is handled in a way that not only safeguards the information, but also ensures that it gets to those who need access to it to perform their missions effectively and safely. Joint Information Center (JIC): A facility established to coordinate all incident-related public information activities. It is the central point of contact for all news media at the scene of the incident. Public information officials from all participating agencies should collocate at the JIC. Jurisdiction: A range or sphere of authority. Public agencies have jurisdiction at an incident related to their legal responsibilities and authority. Jurisdictional authority at an incident can be political or geographical (e.g., city, county, tribal, State, or Federal boundary lines) or functional (e.g., law enforcement, public health). Liaison: A form of communication for establishing and maintaining mutual understanding and cooperation. Liaison Officer: A member of the Command Staff responsible for coordinating with representatives from cooperating and assisting agencies. Local Government: A county, municipality, city, town, township, local public authority, school district, special district, intrastate district, council of governments (regardless of whether the council of governments is

incorporated as a nonprofit corporation under State law), regional or interstate government entity, or agency or instrumentality of a local government; an Indian tribe or authorized tribal organization, or in Alaska a Native village or Alaska Regional Native Corporation; a rural community, unincorporated town or village, or other public entity. See Section 2 (10), Homeland Security Act of 2002, Pub. L. 107-296, 116 Stat. 2135 (2002). Logistics: Providing resources and other services to support incident management. Logistics Section: The section responsible for providing facilities, services, and material support for the incident. Major Disaster: As defined under the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 5122), a major disaster is ‘ any natural catastrophe (including any hurricane, tornado, storm, high water, wind-driven water, tidal wave, tsunami, earthquake, volcanic eruption, landslide, mudslide, snowstorm, or drought), regardless of cause, any fire, flood, or explosion, in any part of the United States, which in the determination of the President causes damage of sufficient severity and magnitude to warrant major disaster assistance under this Act to supplement the efforts and available resources of States, tribes, local governments, and disaster relief organizations in alleviating the damage, loss, hardship, or suffering caused thereby. Management of Objective: A management approach that involves a fourstep process for achieving the incident goal. The Management by Objectives approach includes the following: establishing overarching objectives; developing and issuing assignments, plans, procedures, and protocols; establishing specific, measurable objectives for various incident management functional activities and directing efforts to fulfill them, in support of defined strategic objectives; and

documenting results to measure performance and facilitate corrective action. Mitigation: The activities designed to reduce or eliminate risks to persons or property or to lessen the actual or potential effects or consequences of an incident. Mitigation measures may be implemented prior to, during, or after an incident. Mitigation measures are often informed by lessons learned from prior incidents. Mitigation involves ongoing actions to reduce exposure to, probability of, or potential loss from hazards. Measures may include zoning and building codes, floodplain buyouts, and analysis of hazardrelated data to determine where it is safe to build or locate temporary facilities. Mitigation can include efforts to educate governments, businesses, and the public on measures they can take to reduce loss and injury. Mobilization: The process and procedures used by all organizations – Federal, State, local, and tribal – for activating, assembling, and transporting all resources that have been requested to respond to or support an incident. Multiagency Coordination Entity: A multiagency coordination entity functions within a broader multiagency coordination system. It may establish the priorities among incidents and associated resource allocations, deconflict agency policies, and provide strategic guidance and direction to support incident management activities. Multiagency Coordination Systems: Multiagency coordination systems provide the architecture to support coordination for incident prioritization, critical resource allocation, communications systems integration, and information coordination. The components of multiagency coordination systems include facilities, equipment, emergency operation centers (EOCs), specific multiagency coordination entities, personnel, procedures, and communications. These systems assist

agencies and organizations to fully integrate the subsystems of the NIMS. Multijurisdictional Incident: An incident requiring action from multiple agencies that each have jurisdiction to manage certain aspects of an incident. In ICS, these incidents will be managed under Unified Command. Mutual-Aid Agreement: Written agreement between agencies and/or jurisdictions that they will assist one another on request, by furnishing personnel, equipment, and/or expertise in a specified manner. National: Of a nationwide character, including the Federal, State, local, and tribal aspects of governance and polity. National Disaster Medical System: A cooperative, asset-sharing partnership between the Department of Health and Human Services, the Department of Veterans Affairs, the Department of Homeland Security, and the Department of Defense. NDMS provides resources for meeting the continuity of care and mental health services requirements of the Emergency Support Function 8 in the Federal Response Plan. National Incident Management System: A system mandated by HSPD-5 that provides a consistent nationwide approach for Federal, State, local and tribal governments; the private-sector, and nongovernmental organizations to work effectively and efficiently together to prepare for, respond to, and recover from domestic incidents, regardless of cause, size, or complexity. To provide for interoperability and compatibility among Federal, State, local, and tribal capabilities, the NIMS includes a core set of concepts, principles, and terminology. HSPD-5 identifies these as the ICS; multiagency coordination systems; training; identification and management of resources (including systems for classifying types of resources);

qualification and certification; and the collection, tracking, and reporting of incident information and incident resources. National Response Plan: A plan mandated by HSPD-5 that integrates Federal domestic prevention, preparedness, response, and recovery plans into one alldiscipline, all-hazards plan. Nongovernmental Organization: An entity with an association that is based on interests of its members, individuals, or institutions and that is not created by a government, but may work cooperatively with government. Such organizations serve a public purpose, not a private benefit. Examples of NGOs include faith-based charity organizations and the American Red Cross. Operational Period: The time scheduled for executing a given set of operation actions, as specified in the Incident Action Plan. Operational periods can be of various lengths, although usually not over 24 hours. Operations Section: The section responsible for all tactical incident operations. In ICS, it normally includes subordinate branches, divisions, and/or groups. Personnel Accountability: The ability to account for the location and welfare of incident personnel. It is accomplished when supervisors ensure that ICS principles and processes are functional and that personnel are working within established incident management guidelines. Planning Meeting: A meeting held as needed prior to and throughout the duration of an incident to select specific strategies and tactics for incident control operations and for service and support planning. For larger incidents, the planning meeting is a major element in the development of the Incident Action Plan (IAP).

Planning Section: Responsible for the collection, evaluation, and dissemination of operational information related to the incident, and for the preparation and documentation of the IAP. This section also maintains information on the current and forecasted situation and on the status of resources assigned to the incident. Preparedness: The range of deliberate, critical tasks and activities necessary to build, sustain, and improve the operational capability to prevent, protect against, respond to, and recover from domestic incidents. Preparedness is a continuous process. Preparedness involves efforts at all levels of government and between government and private-sector and nongovernmental organizations to identify threats, determine vulnerabilities, and identify required resources. Within the NIMS, preparedness is operationally focused on establishing guidelines, protocols, and standards for planning, training and exercises, personnel qualification and certification, equipment certification, and publications management. Preparedness Organizations: The groups and for a that provide interagency coordination for domestic incident management activities in a nonemergency context. Preparedness organizations can include all agencies with a role in incident management, for prevention, preparedness, response, or recovery activities. They represent a wide variety of committees, planning groups, and other organizations that meet and coordinate to ensure the proper level of planning, training, equipping, and other preparedness requirements within a jurisdiction or area. Prevention: Actions to avoid an incident or to intervene or stop an incident from occurring. Prevention involves actions to protect lives and property. It involves applying intelligence and other information to a range of activities that may include such countermeasures as deterrence operations; heightened inspections;

improved surveillance and security operations; investigations to determine the full nature and source of the threat; public health and agricultural surveillance and testing processes; immunizations, isolation, or quarantine; and, as appropriate, specific law enforcement operations aimed at deterring, preempting, interdicting, or disrupting illegal activity and apprehending potential perpetrators and bringing them to justice. Private Sector: Organizations and entities that are not part of any governmental structure. It includes for-profit and not-forprofit organizations, formal and informal structures, commerce and industry, and private voluntary organizations (PVO). Processes: Systems of operations that incorporate standardized procedures, methodologies, and functions necessary to provide resources effectively and efficiently. These include resource typing, resource ordering and tracking, and coordination. Public Information Officer: A member of the Command Staff responsible for interfacing with the public and media or with other agencies with incident-related information requirements. Publications Management: The publications management subsystem includes materials development, publication control, publication supply, and distribution. The development and distribution of NIMS materials is managed through this subsystem. Consistent documentation is critical to success, because it ensures that all responders are familiar with the documentation used in a particular incident regardless of the location or the responding agencies involved. Qualification and Certification: This subsystem provides recommended qualification and certification standards for emergency responder and incident management personnel. It also allows the development of minimum standards for

resources expected to have an interstate application. Standards typically include training, currency, experience, and physical and medical fitness. Reception Area: This refers to a location separate from staging areas, where resources report in for processing and outprocessing. Reception Areas provide accountability, security, situational awareness briefings, safety awareness, distribution of IAPs, supplies and equipment, feeding and bed down. Recovery: The development, coordination, and execution of service and site-restoration plans; the reconstitution of government operations and services; individual, privatesector, nongovernmental, and publicassistance programs to provide housing and to promote restoration; long-term care and treatment of affected persons; additional measures for social, political, environmental, and economic restoration; evaluation of the incident to identify lessons learned; postincident reporting; and development of initiatives to mitigate the effects of future incidents. Recovery Plan: A plan developed by a State, local, or tribal jurisdiction with assistance from responding Federal agencies to restore the affect area. Resources: Personnel and major items of equipment, supplies, and facilities available or potentially available for assignment to incident operations and for which status is maintained. Resources are described by kind and type and may be used in operational support or supervisory capacities at an incident or at an EOC. Resource Management: Efficient incident management requires a system for identifying available resources at all jurisdictional levels to enable timely and unimpeded access to resources needed to prepare for, respond to, or recover from an incident. Resource management under the NIMS includes mutual-aid agreements; the

use of special Federal, State, local, and tribal teams; and resource mobilization protocols. Resources Unit: Functional unit within the Planning Section responsible for recording the status of resources committed to the incident. This unit also evaluates resources currently committed to the incident, the effects additional responding resources will have on the incident, and anticipate resource needs. Response: Activities that address the short-term, direct effects of an incident. Response includes immediate actions to save lives, protect property, and meet basic human needs. Response also includes the execution of emergency operations plans and o f mitigation activities designed to limit the loss of life, personal injury, property damage, and other unfavorable outcomes. As indicated by the situation, response activities include applying intelligence and other information to lessen the effects or consequences of an incident; increased security operations; continuing investigations into nature and source of the threat; ongoing public health and agricultural surveillance and testing processes; immunizations, isolation, or quarantine; and specific law enforcement operations aimed at preempting, interdicting, or disrupting illegal activity, and apprehending actual perpetrators and bringing them to justice. Safety Officer: A member of the Command Staff responsible for monitoring and assessing safety hazards or unsafe situations and for developing measures for ensuring personnel safety. Section: The organizational level having responsibility for a major functional area of incident management, e.g., Operations, Planning, Logistics, Finance/Administration, and Intelligence (if established). The section is organizationally situated between the branch and the Incident Command.

Span of Control: The number of individuals a supervisor is responsible for, usually expressed as the ratio of supervisors to individuals. (Under the NIMS, an appropriate span of control is between 1:3 and 1:7). Staging Area: Location established where resources can be placed while awaiting a tactical assignment. The Operations Section manages Staging Areas. State: When capitalized, refers to any State of the United States, the District of Columbia, the Commonwealth of Puerto Rico, the Virgin Islands, Guam, American Samoa, the Commonwealth of the Northern Mariana Islands, and any possession of the United States. See Section 2 (14), Homeland Security Act of 2002, Pub. L. 107-296, 116 Stat. 2135 (2002). Strategic: Strategic elements of incident management are characterized by continuous long-term, high-level planning by organizations headed by elected or other senior officials. These elements involve the adoption of long-range goals and objectives, the setting of priorities; the establishment of budgets and other fiscal decisions, policy development, and the application of measures of performances or effectiveness. Strike Team: A set number of resources of the same kind and type that have an established minimum number of personnel. Strategy: The general direction selected to accomplish incident objectives set by the IC. Supporting Technologies: Any technology that may be used to support the NIMS is included in this subsystem. These technologies include orthophoto mapping, remote automatic weather stations, infrared technology, and communications, among various others. Task Force: Any combination of resources assembled to support a specific mission or operational need. All resource elements

within a Task Force must have common communications and a designated leader. Technical Assistance: Support provided to State, local, and tribal jurisdictions when they have the resources but lack the complete knowledge and skills needed to perform a required activity (such as mobilehome park design and hazardous material assessments). Terrorism: Under the Homeland Security Act of 2002, terrorism is defined as activity that involves an act dangerous to human life or potentially destructive of critical infrastructure or key resources and is a violation of the criminal laws of the United States or of any State or other subdivision of the United States in which it occurs and is intended to intimidate or coerce the civilian population or influence a government or affect the conduct of a government by mass destruction, assassination, or kidnapping. See Section 2 (15), Homeland Security Act of 2002, Pub. L. 107-296, 116 Stat. 2135 (2002). Threat: An indication of possible violence, harm, or danger. Tools: Those instruments and capabilities that allow for the professional performance of tasks, such as information systems, agreements, doctrine, capabilities, and legislative authorities. Tribal: Any Indian tribe, band, nation, or other organized group or community, including any Alaskan Native Village as defined in or established pursuant to the Alaskan Native Claims Settlement Act (85 stat. 688) [43 U.S.C.A. and 1601 et seq.], that is recognized as eligible for the special programs and services provided by the United States to Indians because of their status as Indians. Type: A classification of resources in the ICS that refers to capability. Type 1 is generally considered to be more capable than Types 2, 3, or 4, respectively, because

of size; power; capacity; or, in the case of incident management teams, experience and qualifications. Unified Area Command: A Unified Area Command is established when incidents under an Area Command are multijurisdictional. (See Area Command). Unified Command: An application if ICS used when there is more than one agency with incident jurisdiction or when incidents cross political jurisdictions. Agencies work together through the designated members of the UC, often the senior person from agencies and/or disciplines participating in the UC, to establish a common set of objectives and strategies and a single IAP. Unit: The organizational element having functional responsibility for a specific incident planning, logistics, or finance/administration activity. Unity of Command: The concept by which each person within an organization reports to one and only one designated person. The purpose of unity of command is to ensure unity of effort under one responsible commander for every objective. Volunteer: For purposes of the NIMS, a volunteer is any individual accepted to perform services by the lead agency, which has authority to accept volunteer services, when the individual performs services without promise, expectation, or receipt of compensation for services performed. See e.g., 16 U.S.C. 742f© and 29 CFR 553.101.

SECTION VII: ACRONYM LIST
APHIS Animal and Plant Health Inspection Service AWC Alert and Warning Center CBO Community-Based Organization CDRG Catastrophic Disaster Response Group CERCLA Comprehensive Environmental Response, Compensation, and Liability Act CERT Community Emergency Response Team CFO Chief Financial Officer CI/KR Critical Infrastructure/Key Resources CMC Crisis Management Coordinator CONPLAN U.S. Government Interagency Domestic Terrorism Concept of Operations Plan CSG Counterterrorism Security Group DCE Defense Coordinating Element DCO Defense Coordinating Officer DEST Domestic Emergency Support Team DFO Disaster Field Office DHS Department of Homeland Security DMAT Disaster Medical Assistance Team DMORT Disaster Mortuary Operational Response Team DOC Department of Commerce DOD Department of Defense DOE Department of Energy DOI Department of the Interior DOJ Department of Justice DOL Department of Labor DOS Department of State DOT Department of Transportation DPA Defense Production Act DRC Disaster Recovery Center DRM Disaster Recovery Manager DSCA Defense Support of Civil Authorities DTRIM Domestic Threat Reduction and Incident Management EAS Emergency Assistance Personnel or Emergency Alert System EOC Emergency Operations Center EPA Environmental Protection Agency EPCRA Emergency Planning and Community Right-to-Know Act EPLO Emergency Preparedness Liaison Officer EPR Emergency Preparedness and Response ERL Environmental Research Laboratories ERT Environmental Response Team (EPA) ERT-A Emergency Response Team— Advance Element ERT-N National Emergency Response Team ESF Emergency Support Function ESFLG Emergency Support Function Leaders Group EST Emergency Support Team FAS Freely Associated States FBI Federal Bureau of Investigation FCO Federal Coordinating Officer FEMA Federal Emergency Management Agency FIRST Federal Incident Response Support Team FMC Federal Mobilization Center FNS Food and Nutrition Service FOC FEMA Operations Center FOG Field Operations Guide FRC Federal Resource Coordinator FRERP Federal Radiological Emergency Response Plan FRP Federal Response Plan GAR Governor’s Authorized Representative GIS Geographical Information System GSA General Services Administration HHS Department of Health and Human Services HS Human Services HQ Headquarters HSAS Homeland Security Advisory System HSC Homeland Security Council HSOC Homeland Security Operations Center HSPD Homeland Security Presidential Directive IA Individual Assistance IAIP Information Analysis and Infrastructure Protection IC Incident Command

ICP Incident Command Post ICS Incident Command System IHP Individuals and Households Program IIMG Interagency Incident Management Group IMT Incident Management Team INRP Initial National Response Plan IOF Interim Operating Facility ISAO Information-Sharing and Analysis Organization JFO Joint Field Office JIC Joint Information Center JIS Joint Information System JOC Joint Operations Center JTF Joint Task Force JTTF Joint Terrorism Task Force MAC Entity Multi agency Coordinating Entity MACC Multi agency Command Center MERS Mobile Emergency Response Support MOA Memorandum of Agreement MOU Memorandum of Understanding NAHERC National Animal Health Emergency Response Corps NASA National Aeronautics and Space Administration NAWAS National Warning System NCP National Oil and Hazardous Substances Pollution Contingency Plan NCR National Capital Region NCS National Communications System NCTC National Counterterrorism Center NDMS National Disaster Medical System NEP National Exercise Program NGO Nongovernmental Organization NICC National Infrastructure Coordination Center NICC National Interagency Coordinating Center NIMS National Incident Management System NIPP National Infrastructure Protection Plan NIRT Nuclear Incident Response Team NJTTF National Joint Terrorism Task Force NMRT National Medical Response Team NOAA National Oceanic and Atmospheric Administration NRC Nuclear Regulatory Commission NRCC National Response Coordination Center NRCS Natural Resources Conservation Service

NRP National Response Plan NRT National Response Team NSC National Security Council NSP National Search and Rescue Plan NSSE National Special Security Event NVOAD National Voluntary Organizations Active in Disaster OIA Office of the Assistant Secretary for Information Analysis OSC On-Scene Coordinator OSHA Occupational Safety and Health Administration PCC Policy Coordination Committee PDA Preliminary Damage Assessment PDD Presidential Decision Directive PFO Principal Federal Official POC Point of Contact RA Reimbursable Agreement RAMP Remedial Action Management Program RCP Regional Contingency Plan RCRA Resource Conservation and Recovery Act REPLO Regional Emergency Preparedness Liaison Officer RFI Request for Information RISC Regional Interagency Steering Committee RRCC Regional Response Coordination Center RRT Regional Response Team ROC Regional Operations Center SAC Special Agent-in-Charge SAR Search and Rescue SCC Secretary’s Command Center (HHS) SCO State Coordinating Officer SFLEO Senior Federal Law Enforcement Official SFO Senior Federal Official SEOO State Emergency Operations Officer SIOC Strategic Information and Operations Center SLGCP Office of State and Local Government Coordination and Preparedness SOG Standard Operating Guideline SOP Standard Operating Procedure START Scientific and Technical Advisory and Response Team

TSA Transportation Security Administration TSC Terrorist Screening Center TTIC Terrorism Threat Integration Center US&R Urban Search and Rescue USACE U.S. Army Corps of Engineers USCG U.S. Coast Guard USDA U.S. Department of Agriculture USSS U.S. Secret Service VMAT Veterinarian Medical Assistance Team WMD Weapons of Mass Destruction

ANNEX A Relationship between the Macon County Emergency Operations Plan and the National Incident Management System (NIMS)
A-1. Background

The Emergency Operations Plan details its reliance on NIMS operating principles and protocols in applying Macon County assistance to local and regional jurisdictional partners during emergencies and disasters. The EOP integrates the resources of jurisdictions, incident management and emergency response disciplines, nongovernmental organizations, and the private-sector into a seamless framework for all hazards emergency incident response. The NIMS establishes a uniform system for incident management. The EOP serves as the core operational plan for incident management, establishing coordinating structures, processes, and protocols that must be incorporated into existing interagency incident plans. A-2. General Comparison

The following chart outlines the core elements of the NIMS and the EOP.
NIMS
Purpose Nationwide approach to domestic incident management; applicable at all jurisdictional levels and across functional disciplines in an all-hazards context. It is not an operational incident management or resource allocation plan. Components Command and Management, Preparedness, Resource Management, Communications/ Information Management, Supporting Technologies, Ongoing Management and Maintenance. Applicability The NIMS is applicable across all levels of government and emergency disciplines, and nongovernmental and private-sector organizations. HSPD-5 requires all emergency response agencies to adopt the NIMS. Adoption of NIMS by State and local organizations is a condition of Federal and state assistance. The EOP is applicable to all local agencies that may be requested to provide assistance in actual or potential incidents that require a coordinated and effective response by an appropriate combination of Federal, State, local, tribal, private-sector, and nongovernmental entities. Basic Plan – including Planning considerations, Roles and Responsibilities, Concept of Operations, Incident Management Actions, Plan Management and Maintenance, Procedures and Annexes. Core operational plan for local incident management. Establishes local coordinating structures, mechanisms for local policy and operational coordination for incident management that must be incorporated into existing interagency incident plans.

EOP

A-1

Command and Coordination Structure  CPs on-scene using the Incident Command System  (ICS)/Unified Command  Area Command (if needed)  State, local, tribal, and private-sector EOCs  ICPs on-scene using the Incident Command System (ICS)/Unified Command;  Area Command (if needed);  State, local, tribal, and private-sector EOCs;  JFO, which is responsible for coordinating Federal assistance and supporting incident management activities locally;  The organizational structure addresses site-specific incident management activities and the broader issues related to the incident, such as impacts on the rest of the state, immediate state or regional actions required to avert or prepare for potential subsequent events, and the management of multiple threats or incidents. Incident management and emergency response plans must include:  Principles and terminology of the NIMS  Reporting requirements of the EOP  Linkages to key organizational elements  Procedures for transitioning from localized incidents to incidents of national significance

Requirements Establishes the Incident Command structure and protocols for incident management.

Figure A-1. General Comparison of the NIMS and the EOP

A-2

MACON COUNTY BOARD OF COMMISSIONERS AGENDA ITEM
MEETING DATE: September 10, 2013 DEPARTMENT/AGENCY: Airport Authority SUBJECT MATTER: Matching funds for runway widening project DEPARTMENT HEAD COMMENTS/RECOMMENDATION: Per the County Manager’s recent budget message: “We have been notified that the Macon County Airport Authority has been approved for additional FAA and state funding of approximately $2,900,000 and will require a 10% local match. When that is made official it will be brought to the Board of Commissioners for consideration. It is not reflected in the proposed budget.” The County Manager and members of the Airport Authority can provide additional details at the meeting.

COUNTY MANAGER’S COMMENTS/RECOMMENDATION: Recommend approval with appropriation from fund balance.

Attachments ______ Agenda Item 10D

Yes

_X_

No

MACON COUNTY BOARD OF COMMISSIONERS AGENDA ITEM
MEETING DATE: September 10, 2013 DEPARTMENT/AGENCY: Governing Board SUBJECT MATTER: License Agreement with the Town of Franklin and Franklin 111/C Flyers DEPARTMENT HEAD COMMENTS/RECOMMENDATION: Please see the attached document prepared by the County Attorney in regard to this matter, which involves the use of the old Town of Franklin landfill as an airfield for model airplanes. The County Manager and County Attorney can provide additional details at the meeting.

COUNTY MANAGER’S COMMENTS/RECOMMENDATION:

Attachments ___X__ Agenda Item 10E

Yes

___

No

MACON COUNTY NORTH CAROLINA

LICENSE AGREEMENT

THIS AGREEMENT, is made and entered into as of the _____day of September, 2013, by and between Macon County, a body politic and political subdivision of the State of North Carolina, hereinafter referred to as (“County”), Town of Franklin, a body politic and political subdivision of the State of North Carolina, hereinafter referred to as (“Town”) and Franklin 111/C Flyers * #4643, a charter club of the Academy of Model Aeronautics, Inc., c/o Dave Habermehl, 3415 Highlands, Road, Franklin, NC 28734, hereinafter referred to as (“Licensee”). WITNESSETH: WHEREAS, Town is the owner the lands known as the old Town of Franklin Landfill, lying and being in Franklin Township, Macon County, North Carolina; and WHEREAS, County has performed and does preform certain activities in connection with the closure of the said old Town of Franklin Landfill; and WHEREAS, said property has formerly been used as a Macon County Landfill, which has been permitted by the State of North Carolina under Permit No 57-01; and WHEREAS, the State of North Carolina Department of Environment and Natural Resources, Division of Waste Management has heretofore approved the use of the subject property as an airfield for model airplanes, so long as such use does not violate any postclosure conditions imposed by the Division of Waste Management thereon; and WHEREAS, the property has heretofore been filled and covered pursuant to the requirements of the Division of Waste Management and is in such a condition as will allow its use as an Aero Modelers Airport; and WHEREAS, Licensee has requested permission to use said property as an airport for its members and for the attending general public, and has indicated its willingness to abide by such terms and conditions as are imposed upon said use by Town of Franklin and Macon County, and by the Division of Waste Management as aforesaid, NOW THEREFORE, for and in consideration of the premises and the further sum of One Dollar this day paid by Licensee, the receipt of which is hereby acknowledged by the Town and County, the parties hereto do hereby agree that Licensee shall have the right to use the said property hereinafter described as an aero modelers airport and for all purposes associated therewith, but on the following terms and conditions, which said terms and conditions are expressly agreed and consented to by Licensee:

1.

The term of this License Agreement is from July 1, 2013 to June 30, 2018 and may be extended for five additional one year periods. The property subject to the terms of this License Agreement is specifically identified upon the site plan made by McGill & Associates Engineering entitled "Landfill Cap Repair and Reuse Plan, Franklin Landfill, Macon County, North Carolina" under date of June, 1999, Job No. 93141.001 (hereinafter "the Premises"), a copy of which is on file with the Macon County Solid Waste Director. Licensee's use of the Premises shall be subject to and in conformity with all of the regulations and requirements established by the North Carolina Department of Environment and Natural Resources, Division of Waste Management, and in accordance with any further terms or conditions established by the Macon County Solid Waste Director, which terms may be amended from time to time. Further, Licensee specifically acknowledges that it has been made aware of the post-closure conditions imposed by the Division of Waste Management and represents that it understands said terms and conditions, which are incorporated herein as if fully set forth. Licensee represents that it is a member of good standing at the Academy of Model Aeronautics, Inc., and shall maintain its approved status as a charter club member of the Academy of Model Aeronautics, Inc. throughout the term of this License Agreement and any extensions thereof. The Premises subject to this License Agreement may be used only by a member of Licensee and its guests and invitees. Only Licensee's members may be allowed upon and permitted to use the runway portion of the Licensed Premises. Guests and invitees may be permitted upon the adjacent grassed areas only. Licensee is solely responsible for the safety, health and welfare of its members, guests and invitees while they are allowed upon and/or permitted to use the Premises. Licensee shall maintain a padlock which is interconnected to the County's lock on the gate to the Premises. At no time shall the gate be left open or unlocked unless a current member of Licensee is present on the Premises. The Premises shall not be used for aeromodeling purposes unless there are at least two (2) current members of Licensee personally present. Vehicular traffic, other than aeromodeler planes, shall be permitted only on the existing entrance road and the gravel parking area which is presently in existence upon the Premises and as is shown on the site plan hereinafter referenced, a copy of which has been made available to Licensee.

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Licensee acknowledges that the Premises has previously been utilized as a landfill site and that methane gas is being generated from the decomposition of buried waste at the site. Licensee shall not permit smoking of any sort or any form of fire present at the site. Further, Licensee hereby declares and represents that is has considered and understands the risks of using the Premises and agrees to assume those risks of injury, illness, death or disability that may occur from its use of the Premises. Licensee further declares that the terms of the aforesaid release and assumption of risk is contracted and not a mere recital. Licensee shall maintain the licensed Premises in its entirety, including the cutting of grass, maintenance of the road and parking area, including addition of gravel when necessary. County reserves the right to maintain other portions of the landfill site in accordance with the requirements of the North Carolina Division of Waste Management. Licensee shall not make any improvements to the Premises without obtaining prior written approval which specifically describes the proposed improvements from the Macon County Solid Waste Director and from the Town of Franklin. In no event shall any improvements be anchored to the ground so that the surface of the cover is penetrated. Licensee shall and does hereby agree to indemnify and hold harmless the County, its employees, officers, and officials and Town, its employees, officers and officials from any and all claims, actions, causes of action, demands, rights, losses, liability, damage, costs or expenses which might arise by virtue of the use of the Premises by Licensee. This indemnification shall survive the term of this Agreement. Licensee shall carry liability insurance with limits $2,500,000.00 for each occurrence and $5,000,000.00 aggregate for general liability insurance and premises, operations, products, completed operations, personal injury insurance. Town and County shall be named as additional insureds in connection with all/such insurance and shall be notified in writing no less than thirty (30) days prior to the cancellation of any insurance. Licensee agrees, as a condition precedent to this agreement, to provide the Town and County with a certificate of liability insurance reflecting compliance with the terms of this paragraph. Licensee shall, at least annually, provide the Town and County with an updated and current certificate. Town and/or County reserves the right to terminate this agreement for any cause or without cause upon thirty (30) days written notice to Licensee, at the address set forth. This License Agreement shall be governed by and in accordance with the laws of the State of North Carolina. All actions relating in any way to this Agreement shall be brought in the General Court of Justice in the County of Macon and the State of

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North Carolina. 18. Licensee shall not assign its interest in this Agreement without the prior written consent of the County and the Town. This License Agreement shall constitute the entire understanding between Town, County and Licensee and shall supersede all prior understandings and agreements relative to the subject matter hereof and may be amended only by written mutual agreement of parties.

19.

IN WITNESS WHEREOF, the parties hereto have hereunto set their hands and seals, and/or have cause these presents to be executed in their respective corporate capacities, by their duly Macon County _____________________________________ By: Kevin Corbin, Chairman of the Commissioners Attest: ______________________________________ Jack Horton, Clerk to the Board Town of Franklin _____________________________________ By: _________________________________ Attest: _____________________________________ ______________________________________ Franklin R/C Flyers */4643 _____________________________________ By: Dave Habermehl, authorized representative Attest: _____________________________________ ______________________________________

MACON COUNTY BOARD OF COMMISSIONERS AGENDA ITEM
MEETING DATE: September 10, 2013 DEPARTMENT/AGENCY: Governing Board SUBJECT MATTER: Consent Agenda DEPARTMENT HEAD COMMENTS/RECOMMENDATION:
A. Minutes – Consideration of the minutes from the August 13th meeting, per attachment 11A. Finance – Consideration of Budget Amendments #25 through #29, per attachment 11B. Tax releases – Consideration of tax releases in the amount of $7,383.13, per Attachment 11C. The supporting documentation is on file in the Deputy Clerk’s office. Monthly Tax Collection Report – For the board’s information, the monthly ad valorem tax collection report is attached as attachment 11D. It does not require board action.

B.

C.

D.

COUNTY MANAGER’S COMMENTS/RECOMMENDATION:

Attachments ___X__

Yes

___

No

Agenda Item 11(A)-11(D)

MACON COUNTY BOARD OF COMMISSIONERS AUGUST 13, 2013 MINUTES Chairman Corbin called the meeting to order at 6:00 p.m. All Board Members, the Deputy Clerk, Finance Director, County Attorney, members of the news media and interested citizens were present. ANNOUNCEMENTS: Commissioner Beale announced that the open house for the new dialysis center will be held on Thursday, September 12, 2013 from 2-4 p.m. The Deputy Clerk updated the board on the status of the search for the next county manager, noting that 17 applications had been received as of this date. The board members discussed setting aside time later in the month to review applications, but took no action. It was also noted that a reception would be held for the County Manager on September 27 from 2-4 p.m. MOMENT OF SILENCE: Chairman Corbin asked those in attendance to observe a moment of silence. PLEDGE TO THE FLAG: Led by Commissioner Tate, the pledge to the flag was recited. HEARING ON REFUND REQUEST – LACOSTA DEVELOPMENT CORP. AND ROBERT W. ROME: Chairman Corbin asked the County Attorney to conduct the hearing, and he in turn recognized Richard Melvin, the attorney representing LaCosta Development Corp. and Robert W. Rome. Mr. Melvin referred the board members to the request filed pursuant to North Carolina General Statute 105-228.37, explaining that due to a clerical error in the attorney’s office, the incorrect sales price was placed on documents. This resulted in an overpayment of $600 in revenue stamps placed on the deeds, and Mr. Melvin requested a refund in that amount. The County Attorney reviewed the steps that must be taken in Minutes 08.13.13 Page 1 of 9

this process, adding that if the board felt that the refund was due, he would prepare the appropriate memo to the state Department of Revenue. Upon a motion by Commissioner Higdon, seconded by Commissioner Haven, the board voted unanimously to grant the refund as requested. PUBLIC COMMENT: Bill Van Horn, speaking on behalf of the Appalachian Trail Conservancy (ATC), provided the board with a handout regarding the recent approval of a new telecommunications tower to be located in the Rainbow Springs area. Mr. Van Horn said that the ATC would like the opportunity to comment on any proposed cell tower within four miles of the Appalachian Trail. He asked that towers be camouflaged in order to lessen the visual impact from the trail. He also said that the one-quarter-mile radius for notification in the county’s ordinance appears restrictive and asked the board to consider reaching out further. Bob Kuppers, the vice-chair of the advisory board for the Macon County Heritage Center at Cowee School, told the board he had a three-fold purpose, with the first item being to express the advisory board’s gratitude for the support the county has given in preparing the school for use as a heritage center. He then gave the board an update on the group’s long-term vision and progress at the former school. Finally, he discussed plans for and invited the board members to attend the first annual Cowee School celebration, to be held August 17th, that includes a dinner and a concert by bluegrass group Balsam Range. ADJUSTMENTS TO AND APPROVAL OF THE AGENDA: Upon a motion by Commissioner Haven, seconded by Commissioner Tate, the board voted unanimously to approve the agenda as adjusted, as follows:  To hold a closed session for the purpose of consulting with the attorney as Item 13, per the County Attorney, who noted that no action was anticipated.  To add discussion of the need for a guardrail along Patton Road under New Business as Item 10H, per Commissioner Haven.  To add discussion regarding the sale of alcoholic beverages in Nantahala under New Business as Item 10I, per Commissioner Haven.  To add consideration of a lease for space at the county’s Small Business Center to Flash Domain, LLC as part of Item 10C, per the County Attorney. PRESENTATION REGARDING NIKWASI MOUND: Principal Chief Michell Hicks of the Eastern Band of Cherokee spoke to the board regarding the Nikwasi Mound, located in Franklin. Stating that “the mound belongs to the Cherokee people and it needs to be back in our Minutes 08.13.13 Page 2 of 9

title,” Chief Hicks asked the commissioners for their help in making this a reality. Noting there were jurisdictional issues between the county and the Town of Franklin, Chief Hicks said, “I humbly ask for you guys to give consideration to help us, because it’s time for that mound to come back under the name of the Cherokee.” He said the tribe would consider a trade, taking into consideration the value of the property, and would consider a memorandum of agreement or understanding, promising that the Cherokee would take good care of the mound. Chairman Corbin explained that as the mound is owned by the town, the commission’s role would be advisory in nature, saying that, “We can certainly express our opinion to the town board.” Chief Hicks said that a formal letter of request had been submitted to the town, and asked the commissioners for guidance regarding his next steps. Commissioner Beale said that the county “learned a lot” about the Cherokee heritage during the expansion of the county airport. “We can have a stronger relationship with the Eastern Band,” he said, adding that the mound would be a great place to start. Chairman Corbin offered that the board could support the request, and the County Attorney suggested doing so via a resolution. Following further discussion, the board agreed by unanimous consent to have the County Attorney draw up a proposed resolution for the board to consider. Commissioner Haven suggested discussing the issue with the town aldermen. SCALY MOUNTAIN HISTORICAL SOCIETY: John Bankston, the president of the Scaly Mountain Historical Society, told the board that the 250-member organization maintains one of the only remaining oneroom schoolhouses in the county, which serves as the only recreational facility in Flats Township. He told the board that the group has a list of some $21,000 worth of needed improvements, but was asking that the county provide $4,000 in funding to assist with restoring the playground and to replace the basketball backstop. In addition, he asked the board to consider an annual “stipend” of $3,000 to offset the cost of maintenance and insurance. Commissioner Beale pointed out that the county had provided the historical society with a total of $55,000 since 2006, and Mr. Bankston said he recognized that and offered thanks for the funds. During discussion, Commissioner Tate said that he had no problem with helping fund the request, and asked the board to consider an appropriation of $5,000 to the society. The County Attorney pointed out the need for an agreement between the county and the society. Upon a motion by Commissioner Tate, seconded by Commissioner Beale, the board voted unanimously to appropriate $5,000 to the Scaly Mountain Historical Society, pending a signed agreement, with the funds to come from contingency. Minutes 08.13.13 Page 3 of 9

TRANSFER OF SURPLUS AMBULANCE: The County Attorney informed the board that because the county had not posted notice of intent to donate the 1983 Ford four-wheel-drive ambulance to the Southwestern Community College Public Safety Training Center, this item would have to be postponed until the September regular meeting. However, he said the board could declare the ambulance as surplus, and upon a motion by Commissioner Haven, seconded by Commissioner Tate, the board voted unanimously to declare the vehicle surplus. MEMORANDUM OF AGREEMENT WITH THE NORTH CAROLINA SEDIMENTATION CONTROL COMMISSION: County Planner Matt Mason explained that the proposed Memorandum of Agreement with the state’s Sedimentation Control Commission had been updated to reflect the local government’s responsibilities. Otherwise, he said that everything else remains the same. Following a series of questions from Commissioner Higdon, and upon a motion by Commissioner Beale, seconded by Commissioner Tate, the board voted unanimously to approve the Memorandum of Agreement as presented, a copy of which is attached (Attachment 1) and is hereby made a part of these minutes. TRANSIT FARES, COST SHARE RATES AND CONTRACT RATES: Macon Transit Director Kim Angel presented proposed new rate structures for the Franklin, Highlands and Nantahala areas. In a memo to the board, Mrs. Angel wrote, “Based on previous years’ operating costs and projected current year operating costs, and the fact that we have not raised rates for passengers since 2010, it is necessary to increase fare and cost share rates for transit services.” She noted that the anticipated effective date for the increases would be October 1. Commissioner Beale expressed concerns with the amount of some of the increases, for example, a round trip fare from the Nantahala area to Andrews/Murphy going from $5 to $15. Saying that this gives me “a little heartburn,” Commissioner Beale said the increases would negatively affect those who need the transportation the worst. Mrs. Angel explained that nearly all of those who utilize the service qualify for lower fares under one of the programs that Transit offers, adding that she needs to charge rates that will support the overall system. Upon a motion by Commissioner Higdon, seconded by Commissioner Haven, the board voted 4-1 to approve the Macon County Transit Fees/Cost Share Rates for the Franklin, Highlands and Nantahala areas, with Commissioner Beale opposing. Copies of the new rates are attached (Attachments 2, 3 and 4) and are hereby made a part of these minutes. RESOLUTION REGARDING LOCALLY COORDINATED TRANSPORTATION PLAN: Mrs. Angel presented a proposed resolution Minutes 08.13.13 Page 4 of 9

regarding a locally coordinated transportation plan. She explained that the plan is a needs assessment for all transit systems and is required by the Federal Transit Administration in order to apply for any capital and operating grants. The regional plan was developed by the Southwestern Commission, and Mrs. Angel pointed out that each governing board is asked to approve only the portion applicable to their entity. Following discussion, and upon a motion by Commissioner Tate, seconded by Commissioner Beale, the board voted 5-0 to approve a “Resolution Adopting an Updated Locally Coordinated Public Transportation and Human Services Plan for Macon County, North Carolina,” a copy of which is attached (Attachment 5) and is hereby made a part of these minutes. RESOLUTION AND CONTRACT REGARDING CALL CENTER FOR VETERANS TRANSPORTATION: Mrs. Angel presented the board with a proposed resolution and contract concerning the Southwestern NC One Call One Click Center for Veterans Transportation. In a memo to the board, she highlighted a number of aspects of the project. She explained that this is a four-county initiative (Cherokee County, Clay County, Swain Public Transit and Macon County) with Macon acting as the lead agency. Eighty percent of the funding will come from the Federal Transit Administration and the remaining 20 percent from local funds, to be divided among the four counties. As part of the project, a central 800 number will be developed for use by veterans, veterans’ agencies and the general public, allowing an individual to call one number to access transportation systems in Region A for information and scheduling. A copy of Mrs. Angel’s memo is attached (Attachment 6) and is hereby made a part of these minutes. Upon a motion by Commissioner Higdon, seconded by Commissioner Beale, the board voted unanimously to approve a “Resolution Authorizing Macon County to Enter into an Agreement with the North Carolina Department of Transportation (Attachment 7), a copy of which is attached and is hereby made a part of these minutes. EXTENSION OF LEASE AGREEMENTS WITH FOREX AND HARMONY HOUSE FOODS: Following a brief presentation by Economic Development Director Tommy Jenkins, and upon a motion by Commissioner Higdon, seconded by Commissioner Beale, the board voted unanimously to adopt a resolution declaring property in the county’s Small Business Center to be surplus and to approve a one-year lease of that space to ForEx Currency Trade Advisors, LLC. The lease commences August 1, 2013 and will expire July 31, 2014, with a monthly rent of $333.33, including utilities. A copy of the resolution (Attachment 8) and the lease (Attachment 9) are attached and are hereby Minutes 08.13.13 Page 5 of 9

made a part of these minutes. Upon a motion by Commissioner Beale, seconded by Commissioner Haven, the board voted unanimously to adopt a resolution declaring property in the county’s Small Business Center to be surplus and to approve a one-year lease of that space to Harmony House Foods. The lease commences September 1, 2013 and will expire August 31, 2014, with a monthly rent of $1,840. A copy of the resolution (Attachment 10) and the lease (Attachment 11) are attached and are hereby made a part of these minutes. LEASE AGREEMENT WITH FLASH DOMAIN, LLC: Mr. Jenkins presented a proposed lease agreement for 3,800 square feet of space in the Small Business Center with Flash Domain, LLC, a small technology company that provides data storage and cloud applications. He said the business currently has two full-time employees. Upon a motion by Commissioner Haven, seconded by Commissioner Higdon, the board voted unanimously to adopt a resolution declaring property in the county’s Small Business Center to be surplus and to approve a one-year lease of that space to Flash Domain, LLC. The lease commences on September 1, 2013 and will expire August 31, 2014, with a monthly rent of $150. A copy of the resolution (Attachment 12) and the lease (Attachment 13) are attached and are hereby made a part of these minutes. Chairman Corbin declared a recess at 7:32 p.m. Chairman Corbin called the meeting back to order at 7:40 p.m. CONTRACT WITH HGACBUY: Todd Seagle, the county’s 911 Communications Supervisor, briefed the board on a competitive bidding group purchasing program called the Houston-Galveston Area Council, known as HGACBuy. Mr. Seagle noted that HGACBuy does all of the requests for proposals and bidding for products, making the purchasing process quicker and more efficient. The Finance Director said she had no objections to the use of the program. The County Attorney said that this process was very similar to purchasing under state contract and met the requirements of a particular state statute (143-129(e)(3)). Following further discussion, and upon a motion by Commissioner Higdon, seconded by Commissioner Tate, the board voted unanimously to approve a “Resolution of the Macon County Board of County Commissioners Authorizing Entry into Interlocal Contract for Cooperative Purchasing with Houston-Galveston Area Council,” a copy of which is attached (Attachment 14) and is hereby made a part of these minutes.

Minutes 08.13.13 Page 6 of 9

CHANGE ORDERS ON HIGHLANDS SCHOOL RENOVATION: Terry Bell presented the board with the details of a change order on the Highlands School renovation project. The total amount of the change order is $46,630, and Mr. Bell pointed out that the single largest item involved the heating and piping system, and that the majority of the changes were related to code issues. He also pointed out that $21,770 would be left in the project’s contingency line item. Upon a motion by Commissioner Beale, seconded by Commissioner Tate, the board voted unanimously to approve Change Order Number 1 on the Highlands School renovation as presented, and at the request of the Finance Director, to also approve Budget Amendment #20, which transfers $46,630 from contingency to construction for the change order. Commissioner Tate also volunteered to assist with resolving one of the items in the change order by having his business tie in the downspouts. Copies of the change order (Attachment 15) and Budget Amendment #20 (Attachment 16) are attached and are hereby made a part of these minutes. AGREEMENT WITH NATIONAL UTILITIES REFUND: The County Attorney explained that he had made some changes to the proposed agreement with National Utilities Refund, which will provide audits of the county’s utility and telephone expenses to determine if some savings can be achieved, with the firm getting a percentage of those savings. He told the board that the county is under no obligation to pay National Utilities Refund any money unless it finds those savings. Upon a motion by Commissioner Higdon, seconded by Commissioner Tate, the board voted unanimously to approve the agreement as presented, a copy of which is attached (Attachment 17) and is hereby made a part of these minutes. AMBULANCE BIDS: Emergency Services Director David Key said that bids for two new ambulances were opened on August 12th, resulting in one bid from Custom Truck & Body Works at a unit cost of $100,483 or $200,966 for both. He noted this was the same price the county received on two new ambulances last year. However, the county could not “piggyback” on its own bid and therefore went through the bid process again. Following some discussion relative to the performance of the newest ambulances, and upon a motion by Commissioner Tate, seconded by Commissioner Haven, the board voted unanimously to accept the bid as presented. GUARDRAILS ON PATTON ROAD: Commissioner Haven provided photographs of a segment of Patton Road that had been brought to his attention in terms of the need for safety improvements. Without a guardrail, he said that a vehicle leaving the roadway would likely end up in Cartoogechaye Creek. Commissioner Beale pointed out that this issue Minutes 08.13.13 Page 7 of 9

had been brought to the attention of the state Department of Transportation (DOT) before, but that funds were not available to address it. Upon a motion by Commissioner Haven, seconded by Commissioner Beale, the board voted unanimously to contact the DOT District Engineer to request assistance in addressing these safety concerns. SALE OF ALCOHOLIC BEVERAGES IN NANTAHALA: Commissioner Haven said that he had been approached regarding the possibility of the sale of alcoholic beverages in the Nantahala area, and asked for direction in how to respond. Following discussion by the board and the County Attorney, the County Attorney agreed to review the state’s ABC laws and suggested that the board take the matter under advisement. CONSENT AGENDA: Upon a motion by Commissioner Haven, seconded by Commissioner Higdon, the following items on the consent agenda were unanimously approved: Minutes – Approved the minutes from the July 9th and July 30th meetings. Budget amendments – Individually reviewed and approved the following budget amendments: #15 for the Department of Social Services to transfer $53,167 in funding for foster care and adoption expense from fund balance; #16 for Solid Waste to appropriate the 2013 Community Waste Reduction and Recycling Grant in the amount of $9,480.99 and to appropriate the 20 percent county match from the Solid Waste fund balance; #17 for Solid Waste to carry forward the $779 balance of the fluorescent lamp recycling grant; #18 for the Health Department to roll unexpended grant money totaling $14,834 to the current fiscal year; #19 to roll the $18,658 balance from the Holly Springs Community Building project that was approved in Fiscal Year 2011-12 to the Fiscal Year 2013-14 budget. (Revisions with corresponding numbers attached.) Tax releases – Approved tax releases in the amount of $9,963.14. (A computer printout of releases is on file in the Tax Department and the County Manager’s office.) Settlement for current taxes for Fiscal Year 2012-13 – Accepted a settlement report from Tax Collections Supervisor Margaret Perry for current taxes (general and motor vehicle) for Fiscal Year 2012-2013. (A copy of the report is on file in the Deputy Clerk’s office.) Report on sale of surplus property utilizing GovDeals: Accepted a report on the sale of $19,887 worth of surplus property auctioned on GovDeals during Fiscal Year 2012-13, plus an additional amount of $5,960.01 in surplus items auctioned so far in the current fiscal year. Monthly ad valorem tax collection report – No action necessary. APPOINTMENTS: Technical Review Committee: Following a recommendation from County Planner Matt Mason, and upon a motion Minutes 08.13.13 Page 8 of 9

by Commissioner Beale, seconded by Commissioner Haven, the board voted unanimously to appoint the Technical Review Committee for the Macon County Subdivision Ordinance as follows:  Members – Matt Mason, Subdivision Administrator; Derek Roland, Planning Board Member; Jimmy Teem, Fire Marshal’s Office; Kyle Jennings, Environmental Health and Bobby Bishop, Planning, Permitting and Development.  Alternates – Chris Hanners, Planning Board Member; Todd Seagle, Fire Marshal’s Office; Justin Mintz, Environmental Health and Jack Morgan, Planning, Permitting and Development. CLOSED SESSION: The County Attorney said that after consultation with Chairman Corbin, there was no longer the need for a closed session. ADJOURN: With no other business, and upon a motion by Commissioner Higdon, seconded by Commissioner Haven, the board voted unanimously to adjourn the meeting at 8:13 p.m.

_____________________________ Jack Horton, County Manager Clerk to the Board

______________________________ Kevin Corbin Board Chairman

Minutes 08.13.13 Page 9 of 9

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326.00-

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13A40238.12 G01 9.75F01 1.051.05- 0.00 10.8010.80-

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328.22- 0.00 0.00 0.00 0.00 0.00 0.00 0.00

DOOLEY, JAMES E. 08/06/13 105242 13A6585626303 F01 21.08SCHAUF, STANLEY EUGENE 08/06/13 111093 13A6576577674 F07 0.80FOUTS, GAY

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196.060.00 217.14-

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08/07/13 99741

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72.51- 0.00 0.00 94.34257.700.00 296.49-

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G01 257.7038.79- 0.00 296.4972.0072.00-

DOSTER, JEAN A LIFE ESTATE 08/13/13 18275 13A18275.10 L01

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OWENBY, MARGARET

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*** 20

93.06-

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13A88969.14 G01 25.49F10 0.830.83- 0.00

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MICHAEL & CATHI MEAD DBA

08/14/13 110084 12A110084.14 G01 767.25767.25- 0.00 F10 24.7524.75- 0.00 0.00 H01 371.25371.25- 0.00 0.00 LOG CABIN STEAK HOUSE 1163.251163.25-

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08/14/13 110084 13A110084.14 G01 767.25767.25- 0.00 F10 24.7524.75- 0.00 0.00 H01 371.25371.25- 0.00 0.00 LOG CABIN STEAK HOUSE 08/14/13 84793 1163.251163.2517.91- 0.00 0.00

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CIT TECHNOLOGY FINANCING 08/20/13 98608

19.84-

19.84-

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13A6580117687 G01 60.2660.26- 0.00 F03 10.5810.58- 0.00 0.00 L01 72.000.00 72.00- 0.00 142.84G01 486.5873.25- 0.00 559.8370.84486.580.00

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HENSON, ROBERT ALLEN 08/20/13 112239 13A7503661135 F04 73.25PLANT, JOSEPH M 08/20/13 123081 13A7505025544 F01 94.97L01 72.00-

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G01 883.23883.23- 0.00 94.97- 0.00 0.00 0.00 72.00- 0.00 1050.20978.20-

*** BETHEL UNITED METHODIST CHURCH CLERICA 27 08/20/13 38382

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13A38382.01 G01 6.446.44- 0.00 F01 0.690.69- 0.00 0.00 L01 72.000.00 72.00- 0.00 79.137.130.00 72.00-

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BARNES, DANNY 08/20/13 38382

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BARNES, DANNY 08/20/13 130223 13A130223.08

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29.04-

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REEVES, CECIL EVERETT 08/21/13 125006 13A7507369923 F11 58.80WATERSON, CLAYTON E II 08/22/13 96862 13A6585777545 F01 0.97-

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GIBSON, BEN ROBERT 08/23/13 75927

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0.00 72.00-

0.00 0.00 R CLERICA

10A75927.11 G01 9.049.04- 0.00 F08 2.662.66- 0.00 0.00 L01 72.000.00 72.00- 0.00 83.7011.70-

0.00

*** 37

GIBSON, BEN ROBERT 08/23/13 75927

0.00 72.00-

0.00 0.00 R CLERICA

09A75927.11 G01 6.846.84- 0.00 F08 2.122.12- 0.00 0.00 L01 60.000.00 60.00- 0.00 68.968.960.00 60.00-

0.00

*** 38

GIBSON, BEN ROBERT 08/23/13 75927

0.00 0.00 R CLERICA 0.00

08A75927.11 G01 7.907.90- 0.00 F08 2.452.45- 0.00 0.00 L01 60.000.00 60.00- 0.00

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Seq Date Account Taxbill Rev Nbr Number Number Number Descriptn *** 39 GIBSON, BEN ROBERT 08/23/13 75927

Tax Transaction Code Amount

Levy Penalty Addl Interest Discnt Trn Check Trans Amount Amount Chgs Amount Amount Cde

70.35-

10.35-

0.00 60.00-

0.00 0.00 R CLERICA

07A75927.11 G01 7.847.84- 0.00 F08 2.142.14- 0.00 0.00 L01 60.000.00 60.00- 0.00 69.989.980.00 60.00-

0.00

*** 40 *** 41 ***

GIBSON, BEN ROBERT

0.00 0.00 R CLERICA 0.00

08/23/13 119262 13A119262.08 G01 26.73F05 5.365.36- 0.00 HILDITCH, FRAN 08/26/13 89663 32.09-

26.73- 0.00 0.00 0.00 0.00 193.06- 0.00 0.00 0.00 0.00

32.09-

0.00 0.00 R CLERICA 0.00 0.00 0.00 R CLERICA

13A7418012575 G01 193.06F06 24.2224.22- 0.00 217.28217.28-

NIX, TRAVIS A

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Tax Code Totals F01*08- FR FIRE 0.95F01*09- FR FIRE 0.95F01*10- FR FIRE 0.95F01*11- FR FIRE 1.05F01*12- FR FIRE 2.53F01*13- FR FIRE 122.93F02*13- CL CH FR 88.20F03*13- OTTO FR 43.34F04*13- CULL FR 73.25F05*13- WM FIRE 7.04F06*13- SCALY FR 24.22F07*13- BT FIRE 5.22F08*07- COWEE FR 2.14F08*08- COWEE FR 2.45-

0.95- 0.00 0.00 0.00 0.00 0.95- 0.00 0.00 0.00 0.00 0.95- 0.00 0.00 0.00 0.00 1.05- 0.00 0.00 0.00 0.00 2.47- 0.06- 0.00 0.00 0.00 122.87- 0.06- 0.00 0.00 0.00 88.20- 0.00 0.00 0.00 0.00 43.34- 0.00 0.00 0.00 0.00 73.25- 0.00 0.00 0.00 0.00 7.04- 0.00 0.00 0.00 0.00 24.22- 0.00 0.00 0.00 0.00 5.22- 0.00 0.00 0.00 0.00 2.14- 0.00 0.00 0.00 0.00 2.45- 0.00 0.00 0.00 0.00

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F08*09- COWEE FR 2.12F08*10- COWEE FR 2.66F08*11- COWEE FR 2.52F08*12- COWEE FR 2.39F08*13- COWEE FR 262.71F09*13- NANT FR 47.00F10*12- HLDS FR 24.75F10*13- HLDS FR 27.56F11*13- MTVAL FR 58.80G01*07- GEN TAX 7.84G01*08- GEN TAX 16.28G01*09- GEN TAX 15.22G01*10- GEN TAX 17.90G01*11- GEN TAX 18.31G01*12- GEN TAX 798.88G01*13- GEN TAX 3946.43H01*12- HLD CITY 371.25H01*13- HLD CITY 413.29L01*07- LANDFILL 60.00L01*08- LANDFILL 60.00L01*09- LANDFILL 60.00L01*10- RES FEE 72.00L01*11- RES FEE 72.00L01*12- RES FEE 144.00L01*13- RES FEE 504.00Total for Group REL*13*08 7383.13-

2.12- 0.00 0.00 0.00 0.00 2.66- 0.00 0.00 0.00 0.00 2.52- 0.00 0.00 0.00 0.00 2.39- 0.00 0.00 0.00 0.00 262.71- 0.00 0.00 0.00 0.00 47.00- 0.00 0.00 0.00 0.00 24.75- 0.00 0.00 0.00 0.00 27.56- 0.00 0.00 0.00 0.00 58.80- 0.00 0.00 0.00 0.00 7.84- 0.00 0.00 0.00 0.00 16.28- 0.00 0.00 0.00 0.00 15.22- 0.00 0.00 0.00 0.00 17.90- 0.00 0.00 0.00 0.00 18.31- 0.00 0.00 0.00 0.00 798.35- 0.53- 0.00 0.00 0.00 3945.90- 0.53- 0.00 0.00 0.00 371.25- 0.00 0.00 0.00 0.00 413.29- 0.00 0.00 0.00 0.00 0.00 0.00 60.00- 0.00 0.00 0.00 0.00 60.00- 0.00 0.00 0.00 0.00 60.00- 0.00 0.00 0.00 0.00 72.00- 0.00 0.00 0.00 0.00 72.00- 0.00 0.00 0.00 0.00 144.00- 0.00 0.00 0.00 0.00 504.00- 0.00 0.00 1.18-972.000.00 0.00

6409.95-

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********** Totals By Tax Cycle ********** Cycle Current Delinquent A 5623.991759.14-

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MACON COUNTY BOARD OF COMMISSIONERS AGENDA ITEM
MEETING DATE: August 13, 2013 DEPARTMENT/AGENCY: Governing Board SUBJECT MATTER: Appointments DEPARTMENT HEAD COMMENTS/RECOMMENDATION: A list of the upcoming and/or pending committee appointments is attached. With the board’s direction, all of these will be advertised on the county website the day after the meeting and the board can consider them as needed at the October, November or December regular meeting. COUNTY MANAGER’S COMMENTS/RECOMMENDATION:
Attachments __X__ Agenda Item 12A Yes __ No

Upcoming Board of Commissioner appointments
Economic Development Commission 1. Ed Shatley’s term expires 12/31 Nursing/Adult Home Care Community Advisory 1. Helen Burnette’s term expires 8/31 2. Rev. Andy Cloer’s term expires 8/31 3. Jane Kimsey’s term expires 9/1 Macon Program for Progress (Orchardview Apartments) 1. Stan Jeffress’ term expired on 7/1 Planning Board 1. Jimmy Goodman’s term expires on 11/1 Recreation Board 1. Matt Bullis’ term expired 7/15 2. Gloria Thun’s term expired 7/15 Franklin/Nantahala Tourism Development Committee To Be Determined…

MACON COUNTY BOARD OF COMMISSIONERS AGENDA ITEM
MEETING DATE: September 10, 2013 DEPARTMENT/AGENCY: Governing Board/County Manager SUBJECT MATTER: Closed Session DEPARTMENT HEAD COMMENTS/RECOMMENDATION: The County Manger would like to hold a closed session under NCGS 143318.11(a)(3) – attorney/client privilege – to discuss a matter related to the closeout and final payments for the Iotla Valley Elementary School water and sewer project. Documents regarding this matter will be sent to you in a separate e-mail.

COUNTY MANAGER’S COMMENTS/RECOMMENDATION:

Attachments ______ Agenda Item 13

Yes

__X

No

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