Joint Work Session Meeting March 10, 2025

MINUTES

Joint Work Session

Monday, March 10, 2025 @ 1:00 PM

City Council Chambers, City Hall

PRESENT: Councilor Johana Bencomo, Councilor Yvonne Flores, Councilor Becky Corran, and

Councilor Cassie McClure

ABSENT: Councilor Becki Graham, Mayor Eric Enriquez, and Councilor William Mattiace

1. PETS OF THE WEEK 1.1 None.

2. READ CLOSED MEETING STATEMENT 2.1 The Las Cruces City Council met in closed session and only discussed those limited items as stated in the posted notice to discuss threatened or pending litigation in the matter of Memorial Medical Center – Notice of Breach sent on August 29, 2024.

3. AGENDA ITEM 3.1 OPIOID SETTLEMENT FUNDS UPDATE. Barbara Bencomo, Chief Administrative Officer gave overhead presentation.

Jamie Michael, Director of the County’s Health and Human Services Department continued the overhead presentation.

Athena Huckaby, Medication Assistant Treatment Provider the continued overhead presentation.

Ray Stewart, Recovery Director of Amador Health Center the continued overhead

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presentation.

Dr. Edward (Ned) Rubin, Retired Addiction and Health Psychologist continued overhead presentation.

Jamie Michael continued overhead presentation.

Barbara Bencomo the continued overhead presentation.

Jamie Michael continued the overhead presentation.

Councilor Corran said I have a couple of things I heard in this presentation I feel like these seem like excellent recommended strategies, I deeply respect the work that the committee has done. I do want to sort of speak to I feel like I would like the committee to continue to play a pretty critical role I feel like it’s really a pretty powerful group of folks who know a lot of things. I think that trusting that work I would like to see that really be maintained into the future.

I guess I sort of have a follow up question related to one of the inflection points is strategies and one of them is related to funding. My question is more related to funding, the two trust related strategies, I’m curious because I think I’ve been very vocal in saying I believe that we should be maximizing our benefit as soon as possible because literally we need to be preventing people from dying five years into the past, which we cannot do, but I’m curious, on the models where two different scenarios of funding, I don’t see in here anything that looks like a big pile of money at the front. A lot of these things look like to me, not small amounts of money, but these seem like programs that would seem to maintain in the community longer than a very short initial disbursement, but I say that because I am in favor of us maximizing our benefits at this moment, but I’m curious programmatically if one or the other of these approaches will maximize the number of people effected and/or the capacity in the community to address the issues in the long term and how those two things relate to those two funding related strategies.

Barbara Bencomo said that is an excellent question and that is actually the balance that you would have to perform in order to decide not only would you want to establish a trust, but what proportion of the trust you would want to expend, the two scenarios that I gave you, are really kind of on either end of that spectrum. The first one, as you recall, was setting aside

100% of the proceeds into the trust and just taking a portion, say 5%, for expenditures on an annual basis. That’s the one that gave you about a half a million dollars a year to spend. The second scenario was splitting up the proceeds, 50:50, and we’d have a greater amount of funds to spend on the front end, because we’ve already received funds to date, and then you would proceed with about half a million a year and the trust would then grow, as I said in both cases of those scenarios to just over 20 million, but you could structure a trust so that you set aside 25% and expended 75% it all depends on what time horizon you want to go out, 20 years, 25 years? What is it that you think that you would need for this opioid crisis in the future? And the reason I emphasize for this opioid crisis because as I mentioned, the use of the funds, is governed by the settlement for this specific purpose. So going out 10, 20 years,

I’m certainly not an expert, I don’t know what could come up in those years that we might need to address, that will be different from what we are dealing with now, we would have some limitations on those funds going out years from now.

Jamie Michael said I just want to add a bit to that. It is probably a bit premature to ask you to make a decision about investing the funds right now. What I foresee one of the next steps as

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we put together the proposed activities and really work those out as a scope of work, we can come back to you and say the investment for this activity is approximately this much money or approximately this much money and that may then help you decide how much do we need to then frontload these programs versus how much do we need to have over time to maintain these services.

Councilor Corran said that would actually be really helpful if that could be part of that because

I don’t want us to set up nonprofits or other organizations to have this unpredictable pile of money and then no money or not enough money in the future that would be really helpful to mention when the next part comes forward.

Commissioner Schaljo-Hernandez said I do have a few questions, I was actually really surprised and glad to see that trust portion put in here as well, but I just had a generalized question, maybe for one of the members of the advisory board. So, we have the recommended strategies, off of these recommended four strategies, how many of these are current programs we have in our community versus new programs that we’re going to be introducing into our community. With that being said, also if we can just get a general idea of if they are programs that are in our community already, then someone is obviously monitoring these programs for what kind of outcomes are coming from these programs and do we have a general idea of how successful they are, currently to date in our community.

Jamie Michael said we did an asset map along with this and there is something happening, there is some activities happening in our community related to all of these, that’s why the group is really recommending some very specific using this money to meet some specific gaps. So, for example, medicated assisted treatment is available, in fact we have a lot of providers in our community that offer medicated assisted treatment, and the evidence shows us that is extremely effective, so we know that that is an intervention that works, but when we looked at the asset map, there were very few, maybe one provider, that can work with pregnant women or newborn babies if they have an opioid use disorder. Know that that is a population that is missing. We know that people out in the rural areas have less access, so we know that that is a population and a service that is missing when we look at medication assisted treatment, so we took an effective, proven intervention and we’re trying to figure out how to connect it to more people or to more vulnerable populations that have less ability to access the service. So that’s an example that I hope answers your question, but I’m going to ask Athena to also help me respond.

Athena Huckaby said I was just going to talk for example the company I work with, Ideal

Option, in other states where we have funding available for it, we have mobile units, a van with a logo that goes to rural communities, provides services, via a nurse practitioner, a medical assistant takes the vitals, in some cases can even have the medication available on the van and therefore expanding that access. So, we currently do have a clinic, we have a

24/7 referral line, we have a peer support worker, but that could all be expanded to be more accessible to people. And then the thing that I also would like to talk about is something that

Ned talked about, which is stigma. There still is a lot of stigma, not only around having an opioid use disorder, but around taking a medication for it. Even though these medications are proven to be effective, are FDA approved, have a broad evidence base, people in certain behavioral health providers or certain medical providers or certain peers will say that people aren’t really recovering if they are choosing to take these medications. And so, I can see ways that also the things that Ned talked about like a media campaign could fall in also to reducing stigma around medication assisted treatment and thereby encouraging more people to get into that. If that makes sense?

Commissioner Schaljo-Hernandez said no, for sure, and thank you for addressing that. I love what you said about kind of meeting people in the rural areas where they are, because

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expecting them to come to Las Cruces isn’t practical, that’s thirty, forty-five, sometimes an hour depending on where you are in the county, so I appreciate you saying that. And something that I would really like to see along those lines as well as when we start continuing these conversations hopefully on a more regular basis that we do look at the successes that way us as a board, both boards together can make these decisions as informed as possible.

Because at the end of the day, we do want to make the right decisions not decisions that may or may not work.

So, thank you for addressing that, and that also kind of brings into my ideas of the trust that was talked about is if we were to allocate money for what we said the upfront cost is, for a lot of these to get them going whether it’s working with those one-time payments of whatever it takes to get those providers in house or whatever it is, but also the trust would then set up monies for any possible changes in 5, 10, 15, 20 years to programing when it comes to these funds that way this board can meet again to go over maybe we need to change what money.

It is more of a longevity outlook on hey this best practice isn’t a best practice anymore.

We want to move that money here, well, if we allocate all that money upfront on the front end, we don’t really have that ability to then change programmatics later on. So, I actually would definitely be a fan of the trust. I don’t think 100% is needed but definitely highlighting what needs to be done and then I do see Jamie here now, and then my question was on harm reduction as well. So, I see that we went with harm reduction as a recommended strategy.

Where in these four strategies does harm reduction fit?

Jamie Michael said one thing that is really beneficial working with Vital Strategies is they have laid out how you can take harm reduction treatment and prevention and have it touch all of these recommendations. So, we can do harm reduction in all three of those recommendations. Obviously, it will look different in each of them, but harm reduction touches all of them.

Dr. Ned Rubin said I just wanted to address your question about what else is going on in the community. A couple of things I wanted to mention, there are certainly prevention programs that are going on in the schools, the kind of prevention I talked about earlier is broader prevention program that will have touched the whole community as well as working with the kids in the different medical settings that I had briefly mentioned. There is a project going on right now, to increase providers of medication for opioid use disorder where through the

Center for Health Innovation we’re reaching out to train medical providers in the state, certainly here as well, obviously, on how to provide buprenorphine in the context of their practice. So that they’ll be able to reach more people, that of course partly addresses the issue of stigma, what practices will allow that to happen, which is one of the things that we want to talk about but there is some work going on in the community to try to expand that now. We hope that through some of the work that we can do down the road, we can expand interests and the availability of medication for Opioid Abuse Disorder as well.

Councilor Flores said my question is money. So, you have the trust, who takes care of it, and you talk about money running out, and wanting to allocate money to programs that are going to be successful, but the ones that have been, based on what people are saying, successful.

So, it seems that how much is the trust and they’ve been invested, is it going to grow? You know the corpus; you always have a corpus and is that destined to grow or are you just going to go with this program until the funds run out? That’s the part and I want to applaud everybody, Athena, Ned, Francine and everybody else who has been involved with this project. So, that’s my question Barbara.

Barbara Bencomo said so, I do want to emphasize that we, the City and the County, will be

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receiving distributions for over a 17 year period. So if you think about the receipt of the funds,

I mentioned some of them are front end loaded maybe one time payments, but we will be receiving funds over a long period of time from the various manufacturers, distributers, and retailers. So, there will be a source of funds for quite some time, the trust would protect a corpus, as you mentioned, you could establish that as a long-term investment, similar to what we have done for the Telshor funds, that allows you to invest in longer term vehicles.

Right now the funds the City and the County have received are not designated long-term investments, and so we maintain the same kind of liquidity and short term investments for these funds as we do with our other funds that we hold for our operations, payroll and that sort of thing, we are receiving returns on that, but it’s not the same kind of investment that you would make if you designated it a long term investment. So that’s one thing about how the trust would be administered, and then of course in establishing a trust you would need to establish the oversight, who is involved, if it is the joint city and county, where each establishes their own trust, there are many different ways to do that, many different options.

So, of course, that would be at the request of the governing bodies as to how they’re established.

Councilor Flores said yeah, I suppose the onus would be on the governing bodies, but 17 years sounds like a lot of time, but think about the baby you had a few years ago now who is now 20. I mean that went by really fast! I really laud and applaud the people who are down in the trenches working with people who have addiction and all that but with all due respect, I don’t think it is going to be solved in 17 years. It took a long time to get where we are now, and I know that Athena really emphasizes that the shame part really has to be worked on.

You know there’s no shame in being a woman, there’s no shame in being a brown woman, there’s no shame in being a drug addict, I’m not a drug addict, but one of my brothers became heavily reliable on drugs after Vietnam and I think that happens a lot to our veterans. He recovered, he was ok, he’s passed away now, anyway, has any of those thoughts or any discussion have you addressed that issue of making sure there’s funds to perpetuate?

Because I think we’ve been very fortunate to have something go 17 years, and however that happened, maybe you can make it happen again to make it possible to go longer beyond that time.

Barbara Bencomo said I applaud the advisory council for bringing forward the concern and the interest in providing this option to you all, certainly it was at their behest that we developed these scenarios that we presented to you, we did not go as far as recommending one we didn’t even know if that would be a direction that you would want to entertain. That’s the kind of guidance that we we’re looking for.

Councilor Flores asked what about the money part? I think you all have done a wonderful job in a short amount of time, everybody who spoke, spoke very highly and positively, but I’m just wondering about how much longer this can go on beyond our given lifetimes here.

Barbara Bencomo said I think as Jamie said, if we were to get the go ahead to pursue the strategies that the advisory councils recommended, then we can move to the next step which is the recommendations of certain specific actions and programs and that would certainly help to inform the expenditures that would need to be made when and how and where and by whom and that would all help us to present some more specific options with respect to a trust structure. So, we really need to get to that next step where we start to quantify the actions that can be taken under these strategies so that we can pursue the trust options further.

Commissioner Reynolds said looking at some of the discussion first thing I am totally in favor

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of the trust and putting money in there so that we can have these programs last as long as possible. Part of the reason I feel that way is because Mr. Stewart pointed out something that

I think statistics that are very important, and that is he said that only 10% of people who actually need the support get the support and then the ones that do get it, only 25% of them last in the program for over 6 months.

So, what that tells me is that we’ve got some really good ideas here, I don’t think we have solutions, and I think the only way we are going to get solutions is to take some of these ideas, put them into practice, and try to determine where our money should be spent in the future and if we create a trust, that’s going to provide us long term money and I mean even past 17 years I think we have a better opportunity actually to get a good handle on this situation and appropriately address it. For that reason, I think that it’s important we remember that these are really great ideas we’ve got a great committee we don’t have enough evidence- based solutions yet to determine exactly how to use all the funds we’re going to get and so putting it in a trust gives us a chance to try a few things, change direction and refocus.

Barbara Bencomo said I’ll just add that fourth strategy that you see up there for data collection and research is really going to play into the evaluation of the expenditures and the programs that we embark upon to determine how effective they are for our community.

Mayor Pro Tem Bencomo said I just have a couple of questions in terms of the logistics of how we hope to spend the money. I do think it’s interesting, I was looking at the National

League of Cities and they talk a little bit more about the principal around spending money to save lives and I think that has to happen now, not in 20 years, right? That needs to happen yesterday. It’s interesting because on here it also talks about given the fears of an economic downturn that many localities will be tempted to use, and maybe perhaps even nonprofits will be tempted to use dollars to fill holes in their budgets rather than to expand needed programing. And it warns jurisdictions should use the funds to supplement rather than replace existing funding which I think is incredibly important to keep in mind. I also appreciate the recommendation on the trust, I don’t know, it’s really tricky for me to think about rainy-day funds given the size of New Mexico’s rainy-day fund, and how we hardly tap into it when our communities are mostly in need, and I think there is a really slippery slope in this scarcity mindset. And it is because let’s be honest, this money was never intended to solve our problems.

This money was intended to stop gap, right? These pharmaceuticals created a ginormous problem our communities didn’t have the resources to care for trauma and heal people’s trauma and that is how we ended up here. It’s going to take a lot more than what the settlement is to reverse and to heal the amount that we actually need by no means am I looking at this money thing as our saving grace thinking about a trust is a really smart balance of how we leverage it and extend the life of it. I don’t think 100% of that honors the spend money to save lives principle, I think we need to do that now. We need to invest in programs now. Now getting to that part, just in my experience being on the council I guess the only other thing I can sort of compare this to is the ARPA dollars. ARPA dollars came, they gave us one set of money and they said good luck use it best you can. And of course, we tried to leverage that in many ways, some of it was to supplement budget because of economic downturn and a lot of the rest of it was to provide back to communities. Here we are saying that’s literally what we want to do. Barbara, in your discussions with staff and the committee, is the hope that we would create an RFP process that we would put out to the public and organizations apply with their ideas that fit these strategies?

Barbara Bencomo said yes, we have spoken a little bit about it, we have been really focused

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on the data gathering, evaluation, the establishment of the recommendations to date versus the next step, with this the administrations, and I think Jamie mentioned this, doesn’t involve potentially RFPs and obviously alignment with P code, local and state, etcetera, but we did think about that in the beginning as Jamie mentioned. The folks that are on our advisory council also are there because the groups that they are in, their expertise, not necessarily their employers who might respond to an RFP, but to the different collaboratives that they represent as well, because we wanted to make sure that we maintained the integrity of that process when we did get to it, but yes that is certainly the next step. After we defined the specific actions that could take place under any of these umbrellas, we’d have to determine how do we get those services in place in our community.

Mayor Pro Tem Bencomo said I mean I think that doing this kind of RFP process that encourages collaboration amongst organizations that will decrease less of that somebody talked about this is a time to unify, right? Not split apart when the RFPs come, and we are all fighting for a little bit of the piece of the pie. No, let’s honor and uplift more so projects that are collaborative in nature with organizations in our community. The other thing that I think of, and

I think this will allow for some creativity to come about. In my experience as a social worker, as a councilor, I can certainly say I think programs that have mobile units are really exciting, I think overdose prevention sites are really exciting, but if we as a council and a commission say do that, there’s not necessarily a collaboration with community partners that may be saying there is no capacity, or maybe there is, right?

What I’m saying is I think it’s a lot better to create a space where the end user, the actual organizations in our community are being the ones co-creating and inviting us to participate in a partnership instead of us kind of mandating or dictating what we think should be done. I think it can happen in a collaborative way. That being said, and I appreciate that your thinking about the committee being sort of in place for a while, I think it is important. I do have some concerns; my hope would be that some of the folks on the committee that work for organizations, like Ideal Option or FYI, would be applying for these funds and so have you thought about this sort of conflict of interest that exists there and how we plan to navigate that? And those were just organizations off the top of my head, I’m not saying only those are represented.

Jamie Michael said you are bringing up some great points, when Barbara and I sit down and say ok now logistically how is this going to work? We both go ok wait we need to step back and really put together a good plan, part of that defining the responsibilities of each government looking at different procurement processes. RFP is one procurement process, but there are other procurement processes, but yes, at some point, whatever the procurement process will override the participation and the advisory council. There may be a time where it’s only a few members of the advisory council come together and review proposals for example. We will have to balance that out and it is going to take some thought on both parts of government beyond just us, but with our legal departments and our purchasing departments to figure that out, but I also agree that the more collaborative we can make it, the better and if we really work through some intentional and specific outcomes, then the proposals will all be focused on accomplishing those outcomes and I think we will have a better chance of making sure that the contracts that result from that all work together.

Mayor Pro Tem Bencomo said I appreciate the timeline that you presented in the PowerPoint

I think you know I would like to see some of this money start to flow out this year I think that we’ve done this process, the collection process long enough that I think getting some of this money out is critical now, or as soon as possible. Before I hand it off to my colleagues, say that on to the education piece, if there is anything that we could do also to try to prevent money being used on billboards or strategies that we know are proven to not necessarily work, right? Like I think prevention where is it best and where are the dollars best spent that

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aren’t necessarily like commercials and billboards and those kinds of things I would be very grateful.

Barbara Bencomo said I also wanted to mention you highlighted collaboration, very grateful that you did that, because that’s the whole root of this effort. Certainly, want to make sure that we also highlight the collaboration with the State as I mentioned they are receiving funds, they are utilizing funds for this purpose as well. And one of the things we’ve been very intentional about is keeping that collaboration strong with the State so that we don’t duplicate efforts that we are well aware of areas that will be contributing to, in our community as well.

Tim Jenkins, Member of the Public said thank you very much for the trust fund issues, one thing that was brought to my attention when Corran spoke, if we do a trust fund my concern is something comes up in a year, like we’ve done this for a year, it looks like we could really use a mobile unit. If we have some kind of umbrella in that trust fund that allows us to say we need $80,000 to do this milestone, that we make sure that we put that in there so that we’re able to do that.

Mayor Pro Tem Bencomo asked is there anything else you needed from us today and then when can we expect to be back here?

Barbara Bencomo said so today what we were looking for was guidance on the four recommended strategies so that we can then take that next step to develop the actions and come back to you all with that information according to the timeline that we have here. So, I think we have the thumbs up I see Commissioner Reynolds, thank you so much. That was what we were looking for today.

Mayor Pro Tem Bencomo asked I guess individually as bodies, each of us would be presented with resolutions to vote on, correct?

Barbara Bencomo said yes Mayor Pro Tem once we determine sort of the administrative path forward, taking that through both the City Council and the County Commission. Yes, there would be a whole series of actions that we would need to undertake that would come back before the individual bodies because, as I mentioned earlier, the funds are held separately by the City and by the County and so in order to authorize them for certain uses, you will definitely on the City’s side be getting a budget adjustment resolution for that.

Commissioner Schaljo-Hernandez said I just have a question on the funding. So, if we decided to do a trust or anything like that, and there is monies available can these monies be used as matching funds for grants?

Barbara Bencomo said again, Schedule E which is the allowable uses really what governs the use of the funds, so if the grant were for an allowable use, and I absolutely think it could be used as matching funds and that way we could leverage them.

Commissioner Schaljo-Hernandez said thank you Barbara I think that helps, but also just kind of a final thought, if we did choose to put some money into a trust, I would love to see a provision in there to where if a nonprofit organization that is following the guidelines that we set forth for the use of this money, whether it’s you know whatever it could be, I would hope that we would be able to help out with possible grant funding if it falls in line with the acceptable uses that we put forth as a board. I would love to see there be like almost a process to help shell out some of that money especially if they are helping to bring solutions to our community and it would even help offset those monies.

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So, like what Mr. Jenkins said about needing a mobile unit or something like that I would love to set, and 80,000 dollars is a great estimate if you can find them, we’ll buy them! But to say that hey we’ll match that $80,000 grant for $80,000 more, whatever it is, I would love to see us be able to do that as a board. Maybe that’s another role that the advisory board can kind of help stay engaged with as mechanisms such as that.

Barbara Bencomo said you know we have something similar like this set up with the Telshor fund for health-related public services and our own Natalie Green administers that where there are proposals from the community that meets certain criteria so I think that that certainly is doable and, if I may, I just wanted to speak to one last item here that’s very important, especially near and dear to me, and that’s the transparency for the use of these funds. I know for those of you in the city council, you know that for our opioid funds we set up transparency portals in the website that explain where the funds come from. What are the allowable uses?

How much of the funds we’ve received from where and how are they being used and what is the impact? Right now, we have that set up for the opioid settlement funds, just through the point in time where we were receiving funds, but once we do establish the use of the funds, I very much anticipate that it is similar to the ARPA funds, we would also continue to add to that transparency portal to indicate where the funds are going, who’s administering them and what the outcome is. And along those lines, we certainly have received numerous documents and directives from our state auditor respective to the use of funds, they are certainly watching to make sure that they are in compliance with the allowable uses of the funds so that’s something that we all are very cognizant of and again can be very transparent in how we are spending the funds in order to show compliance with those allowable uses of those funds. 3.2 OVERVIEW OF EMERGENCY TRANSPORT/AMBULANCE SERVICES

WITHIN THE CITY OF LAS CRUCES AND DONA ANA COUNTY. Stephen Lopez, Assistant County Manager, said over the last roughly 10 months, the

City has contracted with AMR, American Medical Response, to provide ambulance service throughout Dona Ana County and this was the result of a joint agreement between the City and the County, and we have noticed on the County side significant impact, adverse impact, to our Fire and Rescue Department and so we started working with the City of Las Cruces administration over the last few months. The City has been noting similar concerns, and so we jointly wanted to bring this item up to you all to start having a discussion about where we may want to go in the future. For example, for the Dona Ana County side of the last 4 months of 2024, the County was averaging having to transport 225 patients each month because AMR could not.

That’s a big impact for County Fire Rescue, and again that’s averaging out over four months, and this becomes a bigger impact to the County because we lease our license, our certificate of need, to AMR as part of the contract. Had we not been doing that, we would have been able to bill an annual average of $1.4 million or more, to insurance. We are currently subsidizing AMR not only in the $3 million that the County provides the City to provide to AMR by contract, but we are also losing out on any potential billable revenue because of what we are having to cover because AMR cannot.

Brad Douglas, City Attorney gave the overhead.

Councilor Flores said I’m not surprised that you’ve presented this report about them, this topic came up several years ago and the person who was heading that or the owner came in here and stormed and was yelling at us, they said, oh you know we’re

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going to take all these corrective measures, and here we are. My concern, first of all, you said they listed how they came about they were one of the only ones who applied, is there anyone else in the area that would be able to perform that duty or that service? You know you can’t take blood out of a stone. I think we are between a rock and a hard spot because what options do we have? But my real concern here is the people who have not gotten the service and we probably have had some deaths or dire consequences of no response, or has our department jumped in?

Stephen Lopez said the City of Las Cruces within the city limits has actually been very well poised, good foresight to build up that emergency response capability within the

Las Cruces Fire Department and so they have been handling those high priority calls, which is fantastic. And you asked what can be done, we’re between a rock and a hard place. At the County, management has been working with our individual commissioners about the potential need to move to Fire based emergency medical services. We expect delivery of three more some people call them Ambulances, in the

Fire service right now they are calling them Rescues, way back in the days of squad

51 they were called Squads, but we are getting three more of those within the next week and a half, with those plus what the Sunland Park Fire Department has and the

Mesilla Fire Department has, we will actually have more ambulances in the outside

Las Cruces area than AMR has right now. So, we are not quite ready, staffing wise, but we are getting there. By July 1 we will be fully prepared to take over fire-based

EMS if need be.

Commissioner Reynolds said I started studying the AMR service about 5 years ago when I first came almost 6 years ago and pulled all the MVRDA data for a year in order to study whether or not we’re meeting the contracts that we have, and since I’ve been on the MVRDA board for the last 6 years now, I’ve not found them to be able to meet the required response times in either the City or the County consistently. And in the year that I’ve looked, part of the reason is the way that they manage their service, one of those is you’ll get a service call out to have somebody show up here at this building, and then it is their choice to move it from one squad to another squad, there’s no hand off so the one squad may get called, 20 minutes later they’ll hand it off to another squad who takes 10 or 20 minutes to respond but there’s no connection from the time of the first call and the squad that actually responded.

So, we have a problem with record keeping, we have a problem with management, we have a problem with response and also having people out. In one of my districts,

Talavera, I’ve actually been there talking to them on several occasions, and they say that their instructions to their family members are drag me into the car and drive me down to the hospital because I can’t wait 45 minutes for the ambulance to get here.

And that’s been the standard practice for the time I’ve been in the office for now almost 6 years. We have been preparing for this moment for about 4 years as well.

Commissioner Schaljo-Hernandez said I just have a quick question. Who makes up the Ambulance Oversight Committee?

Sean Heck, Interim Fire Chief said the AOC is made up of mainly the Fire Department since we were the contract administrators who created it, so the City Fire, we lead the

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AOC but we also have the County Chiefs in there too as well, Sunland and Mesilla,

Las Cruces, Dona Ana and then of course Jamie Michael she’s also involved with this too as well. And that is our responsibility to look at the data and provide the oversight on whether or not we get an exemption on the OCU which is where the money comes from and then the other components of the contract where they’re supposed to be providing us with data on their apparatus readiness, the service on the apparatus, their unit availability times, their plan for deployment, but we have not received that part either yet. And we are past a year of this contract already. It went into effect

March 1.

Commissioner Schaljo-Hernandez asked what is the trigger and/or the mechanism that would force the AOC to kind of start looking at this?

Brad Douglas said that trigger would be if the contract administrator makes a finding that for any 6 month period, and they don’t have to be consecutive in the way that I read them, of the proceeding 12, that AMR is noncompliant with their response times standards, 85 and I’m just making the zones up, but North, Central and South, 85 for those zones 85% of the time and then 90% for the other two, if they are noncompliant for 6 months then the AOC can implement emergency take over proceedings.

Mayor Pro Tem Bencomo asked in terms of the exemptions, can you talk a little bit about that? How do they go about getting an exemption for not showing up to a call?

Brad Douglas said yes, so I can talk generally about it, I’m going to defer again with regard to exemptions. What you would be looking at there is something that is classified as a priority call, and they don’t make the response time let’s say, and then later on it is found that it was actually not a priority call, let’s say it was mistakenly classified as a priority, when really it was only an interfacility transport, you know moving from one hospital to another or one carrier to another, in a non-emergency status. They could contest that finding and request an exemption, Chief Heck, am I on base or totally off-base there?

Interim Fire Chief Heck said no, that is exactly right. There’s in that contract they have some criteria that allows them to get exemption, whether they’re canceled, whether they’re downgraded onto a call, and then of course inside of a call itself there’s certain parameters that they can as well. We were looking at the concept of if the scene is not secure, and then because it isn’t a secure scene, we don’t want people driving code 3 response time criteria kind of tappers off on those a little bit. So, there are a few items within the contract itself that allow us to provide them that exclusion and basically the way the system’s designed is they’re supposed to go through all those calls and then they submit a request to their program first watch, they submit a request to get it exempted and then we turn around on our side between the Chief DC and then the

BC and we go in and we look at those and say yay or nay. So that’s kind of where that’s supposed to go and the problem we’re running into is that they are not doing it.

And that’s why it is uncontested I’ve been trying to make sure that when Brad was presenting, they still have that right to do so per the contract, but it’s been a very challenging process to get that done. We did that million-dollar request, part of that reason we are doing those things is they are not getting that part done. They haven’t

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even looked at quarter two yet, except for 239 calls out of 2,000, none in quarter 3, quarter 4. Again, we are a year in, and we’ve really not done a whole lot for that part of it. So, the way it looks in my head today and talking with staff is that the numbers are the numbers and we’re just going to move forward with that and just call it a day.

Trying to get them to follow through on that part of it.

Just a real quick point of clarification, the zones are laid out in the contract and he’s kind of right there is the north, the central and the south. The response time is only in the central though, the north and the south have what we call level of effort where they just do the best they can. I understand you concern in the County is that realistically there isn’t a true time because one of the things we did is we forced AMR to keep units in the south and in the north. In the past they would take those units from the north and the south, bring them in to cover the city because we’re the busiest but they would also bring them in for non-emergency transfers too, but they would bring them into the city and then you wouldn’t have that unit available at all in that area, so now they have to keep the unit there, and the unit that is there is just doing the best they can with what they’ve got, but they are still running into the same issues that they’re having to transport, no different from us, we’re averaging somewhere in the neighborhood of about 800 transports a month in the city alone for those calls that are not our calls because we took the emergency, we took the big ones, we took the ones that had the greatest impact on life, like CPR, chest pain, strokes, those are Fire

Department, they are getting us, the other ones we are still having to transport in the neighborhood of roughly 800 a month of those calls that are supposed to be done by

AMR just as a lack of availability.

Mayor Pro Tem Bencomo said that’s a significant number. I think the other concerning thing is outside of the control zone like you said, the bar is low, and it is still not being met. I think

Councilor Flores is right we have been here before in terms of this conversation and so obviously I’d like to hear from the Fire Department as well in terms of readiness and the challenges of being able to meet that in July or sooner, you know we heard a little bit from the County in terms of the number of apparatuses that you’ll have, that’s great, I am curious if we can get an assessment from the City?

Interim Fire Chief Heck said as it sits today, we have four rescues, ambulances 24/7 right now that are operating for the department. We just put our fourth one, which was doing 12 hours as of right now it is doing 24 hours so we have those availability right now, we have rescue 9 come February, 9 opens up we’re going to have another rescue that will be there as well, and then of course we have our backups, our reserve that we have in the neighborhood, we have three van style that aren’t the best, but if you need to use them, they work ok, but then we also have an additional four apparatus that are in reserve and we’ve got another one coming. So, for us, we’re set, we were set last year, we’re going to have to pick up a few people to help support this because of the numbers and amount of units we want to have available to meet the needs of the community so that they are not waiting, if we set a standard of 12 and 13 minute response times then we need to meet that too as well as the department.

We’re poised to do that, I think it would have been a little tight last year, but we’re

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definitely in a better position now, because we already have four 24’s running right now and we need 7 total units and we’re almost there.

Mayor Pro Tem Bencomo asked and seven drivers? More than that?

Interim Fire Chief Heck said it’s more than drivers, it’s EMTs and two EMTs on it riding and so you’ll need the two personnel per that we would need another 20, we need five 24 hour trucks and two peak time trucks to meet the needs of the City.

That’s what we would need for us.

Mayor Pro Tem Bencomo said I’m hoping we can, is there a budget analysis from the

City Manager that we can get? And then the last thing I’ll say on this is that the obvious challenges are there, matter of life and death, in some cases, in many cases

I’m sure, just honoring the contract, all those kinds of things. Additional piece that feels really important to bring up Brad is, like this also consumer protection matter, right? So, maybe not, you’re the attorney, it just feels to me like there are serious issues here beyond just not being able to meet the terms of the agreement.

Brad Douglas said that’s exactly right, I think that you or maybe Councilor Flores has mentioned negative outcomes that’s something we want to obviously avoid at all costs, I would say at this point, the next steps that I’m going to pursue, unless I hear something different from you all, I am going to coordinate with the Contract

Administrator at AMR should be expecting to receive that communication this week because we would like to see their plan for remediation to address these issues.

Hopefully that’s the end of it, hopefully it does get addressed to both the City and the

County’s satisfaction. But if it doesn’t work out, the reason for some of the slides that I put in here had a focus on readiness and some of your questions focused on that as well, but I just wanted everyone to be aware that we need to be ready to take over on very short notice if that is what ends up occurring.

Commissioner Reynolds said prior to the contract in 2024 I’ve been on the board since 2019, prior to that contract we did have a specific response time, if I remember correctly, it was 40 or 45 minutes, that we were required. They never met those standards either so based on the numbers that I’ve been able to pull, but I do have a question. If in fact we do take over the contract, do we also get any of their assets?

Like some other ambulances?

Brad Douglas said in my reading as recently as two or three days ago of the agreement, the emergency takeover provision seems to anticipate that the takeover would involve equipment and assets, the only exclusion in my mind or what wasn’t clear was that it would not include personnel. With regard to the 45 minutes that you referenced, that language is actually still in the current agreement. There’s a clause that states that in no event will a call take more than 45 minutes to respond to.

Commissioner Reynolds said that’s what I thought as well, and thank you for responding about the equipment, because it was my understanding that by taking over the utility that we actually get all the equipment as well.

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Commissioner Schaljo-Hernandez said in the contract, you’ve been talking about how they’re curing the calls if there’s any of that, they are asking the AOC to cure whatever. So, in the contract there’s also part about a third-party data review, is that that AOC board?

Brad Douglas said I’m not sure honestly.

Commissioner Schaljo-Hernandez said there’s a lot of people saying no. Ok, so with that being said, in the contract they have to be out of compliance for 6 months, in a

12-month period, and basically, they’re behind how many months on getting us that data?

Brad Douglas said the way that I read the data, is so far, and Chief correct me on this if I’m wrong, every single month has been delinquent getting those response times.

And now the 6-month requirement applies to an emergency take over that would have to be approved and recommended by the AOC, however the remedial measures requirement is only that they’d be not meeting response times for a 3 month period. I strongly believe that we are already there, arguably for both, but certainly for the remedial measures’ requirement.

Commissioner Schaljo-Hernandez said ok, no, that makes sense, so thank you for that, I’m trying to understand exactly, so there’s two things at play then, right? There’s the money aspect of getting compensated that way and there’s the deficiencies on their contract and what they’re actually performing so we believe that they’re in non- compliance with both of those aspects.

Brad Douglas said unless someone corrects me, I believe that is accurate.

Commissioner Schaljo-Hernandez said ok, and then which portion of that triggers the not the money remediation, but the we’re taking over services portion?

Brad Douglas said not meeting response times.

Commissioner Schaljo-Hernandez said for the 3 months or the 6 months?

Brad Douglas said 6 months.

Commissioner Schaljo-Hernandez said 6 months and we have all of that data from the day that they started services in Las Cruces and Dona Ana County to now? We have all that data up to date?

Brad Douglas said I believe that is accurate.

Commissioner Schaljo-Hernandez said ok so then I think the only thing that I just have a question of is in the contract kind of got a presentation on one of the key differences was all that data needs to go forth through a third party data review portion system so that’s my only question is that.

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Interim Fire Chief Heck said that is that First Watch Program, the OCU, the Oversight

Compliance Utility that third party program, it was in the contract that they have to fund, and it’s their program, they’re the ones who went out and got it, they use it in other locations, so this is a program that they’ve been using in other locations that have similar standards that we set forward, we’ve already been exercising this program. It came online in August, we spent two months exercising it, get it right so all the data comes in, what’s our clock start time what’s our clock stop time for those response times, so we went through all that effort for two and a half months to get it where it’s supposed to be and that’s that review that you’re going to be so, that’s the data that’s sitting there, that’s that review that you’re referring to sir, it’s through that company called First Watch. It’s in play, like I said our problem is they’re not exercising it, they’re not utilizing it as the contract said. Even if they did, their average response time percentage right now is like 45% in the city and even at their best, trying to scrub some there’s no way they are going to get another 40% back in my mind. So that’s why I’m very confidant in what Brad’s bringing forward, they haven’t been hitting it at all, they haven’t been hitting those benchmarks at all.

Commissioner Reynolds said there’s one more thing that both boards should know.

That is one of the biggest challenges we’re going to have is transitioning into this service is that having someone to actually do the billing for the transports because it is insurance that gets billed, and right now I don’t believe the county is in a position to start taking over that billing and I’m not sure that the city is either.

Interim Fire Chief Heck said we have a contract with someone for two years now, but I think we’ve been using EMSMC we’ve been using them for the past couple years since we got our CON that was one of the benefits of getting it, since we’ve been transporting so much, since we started tapping into that part. They are poised and ready to help you when you need it, they’d love to get your business.

Commissioner Reynolds said that’s something the County will have to deal with.

Councilor Flores moved to end the joint work session and Commissioner Schaljo-

Hernandez seconded it.

Adjourned at 3:10 p.m.

Mayor

City Clerk

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