NACo DRIVES MESSAGE HOME DURING NATIONAL COMING SOON? SHARING RANSOMEWARE IS INFRASTRUCTURE WEEK THE SIDEWALKS WITH TERRIBLE, AND PG. 4 ROBOTS PG. 6 PREVENTABLE. PG. 9

NATIONAL ASSOCIATION of COUNTIES VOL. 49, NO. 11 MAY 29, 2017 ANALYSIS More fronts Trump budget open in the weighs in at $4.1 trillion war against

President Trump’s FY18 opioids budget released May 23 out- By Charlie Ban lines the administration’s senior staff writer $4.1 trillion spending propos- al, with discretionary spend- Counties are continuing ing levels set at $1.151 trillion to grapple with the widening and mandatory spending scope of the opioid drug epi- levels at $2.943 trillion. The demic. discretionary spending lim- Another county has filed suit its adhere to the budget caps against a pharmaceutical com- set in the Budget Control Act pany that marketed painkillers, (P.L. 112-25). while King County continues The $1.151 trillion in discre- to search for locations for its The Western Interstate Region’s (WIR) executive team, elected May 26, takes center stage in tionary spending includes $54 Deschutes County, Ore., site of the 2017 WIR Annual Conference. Pictured (l-r): Second Vice Presi- safe injection sites. Meanwhile, billion in increased spend- dent Kevin Cann, Mariposa County, Calif. supervisor; First Vice President Tommie Cline Martin, Gila a synthetic drug is raising the ing on national defense, with County, Ariz. supervisor; President Joel Bousman, Sublette County, Wyo. commissioner; and Imme- See LAWSUITS page 3 equal reductions in non-de- diate Past President Gordon Cruickshank, Valley County, Idaho commissioner. Photo by Charlie Ban fense discretionary spending. The budget also includes sev- eral proposed changes that Ryan launches new bipartisan Task would reduce spending on mandatory items. Force on Intergovernmental Affairs See BUDGET page 2 By Zachary George ernments at the federal level Rep. Jenniffer González-Colón 4) Developing proposals to legislative assistant (known as the Big 7) – the Na- (R-P.R.); Rep. partner with and empower tional Governors Association, (D-Mass.); Rep. Raúl Grijalva states, tribes, local govern- Speaker Paul Ryan (R-Wis.) National Association of Coun- (D-Ariz.); Rep. Gerry Connol- ments, private institutions, and Democratic Leader Nan- ties, National League of Cities, ly (D-Va.); Rep. Norma Tor- families and individuals; and cy Pelosi (D-Calif.) have an- U.S. Conference of Mayors, In- res (D-Calif.); Rep. Anthony 5) Examining the extent nounced the creation of the ternational City/County Man- Brown (D-Md.); and Rep. to which the burdens shared bipartisan Task Force on Inter- agement Association, National (D-Fla.). The task among states, tribes and local governmental Affairs. Conference of State Legisla- force is charged with: governments may be re-allo- “The Task Force on Intergov- tures and the Council of State 1) Partnering with states, cated to improve the quality of ernmental Affairs will study Governments – will serve as an tribes and local governments life in all communities. ways to restore the proper advisory council. to balance the interests of gov- The announcement came balance of power between the Six Republicans and six ernments on the heels of Infrastructure federal government and states, Democrats will serve on the 2) Providing a forum for Week, during which state tribal and local governments, task force chaired by Rep. Rob states, cities, and counties to and local leaders met with and eliminate unnecessary Bishop (R-Utah). Members showcase their innovation and congressional lawmakers to regulatory burdens facing are: Rep. Gary Palmer (R-Ala.); creativity in solving public pol- highlight the importance of communities across the na- Rep. (R-Ind.); icy problems a strong federal-state-local tion,” Ryan said. Rep. Mark Walker (R-N.C.); 3) Examining the effects of partnership in addressing The seven organizations that Rep. John Culberson (R-Tex- federal rules and regulations the nation’s infrastructure represent state and local gov- as); Rep. (R-N.Y.); on state and local partners. needs. 2 MAY 29, 2017 NATIONAL ASSOCIATION of COUNTIES COUNTY NEWS Trump budget proposes realignment of federal spending From BUDGET page 1 Protection Agency (30 per- economic growth on the bud- chance Congress will pass it cent); Department of Agricul- get, claiming it will both offset without significant revisions. Among the most significant ture (21 percent); the Depart- America’s counties lower tax rates and help pay Each year, the president cuts made under the budget ment of Labor (20 percent); are concerned down the deficit. submits a budget proposal proposal is a major revision Department of Commerce that this proposed Governmental responsibil- to Congress, which begins of the Medicaid program that (15 percent); Department of ities are shared among fed- the annual appropriations would institute block grants Transportation (17 percent); budget largely eral, state and local partners, process. Upon receiving this or a per-capita cap on fed- and the Department of Hous- abdicates the as they are the fundamental request, the House and Sen- eral Medicaid expenditures. ing and Urban Development federal role in the components of a broader na- ate Budget Committees are This proposal would reduce (12 percent cut). tional interest in serving the charged with developing and the federal government’s federal-state-local country’s citizens. The na- reporting a budget resolu- contribution to the program County programs intergovernmental tion’s 3,069 counties play a key tion to set the total amount of by roughly $600 billion over would be hit partnership that role in administering federal money congressional Appro- the next decade. The House’s Certain programs on which programs and services with- priations Committees may AHCA bill would also cut counties and their residents is essential to in their local communities, spend during the fiscal year. Medicaid by another $800 bil- rely would also be reduced or addressing the including building and main- The committees must then lion. eliminated. The Communi- nation’s most taining public infrastructure, complete 12 individual ap- Other reductions include ty Development Block Grant providing law enforcement propriations measures to al- major cuts to several federal (CDBG), which helps coun- pressing and public safety services and locate money to each federal agencies: the Environmental ties improve economic devel- challenges. protecting the public’s health agency and program, which, opment and small business and well-being. While the if passed, are signed by the growth, would be eliminated. policies and programs estab- president and enacted into Likewise, the HOME In- Security (7 percent) and the lished by the federal govern- law. vestment Program, which Department of Veterans Af- ment are intended to guide However, in recent years, as helps low-income individu- fairs (6 percent). and coordinate efforts, coun- battles over federal spending als obtain housing, would be The administration touts ties often are the implement- have intensified, Congress eliminated. Also eliminated the proposal as one that will ers, and even co-regulators, at has been unable to enact are USDA grants to expand reduce deficits and lead to a the local level. stand-alone appropriations broadband access to rural ar- balanced federal budget, pro- America’s counties are bills through the regular ap- eas, the TIGER transportation jecting a small budget surplus concerned that this pro- propriations process, instead grant program, and programs by 2027. The White House posed budget largely abdi- relying on omnibus measures, to provide heating and ener- banks on significant econom- cates the federal role in the which combine all 12 bills, or gy assistance to low-income ic growth generated by sever- federal-state-local intergov- continuing resolutions that SNAP STATS families. al policy changes in the bud- ernmental partnership that fund the government at pri- TOP PUBLIC Other programs that are get proposal, including the is essential to addressing or-year levels. It remains to be LIBRARIES priorities for counties would suggested reductions in dis- the nation’s most pressing seen if Congress will be forced be reduced, including a $68 cretionary federal spending. challenges. The scale of the to take the same approach Los Angeles County million cut to the Payments in In calculating the econom- proposed discretionary and this year, or if they will suc- King County, Wash. Lieu of Taxes (PILT) program ic growth and revenue pro- mandatory cuts would far ceed in returning to “regular Hamilton County, Ohio and reductions in multiple jections, the White House outpace the ability of state order” and passing each ap- Maricopa County, Ariz. programs that provide grants assumes comprehensive tax and local governments to propriations bill individually. Cuyahoga County, Ohio for local law enforcement. reform will be completed, backfill this funding and sup- NACo will continue to work The two largest drivers of the and port local needs, which could closely with appropriations

Source: American Library Association; America’s debt, Medicare and its accompanying taxes and force state and local govern- leaders in both the House 2014 rankings based on size of population Social Security, are left largely regulations will be repealed, ments to either raise taxes at and Senate to ensure that the served, size of library collection, circulation and number of visits to library. untouched in the budget re- and Congress and the admin- an unprecedented level or needs and interests of coun- quest. istration will continue to roll simply turn their backs on ties are reflected in the final A few agencies would see back many other regulations those who truly require pub- FY 2018 appropriations mea- funding increases in FY18 from the Obama Administra- lic assistance. That said, the sures, and we will continue Profiles in Service under the president’s budget tion. However, critics have president’s annual budget is driving home the importance will resume in the request: the Department of pointed out that the admin- largely a statement of princi- of the federal-state-local part- June 12 issue. Defense (8 percent increase), istration’s budget appears to ples and an offering of ideas, nership in serving our local the Department of Homeland “double count” the impact of and there is effectively no communities.

President Executive Editor ADVERTISING STAFF Published biweekly except August by: The appearance of paid advertisements in County POSTMASTER: send address changes to Bryan Desloge Beverly Anne Job Market/Classifieds National Association of Counties News in no way implies support or endorsement County News, 660 N. Capitol Street, N.W. Schlotterbeck by the National Association of Counties for any of Publisher representative Research Foundation, Inc. STE. 400, Washington, D.C. 20001 Matthew Chase Senior Staff Writer 660 N. Capitol Street, N.W. STE. 400, the products, services or messages advertised. National Accounts (USPS 704-620) n (ISSN: 0744-9798) Charlie Ban Washington, D.C. 20001 Periodicals postage paid at Washington D.C. and Public Affairs © National Association of Counties representative 202.393.6226 | FAX 866.752.1573 other offices. Director Senior Staff Writer Research Foundation, Inc. Brian Namey Mary Ann Barton Beverly Schlotterbeck E-mail [email protected] Mail subscriptions are $100 per year for non-mem- (202) 393-6226 bers. $60 per year for non-members purchasing Design Director Online address www.countynews.org Leon Lawrence III FAX (866) 752-1573 multiple copies. Educational institution rate, $50 per year. Member county supplemental subscrip- tions are $20 each. Send payment with order and address changes to NACo, 660 N. Capitol Street, We are commited to getting County News on your desktop ASAP. Send your address corrections to [email protected]. N.W. STE. 400, Washington, D.C. 20001. COUNTY NEWS NATIONAL ASSOCIATION of COUNTIES MAY 29, 2017 3

Orange County, N.Y. latest to file suit BEHIND SOUTHAMPTON COUNTY, VA. THE From LAWSUITS page 1 that could be deadly in small Introduced in: 2000 amounts. SEAL Created by: Michael Long stakes for users and first re- CN UPDATE In mid-May, the county sponders. California’s Santa Clara northeast of Cincinnati was Orange County, N.Y. became and Orange counties confirmed to be a home of he Southampton the latest to take drug compa- “Gray Death,” named for its County seal identifies announced a settlement nies to task for misrepresent- resemblance to cement. It’s a the date of the found- May 24 in a lawsuit T ing the safety and efficacy of combination of heroin, fentan- ing of the county — 1749. long-term use of opioid pain- against Cephalon and yl and carfentanil, each more On the eastern edge of killers. Sitting on the New Jer- Teva over alleged decep- potent than the last, and it has Virginia’s border with North sey border, it’s the fourth New tive marketing practices been detected in overdose Carolina, along with several York county to pursue compen- for their opioid painkill- deaths in Ohio, Georgia, Flori- other counties, Southamp- satory and punitive damages ers. The settlement will da and . ton County is contiguous from drug companies, this time provide $1.6 million for “This is very new,” said War- with the independent city Purdue Pharma, Teva Pharma- substance abuse treat- ren County Chief Deputy Bar- of Suffolk. Southampton ceutical, Cephalon, Johnson & ry Reilly. “It’s even more of a County was settled soon The corn, peanuts, cotton and ment and education in pine trees draw attention to the Johnson and Endo Health Solu- threat because it’s so potent, after the establishment county’s agricultural heritage. tions. Suffolk, Broome and Erie the two counties. and it can be absorbed through of Jamestown in 1607. counties have also filed similar the skin or inhaled, so it’s a haz- Most of Southampton The rising sun is symbolic of suits. Duchin is a member of the ard to a first responder answer- County was originally part prosperity and the seven stars “As a county, we are working King County Heroin and Opi- ing a call or someone who finds of Warrosquyoake Shire, represent the seven political with nonprofits and physicians oid Task Force, which recently a family member who has over- was renamed Isle of Wight districts. to bring heightened awareness had several recommendations dosed on it. They touch them County in 1637, and later to the issue, “ County Executive to lower barriers to opioid ad- and get it on their skin or inhale was partitioned from Isle The farm implements are symbolic of the citizens’ strong Steven Neuhaus said when an- diction treatment and health it if they kick it up into the air.” of Wight County to form work ethic. nouncing the suit May 11. “At service operation included in a Still, despite the danger, Southampton. the same time, we want those bill signed by Gov. Jay Inslee. Reilly said the Warren County responsible to compensate for Although there has been Sheriff’s Office has no plans to Would you like to see your county’s seal featured? Contact Charlie the public funds the county has some pushback, including from change its standard procedures Ban at [email protected]. had to pay to address opioid ad- a state senator who represents out of fear. diction.” part of King County and spon- “We’re not going to not stop In 2015, 44 Orange Coun- sored a bill in his chamber out- cars and we’re not going to not CN SPOTLIGHT ty residents died from opioid lawing the CHELs, Duchin said make arrests,” he said. “If it’s a overdoses, and the 943 opi- the biggest impediment has situation where we can plan oid-related hospital admissions been the process of finding the ahead and wear gloves and in 2014 was a 17.5 percent in- best location. respirators, we’ll do that. Oth- crease over 2010. “We’re looking for a place erwise, everyone is equipped Outside of New York, three with a lot of need for what we with naloxone, so if someone is counties in West Virginia and offer,” he said. “Somewhere having trouble, we administer one in Illinois have pursued ac- where there is a concentrated that.” tion against drug companies. population of users who are in- Clay Hammac, drug task jecting in public and could ben- force commander for the Shel- A place to go efit from the linkages to health by County, Ala. Sheriff’s Office, In February, King County, services we could offer.” said education was crucial to Wash. moved ahead to estab- The county is looking for the turning people away from in- lish two Community Health En- greatest impact location, where creasingly potent drug cock- gagement Locations (CHEL), it could reach as many addicts tails. where addicts could take their as possible. “This isn’t going to give you drugs under supervision of “It would be premature to a casual relaxing high,” he said. medical staff, exchange used engage with any community “If you ingest Gray Death, it needles for sterile ones and at this point since we’re so far will kill you. Regardless of how access addiction recovery pro- away from finalizing a site,” matter of fact we are about this, gramming. Duchin said. folks are flocking to it.” One CHEL was planned for But that could change quick- Fentanyl’s lethal dose is the Seattle and one for the rest of ly, he said, once they identify a size of two grains of table salt, the county, but so far, site selec- site. while carfentanil’s dose is the tion has held up the process. size of one grain of salt. “We’re being pretty open- Gray Death “We have to make the pub- EPA POLICY IN DISCUSSION minded about where we place In January, police intelli- lic aware that these are street Hamilton County, Ohio Commissioner Todd Portune testifies the first one,” said King Coun- gence reports told the Warren level dealers, not pharmacists. before a House subcommittee May 19 to discuss the EPA’s ty Health Officer Jeff Duchin. County, Ohio Sheriff’s Office They’re not interested in the integrated planning policy and counties’ clean water responsi- “We’d love to open two simul- that there was a new opioid health and safety of the public, bilities. Photo by Hugh Clark taneously, but finding suitable drug on the market, a combi- they’re mixing this stuff up in sites makes that unlikely.” nation of three potent varieties their kitchen sinks.” 4 MAY 29, 2017 NATIONAL ASSOCIATION of COUNTIES COUNTY NEWS NACo drives home message during Infrastructure Week With the Trump administra- vestment to the doorstep of key Conference of Mayors (USCM) tions (The National League of County, Minn. Commissioner tion and Congress promising policymakers. and the National League of Cit- Cities (NLC); the U.S. Confer- Jim McDonough detailed coun- a new infrastructure package, NACo members focused their ies (NLC), NACo hosted “Built ence of Mayors (USCM); the ty priorities and the need for over 30 county leaders from advocacy efforts on preserving to Last: A discussion on the im- National Governors Association direct funding should an infra- across the country arrived in the tax-free status of municipal portance of local infrastructure (NGA); the National Conference structure package be introduced Washington last week to outline bonds, dedicated funding for lo- investment.” Commissioner of State Legislatures (NCSL); the by Congress this year. (See story how the federal government can cal infrastructure projects, proj- Bill Holen of Arapahoe Coun- Council of State Governments below) Following the briefing, help support local infrastruc- ect and regulatory streamlining, ty, Colo. represented NACo at a (CSG); and the International the entire NACo Infrastruc- ture goals. As with past Infra- continued investment in water live-streamed event moderated City/County Management As- ture Week delegation joined structure Week activities, NACo and wastewater infrastructure by Eno Center for Transporta- sociation (ICMA)), held a brief- the House Oversight and Gov- hosted events on and off Capitol and expanding broadband de- tion CEO Robert Puentes. ing on the future of infrastruc- ernment Reform Committee Hill for county leaders to carry velopment. Later that day on Capitol Hill, ture policy. Joined by Sen. Amy Subcommittee on Intergovern- the message for increased and Kicking things off in con- NACo, along with the other “Big Klobuchar (D-Minn.) and Rep. reliable local infrastructure in- junction with the United States 7” local government associa- (R-Mo.), Ramsey See IFW page 5 Local leaders warn Congress, one size doesn’t fit all in infrastructure spending By Charlie Ban wants to see in his package. be sustainable, particularly in perfect model for all communi- to feed the Highway Trust Fund, senior staff writer “We’re looking at an additional rural areas that counties govern. ties. It doesn’t work in smaller, particularly as increased fuel $200 billion in general revenue, “NACo endorses a user-pay impoverished or rural areas.” efficiency is depressing gas tax President Trump caught the and P3s will be a big part of that.” approach, and public private Whatever the method, Mc- revenue to the point where it’s attention of public works de- Graves is chairman of the partnerships are a key piece of Donough hammered home that become regressive. partments soon after he was House Subcommittee on High- that, but it’s not one-size-fits all,” losing the tax-exempt status of “We have vehicles on the elected, stressing the need for ways and Transit. The admin- he said. “There are large parts of municipal bonds would ren- road that simply aren’t made an investment in infrastructure istration’s plan is due out by our country where that will not der much of any new funding for the gas tax; we have to move during his victory speech in No- mid-June, and the House aims to w o r k .” moot, because the increased to a different mechanism,” he vember. tackle it in September or October, Cleveland, Ohio Councilman cost of borrowing money would said. “It could be vehicle miles “We’re dealing with very little after the summer recess, and, he Matt Zone added to that senti- reduce the number of projects traveled, it could be raising the detail at this point, but P3s (pub- said, after addressing tax reform. ment. governments could perform. gas tax. It could be a hybrid. If lic-private partnerships) are P3s could figure prominently “Over the last two decades, 93 The tax-exempt status of mu- we do replace the gas tax, it will going to be a big part of it,” Rep. in the $1 trillion proposal Pres- percent of all projects that were nicipal bonds has had a target be a replacement, it won’t be Sam Graves (R-Mo.) said at a ident Trump has promised, but done with tax-exempt municipal on it since 2012 and is consid- another layer on top of the ex- Capitol Hill Infrastructure Week Ramsey County, Minn. Com- bonds would not have been eligi- ered an option in tax reform isting tax.” briefing May 17. “It’s absolutely missioner Jim McDonough ble under the P3 model,” he said. discussions. Sen. Amy Klobuchar going to be a big part of it, be- pointed out that the tolls neces- “One of the things that concerns “You can’t provide us with (D-Minn.) said that last year’s cause that’s what the president sary for P3s’ viability wouldn’t me is that it’s not going to be the tools on one side and take away FAST Act surface transportation tools from the other side,” Mc- funding bill created a strong BROADBAND: A LINK TO THE FUTURE Donough said. “We need the foundation from which Con- federal government to be a gress could approach further Infrastructure means more on super-high-speed internet.” signing exclusive agreements partner with us.” infrastructure spending, and than just roads and bridges, Mesa, Ariz. Vice Mayor David with service providers that can Oklahoma City Mayor Mick reduced the pent-up pressure and Montgomery County, Md., Luna shared that sentiment. often leave secondary providers Cornett did his part to make built over years of extensions. Council Vice President Hans “It’s essential for business looking at a $50,000 renovation sure Trump knew that methods “It gave a steady argument to Reimer demonstrated that his attraction,” he said. “If we as to install. were just as important as mon- state legislatures and govern- county is taking that seriously. He communities want to bring “That doesn’t work in anyone’s ey when they met at the White ments across the country that participated in a panel discus- industry, business leaders, large interest,” Reimer said. “Tele- House over the winter. we did our part and they should sion May 18, The Importance companies into our community, phone attachments are also an “I told him how important it do theirs,” she said. “I think it of Building Broadband in Smart we have to have the infrastruc- issue (for spreading broadband was that we maintain the tax- was a good move. We aren’t Communities, held at the NACo/ ture in place to attract them, so infrastructure). The fact that free status of municipal bonds,” struggling to make some deal to NLC Joint Conference Center. broadband is important to doing it’s so expensive to get on the Cornett said during a Capitol just make up for something that “Broadband is essential. To me, that.” telephone poles, makes it one Hill Infrastructure Week brief- we hadn’t paid for yet. We have it’s like our responsibility for wa- Even in a large metropolitan of the single biggest barriers ing. “He assured me it was in his the base money done and that ter, for roads and power,” he said. county like Montgomery, there to competition in broadband plan, but since I haven’t heard gives us an exciting opportunity “It’s essential infrastructure, are barriers that remain to delivery in our community. that said since, I would love to at a time when we shouldn’t be and to me it’s essential because more thorough and competitive “The notion that we would rent hear some reassurance from governing by crisis.” it’s the gateway to opportunity internet wiring. The county is out our poles for $50 a pop, I the White House that they still Graves expects repatriation to everything that’s happening considering a broadband-ready couldn’t abide by that. There’s a feel that strongly.” of overseas assets to play a part out there, all the benefits of building code, which will prevent lot more value in our right-of-way Graves said “everything is on in infrastructure funding. Klo- technology and innovation rely real estate developers from than that.” the table” in terms of figuring buchar prefers a longer-term out a new funding mechanism solution. COUNTY NEWS NATIONAL ASSOCIATION of COUNTIES MAY 29, 2017 5 Broadband need spotlighted Annual Conference to From IFW page 4 ies hosted a program, The Im- feature Opioid Townhall portance of Building Broadband mental Affairs Chairman Gary in highlighting the importance Palmer (R-Ala.) for “Red Tape of broadband infrastructure in and Solutions Exhibit Roundtable: Infrastructure.” communities across the nation. At NACo’s 2017 Annual Con- ceutical practices and sophis- With prepared remarks from Jean Rice of the National ference in Franklin County, ticated trafficking operations. CAPITAL Commissioner McDonough Telecommunications and Infor- Ohio, county leaders will come Earlier this year, at NACo’s and Madison County, N.Y. Su- mation Administration (NTIA) together to assess the suc- 2017 Legislative Conference, pervisor John Becker, NACo moderated the discussion with cesses and challenges of the a townhall session brought LOOP participants engaged Chairman leaders from local government, ongoing local response to the together perspectives from Palmer in a robust discussion the telecommunications indus- opioid epidemic. This special around the country, highlight- Ryan announces new about solutions to the regulato- try and academia on what lo- session will feature an expert ing successes —like the broad bipartisan task force ry hurdles that some claim in- cal communities can do when panel discussion, including availability and successful ad- on intergovernmental crease costs and delay the com- investing in infrastructure townhall-style input from at- ministration of the overdose affairs pletion of local infrastructure. improvements in the years to tendees, as well as an exhibi- antidote Naloxone — and Speaker Paul Ryan (R-Wis.) To cap the week off, NACo come. (See “Broadband: A Link tion of solutions available to challenges such as facilitating and Democratic Leader Nan- and the National League of Cit- to the Future,” page 4.) counties struggling to contain a sustainable recovery for in- cy Pelosi (D-Calif.) announced rates of opioid-related over- dividuals saved by Naloxone. the creation of the bipartisan doses in their communities. These timely conversations Task Force on Intergovern- SOUTHAMPTON The session is set for Sunday, will continue at NACo’s An- mental Affairs to address the COUNTY, VA. July 23, at 4 p.m. nual Conference in Franklin needs and interests of federal, LEARN MORE ABOUT THIS FEATURED In recent months, NACo has County, and will be supple- state and local governments. WORD COUNTY IN ‘BEHIND THE SEAL’ placed a heavy focus on this mented with an exhibition of SEARCH Created by: Mary Ann Barton issue, frequently convening effective and innovative solu- experts and leaders to explore tions being used by counties NACo, NLC decry Z X J S L X A W X G E K O Q Z B Q P A O the roots of the opioid epi- to decrease rates of opioid de- proposed cuts to E X L O R F S E P M C R C Z U J E T A D demic and how counties can pendence, overdose and fatal- White House drug E S U O H E C N I R P E L L E H C O R K work to stem its tide. ities in local communities. czar office A O Q J S N V V Y O F R P M Q R F E F J At NACo’s 2016 Annual Con- In a letter to President I G J Z L H B I K T O V L Z E J D T I M ference in Long Beach, Ca- NACo members are encour- Trump, NACo and the Nation- M O S F A B B R R T U S Q R H S Y C R M lif., Sam Quinones, author of aged to propose items or ini- al League of Cities City-County E Y Q C B G V J O R Z N G V C E R O N E the critically acclaimed book tiatives to be exhibited during Task Force on the Opioid Epi- R E N R U T T A N W E G B O L S R U U K Dreamland, traced the roots this session, and can do so demic argued for the strength- E L D S O B D H G Z N T T I X H X R Y A of the opioid crisis to faulty by contacting Hadi Sedigh at ening of the White House Of- O N J Z D H U H K Y T T A K P I D T T O science, overzealous pharma- [email protected]. fice of National Drug Control E L R A N C H E R O A B I W M R N L R Y Policy, not budget cuts. N J D L A O F T I D L W G P K E B A E U New NACo Q A K R L R Y Y I R Z E O E V C A N G Q Member Q B Y Y G Q B G A K Y D N T F G A D Q S NACo makes R Z W J N G S E H F X O A W T A Z L M O recommendations N A E E E M P O E P H G G F N O P C B R GET TO to EPA on regulatory G C A D W X M G L A B Z F Z A Y N F S R KNOW... reform efforts G R L O S H D B M A L P C U N S Z W L A As part of a regulatory review L T S N H C J M Q K R L O B T A I J A W Midland process initiated by executive T H O M A S Q L Q U Y T Z D D A A U A R County, order, NACo and other local Mich. government groups provided PEARL BAILEY Singer and actress dants still live in the county. comments on how to provide from the county. ROCHELLE-PRINCE HOUSE Built greater flexibility within sev- BLACKWATER RIVER The county in the early 1800s by the Rochelle eral key EPA programs and boundary to the east. family; James Rochelle was the clerk guidelines including the 2015 JOHN BROWN Fugitive slave from of the county court during the trial of Welcome, Midland County, Mich. the county. Nat Turner. Midland County houses the headquarters of the Dow “Waters of the U.S.” rule, poli- COURTLAND The county seat. DRED SCOTT Namesake of landmark Chemical Company, one of the world’s top multinational cies relating to stormwater and Supreme Court decision. Briefly lived EARL County may have been named wastewater and the 2015 ozone in the county, which became the chemical corporations. The Dow family still resides in the for Henry Wriothesley, Third Earl of rule. partial setting for Harriet Beecher county, running several foundations there to support the arts: Southampton. Stowe’s Dred. Dow Gardens, the Alden B. EL RANCHERO #1 ranked restau- SOLAR Largest solar farm in Virginia is rant in the county on Yelp. Dow Home and Studio being built in the county. NACo wraps up ENGLAND County may have been and Dow Diamond, THOMAS Birthplace of Union General Infrastructure Week named for Southampton, England. home of the minor- George Henry Thomas. On and off Capitol Hill, MAHONE Confederate Gen. William league baseball NAT TURNER Slave lay minister who NACo members in Washing- Mahone was a native son; later led violent uprising on Aug. 21, 1831. team, the Great elected to U.S. Senate ton for Infrastructure Week WARROSQUYOAKE Most of the county Lakes Loons. brought the county perspec- NOTTOWAY Tribe of Native Ameri- was originally part of this “shire” in the cans, along with the Meherrin tribe, tive on the issue to lawmakers 1600s. that settled in the area. Descen- and the administration. 6 MAY 29, 2017 NATIONAL ASSOCIATION of COUNTIES COUNTY NEWS

Is a delivery robot coming to a sidewalk near you?

A Starship Technologies delivery robot roams a sidewalk. Photo courtesy of Starship Technologies

By Mary Ann Barton possibility of delivery drivers consider Yee’s proposal in June. Idaho giving their OK for robot mode,” said Pat Carroll, state senior staff writer losing their jobs and people “We met with different stake- deliveries, Wisconsin lawmak- liaison for Arlington County, with tech skills possibly gaining holders and concluded that the ers recently passed legislation Va., which counts several ur- Although flying drones have jobs. best way to protect our public that awaits Gov. Scott Walker’s ban corridors that could be grabbed most of the headlines Schakowsky said she was also right-of-way is to prohibit the signature, and two Florida law- seen as ripe for robot deliver- as the delivery service of the concerned about safety, noting use of these automated delivery makers are also exploring leg- ies. future, robots about the size that one of her staffers was re- robots,” Yee said in a statement. islation looking at regulating Carroll said that the county of a beer cooler are beginning cently startled by a delivery ro- “Our public spaces should not ’bots as well. Board members would like to to roam sidewalks and cross bot on the sidewalk, while walk- be commercialized.” In Wisconsin, the legislation arrange a demonstration of streets in some urban areas, de- ing in Washington, D.C., where Yee said he is concerned that passed allows robots to op- any robot delivery service be- livering everything from take- a robot delivery pilot program is about safety, especially for se- erate on sidewalks and cross- fore making any further deci- out tacos to office supplies to underway. niors, children and disabled walks, sets an 80-pound limit sions to tighten restrictions or bouquets of flowers. Most of the The robots typically are be- people who might not be able on robots and a 10 MPH speed ban them. deliveries are in test mode. ing managed remotely and are to get out of a robot’s way. limit. A spokeswoman for the “I heard one of the robots in Some state and local law- equipped with sensors, camer- Companies say the robots have Wisconsin Counties Association D.C. got surrounded by a big makers are exploring how to as and two-way audio. Custom- built-in sensors and would said the group has not heard crowd on the sidewalk,” she regulate these “last mile” de- ers usually gain access to their stop. from its members on the issue. said with a chuckle, referring livery robots on their sidewalks delivered goods using a code Privacy issues — the robots In Virginia, delivery robots to the pilot program in the and streets, as companies reach texted to them that unlocks a are loaded with cameras — the will be legal starting July 1. nation’s capital that began in out to test the concept. Federal compartment on the robot. potential for people to lose de- Under the new law in Vir- February. lawmakers are also interest- livery jobs and the possibility ginia, robots won’t be allowed Delivery robots will also ed in hearing more about how Robot ban in San for a robot to be loaded with to go any faster than 10 MPH become legal July 1 in Idaho. this new delivery service might Francisco? explosives were also concerns or weigh more than 50 pounds Like Virginia, Idaho’s coun- impact their communities. On A ban on robots proposed Yee has mentioned. and must stay in crosswalks ty officials will also be able to May 23, the House Subcommit- earlier this month by Super- Dan Rogan, an attorney for when navigating streets. further regulate or outright tee on Digital Commerce and visor Norman Yee of the City the Hennepin County Board of Local governments may ban robots if they choose. De- Consumer Protection held a and County of San Francisco Commissioners, said he fore- further regulate how robots livery robots can weigh up to hearing on Capitol Hill dubbed is in stark contrast to the open- sees regulation of robot deliver- operate in their jurisdictions 80 pounds in Idaho. “Disruptor Series: Delivering to armed welcome by Virginia ies mainly in urban areas. if they want stricter measures, Rural counties, take note: Consumers,” looking at regula- and Idaho state lawmakers, “I think it would most like- such as slower speed limits, Although most delivery robots tory challenges that exist at the who have passed legislation, ly be a city thing, not a county timeframe restrictions or an are geared to urban areas, a federal, state and local level to initiated by robot manufactur- thing,” he said. “…the Legisla- outright ban. Swiss company called Telere- deploy the new service. er Starship Technologies, al- ture could weigh in as well. tail AG, according to Tech- “There are potential winners lowing the robot deliveries. County hoping Crunch.com, has developed a and losers,” said Rep. Jan Scha- Members of the San Fran- Saying ‘yes’ to robots for robot demo robot to cover longer distanc- kowsky (D-Ill.), referring to the cisco Board of Supervisors will In addition to Virginia and “We are in a ‘wait and see’ es of up to 50 miles. COUNTY NEWS NATIONAL ASSOCIATION of COUNTIES MAY 29, 2017 7 Foster Grandparents Program matches senior volunteers with at-risk children By Mary Ann Barton One of the most ious county departments on Younger volunteers How to find great senior staff writer challenging aspects aging or volunteers, state offic- Betley said that since she’s volunteers One of the misconceptions es or sometimes involvement been managing the program in “Our most successful recruit- In Alachua County, Fla., Ka- of the program, Gehr-Deckert by groups such as United Way, Kalamazoo County, she’s seen ment efforts come by word of lamazoo County, Mich., and said, is that people think the vol- Catholic Charities or Goodwill younger and younger volun- mouth from our current vol- Sauk County, Wis., and dozens unteers are older foster parents Community Services. teers, due to the economy. “It unteers who serve as program of other counties across the who open their homes to chil- used to be mostly people age ambassadors,” Fleming said. country, “family” for a foster dren. Alachua program 65 to 80 volunteering,” she said. The county also participates in care child may include a senior “One of the most challeng- started in the ‘70s “Now with our economic cli- community outreach events citizen who volunteers for the ing aspects of working with the In Alachua County, Fla., the mate, we see 55-year-olds who and gets plenty of local media Foster Grandparents Program. Foster Grandparents Program is program has been sponsored by still need a job.” coverage. Currently, the pro- Directors of the program say the confusion with foster care,” the Board of County Commis- The stipend and transporta- gram has a complement of 80– it’s a “win-win-win” for volun- said Gehr-Deckert. “The word sioners since 1973, with a total tion reimbursement are tax-free 90 volunteers. teers, children and communi- ‘foster’ means ‘to promote the annual budget today of $507,183, and most receive a meal from The program is popular, with ties, and they are getting the growth or development of.’ Fos- which is funded by the federal the school where they voluntee most volunteers sticking with it word out about it during May’s ter care most frequently means Corporation for National and “It’s about $212 a week,” she for five years, she said. One vol- National Foster Care Month. that for a period of time, a child Community Service ($374,620) said. With the extra money, unteer has been in the program Part of Senior Corps, and lives and is cared for by adults and the county ($108,563), said they can “buy healthier food or for 26 years and some volun- its umbrella organization, the who are not their biological par- Samantha Fleming, program cover their prescriptions.” Her teers are in their 90s. Alachua Corporation for National and ents. coordinator. Local partners also average volunteer has an annu- County provides a mandatory Community Service, the pro- “On the other hand, Foster kick in in-kind contributions of al income of $9,000 and lives in 40-hour pre-service training gram involves 25,000 volun- Grandparents do not care for $24,000. About half the budget is subsidized housing. program. “Ultimately, volun- teers, age 55 and older, who children in their homes,” she used to pay volunteers’ stipends Fleming said the most chal- teers must be patient and com- serve as role models, tutors said. “Foster Grandparents vol- and other benefits such as travel lenging part of the program is passionate with a true desire and mentors to foster children unteer at approved sites.” reimbursement and recognition “finding volunteers that are a to see children succeed,” said and other at-risk children in Another challenge is funding programs. good fit.” Fleming. the Foster Grandparents Pro- and management; while the In Alachua County, the pro- Vetting is very strict for those In Kalamazoo County, Betley gram. They meet at schools, programs receive federal funds gram mainly focuses on chil- who wish to volunteer in the said she has a volunteer who is Head Start centers and other they are usually coupled with dren ages 2–6 years old. There program, Gehr-Deckert said. almost 90 years old and volun- youth facilities, where volun- local funding from the state, is almost always a waiting list, Every volunteer has three teers 40 hours a week. When teers help with reading, tutor- the county or other organiza- Fleming said. Typically, teach- background checks: National the program starts to run low ing and just being a friend. tions. Across the country, local ers identify at least two children Sex Offender Public Registry, on volunteers, they visit areas “Volunteers really enjoy programs are run in a variety per classroom who could bene- Department of Justice and FBI helping out in the communi- of ways, with help from var- fit from one-on-one help. fingerprinting. See SENIORS page 9 ty, and some say it’s a reason to get up in the morning,” said Cindy Gehr-Deckert, who runs the program for the Southwest- ern Wisconsin Community Ac- tion Program in eight counties: Crawford, Grant, Green, Iowa, Lafayette, Richland, Sauk and Vernon. The program has seen success in several of those counties going back 40 years. “When students do bet- ter in school, the community benefits,” Gehr-Deckert said. “Many educators find having an intergenerational volunteer enhances the classroom envi- ronment and offers increased opportunities for one-on-one.” Karen Betley, who manag- es the program in Kalamazoo County, Mich., agrees. “If you can turn around one child, that is a huge difference to the com- munity — and to the child,” she said. A Foster Grandparents Program volunteer tutors a student. Photo courtesy of Corporation for National and Community Service 8 MAY 29, 2017 NATIONAL ASSOCIATION of COUNTIES COUNTY NEWS SPECIAL TO COUNTY NEWS RegionSmart Summit in Tennessee explores importance of regional collaboration

By David E. McKinney

As counties, we are largely defined by political and geo- graphical boundaries, yet the challenges that we face are rarely confined to these pa- rameters. The robust econom- ic development and transit system of a neighboring coun- ty or metropolitan area can yield positive dividends and opportunities for surrounding counties. Conversely, an opioid ep- idemic, increased criminal activity, and poor health indi- cators in one county will yield consequences for others. Regional collaboration is an essential tool in the growth and development of one’s own community. In 2013, with this guiding principle, a cohort of county and municipal may- ors, including NACo Board of Directors member and Shel- by County, Tenn. Mayor Mark Luttrell founded the Mid- South Mayors’ Council. “In the first year of Region- Shelby County Mayor Mark Luttrell, Michael Randle, Christopher Masingill and Mayor Jeff Huffman take a camera break at the Region- Smart, we were attempting to Smart Summit held April 27 in Memphis, Tenn. Photo courtesy of Shelby County do something bold and frank- ly unprecedented,” said Mayor ufacturing in the South and for people to fall in love with same boundary constraints of existing services and become Luttrell. retrofitting suburbia. their community. “When pets, generations past. As govern- absolutely critical as we look “While our individual coun- Former Charleston, S.C. plants — even objects — are ment and community lead- to enhancing those services in ties and municipalities have Mayor Joseph Riley served as loved, they thrive,” Kageyama ers, we should strive to gain a the future. enjoyed some success over the keynote speaker. Drawing on said. “So too with cities. We more comprehensive under- Regional entities are ideal past several years, we could his experience as a 10-term can argue about the degree, standing and sense of aware- vehicles for discussing, de- be missing transformative op- incumbent, who recently left but I think people realize there ness of those efforts impacting bating, and strategically ad- portunities if we don’t begin office in 2016, he shared sev- is at least some value to that. the region. Our effectiveness dressing area-wide solutions. to critically think, plan, and eral illustrations and narra- Yes, things have a cost, but is severely curtailed if we op- County leadership is better behave as one Mid-South re- tives related to buildings and they also have a value beyond erate in silos. As county mayor, than any other government gion.” structures that had been saved the purely financial. I’m trying in large part, your success will actor to create regional-fo- At the Second RegionSmart during his 39-year tenure. to get people to recognize and depend on your ability to work cused leadership efforts be- Summit, on April 27, more Riley detailed his city’s deci- be able to discuss that value.” with thc city mayors.” cause we are best poised to than 300 community leaders, sion to buy housing slated for At the end of RegionSmart, As county budgets are tight- account for the local cultural, government officials, and citi- demolition, instead renovat- over a dozen mayors gathered ened and projects delayed, political, and economic fac- zens from a three-state region ing them as affordable hous- on stage to issue a call to action collaborating and coordinat- tors that make each of our gathered in Shelby County, to es. “It’s the public realm,” he in support of new and distinct ing resources and services be- communities unique. It’s a develop tangible strategies and said of his policies. “It creates regional efforts. Jeff Huffman, come increasingly important. new way of doing business, further explore issues such as a sense of shared citizenship. Tipton County executive, told Benefits ranging from re- but the results can be power- workforce development, trans- It gives our citizens a sense of the group that “Regionalism is gional thought and leaner ful — and the need cannot be portation and land use that im- pride.” not going to go away. We don’t approaches to comprehen- understated. pact the region. Peter Kageyama, author and have a choice …We’ve got a lot sive infrastructure planning For RegionSmart’s second co-founder of the Creative Cit- of work to do.” must be leveraged, but the David E. McKinney is Shelby year, we specifically explored ies Summit, explored the emo- Mayor Luttrell added that results are significant. Long- County director of legislative concepts such as sustainable tional engagement with plac- “Today’s workforce and major term, region-wide planning is affairs and assistant county at- transportation planning, man- es and why it’s a good thing employers are confined to the necessary for us to maintain torney. COUNTY NEWS NATIONAL ASSOCIATION of COUNTIES MAY 29, 2017 9 Retreats foster grandparents Ransomware — Both program From SENIORS page 7 Terrible and Preventable where low-income seniors might gather including com- Alan Shark, PhD ways present and the bad guys modity distribution centers, executive director are constantly perfecting their where they bring a volunteer Public Technology Institute (PTI) craft. Some localities have held or two who can talk to potential off updating their operating volunteers. “We have a captive American companies, coun- systems because of concerns audience there,” said Betley. ties and cities are breathing a that the newer systems were They also put up flyers at laun- sigh of relief that there was min- viewed as being incompatible dromats and distribute paper imum impact from one of the with some major legacy soft- placemats to local fast-casual most wide-spread ransomware ware. restaurants at the beginning of schemes in recent memory. Organizations that have re- the month when Social Securi- WannaCry, as it was dubbed, ceived ransomware threats ty payments are made. infected hundreds of thousands were notified that all files will COOK COUNTY HIT BY Betley said they hold annual of computers in more than 150 become encrypted and will be ‘WANNACRY’ MALWARE ATTACK events to recognize volunteers, countries in mid-May. destroyed unless a payment is which is one of the benefits Ransomware is a type of ma- made —often in Bitcoins — not Computers in Cook County, Ill., were hit May 12 by the “Wan- of the program. “We always licious software that infects a credit cards. This ransomware naCry” malware, a global cyberattack that took computer files in have a theme,” she said. Past computer and restricts users’ threat is also impacting per- at least 150 countries hostage with ransomware. The WannaCry events have included “Volun- access to it until a ransom is sonal PCs — some connected malware was tentatively linked to hackers in North Korea, the teers Make Magic,” a red carpet paid to unlock it. Old versions to public sector information and others reported. with paparazzi and a baseball of Microsoft Windows operat- systems. Most entities wind up “I can confirm that a small number of Cook County systems theme. “The volunteers love it,” ing systems that had not been paying the ransom as it often is were impacted by the WannaCry malware attack last Friday,” she said. “It’s a lot of work, but updated were the ones at risk relatively cheap compared with said Frank Shuftan, a spokesman for Cook County Board we like it too.” for this particular attack. the time and cost of restoring President Toni Preckwinkle. “We initiated our standard security A three-time president of It would be easy to sit back systems. procedures to address the issue.” the Association of Michigan and move on without using But as bad as this threat is, No major county operations in Preckwinkle’s offices were im- Association of Foster Grand- this incident as an important it is highly preventable. Here’s pacted, he said. On Tuesday, the county was working to finish up parents and Senior Campaign, wake-up call. But the continu- what an IT staff can do, and restoring its computer systems that were hit with the malware. Betley said holding retreats is ous threat of ransomware and keep in mind the following is There have been no reports of other U.S. counties being extremely helpful. “We share other forms of malware exists generalized for county as well infected with the malware. best practices and talk to oth- at all times. And while 2015 as personal computers: er people facing similar chal- was a bad year for ransomware ●● Make sure that whatever lenges,” she said. “It’s nice to attacks IBM reports that it in- operating system you have - all meet someone and know you creased 6,000 percent in 2016. recommended updates are cur- importance of being ever so cal government IT executives. have someone to call.” She Most alarming is the fact rent. careful in opening attachments This most recent attack advises that counties consid- that malware enters systems by ●● All data must be backed up. or clicking on links. shows just how vulnerable IT ering starting a program need someone opening an attach- While county IT staff do this re- ●● Encourage staff to quickly systems can be. And with the to plan well, get familiar with ment or link that usually looks ligiously, many mobile and per- come forward when some- notoriety it has caused, Wan- regulations, reach out to other authentic. In the government sonal devices often get missed. thing doesn’t look right or they naCry serves as a reminder counties that have a program sphere, most at risk are usually A good practice is to use offline clicked on something they that cybersecurity is no longer and join the National Associ- small counties and cities — in- (not network connected) exter- realized a moment later they just for IT professionals. Being ation of Foster Grandparent cluding local police and hospi- nal drives or subscribe to the should not have. Early report- “security aware” involves ev- Program Directors. tals. many online backup services ing is far better than any short- eryone within the organization. “This program is such a great That said: It appears that that do this automatically. sighted punishment. This most recent scare should opportunity for any communi- most local governments have ●● Use reputable security soft- Cybersecurity and protect- be viewed as an opportunity ty,” Fleming said. “The design been quite good at updating ware and of course, make sure ing government systems and for local government officials of this program provides a dual and protecting their operating that it is set for updates. information consistently rank to re-examine policies and pro- benefit to two of our most vul- systems. However, the risk is al- ●● Train all county staff on the as the number 1 priority for lo- cedures to protect government nerable populations: senior networks. When was the last citizens and children. The in- time your security policies were tergenerational dynamics that PTI RECOMMENDS YOUR CYBER-SECURITY PLAN reviewed? occur during this relationship ADDRESS EACH OF THE FOLLOWING AREAS are monumental.” For additional resources, vis- Gehr-Deckert echoes those l Physical-Facility Security l Data Security l Disaster Recovery, and it the Multi-State Information sentiments. “Despite having l Personnel (qualifications, l Network Security l Employee Awareness and Sharing and Analysis Center ‘been around’ for the past 50 access, certifications) l Incident Response Policies Training. (MS-ISAC), a division of the years nationwide,” she said, l Password and Account l Communicating with the Pub- Center for Internet Security: “the Foster Grandparents Pro- Management lic and Other Key Stakeholders https://www.cisecurity.org/ gram is a hidden gem.” ms-isac/ 10 MAY 29, 2017 NATIONAL ASSOCIATION of COUNTIES COUNTY NEWS REGISTER TODAY www.naco.org/annual

NACo’s ANNUAL CONFERENCE & EXPOSITION Greater Columbus Convention Center • Franklin County, Columbus, Ohio • July 21–24, 2017

CONFERENCE SCHEDULE (FULL SCHEDULE AVAILABLE ONLINE) THURSDAY, JULY 20 SUNDAY, JULY 23 9:00 a.m. – 4:00 p.m. Mobile Workshops 7:30 a.m. – 8:30 a.m. Non-Denominational Worship Service FRIDAY, JULY 21 9:00 a.m. – noon NACo Board of Directors and 8:00 a.m. – 5:00 p.m. CIO Mobile Forum Resolutions Committee Meetings 9:00 a.m. – 4:30 p.m. Policy Steering Committee 9:00 a.m. – noon Exhibit Hall Open Meetings 9:00 a.m. – 5:30 p.m. Educational Workshops 11:00 a.m. – 4:30 p.m. Mobile Workshops Noon – 1:45 p.m. NACo Achievement Awards Luncheon 4:00 p.m. – 6:00 p.m. Exhibit Hall Reception 5:30 p.m. – 6:30 p.m. “Brilliant Ideas at Work” Awards 6:00 p.m. – 8:00 p.m. NACo Opening Reception Reception (invitation only) 7:15 p.m. NACo Night at the Ballpark – 5:30 p.m. – 7:00 p.m. Open for State Association and Clippers vs. Syracuse Affiliate Meetings 7:00 p.m. – 9:00 p.m. LUCC/RAC Reception (invitation only) SATURDAY, JULY 22 8:30 a.m. – 3:30 p.m. Standing, Ad Hoc, Advisory MONDAY, JULY 24 and Task Force Meetings 8:00 a.m. – 9:15 a.m. Educational Workshops 9:00 a.m. – 3:00 p.m. Exhibit Hall Open 9:30 a.m. – 11:30 a.m. NACo Annual Business Meeting and 11:00 a.m. – 3:00 p.m. Tech Town Hall Election 1:45 p.m. – 3:00 p.m. NACo Board Forum 11:45 a.m. – 12:30 p.m. Regional Caucus Meetings 3:15 p.m. – 5:00 p.m. General Session 12:45 p.m. – 1:15 p.m. NACo New Board of Directors Organizational Meeting 5:00 p.m. – 7:00 p.m. Open for State Association and Affiliate Meetings 2:00 p.m. – 4:00 p.m. General Session 4:30 p.m. – 6:00 p.m. Open for State Association and Affiliate Meetings 6:30 p.m. – 9:30 p.m. Conference-wide Celebration Event COUNTY NEWS NATIONAL ASSOCIATION of COUNTIES MAY 29, 2017 11

BRIGHTIDEAS ADA COUNTY, Idaho Serving Up Ballots with ‘Food Truck Voting’ tial election. With more than quickly in an emergency.” To get the word out about was electricity. “We may end 425,000 residents, the county is And the food truck idea? the early voting and let people up paying a little more to add a PROBLEM: Idaho’s most heavily populated. “This will sound odd, but the know where the truck would battery system,” McGrane said. Residents waiting in long lines on County election workers concept came from my hob- be, the county sent out press “That will free us up from using Election Day. used previous voting data to by of competitive barbecue,” releases, posted to social me- a generator. We initially tried to SOLUTION: determine the best locations McGrane said. “We use a sim- dia and on the county web site. plug in where we went, but our Bring early voting to street cor- — where the longest lines had ilar trailer-tent setup when we “The places we worked with power needs were too demand- ners around town, using mobile been in past elections — to compete. The design makes it also helped spread the word ing.” The generator also proved ‘food truck voting.’ park and attract a high con- both cost-effective and easy to in the region,” McGrane said. to be loud, he noted. centration of voters, including move around. We can set up That included large employers Other things the county spots near some of the county’s or tear down in 20 minutes. It like Hewlett Packard and Idaho would reconsider include or- By Mary Ann Barton largest employers and hospi- makes it very mobile.” Power. “Also, a big thing was our dering a longer trailer. “We had senior staff writer tals. The trailer was available The county purchased the graphics,” he said. “They stand some serious demand at some on Election Day for backup, in trailer from a local company out. This was intentional and of the locations,” he said. “The Long lines, no parking, no case any polling places had any that builds food trucks and helped attract voters who were concept proved to be extremely time. Some of the most com- emergencies, but wasn’t need vending trailers. walking or driving by.” popular, which may have been mon excuses for not voting that day. “They put the windows in When voters stepped up to our biggest challenge of all.” were taken out of the equation In 2016, 47,740 voted early, and counters to fit our needs,” the food truck, they could give Ada County uses the truck for last fall when Ada County, Ida- with an overall turnout of 75 McGrane said, noting that the their name, with election work- other elections (they have about ho introduced “food truck vot- percent. Of those early voters, windows are a little lower in ers finding it on a computer- four a year) and for registering ing,” making voting as easy as 5,456 voted at the food truck their truck compared to most ized voter roll, and printing out voters throughout the year. ordering lunch. voting trailer. food trucks, so that election a ballot. Voters could step over Advice for other counties In last November’s election, The idea for the mobile vot- workers can sit down and be to cardboard voting booths considering a similar con- the county tried out mobile vot- ing unit first came about as “an eye-to-eye with voters set up in the tent adjacent to cept? “Do it,” McGrane said. ing using a converted food truck, idea for how we could respond The trailer alone cost the the food truck. As they exited, “If a county has a number of with much success. Although in an emergency,” said Phil county just over $20,000. The they slipped their ballots into smaller towns spread out, it the county offers four locations McGrane, chief deputy clerk, tents where voting booths are a box with an optical scanner. may be too expensive to set for early voting, the converted Ada County Clerk’s Office, who located adjacent to the trailer The county hired a cybersecu- up in each town, but with this, food trailer-turned-voting cen- oversees elections in the coun- and graphics accounted for an- rity firm to ensure the mobile you can easily travel between ter could be moved all around ty. “We had a school that was a other $13,000. With all the com- voting process was secure, Mc- them and vote people on dif- the 1,060-square mile county polling place go on lockdown puters and other equipment Grane said. ferent days. I think this really to hit highly populated areas in once. We realized then that we needed inside, the county spent One of the biggest challenges helped provide greater access the weeks before the presiden- needed to be able to respond between $50,000 to $60,000. for Ada County’s mobile voting to some people.”

Voters in Ada County, Idaho line up for early voting at the county’s new mobile voting unit, a converted food truck. Photo courtesy of Ada County 12 MAY 29, 2017 NATIONAL ASSOCIATION of COUNTIES COUNTY NEWS LEADERSHIP EDGE Study Finds Weak Employee Engagement

quires commitment and action sponses from 1,946 public and engaged compared to 38 per- 50 percent of local government across the entire organization. private-sector employees. The cent of public sector employ- employees are fully engaged. results are nationally represen- ees overall. This difference is Engagement is low tative of the private and public statistically significant. What drives Despite the link between sectors, as well as ththree lev- In the public sector, we also engagement in local employee engagement and els of government. found variability across the government? performance, the results from The results, shown in Figure levels of government. Em- In addition to assessing over- a national poll reveal that the 2, and soon to be released in a ployee engagement in local all engagement levels, our goal level of employee engagement more detailed institute report, government, which includes was also to understand the is low across the U.S. econo- revealed that 44 percent of pri- counties, is higher than in the factors that have the biggest my, including in local govern- vate sector employees are fully other levels of government, impact on employee engage- ment. and is also on par with the pri- ment — the key drivers of en- By Robert Lavigna The poll, conducted by my vate sector. However, the level gagement, statistically. In other organization, the CPS HR Insti- of fully engaged employees in words, which workplace factors These are tough times for tute for Public Sector Employ- local government is 47 per- will generate the highest return government. Across the na- ee Engagement, included re- Impo cent. In other words, less than on an investment in improving tion, local governments are namn engagement? under enormous pressure to Based on previous research, maintain and improve perfor- Figure 1 we analyzed potential drivers mance, while at the same time such as leadership, supervi- doing more with less. sion, training, appreciation and One proven response to this inclusion. leadership challenge is to im- In local government, we prove the level of employee found that the top workplace engagement. After all, the pri- Mo drivers are: mary resource we have in gov- ENGAGEMENT ●● Leadership and managing ernment is talent. If our people n poman change are engaged and perform well, onmn VALUE CHAIN ●● My supervisor government will also perform ●● Training and development well. ●● Employee recognition Decades of research have ●● The opportunity to come up shown that improving employ- with new and better ways of do- ee engagement can be a key to ing things. improving organizational per- In other words, these are the formance, including in local H areas that, in general, local gov- government. n ernment employees feel most As I detail in my book, En- strongly about. gaging Government Employ- aaon ees, engagement is linked to How did local outcomes that are important government score? in government such as achiev- The rest of this story involves ing strategic goals, delivering the actual local government responsive customer service, Figure 2 ENGAGEMENT LEVELS scores for these engagement promoting innovation, retain- drivers. We found that the score ing good employees, driving for local government is signifi- high attendance, and keeping PRIVATE SECTOR cantly lower than the private workplaces safe. sector for the top driver, leader- The “engagement value ship and managing change. In GOV’T. OVERALL chain” shown in Figure 1 illus- business, 65 percent of respon- trates why engagement mat- dents are positive about leader- ters in local government: FEDERAL GOV’T. ship and change management As this cycle shows, mea- in their companies, compared suring and improving engage- to 59 percent in local govern- ment is not just a touchy-feely STATE GOV’T. ment. activity or exclusively the do- For the next two local govern- main of the human resources LOCAL GOV’T. ment drivers, supervision and department. Instead, creating training/development, the lo- a culture of employee engage- Fully Engaged Somewhat Engaged Not Engaged ment — the ultimate goal — re- See LEADERSHIP page 13

FULLY ENGAGED

SOMEWHAT ENGAGED

NOT ENGAGED COUNTY NEWS NATIONAL ASSOCIATION of COUNTIES MAY 29, 2017 13 MONEYMATTERS Bitcoins: Some Basics about the Cryptocurrency By Tadas Pack loosely to e-mail. Bitcoin “wal- be completely anonymous. gradually being folded into our compared to conventional as- research assistant lets” consist of a public address This means Bitcoin users can current financial system. sets. As usage increases, bot- (think e-mail address) and a easily receive their spoils, with- Many companies already tlenecks are starting to occur in New ransomware called private key (like the password to out having to worry about a pa- accept Bitcoin as a payment transaction speed. “WannaCry” recently crippled your e-mail account). per trail or law enforcement. method. We are even seeing at- There have even been at- computers worldwide. The at- One can only spend money In the case of WannaCry, tempts to create new financial tempts to regulate the network. tack seizes up computers, pre- from an address if they have the there have already been tens of instruments with a more tra- Because Bitcoin is decentral- venting users from accessing private key. thousands of equivalent USD in ditional structure that closely ized and largely esoteric, these files. Another strange feature of Bit- payments, which by themselves follows Bitcoin’s value. Like any attempts have failed outright. It demands a payment if coin, lies in how it is controlled. are easily traceable. currency, Bitcoin’s value is de- But developers have been you ever want to see your files It does not have any central au- But there is simply no way to termined by market forces. hard at work to solve the issues again. Malicious groups who thority like the Federal Reserve. identify who owns that Bitcoin The supply and demand at facing Bitcoin today. create such malware have tak- Rather, it is governed by a wallet, until they are spent in any moment will dictate which Both scholars and hackers en a liking to Bitcoin to receive democratic system of com- some way. direction the price moves, and alike are continuously studying those payments. puters. The computers (called Even then, mixing services by how much. and improving the system in- So, what exactly is Bitcoin? nodes) form a network that is exist. These can be likened to However, Bitcoin’s similar- frastructure. At its heart, it is a currency like collectively the structure Bit- pooling money together in a ities as a currency end there. Like any new technology, it the dollar and euro. It has val- coin operates on. pot and drawing your share Unlike fiat currencies, Bitcoin will take fine tuning over years ue because people accept it as These nodes are the back- back out. The “clean” money does not have a central bank to come before it reaches ma- payment, as currency. bone of Bitcoin, keeping a pub- drawn out cannot be traced to enact monetary policies. It turity. And with so many hands But unlike those currencies, lic ledger of payments called back to any specific owner. is laissez faire, and ultimately on-deck, the future of block- Bitcoin has many quirky fea- the blockchain. Nodes also per- Although Bitcoin is the pay- decided as a collective by those chain technology looks brighter tures which enable it to work form many other critical func- ment of choice for online crim- that participate in the Bitcoin than ever. and makes it a popular choice tions behind the scenes, which inals, Bitcoin can be used for network. P.S. On May 25, the value of 1 to pay for goods and services … allow Bitcoin to stay secure and both nefarious and positive Bitcoin’s future certainly Bitcoin in USD was $2,263.72 or ransoms. decentralized. purposes, just like any other holds more growing pains. Al- For starters, there are no phys- The final piece of the puzzle currency. though it is not quite as volatile Pack is a research assistant with ical Bitcoins – they exist entirely for creators of ransomware is Adoption is ever-increasing as it used to be, it is still subject NACo’s Counties Futures Lab online. Bitcoin can be compared anonymity — transactions can even on Wall Street, and it is to extreme price swings when and a former Bitcoin trader. What drives workplace engagement?

From LEADERSHIP page 12 private sector score (70 per- one-size-fits-all solution to im- ON THE MOVE cent). proving engagement in govern- cal government scores (68 and ment, especially since there are NACo STAFF College (now Univer- 66 percent positive, respective- Applying the results more than 90,000 government ly) are on par with the private So what do we conclude, and jurisdictions just in the U.S. l Joe Schultz has sity of the Potomac) joined NACo as a in Washington, D.C. sector. what is actionable, from our re- Instead, each county should senior IT engineer. l Linda Langston, However, these scores still search? survey its own employees to ●● Joe will be respon- strategic relations di- show that about one-third of Engagement in the public identify where it is succeed- sible for NACo’s net- rector, represented local government employees sector is lower than in the pri- ing and where it can improve. Schultz work environment NACo at the FEMA responded negatively to the vate sector Then, the organization needs to ●● including servers, National Advisory questions in these categories. Local government employ- take action to build a culture of Wi-Fi, firewall secu- Council meeting May In response to the question, ees have a higher level of en- engagement. rity, system backups 22–25 in Hillsbor- “I feel valued for the work I do,” gagement than employees in and disaster recov- ough County, Fla. 68 percent of local government federal and state government Lavigna is currently the director ery. Prior to joining l Jenna Moran, employees agreed, compared Priority areas to improve en- of the CPS HR Institute for Pub- NACo, he worked for program manager, to 72 percent of private-sector gagement in local government lic Sector Employee Engagement. Accenture Federal Langston spoke at a peer ex- respondents. include: The institute is dedicated to help- ●● Services in various change and training The final driver we found is Leadership and managing ing public sector and nonprofit capacities. He holds for local planners on “I feel encouraged to come up change organizations measure and im- ●● certifications in data Improving Communi- with new and better ways of do- Supervision prove employee engagement. ●● communications ty Resilience through ing things.” Training and development Before joining CPS HR, he ●● systems and infor- Risk Modeling in San Despite the importance of Appreciation/recognition was assistant vice chancellor ●● mation systems se- Luis Obispo County, this factor across sectors, only The opportunity to identify and director of human resourc- 68 percent of local government better ways to operate es for the University of Wis- curity from Potomac Moran Calif. on May 22. respondents agree with this While our results are use- consin. You can reach him at: statement, almost equal to the ful and revealing, there isn’t a [email protected] 14 MAY 29, 2017 NATIONAL ASSOCIATION of COUNTIES COUNTY NEWS

NEWS • ST. JOSEPH COUNTY, Ind. recently loosened FROM property restrictions for ACROSS keeping bees, chickens and other livestock animals such as goats and horses. The tweaked ordinance THE NATION says that instead of requir- ing a minimum of five acres for such animals, residents CALIFORNIA who fancy themselves hob- by farmers can live on just a After residents voted by near- half-acre. The county ordi- ly a 70 percent margin in March nance also removes a four- to raise the sales tax by a quarter pet household limit on dogs cent to fund programs to help and cats, stiffens penalties the homeless, LOS ANGELES for pets left in hazardous COUNTY is now deciding how weather and restricts pet to spend an estimated $3.5 bil- shops from selling cats and lion over the next decade. A cit- dogs in unincorporated ar- izen panel largely endorsed rec- eas, unless the store is host- ommendations made by county ing an animal welfare orga- agencies, including providing nization that is trying to get short-term rental subsidies and pets adopted. The county services (such as job training, still has to make changes to substance abuse counseling and its zoning ordinance, which mental health treatment), more will likely happen in June. shelters and expanding interim housing. “Bridge housing” will provide in-house services to en- Chickens like this one hanging out in New York could soon be more plentiful in ST. JOSEPH COUNTY, Ind., which recently loosened sure the homeless are ready to regulations on backyard chickens and other animals. Photo courtesy of Kathy Shea Mormino move on to permanent housing. The sales tax rate in the county these days for COOK COUNTY teaches inmates skills they can They are the latest county in IOWA will climb to 9.5 percent in July. inmates, who can order pip- use when they’re released and the state to launch a program Will there be a showdown over ing-hot pizza delivered straight looking for work. Abate told the using Vivitrol to combat opioid a new gun law in Iowa? Gov. Ter- to their jail cells. But it’s not Chicago Tribune that his main addiction. The non-addictive, ry Branstad signed a law in April what you think — they don’t goal is to improve inmates’ non-opioid drug, given in a that gives gun owners the ability have Domino’s on speed dial. self-esteem and love of food. monthly shot, prevents opioid to sue local governments if they Six different kinds of pizzas are users from getting high and has have been “adversely affected” FLORIDA made on the premises by fellow INDIANA also been used in MADISON, by a firearm ban, such as those Play ball! TheSARASOTA inmates, and pre-trial detainees l After first responders made HANCOCK, SHELBY, JOHN- at several county courthouses. COUNTY Board of Commis- fork over their commissary cash 600 overdose runs in February SON, HAMILTON and BOONE But Carroll Edmonson, adminis- sioners recently voted unani- for pizzas ranging from $5 to $7. and March, officials in MARI- counties. Marion County re- trator with the state’s 6th Judicial mously to approve its portion of Revenue generated from piz- ON COUNTY are hoping they ceived a $200,000 grant award- District, which includes LINN financing a 9,000-seat spring za sales support the jail’s “Rec- can turn things around with ed by the Indiana Department and JOHNSON counties, said he training complex for the Atlan- ipe for Change” program run a new prescription drug, ac- of Correction Community Cor- expects existing bans to remain ta Braves baseball team. Com- by local chef Bruno Abate, who cording to a report by FOX59. rections Grant. at both county courthouses. “My missioners voted to reallocate understanding is we will contin- some revenue from an exist- ue things the way they are,” he ing local tourism tax, collect- recently told the Cedar Rapids ed from hotel guests, to cover Gazette. “There’s an attorney annual debt service on bonds general’s opinion out there that that will be issued to cover the allows us to maintain security in county’s $21.3 million share of the courthouse the way we have construction costs. The rest of before, which means we can re- the funding is expected to come strict people from carrying guns from the state, the developer, in the courthouse.” the City of North Port and the Braves themselves. If all goes MINNESOTA according to plan, the facility is Most of a group of 60 Soma- slated to open in 2019. li-Americans who recently came down with the measles in Min- ILLINOIS nesota were not vaccinated, ac- There’s nothing like a slice of cording to the state Department your favorite pizza when you’re A local chef in COOK COUNTY pauses for a photo with inmates participating in the “Recipe for of Health. Cases have been re- hungry. And that’s an option Change” program. Photo courtesy of Recipe for Change ported in CROW WING, HEN- COUNTY NEWS NATIONAL ASSOCIATION of COUNTIES MAY 29, 2017 15

NEPIN, LESEUR and RAMSEY ments will work with the rele- ner. Inmates have smuggled in Morning Call article pointed out travel to North Carolina and counties. All but three cases vant agencies to defer adjudi- heroin and fentanyl into the jail their absence and several com- Mississippi on the grounds that were people who were not vac- cation in favor of relieving stress in body cavities and clothing, munity members followed up they had enacted legislation cinated. Health officials in the during rehab. The Daily Call reported. on that. County officials believe that discriminates. state have had to work to count- “It’s not a get out of jail free the stickers were discontinued er misinformation about a de- card, we’re not going to dismiss OREGON during a budget cut, but could l An agreement with MIL- bunked link between the MMR the warrant,” Batelli said. “And if After five failed attempts at not find any corroboration, going WAUKEE COUNTY will give (Measles, Mumps, Rubella) it’s a serious violation, they may the ballot box, a levy to fund as far as to ask the 95-year-old Milwaukee city police officers vaccine and autism, the Pioneer have to address it before going to public safety services passed registrar who had retired in 1998. real-time access to location Press reported. The measles out- rehab. But a lot of these offend- in JOSEPHINE COUNTY. De- data from juveniles wearing break is the worst the state has ers have low level failure to ap- clining federal timber subsidies WISCONSIN GPS monitoring devices. seen since 1990. pear, minor possession charges. forced cutbacks to sheriff’s pa- If a state has passed legis- Under the new agreement, Those we can work with.” trols and closed the juvenile de- lation discriminating against the Police Department’s In- NEW JERSEY tention center. Both will be re- people based on sexual orien- telligence Fusion Center and BERGEN COUNTY is trying OHIO versed with a 93 cents per $1,000 tation, gender identity or gen- dispatch center can access the out OCEAN COUNTY’s heroin The state budget bill may no assessed property tax rate hike. der expression, DANE COUN- information if a youth has an addict amnesty program. Ad- longer include a proposal to con- County Commissioner Simon TY personnel probably won’t “unauthorized violation,” or is dicts can turn themselves and solidate municipal and county Hare told The Oregonian that be there on official business. found to have broken rules of their drugs into three municipal- clerk of courts offices, but the asking for money specifically The County Board passed their supervision by going out- ities’ police stations and they will CLARK COUNTY Criminal Jus- for the juvenile detention center an amendment that forbids re- side a designated area. Police be assisted in enrolling in reha- tice Council will still pursue the and more jail beds and keeping imbursement of expenses for can also access the informa- bilitation programs without the idea. The two offices are budget- the levy under $1 largely con- travel to such a state. Elected tion if they have probable cause threat of arrest for possession. ed to spend $3.2 million to oper- tributed to its success. officials and employees will to arrest the youth for a new “The concept is to get them in ate in 2017, but Rep. Kyle Koehler also not be required to trav- crime, the Milwaukee Journal the door, get them introduced to told the Springfield News-Sun PENNSYLVANIA el to any such state. There are Sentinel reported. the counseling and that really is they could save up to $400,000 if After more than 18 years, “I exemptions for travel the sher- the key to solving the problem. they combine their offices. voted” stickers are coming back iff deems necessary and for News from Across the Nation is It’s not going to be done through to NORTHAMPTON COUNTY juvenile residential treatment compiled by Charlie Ban and the courts,” Mahwah Police Chief l Drug overdose deaths in polling places for the General placement, the Wisconsin State Mary Ann Barton, senior staff James Batelli told NJTV News. the MIAMI COUNTY jail have Election. Journal reported. writers. If you have an item for If they have warrants issued prompted the Sheriff’s Office to The County Council request- County Executive Joe Pari- News From, please email cban@ for other offenses, the depart- consider buying a body scan- ed they make a comeback after a si barred nonessential county naco.org or [email protected]. Tell Your Story TALK TO

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Looking forward to hearing from you, Bev, Charlie, Mary Ann 16 MAY 29, 2017 NATIONAL ASSOCIATION of COUNTIES COUNTY NEWS the HR DOCTOR Hiring a New Knee With Phil Rosenberg mination. Here the similarity ends since I was not offered the opportunity to perform my own surgery. The same care and con- his is a sequel to a sultation with experts is also recent HR Doctor necessary when it comes to article which ex- an agency recovering from plored the ironic the difficulties which virtually similarities be- always result after a position Ttween my recent experience is vacated. Whether the new with a total knee replacement vacancy resulted from a ter- and the very tough HR deci- mination, retirement or even sion to fire an employee. That a basic resignation, the ques- article looked at essential ele- tions inevitably arise about ments to pay attention to when how we replace the former firing an employee or, in my employee and what we have recent case, “terminating” my to care about in making that lifelong relationship with my decision. right knee. In fact, executives should A core part of both the bio- not be allowed to simply go logical issue and the employ- about terminating someone ment issue is the need to focus and then move on to the next on performance and behavior difficult decision without in making tough decisions like carefully including thoughtful discipline or termination. Per- considerations about some of formance and behavior in rela- the same considerations that tion to the job description is a I have recently experienced in strong indicator that the deci- dealing with my knee. sions were job-related. After firing anyone, whether That job-relatedness con- it is an FBI director or an entry cept, in turn, is a prime defense level worker, executives need to against charges of unlawful look back at what they’ve done employment practices such as and consider how the next de- race or gender discrimination. cisions could be better made I spent a great amount of time or better implemented. That working with my former knee certainly includes several chats trying to get his behavior cor- at least with HR to make sure rected and improved. I provid- that the actions were well-doc- ed coaching in terms of exercis- umented and defensible. ing, and considered other lesser These executives need to actions such as just living with rations were undertaken, a pleasant experience of a I hope to resume driving next practice their HR skills to see the poor behavior and perfor- couple of meetings held with month of physical therapy week and to resume that won- that they strengthen them and mance or cortisone injections the caring and very compe- involving three home visits a derful concept of sleep in the that the study and practice — all less drastic than a knee tent orthopedic surgeon Dr. week. All of my friends who very near future as well. necessary to do great HR is replacement. Finally, despite Jim Duke, and seeking per- have shared their own knee Deciding and acting on ter- faithfully followed. my best efforts, the poor behav- mission from the all-power- experiences tell me that I had minations in a civil service If not, the organizational ior and performance continued ful insurance company, the better pay close attention and world is something which re- “physical therapy” will be pro- and I decided to move ahead surgery occurred. It lasted for follow through with all rec- ally requires the same kind of longed, much more painful, with “termination.” 40 minutes and I’m happy to ommendations. If I didn’t, re- expert consultation as does the and likely very much more ex- This was done after consult- report that I awoke from the covery would be delayed and decision to adopt a new knee. pensive. ing with experts including sev- anesthesia! much more painful. I was also The orthopedic surgeon is I have named my new knee eral orthopedic surgeons and The process involved super reminded about the high-tech the equivalent of the HR di- “Rod–Knee.” I sincerely wel- my own personal physician, Dr. gluing the incision and be- medieval instrument called rector in these cases, com- come my new titanium friend Daughter Rachel. The employ- ginning a monthlong series of “the rack.” plete with the fact that often into my body. Rod-Knee let ment parallel would be consul- home-nursing visits, checking Writing this a month after executives will seek the active me know what I can do to help tation with your friendly neigh- vital signs, inspecting the in- surgery allows me to now look involvement of the HR staff, you help me become better, borhood HR director of your cision area and making sure back and realize that I’m re- including possibly offering a more thoughtful and stronger organization. any questions I had were ad- gaining a lot of mobility, I’m free lunch in trade for HR ac- than before. Think of Rod- So, the decision was made. dressed promptly. walking without assistive de- tually meeting with the em- Knee as you make your own After pre-operation prepa- There was also the most vices like a walker or a cane. ployee to tell them of their ter- tough decisions!