Board of Commissioners - Regular Meeting

You and me, in a time full of war, be at peace.

In a place that needs change, make a difference.

In a time full of noise, just listen.

Cause life is but a breeze, better live it. In a place that needs change, make a difference.

If love was a melody, I'd want you to sing to me in that voice that whispers my name. If the world was a dance floor, I'd walk you shore to shore while the steel and twin fiddles play. A love song that goes on forever. For worse and for better, we'll two-step together. And I'll hold you close.

you Thank you. Thank you. you you you you you you you you

for a written transcript of this meeting, or if you need reasonable accommodations, including this communication in an alternative format due to disability, please contact the clerk to the commission's office at 404-612-8232.

All right, good morning everyone and welcome to the second regular meeting of the Fulton County Board of Commissioners. September, today is September 16th, 2026, it is 10.03 AM. Madam Clerk, please call the roll.

Chairman Rob Pitts.

Present.

Commissioner Bridgette Thorne. Mr. Chair. Present.

Actually, Commissioner Thorne will be on Zoom, is that correct? Where is she?

Yes.

Okay. She what?

I'm here.

Now, she's eligible to be on Zoom today?

Yes.

Okay.

Commissioner Bob Ellis? Present. Commissioner Dana Barrett? Present. Commissioner Marvin Arrington, Jr.? Present. Vice Chair Khadijah Abdul-Rahman. Mr. Chairman, you have a quorum.

Thank you. Please rise for the invocation followed by the Pledge of Allegiance.

Let us pray. Almighty and gracious God, we come even this morning just to say thank you. We thank you, Lord, for all who have gathered. We pray now your continued blessings be upon this meeting. Bless our commissioners as you lead and guide them with your wisdom. It's in your name that we humbly pray. Amen.

All right, continue, Madam Clerk.

On page two, consent agenda, 260559, adoption of the consent agenda. All matters listed on the consent agenda are considered routine by the county commission and will be enacted by one motion. No separate discussion will take place on these items. If discussion of any consent agenda item is desired, the item will be moved to the second regular meeting agenda for separate consideration.

Nothing, all right. Nothing, commissioners. All right, a motion to adopt by Commissioner Barrett. Is there a second on this consent agenda? All right, I'll second.

And the vote is open.

All right, what's going on? Where's mine?

I hit it. And the motion passes, four yays, zero nays. On page five. Adoption of the second regular meeting agenda, 260574. Mr. Chairman and members of the board, we have some amendments to today's agenda. First amendment on page nine. 26-0593, finance. Presentation review and approval of the September 16th budget soundings and resolution. This item has been revised to amend a requested dollar amount on the annual hardware and software maintenance and support list. On page 11, Commissioner Ellis has requested to remove his resolution 260607, authorizing funding to restore monthly cadence and consolidated trial calendar, implement My Justice Portal platform, and to fund targeted third party forensic laboratory testing in criminal cases. That item has been requested to be removed. And also finance has requested- What page? Actually, they're moving up items so they can be together. What item? Moving up 2695- What page? 0595 and 0596 on page eight, nine, I'm sorry, on page nine. Those items will be moved up. with items starting on page six.

I'm not following, what are you saying? On page nine.

We're moving up 260595 and 260596. Moving up to? To page six before 580. so that all those items will be together, the healthcare items.

And it's in the order of 596 being first, correct? Correct, yes. Thank you.

Okay. Anything else?

That's all I have.

All right, then there were, it's brought to my attention that there are, let's see, three or four items dealing with the Ethics Board, take all of those together. Okay, anything else? Anything else? Now, I have a constituent ask me to add to the agenda today a discussion on deed thefts. And I explained that it would take in order for us to add to the agenda, it would require a super majority vote, which is fine. and would also have to be an emergency. The request is that we discuss this today. There are citizens that come before us pretty much at every meeting to talk about deed thefts. So that's the request. And I'll make a motion. Well, it has to be an emergency, but I'll make the motion. Commissioner Arrington?

Mr. Chair, I'm happy to talk about this. It might just be better to bring it on the next agenda or wait until we get five votes. We don't even have five votes. Even if everyone that was here supported it, we don't have the five votes, so it may just be better to be included on the next agenda or consider once the fifth vote comes in. Okay.

All right. That being the case, I'll add it to the agenda at the next meeting to discuss it. All right. Anything else? All right, on the agenda as amended. Is there a motion?

And the vote is open.

What is it? What's happening with the? On the agenda as amended. That's fine. All right, let's vote.

And the vote is open. And the motion passes, four yeas, zero nays. 260575, ratification of minutes. Second regular meeting minutes, August 19th. First regular meeting post-agenda minutes, September 2nd, 2026.

Motion to approve by Commissioner Barrett. Is there a second? All right, I'll second.

And the vote is open. And the motion passes, four yays, zero nays.

Now of course, is Commissioner Thorne voting or not voting?

I can vote, do I have oral vote?

What is she saying?

Do I just give an oral vote?

Yes, can you hear?

Yes. All right.

Yes, I can hear. Okay. 260576, Presentation of Proclamations and Certificates. First proclamation is recognizing National Field Epidemiology Month sponsored by Chairman Pitts with full board support.

Good morning, everyone. Chairman Pitts has asked me to read this proclamation on his behalf this morning. Y'all, come on both sides. Thank you all for being here. And the proclamation reads, whereas every year, World Field Epidemiology Day, it's not my day today, celebrated on September 7th, recognizes the role epidemiologists play in protecting the health of people around the world. The day honors field epidemiologists who track, investigate, and stop disease outbreaks. God, you guys are going to make me say this word like 20 times.

Why did you say epi?

There you go. The goal of the Fulton County Board of Health's Office of Epidemiology is to track the occurrence, growth, and development of diseases and illnesses to protect the health of the general public in Fulton County. And whereas, while the ultimate goal is quick containment when the threat of an outbreak escalates, this program provides assessment and coordinates with other government agencies to create strategies and policies that address arising issues. And whereas in order to prevent the future spread or a return of an outbreak, the Epidemiology Office provides ongoing guidance and continued education to populations who are most at risk. And whereas the Fulton County Board of Health through its Epidemiology Office conducts surveillance to detect diseases and adverse health conditions, investigates reports of acute diseases and outbreaks, provides guidance for individuals, healthcare providers, and facilities, recommends actions for prevention, treatment, and control, and carries out other activities in the interest of public health, Now therefore, be it resolved that the Fulton County Board of Commissioners hereby commends the Fulton County Board of Health's Epidemiology Office for its commitment to supporting and protecting the health of the community and does hereby proclaim September 2026 as National Field Epidemiology Month in Fulton County, Georgia. Who wants to speak?

Thank you. My name is Sasha Smith and I'm the Chief Epidemiologist for Fulton County Board of Health. And on the behalf of the Office of Epidemiology, thank you for this recognition. It is truly an honor to have our work acknowledged. Public health work is often a thankless job that happens quietly and behind the scenes. So it takes a tremendous amount of effort and dedication, teamwork and commitment to protect the health of our community. The best leaders do not stand above their teams. They stand with them. And I am incredibly proud of these group of individuals and grateful for the way they continued to show up and support one another in Surfelton County. Thank you, Chairman Pitts and the rest of the county commissioners for recognizing our efforts and for your continued support of public health. We are truly appreciative of this honor. Thank you.

Send her in on the picture.

The next proclamation is recognizing Small Business Opportunity Week sponsored by Chairman Pitts with full board support.

You want to do it? You want to do it?

All right. Do we have? Oh, there you go. Okay. Come on down. Isn't that a game show? Come on down, good people. And if some of you can go to the left and some stay to the right, just for picture purposes. We want to balance it out.

Price is right.

Price is right. That's it. Thank you, Commissioner Arrington. All right, good people. All righty. Whereas the state of Georgia is proud to be recognized as the number one state for business. You can clap for that. Supported by a competitive business climate and thriving community of small businesses and entrepreneurs across the state, and whereas small businesses are the backbone of Georgia's economy, representing more than 1.2 million businesses and employing more than 1.7 million Georgians across diverse industries and communities. And whereas Georgia's small businesses drive innovation, create jobs, strengthen local communities, and contribute to the state's long-term economic growth, resilience, and prosperity. And whereas organizations like the Georgia Business Council work to develop, convene, and advocate for small businesses by helping companies build capacity, strengthen supply chain readiness, expand connections, and access opportunities throughout Georgia? And where is the collaboration between small businesses, corporate partners, government agencies, and community organizations help strengthen Georgia's businesses ecosystem, support workforce development, and create pathways for success, and where a Small Business Opportunity Week serves as a time to recognize and celebrate the achievements, resilience, and economic contributions of Georgia's small businesses while encouraging continued investment in entrepreneurship, innovation, and business growth across the state. Now, therefore, be resolved that the Fulton County Board of Commissioners encourages the residents of our community and communities across the country to support small businesses and merchants throughout the year and does hereby proclaim the week of September 20th through 25th. 2026 as Small Business Opportunity Week in Fulton County, Georgia. Would you please put your hands together for such a great organization?

Good morning, ladies and gentlemen. My name is Kimberly Starks, principal consultant of Blue Scorpion Reputation Management, a native Atlantan and a proud Fulton County resident. Blue Scorpion Reputation Management is honored to conduct business in Fulton County, a community that has long supported entrepreneurship, innovation, and small business growth. I am also honored to serve as the Professional Services Co-Chair for the Council's Small Business Impact Committee at the leadership of Stacey Key. It is a privilege to join you today as we recognize Small Business Opportunity Week taking place this week, September 21st through 25th. This year marks the sixth year of recognizing this important initiative, and Fulton County has supported Small Business Opportunity Week since its inception. On behalf of the small business community, thank you to Fulton County for your continued partnership and commitment to businesses that help drive our local and state economy. Though my work as an entrepreneur, consultant, and small business advocate, I have seen firsthand that small businesses need more than encouragement. They need meaningful access to opportunities, resources, relationships, and partners committed to helping them grow, compete, and succeed. As one of Georgia's largest and most dynamic counties, Fulton County understands the essential role Small businesses play in creating jobs, strengthening communities, promoting entrepreneurship, and contributing to economic growth. When a county intentionally invests in its small business community, the impact reaches far beyond individual companies. It helps build stronger neighborhoods. creates lasting economic opportunity, and supports a more resilient local economy. I would also like to recognize the small businesses joining us today. Your courage to start, your willingness to invest, and your perseverance to keep building are what make our community stronger. You are not simply operating businesses, you are creating jobs, building legacies, and contributing to the economic future of Fulton County and the state of Georgia. Thank you Fulton County for six years of supporting this effort.

The next proclamation is recognizing Winship Cancer Institute Appreciation Day sponsored by Commissioner Ellis with full board support.

I'd like to ask the folks from Winship to come on down and join us.

All right.

I'm so pleased to recognize Winship, and I'm gonna share this proclamation, and then I'll just share a couple of comments here at the end, in terms of why this has a special place for me. Whereas September is Prostate Cancer Awareness Month, observed each year by health advocates and individuals concerned with men's prostate health and prostate cancer, and whereas about one in eight men will be diagnosed with prostate cancer during their lifetime, and about one in 44 men will die of prostate cancer, and whereas certain men face higher risk, including black men and those with a first-degree family history of prostate cancer, such as a brother, father, or son, and whereas Emory University's Winship Cancer Institute provides innovative treatment options for prostate cancer patients in Georgia and throughout the Southeast, and whereas the Winship Cancer Institute's Mobile Prostate Cancer Screening Bus took part in Fulton County's recent Men's Health Tailgate event, performing a total of, I thought we said 110, 109. The record is 120, but we had 109 PSA blood tests, one of the largest one-day totals in recent years. Now therefore, be it resolved that the Fulton County Board of Commissioners are pleased to recognize September of 2026 as Prostate Cancer Month in Fulton County, and it is our distinct honor to salute the Winship Cancer Institute for its tireless efforts to save lives, to increase early detection, and to help reduce longstanding disparities in prostate cancer treatment, and does hereby proclaim Wednesday, September 16, 2026, Winship Cancer Institute Appreciation Day in Fulton County, Georgia. Let's give them a hand. And I'll just take just a point of personal privilege. Last fall, I was diagnosed with prostate cancer. I found it early through a strange set of circumstances. And I got the help I needed. And I'm very excited about my treatment plan. And I feel very confident in my approach going forward. But then a few months later, I'd heard about Winship. And I heard something on the radio. And I said, I need to tell my story. We need to get men out, screen early, find it early, because if it's found early, this is something that has a high degree of treatment success. And we reached out, we contacted them, and we planned this event that we recently had. They were spectacular. It really was about meeting men where they are. And we had a phenomenal response. And it was just, it was a great day. Hopefully none of those men found out that they needed to go do something, but if they did, hopefully they caught it early and they're able to go out and engage in treatment and live their fullest lives. So it's a phenomenal thing. Also thank Arthur Blank for his contributions to allowing this mobile screening bus to be out and be active. And I know they're going to talk to you a little bit Ask them to talk to you a little bit more about that. But again, I want to give a huge round of applause to these folks.

Commissioner Ellis definitely took all the talking points I had today. So maybe we'll give you a little bit of statistics in that moment. But my name is Anthony Jackson. I'm the program manager for the Emory Mobile Prospect Unit, or we call it the Big Blue Bus. First, we want to say thank you to Fulton County. We want to say thank you, a big thank you to Commissioner Ellis. When he reached out, Ms. Renee reached out, and they told me a story, I was like, this is something we have to do. This is what we do it for. And I also want to give a huge thank you to the Arthur Blank Family Foundation, because without them, I wouldn't be here. My best friend Roy wouldn't be here either. So we're able to go out in communities and do things such as this. One major thing we want to accomplish is that in the first year, so September 2nd, 2025 through today, we've done 15 counties across the state of Georgia. We've screened 2,600 men or over 2,600 men, and we've completed almost 170 screening events. So our goal is not just to ensure that we're helping, it's to ensure that we're filling healthcare gaps across multiple communities all across the state. So Commissioner Ellis, this event was fantastic. I can't wait to do it again. this award means a lot it's not just a finish line it's a reminder to keep striving it's to keep showing up and to do better every single day because we know that health care is something that we fight for that's important not everybody has but this initiative allows us to fill that gap fill the needs and ensure that a brother a son a father or a relative can live to fight another day To Commissioner's point, prostate cancer is beatable, treatable, if you catch it early. But if you catch it late, it's just trying to keep your quality of life. So we thank you, Fulton County, Commissioner Ellis, the Arthur Blank Family Foundation, and the Winsor Cancer Institute, and we hope to see you all again soon. Thank you.

The last proclamation is recognizing 1906 Atlanta Race Massacre Remembrance Week, sponsored by Commissioners Barrett, Arrington, Ellis, Thorne, and Chairman Pitts.

I don't know. Y'all, this is a proclamation remembering the anniversary of the 1906 Atlanta Race Massacre, which occurred or began, actually, it was a multi-day massacre that occurred over four days starting on September 28th. 1906. And so Anne Hill Bond from the Fulton County Remembrance Coalition asked us in Fulton County to help them share this important anniversary and take some time to honor the history of the people who died and whose lives were impacted. The proclamation reads, whereas Fulton County is committed to truth telling about its full history, including its history of racial inequity and racial violence, and whereas September 22nd, 2026, marks the 120th anniversary of the start of the 1906 Atlanta Race Massacre where mobs of thousands of white supremacists terrorized Atlanta's black communities and murdered black residents without ever being held accountable. And whereas from September 22nd, 1906 to September 25th, 1906, motivated by months of sensationalized, unsubstantiated newspaper reports and the racially-diversive rhetoric of the 1906 gubernatorial campaign, white mobs burned down thousands of homes and black-owned businesses and killed at least 25 black residents, with credible estimates indicating the true death toll to be in the hundreds. And whereas victims include William Henry Welch, Frank Smith, Leola Maddox, Will Marion, Annie Shepard, Milton Brown, Zeb Long, Sam Magruder, Clem Rhodes, Frank Fambro, George Union Wilder, Will Moreland, James Fletcher, and Sam Robinson, along with many others whose names were never recorded. And whereas the terror of 1906 accelerated the disenfranchisement of black Atlantans and the expansion of Jim Crow segregation and drove thriving black families and businesses from their destroyed neighborhoods. And whereas the memory of the 1906 Atlanta Race Massacre has been preserved by the Fulton County Reparations Task Force the Fulton County Remembrance Coalition, and dozens of other community partners in their efforts to pursue racial justice and healing. Now, therefore, be it resolved that the Fulton County Board of Commissioners honors the memory of the victims of the Atlanta Race Massacre whose lives were lost or upended, and commends the Fulton County Remembrance Coalition for their work, and does hereby proclaim September 22nd through the 25th, 2026 as 1906 Atlanta Race Massacre Remembrance Days in Fulton County.

Oh, shoot. Hi, good morning. My name is Anne Hill Bond. I am part of the Fulton County Remembrance Coalition along with Alison Bantimba and Christopher Swain. We are here to commemorate the 25 lives lost along with the hundreds of lives that have been misplaced and forgotten here in Fulton County. One of the things that is very important to us is about racial healing. And so we do so through our soil collection, putting up markers and partnering with our friends over at Out of Hands Theater, as well as Truth in Southern Reconciliation. And we just want you all to join us next week, starting on September 20th, all the way through the 27th to remember the lives that were lost here in Fulton County. It is important to note that Fulton County is the largest lynching site in the state of Georgia. Georgia is the second largest lynching site in the nation. This massacre makes Fulton County number one in the state of Georgia. So it is important that we not only honor these victims that still has the sentence here in the county, in the city of Atlanta, and other municipalities in Fulton County, but remembering them by calling their names and honoring them by seeking healing in this work. So thank you. Christopher from East Point.

Good morning. I just want to add to the list of names that were mentioned this morning is one I'd like to acknowledge that was lynched in the city of East Point. His name is Warren Powell. I especially want to mention his name because Warren Powell was a 14-year-old boy. He was a child. And when they took him away to lynch him, Warren had the wherewithal to turn to his soon-to-be killers and ask them that they take his body far away from the city center so that his parents wouldn't have to see his body hanging from a tree. So I just want to acknowledge Warren Powell.

Can you say something?

I continue, Madam Clerk.

Continuing on page five, public hearings, 260577, public comment. Citizens wishing to participate in public comment will be allowed to appear in person or may choose to participate virtually via Zoom video conferencing by registering on the county website, www.fultoncountyga.gov. Priority for public comment will be given to Fulton County citizens and those individuals representing businesses, or organizations located within Fulton County. Speakers will be granted up to two minutes each. The public will not be allowed to yield or donate time to other speakers. The public comment portion of the meeting will not exceed 60 minutes. In the event the 60 minute time limit is reached prior to public comments being completed, public comment will be suspended and the business portion of the BOC meeting will commence. Public comment will resume at the end of the meeting. Mr. Chairman and members of the board, we have received 10 speaker cards. Will the first five speakers please come forward? Maggie McCollum, Janet Hill, Eric Tatum, Robbie Caban, and Margie McLeod.

Good morning, my commissioners. I am Maggie McCollum, and I am representing Commission on Aging today. It's the small things, and whatever you do, do it heartily as unto the Lord and not unto men. Colossians 3, 23. It's not always the big things that are keeping us from God's best. It's the small things. If we aren't showing respect and honoring our boss or coworker by doing the small things that's important to them, that the small thing will keep you from your greatness. Sometimes it keeps you involved in things that we don't feel like doing. and even something that doesn't seem fair. Go the extra mile. The election workers. What is the protocol for the workers and how they are protected in every election, especially this one? Which is under 30 days away. Can I get answers? Before this happened, in the next few weeks, what if the FBI comes to the facilities? What are their safety? What are the provisions that has been made? I am standing here for those workers because somebody need to hear the call. grant you everything that I come down here to do. And that is, it may be a small thing just for protection. I hope that you consider them in this election. Thank you so much. And I hope it's well with you, Commissioner Arrington. Thank you.

Good morning. I'm Ms. Hill. I'm here to first formally thank the Commission for agreeing to put this serious issue of de-theft crimes on the agenda for the next meeting. And I want to share a little bit of good news because I want it to be clear that we are focused on solutions. This is not about an opportunity to throw people under the bus. It's about getting to a solution to return stolen homes and some form of restitution. Having a solution also enhances the opportunity to reduce homelessness, to restore mental, physical, and emotional distress, judicial integrity, mismanagement of court and government resources, and the ability to vote. When people are displaced and taken from their homes unlawfully, they can't vote. I also want to mention that there are several adjudicated cases that we'll be able to reference where these situations have been resolved. Jail time goes anywhere from 18 months to five years. So thank you again. We look forward to the opportunity to come before you with a full presentation in the next meeting. Thank you so much.

Good morning, Chairman, Vice Chair, and Commissioners. I'm Eric Tatum, candidate for the Chairman of the Fulton County Commission. And I'm here today to raise serious question about the transparency in our campaign finance system. The publicly available campaign finance records of my opponent, Mo Ivory, appear to contain significant discrepancies. I have been unable to locate her June runoff disclosure or her July 31st disclosure. But what concerns me the most are the filings that do appear. Two of Ms. Ivory's disclosures bear the unmistakable watermark, preview, do not file this copy. They also appear to lack the red filing date stamp found on every other candidate's filings and do not contain a completed signature. These are the records that are available on the Easy Campaign Finance website and the State Ethics website. I have submitted an open records request act to determine how these documents were received, who has the authority to manually enter the campaign filings, and what procedures govern that process. There may be an explanation. If there is, the public deserves to hear it. Campaign finance disclosure exists for one reason, transparency. Every candidate, Democrat, Republican, or independent, should be held to the same rules, the same deadlines, and the same standards. So today, I am seeking action. I am calling specifically on Ms. Williams and the BRE to determine how these documents entered the public record, who accepted or inputted them, and whether the same procedures have been applied consistently to every candidate. then make those answers public. That is accountability. This is not about personalities or politics. It is about one standard for everyone. The people of Fulton County should not have to wonder whether the rules are being followed and applied equally. We should know that they are. Thank you and God bless Fulton County and God bless you all.

You have the floor.

On September 11th, 2026, a federal lawsuit was filed in the Northern District of Georgia. Speak up a little bit, please. On September 11th, 2026, a federal lawsuit was filed in the Northern District of Georgia, case 126-CV05260-VMC, involving the alleged unlawful seizure and euthanasia of my senior-owned microchip cat, Ninanina, that you all are aware of. and broader allegations concerning Fulton County Animal Services and the county contractor Lifeline Animal Project that you have oversight of, all of you, including the county manager. For years, residents, volunteers, and whistleblowers have raised serious concerns about transparency, enforcement, management, animal treatment, and retaliation. Former Fulton County Animal Control Officer and Supervisor Amanda Mandy Jo Brennan has alleged serious operational failures. improper seizures, employee safety related concerns, harassment, and misconduct. Commissioner Bridget Thorne spent two hours listening to her concerns and I was there. I don't know why the GBI wasn't called, especially when Thorne was told that drugs were sold from our animal control trucks, illegal drugs by animal control officers who were carrying guns illegally. Yes, Fulton County still has not ordered the truly independent forensic or operational audit residents have repeatedly requested. I also want to Address the Animal Welfare Board. Fulton County currently lists two vacant seats. I understand former board members themselves have raised concerns, including Pamela Harvey and Yoshina Bradford, about the board's effectiveness directly in writing to Commissioners Rotman and Arrington. And I believe the rest of you are cc'd. I'm still awaiting a response regarding my own request for appointment, Commissioner Arrington. especially with empty seats, yours included. If the body charged with studying animal welfare issues and advising this commission is losing members, carrying vacancies, and being described by participants as ineffective, that itself should be a warning. This taxpayer-funded system affects public safety, public health, taxpayers, donors, residents,

Good afternoon. I'm here for CBC, Concerned Veterans Affairs Committee. I'm talking about the budget that probably next year is going to affect, so you're not, Raw pigs, I know you want a veteran. So what I'm saying to you, if you had went into the military, you would have more knowing how we feel. We don't need no programs to be cut from the veterans. Then number two, I'm not just here for the veterans. Also programs that you might for this budget that y'all getting ready to do for next year, nothing will need to be cut. Taxes don't even need to be a raise. So what I'm saying to Bob Ellis, if he ever went into the military, y'all would have a better understanding how would the veteran go through. You should never want to cut the budget or do anything. They need to put more money in the budget. And homelessness, it's not going to get no better. It's going to get worse. You've got a lot of single women losing their jobs over AI. So what are we going to do? We have to put money where you're going to make sure the money is going to be used for. And I know you've got a lot of nonprofits out there doing things, but we don't monitor them. So what I'm saying to you, Rob Hicks, thank you for your work. Thank you for Bar Ellis. Thank you also. So what I'm saying, when you look at the budget, please don't cut it. Do the right thing. You from Jones County, I talk to your family. That's how small the world is. And it wasn't easy when you were growing up. And I know it wasn't. But what I'm telling you, go out in style. Have a blessed day.

Last five speakers in Assembly Hall. Please come forward. George Pond, Mrs. Hand, Brandon Pink, L.A. Pink, and Carmela Charrington. Thank you.

Good day, my name is George Pond. I'm a licensed attorney in the state of Georgia. I want to comment on the proposed deal to purchase the Atlanta City Detention Center from the city of Atlanta for $68 million. I kindly ask you to reject any deal for ACDC. Fulton County already rents a majority of the available space in the city jail, so this purchase would not alleviate any of the overcrowding issues in the county jail. The county jail is over max capacity and the city jail is near max capacity. More to this point, I have personally witnessed 20 adult men in a single holding cell at the Fulton County Jail with standing room only being held there for three weeks on end because there was nowhere else to put them. This is entirely due to the inefficiencies of the Fulton County judicial system. I was informed yesterday that a man who I represented in June of 2024 was only released last month after spending over two and a half years of his life in the Fulton County Jail pre-trial. Like so many others, his case ended with a plea deal in exchange for a sentence of time served. Every time that a Fulton County judge passes such a sentence, the Fulton County Court is explicitly stating that this human being has been sufficiently punished for criminal offenses and that all the punishment for said crime occurred before the plea was made. Instead of spending $68 million to buy a jail near max capacity, I ask you to instead budget that money to hire more line prosecutors, more public defenders, and more state and superior court judges. Your judicial system is drowning in cases which regularly causes violations of the 5th, 6th, 8th, 13th, and 14th Amendments of the Constitution of the United States. These violations are happening on your watch, and you hold the power of the purse. Please don't buy more cages. Please hire more judges, hire more prosecutors, hire more public defenders. Thank you.

Good morning, County Commissioners. My name is Brandon Pink. I am the co-chair of the Atlanta Alliance Against Racist and Political Oppression. We are the Atlanta chapter of the National Alliance Against Racist and Political Oppression, and the work that we do revolves around fighting against mass incarceration, fighting for justice for victims of police brutality, not only locally but nationally. Locally, though, in Atlanta, there is an elephant in the room that needs to be addressed. that is constantly being swept under the rug. Right now, regardless of how much good PR we try to do about this great city, black Mecca, black Hollywood, the reality is right now, Atlanta is known for two things. The first, being the most surveilled city in the country. The second, being home of one of the deadliest jails in the country, the Fulton County Jail on Rice Street. Inmates in the jail keep dying and everyone who has read the 60 page DOJ report knows exactly why inmates keep dying. It's because this jail is overcrowded and at its capacity. What people might not know is that more than half of the inmates in the jail are in pretrial detention. The vast majority of individuals who are subjected to the horrible conditions in Fulton County Jail have not been convicted of a crime, but instead are there because they cannot afford their bond. It is a stain on the elected officials who oversee the jail, including all of you. And it is a stain, more importantly, on our great city, that people can continuously die, be subjected to human rights violations, and be subjected to the violations of their constitutional rights. simply because they are impoverished and too poor to afford their bond. Our demand is that cash bail be ended on the county level. We see ending cash bail as an immediate and necessary step that must be taken to end the current situation in the jail. This is not something that is unheard of. We've seen the elimination of cash bail in places all over the country. It can be done here in Fulton County as well. You all have the power and responsibility to your constituents to help get it done. We ask that this board unite with us on our resolution to end cash bill in Fulton County to our allies who may be afraid or who may say that this is impossible.

Thank you.

Good morning.

My name is Mrs. Hand.

I am a puppet. And this is my puppet master. I'm just like Maggie Goon Woman. She's also a puppet. She's been steered and groomed more than nearly influenced. by other members, possibly of this board. She falsely reports responsibilities, makes misrepresentations and lies about this board, especially Bridget Thorn. The shameful thing is that she is being groomed by at least one member of this board. Dana Barrett, where you are, does that sound familiar? More on Maggie, doesn't understand the concept of constitutional officers and blames this board for problems with the jail, the sheriff, the judges, who are duly elected officials. Moron Maggie is the type of person that needs the GPS to find the restroom. If you are disturbed by my presentation or that of my puppet master, then you might just be in for a life of hell if she gets elected. Thank you.

You have the floor.

Good morning, my name is Carmela Charrington. I just flew in again. I guess I'm gonna have to keep coming here until we get things done. I am here looking for my father, Allman Charrington. My father has been kidnapped from the Department of Aging. And this is all due to Kenya Johnson. Kenya Johnson is allowing Luann Bonnie to illegally liquidate family's estate. I am my father's POA since 2019. I came to the probate court looking for assistance, looking for help. This is what I did, my sister and I. Because my father was married to a woman that was illegally liquidating his assets. Do you know where the wills are being held? They're held in the probate court. So Kenya Johnson knows exactly what my father's wishes was. He has a prenup. We are his POA since 2019. I applied for guardianship and conservatorship. We was denied. She appointed Lou Anne Barney, and she appointed Department of Aging, and only to liquidate his assets. They tried to take his property in New York. We stopped it in New York, and we're coming here to stop it in Georgia on Giff Avenue. So if you want to see what we have done in Bedford-Stuyvesant, look up my name, Carmella Charrington. We are coming here to do the same thing because this is my third time coming here and I have not seen any changes. So we're on the way. We're going to change the peach into an apple. Thank you.

Mr. Chairman, members of the board, we have seven speakers on Zoom.

Good morning, commissioners. The first person to speak is J.W. Grenadier. J.W. Grenadier.

OK. OK, there we go. Good morning. I came to speak about one thing, but I'm going to add something else regarding Charmaine's father. I am familiar with his case. I live in Alexandria, Virginia. This is a nationally known case. This is a case that is no different than so many others. I have another one where a military man has a condo in Hawaii. He lives in Delaware. They messed with his condo fees and now they're looking for a conservatorship in Hawaii for a man who lives in Delaware who fought for our country. Guardianship is a problem and there is no oversight. The only thing that a families can really do is to get ADA advocates involved. Judges do not have immunity from the ADA, but we also need to get the Department of Justice overseeing these cases. We need to get the Department of Justice coming in and following the money because guardianship, usually the person who's pursuing it, it's about the money. It's all about greed. No different than the foreclosure situation that Janet Hill talked about. Janet Hill and I have the same issues. I just, through the Court of Appeals in Virginia, got the first honest order from a judge. And it was basically fraud on the court, fraud by the court, fraud by the judges. Void ab initio. And when it's void ab initio and the state employees are the ones who are empowering this type of conflict and this type of theft, the state is available, is accountable through their risk management. They try to hide it, but you've got risk management involved.

The next person to speak is Charmaine Crook. Charmaine Crook.

Hello, Chairman and Board. Hello, chairman and board. Can you hear me? Yes. Okay. I do everything for a reason. You all have failed in your duties to mitigate and negate what's to come. You all have a say and an answer to lead them. I submitted documents to be included for the record today. My purpose here now is complete. I have what I need on you all. Oron Sneakfield knew he could do what he did to me and get away with it. And I can prove it beyond reasonable doubt. There is a conspiracy against my rights under color of law. No matter how history revisits this past, my paper trail suffices all claims. This is a return to sender. So out of 35 defendants, who will accept, please? Will 21 accept for 12 to reject? Will 11 be convicted and one acquitted of all charges? I do not stop and I'll only cost more and more. This is my fourth public testimony and four can be seen as the number of house. I can come back a fifth time, the number of grace. And with grace, I can reveal more factual information and name even more powerful people than Fannie Willis and Pierre Thomas, CEO of Quality Control, individuals who both can be replaced. Now, I would love to receive justice and for the following year to be all about finally healing and finding. a way to love myself again i would despise not taking a year break away resetting instead to spearhead initiatives that have already been forethought continue to delay and deny me justice on my ancestors land and soul thy know whom db thy know thy power i am no negro scare tactics highly upset me and cost more everyone involved i name i have them caught in the act can we make it make sense Why am I receiving jury duty notices again, and I can't get a jury for the man who confessed to violating me? My only waking reason is to receive justice. The air I breathe is because I will be justified by hook or by crook. When physical force can't be applied, it is mental force that is then applied. Everything by the book, and you are all under oath by the book. No one has attempted to atone or correct this wrongdoing, and this all will be included. Everyone and their legacies will be annihilated. Fulton County protects rapists and persecutes the victim. Justice for Charmaine Seacrook without any further delay. See the quid pro quo for what it is or go down with them all because I am the one who has been defamed, stalked, harassed, physically and sexually.

The next person to speak is Jen Simmons. Jen Simmons. Next person to speak is Susan Eppard. Susan Epard. The next person to speak is Tasha Jackson. Tasha Jackson. And with that said, this concludes the Zoom public comments.

Thank you. Continue, Madam Clerk.

On page six, county manager's renewal items under open and responsible government. 260578, real estate and asset management, request approval to renew an existing contract in an amount not to exceed $433,026 to provide medical and clinical general cleaning services.

A motion to approve by Vice Chair Abdul-Rahman, seconded by Commissioner Barrett.

And the vote is open.

Now, once again, is she voting? Yeah, but is she voting? Do you know, are you recording her as voting?

I can vote. Can you hear me?

Now we can hear you, yes. Is that a yes vote?

That's a yes vote.

Okay. Thank you, Commissioner. Continue, Madam Clerk.

And the motion passes, six yays, zero nays. 260579 requests approval to renew existing contracts in a total amount not to exceed $365,000 to provide standby on-site plumbing repair services.

Motion to approve by Vice Chair Abdur-Rahman, seconded by Commissioner Barrett.

And the vote is open.

That's a yes.

And the motion passes, six yays, zero nays. First item to be moved up, bottom of page nine. 260596, finance, request approval of the 2027 premium rates for the medical and pharmacy dental and vision plans effective January 1st, 2027 through December 31st, 2027.

All right, then the other two will be heard at the same time.

Yes, sir, for all those particular people, yes. All right. So good afternoon, commissioners, Ray Turner, finance department. I'm here to present the proposed premium increases on our health plan. I would like to thank the board for meeting with us and our team, which is Verna Thomas, our employee benefits manager, as well as our consultants with Siegel, Gina Sanders, and Paul Janis over the last few days. to really discuss the difficult financial realities of the rising cost of healthcare in our employee plans. So we have a presentation for you today that I'd like to go through along with our team members. It's really, we're gonna open up with a really planned cost summary, what our proposed rate increases are for our plan. followed right after with some reasons, causes, some discussion of the factors of our rising cost in healthcare. We'll go over some specifics on our self-funded plans, which is largely Anthem, and our fully insured plans, which is largely Kaiser and Humana for the over 65. We'll touch on our dental and vision. No significant changes to our dental and vision plans, and some other considerations that we have discussed for future cost management of the plans, including an RFP that Finance plans to issue later this year to look for firms that may have other cost-saving strategies or other alternatives or options that may help with their continued rising cost of healthcare. Next slide, please. So this is really the full overview of what finance is proposing today. The top chart is really an analysis, compares 2006 plan year to the 2007 plan year. Our total healthcare spend is projected to be 115 million in 2026. I'm looking for 127, almost 128 million. over in the 2027 plan year. So again, costs are continued to accelerate both on the Anthem and as well as the Kaiser side for our employees. No major plan design changes are recommended. We do have a couple of recommendations for the board. In the Anthem self-insured side, we have a point of service plan, a POS plan. And our consultant mentioned to us that the out of pocket maximum for that particular plan is quite low compared to other plans. We're advocating an increase to the maximum out of pocket. And also, if you can remember last year in the Anthem over 65, we brought to the board a group waiver plan for pharmacy, projected to save $5 million last year in pharmacy for the over 65. That's a reality. We will probably even save more than 5 million. So we will save a significant, we are saving a significant amount of money this year on pharmacy for over 65 on the Anthem side. So now we would like to do that for the Humana over 65 plan. And again, Gina can explain some of the nuances of that change. But that is forecasted to lower pharmacy costs for folks who are currently over 65 in that Humana plan. Consequently, with lower pharmacy costs, we can lower premiums for the over 65 group, both on the Anthem side and on the Humana side, because Medicare is now funding a larger portion of the pharmacy costs in those plans. Back to the active side and for the under 65 who are not on Medicare, on the Anthem side, based on what we see trend with the significant increase in healthcare costs on those plans, the math comes to a 19.1% increase for premiums for the active and the pre-65 in Anthem. Conversely, on the over 65, a 15% decrease is what we're recommending for the post-65 retirees. That's the self-insured side. On the Kaiser Medical side, that's their fully-insured plan, and Kaiser's been a partner now for seven or eight years here at the county. A 9.7% increase in their HMO and pre-'65 plans is recommended, but a very small 0.9% increase in their post-'65 senior advantage plan for Kaiser. As I discussed earlier, that Humana MAPD plan, 13.6% decrease, an 8.8% decrease if you're in the enhanced Humana plan. Again, if we opt for this NISCO decoupled Part D pharmacy, pharmacy costs will drop, premiums can drop in that particular plan. And as I mentioned earlier, not much of a change in dental and superior vision. 1% increase on the dental DPPO plan, 10% decrease for vision. Again, the ask is for that out-of-pocket POS plan for an adjustment and for that pharmacy group waiver on the Humana plan. So what's causing the increase? What's the drivers of this increase in our healthcare spend? If we can go to the next slide. Siegel has done a great job at bullet pointing some of the big cost drivers. At this point, I'd like Gina to come up, Gina Sanders with Siegel, and go over some of those specific drivers that we see for increased healthcare costs.

Good morning, commissioners. I'm Gina Sander with Segal. And these are a lot of the issues that we're seeing globally in the health insurance market, health care market.

This would be public sector and private sector.

Public sector and private sector. The increased private equity involvement. So in the local area, a lot of these private equity firms are buying up health care systems, hospitals, physician groups, and so forth. And in the Atlanta area, the local hospitals are not backed by private equity. They are still not for profit and governed by a board. But there are prominent physician groups that are backed by private equity in the area.

Do we know which ones?

I do know which ones. I know some of them. I don't know all of them.

But the hospitals themselves, the ones that we know are not.

Correct.

But there are private physician groups that are.

There are a few, yes. Yes.

This is a very important point for the listening public.

Yes. And, you know, private equity, they buy these physician groups and they take over the operations of the group, the billing, they help them with recruiting and things like that, but they're there to form efficiencies and, of course, to make money for those who have invested in them. So the second bullet is increased use of artificial intelligence.

Before you leave it, first, how do they make money?

Well, they want to move people through the process more, so your visits might be lower to get more people through the door. They may be able to pay more money to get different doctors in, so you might have good doctors coming in. I mean, they use private equity to to try to bolster their practices. But the private equity firm that owns them wants to make money from the business, so they're trying to put in efficiencies. They have central billing for the various practices so that the practices don't have to do it. They're streamlining their expenses as much as they can. Closing the time frame on the visits so that more people can be seen during the day. You hear people complaining about not having enough time with the doctors. But it's those types of things.

Just one other question and I'll be quiet. Define a private equity firm for those who do not know what you mean by that.

It is a firm that individuals can invest in that goes out and purchase. It's an organization or a group of people that go and purchase businesses or services that they feel can make money for them, they can make money off them. So they get investors to invest in this and private equity, that's what it is. It's investments that people put in to a cause or a service that they feel is gonna make money.

They buy the practice.

Yes.

And the motive is profit.

Yes.

Not necessarily patient care.

Correct. I'm sure that patient care is part of it, but the primary motive is a good investment to make money. The second bullet is the increased use of artificial intelligence in the healthcare industry. This is being introduced to more accurately code the services. In fact, you know, you see the doctors walking around with the laptops now and the nurses and there is software on there that can prompt them to say, it's listening to them, you know, and it can say, I heard you mention this. would this code be applicable to this service that you're providing? So they're trying to maximize as much coding in there to be paid as much for the services that they're providing. Third bullet, new and more expensive treatments and therapies. These are the infusions and specialty drugs that people have for the cancer and other difficult conditions that people have. Increased prevalence of chronic conditions like diabetes, autoimmune diseases, musculoskeletal conditions, HIV, cardiovascular conditions, anything that, you know, you hear people being on maintenance drugs. These are conditions that people have on an ongoing basis. So there's a higher prevalence of chronic conditions. The next bullet is exploitation of the independent dispute resolution and arbitration process associated with the No Surprises Act, which was effective 1-1-2022. This act was designed to protect the patient from balanced bill, from out of network physicians or services that they had no control over. Let's say you go into an in-network facility to have a knee replacement and the facility is in-network, the surgeon is in-network, but let's say the anesthesiologist or the radiologist is out of network and you have no idea, you went to an in-network facility, so before this act, you might get a separate bill for that anesthesiologist and it would have been balance billing you for an amount because it was out of network, even though you didn't know that this person was out of network. So now, since this act, you don't get that bill anymore. However, that anesthesiologist is negotiating with Anthem, or whoever your administrator might be, or carrier, Kaiser may see some of the same things, but Anthem would see this and the out-of-network anesthesiologist, let's say, says, I need $10,000 for this service I performed. And so Anthem says, no, we're gonna pay you 1500 for this service. And they say, we wanna go to arbitration. So they each submit information to an independent reviewer, and it's baseball style. So the independent reviewer gets information. There's a particular, there's a very specific form that has to be completed. and they get the information from each party and they have to choose one. There's no negotiation, there's no going back and asking questions, they have to choose. So they choose based on how much of the information was provided because there are like six boxes that have to be checked in terms of the information and if one party completes three and the other completes five of the six, of course they're gonna choose the five, the one that completed five. Or whichever one completes the information they think is the best information. So they choose one and 80 to 90% of the time, the out of network, our entity is winning these arbitrations. And so in that case, the county might end up paying 10,000 instead of 1,500, because that's what the independent reviewer chose. So that's why I say the exploitation. There's a lot of noise around this right now. Several health systems, health carriers have petitioned Congress and there's a lot of review going on of the process to see if what can be done to reduce the exploitation. Next to the last bullet, of course, is the higher acuity and more complex illnesses. So people are just sicker. They have more difficult situations and illnesses, things that are harder to treat. It's more complex. And of course, general inflation is part of this also. Next slide. So Fulton County, here are some healthcare stats briefly. So 54% of Anthem enrollees have a chronic condition, an ongoing condition for which they need regular treatment. Another 6.2% have critical health issues. Those may frequently end up in the ER or inpatient services, they need significant treatment. care. The health risk score for Anthem enrollees continues to go up. It's gone up 4.8% to 2.9 and the health risk score is an indicator of the overall sickness burden of the population that we're looking at. So these are enrollees in the Anthem plans. So this group is getting sicker. They're the complexity of the care that they need is increasing.

And let's be clear, when you say this group, that means Fulton County employees.

That means Fulton County employees and retirees that are enrolled in the Anthem plans. The medical trend has been hovering around 20% during the most recent 12 months, which is higher than the average market trend of eight to nine and a half percent. And by the way, that market trend is going up. I've already seen adjustments up to 11% on that. All the surveys continue to adjust up going into 2027. The good news is that you have 98.7% of your claims running through in-network facilities. So that's very high. Everybody's using the in-network positions. So that's a great number. And your overall savings or discount rate is just under 60%. And this refers to the contracts that the administrator negotiates. So Anthem is consistently and constantly negotiating with healthcare systems around here and physician groups to try to get the best discounts and the best pricing for their members who are enrolled in their programs. Next slide. So over the last three years, we see here in those red circles that the inpatient discounts that they've been negotiating with the hospitals have been declining. And 26% of your medical costs are coming from inpatient care. So Like I said, they're constantly negotiating, but it's appearing that their negotiations are not as good. They're not able to get the same level of discounts, and they've gone down over the last three years. The discounts for outpatient, emergency, and professional, which is your PCPs, your physicians, your primary care physicians and specialists, have not changed that much. They've hovered around the same levels all three years. Next slide. So this is on a per member per month basis. You can see that the cost of inpatient hospital and outpatient hospital. Outpatient hospital would be your surgical facilities that may be standalone from the hospital as well as the outpatient area of the hospital where you may go to get services done, radiology, infusions, things like that. You might get a one-day hip replacement outpatient surgery at a surgical facility. So you can see that over the last three years, those costs, well, two years, from 24 to 26, have increased quite a bit, 34.5% for inpatient and 53% for outpatient surgery. and your specialty costs for the specialty physicians has also increased. So overall your total member per month costs for all of these services has increased 33.5% over the last two years. And this is due to utilization and all the increased costs that we went over earlier. Next slide.

Just real quick point of clarification. That's just for Anthem?

Just for Anthem. All of these slides right here are just for Anthem. And this also is just for Anthem. So this is a rolling 12 months for the most recent 30 months through June of 26. And you can see in February of 25 under the rolling 12 month column in the left column grid, which is medical only for active and under 65 retiree plans, you can see where the costs started ticking up. And you can see their run rate and the actual claims that were paid every month, the number of enrollees every month, the PEPM, you can see how it ticks up significantly. And then on the right side is the prescription drug coverage. and it's been hovering in the mid to upper teens most of the time also. We've seen the high drugs over the years, for the last several years, they've been hovering in that high category. But the medical this past year just exploded in costs. Next slide.

Thank you, Gina. So I want to go over just very quickly some of the rates and a couple of other things we're doing in finance. And I'd like to advance it to hear your questions and your comments. We also have Anthem and Kaiser representatives here if you'd like to ask questions of them directly. So the Anthem self-funded plans, again, as I said earlier, right now the financial reality, I'm looking at a 19.1% increase in those particular plans. If we can advance to slide one, thank you. This shows what the full rate is, and again, And on the Anthem side, for most of those plans, the HSA and the HMO, the county pays 80%, the employee pays 20%. In the top POS plan, the county pays 75%, the employee pays 25%. Those are the rate increases. 19.1, if we make that change in the max out of pocket, if the board decides not to, I'm looking at a 20.6% rate increase among these Anthem plans that are before us. Next slide, please. This is the funding rates for 26 and funding rates for 27, again, showing that same increase. This is for the pre-65 group, which again, bear that same rate increase. Next slide, please. Post-65, again, last year we made that pivot. With the group waiver pharmacy plan, that is bearing fruit. Those premiums can drop 15% from their current rates. Next slide, please. Fully insured medical rates, the top is our Kaiser plan. And just as information, we're pretty much half and half on the active side between our Kaiser fully insured plans and our Anthem self-insured plans. 9.7% rate increase for the actives and the under 65, for the over 65 on the Humana side, we can offer a 13.6 or an 8.8% decrease, depending if you're in the base medical or in the enhanced Medicare plan. The Kaiser Senior Advantage plan, also a very small rate increase. There's a few on the Anthem Part D plan that would have a 9.8% decrease. That's a fully insured plan. Next slide, please. We discussed this earlier on the Humana side, and it's similar to what we did last year on the Anthem over 65 for pharmacy. They refer to it as a decoupling. It allows for more Medicaid subsidies for pharmacy in those plans. If we ought not to do it, the mathematics indicate, I would have to do an increase to those over 65 retirees currently in Humana. Speak up. I'm sorry, yeah, so if we don't opt for that decoupling and take advantage of those Medicare subsidies, we would have to do a rate increase in that Humana over 65 plan. If we can take advantage of that Medicare election, it's a 13 to an 8% decrease in that plan. And again, very little impact on the over 65 retirees as far as their medical pharmacy experience and what they can get. Next slide. Dental and vision, if you can continue the slide. Very little changes in dental, PPO, and vision. Not changing the plan, very little change in rates. Vision's coming down 10%. Next slide, please. Next slide, please. Next slide, no change on the insured dental rates. So again, I wanna go over a few bullet points here. We've mentioned the POS adjustment of raising that out-of-pocket maximum. Doesn't change the premium, but it changes at which level they hit the out-of-pocket maximum. Once someone in the POS plan hits the out-of-pocket for covered services in that plan, they do not have to pay the county bears the full cost. So our health guard consultants, who also review a lot of plans in this area, notice that our max out-of-pocket was low comparative to other plans. So that's why we're recommending a change to a more normalized rate compared to our peer groups. Another thing I'd like to touch on, so the increase in healthcare that we see is stark, as is the increase in premiums. What we are currently not recommending is more disruption to the healthcare experience of our employees when they are at the doctor, when they are at the hospital, when they're at their orthopedist. So we're not advocating any other plan changes. The full brunt of the change is being born in the premiums that we're assessing for 2027. Some other options that the county's looking at. Again, we fully intend to do an RFP. Companies have reached out to the county with various cost saving strategies. They would work in concert with our healthcare consultant. Some other strategies we'd like to seek is maybe some improvement on that arbitration process that could assist the Anthem plans. federal and state subsidies that might be eligible for some of our healthcare costs, some other bundle pricing options. We'd like to issue that RFP in 2026 and in early 27, look at those options and evaluate those along with county representatives and our healthcare consultants to see which ones could bear fruit and then bring that back to a board, to the board of commissioners for approval. If you can go to the next slide. Please continue. So the following, and I won't go through all of these. These are basically built into the slide to show the actual premiums for each specific plan for active, for the retirees and the various plans, just so we have that embedded into the approved presentation. I do appreciate your time. I would like at this point to maybe bring up Verna to really talk about some of the communication plans that we normally do with employees when it comes time to open enrollment, which is rapidly approaching. And given the increase on both Anthem and Kaiser, some of the other things that we would like our benefits folks to do and reach out to the employees.

Good morning, Verna Thomas, Employee Benefits, Finance Department.

Okay, speak up, speak up.

Verna Thomas, employee benefits manager in the finance department. I'm here to speak on what communication strategy for the upcoming open enrollment so that employees will know that we are here for them and they can access us for any questions that they have about their medical, dental, vision, or any changes that are being brought down. Open enrollment for active employees for this year, I mean, for 2027 plan year is going to be September 28th through October 9th. We currently have three sessions planned online, which... Over the years, we've noticed that online sessions yield more employees able to log in. Of course, they may not be able to get away from their desk, but they're able to log in and kind of listen. So there are three sessions, one before the start of open enrollment so that employees can already know what the plan options and offerings are, and then they'll be able to make a decision when open enrollment opens on September 28th. as well as to the two weeks of open enrollment. For our retirees, the retiree open enrollment session starts October 5th, and it goes through October 16th, and we have two sessions online for those retirees as well. Do we have any questions? Mm-hmm.

Thank you, Vernon. At this point, I would very much like to open it up to the board for questions and comments. All right, thank you, Commissioner. Whether it's myself or a consultant.

All right, Commissioner Arrington, followed by Commissioner Ellis.

Thank you guys for the work that you've done in pulling this together. I guess I hate that we're getting it At this late date, because there's not really any time to do anything else or to go back out or necessarily have any negotiations. Can we go back to slide eight?

Which one, Commissioner?

Slide number eight. So- My understanding is that the rates are gonna increase by 20.6%, and that the proposal is to double the amount from 2,000 to 4,000 for those that are on the Anthem POS plan, is that correct?

That's correct, for the maximum out-of-pocket, not the premium. but for when they hit that maximum out of pocket, we would in effect be doubling that limit in that particular plan.

And doubling that limit means that those employees will be paying twice as much as what they've been paying?

No, no sir. So the premium cost is going to be the same whether we do the 19.1% increase or a 20.6% increase. What it means is as they progress throughout the year in the POS plan, they're paying their co-pays, they're paying maybe some out of pocket, some services are covered at different percentages. So at some point, as they are paying their share, they hit the maximum out of pocket. And at that point, they don't have any more co-pays. When they go to pharmacy, they don't have any co-pays. Basically, it's all county costs at that point. So currently, for a single, if they are out of pocket $2,000, that's when the county picks up 100%. We are advocating to move that up to 4,000 And again, all the services are still covered, but they're paying their co-pays up to the 4,000 level instead of down here at the 2,000 level. That does save some cost to the plan, which means everyone would do with the 19.1%. If we opt not to do that, and again, it's a board decision, that means my POS costs will not drop a small amount, which means, mathematically, we'll have to do the 20.6% increase among those Anthem self-insured plans.

All right, and my understanding is, what is the total number of employees that we have on the health plan? Do you have those numbers?

You want to come up, Paul? I'm Paul Janis of Segal. There's about 4,000.

Please speak up, sir. Excuse me.

There's about 4,000 people enrolled in the, 4,000 employees and subscribers enrolled in the Anthem Plan. Another 22,000 enrolled in the Kaiser HMO? 2,200. 2,200, okay.

Okay, so 4,000 enrolled in the Anthem Plan. And how many of those are enrolled in Anthem POS?

It is, I wanna say 1,300. Okay, is that right? Yeah.

Okay, thank you. 1,300, okay, so the number I was told yesterday was 400.

So there were 400 individuals, approximately 400, that hit the out-of-pocket maximum. So as you, approximately 400 of those 1,300 that are enrolled in the POS plan had hit the out-of-pocket maximum at the $2,000 level. So as they paid their co-pays, if they went into the hospital and had to pay coinsurance, whatever, their expenses at some point hit 2,000, and then after they got up to that level, then the county picks up 100% of any costs above that level. So what we're advocating is, and that's a very low level before the county picks up everything. So we're asking that they, we're proposing that that level be doubled, so it would be 4,000. So individuals would still pay their 20 or $30 copay that they have when they go to the doctor, It's just that they wouldn't hit that point where this county picks up 100% of it until they had paid out more of their pocket. But it's going to be a different group of people every year depending on how your expenses fall in that year. It's not going to be the same people that hit the out-of-pocket maximum every year.

Right, but so I think the long and short of it is the plan's going up by 20%. And we're proposing that 400 people or 400 or 1,300 people cover the cost of reducing it to 19.1%.

not necessarily i mean it's it's just they're it's reducing the point it's it's making the point higher where the county picks up the costs so it could be that they spend eighteen hundred this year and would never have hit the out-of-pocket. It could be that they spend six hundred this year and never hit the out-of-pocket. It could be that they spend three thousand next year and don't hit the out-of-pocket because we had raised it to four thousand. But, you know, there It's variable every year based on your specific health needs that year and how you use the system and what you need from the system.

My questions aren't about the individual care. My questions are about the 20.6% increase. And the way to get that 20.6% increase down to 19.1% is by doubling the amount from 2,000 to 4,000 for those employees that are on the POS system, right?

I'm sorry.

That's the proposal. You're proposing that double the amount that these have people pay for out-of-pocket expenses.

Double the amount that they would be paying before they hit the out-of-pocket limit.

Limit, before they hit the cap, double the amount.

Before they hit the cap, yes.

Yes, so double that amount for those 1,300 people, of which only 400 are hitting that number. So double that amount for those 1300 or really those 400 people in order to bring the cost down to 19.1% for everybody. So basically 400 people are paying to reduce the rate 1.5% for everybody else.

Yeah, that's correct. And you can look at it conversely as well. So if we opt not to make that change, the POS, again, is one of the more expensive plans in the Anthem suite of plans that we offer. So I cannot make the adjustment, which means costs are a little higher, which means I'm asking everyone not in the POS plan to contribute 20.6% in order to fund the cost to maintain the POS at the current level.

Okay, I like that.

So that's sort of the flip side of it, right? Right, I like that. Right, it's like who's bearing what cost. So that's, fundamentally, that's a board decision, a management, technically a board decision. How do you want to spread that particular decision? facet of cost. And again, there's a lot of changes that we could have recommended that we did not want to. Again, I'm not looking to really change that healthcare experience for our employees, but this is one thing that Siegel mentioned. They actually provided a slide that, again, looks at a lot of other entities in this particular area looking at their limits for out-of-pocket, and ours were, I think, the lowest or one of the lowest in the general area. So we make this move, and doubling sounds bad, right? That's a big increase. But it actually brings our POS plan to pretty much what the other government entities are offering in this particular area.

No, and I'm glad that you pointed out the flip side of that coin. I mean, the challenge, I guess, for me and us up here is not only do we have to look at this from saving the county money, but we also have to look at it from the employee side as well, right? Absolutely. And so there's a delicate balance between how do we save the county money and passing that burden on. But I think your point is, well received that if we don't do that, then all the other employees are covering the cost for.

Yes, sir. And that is part of the analysis that does take quite a bit of time. Again, how much is county versus employee? And I think a lot of our focus is going to be on what the total claim cost is, because that's the real number that we're trying to recover through whatever means. And what are our thoughts over the next few years to try to prevent the increases certainly that we've seen in the last 12 years? I mean 12 months, I'm sorry.

All right, yeah, I mean, prices are going up everywhere. Prices are up at the grocery store, the gas station, so it only makes sense the healthcare costs would be going up. I just didn't want to unfairly place that burden on- Yes. 400 people to reducing the plan for everybody else. But again, I think your point is well received. That's the most expensive plan. So those people might be getting. they may be passing the burden on to all the other employees for having the most expensive plan.

Yes, sir. They're difficult choices, absolutely.

Thank you.

Yes, sir.

Commissioner Ellis.

Thank you. You kind of got at one of my questions, and that was just in terms of plan design on the out-of-pocket. These changes would put us more in line with kind of what the comparable folks are. So we've been on the low end. And sort of in the same vein, too, POS, HSA, and HMO, all those, we sort of got it sort of at the same, you know, premium change things, but is the experience in the HSA plan specifically been you know, as bad as any others, or are we blending these together just for practical purposes?

Right now, practical purposes. We treat these as one insurance cost center, these particular plans. We, over the years, have not run rates specific to each separate plan. So again, that total cost we need in this Anthem suite of plans, it's either 19.1 versus 20.6. HSA plan is one of the least costlier plans. That's the high deductible plan. The POS is generally the more expensive. We have a lot of folks in the HMO plan, which is supposed to be that middle ground.

I guess, you know, our delta on that, I mean, I guess just sort of thinking about it, you know, in terms of you want to have stuff structured so that, you know, you're potentially incenting people to consider, you know, kind of, you know, plans where they take a little bit more risk and, you know, more actively manage it, right? So I guess in terms of this, Is this a typical approach in terms of just where you would treat all this sort of the same versus create a degree of distinguishment between HSA versus the other structures?

So, again, I'll just chat with Vena. It varies by client. It varies by client. to your point, maybe something we review in a more broad review of these plans, and do I run each separate plan as a separate insurance pool? Okay. We typically have not done that, but that's something we can put on the radar for next year.

So right now we're potentially, participants in the HSA may be subsidizing some of the costs. Absolutely, yes, sir. Yeah, right now they're in some costs. That's basically where I'm getting at. And then on, you mentioned this Humana plan and taking advantage of that and all that. Is that built into kind of all of the figures that you showed us, or is that something that's not factored into? I'm not quite sure.

So that is not included, certainly, in the anthem plan. That one we run. No, I know.

And the overall thing, if I go back to kind of this, you know, kind of overall pick. Oh, yes, it is. Yes, sir. It's included in that. Yeah. So that's not something that...

We'll generate additional, no, that's with, yes. That's with, that's built in here. Yes, sir.

Okay. The concept of pulling an RFP, approaching these folks about some of these options for getting at some of the things that you said, and I guess there are probably some real practical pieces to this too, right? Because of that And those cost driver pieces of it, you're at, significant portion of this is chronic, chronic or critical, right? 60% of the cost associated with things.

And we have some on Kaiser, but we believe...

Right, I know, right. But it lends itself to some of these programs, right, in terms of just... It could, yes, sir. If you're on the same type of, you know, prescription stuff, being able to extract discounts off of that, or material cost in it, right? So I guess my question is, how quickly can we get this out? And let's say we find something, and we... see that there are benefits to that. How do we, when can those potentially be realized and can there be some adjustment midstream or is this a future look kind of thing that only gonna come in in 2027.

I think future look, so last year when we did the contracts for all our plans, we included language that allowed, and I'm gonna use the term, it's probably not accurate, but a bolt-on solution to the existing suite of plans that would allow for something like we're considering. The RFP, I hope that we can get out probably in the next couple of months with help from Segal. Get responses back. evaluate those responses as to merit and financial advantages of those plans, see what kind of contracting would take place for those plans. So again, it's going to be a broad RFP. I don't know the specifics of what we will see, but I'm very interested in evaluating what proposals could come back.

Okay, I guess maybe I'm going to answer my question. If we do this, we run it, we implement something, let's say, you know, in the first quarter.

Right.

Right? We start to see some degree of benefit from that.

Yeah, can I change rates midstream? Right. That's my question. I will have to ask Verna and the group. We've never done that before, but that doesn't mean that we can't. Doesn't mean that we can't, to my knowledge.

Do we need Amana to answer that? I mean, do we need Anthem to answer that question?

I think that's our decision.

That's our decision, right? I think that's our decision. We're controlling that cost. Yeah. Right. Well, I mean, I think we aggressively need to do this. I mean, if I'm looking at that, then I know you highlighted, well, you highlighted clearly the medical trends, you know, that those pharmaceutical costs are pretty persistent, right?

And they're pretty consistent, right? And I think that's,

Those are pieces, and if I looked at that, it looked like that's like a 11, 12% trend on pharmaceutical costs, which have been like this too, right? And it seems to be from looking at a lot of these programs that are out there, that's where a lot of times the more quicker realization of cost savings rest. Is that a fair statement?

Yes, and I'll... I very much would like to see that. I would really like to see something, and you saw on a previous slide where the substantial cost growth in hospital inpatient outpatient. So also looking forward to any potential saving strategies in that regard, because that is a big driver of our increase in cost over the last several months. But yeah, saving money is saving money, whether it's hospital or it's pharmacy, whatever. Great, I get that. All are welcome. All are welcome, yes sir.

okay and then like we're you know is there anything in there where like let's say you know that's different like our top 10 20 claims are outsizing sort of impact on cost is that is there anything that's indicative of that in terms of either this year's trend or just historically, right? Are we running where your top 20 claims or something like that overweight kind of the cost driver or no?

We had a very large claim this past year that was,

quite a bit an outlier. And we found out that that person is no longer on the plan. So we took that out of the experience and did not project that cost forward. So we do, we remove a lot of the higher outliers to look at what the future experience may look like.

Is that what you're asking? Right, but you're going to factor in sort of streamlining that through, right? You're going to say, hey, I had this outlier, but you're going to predict that I have an outlier once every three or four years or something, so I blend that in. I guess what I'm really getting at is like, and this is sort of getting at this RFP thing, right? If you've got, and I think this is where some of these programs are, I think that are out there that are designed to try to get at how do you help fund sort of these cat claims, if you will, right? Not only for the employers, but also for the participants, right? Because let's not lose sight that many of these are pretty catastrophic events for the folks that are having to go through the care. So like is that bucket of sort of really large claims each year, is it a significant piece of kind of the overall cost?

It is a significant piece of the overall cost.

Like what would you suggest in terms of level of magnitude?

And how would you look at sort of? Probably 40 to 50%, maybe even higher some years.

Or driven by the overall cost? Top 20 claims?

Do what?

Are driven by top 20 claims?

Are driven by the top, I would say of claims, maybe over 100,000, like large claims. So high cost claims, let's say claims over 100,000, which could be 100 claims or more that you have. But the top, let me try to add this up in my head. It's probably 20% or so of your cost, the top 10 or 20.

Okay, so that's another piece where I think in a lot of these programs that are out there, I think that there's an opportunity to attack that as well as sort of this prescription piece for folks that are on persistent meds that are predictable. So I guess that would be my ask, as long as can we get that stuff out there as quick as possible so we can start to evaluate it.

And I know you were asking, I want to come back to your question about changing rates in the middle of the year. If we put something in, we would want to see how it's actually playing out before we make any changes in anything to make sure that we're actually getting the savings that

was promised I get the actuarial piece of it and all that but you know just you know whether it's a you know right small adjustment right you know versus a large adjustment kind of thing until you get something that bears out but I think if we learn something given the magnitude of these jobs it's something that potentially that we've not done before but I think that we should consider if we still see that because as I understand it too some of these things they require, in order to realize the savings, they do require participation from, for the participants, right? To enroll in things like mail order prescriptions and that sort of stuff, right? So if some of that stuff could potentially be coupled together and then help, you know, bring that down by participation from employees, I think that there's some rationale for it. So anyway, thank you.

All right, Vice Chair Abdur-Rahman.

Thank you, Chairman. Did you all say someone from Anthem was here?

Yes, ma'am.

Okay. Out of curiosity and for the listening public, what was the total corporate net income? Does anybody from Anthem know that for 2025? What was the question? What was the total corporate net income for Anthem for the year 2025? Can anybody answer that?

And where are they? They're right here. Okay, y'all sitting far away.

Can y'all, can somebody answer that? Can somebody come forward?

Good afternoon, I'm Sawanna Jefferson. I'm the strategic account manager with Anthem.

Good afternoon, my name is Carky Freeman. I'm clinical account director with Anthem.

Okay, thank you for being here. I was just wondering.

And Sawanna's trying to find an answer to your question.

Okay, all right.

If y'all don't mind, I'm gonna share a little bit about high-cost claimants and what's driving a lot of Fulton County's cost, if I may. So in 2024, Fulton County had, and by high-cost claimant, I'm gonna define this as $50,000 or more, better. And for 2024, Fulton County had 276 members that had claims in excess of $50,000. Oh, how much?

I'm sorry, I didn't hear the last part.

$50,000. $50,000? Yes, ma'am.

Thank you.

Okay, for 2025, that number increased to 332 members with claims over $50,000. And then for 2026, right now we've got 90, but that data is only good through August of this year because we're still in September, so I'm not going to have the most recent information.

Can you all hear me okay? Okay. Yes, sir.

So for your high cost claimant spend in 2025, your top 10 high cost claimants were $5.5 million. I'm sorry, that was 2024. For 2025, can I round 8.98 million up to nine million for mathematical purposes? It'll make it easier for me to calculate that that was a big increase in your spend as well. and a lot of your high-cost claimants are gonna be ongoing high-cost claimants. I did hear the consultant mention that one of your high-cost claimants did drop off, but you've got some ongoing high-cost claimants that will be ongoing in excess of several hundred thousand dollars a year. What's driving these costs? There's a couple things driving it. The pharmaceutical industry, for one thing, has a very large impact. If you go home at night and you turn on the TV, how many folks have seen the TV commercial for Skirizzi? Anybody want to take a guess at how much Skirizzi costs? $27,000 a month. If you've seen the ad, there's a new commercial for Caquizzi. Caquizzi is a cancer, breast cancer medication. Don't know if y'all have seen that one yet, that medicine. It's $44,000 a month. Councilman Ellis mentioned that, or Commissioner Ellis rather mentioned about having prostate cancer. There's a commercial on right now for Pluvicto. Pluvicto is a six-dose treatment. It's $480,000, that's contracted rate. Thyroid eye disease, you've seen the ads for Tepeza. It's an eight dose treatment, $480,000. What keeps me awake at night is making sure that we have prepared our clients for what lies ahead in the future. And what really concerns me for our clients is the genetic therapy that's coming down the line, the oncology that's coming down the line. There's a condition that children are born with that typically affects males. It can affect females, but it's called Duchenne's dystrophy. It's a type of muscular dystrophy. It's usually not diagnosed until a child is about four years old. And the way they diagnose it usually is the child's having trouble getting up from the sitting position to the standing position. And all of a sudden, we start doing a study to see what's going on with them. Well, they get to change history as a diagnosis. There's a medicine to treat this now, and I hope the commissioners are hanging on to their chairs right now, but that medicine is called Elevitus. It is $3.2 million for a one-time treatment. The scary part of this is most families, if they have a four-year-old, if they're planning a family, either the next child is here or possibly they're planning the next child. We've got a group right now that's got two kids that have this, and it was $6.4 million for two claims. Hemophilia A, hemophilia B, they have genetic therapies available too. One of them is $2.8 million, one of them is $3.4 million. I lay awake at night thinking about how insurance plans will continue to afford this, and it bothers me to the point that I think that some companies will have to decide that we're not gonna cover this anymore, or this is something that we just exclude. But there is light at the end of the tunnel. There is a way that we can partner with your consultant to try to give some solutions for this. Fulton County last year, you had 2.3% of your population that accounted for almost 51% of your spend. that is a very small percentage of people accounting for that spend. And one of the ways that you can think about doing this, I know your consultant has mentioned some RFPs that they have out, but one of the things that you could consider is doing stop loss. This stops the bleeding. So if you do a stop loss for a member at $300,000, anything above $300,000, your stop loss carrier, which could be Anthem, will pick up that cost. Fulton County also has an aging population. Fulton County has, I believe it's around 1,700 members that are over age 65 that are still working. Your top 10 high cost claimants, if we factor out the child that Segal mentioned a moment ago, your top nine high cost claimants, the average age is 60. So you've got an aging population as well. So again, our job is to try to partner with you to find some viable solutions for you. And Solano's got the answer for you, Commissioner.

So for quarter two, it was reported at roughly 1.45 billion for 2026. What? One quarter? Quarter two ended in June 2026, the net income.

Okay, were you finished, sir?

Actually, I was gonna take a break and take a breath and give you guys opportunities to ask questions of us.

Okay, thank you for giving me that information. I am very concerned about the Anthem increase and its impact. You're talking about 19% this year and nearly 25% in two years. For me, as a legislator sitting here, I have to think about the employees. I have to think about their families. I have to think about the fact that there's a rising housing cost. There's rising food costs. There's rising costs when it comes to educating our children. There's a rising cost with everything. So I get it. I would be remiss if I didn't tell you what concerns me about this. And it's not just Anthem. It's the whole industry. Yesterday after the meeting, I asked my staff to pull fiscal year 2025, 2024, and 2023. For the year 2023, the total corporate net income for Anthem was $5.99 billion. And that was the corporate net income. Now the health benefits operating gain. That's the coverage profit was five point seventy billion. That was in twenty twenty three. In twenty twenty four it was five point ninety eight billion. The corporate net income and in twenty twenty four. it was $5.40 billion in the coverage profit, the health benefits operating gain. And in 2025, the total corporate net income was $5.66 billion, with it being the health benefits operating gain coverage profit of $4.20 billion in 2025. Now, that's not to throw Anthem up on the... It's a bust. But when we make decisions that are gonna affect the lesser of these, people that's gotta choose between getting to work taking care of children, having to make sure that they can come in to work every day and serve Fulton County. And I'm not talking about, because Commissioner Arrington and I have had several conversations about this. We're not talking about those six figure people, those people that are making 90. and 80,000 which some of them are feeling it too. We're talking about those employees that are making 30,000 and 24,000 and 40,000. They are going to be the ones that are going to suffer with this chairman. I just want to make sure my charge not only to my colleagues, But to those that bring us the information back, that we make sure that we don't put an undue burden on employees who are getting burdens put on them every day. Now, I understand very well, being the daughter of an entrepreneur and an entrepreneur myself, that people are in the area to make money. You want to make profit. But when that profit comes on the backs of our security guard or our dream employees or any of our employees that are front-facing employees that are robbing Peter to pay Paul, I want us to make sure that we have the best coverage for the least amount that's going to allow them to be able to face what they need to face on a daily basis. I get it. I understand there are rising health costs. I also understand everything that you just said. But I don't want to lay awake at night thinking about that Fulton County employee that has to choose between possibly dropping coverage and having to make sure that they can pay their rent, that they can pay their car note, that they can do all the things that they need to do to be able to keep their employment here. So forgive me if I'm not supportive of this, Chairman, because it would be very hard for me to be supportive of something that ultimately will affect the leaser of these. And so those are my comments on this.

Thank you, Vice Chair. Commissioner Barrett.

Thank you, Mr. Chairman. I, for the most part, agree with everything my colleagues have said, and in particular, Madam Vice Chair, I completely agree with you. I have some questions, for starters. You know, and this is really directed to you, Ray, or to county management, but you know, this timeline that we have every year is And Commissioner Arrington brought it up. You know, we get a presentation of the proposed rates a couple of days a week before this meeting. And we are informed that we essentially have no choice but to accept what is being put in front of us. Because if we don't, we will not be prepared to start open enrollment on time. And so that essentially turns our vote into a rubber stamp and takes away any actual authority we have over setting these rates. So can you please explain why the timeline is the way it is, and then secondarily, how do we change that so that we can get involved earlier?

Right, and certainly, you know, it's the change that's necessary when we roll into 2027. You know, it needs to start earlier. So as we go through the first half of the year, we're looking at current claims. Siegel pulls those claims from Anthem-Kaiser. Those get evaluated. There's an internal vetting process. I know they go back and forth with Kaiser and Anthem. Sorry, is that better? So again, a few years ago, honestly, we brought these in August. Last couple years, it's now the second meeting in September. So I've talked with my staff as well as Segal that we've got to change and we have to do this earlier, especially given the aspect of the growth in healthcare. Last year for Anthem, it was a 4.5% increase. If I'd had a crystal ball, would I have done a higher increase? You betcha. But attacking that analysis earlier is beneficial to where we can get more runway with the board in evaluating what those prospects are. And conversely, interfacing more is what potentially our proposal would be for healthcare in the next year. So I completely hear your comment and understand.

Yeah, I mean, I think we need to have an official policy that this comes earlier so that we do have the opportunity to push back. You know, this is...

And again, in that pushback, it's the, you know, what's the plan B? What's the option? You know, what is the option? Do we, because again, especially on the Anthem side, we're a self-insured plan.

Right.

And, you know, no one likes the price of gas at the pump, but it's hard to go to the pump and say, well, I just won't pay it. Gas will not go in your car. So on that self-insured side especially, what would be the change based on that pushback? Is it increased co-pays? Is it increased out-of-pocket?

Is it... Is it find a better provider that's not going to double, you know, give us a 19.1% increase? Right. I mean, we need some competition here. Right. And we don't even have time to demand that. Right. You know... So let me ask you just a little bit further about the timeline here because we are now, you know, September 16th. Right. I just saw an email that said open enrollment starts in like two weeks or something. Is that correct? What is the legal requirement for open enrollment time period?

Vernon, would you know?

Is there one?

There's no legal requirement per se, but it's all timing with when the vendors get our file, get the employees, the cars. And right now, with us having a two-week open enrollment period, we process everything, and we have to have the file over to the vendor by the first week in December.

Okay, so right now, open enrollment would go from the end of this month through, when does it end?

October 7th. October 9th for active.

October 9th. So they have, people have two weeks basically or something like that.

We've historically had two weeks.

Well, so what can be done to expedite? Cause it sounds like what we're really saying is there's a long administrative time period between, um, when open enrollment ends and the work that has to get done to make sure everybody's on the right plan and has their cards. That seems excessive, that it's gonna take multiple months to get an administrative process done, which I'm sure, and I'm sure there's reasons, and I'm not an expert on how you do your work, but I think, you know, my question would be what can be done to push open enrollment, either start it later or end it later, or something so that we are not forced to take a vote today on something where we haven't even had a chance to say no. I hope we do better next year, but what can be done this year? Because I think there are several of us, at least one who I'm hearing, is not okay with this and is not okay with Anthem putting a 19 or 20% increase on us. And so my question is, can anything be done and what could be done to expedite the administrative process?

That's also a good question. And again, as far as the administrative process, I can let Verna chime in. As far as, I sort of want to be clear on Anthem forcing a 19.1. It's not Anthem. Anthem manages, for an administrative fee, the claims cost that we financially endure. Our Segal consultant looks at what we have been spending, what we project to spend, and that's where the 19.1 percent is derived so we and it's we're going to have the same conversation in the next few months on the general fund so we have our projected spend i need to recover enough revenues to pay for that spend so i realize that you may want additional three weeks i totally understand that but again That three weeks is not gonna change the claim experience that we have on Anthem. It's not really gonna change what revenue requirement is gonna be for that Anthem plan, based on the plan as it looks. as far as real options in three weeks, it would be significantly change the existing Anthem coverages for 2027, whether that would be co-pays or out-of-pocket, whatever, but something to lower the projected claims cost in Anthem in 2027. And the board can do that. In this initial proposal, again, that was a conscious decision on my part that the premium increase would be the pain, would not put pain at the healthcare experience of someone who's going to the doctor. My copay went from 40 to 60. My emergency room copay went from 200 to 400. that in this particular plan, I'm not altering that experience. And again, it's been on premium.

I mean, I hear what you're saying, and I appreciate what you're saying. But at the same time, Anthem has a role. And part of that role is negotiating with the providers. Apparently, they're not doing a great job of that. Just bear with me for a minute. And clearly, because it's page two of your presentation from Siegel, you are laying out a bunch of reasons as to why our healthcare costs have risen. Some of those are the health of the population in the county. The number one thing on here is the first thing, I'm taking them to be in order of importance, that could be wrong. But the first thing on here is increased private equity involvement. And Mr. Chairman, you alluded to this. I looked up some of the local firms who are private equity, resurgence orthopedics. And I'll say I believe so that I'm not calling anybody out if I'm getting it wrong. But what I believe from my Googling is resurgence orthopedics, North Atlanta Primary Care, Atlanta Gastroenterology Associates.

That's me.

Yeah, well, I go to two of these already, and I'm planning on changing that. Metro Derm, Eye South Partners, which is Georgia Eye Partners, and Steele Dermatology, just to name a few. And I don't know how many of those are, you know, our claims are, I don't know. But I think it's worth taking a pause about the Fulton County situation and to just say about health care in general, private equity is, and maximizing profits, is fine when you're talking about widgets and cars, maybe not even cars, but it's not fine when you're talking about lives. And it's not fine when you're talking about people's health. And I am fine with doctors making a living and making money. I'm fine with insurance companies making a profit. What I'm not fine with is people maximizing profit at the expense of health and people maximizing profit and charging the funds to employees who are barely getting by, and frankly, in the public sector, to taxpayers, ironically many of whom can no longer afford health insurance. If we're talking about, and I think I asked this question online, I don't remember the answer, but the total increase in cost to Fulton County per year of the current poorly negotiated plans, sorry, is 10 million a year it's going to be about 11 million total on the county side about two and a half 2.6 on the employee side depending on what point so okay so so right so our employees are paying 2.6 million more and our and we the the county government is paying 10 million more and madam cfo that's how many mills in our tech in our property tax rate

10 mil would be more than 1 tenth of a mil. Each 1 tenth is about 8 mil.

So we're raising taxes, arguably, or we're cutting services in some other arena so that private equity and insurance companies can maximize profits. That's what taxpayers are having to bear. I'm not okay with that. And I'm especially not okay with it when it's double the annual or the national sort of increase of 8.9, whatever it was, 8 to 9% that we're seeing around the country, right, as the rate increase. Like normally I'd be complaining about Kaiser at a 9 point something percent increase, but that is aligned with the market as much as I don't like it. It is what it is. 19.1, not so much. So I guess my question is, so you've got on here AI, private equity, And this dispute resolution issue, so these are non-medical issues that are a part of this cost increase. Why is it that our taxpayers and our employees are the only ones bearing the cost of this? To my colleague's point, $5 billion in profit for Anthem. How much are these private equity firms making? We don't know. But at the end of the day, if there's no competition and we have no one else to go to, we can't go to other providers or other brokers, no offense, who are negotiating better rates. then I guess we are stuck. But that's not how this should work. And it's not how it works everywhere. There are plenty of examples of other governments who have had more time and who have said no to these outrageous raises in cost and who have found other providers, brokers, insurance companies, whatever it might be, and found better rates. So I could go point by point. You all know I like to go on and on and on. I don't have to do that, but I can't support a plan that's going to put this kind of burden on our employees or our taxpayers. It's just not appropriate. That burden should be shared.

Commissioner Arrington.

Thank you, colleagues. Yeah, that number of $5 billion and It basically makes the entire discussion about healthcare costs disingenuous. That's $5 billion after you've paid for all your expenses. After you've paid for the top 200, the top 100, the top 500, it's still $5 billion left. So I don't want to hear about your expenses. I don't want to hear that the costs have gone up. That's irrelevant. You're still making $5 billion a year in profit after everybody's salary is paid for, after the taxes are paid, after everything is done, there's still $5 billion a year. I started out talking about the timing, and they talked about the timing as well. I mean, this has got to be done six months in advance. so that we can get United and Aetna on the phone and get some other options and have time to reach out to them and make sure that we're getting the best offer. It doesn't sound like you're gonna get four votes today. It sounds like y'all need to make us an offer we can't refuse. An offer we can't refuse. At 20%, we can refuse that. At 20%, I can get Aetna on the phone. At 20%, I can get United on the phone. In my line of work, there's a term called most favored nations. And what that means is the best rate that you're giving anybody else, that's the rate we want. The best rate and the best deal that anybody in this country or in this world has, that's the rate we want. Maybe we need to look at this, colleagues. We need to be talking with ACCG and NACO. Right? We don't need to be doing this county by county and municipality by municipality. We need to be leveraging not only our 6,000 employees plus Atlanta's employees and Cobb and DeKalb and Fulton's employees to get the best rates for everybody. Because these silos allow for them to maximize their profits without making us an offer that we can't refuse. We wanna provide healthcare for our employees, but, and certainly, everybody's in business to make money, right? I don't wanna beat up on Anthem or any of our providers. Everybody's in business to make money, but It is absolutely disingenuous to come in here and to start telling us about why healthcare costs are going up. You don't have to tell me why healthcare costs are going up. I know why healthcare costs are going up, because all the costs are going up everywhere around the world. What I need to hear about is how are we going to minimize the impact of the fact that healthcare costs are going up on our employees. And so I don't know. I don't know if y'all gonna meet that September 28th deadline for communication. Because based on what I hear, it don't sound like you're gonna get four votes for this. So that's gonna have to be looked at. And Mr. Manager, we gotta find a way to have a six-month runway to be able to be in a position to look at other options without a gun to our head. I mean, this is literally coming in saying, hey, you gotta decide this. Today, it's a stick-up. This is a stick-up. Go up 20% or no healthcare. And you gotta decide by tomorrow. That's a stick-up. Make us an offer we can't refuse.

Vice Chair, Dr. Rockman, and is Commissioner Thorne, are you still with us?

Yes, I am.

All right, wanna hear from you. Vice Chair, Dr. Rockman.

Let me be crystal clear because I am the person that often speaks about staying in one's lane. And so I know that you all have been tasked to do something and you came back. with what you thought probably was the best solution with what you had. So let me be crystal clear. I want to know options. I want to know options. And the reason I say I want to know options is because In my almost seven years of being down here, my office gets the calls from everything from housing issues, employment issues, insurance issues, you name it, the advocacy that the Mighty Six has built, we get the calls. That's not to say that anybody else doesn't. The reality is when I make this decision, I want to truly know that there is no other option. And I want you to know today, I have not been convinced that there's no other option. If you come back in two weeks and you go back to the drawing board and you come back and you say, hey, we've looked over it, there is no other options, then maybe, just maybe, my thought process would be different. But today, thinking about why I'm sitting here, the Fulton County employees, the Fulton County taxpaying citizens. I'm not gonna lay the burden at you all's shoulders without issues with the healthcare industry or the issues with the marketplace and all of that. That's not fair. So I don't want you to think that's the purpose of my comments. The purpose of my comments are Is this the best option for Fullerton County employees and Fullerton County taxpaying citizens today? And I have not been convinced of that, Chair. Thank you.

All right, Commissioner Barrett.

Thank you, Mr. Chairman. I just want to add to the crystal clarity here. The options I certainly want to see are not about how we can reduce the level of service for our employees. So to me, the options of making the employees pay more, a higher share of the same dollar amount or the same increase or having employees get less benefit you know higher out of pocket higher deductible that those are not the options that i'm interested in i want to hear options that include better negotiation in 2027 on the uh On the IDRs, I want to hear options that include better negotiations in 2027 for this plan with the private equity-controlled entities that are providing health care. Those are the things that have to be done. Those are the things that have to be addressed by our providers. Otherwise, what do you provide? If you're just a pass-through, if you're just collecting a fee to do administrative work, I feel like we could probably find that somewhere else. Your job is to get these plans in line for us and get us the best deals at these practices and to win these arbitrations and to not let us be taken advantage of by these kinds of, you know, I think you had a slide that showed that our discounts over time have gone down significantly. Why is that? Whose job is it to negotiate those discounts? I know it's not my job. So I know it's not her job. So that's, I wanna hear how y'all are gonna do better, not how we have to compromise more and our employees have to compromise more. And I agree with Commissioner Arrington to some extent in saying that if Kaiser can come in at 9.6, y'all can do better than 19.1. Maybe it's not 9.6 or whatever, but 19.1, 20 is too high. It's unacceptable. And you have to do some work to get us there. We can't just put it all on us and say, oh, well, sorry, that's too bad. You've got sick people. And private equity is taking advantage. And they're winning these IDR arbitrations. Oh, well. And put it on the backs of employees and taxpayers? Mm-mm.

Commissioner Ellis, then Commissioner Thorne. I'm sorry, you wanted to respond. What?

I don't really want to, I didn't ask a question.

Okay. I didn't ask a question, so.

So I just wanted to make a point.

Just a minute, just a minute, just a minute. Commissioner Ellis? No, she, I think she had one.

I didn't ask a question, so I'm not inviting Tom, thank you.

Okay, all right. Going back to slide two.

Slide two.

Yeah. Is that overview slide?

Did you say slide two? Two, that's it, two. Slide two.

Yes, go to slide two. One, two. Hold on. That ain't slide two of mine. What page? I thought it was slide two. It's the one that says overview of county health care plans.

Go back one more slide, please.

Yeah, the real page two, I guess. All right, so on this here, on this slide here, can you walk me through, and let's just take, on the total plan cost number for 2027. Can you walk me through the amounts, attributable, estimated amounts, because these are estimated based upon who's enrolled and what plan and all that sort of stuff too, right? Correct. Give me the estimated amounts by provider and the total medical and pharmacy costs. These are roll-ups, so just give me the breakout by provider. Okay.

Unless you guys have them at the ready, I would have to give those back to you again. All plans roll up, active, under 65, over 65, those are all embedded in that top run of numbers. Okay.

How long would it take to get that? We can do that.

Does anybody have that?

No, I mean, can we do it like now? I'll tell you why I'm asking this question. If we're going to get to some sort of potential resolution today, I need to know an answer to that. I agree.

We can have that this afternoon, which would preclude us from making a decision today on the health care rates.

The pick in terms of the price increase. This is partly a choice by us that's informed by both claims experience as well as our cost of administration. that we pay to the providers, correct? It's those two components.

We paid administrative cost to Anthem. Right. And I view them as the administrator where the providers are the suite of hospitals, pharmacies.

I got that right. Right, okay, okay. And that's gonna be my follow-up question is, within that 122, how much of that's to Anthem? in Humana and et cetera, right, Kaiser? Kaiser, yes, sir. And what portion of that is attributable to administration and what portion of that's attributable to payout to providers, et cetera? You understand what I'm saying?

Well, when you say providers, you know, we can see... Not providers, I mean the...

The claims. For the claims, right? Yeah, Anthem side versus Kaiser side. So administration versus claims, right? Yes, we can get that data. So claims expense versus other. So how difficult would it be to apportion that out and provide that?

No, we can do that. I don't have that data sitting here at the microphone, but we can get that data very quickly.

They might have it together after lunch?

Could, sure. Is that right? You can get that after lunch? You guys have your machines with you?

Is that a yes? That's a yes. Okay, I'm gonna propose a motion to hold on this so we can come back and potentially get that information.

Okay, yes sir. All right, there's a motion to hold, and I'll second the motion to hold. We wanna hear from Commissioner Thorne. Commissioner Thorne, can you hear us?

Yes, I can hear you, can you hear me?

You have the floor. The motion on the floor now is to hold, but I'm interested in your comments.

okay um i concur with a lot of my colleagues i feel like i don't have a choice but to rubber stamp as well um so but given that you were going to suggest that we raise the deductible for the pos what is the current deductible for the hsa plan for anthem

The current deductible for the HSA plan is 1,800 for employee only and 3,600 for family. That's the deductible. We are proposing an increase on the out-of-pocket maximum for the POS plan, not the deductible.

Okay, and then what's the maximum for the HSA out-of-pocket maximum?

For the HSA? It's twice that, so it's 30, I think it's 3600 on the employee only and 36 and 36, 7200 on the family. And the HMO, I believe, is over 6000 on the employee and 12000 on the family. Little over, I don't know the exact numbers, but in that range.

So if we raise it from 2,000, I mean, if we raise it to 4,000, if you do the raise from 2 to 4 to 3 to 6 to 4 to 8 for families, will that still keep the POS as the lower plan? Because most people do the HSA because you have that health savings account, and if you raise that, that's significantly high, the POS, won't it be comparable, or getting close to comparable, there won't be much differentiation?

No, there'll be a lot of differentiation. The POS plan has lower deductibles than the HSA plan, and it has co-pays instead of co-insurance. The HSA plan is co-insurance.

Okay. Okay. Then I had a question, too. If you go back to, or it was mentioned that 2.3% of our employees have 51% of our spend. And that there is a stop loss at $300,000 that we could implement.

There's no stop loss right now. We do look at that every year. And we got a quote this year, in fact. And we requested quotes at the levels of $500,000 threshold, $75,000. some 150,000 and one million. And at the lowest threshold of 500,000, the premium for the stop loss was about 5.8 million. And looking at your experience over the last 12 months for claims over 500,000, that was about 5.3 million. So the premium would have been about 500,000 more than what you already paid in claims, the premium for the coverage.

Okay, okay. It just seems like there should be some kind of legislation in because to have 2.3% of your population driving a majority of your healthcare costs, it just seems like there would be some other plan, high catastrophic or something that you could put them on. I don't know, I'm not an expert, you're the expert in this, but is there something legislatively we should be urging to get done or advocate for?

There's nothing legislatively that would help this. I did want to respond to a couple of comments that were made earlier in terms of contracting with providers. I do want to say that Anthem and United Healthcare and Cigna and I mean, they're all in the same boat. They're all in the same boat. They're contracting with all of the same providers in the area. We did assist the county with an RFP, a request for proposals two years ago. And when we do these proposals, we send out your actual claims information and have entities reprice those claims to see what they're, negotiated discounts are and at the time Anthem was the best at the time overall for the overall cost. But they're all within a couple of percentages of each other at any given time and if you move I mean, you can certainly move to another carrier, but if you move, you're taking your same risk burden and the same sick population with you. So you're just moving your same experience and your same claims. So I just, I want everybody to understand that. So it's... How often do you...

I'm sorry, you said you did the RFPE two years ago. We did it in 2024. I remember that.

The county has it in for five years, did you say? They go five years.

And then if I remember correctly, it was mentioned that Kaiser hasn't gone up significant, but they did go up 9.6%. But if I remember correctly, last year they had a significant increase in their rate.

No, last year, it was three years ago that they had a significant increase, and we were able to get it down. That one was not, we couldn't support that increase, and they did come down.

Okay, but we... we can support this increase. We weren't able to get it down.

This increase is different. So Kaiser is a fully insured plan, which means they hold the liability. They're also a different type of program. They own all of their doctors and their facilities. So they're a different biome that they work in. And we didn't agree with their underwriting and their increase that they were proposing. And so we pushed back significantly and they were able to come down. So with the fully insured clients, they send us rates and we do the underwriting again and say, yeah, this looks reasonable or no, this is not reasonable. And three years ago, their increase was not reasonable. and they did go back and come down. So with Anthem, that is a self-funded plan, so you pay Anthem only an admin fee, an administrative fee, and some other fees for their programs. It probably comes to, I'm guessing, and we'll get this actual figure for you, but it's usually in the five to six percent of the total cost range that they, have fixed fees that you're actually paying them. The rest of this is claims, and the county funds the claims. So people go to the doctor, it's submitted, Anthem goes through the plan design, adjudicates the claim according to the plan design, and gets money from the county to fund those claims. So these expenses, this cost under Anthem is primarily the claims generated by the population and a little bit of the fixed fee that we pay them to adjudicate the program and That's the cost of the plan and that's what needs to be funded, the whole cost of the plan. So Anthem is not giving us these rates. It's not an insured plan where they gave us the rates. We're looking at your experience and the burdens in the plan and this is what the cost of the plan is requiring to cover everybody's claims.

I also agree with Commissioner Barrett and her concerns with the private equity, just bringing awareness. I don't know if we should do an awareness campaign. I mean, not only is it driving up our costs, but I think maybe one of my doctors is in those groups, and now something that would take one visit is taking multiple visits. And that way they can charge me the fees for coming back for another visit. when they could do the blood work for everything all at once. Instead, I'm having to go to the doctor three times just for, and I'm a healthy person. I have just go for health checks. So I think we should bring some awareness to our employees that it is a significant cost. And if we could avoid private equity firms, backed doctors groups, just to bring that awareness, not that employees would have to switch or anything, but just bring them some awareness on that. And then the increased use of artificial intelligence because they can more accurately code services. I mean, we're gonna have a lot of discussion about artificial intelligence during this meeting, but usually you get some kind of efficiency using artificial intelligence that should be driving down some cost as well. So it seems like we're only they're only using the AI for billing and not for other areas, which is concerning to me. And then the No Surprises Act, I was a victim of No Surprises Act. I went in for just a general test with my doctor, with a testing facility in my network, but the person who translated the actual results of the test wasn't in my network. And instead of being $50, it cost me $4,000 for a well-checked visit. And so I understand that that bill is to protect people like me, but then it really shouldn't be falling on the back of the county and the taxpayers for that either. So there needs to be changes that maybe we should try to be advocating for on the federal level to get that where your doctors have to all be in network or you have to be made aware that this is the only person that can interpret your results. And I don't know if you have ideas for that. I'd love to hear them if you do, but I understand you're probably not a legislature advocate by any means. And with that being said, I'm happy to hold this till after lunch and maybe we can get some more data because I do see the need to, you know, make a decision probably today and not drag it down.

Thank you, Commissioner. Commissioner Harrington.

I think Commissioner Ellis' point is right on point. His question is asking about what are those fees and how much is going because that really drives it. But I guess the other question I have is are there Does Anthem contribute to employee wellness? Will you all come have a fair for us? Is there a percentage of the fee that comes back to help with employee health and wellness? Yes, we've got an aging population. Yes, we have maybe a population that needs more service, right? Where does Anthem, what role does Anthem play in helping educate and provide health and wellness to Fulton County employees?

Yes, we did have a wellness fair. This is our third year running with the wellness fair, and we bring all the carriers, insurance, medical, dental, vision. They come out, speak with the employees, offer healthier eating options. It's a fun fair, but it's also to allow employees to...

Yeah, I'm not talking about does Fulton County have a health fair? I'm talking about how much money out of what Anthem is getting are they putting back? How much are they making sure comes back to the employees in health and education? I'm not talking about Fulton County. I want to hear from Anthem.

Okay.

So we give $600,000 a year to Fulton County for their wellness funds to help support their health fairs, any health and wellness events that you guys have throughout the year. We're giving that money to you guys every single year. And we're also allowing a one-time rollover this year into next year, 50% of any unused funds that you guys do not use. We're allowing you to roll it over.

Do not use. Good Lord. We got 600. They trying to save 600,000 by going up on POS. I don't understand how there could be some unused funds and a rollover. Thank you. Is that number a percentage? Thank you for that. And I think that goes to Commissioner Ellis' question is what is that fee, right? How much is Anthem actually getting versus how much is going out, right? But is that a percentage? How is that number derived? Is that number going up by 20%?

Yeah, so it's $7.95 PEPM that we allocate to each employee.

Okay, is that going up by 20%? No.

No, it's not. Okay.

Yeah, look, I mean, it got to make sense. We got to make it make sense. Yeah. Right? I mean, we can't. It doesn't make sense for y'all to ask us to go up by 20% and y'all not going to join us. And I think, again, that goes to Commissioner Ellis' point. Hopefully we'll get that information because we want to be partners too. We want to be good partners. We appreciate everything that you guys are doing. And we don't want to put an unfair burden on you guys. But when we hear, hey, there's 20% going up, the cap is doubling. The cap is going up 100%. and the cost is going up 20%. Good Lord have mercy. How do we justify that without knowing what Commissioner Ellis asked, how much are y'all getting, how much is coming back to the table, and how do we make it make sense for all of the partners at the table?

Thank you. All right, Commissioner Ellis.

Yeah, I'm glad Commissioner Harrington raised that piece about the 600,000 or whatever. I mean, there should be some discussion of potentially that just gets rolled into a reduction of premiums. So anyway, I'll leave it. But here's what I'm looking for when we come back. I'm looking for what's the dollar adjustment that would be required for the Anthem plans as a whole to have no more than the other average increases that we're seeing, let's say on the Kaiser side, let's say 9.7%, whatever the number was.

You understand what I'm saying? We can compute that.

Quantify that number. We can do that. And what that looks like on both, and have some discussions about, you know, some sharing in that, what that, you know, how we might get to that number.

Well, when you say sharing, currently on those HMO plans, you know, it's 80-20, 75-25 on POS.

I'm not talking about sharing between us and the participant. I'm talking about between us and Anthem. I got you. That's what I'm talking about. So if you could have a little bit of discussion on that, come back with some numbers. Y'all can give us a high sign when you're ready to talk about it. But that's what I'm interested in hearing.

Yeah, they're gathering data as we speak, and we'll bring that back to the board after lunch.

All right, Commissioner Barrett, the motion on the floor is to hold.

I'll be quick, just two more things. We keep talking about this administrative fee as if it's like putting stamps on envelopes. Can you please, Ray, you can explain what is it we're paying for in the administration fee?

So again, it's claims handling. Everyone's going to doctors.

Just claims handling. So you're saying the plans themselves, there's no responsibility on Anthem's part for negotiating rates?

Oh, not at all. No, I'm just saying, briefly, what is that administrator? Again, they are the administrator of our self-insured plan. As far as the tasks, components, responsibilities, I would probably let Anthem address that. As far as what's built into that particular administrative fee.

So I don't really want a whole long thing. I'm not just asking you, Ray. I don't need everybody to talk. I just want to understand, because I don't want to drag this out too much longer, but I just want to understand whose responsibility it is to negotiate the various rates and to fight the... you know, the dispute resolutions and to therefore help bring our costs down. I get that we can't change the health of our, directly in this moment, change the health of our employees, our experience, but... Is it your job right to... No, it is Anthem.

It's administrative of the plan. They do negotiate those rates. And, you know, years ago, you would hear occasionally on the news, Piedmont's arguing with UnitedHealthcare, and United can no longer go to Piedmont. So those, again, Anthems of the world, they do negotiate those rates, yes, ma'am.

Okay, thank you for that. And I also want to say, if we don't push back... We, elected officials here and in any other municipality or county or whatever, nobody will. And we have to push back on companies who are maximizing profits on the backs of our taxpayers and our employees, including the private equity health care providers. I'll just say for myself, if we end up having to inform people about who these private equity, and again, my Google is not a fair representation, but if we need to, we know who's in our network. We know who's in network. We should know who they are and how they're operated and who runs those firms. So if those health care providers are owned by private equity, perhaps we just no longer allow them to be in network. That doesn't prevent people from going there if they really want to, but they would have to pay out of network cost because somebody has to push back. Somebody has to.

I appreciate the comment. Yes, ma'am.

I'm ready to do one more thing. Ray, could you look at how much of our increase is driven by rates and how much is driven by utilization? You don't have to tell me right now. Just bring that back because you're not going to defy gravity. You can push back all you want to, but there's a set of numbers here that are going to chart out what's driving a 20% increase. It's those two factors. You just said two years ago when we looked at this Anthem's rates. were the lowest. Now I don't know if that's changed in two years by a factor of 20% or not, but I doubt that it has. So all this faldera is somewhat driven, almost guarantee you, by utilization. Now it may be that because hospitals collectively are not, from this page four, are not granting as much discount to be in-network, that may be a factor. I don't know if that's a factor that Siegel would know, across all providers. not just Anthem, but if you could just get that number in there as well.

It's a great point, and earlier we did pose that question to Anthem of this increase in claims, which financially, mathematically yields the 19.1%, And we understand, if I'm wrong, that about 25 to 30% was utilization. In 25, I went to four doctors. In 26, I'm going to five doctors. Or I'm going to the same doctors, but they're doing more tests. I have to do more things. versus the 70% number was inflationary, a factor of rates. I'm going to the same doctor. It simply costs more for the same as what I've got the previous year. Is that correct, Gina? Yeah. But no, that's a very good point.

All right, Vice Chair.

In closing, County Manager, you took my words right out of my mouth. That's what I was going to ask about utilization. But I think this board as a whole has been crystal clear on what the directive is, what we want you to do. I just wanted to end by saying I appreciate Anthem being here. I appreciate you all listening to us as legislators, because ultimately we have to make the decisions that affect the Fulton County employees. And I just want to reiterate, I'm real big on people staying in their lanes. So I get it. I understand. I just want to make sure that we have exhausted any other options any other conversations that would maybe make a difference in whatever percentage points. I don't know that it will, but I think you've gotten a clear direction from this entire board. I want to thank all my colleagues for chiming in because it's how we get to where we need to get to what's best for the Fulton County citizens. So thank you for your presentation. I know you all were on the hot seat today. I know Anthem was on the hot seat, nothing personal. But the only way we get to what's best for our employees or sometime to have these, what I call sausage making discussions. Everybody loves the taste of sausage, but they don't like the process. And so thank you again for you all coming today. And I hope the director of county managers, Crystal clear from the board as to what we'd like to see. Thank you.

All right, the motion on the floor is to hold all of these items that are dealing with healthcare until after lunch. Let me add two comments here. I would be interested in knowing what our surrounding, our sister counties are doing. And I'm sure that you have that information, what our sister counties are doing. That's number one. And number two, on the stop loss, I'm a big proponent of the stop loss. And I think you said that to implement the stop loss, would only be about $500,000, is that correct?

No, we get quotes last year on stop loss, and based on those coverages on stop loss, the plan would have paid an extra $500,000.

Okay, we'll need some discussion on stop loss, because I am a big proponent of stop loss, and I think we're missing the boat. You don't have to answer, I want y'all to talk about it while you're...

So what I'm saying is the premium for the stop loss was $5.8 million and you spent $5.2 million on claims. So you would have paid $500,000 additional dollars if you had had the stop loss.

But there's still benefit in stop loss. And I think you and I agree upon that. Huge benefit in stop loss.

Yes.

So please discuss that while you're deliberating. All right. Let's dispose of the motion to hold this item until after lunch and executive session.

Okay, the vote is open on the motion to hold.

And that's all of these items?

Yes.

Okay.

When the motion passes. Six yays, zero nays.

All right, now quickly on the Health and Human Services, those next nine items are all renewing existing contracts. You can take all of those and dispose of those unless you want to hold out any more.

Well, that's on page seven?

Yeah, right now. Yeah. On page seven, those next nine items, and I'd like, if there are no objections, you can take all. No, no, not the health care. These are all public works. All public works. Okay. Except that the first one, 260583, that should read in an amount not to exceed. We need to add the word not, not to exceed. Yeah.

Correct.

All right, I'll entertain a motion to sound the clerk.

260583, request approval to renew an existing contract in an amount not to exceed $349,862.12 to provide corporation stops and brass fittings. 260584, request approval to renew an existing contract in an amount not to exceed $300,000 to provide fire hydrant maintenance and repairs. 260585, request approval to renew an existing contract in an amount not to exceed $165,000 to provide laboratory testing services. On page 8, 260586, request approval to renew an existing contract in an amount not to exceed $199,452.75 to provide manholes, frames, grates, and accessories. 260587, request approval to renew an existing contract in an amount not to exceed $350,000 to provide sewer line chemical root control services. 260588, request approval to renew an existing contract in an amount not to exceed $550,000 provides sewer system cleaning and manhole camera inspection services. 260589, request approval to renew an existing contract for professional services for airport consulting and engineering services. design, engineering, and construction in an amount not to exceed $1,015,000. 260590, request approval to renew existing contracts in an amount not to exceed $127,250 to provide soft dig services. On page 9, 260591. Requests approvals to renew existing contracts in an amount not to exceed $382,764.50 to provide easement maintenance in both the North and South Fulton service areas.

All right, a motion to approve of all nine of those with the one amendment. by Vice Chair Abdul-Rahman, seconded by Commissioner Ellis.

Please vote.

Mr.

Chair, I think it was also your amendment to the first one, the not to exceed, both of those amendments. Correct.

And the vote is open. Yes. And the motion passes, six yays, zero nays.

All right, now I'll entertain a motion to recess for lunch and executive session, where we may take up items of real estate, litigation and personnel.

American community to see themselves in a way that media does not always portray. So you have women who are engaged in activities of socialization, self-care, dressed in elegant gowns, pursuing higher education, involved in community service, and just loving cultural activities. This exhibit came to be from multiple phases. I enjoy social media in my free time. And I noticed that there were a lot of videos that came up about black women feeling tired, wanting to live a softer life. And then I started seeing negatives in the photo negative collection that I'm processing, where there are women who exhibited those things across time from the 1920s through the 1970s. And I thought that would be pretty fun idea for an exhibit that's already gotten wonderful positive feedback. There are nine panels in total. Seven of them are based on the collection that I'm processing, and two are from other collections. So the panel here, for example, behind me is from our rare periodicals and newspaper collection. We also have a panel from the Utopian Literary Society's, or literary club, rather, papers. And then we also have albums from our long playing records collection with album covers that also hint at the themes of the exhibit. So we are still processing this collection. It's massive. It's over 80,000 negatives and we are a little more than halfway through it. What I've observed and received is feedback, a lot of emotion. I've had women actually come up to me crying and I gave one woman a big hug at the opening reception. She just felt very much seen. She felt that this touched a part of her that she needed. And I've heard that from a few people that they needed it. The word need, when it comes to an exhibit, that hits a special place, I guess, in the heart. We have a couple of colleagues here who lived through some really strong times in American history, and for them, this also hit them in a special way to see just portrayals of women that maybe they haven't seen in a long time, or emotion of... taking them back to a different place in time was special for them. Also, the way that the panels themselves are designed, they're set up to look like the way someone's grandmother might have photos on the wall. And so that also makes people smile when they come to see the exhibit. I want the public to know that history is not something far away or unapproachable or untouchable, that people can come in and engage with what we have here, and that we're happy to put together exhibits and programs that make that history contemporary and useful for today. Also, it's important because Where we work, working with African American culture and history can sometimes have very heavy emotional impact on patrons and the people who work here. So to be able to do something in a different way that focuses on something uplifting, light, positive, to give a balance to some of the heavier content that also resides here, I think is important for people to not feel fatigue. Please go to fullcolibrary.org slash AARL for more information about programs, for links to our digital exhibits. There's also a digital exhibit that ties into this exhibit that has a recommended reading list in addition to photographs and a Spotify playlist.

This inspiring exhibit offers visitors an opportunity to celebrate history, identity, and artistic expression while experiencing the unique culture programming available through the Fulton County Library System. To learn more about upcoming events at the Fulco Library, please visit fulcolibrary.org today. What an incredible summer reading season! Thousands of readers participated in this year's Unearth a Story summer reading program by logging books, attending exciting events, and discovering everything the Fulton County Library System has to offer. Take a look back at some of our favorite moments from this summer as we celebrate the amazing participation, memorable programs, and community connections that made this year's summer reading program such a tremendous success. This summer, libraries across Fulton County joined communities nationwide in celebrating America 250 through engaging programs that explored our nation's history, stories, and shared experiences. As the celebration continues, we're excited to introduce the limited edition America 250 Georgia Reads Library Card. Stop by your local Fulton County library to learn more and celebrate this historic milestone with us.

Thank you. Thank you.

Join the Fulton County Library System for a special community reading celebration with our 2026 One Book, One Read selection, The Last One at the Wedding by bestselling author Jason Reculak. This annual countywide program invites readers across Fulton County to share the experience of reading the same book and connecting through conversation. In this gripping suspense novel, a father attends the lavish wedding of his estranged daughter, hoping to reconnect. But the celebration slowly reveals unsettling secrets about the groom and the powerful family hosting the event. Pick up a copy of the book from your local library and join the discussion at one of our 34 library branches, hosting book conversations and programs throughout the community. Then, celebrate the story in person at Central Library on Saturday, September 19th for a live conversation with Jason Reculac, moderated by award-winning journalist Karen Greer of WSB-TV. Meet the author, hear behind-the-scenes insights about the novel, and stay for a book signing after the discussion. You can also watch the event live on our Facebook and YouTube channels.

If you're interested in getting more updates about what's going on in the Fulton County Library System, please subscribe to our bi-weekly e-newsletter. You'll receive updates on new materials, staff recommended book lists, event highlights, upcoming programs, and more. Visit our website to subscribe today. Thank you for watching Library Access presented by the Fulton County Library System. Be sure to follow us on Facebook, Instagram, TikTok, and YouTube at Fulco Library and visit us at fulcolibrary.org. I'm your host, Brianna Botsford, and I will see you next time on Library Access.

We're here today for our summer graduation. We have our graduations quarterly, so we were able to celebrate our participants graduating from five of our programs, Drug Court, Behavioral Health Treatment Court, Misdemeanor Mental Health Court, Veterans Court, and then also Recovery Treatment Court.

be happy about a Friday afternoon to hear people that are motivated about change and about the things that they have done in their lives to bring them from where they were to where they are now.

There are people outside these walls who's never dealt with addiction, never been arrested, yet still struggle with accountability. This is an opportunity to build you. It has taught me the true meaning of what life looks like with discipline, consistency, honesty, structure, and accountability. These aren't just recovery skills. These are life skills. It's about becoming a better human being overall. he is such a positive and lovely person to be around. And so often what Mr. Williams has done and what he's been working through in Drug Court is turning that positivity on himself. He's always been his own worst critic and I'm really glad to see him surrounded by people who love him and who reflect that positivity back at him. to remind him what a great person he is and all the great things he has accomplished in his life and in this program. And that's why I'm so proud of him for graduating today. Well done, sir.

He has been a star since entering the program. Even more importantly than that, he became the proud father to a baby girl. He was such a good dad, such a proud dad. We just would love that of him talking about her. He maintained his job as a forklift driver, maintained his sobriety, learned how important it was to take care of his mental health, and he just kept working hard.

You have learned a lot. You can stand with pride and confidence that you faced adversity and struggles like we all do in life and went on and successfully completed this program and went to the other side of life and joy. And so the circumstances that brought you here, you have evolved. You can say that you learned that you worked hard that you had the tenacity to complete this very difficult program for yourselves and for your family and for the citizens of this county job well done everyone job well done

Today, the Department of External Affairs decided to have an impact tour with our state and federal delegation members. The purpose of these impact tours are to highlight services offered by Fulton County and to let the departments interact with their elected officials to know what's going on and how they can help them at the federal level and the state level.

This is important because this is how our elected officials really understand what we do, how we do it, what funding needs we may have in the process of either responding to or recovering from disasters, or even on the preparedness phase. Mitigation is a big thing that typically we have to really fight for funding on.

Okay, so a lot of times people really don't know what takes place at 9-1-1, so it's very important that we're able to give them some insight so they're able to connect those pieces of what it looks like when the responder actually shows up on scene.

Well, I think what's interesting about Fulton County is the amount of coordination it takes because you have, you mentioned, I think, eight other cities within the county that have their own or are part of another one's 911 system. And that's unlike the rest of Georgia. Georgia statewide, I think 90% of the, at least the public safety answering points are county run. So here it's unique because of the amount that are run by cities and cities partnering and how you coordinate with them for emergency response, emergency services. That's definitely unique about Fulton.

I am so glad to have come to this impact tour today to really learn about Fulton County's emergency management system, 911 call center, and how we prepare for emergencies. Fulton County is the largest county in the state of Georgia. It is important that we are prepared, that the staff knows what to do. when any kind of an emergency happens so that they can help to keep us as residents safe. So it was really great to be here today, hear about the kinds of projects that they're working on, the kinds of things that we ourselves can think about that we can do at home to prepare for emergencies, and just know that if something happens in Fulton County, that there are people who will direct us and who will make sure that we are well taken care of.

We wanted to highlight emergency services today because as a part of the 2027 legislative agenda, we will be advocating for support and funding for Next Generation 911 to help expand services across the state and in Folsom County.

We're on Fulton Industrial Boulevard at one of the Fulton County facilities, and we're having the Board of Equalization swearing in. It's important because if they're not sworn in, they're not able to hear the tax appeals for the citizens. These board members do an important job. We did 27,000 tax appeals last year, and what I just heard from the tax assessor is that we're going to be doing 30,000 this year. So the work that they do for the citizens is very, very important.

There are people who get the assessment notice that says what their value is going to be and maybe they think it's too high and maybe they don't read further and know that they can appeal it or they don't know who will be hearing the appeal. So this helps them be able to understand how that process works because there is many steps to it. This gives them a feeling of, you know, maybe I can do this on my own.

Well, I've always been about service. I've volunteered a lot of different places, especially with food banks, with the way things are now. And I just thought this would be a way to serve. I know what to look for, especially when I get my tax assessment. But then I can share that with my community, the members in my community, and my friends and family that live in Fulton County, of what they need to do to make sure that they are being assessed fairly.

I appreciate the board members more than they will ever know. And the citizens should appreciate the work that they do. We listen to the tax appeals. We are a neutral party. And I know people just want to be heard. And they're here to listen. and make impartial decisions. And so I'm really proud of the work that they do every day.

Hello and welcome to Experience Fulton Healthy Aging. My name is Kweli Rashid-Henry and I'm the Interim Director for Senior Services, the Fulton County Department of Senior Services. Today I am joined by Mr. Jeff Edwards. He is a member of the Helene S. Mills Senior Multipurpose Facility. Welcome.

Thank you.

Yes, we're happy to have you today.

Glad to be here.

Thank you. Thank you. So first let's start off with you just telling us a little bit about yourself and how you got into gardening.

Well, I was born down in Vienna, Dooley County, Georgia, 50 miles below Macon. And I went to, uh, finished high school at Edvina High Industrial School. I went to the Navy, stayed four years in the Navy. Then I went to Albany State for a few years. And I left there. I worked for the post office for 30 years, from 1978 to 2008. And I got a part-time job with the security company, and there they put me into security. um helenese meals and there were two guys who were always gardening and i didn't participate because i was working at the time and so both of them stopped gardening and they recreated a garden club and i got interested in gardening and i remember uh that i had my grandfather was a retired farmer and he would plant corn, I mean, many vegetables in his backyard. And he was so successful at that. He would eat out of that yard the whole summer. And so I remember some of the stuff that he did. I wasn't a participant garden all the time because I worked all the time. So I decided to just try my hands at it. I did one other time. I was in the community garden and We did pretty good there. So when they started the garden club, I decided to join that. And we've been learning to do gardening ever since. So that's about the size of it.

Yes, yes, that's fantastic. A lot of varied experience there, right? And it's wonderful that it ends up, so to speak, where we are today at the Mills Garden. So tell me about that experience. garden club and maybe what you all are doing at the Mills facility with the garden there.

Well, the garden club is members going to John. We join the John and we learn together for his gardening. We have a little budget. They buy us our seeds and some of the products that we need. And we just go out and have fun. We try to make enough vegetables to give to the other participants and to ourselves. And it's relaxing and it's good, and we just enjoy it.

Okay. Okay. So what would you say to any of the seniors out there who might be interested in gardening, but maybe not sure where to start? What would you say might be some of the first steps that you would need to do to get prepared to begin gardening?

I would say do container gardening. or join a garden club and don't bite off more than you can chew. Just get a small plot, a small container from, you know, the big ball stores and plant something that's kind of easy like peas or even flowers. We plant flowers too at the garden clubs. Everybody loves flowers. And so I would say you join a garden club, Use Container Garden and look on YouTube for gardening information because it's not a complete science. I mean, what may work one year or your friend may not work with you. So just get started a little bit at a time or join a garden club.

I love that advice. And what's a container garden? I think I know, but can you tell the audience what a container garden is?

Container garden is just pots, and they got raised beds that you can get at Home Depot and different places. Just pots and raised beds, and some people do it on their balcony. I know one of my sisters, she lives in St. Petersburg, Florida. She had a very, very small apartment, but she had a balcony. And she raised a lot of stuff out there, peas and corn. Well, not corn, maybe, but a lot of peas and okra and cucumbers. Just on her little garden, plus flowers, too. And some people even take old anything, you know, old wheelbarrows or Home Depot orange buckets, that could work. Put holes in it and put your dirt and other materials in it and that'll work too. So that's basically a container garden. Anything that's not in the ground, it's called a container garden.

Understood. Yes, very good. And it sounds like there are lots of ways to get started.

It's lots of ways to get started, yes.

And maybe the important thing is to just start small. Start small, yes. And base it off of what you have. Yes, definitely. Whatever space you have, whatever you can accommodate. Yes. You know, just kind of think about it in that way.

Yes.

All right, all right. So tell me about the connection between healthy aging and nutrition and what you're doing in the garden to produce that food.

Oh, that's a very good question. First of all, you're out there. You're relaxing. You're getting a little sweat. You get disappointed that stuff doesn't come up. But when something does come up, I mean, you're just as happy as you could be. And the food tastes a lot different than what the store because you can let it stay on there. the vine to ripen more. And people in the store, I mean, the poor ones in the store, they have to pick it unripe so it'll be ripe by the time you get it. But you can wait to get ripe on the store. And it's more nutritious. It tastes better. It has a different taste. And as we age, we need to eat fresh food, fresh vegetables. And like I say, it's a... mental thing you get out you relax you can do exercise cause you got to move around even people in wheelchairs I know people in wheelchairs they have raised garden beds and they'll go around in the bed with a wheelchair and pull weeds plant stuff into it so and they get a lot it's a lot of relaxation out of it I mean it's almost like you want to get out there and see what's going on in the car and you can't wait to get there and some of our participants they see me and they are They see me in the hall when I'm off a day or so and they say, we did this and we did that to the garden. They love it. Once you get out there, you love it. And it would help you physically, mentally, and I think morally because sometimes we sit there and talk about things. So, yeah, it's a very good hobby.

Yes, yes. You covered the whole gamut, right? Just thinking about what it takes to be healthy as we get older. So I appreciate you touching on that and thinking about how gardening can offer just some support and some solutions for all of those aspects of aging and being healthy from the nutrition to the mental health to health. You know, just settling your spirit and having something to do that you enjoy. Yes. So that's that's awesome. That's awesome. So tell me a little bit about talk a little bit about when is the best time to harvest certain fruits and vegetables. So I know there there is a season to gardening, if you will. So describe that for us.

Yeah, that's. That's three different seasons, really. Being in Georgia, you'll have a spring season. You can start planting your spring stuff in maybe March or late February, or something like your cabbages and stuff like that. They're called the brassicas, you know, the greens. And you can About six weeks before you start harvesting, stuff like potatoes, both sweet and white potatoes, you plant them in late April after the frost. And you have to wait at least 90 days for the white potatoes, 120 days for the sweet potatoes. And so you won't pull them until the fall of the year or late August. And corn is different. It takes about, I don't know, maybe six weeks, maybe eight weeks. And you can have two harvests of corn. You can crop the corn and then plant some more. Matter of fact, we planted some more last week.

Okay.

And so they'll go on to... maybe October, and then stuff like watermelons, it takes about 90 days, and you have to harvest it for the frost, all the melons, besides pumpkins and stuff like that. You can harvest them up until December because they can take the frost. So it just depends on the crop. The peas, six weeks maybe, and they'll bear and bear and bear most of the time. And so the idea to keep your food producing is to pick them quite often. That sends a signal that they need to make some more seeds and make some more fruit. So you have to pick them quite often as they start. picking them, harvesting them, it shuts them down and say like, you know, okay, I've done my job. I make the next generation, which are the fruit, the seeds, whatever, and they'll start bearing. But something like peas, you pick them often and often, and so that they'll keep bearing too. Eventually they will die, but you know, it'll last you all summer. Yeah.

Okay. Are there any foods that you can grow during the wintertime?

Yes. You can grow carrots, Swiss chard. We had a lot of that one year. You know those foods like that because they are northern food. I mean, it was like in Switzerland, some of the bread in Switzerland. All of the cabbages kind of food, you can grow them in the wintertime. In Georgia, we prefer to grow them in the wintertime because... have less insect bug pressure because they're not there. In the summertime, unless you use a lot of chemicals, the bugs will eat them up. They'll grow this summer, but we don't do it. We plant ours. fall crop we're gonna plant the cabbages and the collards around late September. And so they'll grow during the wintertime most of the time, yeah.

Okay, okay. So at the Mills facility, as you're caring for the garden there, and it's beautiful, I've seen it, how do the seniors share in that responsibility, right? Because you're describing a lot of maintenance. in terms of, you know, just making sure of the weeds and continuing to plant and harvest. So how do the seniors share in just keeping the garden up?

Well, most of the time it's the folks in the class. We have made it an official class. Okay. And there's several folks in the class, and we – You know, plant, everybody helps plant. We help till the ground and everything. So it's just me and another gentleman, we do most of the labors for tilling the ground. Okay. And then we let the ladies and people who are not able to just plant the seeds. Okay. And since it's a class... Most people don't come out and help us unless we give them the food because it's a class. Some people will bring us seeds, plants,

just because they enjoy us going back looking at it and uh but most of this is a class and we uh all work together you know for that okay all right so um why this is my last question for you but why do you enjoy gardening and what would you say to the listening audience again um as an appeal to them to get involved

I don't know. I enjoy it because you see the fruits of your labor. You see, you know that you're eating fresh food. And I'm somewhat of an amateur historian. I know that they got a pictograph in the Sahara Desert that the women... African women were the first gardeners. They'd plant the seeds there as they migrated and come back and see something up and say, oh, we'll plant this again. Coming from a farming community, I know what the farm has done. I know that my grandfather was a very successful farmer. He was born May the 18th, 1886. And he sent three of his children, we had 11 children, he sent the last three to college off that little farm, which is still in my family. And so... I think it's a historical thing for me, and I know what it has done for not only the black community, but the whole world.

Yes.

Because without farms, without food, how are we going to exist? And so I feel that farming or raising your own garden is a way of being independent, and it will help. help you to relax, help you to figure things out, help you get over disappointments because it can be disappointing. I know one year I planted my garden and my stuff came up and a deer or something ate it all up. But I said, well, I'll just do it again. I think it's like I had mentioned before, it's It's healthy for you physically, mentally, and morally. And it relieves stress. And plus, you're getting food. Now, I also like flowers. I have a big flower bed. I mean, I go out and see the bugs and the butterflies and the hummingbirds and many other things fly around. And the bees getting themselves out of the flowers. And they're pretty. And so, all that is Back to nature. So I think that being going back to nature helps us sometimes. Sometimes I go out and walk in the park or I'll go to visit other gardens that people really, really have big gardens. They went off of Sylvia Road I go to a lot. They got honeybees and everything else that they need. And I go to ones that literally has chickens, you know. Yeah. I might have went on a tangent, but I forgot the original question. No, no. You have done great.

You've been great. You've definitely enlightened, you know, our community, the audience today about just the importance of gardening and how rewarding it is. Right. I feel your passion. Yes. So thank you so much for joining us today. We appreciate all of the insights that you shared.

Yes.

And I look forward to hearing more and maybe potentially tasting some of the items from your garden one day.

Yeah.

All right. Thank you so much, Mr. Edwards. So that has been another episode of Experience Fulton, Experience Fulton Healthy Aging. And we thank you so much for tuning in and look forward to you joining us again next time.

welcome to inspection central your trusted guide to the latest restaurant inspection scores in fulton county the diligent efforts of fulton county environmental health services ensures that more than 6 000 food service establishments maintain the highest standards of safety and cleanliness By promoting proper sanitation, investigating concerns, and minimizing potential hazards, EHS plays a crucial role in keeping our community healthy. This dedication to excellence continues to make Fulton County a great place to dine.

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Three, two, one.

This is the signing of our cheese floss agreement. This is the third of five-year agreement and this one will amount to some right under 700 million dollars to be used for transportation purposes for our 15 cities.

As someone has stated earlier, this is one of the few collaborative efforts of all the cities in Fulton County. And what a big deal that is, what an accomplishment it is for all of our cities that we've agreed to promote the need for T-Splash and the accomplishments and achievements that we've made over the decades with T-Splash dollars.

everybody knows that that the commuting the congestion is one of the top issues that citizens won't address. So this will represent in the third sense, another five to $600 million invested in those improvements. So we're very proud to be a part of that operating with all of our cities and delivering those results for citizens.

This is super exciting for Palmetto.

This is yet another opportunity for us to show that not only are we able to grow, but we're ready to grow. It's hard to do it without dollars, and now we have dollars to make sure that our streets, our sidewalks, we have a safer community for the constituents and those that visit Palmetto.

Well, the city of Alpharetta, our 68,000 residents, the T-Splash renewal will mean that over $70 million of road construction and infrastructure projects will be paid by sales tax of people that come into our city and use our facilities and buy in our stores and things like that.

For most of the cities, this is the number one funding source for them to do transportation projects. Most cities do get some money from GDOT or from a state level, but that does not meet a lot of their needs. So if they don't have this as a funding source, they usually have to look towards the general fund, which obviously is based on property taxes.

Once again, another great day in Fulton County, Georgia.

We are at the Bremen Museum and Cultural Center here in Midtown in Fulton County, and we're really excited. This is our annual Contract for Service Mixer, so in this room you're going to have over 200 artists and arts organizations that get funded by us every year.

The Bremen's mission is to connect people to Jewish history, culture, and the arts. We are story keepers and story seekers. From meaningful conversations about the Holocaust and the civil rights movement to captivating exhibitions and musical performances, we strive to inspire community and connection.

I am really excited because this gives us an opportunity to really appreciate and to feel the honor of being blessed to be able to partner with art and culture legends in Fulton County. These are organizations that are noted for making sure that creativity lives and thrives in the county and we are so honored to partner with them in their efforts.

This is where all of our CFS awards recipients are getting together. This is a great group of artists who we gave grants to. We don't usually get to mix with each other, so we get to celebrate together that they are winners of our arts grants and just celebrate the arts in Fulton County.

We love this because it gets us in one place and people who don't necessarily look like each other, who don't necessarily see each other have one common goal and that's to make sure that arts and culture survive. It is a premier event every year. I love it because it really shows you what I call the people that are at the street level making sure that the arts and culture is getting to all areas of Fulton County.

So I just want people to know that there are folks that are out here that are making ways for organizations like our own to be able to continue to thrive and do the work that we love to do.

This event was so wonderful. I really appreciate Fulton County Arts and Culture bringing us all together. It's really rare nowadays that we get so many of us arts organizations in the room together.

We had Citizens University tonight and it's always a pleasure to have folks from the community come in and actually learn a little bit about what we do behind the scenes. A lot of people think we just kind of stand around and wait for the emergency to happen. And I always tell people we don't wait for the emergency. We're always preparing for the emergency, which is a major difference. Most people don't know what we do or how we do it. There's always the what they imagine as a firefighter, police officer on scene, kind of coming in and putting out the fire or taking someone to jail. When there's an emergency, they're the ones directing traffic and field, but there's a whole group behind the scenes that is preparing for those emergencies and is constantly training for those emergencies and coordinating those agencies that are responding. with the first responders.

What we like to do is kind of explain to our folks how the 911 center works and how we use the assets at our disposal to get the emergency services to the folks in the community. And so one way we do that is obviously most people use a cell phone to call 911. So what we like to do is kind of discuss how the technology works as far as When you call 911, how do we know where you are, what you're calling about, and how do we get the assets to you as quickly as possible? So we kind of go over those technologies that we use behind the scenes to get the services to the people that need it most.

Citizens were able to peer into what we do here in 9-1-1. And that's essentially what the purpose of this is, so they can get more insight and understanding of what we do day to day in 9-1-1.

Some of the things that I learned today were how hard I think all of our public servants are actually working. I didn't realize, I mean, I know we all watch TV, we watch the 9-1-1 shows and cops and YouTube. However, I didn't realize how much energy and time that it takes an effort that it takes for public officials to make sure that we are all actually safe.

I got to do something to stop the blow. I got to get it in there. Is it in there? Ah, help me, help me, help me.

We're here tonight because we are having our annual Citizens Academy. It'll be our training night. They'll get to experience a lot of the things that the officers do to get certified as officers, as deputies. They'll be able to see DT training, get to experience simulation, gun simulation, as well as taser simulations.

What we try to do with all of our recruits here at the academy is to teach them how to take care of themselves when they're out there doing whatever prospective jobs they have inside of the agency. One of them is what we call defensive tactics. Defensive tactics deal with all control techniques. It deals with good stance, hand technique. and being able to then use your 10 natural weapons to defeat the human body.

So it gives them an insight because you have a lot of questions out there, right? What do they do? What exactly does the sheriff's office do versus what the police do? And we're somewhat the same, but we are a little different. We're a little better as they say, right? Um, but nonetheless, we, we go through the different, um, demonstrations to show them exactly what it is that we do to be certified. Um, And all of those good things. So they get hands-on experience as well as Q&As with the sheriff himself, which they did on the first day. Tonight is night four, session four. So they were able to come into the training center with the trainers that train us on how to be certified and to keep our certification. They're going to actually have those hands-on experiences.

You can't just shoot, shoot, shoot, shoot, shoot, but you have to give a command. Hold it. That's still, you know, something along that line.

But I enjoyed it to the fullest. It was very exciting. My heart is still racing. It was a lot. I mean, you know, it's my understanding of a taser without going in there and being taught in depth. It was just something that you just point, and there's no way you can really miss. But you have to be really trained. And then also talking about the 12-inch range, distance between, so you gotta be able to hit it with a probe and then 12 inches away, making sure you're staying away from center mass. And it's just a lot of intricate things, and so it was a really, really good experience. Something that we had an opportunity to do, because it's one thing to look at it on television, and now it's much easier to empathize with law enforcement when they're using the taser.

Next year, please sign up for 2027 Fulton County Sheriff's Citizens Academy. You do not want to miss it.

We're here today because we're offering a master class in documentary television and filmmaking. We felt that it was so important to come and to try to offer something to the community that they might be interested in, a career behind the camera, a career in creating. So we said, ha, here's an opportunity to do something with somebody that is wonderful in the field, that can give us some tidbits and some nuggets and some information on how to do it and do it well.

I think Fulton County offering this opportunity to teach the community about filmmaking is amazing. I didn't have this situation when I was a kid growing up. I think of how easier my process would have been if I was able to come to a community, a government sanctioned thing as such, where I could learn filmmaking, where I could learn the introductory of filmmaking and go in already having the basic done. So I think them being able to throw something like this is amazing. I look forward to other things that they're doing.

I'm a fan of documentary filmmaking. The genre just, it sucks me in and keeps me compelled. It doesn't matter the subject matter of a documentary, just the process of the documentary storytelling is It's so fabulous to me.

Hope that you'll tap into what arts and culture is doing in Fulton County. If you want to know more about what we're doing here, please go to our website, FultonArts.org, to see all the amazing things that we're offering to our citizens in Fulton County and our 15 cities.

We are here at 4700 North Point Parkway in Alpharetta. We're here with the Emory Winship Cancer Institute Mobile Prostate Cancer Screening Bus. And we're encouraging all men to come out and get a prostate cancer screening because early detection of prostate cancer is critical. Highly important. It's eminently treatable. It's one of the most eminently treatable forms of cancer. So if you find out early, your options are great and your success rate is extremely high.

I wanted to be here because I think it's important for men to take care of their health. I wanted to get screened for the prostate screening and I just wanted to see what new is available and just make sure I stay on top of checking myself out and get available brochures and different things for the event that would be helpful for me.

This is particularly personal for me because last fall I found out that I have prostate cancer through an early test that I probably wouldn't have except for just a fluke chain of events. And finding out early for me meant that I was able to find a treatment plan that I was highly confident with and gave me a high degree of confidence about my future. I feel great.

Prostate cancer and men's health is very important to all of us. And I think being here to support the commissioners is great. They do so much for Fulton County Board of Health and for the community. You know, it feels great to be here supporting.

We are at the Bremen Museum and Cultural Center here in Midtown in Fulton County and we're really excited. This is our annual Contract for Service Mixer. So in this room you're going to have over 200 artists and arts organizations that get funded by us every year.

The Bremen's mission is to connect people to Jewish history, culture, and the arts. We are story keepers and story seekers. From meaningful conversations about the Holocaust and the civil rights movement to captivating exhibitions and musical performances, we strive to inspire community and connection.

I am really excited because this gives us an opportunity to really appreciate and to feel the honor of being blessed to be able to partner with art and culture legends in Fulton County. These are organizations that are noted for making sure that creativity lives and thrives in the county and we are so honored to partner with them in their efforts.

This is where all of our CFS awards recipients are getting together. This is a great group of artists who we gave grants to. We don't usually get to mix with each other, so we get to celebrate together that they are winners of our arts grants and just celebrate the arts in Fulton County.

We love this because it gets us in one place and people who don't necessarily look like each other who don't necessarily see each other have one common goal and that's to make sure that arts and culture survive it is a premier event every year i love it because it really shows you what i call the people that are at the street level making sure that the arts and culture is getting to all areas of fulton county

So I just want people to know that there are folks that are out here that are making ways for organizations like our own to be able to continue to thrive and do the work that we love to do.

This event was so wonderful. I really appreciate Fulton County Arts and Culture bringing us all together. It's really rare nowadays that we get so many of us arts organizations in the room together.

Welcome to Inspection Central, your trusted guide to the latest restaurant inspection scores in Fulton County. The diligent efforts of Fulton County Environmental Health Services ensures that more than 6,000 food service establishments maintain the highest standards of safety and cleanliness. By promoting proper sanitation, investigating concerns, and minimizing potential hazards, EHS plays a crucial role in keeping our community healthy. This dedication to excellence continues to make Fulton County a great place to dine.

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Public Works was very fortunate. We got to host the Citizens University from Fulton County to tour Big Creek wastewater treatment plants. Though we spent the day really talking a lot more than just what happens here at Big Creek, I introduced them to all of Public Works' functions, including... our drinking water, our wastewater treatments, the airports, and the little bit of transportation we do in the unincorporated area around the airport. Most of the time, it takes a little bit of discussion and understanding the difference between what happens at a drinking water plant versus what happens at a wastewater plant. So we spent the first half hour or so talking about those differences. Then once they understood the differences, there, they had a lot of great questions about the actual biological process that we follow here when we treat the wastewater before we return it back to the Chattahoochee River.

The tour of Big Creek has been fun, very interesting. I learned a lot. I learned how resourceful we can be when we think about our environment and think about the systems that we use. And I'm very proud and happy to know that we reuse our water.

We give back to the environment and that we have clean and healthy water systems.

I think for me at this point in my life, it's extremely important because as I get older and as I want to be more involved as a public servant, I need to know how these things work. I need to know exactly where my water comes from. so that I can tell other people as well, like, you know, this is exactly how it works. And it's actually very interesting to know. I never would have thought that our waters run through membranes and that it has to be stripped of as many impurities as possible and then dumped right back into the river.

We love the opportunity to really showcase what we do on a day-to-day basis, because we have always felt that if people understand where the water comes from, where the water goes, they really take a much greater ownership and the environmental importance of conserving water, using water appropriately, and making sure that we turn the water back to the Chattahoochee, not only for recreational purposes, but for our downstream neighbors.

We are here at 4700 North Point Parkway in Alpharetta. We're here with the Emory Winship Cancer Institute Mobile Prostate Cancer Screening Bus. And we're encouraging all men to come out and get a prostate cancer screening because early detection in prostate cancer is highly important. It's imminently treatable. It's one of the most important. eminently treatable forms of cancer. So if you find out early, your options are great and your success rate is extremely high.

I wanted to be here because I think it's important for men to take care of their health. I wanted to get screened for the prostate screening and I just wanted to see what new is available and just make sure I stay on top of checking myself out and get available brochures and different things for the event that would be helpful for me.

This is particularly personal for me because last fall I found out that I have prostate cancer through an early test that I probably wouldn't have except for just a fluke chain of events. And finding out early for me meant that I was able to find a treatment plan that I was highly confident with and gave me a high degree of confidence about my future. I feel great.

Prostate cancer and men's health is very important to all of us. And I think being here to support the commissioners is great. They do so much for Fulton County Board of Health and for the community. You know, it feels great to be here supporting.

So AFSEBA is Emergency Management Agency. So it stands for Atlanta-Fulton County Emergency Management Agency. And we have four primary missions. It's preparedness, mitigation, response, and recovery from disasters or any other large-scale emergencies.

My name is Destiny Ruffin. I serve as the Emergency Management Captain here at the Atlanta-Fulton County Emergency Management Agency, also known as AFSEMA. What most people don't know is we're the local version of the Federal Emergency Management Agency, which is FEMA. We're the local aspect of it. We report to the state and then to FEMA, and we are that coordination piece for residents to get assistance.

The Multi-Agency Coordination Center, also known as the MAC, is where multiple agencies come together for one mission. So whether it be for a planned event like the Peachtree Road Race or an unplanned event, the MAC is there to help support those that are out on scene, the incident commanders of various locations, And then also to coordinate resources and personnel among those different sites, especially if there are multiple sites within the county. The MAC is the one that really decides what resources go where based on priorities, based on public need, anything like that. So it looks at the big picture and helps coordinate all of the information and all of the resources that are needed.

Hazard mitigation. The county is required to have a hazard mitigation plan federally approved every five years. So every five years we go back and we try to figure out what hazards are most prone for Fulton County. Currently we have a lot of severe winter weather as well as flooding and also recently more of a heat wave has become more of a hazard than we expected.

So we track crisis through multiple platforms. We have situational awareness displays throughout our emergency operations center that we can display any news footage, we can display cameras, helicopter feeds, web EOC, and any other information that allows us to gather a full picture of what's going on and to help coordinate those resources and personnel.

most people don't remember people's phone numbers so start off with a family communications plan that basically means you written out all the important numbers for your family to have just in case you're not able to contact someone but also create a kit sometimes emergencies happen you have to run out of your home and it's good to have something like a go bag where it has your medicine maybe have some important documentation might have some non-perishable food and water so it's something you can be able to have i always encourage also residents to inform your children and get your pets involved because they're part of your essential key essential to your family so we always say plan make a kid and also stay connected with some form of notification system even with via social media or even from the faculty system we have various supplies in the warehouse we have supplies uh still from covid response so

Maintaining a 90-day PPE supply is critical for the county if something else were to happen. We also carry supplies for immediate response. We have bottled water. We have cots for sheltering. We have tables, chairs. We have cones, we have light towers, we have message boards, we have all of this. It's really designed to respond to the first 48 hours of an event until other contracted resources can come in or until state and federal resources can come in.

So the county currently uses the Falcon system, which is an Everbridge system. This allows residents to be able to get alerts, but you can also manage what alerts that you want to come to your phone. Do you want it to come via cell phone? Do you want to come via email? Or do you want a landline phone? So we're giving residents the options to opt in and opt out of certain alerts they would like. So that's what the Falcon system uses.

Generally during a disaster, if it's declared, there's a lot of assistance available. If it's undeclared, assistance is very limited. So for instance, let's just say it's a large emergency, so a large apartment fire, we will bring in Red Cross to provide monetary assistance and then also to assist with sheltering if that is needed as well. If it's a declared disaster though, we actually have two different types of declarations we have a public assistance which is actually kind of contradictory to how it sounds but that's really to get government and resources back on their feet so it's debris clearance it's infrastructure it's emergency protective measures things like that to really respond and government recovery to get community lifelines back in in service?

It really depends on the disaster or the incident. Typically, if we get federally declared, that means federal funds become available and that allows us to be able to support. For instance, we recently just had Helene, Hurricane Helene, back in September of 2024. That particular incident allowed for individual assistance, so that means your homeowners, your renters, to be able to apply for rental assistance and assistance for their improvement of their home if they hadn't already got any assistance from their insurance companies. But that typically varies, depends on what kind of assistance that we're going to get. Typically, we don't have a big pot of money or anything like that, but we also lean on some of our partners like United Way and the American Red Cross, as well as the Salvation Army.

Recently, there was legislation that was put in place that mandated that local law enforcement emergency management must approve all school safety plans. So we really take a look at those plans and work with our school districts, both Atlanta Public Schools and Fulton County Schools to make sure it's covered. We don't necessarily dictate what is in their plan. That's up to each individual school and each individual district. But we help them with that planning process. So we give them guidance on what should be in there. And then we also have, through GEMA, Georgia Emergency Management Agency, a list of requirements that they must have.

always encourage our residents to create a plan, build a kit, make sure you connect with your different type of social media outlets, as well as your news source or any kind of, have a way to get information just in case of an emergency. But they can also follow us on social media. We try to be very active on there. You can follow us on Facebook, ex, formerly known as Twitter, as well as Instagram at AFCEMA.

Welcome to Fulton Fit. I'm Derrick Barber, and today we're taking on one of the most effective workouts you can do in a short amount of time, and that is called circuit training. Circuit training combines strength and cardio to help improve endurance, build muscle, burn calories, and keep your heart healthy. Best of all, you can modify each movement to match your fitness level. Today's workout includes five simple exercises. We'll complete 10 repetitions of each exercise, and then we'll repeat the entire circuit three times. And here are today's exercises. First, we have 10 jumping jacks, then we have 10 mountain climbers, 10 body squats, then 10 pushups, and finally to top it off, we have 10 plank shoulder taps. Remember to move at your own pace and focus on good form, and remember, it's okay to take breaks when you need them. Let's get started. One, two, three, four, five, six, seven, eight, nine, 10. All right, good job everybody. So next, we're gonna go straight into mountain climbers. And for this exercise, remember, one leg up, the next leg up, that's one rep. So let's get started. One, Two, three, four, five, six, seven, eight, nine, 10. All right, good job, everybody. So for our next workout, we're gonna go ahead and do 10 body squats. And to do this, I want you to position your feet at shoulder length apart, and let's go ahead and do two reps. 10 reps, sorry. One. Two, three, four, five, six, seven, eight, nine, 10. All right, all right, good job, good job. All right, so for our next workout, we're gonna go ahead and do 10 pushups. So make sure your arms are shoulder length apart. You wanna keep your back straight. And let's go ahead and start. One, two, three, four, five, six, seven, eight, nine, 10. All right, good job, good job. So actually, for our last workout, we're gonna stay down where we're at, and we're gonna do plank shoulder taps. So let's go ahead and get in position like you was for pushups, and we're just gonna tap our shoulders and take turns alternating. Ready, set, go. One. Two. Three. Four. Five. Six. Seven. Eight. Nine. Ten. All right, everybody, good job. That was round one. We got two more rounds, so stay with me. One, two, three, four, five, six, seven, eight, nine, 10. All right, let's go ahead and get into the next workout. We got 10 mountain climbers. Go. One, two, three, four, five, six, seven, eight, nine, 10. four, five, six, seven, eight, nine, 10. All right, next workout, body squats. Feet positioned, ready, go. One, two, three, four, five, Six. Seven. Eight. Nine. 10. All right, almost there. We got 10 pushups. Ready? Go. One. Two. Three. Four. Five. Six. Seven. Eight. Nine. Ten. Give y'all a slight break. Last workout we got is plank shoulder taps. So let's go ahead and get into it. Ready? Go. One. Two. Three. Four. Five. Halfway there. Six. Seven. Eight. Let's finish strong. Nine. Ten. All right, clap it up. Good job, everybody. Excellent work. Now let's take a quick break to refuel. Let's check in with Cecilia for a healthy recipe that's as delicious as it is nutritious.

Hi, my name is Cecilia Tran and I'm with UGA Extension. Today we're going to make energy bites, which are a great workout snack. They are great for breakfast. They are great if you are running late and need something on the go or you're sitting in traffic all day long after work and you need a little pick me up after that long, long day. I get it, right? But look, you've been working hard. So why don't we have the kids or the grandkids get involved and let them do it, right? Because I think you did enough, right? You deserve it. So I really love this recipe because it's really versatile. You can add whatever ingredients you want. You can take away whatever ingredients you want. And this is what it's gonna look like. So I'm gonna make a variation today, but feel free. If there's something here that you're not jiving with, please don't use it, okay? Let's start off pretty simple. We gotta make it delicious. Chocolate chips, right? The thing about health is that sometimes we want to take away all the flavor. We want to take out the sugar and the fat and the salt, and while that's good, there has to be balance, okay? We can't take it all completely. I'm not making this entire thing chocolate chips, but I am going to add some. I like the mini ones for this because when we go to roll it, it's much easier for them to stick together. If you have the jumbo ones and you don't want to go to the store, you can use it. It's totally fine. Then I am going to add some flaxseed. So this is an ingredient that you can find in your baking aisle and this is a really great binder, one. But two, it has a lot of omega-3 fatty acids. They're really good for your heart. They help you increase your good cholesterol and they also have some fiber in there as well. So I'm going to add that in. If you can't find this, it's totally okay. Again, you can omit it. It just kind of helps everything stick together a little bit. Then I'm going to add another omega-3 fatty acid source, and that is my chia seeds, right? Y'all remember chia pets? That's where it came from. So these are seeds, and what you can do is you can also sprout it, and they have these little microgreens that come off. You can clip those off and toss it into your salad. It is a really good source of vitamins and minerals that really doesn't taste like anything. Just add it into your mix. If I ever make overnight oats or like a Greek yogurt parfait, I'll add them in. It helps thicken it up. If your kids or your grandkids like boba tea, then what you can do is you can add this to their favorite drink or even water and shake it up. And what that does is each one of those seeds, it forms a little bubble around it. encasing that juice or that water or whatever, and they become little pearls. This way, you get your fiber in without feeling like, oh, I've got to eat my vegetables, or I've got to take my Metamucil, or anything like that. Another thing you can do if you're in a pinch, you don't have any strawberry or blueberry jelly on hand, or whatever, you can get frozen berries, and you can pop them in the microwave. and let it thaw and have that little juice come out. And then you can mix your chia seeds in there, stir it up and let it gel. And then basically you have strawberry jelly or blueberry jelly, whatever you like. And then if you're vegan, this can be a vegan egg, right? So what you would do is same thing, suspend it in water, stir it up, because you want all those seeds to get in contact with that water. If not, they'll just look like ants floating on top, okay? We don't want that. We want to stir it up. So they all get get mixed in there and let it set. And then again, if you're vegan and you're trying to bake or bake something that will be your binder and it's really great too. So really versatile. It has a lot of uses. So just going to give this a little quick mix. And then again, I want to add a little bit of flavor. So I'm going to add just a teaspoon of vanilla. Okay. And that is powerful in and of itself. And then to make this bind together, I'm gonna add some protein in the form of peanut butter. Now, most recipes will call for creamy peanut butter. I'm a chunky girl, okay? I like it thick. I like some texture in there. I wanna chew onto something, okay? So I'm using crunchy. Now, if you're allergic to peanut butter, you can use almond butter, you can use sunflower butter, you can use cashew butter, whatever you please, okay? But we need something in there to bind. And again, this is our protein. So after we work out, we need something that's going to help repair our muscles. So this is going to help with that. And then again, a little bit of sweetness and a little bit of a binder. This is our honey. If you're vegan, you wouldn't use honey because it comes from an animal. It comes from bees, right? So you could substitute this with maple syrup if you felt like. So this is a third of a cup of honey. For my flax seeds, I used about a half a cup. My chocolate chips, about half a cup, you know, more or less depending on how you feel, right? If it's a bad day, maybe we do a little bit more than that. And if you're worried about your figure or your blood sugar, then maybe do a little bit less. Whatever you please. So we've got our flavor in here, we've got our fatty acids in here, we've got our protein in here, and now we're gonna add our oats. These are just old-fashioned oats. You can also use rolled oats if you feel like it. We need a carb in here, right? Now again, carb is always demonized. We're worried it's gonna make us fat, it makes us gain weight. It's not good for our blood sugar, but it's all about moderation. I've added a cup of oats in here. And now I'm just going to stir this together. So you see how simple that is? Like if I want to get my kids involved, I can have this portioned out already and have them dump it in as they go, or I can have them measure it out, right? and give them a little bit more power in it, a little bit more say. Now, we could do this with the spatula, but let's get our hands into it. Sometimes you really can't feel it. You're not really going to get a good mix. I'll be throwing oats all over this place, making a mess. And like if you want to clean it up, you can, but I don't. I got things to do. So we're just going to get everything incorporated in here. And again, this is a great workout snack. before or after, because those carbs give us that quick energy. That protein helps us build our muscle and it also helps us stay full. The oats also have really nice fiber as well, which helps us stay full, helps us lower our cholesterol. Those fatty acids that we get from our chia seeds and our flax seeds, that is going to help our cholesterol as well. And they have some fiber too. And then the chocolate chips are for fun. Because look, mental health is a part of your overall health, okay? And if you hate what you're eating, right? then that's not fun, right? If you're miserable at every meal time because you're like, oh, I got to eat plain oatmeal. Oh, disgusting, right? Like that's not fun. That's going to stress you out and then that's going to make your health even worse. So we got to add a little bit of joy in there, okay? Now, there's a lot of different variations for this. Like I said, you can change out the nut butters if you feel like it. Maybe it's around Christmas time or the holidays. I could add cranberries in here and instead of chocolate chips, I could use white chocolate chips. I could add slivered almonds in here. I could do walnuts or pecans if I felt like it and chop it up really finely. You don't want any big chunky things because it'll fall apart on you and it's going to be a hot mess, okay? We don't want that. It's easier if all the pieces are about the same, so it makes it one, easier to roll, and two, easier to stick together. Some people find that it's a little bit harder for them to have it stick together right off the bat. I'm a professional, okay? So if you have those issues, you can leave it in the fridge for one to two hours, maybe put it on the top shelf so nobody sneaks a bite of it, right? Unless you want them to, that's fine too. And after about an hour or two, it'll set and it'll be easier for you to roll. You can also lay this out in like a cake pan and cut it into bars too if that is more visually appealing to you. But all I'm going to do, just going to roll these up. and add it right on top. Oh, another one of my favorite variations is adding coconut flakes to this, and then you basically have like an Almond Joy type deal. Mmm, delicious. If you love peanut butter, you could add peanut butter chips instead of chocolate chips, or in addition to. Really, you make it any way that you want to. So I hope you learned how to make a quick, easy, and delicious post-workout snack, breakfast, or even a sweet treat. If you want any more recipes or nutrition tips, follow us at UGA Fulton Extension on Instagram or Facebook. Thanks for joining us.

Welcome back. Great job making it through today's circuit workout. Remember, fitness isn't about being perfect. It's about showing up consistently and challenging yourself one step at a time. Now take a few minutes to hydrate, stretch the muscles we worked today, especially your shoulders, chest, legs, core, and hips. A little movement every day adds up to big results over time. For more workouts and wellness tips, be sure to check out episodes of Full2Fit on FGTV's YouTube channel. Thanks for joining me. I'll see you next time.