Travis County Commissioners Court
September 21, 2004
Item 29
(One moment, please, for change in captioners...)
... Or to approve the recommended changes first?
>> I think it's better for you to go through the corrections list and then see the resources you have available in the event you wish to dedicate those resources elsewhere.
>> we really need highlighted --
>> I can go through them very, very quickly. Let me tpepbgs first of all, we did move the red lined employees performance based pay from ongoing to one time in both the road and bridge fund and any other special revenue request that Commissioner Sonleitner had made. On the general fund, a lot of these corrections have to do with the allocation, first of all, a little additional allocation on performance based pay. These others were expense items that correspond to revenue within the fifth revenue estimate. On page 2 of 12, you'll see h.h.s. These are the expenditures that were reduced from the health and human services budget, from centralized leases, from maintenance and utilities in regard to the hospital district reduction in the tax rate. These expenses will be coming back to Travis County through an interlocal with the city of Austin, but pending the approval of that interlocal, we have gone ahead and put the expenditures for that staff at six f.t.e.s and these other operating expenses back into the budget. And what will happen is once the city of Austin signs the interlocal, the county auditor will certify that money and it will go into allocated reserve since we've already got the expenses covered. You approved a pilot program last week in j.p. 3. There's the $30,000 that's related to that. The next probably six or eight entries had to do with the action that the court took to raise the permanent positions to $10 per hour. And we went through -- you'll see that in the other funds also, but there are the accounts. After the fifth revenue estimate, I went in and calculated the unallocated reserve in relation to the road and bridge fund, a debt service fund, and the general fund. And in the fifth revenue estimate there were additional funds available in debt service due to interest income so that off set some of the increase from the unallocated reserve requirement in the general fund. The last two entries have to do with hospitalization to do the incremental amount from the preliminary budget. The next sheet, 4 of 12, has to do with other funds, and you'll notice what we -- what we're doing in most of these entries is moving to match the fifth revenue estimate to balance out from the preliminary budget which was based on the fourth revenue estimate. We do have -- on page 5 of 12, on t.n.r. In the road and bridge fund, we're placing the $1,960,000 into a transfer line. As you recall, the revenue, the fine revenue that we're going to be transferring. You take it out of operating lines, put it in a transfer line, then we transfer it over to the general fund. And that's been accomplished in the fifth revenue estimate. The others, starting on page 7 of 12, you have cost neutral changes. The first sheet, first couple of sheets has to do with the centralization of the four-person accounting team from being spread out in 10 different offices. All 10 offices have agreed to centralize all of that budget into j.p. 2s department. And that's what they -- the 7, 8, 9 and most of 10 involve. And that's a cost neutral. It's just reducing those budge nets the 10 offices and increasing in j.p. 2. Several other hospitalization corrections to get the correct amount. On page 11 of 12, you'll see cost neutral changes in other funds. The fund being over on the left-hand side starting with 11, the law library fund. And what we had to do here is go through and allocate the compensation increases, remove it from allocated reserve in most cases and put it into the proper salary and benefit line items. You'll notice at the bottom is the entry on the road and bridge to make the 4% one-time instead of ongoing for the road and bridge fund. The same on page 12 of 12, has to do with the risk management fund is 525, and then with the hospitalization fund of 526. I apologize that I didn't get you this earlier. We actually worked yesterday into the evening kind of getting this pulled together. And then what we've done is incorporate those corrections into your computer spread sheets to show you what type of resources that you have left after you incorporate again the remaining funds, being 355,992 in total, but we do have an end balance currently of 394,047 of ongoing funds with availability of 750,039 of one-time funds.
>> and I might remind this court and this may or may not have bearing on decisions you may make today, but for f.y. '06 we have this $400,000 ratchet. We have another $200,000 ratchet because we did -- the court approved doing away with the annualization reserve. So we walk into '06 with that $600,000 to take care of, and in addition during markup you characterized the $250,000 augmentation for basic needs as one time. That's in the budget, but it's one time. And the $387,000 after-school reserve is one time. So that's another 600,000. So I知 -- you -- we have some challenges in '06. We have always met our challenges. But the closer you can get to balancing one time an ongoing the better it is. The farther you get away, the worst it is. And the bottom line is 355,992 that is available to be either appropriated for ongoing -- appropriated for one time or added to reserve as you see fit.
>> the other item that we would ask that you address in your vote on corrections, that if in fact we have maybe an amended fifth revenue estimate, there are a few little jiggles the auditor's office is working with us on, that we be allowed to balance the proposed budget with any additional revenue or resources that we find against the allocated reserve in the general fund. And that's been a traditional balancing technique.
>> and we file this Friday. Formally file the proposed budget on Friday and then you are formally slated to adopt on Tuesday. And any changes between Friday and Tuesday appear on a motions list.
>> so if we put this in the bank, we would minimize our ratchet for '06.
>> yes, ma'am.
>> by -- what do your figures show?
>> $355,992.
>> okay. But I mean the number -- the ratchet is 600,000?
>> well, you've got a formal ratchet of 600, and depending upon what happens with basic needs and after school. If, for example, those are $637,000 worth of resources that will be approved in '06, we need resources to accommodate them. They were skarbg rised as one time -- characterized as one time. I do not know whether they are or not one time. In addition the court decided to characterize its entire $1.9 million allocated reserve as a one time. So it's just something to be aware of.
>> we need a motion to approve the 394 ongoing from the 750,000 one time?
>> you need a motion to approve the corrections list. And that motion then results in those numbers you just identified.
>> so moved.
>> second.
>> this is on a corrections listing. What you are saying is any corrections you have the ongoing shortfall.
>> yes.
>> covered by the one time.
>> yes.
>> all in favor of the motion? That passes by unanimous vote.
>> that brings you then to the programmatic questions.
>> let's talk about the three we know about, and if somebody has another one, we can discuss that too. First one is the health clinic t funding for this if we approve it will be from the health care reserve. How much is in the health care reserve?
>> we estimate right now that it would be between 5.1 and $6 million at the end of this year.
>> how much was in there at the beginning of this year? Norman?
>> about 3.6 million.
>> and to what do we owe the substantial difference?
>> our claims have been lower than the projected budget that was set. We projected something like 500,000, $507,000 a week, and it's been running about 470 on average. Our claims are down somewhat.
>> okay.
>> they are down to estimates. They are up from last year.
>> from last year.
>> 22 to 23 million, about.
>> we're looking at an accrual though that we won't know for sure until, what? About 45, 60 days from the end of the fiscal year?
>> yes, sir.
>> that's right.
>> now, remind me why the health clinic is a good idea.
>> well, I have here the health clinic is an excellent idea because --
>> excellent or good?
>> I think it's excellent. I知 going to go out on a limb and say it's excellent. The health clinic is designed, married together wellness and health care. It's designed to pick up the pace of employees' involvement in maintaining their health, but it's also there to provide acute health care to off set costs the health plan would otherwise pay. For instance, when you have a an office visit, your co-pay may be $20, but the plan pays on average $85. If we can have clinic utilization where we think it will be, we'll be eliminating some of the cost of that $85 office visit. So the idea of the health clinic is to bring management and control of the health plan where we can affect the cost over a period of time.
>> it also would address preventive programs such as a wellness program that the court created this last year. It would be able to track and measure the results of wellness programs much better than what we're doing now in terms of just not having the resources to do that. The physician's assistant could also assist in early detection of things like tumors or other illnesses that may be worse than what the employees thought. We do indeed have individuals that have probably waited too long to go and have the tests that needed to be done, and I think this would provide a safe and friendly environment for examinations that may catch illnesses or diseases at an early stage. It would be an area that would promote things like self-breast exam, signs for other diseases that, again, may be caught at an early stage and have less of a devastating effect not only financially but to the individual and their families.
>> how would it cut absenteeism?
>> well, I think from the standpoint the employees will be -- actually as the clinic earlier while they may not go to a doctor because of the co-pay, they may access the clinic earlier before the condition becomes more critical or chronic and avoid missing work by eliminating sick days.
>> what's the current price tag?
>> valerie from planning and budget office. If the three positions were funded at entry level with fiscal year '05 benefits, the cost of the wellness clinic would be $283,877. There's also a -- a building improvement cost of $17,560 one time that would be budgeted in facilities if you chose to fund this.
>> we are requesting $299,000 to give us some flexibility with the salaries of individuals that would apply. This is one area where we probably don't want to look at a low bid situation in terms of health care. Especially in the area of nurses and physician assistants. That's a very competitive market, and we would like a little flexibility in terms of what level to bring them in, so the difference would be between the 283 and 299,000.
>> and --
>> this 283 plus 17, 560.
>> correct.
>> a little more than 300,000.
>> or it would be 299 and the 17 then.
>> I think that -- I would then suggest for the f.y. '05 health fund.
>> correct. The 283 figure, which is just the non-construction, non-building renovations costs.
>> the skill level that we're looking for in physicians and assistant is a little broader than entry level. We're looking for someone with background in nutrition as well as a health care provider.
>> dan -- are you finished? When you made a presentation earlier I think before us, it was a question posed to show how this particular concept has been utilized in another area or other areas and it's supposed to have been very beneficial to that area that had employed this type of wellness program. Could you remind me again what area was that and where was that concentrated? Was it a similar type concept as this and actually what it really does do for a governmental entity that actually embraced the wellness program as what's being presented here to us today?
>> the two main areas that have health clinics that have proven beneficial, been in operation three or four years is jefferson county, beaumont, Texas, and this past year eliminate their co-pays and just go with the clinic aspect. And city of garland has a successful clinic. They are still operating as they were, but they realized only a 5% increase, is my understanding, in health care costs last year. And it's attributed to having the clinic and having promoted and structured the clinic in a way very much similar to what we're looking at doing.
>> okay. It's been a couple of questions that have been asked of me since you all have come before us, and one is that will there be a centralized location whereby the county employees will have access to a central location, and a second question was a spinoff from that and if not, then how will you get out into the field to address employees that are not centralized, per se, of Travis County? How will the operation really --
>> the main clinic would be located in the lower level of the u.s.b. Building.
>> okay.
>> but we would have remote sites at both airport and at del valle where we have a large concentration of employees so that they would be able to access the clinic as well. And that would be on a scheduled basis. It wouldn't be staffed full time. So full-time clinic would be down on campus area, but we would have at least weekly scheduled visits to airport and del valle.
>> and my last comment, but I recall speaking to the actuary and looking at what they would look at as far as united health care and the actuary that dealed with this and that is a program of something of the magnitude that hopefully we'll approve today is something that they kind of lean in favor of because it really does help the overall well-being health-wise of the employee itself. And I guess that's something that you all have also looked at and kind of dug into that to see if those actually are true comments and statements made by those folks.
>> yes, Commissioner Davis, both united health care and our actuary are supportive of the clinic concept as an approach to getting control of health care cots.
>> as is the employee benefits committee. They considered this proposal and have indeed recommended it to the court for approval.
>> judge, I would like to move approval of this. I know maybe some further discussion, but I do know when I looked at this as far as servicg that I supported and I知 not going to divorce myself from that support because I think it's something we can move forward with. I would like to support this in the amount of $294,415 from the general fund.
>> and if you look at your backup, there are performance measures and we're asking for it to be approved and run till f.y. '07. At that time we would take another look at it. And on an annual basis really along with our quarrel reports, we would -- quarterly reports, we would bring in also a report on the health care clinics. There are specific performance measured attached.
>> the 526 reserve is something that's available to help [inaudible] as far as 526 [indiscernible]. Is that correct?
>> yes.
>> the county attorney has advised us that yes, it could be [inaudible].
>> yes, sir. That motion to approve the poem. I second it. Commissioner Daugherty, discussion?
>> I do think that given that it's got performance measures is a big plus in this in that we do have a date in mind, 2007, where we really will see whether, you know, we've been able to obtain what we would like to do. What would be the bottom -- and this is a guestimation, I知 sure. If everything went to, you know, where in a hand basket, what's the most exposure you think we could have. How much are we buying? I mean I would think that, you know, the setup on this thing you've got some exposure there, and then I guess you would have some resale on whatever we would buy to set up the program. I mean I知 entertained by the fact that we can take, you know, 3 or 4% of the reserves and basically fund this thing, so I mean that's a real plus. I guess 5 million bucks, you mean do you think we're going to have given that we've grown from from three six to a little over 5 million and that was really predicated on our setting, you know, probably a higher bar, so to speak, with regards to what we thought we were going to have this year, we didn't get there this year. Did we bring our bar back down or are we likely to see that 5.1 million grow again? That's always a question mark in this health care stuff, I realize. How aggressive were we with what we did projection-wise this year?
>> well, we were somewhat aggressive from the standpoint that we were creating reserve within the fund, and that was an essential thing to do to have a margin in there in the event that our claims were high. So we were somewhat aggressive, but for plan year '05, I think we had more accurate data that we were able to project using our actuary study. So I think our reserve is there and it's somewhat -- taking this health clinic funding from the reserve is not going to affect the integrity of where we're at.
>> and that's pretty obvious. I mean so what do you think that we -- if in '07 we had to close it down, would we have $200,000 worth of stuff that we had put in it that we couldn't recoup at all or what do you think?
>> the startup costs that we've estimated as $79,570, I think, taking the newer figures. And I would assume you would have some supplies that would add to that is correct but I think you are looking probably at an amount, if we were liquidating the clinic, you would be looking at an amount between 125,000 and 150,000 $150,000. Some of that equipment does have a high surplus value because it's medical equipment. As long as it isn't abuse. So I知 not sure what the offset would be. Maybe 75,000.
>> well, then we've got -- I think it's a -- you know, it's worth a try given that we have the source to fund this thing that's not coming, you know, out of the general fund. And it's -- I mean, hey, we all hope that we can find ways to diminish, you know, what we know is just an absolute freight train out of control and that's health care. So I think it's, you know, worth the efforts.
>> the motion that was made did not include, and I wanted to make sure we have the numbers right, it included 299,415, but it did not mention the capital, our request of 17,560.
>> that's included. That's the capital -- [multiple voices]
>> no, I don't believe it is.
>> you broke it --
>> right. What the department is requesting is a --
>> 317.
>> so it would be 29,415 for the operating --
>> 299,415.
>> 299,415 and 75 skoplt 160 160 one-time costs to improve the site.
>> the 79 should be included in the 299. The continual operating cost is $230,000. The startup is 79.
>> correct.
>> 17,560.
>> could someone summarize the actual total budget request of -- that the department has, which is to budget not at entry but at higher salaries, and I assume budgeting at mid-point for either all or some of the physicians and the total capital? Because there's -- so that the record is clear.
>> you ought to get together between now and next week or now and this afternoon.
>> well, we need to -- we need to put together a budget that is accurate.
>> that's what I知 saying. Put your heads together between now and this afternoon? [multiple voices]
>> but I don't --
>> it's included.
>> I don't know that our commitment is waiting till '07 to take a look at this again. Seems to me we ought to get quarterly reports to make sure we're moving in the right direction. Obviously it cannot succeed unless employees use it, but we can all work together and get out word of its availability and make sure that we are picking up some of the costs they would occur were they to go to their private physician. Our thinking is long term this will save us more money than it costs to operate annually even if that's not the case the first year.
>> that's right.
>> but quarterly reports will indicate to us whether we are headed in the right direction.
>> yes.
>> yes.
>> and it's for those reasons that I seconded the motion and am supporting it.
>> there was a request from the auditor office in the event the wellness clinic was approved that a new budget rule be added to the list of budget rules that would essentially make it a review [indiscernible] the fund that the wellness funding was set up in or the division the wellness clinic was set up into.
>> that is friendly to me. Is that friendly Commissioner Davis?
>> I took the liberty of drafting it.
>> I think I saw the e-mail [indiscernible].
>> yes, sir.
>> any other discussion? Now, if we have the exact figure now, fine.
>> it would be nice to have it.
>> 299,000. That's what we have. That includes the building.
>> I think we need to discuss this further because -- [multiple voices]
>> I think that increased that cost. Why don't we --
>> between 299,000 and $329,000. Let's have the exact figure this afternoon. Any more discussion of the motion? We'll get the exact figure this afternoon. All in favor say aye? Show Commissioners Daugherty, Davis and yours truly voting in favor. Commissioner Gomez voting against, Commissioner Sonleitner temporarily away. So we'll plug in the exact amount this afternoon. Now, there were two other issues that we discussed last week as possible additional markup items.
>> exposition center, I believe, was one of them, and we have worked with p.b.o. And met yesterday, and the amount of the subsidy that we believe we would need for f.y. '05 was reduced and it's $141,877 is what we came up with as opposed to the 200,000 plus.
>> but it is above the reserve amount. There is a reserve currently in the preliminary budget of 138, and have I the number.
>> 690.
>> thank you.
>> so you need how much?
>> 141,877.
>> do we need the difference then, 3,000 plus added?
>> yes.
>> move approval.
>> second.
>> discussion? What's that exact amount?
>> 141,877. I heard 141870.
>> 877, christian.
>> so the exact amount is $3,187, which would be added to the 138,690 reserve to bring it to 141,877.
>> the question is sit still reserve or is it appropriated.
>> that's -- there's a similar question that will exist in the after-school reserve. Do you wish -- we'll bring it up later on the after-school reserve, but do you wish this to be a reserve that you hold in which case the department needs to come back to you when and if it needs all or some of that reserve. Or do you wish it to be an appropriation which goes into the department's budget as a transfer from the general fund to the expo center fund on day one? And there are reasons to do it on beat sides and it's your call.
>> my vote would be a.
>> that's fine with me. For a new hampshire vote, i'll take a. -- unanimous vote, i'll take a. That passes by unanimous vote.
>> we want to be clear in terms of bringing it back. It's dollar for door.
>> [indiscernible] voluntary request to access.
>> okay. And what that will mean is that the utilities line item within the expo center will be budgeted at 276,139 and it will probably be short for the year.
>> because that's how you balance it. You got to have a balanced budget. As long as everyone knows that.
>> that's good if we keep it in that line item.
>> at the end of the year we bring it all back as one thing as opposed to the nickel and the dime.
>> you have a suggestion that you wanted to discuss the original request of $130,000 subsidy increase to triad.
>> i'll move approval of that.
>> from one-time money?
>> no -- well, I知 assuming it's ongoing.
>> yes.
>> I mean you -- triad, the nature of the triad program would not.
>> all we need is the oeupb time money, right? Of $365,000.
>> we don't do that this year.
>> you want it in the budget and you want us to take it out for '06?
>> we'll look at it again next year.
>> second that motion. Any more discussion?
>> now, tell me exactly the triad, what --
>> the 130.
>> 130,000 even was the original request.
>> triad basically is for child protective services more than anything else.
>> that fall through the cracks.
>> this is child protective services. Unfortunately this is one of those tough areas where it looks like we're doing more than most counties do, but these are Travis County kids. All in favor? That passes by unanimous vote.
>> there are two other --
>> two other critical items?
>> yes. One has to do with the scrubbing of the c.o.s and the question you poedzed for looking at the c.o.s four additional resources and we need guidance what to do with the after-school reserve. Is it reserve for appropriation? Those are the two items. Jessica can give you a quick update.
>> there was a request last week for p.b.o. To go back and look through old c.o.s to see if planning money for the expansion improvements at del valle could be found. There were three items. The first rethe remodel of the first floor of the c.j.c. You asked me to look at old c.o. Funds. I have found fund 455 with the county auditor's concurrence and to the attorney so I would like action for me to propose $20,000 coming out of the fund. This is a memo received in your office on September 17th. And on the back --
>> so moved.
>> second.
>> discussion? All in favor? That passes by unanimous vote.
>> the second is for the planning for the new civil courthouse. It has been somewhat difficult to find funds in old c.o.s for this planning money. P.b.o.'s proposal that it be added to the new f.y. '05 c.o.
>> how much is that?
>> $150,000.
>> move approval.
>> second. Any more discussion? That's the one you will be putting together over the next couple of months. All in favor say aye? That passes by unanimous vote.
>> and the third is really just an update. It's planning for expansion or improvements at del valle. The amount currently is unknown. We have looked at two possible funding sources, fund 455, that c.j.c. Fund we spoke of earlier, and found 435, which was previously determined to be i.j.s., But it does not longer have that tag as of this morning. And the update is in the memo. I can answer any questions. We are continuing to work on that and I think there's some more that's going to be --
>> [indiscernible] yes, no, I don't know.
>> possibly, yes. There are two --
>> half a million dollars?
>> there is one fund that has 662,000 and another fund that has 300, I believe, thousand.
>> we ask you to keep on keeping on. It will be on the agenda next week. And the jail operations folk will be back next week also for the recommendations so if we can discuss possible funding sources at that time, that will be better than good.
>> the question about the after-school program reserve is similar to the expo reserve, it's 387,000. It started at 200. You augmented it by $187,000. It's a one-time expenditure. Do you wish it to be appropriated to the department on day one or wish the department to come back to you in the future or you to make a decision on the use of that reserve and --
>> we would appropriate that to the department because we have already asked the department for monthly updates. We ought to look to see if it's headed in the right direction and if it's not, instead of slowing down funding, credit. The [indiscernible]. When you are short of money, we have to add. But we don't have to -- [multiple voices]
>> discussion? All in favor? That passes by unanimous vote.
>> and then there's the one item that leroy brought up about balancing against the reserve. We need your authority for us to do that.
>> if do you that is correct you'll bring it to our attention.
>> we will bring that to your attention next Tuesday prior to adopting.
>> that's why I move approval. Discussion in all in favor? That passes by unanimous vote. Thank you all very much.
... And we did approve that. Unless you all want to talk us out of that.
[inaudible] we'll call back up 29 and that's get the exact figure on the health
clinic.
>> [inaudible] at mid point rather than entry level, the
cost of fund 526 will be $315,457. The capital costs remains the same, 17
skoplt 560, a total of 333,017. And I think that's the department's desire
to request that those positions at entry level. Just to note, at mid-point,
the cost is over entry level, the cost is an additional 31,580. He it's that
much more than if they had been requested at entry level.
>> so the total --
>> the total is $333,017.
>> move that be the amount we put in. [indiscernible] all
in favor? Show Commissioners Davis, Daugherty and yours truly in favor. Voting
against Commissioner Gomez and away is Commissioner Sonleitner.
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Last Modified: Thursday, October 27, 2005 9:42 AM