Travis County Commissioners Court
December 7, 2004
Items 12 & 13
12. Consider and take appropriate action on an interlocal agreement between
the city of Austin and Travis County for use and management of star flight.
13. Consider and take appropriate action on an interlocal agreement between
the city of Austin and Travis County for emergency medical services.
>> good morning, I知 danny hobby, emergency services coordinator
for Travis County. Today I知 here to ask you to consider and approve the star
flight interlocal and the e.m.s. Ground interlocal. Last week I was here with
some other good folks who reviewed with you what we considered to be the major
components of each one of those agreements. There are now two agreements instead
of just one, but we also provided for you operational benefits as well as
financial benefits, so we are hopeful today to answer any question that's
you might have in regards to those agreements and ask that you approve them.
>> did we give any more thought as to how we would monitor
basically implementation of the various --
>> yes, sir, we did. I visited with various folk. As you
brought up last week, there are many resources that we do have, including
the committee as well as my staff as well as other staff members and other
offices. And I think in the best interests of everything here, I think it
might be good to come back after we have actually gotten into the agreements
and see really what is involved with the agreements to see if we can handle
it in-house. Right now we are assuming that we probably can. But I would like
to come back by March first and give you a status report. That will give us
an opportunity to dig in and really see what it is that we do have. The reason
why I think it's important, judge, that we come back. Again, I want to make
sure that we have the resources, both at my level, as -- as being in the role
of the county e.m.s. Manager and both contracts, as well as appropriate resources
elsewhere to really handle these agreements like you would want us to handle
them. That's looking at the performance measures, that's looking at the financial
reports and that's looking at -- at potential budgetary concerns for next
year. The whole gamut of what all of these agreements, both of these agreements
involve. So I would like to come back and meet with the committee and let
the committee continue to assist me and use the resource that's we have in-house
and come back with a status report in March.
>> any reason why we cannot review a quarterly report? On
each of these contracts.
>> there is no reason whatsoever, judge.
>> we really ought to generate the data. If we generate it,
we really ought to put it to good use. That means reviewing it.
>> yes, sir.
>> and that way we know not only where we are, but where
we seem to be head thrudout the year. Throughout the year, that makes sense
to me. The city of Austin has already approved both of these, right?
>> yes, sir.
>> judge, can I ask --
>> yes, sir.
>> danny, tell me how exactly the e.m.s. Advisory board is
put together, how many members are there, who makes the advisory board payments
and is this advisory board, does it also address star flight issues or is
it just more of the e.m.s. Agreement excluding the --
>> I think where we are, Commissioner, is -- is in looking
at the current advisory board and looking at changing focus of the board,
to where it does include both star flight and ground, looking at the makeup
of the board, and I think that's a very important review that needs to be
made, are the right people on the board, and what is the focus of the board.
So I think the intent here is to take what we have and build upon it to where
it can be the board that can benefit us in regards to these two agreements.
So it's not looking at today we are saying we are satisfied with what we have
today because we have two new agreements it's time for us also to look at
the board. That's why we have kept the board active and kept it in the agreements
because we feel like it can be -- play a very important role for us.
>> how many members are there?
>> oh, gosh is it seven? I think it's seven members. Most
of them are representatives of the large hospitals in town in terms of the
players related to e.m.s. There's a representative from the esd's, jimmy [indiscernible]
from out of esd number 2 in Pflugerville, I represent Travis County on this
particular board. I will be really frank with y'all. This is a board in transition,
it is the renewed committee that came out of the old quality assurance team.
And in terms of what -- with ems. Now it's an advisory board. Quite frankly,
they have searching for what shall be the role of this committee. There's
also a consumer that is named by Travis County, dr. Donald patrick has been
our representative on there. Changing faces and players here. But the one
place that I have always felt there has been a lack of feedback and input
to both the stus and ustin and Travis County, is for somebody out there to
be looking at where ought stations be put in, without regard to can we afford
it, without regard to the politics of where these e.m.s. Stations go, that's
both within the city of Austin and outside. There's really nobody saying this
is where the system needs to go. The meetings that we have been having as
the advisory committee have almost exclusively been talking about issues that
used to be the purview of the old quearlt assurance team in terms of medical
procedures, et cetera. There are some duplicative committees I believe with
the medical society and other venues with dr. Rock talking about, you know,
the medical procedures and policies and protocols, so this -- this committee
truly is searching for -- for another kind of a role but just completely taken
out would not be appropriate, I don't believe at this time, simply because
it would leave a vac cool on some -- contact viewm on some good -- vacuum
on some good policies issues. I think there needs to be direction on the new
role of the advisory committee regarding the new interlocal and the spirit
of cooperation between all of them.
>> ms. Wilson?
>> [indiscernible] asked about the membership in discussing
that a number was not put into the agreement because it was felt that it was
really important that it be representative of each type of organization that
participated in the system. So rather than tie us to 7, 9, 15, whatever number
we might come up with in discussions, it was left open to -- to once a really
good view of who needs to be participating in it should be. You could taylor
the size of the committee to -- to address the representatival -- representational
needs that was thought needed by the city of Austin and others, you wouldn'ted
want it to go down to 3, not up to 35 either, so good sense I hope will prevail.
>> judge. I -- first of all, I mean, danny and karl thanks
for all of the work that you have done on this. Barbara in my office has worked
very closely with them. I think that we really have the beginnings of something
that really is going to work real well for us. , I mean, for one, I mean,
I need to be very comfortable with the fact that we really have some sort
of a model to go to where we have these performance measures that have put
in place because quite frankly that's always the first question that everybody
wants to know, are you getting what you are paying for. All of us recognize
that this is such an important part of our community. So I知 really encouraged
with where we are heading with this thing, working with the city. I think
that it is paramount that we immediately get -- hide behind the creation of
this e.m.s. Manager. I mean because what I don't want to see happen is just
sort of stay in place like it is right now before you know it, I mean, these
are the two people that are kind of like our e.m.s. Managers I know that they
have their plates pretty full right now. I would really want to see the court
be very aggressive with -- with sitting down immediately and coming up with
how we are going to identify this e.m.s. Emergency because this is the perfect
time I think to bring that person into the fold so that they are learning
with this on -- you know with the new contracts or the interlocal that's we
have. So I知 confident that if we will -- if we will aggressively, you know,
go forth with the recommendations that you all have put that -- that we really
will take a giant step in the right direction, I just don't want to see this
thing -- now that we have kind of got this thing put together, everybody take
a deep breath and now let's put it on auto pilot. Auto pilot means -- danny
and carol, are you all still making sure that all of this is done. I知 very
-- I知 very optimistic about what we are doing here and what -- when it comes
time, maybe now is the time for me to make the recommendation to -- to, you
know, to appropriate the action of what's being asked in 12 and 13. So I would
move that we move forward for this, but take, you know, some of those things
that I just mentioned --
>> I知 happy to second with you.
>> does that include what the judge requested though earlier
that is -- that is a way to measure this as far as -- as this report, performance
report every quarter in your motion.
>> that would be part of it [multiple voices]
>> very significant to see where we are and where we need
to go with those reports that are coming on a quarterly basis.
>> I think that that's absolutely necessary to -- to do what
the judge is asking, quarterly report, which is -- [multiple voices] -- also
the reason why for us to identify this manager that we are going to have so
that they can really have a lot of input and a lot of understanding as to
what we are going to do with this thing and how we are going to go about it.
That's certainly, you know, part of the motion, judge.
>> okay. All right.
>> the -- the quarterly reports are already going to be coming
in. The reality is that we need to make sure that they indeed do come in and
are transmitted to the Travis County Commissioners court so it's kind of like
closing the loop, kind of like what we do with our own health insurance situation
monitoring, especially the first year or so. But I just want to add on here.
Sometimes we forget how much progress has been made in an amount of time,
this is a moment to just take a moment, there was a time, and it was within
the last 10 years, there was no Austin Travis County emergency medical services
system. It was the Austin e.m.s., One of the finest e.m.s. Systems in the
united states of america, they built it from scratch, it was a model. We then
went through the process of taking it from an excellent city model to one
of a regional model of excellence. And I am just so proud of the fact that
we have been able to combine and merge so that for the citizen it is a seamless
delivery of -- of emergency medical services and that we are now no longer
talking about city or county. We have got all of the players at the table
and we are talking about equity in a system. And I think that's huge and I
just want to add my congratulations, the only to everybody on the Travis County
team who played a huge role in this, but to once again acknowledge our partners
at the city of Austin who were there from the very beginning in terms of making
something that we all wanted to be a part of. The Austin e.m.s. System is
amazing and now it is going to be even more amazing as the Austin Travis County
e.m.s. System. Star flight's part of that.
>>
>> [one moment please for change in captioners]
>>
>> it depends heavily on our system. The emergency services,
whether ground or air. And it's been demonstrated so many times over and over
again. So applause goes to the great staff who works hard. We thank you very
much.
>> judge, if I may, the one person's name that has been lft
off of this is dr. Ed rock. We are so blessed to have one of the medical directors
of e.m.s. In the entire nation. And it is always him that we think of in terms
of politics, doc was always there in terms of what is best for the patient.
And we are very pleased to have dr. Ed rock as the head of our e.m.s. System.
So I want to make sure that he gets kudos as well.
>> I like that list, don't start it because you will leave
somebody out. Everybody has had something to do with it.
>> is somebody looking into the role of the advisory committee?
>> yes, sir.
>> at some point the Commissioners court will be presented
recommendations about what the role will be.
>> yes, sir.
>> and that will look into who ought to look into being a
member.
>> yes, sir.
>> and who does the advisory committee advise?
>> the way we have it is the up, judge, is that advisory
committee will advise the county and the city, and that my role right now
as the county e.m.s. Emergency manager will become a more viable role in that
group. I will ask my partners in the city to do the same where we will now
be attending those meetings along with dr. Rock, as Commissioner Sonleitner
mentioned, we hope he will continue to play a major role with this group.
And so we've already had discussions with him and we've had discussions with
the city in the negotiations about how we want to try to approach this committee,
so the committee will actually be working with those groups.
>> okay. Because I知 having a hard time recalling anything
we have received from the advisory committee.
>> and I think in large part, judge, because they're so focus
odd what we would all call quality assurance, really medical society kinds
of issues that, quite frankly, never really needed to come back to the Travis
County Commissioners court or the city of Austin because it did not involve
a policy issue or a funding issue of either one of our bodies. It was really
how do we handle medical protocol, which quite frankly they were internally
handling between the e.m.s. Providers, dispatch issues, and it was protocol,
not really something that would come back to be micromanaged by two political
bodies. It really was working out protocol issues between the medical community
and the medical providers and the --
>> they might have been there 14 or 15 years.
>> yeah.
>> the other question is if the Commissioners court has appointees
on the committee, we need to make those appointments in open court.
>> yes, sir.
>> when?
>> gosh, the last time was, what, two, three years ago?
>> then these ought to be on our list of appointees. And
when do the terms expire?
>> well, the Commissioners court one, we always do our appointments
in January every two years. And that, judge, we have consistently done in
open court as part of the master list.
>> it seems to me that if the advisory committee is in place,
and I知 not the one who says what their role ought to be, we ought to know
what the role is, though. And we ought to know how the Commissioners court
is expected to respond to the various recommendations. And if we have representatives
on the advisory committee, there needs to be a presence in court, we need
to hear from them and need to know that they are there are for us and that
the committee is working. So in order for this to materialize, barbara, I
guess -- and julie, I guess at some point we need to see a document that the
court actually acts on. And if the group that reviews this concludes that
we don't need the advisory committee anyway, I知 happy with that. That ought
to be brought to us too, I guess. So at least we can ratify the decision of
the advisory committee. We look at stuff like this -- I know there's been
stuff out there just working for years, but to the extent that this committee
represents the Commissioners court rtion then I think we ut --, then I think
we need to know more than we have historically. And I知 speaking more to what
we ought to expect in the future than what's happened in the past.
>> judge, I think one of the roles of the Travis County e.m.s.
Manager ought to be coming in and giving you a quarterly report, which brings
in all those pieces of what we're trying to do here, produce that system,
and the system includes all these pieces, including that board. So with your
okay and the court's okay, i'll be back on a quarterly basis and i'll be giving
you updates in regards to what's going on.
>> that is music to my ears. Any more discussion of the motion?
This motion covers 12 and 13.
>> and to report back to the Commissioners court.
>> we know the interim manager.
>> yes, sir, you do.
>> all in favor? That passes by unanimous vote. Thank you
very much. Thank everybody that worked on that hard working committee.
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Last Modified:
Wednesday, October 26, 2005 2:20 PM