This is the official website of Travis County, Texas.

On This Site

Commissioners Court

Previous Years' Agendas

Intergovernmental Relations Office

Administrative Ops

Health & Human Svcs

Criminal_Justice

Planning & Budget

Transportation & Natural Resources
 

On Other Sites

Travis County Commissioners Court

July 11, 2006
Item 13

View captioned video.

Number 13. The consider and take appropriate action on the following employee benefit recommendations for the annual fy '07 benefit plan. You think we may work our way through this most efficiently if the we just cover the particular subsection in full before we move to the next one? Rather than trying to put all of them together is this.

>> yes.

>> a is July 24 through August 23, 2006, as fy '07 annual open enrollment period. And I move approval.

>> second.

>> that is that we set the annual enrollment period for this year to begin on July 24 and end on August 26. Any discussion of the motion? All in favor. That passes by unanimous vote. B is fy '07 annual proposed employee and county insurance premiums. B 1, annual fy '07 premiums for active employees. Two, under b, annual fy '07 premiums for retirees under 65 years of age. And b 3 is annual fy '07 premiums retirees over 65 years of age. And the proposal is what?

>> the proposal, you have it in three sections. And as you know, and my name is alici anna ben , executive manag manager for county operations. And the county offers three plans right now. It's an epo, much like major medical, a ppo, a 90-10 plan, meaning the plan covers 90 percent of all major medical, and a coinsured e po plan which is a 80-20 plan. The plan covers, the entrance covers about 80 percent of all major medical. And all of these have a limit of 500 per individual out of pocket maximum--1500 per individual out of pocket maximum and 3,000 per family. There are increases, minimal increases am we averaged about three percent increase through throughout the plans. On the active premiums, the ep , which is 100 percent for--epo, which is 100 percent coverage for major medical, experienced the highest per individual if they wanted to have that plan, down to about 7 percent for family. The epo and the coinsured epo are both free of no charge to the employees only and that's a very major and very good benefit benefit. And then it's a three percent, a small increase compared to what we have seen, a three percent across all tier. And that is for active. For the retirees under 65, this is a group that is the costliest in terms of the claims that we see because most of them, well, if you're under 65, you don't get medicare. And this is the primary insurance for that group, and you don't have such a large group as do you in your active, to where the pool is larger and you include a lot of children. This is a much smaller pool. I do want to point out, you had expressed concern, Commissioner Sonleitner, about the subsidiary not going down. We went through and reviewed that and your instincted were correct. There had been a reduction in subsidiary. Went from 85 percent in epo, and in 94 from '91. So there had been a slight reduction.

>> which would have been consistent with what was going on with rank and file and with the over 65 retirees. So everybody is being treated equally.

>> yes.

>> thanks.

>> it had not been reflected in the material that we had provided the court previously. This group probably followed the largest increases of the three. And they averaged anywhere from 29 percent for anybody that's on the epo, to about 19 percent or so.

>> should I be looking at the one page you just handed out?

>> yes.

>> what line did you just read from?

>> okay. A percent of increase at the bottom, 29 percent.

>> okay.

>> if you're an employee only under epo.

>> right.

>> 42 if you're under the ppo. And 70 percent if you're under the coinsured epo. Then depending on the tier, we have six tiers, employee, employee plus one adult, employee and child, employee and children, employee, spouse and one child, and then employee, spouse and children. So each of those, again, saw an increase ranging from 42 percent or 70 percent for the coinsured epo. And I say that, but if you would like at the proposed employee contribution for even the increase there on the coinsured epo, it's 105 per month that they pay. So that's very affordable insurance for someone under the age of 65 or a coinsured epo, 10 105. Goes up if you're on the ppo to 178. And it goes up to 304 if you're an employee only under the epo, which is a little bit higher but then compared to the open market for 100 percent coverage of major medical, we believe it's still very affordable.

>> so for the retirees under 65, what advice do we have other than hurry up and get to the age of 65 where medicare will pick up most of it the cost? Is there any?

>> our advice is to, really this is a very, very good plan. And it is very affordable.

>> compared to?

>> compared to going out on the open market and trying to get 100 percent of coverage of your major medical with a maximum of 1500 per person.

>> we believe the increase is justified--

>> yes.

>> --because of the amount of the claims that this group files against the--

>> yes, sir, that's correct.

>> but the issue is going to be that here, as this number grows, that is startling and frighten frightening part of what you have to deal with here. We add to these numbers.

>> yes.

>> .

>> it's not going to get--

>> on the national news yesterday, this group, they don't come close to having the money they need to retire.

>> the message on is to be prepared, and this is for all of us. Health care will be one of the major costs of getting older or being retired in anyone's budget budget. Health care will be a major cost cost. I think we all need to prepare, whether it's through savings or health savings account. We will be looking at other programs that will allow individuals to save money and be able to roll it over pretax. We just weren't ready this year to present those programs because there are good things about them and then there are down sides. But we will next year.

>> I think another message, and I think sues will be join in on this one, is that there are annual budget decisions made by the Travis County Commissioner's court and future courts in relation to what benefits are going to be for the different classes. And those will change on an annual basis. And people need to not make any kind of assumptions. Susan, did I get that language correct? About annual decisions of the Commissioners court related to the amount of dollars that are put fourth for these good efforts.

>> can you tell me, the contract renewal, for example, united health care is the provider that bee use, but there are other things that we deal with health care, vision, dental, things of that nature. Can you basically tell me when those contracts will probably be coming forth on some of those? There are some concerns, I know, for some, some complaints I have heard on some of these things, and I'd like to make sure that if there are contracts coming forward, that we need to maybe address some of these concerns as quickly as possible.

>> we're working with purchasing now to develop a modification to the contracts. I believe they will be coming to you here in the next couple of weeks.

>> couple of weeks?

>> before the court for discussion.

>> okay. During the public hearing we heard from the public on some legitimate complaints, I thought they were legitimate and they do to, or else they would not have expressed them in the public meeting that we had on health care. So that will come up in two weeks and we'll have a chance to visit some of those contracts that we use as far as health care. Is that correct?

>> yes, yes, sir.

>> okay. I didn't want nobody to think that we just locked into a situation where we can't do anything about the complaints that we are receiving for some of this stuff.

>> and we can have the various vendors present.

>> that would really be nice to have them here.

>> we can certainly do that.

>> thank you.

>> back to the under 65. Because, for the retiree under 6 65, will go from 126 to 178 for the ppo.

>> yes.

>> and so the county's cost goes from what to what? '06 to '07?

>> go ahead.

>> from 1010, from $1,10010 [po] 1,120. That's what's known as the composite rate. That's what the county would be funding for everybody under 65.

>> regardless of the plan.

>> okay. So in '06 our cost was 1,120.

>> it was 1,010.

>> 1,010.

>> yes.

>> 1010.

>> yes.

>> and for '07 the cost is what?

>> 1,120.

>> so our cost goes up $110.

>> yes, sir.

>> per retiree under 65.

>> yes, sir.

>> one thing I would like to say took on how retirees can make this more affordable for themselves, is to educate themselves on the different plans. Sometimes our knee jerk reaction is to go with the high plan, the ep , because it pace 100 percent percent. But in some cases you don't need that 100 percent coverage and you could reduce your monthly cost a lot if you had had an open mind and looked at some of the other ones. We'll be glad to sit down with people and walk them through and educate them before they are called upon to make that decision. So just everyone know that we're available to sit down and talk with you about your options when you get close to retirement.

>> somebody came to the the public meeting. I guess as far as the retirees are concerned, that is notice of the health plan and how they basically, the changes, the expenses that they concur. Are they basically notified of what we're doing here?

>> yes, sir.

>> as much as possible?

>> yes, sir, we did a mailing to all of the retirees that are on the health plan prior to the public hearing like we always do do. Then we're going to do another one probably tomorrow or the next day, as soon as the rates are approved, and let them know what they need to do to complete their open enrollment > we send the mailings throughout the year when things come up such as the wellness clinic and things like that. We do a mailing to everyone on the plan. We're not mailing to every retiree out there because a couple of years ago the court decided that if you wanted to be on the plan and you were already a retiree, you needd to join that year. So if you're not on the plan and you're a retiree, you may not be hearing from us but if you're on the plan, we communicate with you frequently.

>> thank one of thing on aspects we want to stress--

>> thank one of the other aspects we want to stress, retiree both over and under 65, wellness services are available to them and their dependents. That's something we're going to do an aggressive outreach program to inform the retirees of the wellness clinic and the programs available.

>> on the ppo for active employees, there is no monthly deduction.

>> right.

>> that's correct. For employees only.

>> for retirees there is this amount that will be deducted monthly.

>> yes.

>> so the retirees that are interested in chatting with somebody at the county about available options, do we invite them to communicate with you all also?

>> yes.

>> yes.

>> absolutely.

>> I'll be glad to be the person on that if you want to give them a name.

>> we have retiree appreciation day set up for August 4 out at airport boulevard in the training room out there so we hope we have a lot of retirees come visit us and we can sit down and work with them on their open enrollment.

>> that appreciation--

>> staff appreciation.

>> okay.

>> that name is cindy kiernson if they want to call.

>> but don't call.

>> retirees call though.

>> all right.

>> that concludes the retirees under the age of 65. We go to retirees over the age of 65. Again, in all these plans the ep epo saw the highest increase. And the ppo, with the retirees over 65, was about 14 percent across the bored. And then there was really no increase for for the po co coinsured ppo for retirees only over the age of 65. Then the increases averaged about 14 percent for all the other tiers >s.

>> and we do have on the over 65 a pharmacy only plan. It costs $37 a month if they want to just depend on medicare. And then just get the pharmacy only, which sometimes, well, medicare did not cover. And this is a very good plan. But again, let me point out to you that a coinsured epo, which is a 80-20 coverage, for someone over the age of 65 is $29 a month. So that would be the secondary, sorry, 33. Okay. Yeah, on the proposed employee, it's $33 a month. Again, that would supplement any medicare policy which the employee may have. And that covers pharmacy too.

>> were we able to generate a one-pager for each category? If I want to see the information I'm 67 years old, retiree. See what I'm saying? I don't know that, if you send, we send all the information, it may be a whole lot more than I would want to see.

>> uh-huhif we had like a one- one-pager for the over 65 retiree category, we could just send out.

>> that's what we did for the retirees because this is too complex.

>> same for under 65 and give employees?

>> yes.

>> I know we will get some questions from active employees after enrollment starts and they start the process. Okay.

>> uh-huh.

>> so the difference for active employees, the epo, monthly deduction, will go from what to what?

>> from $80, employee only, to $ $91.

>> so instead of the $40 per paycheck deduction, it will go to $45.50.

>> yes, sir.

>> so $5.5 paycheck additional deduction.

>> yes, $11 a month is what it went up.

>> okay. Danny and I talk about the many advantages of being in the ppo, and I think that on the one pag pager for the epo active employees, we may as well go, if we plan to do this, to adopt the item down there where we give one year's notice of our intention to terminate ppo so folks can start thinking about it. If you give it some thought, a whole lot of active employees, it really will financial lee be a much better deal. To get sold on it, you really have to be familiar with little steps you can take, little things can you do throughout the year and not just wait until there's some illness that causes you to pay under the ppo.

>> correct.

>> means using your flex. That's the answer to it. And that is the deal that you just need to make sure that you plan that. That's the way to do it.

>> yes. That's my point basically. Deducting on the po, you take the Sam amount and put it in the flex plan to use, the problem is you have to use it before the deadline.

>> that's true. That's one of the components, the chief component in being able to finance any deductible or coinsurance. Again, there's a $1500 maximum out of pocket stop loss for each employee and $3,000 for the families lisa mention. So there's some protection there and we have to get the word out to employees that this is not a major leap. It's just a jump.

>> a change in the account from years past--flex account from years past. Now we have the carriover of an extra three months to be able to ease up as opposed to all of us rushing to the doctor in the month of September to use all of our dollars.

>> about how many retirees under 65 have our plan?

>> about 225, something like that.

>> about 225. Anything else under b, 13 b? Move approval of the recommendations. Anymore discussion. All in favor. That carries unanimously. 13 c.

>> next item is small changes in the epo plan that increased five dollars for office visit copay for primary and specialists. It's just a $5 to the office visit, $5 increase. Goes from 20 to 25 and then 35 to $40 if you go see a special specialist. It's a $5 increase to copay.

>> and $5 for visits, basically basicallyyes.

>> and if you use your flex plan keep the receipts, you get reimbursed.

>> that's right.

>> move approval of c.

>> seconddiscussion? All in favor? That passes by unanimous vote. D.

>> d is an administrative item that we always bring to court. We do have open enrollment from July 24 to August 23. We have made it very easy for employees just to enroll from their deck top computers in their office. But every once in a while have people, or every year, we have people who for whatever reason do not enroll. So what we'd like here is to have the court approve the co coinsured epo as a default option if an employee does not complete all ten steps for their annual enrollment.

>> move approval.

>> second.

>> what's the basic difference between the coinsured epo and the epo?

>> the type of coverage. It's 90-10 plan is a ppo and the coinsured epo is a 80-20 plan. You also, when people do not enroll and they go to this default, only the employee will be covered. So if previously they had any family members covered, those won't be covered. Only they will be covered.

>> I think we they'd to get that message to employees.

>> uh-huh.

>> you don't go through the enrollment process, you have been carrying your family, we will default you into coinsured epo but your family will not be covered.

>> uh-huh.

>> if you miss the deadline. I think we ought to get that out out. If you have a family that you have been covering, it's really a big dealwe have been doing this for each year--

>> we have been doing this each year. The numbers ought to speak for themselves? We are getting better every year year. Last year we ended up defaulting receive or eight people. They do maintain their basic life at the same time. So they get basic life and employee only coinsured epo.

>> now this year, we default the coinsured or just the epo? In '06.

>> each year it's been the co coinsured epo.

>> same thing? Okay.

>> of course, you all sends us must reminders not only to employees but to the managers of the different offices and we all appropriately bug our staff to say have you completed open enrollment. There's lots of shared responsibility here.

>> if they go employee only co coinsured epo, they get no dis disability coverage, no dental care coverage, they get nothing except the basic life and the co coinsured epo for themselves only. So if they want any of the other coverages, they need to be en enrolled.

>> if you don't enroll in a timely manner, nothing but bad things happen to you. Don't wait until the last day like the county judge. I had fun doing that, but don't do you that.

>> what are the reasons that have been indicated in the past when persons have ended up going to the default category? Have they state add reason of what happened?

>> most people think it's automatic, and there is nothing automatic about our any you'll enrolling am. We have what's known as a positive enrollment which means have you to take steps every year. If you're enrolled under the health plan, even if you're a de deliner, you have to go in and do all ten steps of when I say decliner, somebody getting their insurance on their spouse's plan you still have responsible for going in and making choices because there are things that you may have other than your health insurance. So you're responsible for going in and completing all ten steps of the open enrollment process. If anyone is confused, let us know and we will walk you through it. We will either come to you or you can come to us, but we will help anyone that's confused. Everyone has that responsibility to go in and complete all ten steps.

>> barbara's point related to the other coverage is that the county could not appropriately say, we're just going to force to have deductions being taken out of your paycheck for dental and other kind of things. Those are anofficialtive decisions that an employee needs to make and the county can't take money out of your paycheck without you authorizing those deductions.

>> right.

>> anymore discussion? All in favor. That passes by unanimous vote. E.

>> e is the discussion that we had with the court last month about adding bariatric surgery as an option to the health plan. We discussed certain criteria that would have to be met before the surgery, certain criteria would have to be met after the surgery. In a discussion with judge Biscoe, there was some indication that the $2500 deposit that was discussed might be an inequitable amount considering lower income employees may have interest in the surgery. So the recommendation was to lower that to $1,000.

>> the other thing is that we require a one-year demonstration of commitment to lose weight, get more fit, deal with whatever the issue s right?

>> that's correct.

>> and if you don't pass that, you're not eligible for this kind of surgery anyway.

>> that's true.

>> you pass the one year due diligence test, then we agree, go ahead [a-b] giver you the surgery. And in my view we ought to make it as affordable as possible. The carrot to me is at the end of the one-year period. I think $2500 is very, very steep for a loft our employees. $1,000 is still steep but not as steep as two and a half times that much. The other thing is that we have one year to look at whether or not this policy will be implemented anyway by anybody.

>> it would be one year from the date of the new plan year before any surgery would be approved.

>> okay. So that's my recommendation. That is you all's recommendation now too?

>> yes, sir.

>> in relation to a motion that I figure is fixing to come, I'm not going to be supportive of it it. This is one where no other government locally has this particular plan. Be it the state of Texas, any of the school districts, the city of Austin. There are too many other challenges going on with our health plan in terms of how we are trying to make this all affordable. The gap insurance, whatever. These just a very expensive thing to add on. And I don't think that it's appropriate. I think the timing is off on this one. So when a motion comes, that's where I'm headed.

>> I think we ought to do it because this is, based on what I see, there are some folk who try to do this and just can't do it. This surgery benefits them. What we're trying to do is put the county in a position to allow those individuals to help us help them reduce their cost to the county plan. Right?

>> appears so.

>> that's where I move approval of e.

>> second.

>> that is with the $1,000 demonstration after the 12-month due diligence period.

>> seconded by Commissioner Gomez. Any more discussion?

>> you can explain to me what the due diligence criteria is for that one-year period? In other words what does a person have to go through to immediate whatever requirements that they are being asked for that one-year period to make sure that they are serious about receiving this type of surge are arery? What are we asking them to do?

>> the one-year period is to demonstrate that they have attempted, with good faith, to diet, that they have entered into an exercise program. They start off with being screened and provided information on diet and exercise as appropriate for them. Some people can't do strenuous exercise because of weight or because of physical inability. But there are exercises that can be done. Then they are monitored for that 12-month period, on a regular basis to--screened on a regular basis to make sure they are progressing and adhering to the requirements. At the end of that time, there's also a psychological evaluation done, and at the end of that period, if they have met all the requirements and consistently held to their diet and exercise regime, then they would be approved for the surgery at which point they would deposit the $1,000 fee or whatever it's calledwho would monitor this?

>> --

>> who would monitor this?

>> they could either do it through the health clinic or if they did it through their personal physician, they would have to provide information to the wellness and health clinic to verify that they are adhering to go the diet and exercise.

>> we would expect some document documentation of the one-year commitment.

>> yes.

>> we have to.

>> we have to.

>> yes.

>> I just think this is not for everybody but there are some individuals that this seems to have worked for. And if it's successful, premiums for this individual will go down down. If successful. If not, we are just where we ar.

>> cost.

>> costs.

>> premiums will stay.

>> costs of claim.

>> thank you, lawyer wilson.

>> do we have any idea right now as to how many people really might participate? This? And if we applied, if we do know that, what kind of bearing would that have on our premiums? I mean because obviously, I mean you know, premiums overall will be reflective of how much of this stuff is used. Right?

>> I have to go by what dr. Turner said the other day. I believe he ranged between three and 400 people might qualify. Not to have the surgery because obviously some of those would not complete the first year. If you just take 25 percent of 100 people at $25,000 a surgery, that would be the outside cost.

>> okay. With that, though, there was a range, if I can remember from that public meeting, there was a range of weight, a category of weight that would be eligible. And I cannot recall exactly what that weight factor is. In other words, so many pounds over blah blah blah blah, then you would be more likely eligible for this type of surgery. Can you recall exactly what weight factors were a part of that?

>> yes. I have that here. It's body mass index of over 40.

>> pardon me?

>> a body mass index of 40 or more, or a body mass index of 35 with a core more bid di, meaning a disease category. So if you have a b mi of 40, you're probably going to be at least 140 to 150 pounds over weight. If you have a b mi of 35 with high blood pressure, diabetes, muscular skeletal problem, your weight might be under 150 over but it would still fall within the bmi of 35.

>> 150 over the recommended weight?

>> yes.

>> that way it would be 300.

>> 300 pounds.

>> it would depend on the individual. It could run between 100 and 150 pounds overweight most likely.

>> I remember that portion and I remember the lady, one young lady that did testify before us in that public meeting. So we have about 300 employees that may be eligible for this if the court decides to go forward with this, and they know all the requirements as far as what we did, that will be disclosed to them as they come forward, as far as what the basic requirements are for them to be?

>> yes.

>> pardon me?

>> yes, sir.

>> all right. I wanted to get those, I wanted to get a clearer an understanding as far as what we're doing so whoever is listening to this, and those persons out there, will know what they have to do in order to to--

>> we would probably create some form for them to sign that would acknowledge that they understand the requirements of the program.

>> where are these? I see some people walking around with some weight on them, but my god, I don't see, you're talking three or 400 people with 100 to 150 pounds overweight? They must be not going out anywhere. I don't see them. Out of our employee base?

>> that's what they said.

>> that's probably why you don't see them, they don't get out. Could be that they don't get out a lot. You know, I mean, but yes, we do have an issue with individuals who have, I they can, gone beyond what it is that they can control into a real illness that they need some assistance.

>> which is one reason--

>> yes, if you're 5-6 or 5-7, you're d to weigh about 150 or-- or--supposed to weight about 150 or so and you weigh 300 pounds, yes.

>> absolutely but I just don't see that.

>> yeah.

>> you know, I kind of tend to agree with aaron on this. This thing would scare me if I thought that we really had 100 people that would qualify or that would go forward, you know, with this thing, you know, with that kind of expense because that really would start affect affecting our premiums. Unfortunately, I think that given that you have got to do these steps before, you will probably wash most people out. Not only the 2500 that people can't give but all of the stringent things that you have to do to that point.

>> we will know this time next year how many are in the pipeline.

>> sure.

>> would we legally have the authority to limit the number of these operations per year to say 20 or 25? Based on the cost?

>> you certainly would have the authority to do that on an initially basis from the standpoint of treating it not as an enhancement of the program but as a pilot project to be considered in relation to a potential enhancement of the program. I am not farm with anybody who has ever, just as a limitation on their benefit, saying first 25 only are the ones that get it each year. But I think if you wanted an initial year limitation that was lower and you wanted to treat it as a pilot project, that would be--

>> safe to do that is this.

>> this time next year we will know how many are ?ythe pipeline. Assuming they start October 1, or immediately after open enrollment, it will not be quite 12 months this time next year. So we get a report from the dr. Turner that knew about them, we can't know that they are participating in the program anyway. Right?

>> correct.

>> so we get an update. Affordability has to matter. I just don't see that many people electing to have this operation.

>> also, would this be just the employee or other member of the family?

>> thank you.

>> if they are covered, it would probably extend to the dependents as well.

>> there you go. So all of a sudden now we're talking about the spouses. Then our under 65 what don't even work here any longer who are already a group that the costing us a we'll lot more, and their spouses. And what caught my guard is when we were talking about that it was with the--me offgourd when we were talking about the requirement system of the teachers, that's the biggest hit to their health insurance plan, is that. And that's a lot.

>> if we're trying to address the health issue of the employee and being able to work, can we limit it to just the employees?

>> because of the relationship to their performance on the job. Member of the family don't contribute to the perform isance of the job. Retirees are not contributing anymore to the performance of the service that to -- Travis County delivers to constituents.

>> can we delay this for two weeks and give legal counsel an opportunity to review some of these questions? There are two or three.

>> I'm inclined to say that if you want to put the kind of limitations that you all are talking about.

>> I was going to say, it's going to be active employees.

>> job related.

>> job related.

>> I think that if you want to put that kind of limitation on it, you're better not doing it as a part of the health plan. But doing it as a separate benefit.

>> pilot project.

>> pilot project, separate benefit.

>> can we bring this matter up two weeks from now? And try to get the [tao-pbs] these legal questions and determine at that point how to proceed.

>> that is in time for open enrollment?

>> we were discussing. If we do it as a pilot, then it went.

>> hoping it won't be necessary.

>> if that's the way we're going it would be appropriate.

>> 7-25. Have to work on Commissioner Sonleitner between now and then.

>> me too.

>> and Commissioner Daugherty.

>> have to get the business guts after the third floor

>>

>> yes?

>> did you call up part 2, judge, because I kind of wanted to talk about that, f-1 and 2?

>> well, not yet. Are we still -- is the recommendation still the mobile health and we willness unit?

>> we were going to ask that that be held in abay ens until we could study this more in using your facilities.

>> I favor bringing in the doctor and the lvn and let them operate at current county facilities and take a year to see how that works. And if we think the unit -- the mobile unit is necessary, then address it next year. That's a motion.

>> my suggestion would be, and this is just from a financial end, maybe bring back in two weeks when you're looking at the surgery because I think that one thing looking at the status of the fund and what we can use the money -- some of these are accounting issues. We're looking at a lot of those things right now and everything is not just pinned down. We may have an opportunity and it may be the right thing to do do, is aside from one to set aside an allocated reserve in that health fund for an expansion next year to be analyzed, whether that's a mobile unit or what else, but I think that we will have the money in that fund to set aside to look at that. And when you discussed this a couple of weeks ago, I had a different meeting and I am sorry that I couldn't be here, but the -- as we're looking at the explosion of health costs, there is no doubt that the approach that Travis County has taken is showing some really positive success. And it's not just the money, but it's the health of people. If we can get people who do not get to the place where they are morbidly obese, if they don't get some of the diseases that we now know they will get under certain circumstances, and if werk get throughout our county, which is somewhat decentralized now, access to that health care before they get ill and the we wellness, not only will it be a financial savings, but it's the right thing to do in terms of productivity for our people and who we ensure on this plan. So I think that it is money well spent and I think that the savings that we have, if we reinvest that in more, I agree with you, judge, that the facility across the street has been highly successful, but if people can't get to it or either they can't logistically or it becomes so crowded that you can't get in for two or three months, then the effectiveness is not as great as we might be able to do. So if you would -- when you bring back this other thing in two weeks -- and I'll get together with them. I want to talk money with hr and also with the budget office. We're just analyzing those statements right now. And I think that we might have an opportunity to at least set aside reserves. If you don't want to use it for that next year, use it for something else.

>> for f-2?

>> yes.

>> we'll bring that back to.

>> f-1 move approval.

>> there's already a motion and a second on f-1. There's something real enlightening that ought to be said.

>> okay.

>> I thought you were about to say it. [ laughter ]

>> is there something?

>> we support bringing the two staff on this year and we support bringing the three staff on next year based on the numbers that dan and I worked on this past week. The benefit is going to out weigh the cost and we support it.

>> just for clarification, we are talking about bringing on a female md, contradict? Correct? It's a big deal in terms of women health.

>> this is not gender discrimination, this is equal opportunity.

>> we better go ahead and take this vote. [ laughter ] all in favor? That passes by unanimous vote. Our lawyers are looking at us. G is discontinuation of epo plan in year f yovment '08. Move that we indicate our intention to discontinue the epo plan next year and between now and then we educate our employees on the many, many benefits of the ppo.

>> second. And with that I'd like to also see what staff is going to do to indicate, if this passes, how will we indicate and let folks know that we are going to really discontinue this type of insurance. So that basically has been something --

>> that's a directive, yes, sir. And we will do that.

>> okay.

>> makes sense to me. Any more discussion? All in favor? That passes by unanimous vote. Thank y'all for your awe standing public service on this item.

>> thank you for supporting health care benefits throughout the years. We have a very, very good plan and we're very, very fortunate to be able to have the support of the Commissioners court in health care. Thank you.


The Closed Caption log for this Commissioners Court agenda item is provided by Travis County Internet Services. Since this file is derived from the Closed Captions created during live cablecasts, there are occasional spelling and grammatical errors. This Closed Caption log is not an official record the Commissioners Court Meeting and cannot be relied on for official purposes. For official records please contact the County Clerk at (512) 854-4722.


Last Modified: Wednesday, July 12, 2006 10:47 AM