Travis County Commissioners Court
July 15, 2008
Item 29
Number 29, discuss Travis County health care district budget overview for fiscal year 2009. And our next item will be number 27. Good morning.
>> good morning.
>> good morning.
>> we're just getting our presentation set up. Hello, judge. Long time no see.
>> good morning.
>> we have mr. Carl richie, chairman of the Travis County health care district board with me today. I'm trish young, president and ceo. And we dr. Tom coopwood, vice chair of our board. And christy garvey, who is our communications officer, is do the technological aspects of our presentation today. And we're set to go. This is I think becoming somewhat of a routine for us which is kind of nice. We're in another round of budget with you and this our first discussion with you. And this is just to set up how we're going about budget preparation this year. Some discussion about what might be some changes or new additions to this budget that you may have not seen before that relate to where we're at in our development, particularly with regard to the transition of the community health centers to the district's responsibility next year. So we're going the talk a little about main elements of our budget preparation and also give us just a little history about what we've been up to since inception and how we've been focusing on service expansion. We are going to at the end just talk about what our preliminary effective tax rate looks like and then where -- what our next steps are in terms of bringing a budget to you for your consideration. So if we're okay to go, if we could go to the first slide in our presentation. These are items that you've seen before in terms of the district's strategic plan. And we tie all of our budget preparation to the district strategic plan. We go through a process each year that looks at what our priorities are, how they tie to that plan, make any, I guess, amendments or revisions, updates to the plan in terms of focus. So the original focus areas for the district in the prior years have been expansions of primary care, specialty care, mental health care, focusing on efficiency and integration of the service delivery model, the actual care delivery system in the community. Focusing on our medical students program, which is a program we did inherit from the city and county and combined that into a single program after our first year of operation. We have had some focus and continue on regional health care aspects. We may be a single county entity, but we deliver care in concert with our providers in the community and we know that patients tend to cross county lines when they are seeking health care. Two additional areas of focus in our strategic land that have not been there before but are being added now have to do with very specifically state the community health center transition as well as the development of district operations to further reflect the growth of the district as well as the responsibility to take on community health center operations and support them on an ongoing basis as they will totally detach from the city of Austin in terms of their support and look to the district to provide that for them. So our budget development is as the has been in prior years. We go through a process of reviewing the teenager strategic plan, look ago the the needs presented to us, we'll look at our revenue forecast. Our main components of revenue include, of course, property taxes, disproportionate share and upper payment limit federal funds that we receive and other minor or smaller sources of funds such as tobacco settlement dollars and interest that we earn. That's all fed into our budget priorities and we go through a process with our board to establish those budget priorities and then bring back a budget to them that reflects the priorities that they've set for us.
>> now, I would just add right here that rather than sort of developing a strategic plan and leaving it out there, we just went back to review it a couple weeks ago to make sure we're still on target and whether in fact the priorities we came up with still make sense after being in existence for four years.
>> and that will be an ongoing process as well. In terms of fiscal year 2009 we've listed our pry orders, continuing health care access for health care eligible residents, enhance access to and transparency of district health coverage programs regarding eligibility and benefits in the network, and that's essentially our medical assistance program to make that program more understandable to the user and make some adjustments in terms of trying to expand this service availability to those members. Continue to strengthen the community health center network. Primarily our focus is successful transition of what is now a city department to a nonprofit organization that will be affiliated with the district but will be operating as a stand-alone entity. But we will have shared support. We do continue our role as a community steward by monitoring the quality and effectiveness of the services that we do purchase and use our funds the support. We continue to advance integration of Travis County indigent safety care net system. That continues to be through our efforts with the indigent care collaboration and working with providers and looking at both opportunities to share information and share efforts in actual care delivery standards around the delivery of care to patients that we serve. We continue to maximize district resources by working with regional partners on solutions to making affordable health care available to all residents of central Texas. That has been a large focus in the last career and we've been participating in a large collaboration around making small -- or health insurance available to small employers. That is an ongoing effort and there will be more work to be add in 2009 in that effort. We still have as an ongoing -- I would say this is an annual priority, but to manage, increase and diversify our district resources to maintain the ability to support our strategic goals. We've talked prior times about our tax rate and we'll continue to have dialogue about that and other sources of funds. 2009 is a pivotal year for us. We have a lot of very large activities occurring, have been occurring in the last year and will continue in a very much hurried pace in the next year. And our budget reflects those -- the main components which are the continuation of the delivery of health care services either through direct fund support such as through the community health centers or the purchase of services through contracts. We have the district praises that we continue to establish. You'll recall that when we originally established all of our infrastructure, so to speak, with outsource, there were a number of things Travis County assisted us with in terms of purchasing, accounting, finance, et cetera, and over time we have transitioned all of the support away from the county except for they can -- we do have mary mays continues to provide investment support and cash management which is a fabulous service and we will continue with that. And, of course, we continue to receive legal support from the Travis County attorney's office. So we have transitioned all of our purchasing in-house, our finance and accounting, which was outsourced is now insourced. We are in the process of developing all the other necessary infrastructure such as h.r., payroll, benefits so that welcome provide all of that internally. Of course our third circle is actual transition of the employees and facilities in operations which we are looking at the transfer of 450-some employees in March of 2009. Moving into health care services, the next slide is really to sort of set a framework about how we look at who we attempt to deliver service to and then we're going to get into discussion about building that health care services network. But we look as a Travis County entity we're responsible for the provision of care to the medical indigent, which by statute is 21% of poverty. Of course, our programs go beyond 21% of poverty by policy and we have been focusing on populations that are at or below 200% of poverty. So in looking at Travis County, trying to predict what that need is, we know that -- we have the total Travis County population as a whole. We know there's a portion of that population that is uninsured. And then we know that there's a portion of that population that's uninsured at or below 200%. What we focus on, as you see that last tier, are those -- our district dollars go to support those uninsured at or below 200% of poverty but also looking to exclude or to I guess leverage those that have other payer sources. So we serve medicaid patients, we serve medicare patients. We know that all of those individuals are at or below 200% of poverty typically. So our district dollars go more directly to support those that are not conferred by other programs, but we do know our programs support medicare and medicare programs. This is to give you a visual about who we on an ongoing basis try to think about as target for service delivery. We know we're not necessarily resource to do take care of that entire population below 200% of poverty, but that's who we strive to serve. This is just to give you background. And I didn't want to get into numbers today, but at some point in time we can talk about that in terms of numbers. What we have been doing and will continue to do in the next fiscal year is look at the continuation of building our health care services network. So we -- for those patients that are eligible for our services, we provide primary care, specialty care, inpatient care and ancillary services and we're going to walk through each one to give you idea where we've been and where we're going. When we were created, and I hope the colors are showing up well enough on the screen, I don't have my glasses on, but z the circles on the left represent those that were original providers, in other words, situations or contracts, arrangements we inherited when the district was created. Since then we have been adding to those providers. So in 2008 we added contracts with
>> [inaudible], an urgent care center, located at the health south building adjacent to brackenridge, the university medical center at brackenridge. We have in progress a couple of items that we've been working on in terms of -- bless you -- the development of a contract for what we refer to as a continuity clinic which is essentially a clinic that is operated by the internal residency program at brackenridge. And they focus on serving chronically ill patients that need a medical home and keep them into care so that we bolt enhance their health status but also attempt to improve and reduce their hospitalization and other health care utilization to keep them well and keep them in care. We're focusing on concept of health care clinics. Not totally decided how that works but that's in process. Then we are also in process and have future contracts with individuals or networks of providers to continue to expand the service offerings that we provide. In specialty care, going to the next slide, we started with the -- I think they are blue. I'm not sure if they are blue or green. Four circles. I'm sorry, I have a black and white presentation in front of me. When the district was established, we had -- thank you, carl. We had contracts in plays with the Austin cancer center, with orthotics providers, the specialty clinic at the university center at brack and, of course, a project with project access that Travis County was also supporting at that time. Since then we've added contracts with eye specialists. We are working on a contract with a medi view network which would hopefully provide access to primary care, additional access points. And looking at future opportunities to expand the individual and group contracts with other providers. The possibility of expansion of graduate medical education, a lot of discussion going on. I know you are familiar with the -- about bringing a medical school to Austin which would involve a significant expansion of graduate medical education along with it, which serves as a large source of specialty care access for us. Then also we have opportunities in the next year and in the coming years as we have new health center construction opportunities, if we're replacing clinics, expanding clinics to, also look at what our opportunities are to establish specialty care in those clinics. So we have opportunities in front of us that we continue to work on. In terms of inpatient care, we have the relationship with seton and the Austin womens hospital which we continue to have utmb galveston operate on our behalf. Since then we've added the contract for services for mental health at seton shoal creek. We're in process of adding Austin lakes as a provider for mental health as well and looking for future access to expand patient services as well n terms of visits and who we're serving, just to give you some perspective on where we've been, you'll remember that -- our inaugural year, which began October 1st, 2004 and ended September 30th, 2005, was basically a organizing year. The board was established, the board recruited the president and ceo and then once I was hired I spent much of the first busy months preparing the next year's budget and trying to hire some additional staff. So our inaugural year, I would say say was a fairly consistent year with activities from the prior year. Nothing -- nothing -- I won't say nothing, but there weren't as many expansions as occurred in later years just because it was the inaugural year. Since 2005 through 2007, the total patient visits that are supported through district funding and provided through district funding have increased 30%. And from 2005 through 2008 through our second quarter or the first half of this year, we've had more than 770,000 total patient visits generated through our support. I think that's -- this is the right trend. We're trying to increase access to care, increase the number of services provided. I think it's important to note that, of course, the primary source of support and care that we give is through the community health center system. And that represents for all the patient visits that supported about 87% were provided through that community health center system. So that is and will continue to be a large source of how we provide care to patients in the community. Medical admissions, just going back to the hospitals, again we've seen increases in the number of medical admissions that have been generated through district support. You can see on the graph there that we've had 18% increase between 2005 and 2007, and then from 2005 to middle of the year of 2008 there have been 15,000 admissions that have been supported financially through the district's support. The next slide just shows you the actual number of patients served. And that's distinguished from the number of visits because a patient can have more than one visit. But this just from looking at the number of clinic patients served, for that same time period we looked at from 2005 to 2007 we saw we increased the total number of patients by 15% which is good progress. From 2005 to 2007, in the -- in the community health center system as well as other providers that we contract with, we're serving annually about 53,000 individuals. So again, they may have been seen more than one time, but they've been seen at least one time in that system. Again, this community health center system is still the primary source of that -- of those patients because that is the largest provider that we support.
>> does that fact right there say that less people are going to the emergency room?
>> you know, not necessarily. Because I think -- I think with regard to the emergency room, you've got patients that are supported through our community health care system and the other contracts, contracted providers. But you still have a large number of patients that are going through knowledge rooms that don't touch our system.
>> so that process needs to continue.
>> it's all about access. And not to diverge, but we do still find, and I haven't -- I would have to check to see what the most recent information is on this, but we still have pretty significant emergency room use by people who have insurance as well. It's become an access issue, not just an insurance status issue, but insurance and access.
>> okay.
>> another subject that we've had close involvement with Travis County is the mental health collaboration. And this chart just lays for you chronologically how we've progressed in mental health and this is an area that we're -- I know you are very proud of and we are in terms of the progress that we've been making. We just had our monthly psychiatric stakeholder meeting last night and talked about our progress here and what our next steps are. But we have gone from in -- since December of 2005 in significantly increasing funding both from our resources, Travis County's resources, city of Austin, st. David's foundation, others that have expanded services in terms of the establishment of the mobile crisis outreach team, the funding of inpatient crisis beds. The development of a respite facility. Additional staffing and services at the psychiatric emergency center. Or services center. And also focus on prevention initiatives which involve and continue to expand our behavioral health program. St.david's, I think you saw recent notice about their increased investment in a
>> [inaudible] and other community providers. These are all really, really important investments in the community. We did just go through a process as a community with the state to receive both allocated funds out of crisis services funds that were appropriated in the last legislative session. There was a total appropriation of about 82 million. And this community we received -- there were three buckets, so to speak, of dollars in that appropriate indication to come to communities based on a ratio allocation of population allocation. Travis County mhmr did receive allocations. There was a third bucket of competitive grants, and those dollars -- and those dollars we did compete and were very successful in actually I think we -- if we were not the at the top, we were the second largest allocation or award of those competitive dollars. Which is going to help us further fund inpatient beds as well as expand our pes services, support, the crisis respite facility and generally enhance the service offering. So we are now in the process of working on what we call -- refer to as phase 2 of our plan which is what are the next steps we want to take to further enhance service delivery in the community and do it on the same basis that we have before and leverage with our partnerships. I know there have been -- there have been and will continue to be items that touch the -- this court in terms of the justice system and we're trying to be mindful about how we look at these things comprehensively. Just to touch base on the mental health admissions, in terms of the district supported inpatient beds that we've been funding since December 2006, in 2006 we supported 106 admissions. That doubled, more than doubled in 2007 and that will also probably not quite double but will significantly increase again because the district did -- in addition to approving 2.3 million in the budget that you established or you approved last year, out of our enhancement funds we added another half a million dollars or actually 569,000 to that contract, so about 2.9 funded for this year. We continue to increase that investment in inpatient beds to hopefully reduce the impact on the emergency rooms and get patients into care when they need to. And when we come back and talk about our budget, we can give you more details about our funding collaborations, but this was just to give you an idea. We presented a slide last year, it's been updated, but it shows of the district's investment of 14.2 million, we have leveraged that investment with collaborative investments of 39 million from other community partners. That could be in the areas of mental health, it could be the investments seton has been making and the expansion of brackenridge along with our investment. So this is -- this is a principle, I would say of the district's operation that is correct every dollar we invest we're looking for opportunities to leverage other partners in the community to invest along with us so our dollars are going further to expand service. I want to talk with you just a minute about the chc transition. This is a very pivotal project for us. It requires a lot of energy and a lot of bodies. We've put this in the form of a house because this is what it feels like to us. We're building a house. We're building an infrastructure to support not only the expanded district operations but to support this 18 clinic system that we're inheriting. So we are in the -- as you will see, we've talked with this -- talked with you about this before, but I think it's good to talk about it again so there's an understanding in the community. That the -- that Travis County health care district is a separate entity and will be a separate entity from a 5013-c that will house the operations of the community health centers. So right now those community health centers operate as a department of the city. But when they leave the city, they will actually be housed in their own 5013-c nonprofit corporation. These entities are affiliated, but the district does not own the 5013-c. It's close affiliation. If you look to the middle of the graph, you can see even though we're separate entities, we're sharing this infrastructure. We're developing an infrastructure that creates effectiveness and efficiencies for both to use that infrastructure. We do not want to duplicate anything among the structures because that is not effective use of taxpayer dollars. There are certain things that this 5013-c will do that the district does not do. We're not a provider of care. We will not employ doctors and nurse to deliver car. There are some things that we can share in without necessarily providing the same type of services. The Travis County health care district will -- will receive -- receive employees that are related to the medical assistance program, which are programs of the district, but the staff of the community health centers, their management, their doctors, their nurses, their clinical staff will be part of the 5013 c. As you note in the little roof, the top of this picture, we do have both agreements and policies that are established between these two entities that guide and govern how we operate. And I think it's also important to mention that, of course, the federal government is still very much a large player in this equation is that the federally qualified health center statuses one that's granted by the federal government. And we have had to go through a process with the federal government to get them to approve the status, the transfer of that status to us so that we can establish this arrangement. That process is going through and we're still working with the federal government, but working through the details, but everything seems to be moving -- hopefully moving along. We'll cross our fingers. Set for a March 1 transition. Again, we've been -- this is -- I think it's important on this next slide to think about where the district has been and where it's going because when you do see the budget that we'll present in early August, you will notice that there are changes in the budget. The district has heretofore had a very small staff, has outsourced most of its function, and many of those things -- so therefore they were reflected as a line item expenditure. For example, the payments that we made to the city of Austin were very large because they were in support of 450 people in all these operations. Will you begin to see instead of that being a single line item in the budget, that's going to be broken out and parts of it brought into our budget so there will be more line items, more staff, more functions. So to some degree it's expenses we have been incurring but they have been moving around in the budget. Also this is a transition year and that for the first part of the year it's going to look one way and in the second part of the year it's going to change because we are actually inheriting the operation. When we present that budget to you, we'll be emphasizing -- you are going to see increases in staffing. You are going to see increases in functions that you hadn't seen before. But that's just what's necessary in order for us to take on responsibility for those operations and to have sufficient staff in the district to now manage that on a -- or support the management of that on a day-to-day basis.
>> but the budget will clearly show those trance incisions.
>> yes, we'll be able to show you those transitions. And then I think that -- I think it's probably fair to say to some degree fiscal year 2010 will be a bit of a transition year as well. We're going to transition away from the city March 1st of 2009, but there will be a process of sort of unhooking some of those systems and things that will carry on through 2010. We feel like after -- we feel like going 2009 and 10, hopefully at the end of 2010 we have a much more -- a firmer grasp on what that operation looks like because there are -- I think it was donald rumsfeld that make that statement about when they get to iraq, they didn't know what they didn't know. And I think we feel a little like that here in that we're trying to get as much information as we can out of the city of Austin about how things are done and how those operations are supported. But we're also finding that as we go along each step, we're learning more and more about how it's really done and what it's really costing and changes that we have to make to take that over from them. So we just fully -- we're trying to give ourselves enough room to be mindful what we know today may be different as we move through the next months and learn more about how the support is provided. That's to give you background on what we're facing. As I mentioned before, we'll continue, of course, with our legal services support from Travis County as well as
>> [inaudible] so the next slide, again, just shows you the ccsd employees graphically, a portion of them will be transferring into the employment with the district and remainder will be transferring into employment with the community health center. It gives you an idea where folks are headed. In terms of our budget for next year, this is similar to what you've seen in prior years. We start off with development of a base budget which reflects our existing obligations, whether they be contractual or statutory or otherwise. We look at what our -- what might be built in cost drivers or inflation related to that base budgeted. We then look at expansion opportunities, and that is -- again, part of that process we go through with our board to reflect their priorities for our work in the next year and where they want services expanded. So we try to budget a category of expansion, although we may not have every single item determined at the beginning of the budget year, we've given ourselves rooms that once we develop a service contract that we can bring that to the board and have them approve that service contract and we have the funds already appropriated for that. And then, of course, capital is a component of our budget. This year it's going to be much more significant than in pry years. One, because we are making -- have made both this year, will continue to make into next year investments in i.t. Systems, et cetera, as well as actual health center system investments. We are-the community health center system is opening a new location at william cannon. There is a lease. We will be relocating the north -- what is now the northeast clinic so there will be capital costs related to that relocation and acquisition of a new facility and building. So you will see in the capital budget we present to you will be much expanded than in prior years. Talk about a -- a bit about what we face in terms of our budget. Our revenue pressures are -- we are feeling them in a few areas. With regard to dispro forks nature share and upper limit funding which is our share of federal funding that we draw down via our relationship with seton for the operation of brackenridge hospital, I think you are aware that the state is going through a -- I call it medicaid reform might be the easiest term where they are seeking a waiver from the federal government to -- to implement medicaid services somewhat differently than they are today. That includes the establishment of a health opportunity pool which would create funds that would allow uninsured individuals to access insurance in a subsidized manner. The state is looking to fund the health opportunity pool through the transfer reasons of what are now upl dollars coming into the safety net system. They have -- as part of these efforts, they have capped addition upl payments for 2009 at 2007 year levels. We know our dish payments are being capped. We don't know what the effect will be of the state's efforts around this health opportunity pool. That is still to be determined. So we do know there are some downward pressure there, we just don't know the extent of it yet. We budget conservatively and accordingly. We try to take into account everything we know to this point so you will see that when we present the budget to you. In terms of tax capacity, we know that we're dealing with a fairly low rate here and have been. In terms of tax base, we know we've enjoyed very significant additions to that. Even including this year, but we also know that's going to be slowing down in future years. Same thing that you are experiencing. And in terms of the economy, of course we're experiencing lower interest rate earnings just as you are. And interest does represent a -- I wouldn't say the most significant, but it's a good source of revenue for us because we right now enjoy some cash reserves that are earning interest for us. In terms of expense pressures, I think just inflation, health care inflation, the cost of health care continues to go up, what we have to pay providers for services n terms of the economy, it also has the effect of increasing demand for services. As people lose employment, become uninsured that is correct can put pressure on us there. We have built-in contractual increases that are related to our health care service delivery and so that exists. And then we are incurring costs related to the development of infrastructure that we did not have before. Some of those costs are one-time in that we're having to invest them to create infrastructure, but some of those costs will be ongoing and will become a permanent part of our cost structure in the future. That is still going to take us another year or so to sort out what is ongoing and permanent versus what is one-time startup. So to talk a little bit about revenue --
>> trish, just an asking of you, when you all put these things together, please put -- you know, you use these acronyms like everybody knows them. You are trying to flip through the pages and make sure you know what, dhsupl --
>> we will put a little guide. How is that?
>> just down at the bottom of the page. I think I know what it is, but I have to miss two minutes of what you said to kind of follow.
>> we'll do that, sir.
>> let's plan to take five more minutes.
>> yes, sir. So the district revenue base, looking at the preliminary effective tax rate for next year, we're looking at 60.3 million based on current information that we've received. That represents 71% of our total revenue. Our disproportionate share and upper payment limit revenue is the second major source of revenue and that is projected to be 17.5 million or 21% of the total budget. I mentioned that those sources of revenues are vulnerable. What's happening at the state level. I also failed to mention there are some activities at the federal level, again downward pressure for the federal government to reduce its level of expenditures. And if they reduce their level, it flows downhill. Our revenues will be reduced. As you see on this graph, good represents about 3% of our total revenue. We do receive -- and tobacco settlement represents another 3% of total revenue. Looking ahead, and this is -- I think this is really probably the most salient point of today is just understanding where we're at today in -- might be for 2009, but looking ahead. And this is not unexpected, but if you look at our revenue trajectory, you are seeing over the years we did -- in 2006 and 2007, we did enjoy some unexpected payments of federal dollars in addition to upl dollars, but we don't expect those to continue so our revenue sources are somewhat leveling out. But our expense structure, of course, continues to increase. And you see that crossing, which if you look at that gap, if you look for 2010, the difference between revenues and expenses have to come from reserves or other sources. That's part of what we talk about when we bring the budget to you in 2009. Part of that should be what the tax rate should be, from a policy perspective going forward. Looking at that preliminary effective tax rate that we talked about, for '09 it's .066 based on current information. That compares to the rate that was adopted last year at 0693 so it is a 4.8% decrease at effective. The effect of our tax on the average homeowner for 2008, the adopted rate it was $141.82 at 6.93 cents per hundred dollars of valuation. At the preliminary effective rate for 2009, it's $144.68 at a rate of 6.6 cents, reflecting an increase of 2.81 cents. A one percent increase brings 591,520 additional tax dollars to the district. That's not a large amount of money and that's reflective of the small tax base to begin with.
>> incremental revenue 1% above effective tax. Does that translate to if you take the effective tax rate of roughly 6.5 cents per $100 valuation and took it up to a flat 7 cents per $100 valuation, it would bring in this additional revenue? Yes, a 1% increase. So 1% above 066, which would be -- do you have -- 067. It would bring another 591,000. Of revenue to the district.
>> okay. I see. All right. Okay.
>> each -- correct.
>> so in order to meet the 2010 projections, you would have to have roughly 16% increase?
>> I think the math works pretty close.
>> roughly 16% increase over the preliminary effective tax rate.
>> and again, this does not take into consideration what kind of
>> [inaudible] you might need out of reserves. But if you wanted to look at it and fill in the gap with taxes, yes, that's what it would equate to.
>> it brings into the world of -- and I don't want to start a panic, 8.2 cents per hundred dollar valuation. If you handled it in property tax alone.
>> right. And, of course, we know our rollback rate is at 8%.
>> can we have a list of expense drivers when we see you?
>> absolutely, sir.
>> again. And what are the advantages of setting up the 5013-c?
>> it was somewhat driven by federal government requirement to transfer of the status that the actual board, the board of directors for that entity be incorporated. In other words, they are not incorporated right now. They are an appointed sort of -- I guess they are an appointed board. It also provided us the ability to -- in addition to meeting federal requirements, it provided us the ability to provide an operating structure that is a little more flexible for them as a health care entity. So those were the two primary drivers.
>> so you have in mind the district's board serving as the corporation's board.
>> good question. The board itself has by federal requirement has a 51% consumer user board. Meaning 51% of the members of that board have to be users of the clinic system.
>> that board being the community health board.
>> the federally qualified health center board.
>> might be previous fqh.
>> correct. What's been approved by the feds is our district board will appoint two members to that fqac board. So we have two appointments to that board and we also will serve on the nominating committee for the board. And that reflects the federal government's requirements for the independence of the board in order to have that status.
>> so our next steps will be -- we are -- we have another budget work session with our board at the end of this month, in July. And then we will bring -- based on the results of that work session, will bring a budget to them for their consideration in early August, which they will then recommend that we bring to you to be presented prior to taking that to public hearing. And then again back to our board for approval and then to you for final approval in September. So we've got those meetings scheduled out so we're looking to come to you I believe the second week of August for the presentation of the preliminary budget as approved by the board to bring to you. Any other questions?
>> thank you very much.
>> thank you.
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Last Modified:
Tuesday, July 15, 2008 1:51 PM