Travis County Commissioners Court
September 23, 2008
Item 23
>> 23. The interlocal.
>> we need to get this -- 23 approve amendment number 2 to interlocal agreement il 080014 ml, city of Austin, for central booking and related jail services. I thought we should discuss that today and take action next week unless we think it's so routine we can approve it today. This is central booking interlocal. Let's just lay out the issues that y'all have been discussing and where you apparently have landed on it.
>> roger jeffries, executive manager of justice and public safety. I have darrin long major at the Travis County sheriff's office corrections bureau. We're here to just present to you what we have worked out with the city of Austin, the Austin police department regarding the interlocal that provides the booking services to the Austin police department.
>> when did you find out I guess basically of the changes that took place, you know, as far as the original backup? But there's some additional changes that came in.
>> yes, last night there were a couple of -- I think jim connally sent you a couple of changes. They were minor. They were language changes the city of Austin requested be added to the interlocal. I think he has copies. I've got copies as well.
>> the point is that, you know, and I understand where you are coming from, but the point is that when you -- you know, you
>> [inaudible] stuff and you -- and it changes, stuff like that, sometimes you are not aware of them, and especially if it's 7:00 at night. And you know, so when you come in, you don't know about some of these things and you kind of leaves you behind the eight ball on those kind of changes. It would be good, I think, if there are changes to be had they come in a more timely manner. That's my concern. For me. I don't know about anybody else, but as far as I'm saying, it would be good to get them a lot earlier than later.
>> okay. Certainly will.
>> okay? Thank you.
>> bottom line, the reimbursement amount that we've worked out with the city of Austin this year is $5,052,328. The budgeted expenditures are 8,861,250. And basically the formula in a nutshell is you take the '09 budget for central booking, substract out the amount of the Austin police department cost for magistration and identification and apply a percentage of the Austin police department's bookings from previous year to come up with the 5 million. That's a 9.1% increase over fiscal year '08. Which is amount of reimbursement was $41,426. In addition to the additional -- in addition to the increase in the reimbursement amount, there were a couple of things that are actually three things we worked out with the Austin police department that we added to the amendment 2 to the interlocal. One is we've agreed to a true-up provision. And what they -- this is a request from the Austin police department. Where at the end of the fiscal year we'll look at the actual number of bookings for the fiscal year, apply it to the cost model, which is exhibit a of your agreement. And if it's a greater amount to the county, the city will pay. If it's a greater -- if it's a lesser amount to the city, then it will be deducted from the first quarter's payment in the next fiscal year. We agreed to this or thought this was a good idea, one is the Austin police department is considering doing their release to summons policy and implementing that which we anticipate might affect the number of bookings in the coming fiscal year. That would be a benefit to the police department obviously but also to we think to the county jail. We also agreed to or the sheriff's office agreed to provide a space for a phleb to. Mist and we also agreed to work with the Austin police department to implement some performance measures. Two additional performance measures. One is actually a refinement of an existing performance measure that's in exhibit e of your agreement, but it's going to measure capture report and measure the turn-around time that -- for Austin police department officers from the time they enter the booking facility to the time they leave. And then we're also going to collect the number and types of medical refusals of -- in the booking facility. And then finally we also agreed with the Austin police department to work jointly to increase the operational efficiency of the central booking operation. And in your memo you have, it just quickly it's both parties will jointly work to increase the efficiency of the central booking operation by utilizing the performance indicators that I just described. And to monitor progress towards mutually agreed goals. Secondly, the central booking coordinator -- coordinating committee will study feasibility of coordinating both performance measures and a true-up of the actual costs. They had actually requested that for this fiscal year. We felt we weren't quite ready for that but we did agree to discuss that with them further in the next fiscal year. And then finally, we agreed -- or the sheriff's office aristide to strive to keep central booking operating model and the staffing plan as fully staffed given an arena allowance for attrition and time to replace personnel.
>> questions?
>> go ahead.
>> one idea I had was if we keep a record of the refusals for medical reasons, then we ought to keep some record of of exactly what happened when they checked into the emergency room. That's what those are basically. Arrestees are presented to the central booking. We believe they ought to go to the emergency room for medical attention.
>> exactly.
>> so keeping the number that we actually refused and accept is one thing, the other thing, and I see where this is headed, we ought to know what happened after they presented to the -- at the emergency room. I mean, because if we keep referring people who don't need medical attention, that's one thing. If we refer you over there and you need medical attention, the number doesn't matter. Right?
>> true.
>> okay.
>> but there's a large number and they don't need medical attention that means we've a procedure problem. We need to do a better job of evaluating when we turn you down. When we refer you to the emergency room for medical attention. They go hand in hand in my view.
>> I think we can add that. We have a coordinating committee that meets monthly.
>> we can keep that ourselves. I don't know it has to be part of the agreement. Right?
>> yes, sir.
>> what's part of the agreement is if we refuse to accept an arresty for medical reasons, we report that. I'm saying if we report that number, we really ought to report what happened when they went to the mnl room. -- emergency room.
>> okay, we can certainly figure out a way to collect that.
>> if you want it in the contract, that's fine. I think we ought to keep it for ourselves.
>> okay.
>> otherwise it doesn't -- otherwise it doesn't help to keep a record of the number of arrestees that we refuse for medical reason.
>> judge, are you talking about the results of the medical procedure at brack, they were taken over there and eventually they come back to us, what the results of that treatment was?
>> yeah. If brackenridge emergency room refuses this person too, the implication that person shouldn't have been referred in the first place. But if they provide some sort of medical attention, that means we made the right call. And I'm not saying what the medical attention should be, I just think any medical attention that the inmate should have gotten and did in fact receive we ought to know that there are happened.
>> so we can add a followup piece of information to the individual records that we're going to collect.
>> yeah, I hate to see a number like 500 that we refused and just leave it at that. You know, because 499 of them may well have been referred and got medical attention. Maybe one, it was just a minor problem and, you know, the medical attention was insignificant. But even at that, I think it's better for us to err on the safe side because if inmates really need medical attention and we're kind of making that determination, you know, I guess fairly quickly, right? You show up, you got blood all over you, do we call a nurse to look at you?
>> yes, sir, it takes place during the intake process that our officers make an initial assessment, send them over there to the medical screening office, and the arresting officer may tell us ahead of time, hey, this is what's going on with this individual and get routed over there to the medical screening. Our nurses will do a screening assessment on there. If they've got real high blood pressure or if they are way too intoxicated or an obvious broken arm, they are going to say, okay, we're not going to accept them, take them to the hospital. So there's a variety of reasons why we would decline accepting that individual. Until they are properly treated and properly, you know, looked at by a physician at a hospital.
>> major long, does this dove-tail in any regard with your -- I know that you are actively engaged in attempt to computerize our medical records for the inmates that we do take. Would that be sort of a back door way to track this? Because I'm assuming they come back to us after they've been treated.
>> the care network that you are talking about, I think for long-term care that's going to be beneficial so we can look at each other's records and see how to stabilize and treat that individual. But for a screening process that it's so linear and happens so quickly.
>> stand alone?
>> yeah, you probably don't have time to do all that research. If you notice the blood pressure is out the roof, they are going to send them. If they see an obvious broken append age, they are going to send them. If they see they are obviously too intoxicated where they are at a dangerous level they are going to send them. A lot of this is very quick assessment they make a determination that they shouldn't be accepted at our facility because we don't have the means to treat them for those type of serious things that they need to be treated for.
>> but a nurse makes that call?
>> yes, sir. We only have one doctor. So it's mainly the nurses that do the assessments.
>> I don't know that second guessing a nursing --
>> they are capable of making --
>> yeah, they are nurses. It's not just officers making this assessment.
>> [multiple voices]
>> the nurses are the ones making the determination to not accept -- not the individual officer.
>> okay.
>> I do want to commend you all on this cooperative transparent process that y'all are including in this contract. It's really such a pleasure to see the idea of performance indicators that are collaboratively developed and consider folding them into the formula for reimbursement. I would love to tee that kind of trusting, transparent, collaborative effort in some of our other city-county endeavors, and I think we can get there.
>> this is a new process for roger and I this year too so it was a learning process too. It's good meetings and we think we've come to a good agreement and we'll reevaluate it every year and see how we're doing and --
>> good job.
>> judge, have we ever thought about doing anything with the folks that need medical attention? We have, what, two physicians?
>> we have one --
>> we have two physicians at our wellness clinic. We have two doctors that work for Travis County. I mean, I think we ought to at least look into are there places where we could utilize -- I know that central booking is probably heaviest when our doctors aren't here at 2:00 in the morning on Friday morning or Saturday morning or Sunday morning, but I mean, there are obvious cases where we probably during the data somebody to brackenridge or somewhere, right?
>> yes, sir.
>> so it would be interesting to see if we could talk with our folks at the wellness clinic and say, you know, after all, they are mds.
>> but it's not hospital care. They are general practitioners.
>> I'm not saying they are hospital care. I'm just saying that sometimes we're not sending them over because we need necessarily hospital care. If it's obvious -- just look into it.
>> are you referring to supplementing the central booking medical staff or the -- that would be the place that -- or that would be the destination for someone that the central booking staff had been determined needed additional medical care?
>> I'm just saying if there is a place where we can save some money, because once they go over there on our watch, aren't they on our nickel?
>> no.
>> if we send somebody to brackenridge --
>> part of the screening process in the interlocal chit describes is we have to accept them for Travis County to except responsibility. Our nurses are part of that screening process where they will determine, say, if it's an a pd arrest and there is a medical need that needs to be addressed that our staff cannot do, we'll send them over there and they will get them treated and screened and usually bring them back after they've got a cast on their arm or switched up or whatever.
>> I'm talking about the folks that are in our jail. They've been in there overnight. The next day you find out these people need to see a doctor.
>> yes.
>> and let's say that they -- I don't think it makes any difference who brought them in. The fact we have received them, they are ours, correct?
>> yes.
>> and we do pay the tab for these people once we take them.
>> yes.
>> that's what I'm saying. Let's just look for ways, if we've got some efficiency or potential efficiencies there, you know, if our positions over there say that's not something we can take care of, they need to go to the, who fine. But sometimes it's like what this person needs as opposed to getting an 8 hundred dollars bill. Just look.
>> we'll have this on the agenda next week for action. How is that?
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Last Modified:
Tuesday, September 23, 2008 3:05 AM