Travis County Commissioners Court
January 27, 2009
Item 31
>> number 31 is to consider and take appropriate action on request from seton medical center Austin regarding the children's optimal health partnership. If we could just have someone briefly lay out the request. Why it's put to Travis County and why it makes sense. Morning.
>> good morning, your honor, good morning members of the court. My name is ashton cumberbatch and I'm here with the seton family of hospitals and I'm here with jim walker from sustainability indicators. We are expecting diana resnick, senior vp from community health services to join us. She is at another meeting and may come in during the course of our presentation.
>> do we need to give her five minutes or so?
>> that would be great if we could. I don't want to inconvenience the court, but if we could, that would be fine.
>> what if we wait another five or 10 minutes then and see if she arrives? I would hate to -- yeah. If we can have her, that would be fine. This is Travis County. We have plenty of other work to do.
>> [ laughter ]
>> okay. Thank you very much.
>> we'll call this up in about 10 minutes. Is that okay?
>> thank you.
31 is to consider and take appropriate action on request from seton medical center Austin regarding the children's optimal health partnership.
>> good morning. We want to thank Commissioners court and judge Biscoe for allowing us to come before you today and talk to you about children's optimal health. I'm a board member on a very new initiative where we're really trying to come together with numerous agencies from across the silos of wellness and health care beyond just the typical medical, housing, schools, all of our agencies, being able to share data at a granular level that will give us an ability to see patterns in the community and throughout the county that are far more in-depth than anything we're able to see with aggregate zip codes and aggregate data. I didn't tell you, my name is deanna reznick and I'm with seton families of hospitals, but representing children's optimal health board. We want to be brief, so I'll pass it over to jim walker, who has been helping us from the very beginning on a very innovative way to geo map this data to really give us a better understanding of how we can utilize resources and affect change in our county through the use of sharing data and mapping data.
>> thanks. I have a powerpoint. I'm not sure who's going to -- how do I switch that on so everybody can see it?
>> media, can you do that from -- where you are?
>> there it goes. Thank you all for the time. And I'll go through this and please feel free to interrupt with questions or to hold them. This will be a quick overview of some of the stuff that we are actively doing. One of the biggest value adds of how children's optimal health is investing in gis. And gis is geographical information systems. It's how to connect where something is with what it is or what's happening. I know y'all see happens ma all day -- I know y'all see maps all day long. One thing that we are bringing to gis is access to data sets from really big players. Like aisd, like the city of Austin, like seton and st. David's. Data that hasn't previously been able to be used or optimized in the public realm. A lot of that is built on trust. It is local players within Austin and Travis County who know each other and say, okay, I get what the bigger purpose here is. I know we have data. We have a battalion of lawyers and if we can figure out how the technology works with all those folks, then yes, let's use data and share data so we can work. All gis works with overlay and pat dat ta and working with the different patterns, the different correlations. The kind of correlations we're looking at right now are not deep research. They're not necessarily statistically valid. They're not causal relationships necessarily, but as you all know when you go into a community, people are living the kind of relationships that we're mapping. And a lot of times the visual overlaying can really reinforce both what the issues are and what kind of solutions might be needed. And there's a rigger met dolg that I will dig into in a second here. And then leveraging data towards action, I know the board has that hazard its primary goal. It isn't just another exercise in collaboration and pulling data together and seeing what we can do. This really is trying to -- how we figure out where the deep needs are for the kids in our community, how those things relate across sectors and how do we do better. I really do believe that. I wouldn't be involved in it if I didn't believe that, to be honest. So this is kind of some of the value added approach that coh I think is bringing. Because this is such a big point, we spent a little bit more time on this. Privacy and protection of data. With the kind of data that we're handling, a lot of it is protect bid federal law such as hippa which protects patient information when they go to the hospital and the integrate care collaboration is the long time partner in the community for health data and coh is working with them. And ferpa is a similar kind of thing that protects education data. You're a student in the educational system, ferpa is the laws that protect your information. We are taking incredible due diligence to stay compliant with both of those kinds of regulations depending on whose data it is and what their particular local issues are, and that's the other bullet here. Every different agency that owns data or has data, whether it's a nonprofit, whether it's a corporation, whether it's a government, has their own procedures in place for data handling, for comfort levels of that lar particular policy making board, that should be you all in this case. That's fine and that's how it is. And coh's role is to work with them, not to dictate to it, not to say you have to put data in or you have to work with it, it's to work with that and it's the trust building aspect of it all. The data sharing agreement that we're developing, and we have templates of those and copies of those, the city is looking at one right now and you all have seen one, those reflect all the time, the immense amount of time that's gone into making sure that we are documenting the trust relationship and protecting the data that then comes with that. And I know this seems like a lot of time to spend on one particular point, but it is a hinge point for the entire coh approach. So here's how we handle data. This map shows Austin independent school district students by zip code. This is kind of the raw density for the 2007-2008 school year. On the left bigger map, this is a great way to show information if you want to show what's happening across the entire county or the entire city. If you want to see a big region level analysis, kind of a local resolution, if you will. Now, that inset map that assumed in there on the riverside pleasant valley area, this approach, the zip code approach isn't so good for really seeing at the neighborhood level what the characteristics are of a particular population or what's going on and how you would target inknow vengses. In a time of resources, which we were in before with health and human services, but certainly we're heading into now, targeted intervention is really a much more meaningful type of topic. This is the data that's behind those. You have a bunch of individual data with addresses and zip codes and what we can do, what a lot of people can do, what anybody can do is convert an address into a latitude and longitude. A place on the plon net. We can then shift that in order to take it out of its true location. And that is the first kind of layer of privacy protecting, and I can spend a whole afternoon talking about really dorky level stuff about that, which I won't do now, but would welcome the opportunity. This is the one page -- this is the one page slide of how that shifting works and what it does. Coh is by no means interested in building a black box about how we're handling data. This is how we handle data. This is how we protect it right here. We feel like being transparent on that helps build the trust, reinforces the trust in how we're using the technology. This then shows all these -- these are all a bunch of points. This is the same data that underlies the zip code map. The exact same data set. These points that are all shifted off their true location, but it's still kind of nudging on the comfort level of what anybody really wants to share. So this is what aisd produces in the partnership relationship with coh. This then is the second level of privacy protection. We kind of fuzzed that data into a neighborhood and the red areas are where there are more kids, higher density of kids, the blue areas is where there is there's not as much density and the green areas are where there are quote, unquote, neighborhoods or areas where there are less than five kids generating that data. So I don't want to show those and that's the third level of privacy protection. The rule of five is what pea uses. It's what the feds use, what their business level data. You show stuff when there's less than five and generating that data. So we're going to take all those out. And this now is a density map of where aisd students reside in our community that I feel like I can publish in the statesman because you can't discern an individual back through that map. But I have a lot more detail and richness about where the distribution, how kids are distributed across the Austin community down into neighborhood level. So this is just raw density that we spent a lot of time on this because it's the core way of how we handle a lot of this data. This then is the same data set. This is a kid density. Fitness tracking is the thing the state told all school districts to do. So twice a year you get all your kids or you get a sample of your kids. 11 and a half thousand kids were sampled in aisd. They were weighed, measured, they ran around a track. They were made to do setups and pushups and we got from that a health on score, health tracking. This map represents that health tracking. The red area shows the majority of the kids in the red areas are poe oa bees for their age and gender. The green areas, the majority of kids are at healthy weights. It doesn't track exactly where the densities are. It's not a straight correlation to student density. But this chart is giving us a really targeted sense about where do we start doing childhood obesity stuff. Where would you start -- this drives the collaboration. All the folks that you all are funding. The city is is funding, st. David's foundation who are focus odd childhood obesity, which is a very popular thing to fund right now, this starts to drive some of where the actions might be targeted. So real quick to reiterate, it's combining community data sets. There's multiple proprietor owners, there's multiple stakeholders. There's a richer understanding. The deeper research comes later once the map -- the contents of the maps is really driving the conversation, driving the collaboration. And the outcomes need to be the focus is that if we can't cool off the hot spots and where there are obese kids, then there's not really a point to do this. I'm going to fly through a couple other maps. This is focusing on another neighborhood in our community up around lanier high school. This is a student density map. Again, the orange dots are housing authority, city of Austin housing authority, some are their communities. Straight density map. Economically disadvantaged has a flag in that map. I've already applied all that privacy protection stuff we just went through to these. So this is raw numbers of kids and it kind of mirrors the student density, which not surprising necessarily doesn't mirror it exactly, but it kind of does. Here's our bmi map again. This does not map either straight directly to where the raw numbers of kids are, which is interesting in and of itself. Now, where these red areas are or where there's a majority of the kids who were tested that are overweight for their age and gender. What's interesting about this and where the collaboration starts to come is with some of the red areas are around a park or they're right across the street from an elementary school, which is contrary to what the literature suggests should be true. So now we have a question that the content has driven us to, the data has driven us to a question that is now a genesis point for further action. Very targeted action. The yellow triangles by the way are fast food restaurants, fast food places and convenience stores. The house like structures are grocery stores. The h there in the middle is the clinic.
>> this is going to be so useful to the sustainable foods project.
>> [ laughter ]
>> and mapping food and food desserts and mapping food access has been across the radar of coh for white awhile. There's a little bit of investment. I think the group that you all are forming with the city would be the perfect thing for you to have that conversation in, updating the access denied report that was done in montopolis 10, 11 years ago. Doing that for the entire county would be really interesting and fabulously informative to this kind of thing. This is all of a.p.d.'s crimes in 2006 that happened in this zip code. A.p.d. Has 538 offense codes that it can select from. When you apply the exact same methodology to this point data that we apply to the data you get a heat map like this. This again shows the red is where there's a high number of a.p.d. Incidents. Right around that very same park where there was a high number of kids and a high number of overweight kids. So right there just with two overlays from two big major data sets that have never really been combined before start to -- again it not like an x and y equals correlation with a margin of error, whatever, but this is almost enough to start doing community kind of discussions and community actions on. It's not a very safe park to be around. If you dig into that a.p.d. Data a little deeper, you get crimes that particularly affect children. These are family date related crimes, these are all the violent crimes that the f.b.i. Tracks and some of the more egregious, direct child kind of crimes. All crimes is this map. This is the crimes that affect kids. It's a different pattern. It's relevant to know where the pattern gets darker red, where the red shows up that it didn't show up before. That kind of drilling into the data is what -- at the neighborhood level is what I think the coh, the really value out of the coh process. And to juvenile justice issues, because I know the county is particularly invested in, and in terms of reconvening the criminal justice community and really kind of focusing it, applying this would be fabulous. Getting the sheriff's office data into this would be awesome. This is the little animation of four years of a.p.d. Data for the entire city we zoom back out. You can see that some hot spots dissolve just over four years. And some are persistent. This kind of showing trends over time and showing where the hot spots cool off, what the map doesn't tell you is why a hot spot cooled off. That again is where the map and the coh application of it is going to drive the community conversation and the collaboration. Was it a neighborhood watch program? Was it a strategy intervention by a.p.d. And the sheriff's office? What was it? You can drill down into this for particularly for juvenile crimes in particular, for family date violence related crimes, accidental crimes. The technology really lets you do a lot of different things. I would love to talk with the county about the sheriff's office data and some of the exiend emergency data that you all have purview over. This shows asthma, youth asthma from indigent care collaboration. This is youth asthma that presented at an emergency room. This is where seton and st. David's start to get really interested, the health care district starts to get interested in how would you minimize e revment visits and those kind of costs if you could approach health care issues in a neighborhood where there were particular hot spots and wanted to cool those off? Any baby can, which is a nonprofit, can also share into this application their client data and start to see across the community how are -- after all that other stuff we just looked at, are they not present, did they not have client in parts of town where they really should because of all the other kind of dem dprasks we're looking at. It helps individual nonprofits that you all as funders might be interested in that to really target their services. This is any baby can citywide data. And they're mostly active down there in riverside, pleasant valley, south of the river kind of data. Additional data sets and process, we're getting a second round of aisd school year data for the 2008-2009 school year. Something we're really interested in looking at is the mobility of students. If it's well-known or well cited that 25% of aisd kids move within the academic year, change addresses within an academic year, having a map of that, showing that would help us tell a whole lot of stories about where are they moving from what neighborhoods are they moving into, what's the service fabric in those neighborhoods that we all fund. The housing authority of the city of Austin is also a current coh member and early adopter. They're really interested in how do the kids that live in housing authority projects, how are they doing in school and is there any difference geographical or spatially. We're looking at distribution of births and prenailgt care. How would you really get at that 20% of mothers who don't get prenatal care. They really try to lower that number. Just recent health care facilities, we've been working with the Travis County health care district district for a long time and by virtue through thru that relationship with the city of Austin on the kind of data they are interested in, where facilities are, how the facilities are distributed by the population that they serve, which is the uninsured population and working with the indigent. So that was the 10 minute elevator overview of how we're using gis and coh and I hope you all become a member so that we can further the collaboration.
>> just a couple more points. I think that the board is most interested in not only what it will tell us to focus on, but knowledge that it has a longitudinal opportunity to see that we're actually making change. And because these are data points that we are populating, meaning they belong to real people, they don't get fueled by regentrification or other kinds of things. We're looking at data elements that belong to the numerous agencies asking the question. I think the other thing that excites the board is that questions can be anything. So as we just talk briefly with some of you, you've justice we can overlay dropout to crime rate. It's as opportunityistic as we want it to be for solving these kind of real questions. And instead of going with our gut or with our broader theories of the case, we actually can see it evidenced by the data points that belong to the agencies actually serving the people. We think it's compelling and incredibly exciting. Mapping can be done by anybody. And a lot of our individual agencies can do their own mapping. So the opportunity for children's optimal health is to map together, is to take databases that are normally not shared and overlaying them on top of each other along with public information that will really give us the insights to what it is we should be focusing and more importantly whether we're making change. So today we wanted to share this with you and we wanted to invite you to join on our board. I'm not sure if we shared with you -- we have an executive summary that kind of gives you these points, but we wanted to share with you some of the folks on the board. We have the Austin independent school district, the greater Austin chamber, the housing authority, the integrated care collaboration, the seton family of hospitals, st. David's, Travis County health care district, university of Austin, the university of Texas public health, and then we brought in a few of the social service agencies so any baby can and live works have joined us. In addition we've tapped into e 3 alliance because they're doing so much understanding of the educational arena, and Austin project, which is working with work source and ready by 21, success by 6. And all of them are tracking or setting different score cards or different metrics for the community, but how do they know it's really working? This is what we want to try to get to. So as everyone shares data we can show them. So your metrics say this, but here's what we're seeing with real data overlaying on top of each other. So what we're hoping is to sustain this new agency and we're asking for charter members of contributions of 35,000 each for three years to get it solid, to really begin to deliver outcomes, to make it something that can sustain itself because of the value that we really think this new opportunity brings to our county for really assessing. And there is a hope that as we build this, we can be broader than one county.
>> talk to us about the total budget and I guess other sources of funding.
>> we're looking --
>> I went to the meeting with the robin wood johnson representatives.
>> yes. And judge Biscoe and also sherri were part of that. We've had site visits from robert wood johnson who are very interested in this concept. They're also pursuing geo mapping. But what they never realized was the opportunity because of our trust in this community and the history of chab ration that we've had -- collaboration that we've had, it never occurred to them that we could actually take data and deidentify it like jim had mentioned and overlay it. So they're very interested in what we're doing. We've also talked with the community foundation and also with other foundations locally who got very jazzed about the idea of sharing and looking at this so that they can see their investments and they can help guide some of the agencies into a more strategic intervention and see how it's working. So we think we can get the interest of foundations and also resources of outside dollars as we begin to show these maps and begin to show how our -- what they want to know is what are you going to do with this information? So the agencies at the table as part of this board that's starting to drive some of thighs questions will help us show some positive outcomes that we hope will draw in some additional dollars. The budget, basically we're trying to keep it as modest as possible. We're funding some of jim's time, some of dr. Malaise time and a little bit of administrative support. We're trying to get in kind from the agencies in terms of space, rent, other kinds of things so that we don't overburden trying to stay as lean as possible. The total revenues currently are 245,000, and our expenses right now are 158, 59. So we've got some reserves and I think that where we will spend more is as we ramp up. Because right now as jim showed you, we're only looking at four projects trying to keep it contained to the hours that we have available of staff time to do these. As we really get going and more and more agencies say, boy, I want to try this with merging this, this and this, it's going to be about how quickly we can get agreements to share data with each of the individual agencies and then how fast we can produce these maps on a real sound theory of the case. What is it that we're look looking for and knowledge that that really is going to be something that has to be done collaboratively and that the interventions have to be collaborative. So we're setting up the process through the agency to figure out how we deem these projects appropriate for children's optimal health and then the time line or the scaleability. And that's where the additional dollars will help us staff us.
>> so the goal is to take data that's collected from various sources, put it on your computer, but possess the ability to drill it down to the neighborhood level. So --
>> the only nuance there is it doesn't go on my computer. So as part of the data sharing agreement -- this is driven by the lawyers and ferpa and hippa. All the data goes on to a secured server and it lives there. And so I take it out as a jpeg file and put it into a powerpoint, but the raw data all lives in a secure environment and it stays there until a publishable map can come out.
>> so who does the drilling down?
>> right now I do and susan malay. So we're the two essentially technical consultants that will both work with whoever the data person is and a particular data owner, make sure that the resolution and all the fuzzing or shifting of data is done consistently and then take that into the secure server and then work with it there. And then once we have maps like I showed you, that then comes out into another kind of committee of the board which works on interpretation and the story lines for those.
>> okay.
>> judge, I apologize. I've got to leave in five minutes and I wanted to bring up an issue here. You've heard the objectives here, and my office has been involved in this in the past from the legal analysis of it. And I think what they're here asking you today to consider is to partnership with them in a way to better research these objectives. There are many ways to partnership. The way they prefer is that the county enter into an agreement where you become a member of the board, which this is a legal entity that they've created, called a tuna. And they would prefer that their partnerships go by virtue of membership, which brings up legal issues. In the past when they've been addressed, we've seen it on more of a cursory level and brought up the usual standard type problems that the court has kind of had reservations on in the past. I'll give you an example. If you're a member of another legal entity, then of course one of you would be on their board. If you look at cases where the Commissioners court has gotten members on various boards representing the Commissioners court, campo, capital metro, those are set by statute. We are members because of a statute that's done. I think it one of the issues that the city has and that they're going through some of these same legal issues. I've looked at these and I honestly can say that I think these legal challenges can be overcome. I think they've talked about a three-year commitment. Of course we know that when we do that commitment over a year we've got to put in funding out clauses. So it's really something that brings up a lot of legal issues should the court decide to go in as a member and we would have to go through those. In the past I think we've had an idea like there may be like too many. After my look at it, I think that should the court be interested in going that direction, there are other options. You can just contract, but should the court be wanting to go with that option, my office would be willing to put the resources together to see if we could overcome those challenges. Right now I'm hopeful that we could. That's really been the issues up to this point is what's the interest of the court and are they interested in participating at all? If they are, and what level, what vehicle if they are as a minimum, whatever one we be involved in putting the documents together, but particularly if it's to be as a member of this organization, a member of the board, particular challenges approach, but I believe we can meet them, but we would need the time to do that.
>> I have a couple of questions for y'all. Northward to its title, the children's optimal health, I'm a huge fan of opportunity mapping and that's essentially what we're talking about here. Is the organization limited to -- as would be assumed by its title to children's health issues?
>> no. In fact, we set health, but we define it in a very broadway so health includes safety, health includes education. Because everything is integrated. You can't have optimal health without kids that graduate, kids that aren't involved in risky behaviors, kids that have good homes, kids that have good food, kids that have sidewalks, safe parks.
>> so we're looking at well-being overall.
>> it's well-being. It's defined as much, much broader than health.
>> that's why you see the chambers as a board member, aisd is a board member, university of Texas at Austin is a board member, because it is broadly defined. And age depose from zero to -- and age goes from zero to 22.
>> that was my next question. And as the county attorney articulated so well, we have for legal reasons concern about membership organizations and we usually contract for services when we see something that's -- I can think off the top of my head many ways that we could utilize this information and also enrich the data that you all have access to. And I see one executive manager out there that might be able to inform us of how she might find it useful and she's not the only one. I don't mean to single sherri and health and human services out because I could also see how juvenile justice might be able to profit by it, criminal justice safety for our adult criminal population -- I shouldn't say criminal population. Our adult population especially broiled in the criminal justice system. As well as other areas of the county. Transportation also could greatly utilize this information. Our transportation and natural resources. Share, what are your thoughts?
>> well, certainly we have been involved and know a lot about what wire trying to achieve here. Certainly the technology is cutting edge in term of how we look at needs and services across the communities. And certainly we have supported collaboration robustly through my office and from your direction. This organization reflect partners that we are already engaged in various activities with. Then also the work could be very relevant to us in facility programming, program planning, many programs in my department are zip code based. So certainly those programs as we look toward expansion. The effectiveness of those programs could certainly benefit from data sharing in this way.
>> do you see any -- I'm sorry, one moment, ashton.
>> please go ahead.
>> do you see any ability to utilize this tool in regard to measuring performance in our contracts for services for some of these populations? And I don't mean to -- I don't mean to imply that we would be measuring their performance based on this fuzz data alone, but to see how our efforts through funding or through direct services were impacting?
>> certainly I think there's opportunity for impacts to be derived from looking at this data if we overlay certain program objectives, for example, and we look at those persons who participate in those programs, and you know, certainly the example that jim used about parks in relationship to kids who are identified as being obese, I think in those areas where we have programs where we can make sort of a one to one collaboration such as that, it certainly could be helpful.
>> has aisd, I know you said they are a member, they are one of the board members. And when I attended aisd schools here, elementary on up, they had something like they call physical education. And of course, we have recess period. We'd go out and play kick ball, all those other things that we would do as children. We would do that so many times a week. And I'm just wondering, that's not in the program anymore, I don't believe. Have they ever considered reinstituting physical education for our young folks on the health side? Has anybody talked with aisd or any of these other school district to see if there's a possibility of reintroducing physical education into our school system? And it seemed to work back then, very positive.
>> yes. Seton family of hospitals has been working very closely with aisd on this issue. Dr. Malay looks at our outcome data and works very closely with the obesity side.
>> I'm concerned about the obesity thing of it as far as children are concerned. We stayed pretty active. We had recess or whatever you want to call it. We're out there playing and doing a whole lot of things. In the gym when the weather was inclement. So I'm concerned. So if they're considering that, I think that may be part of some of the solution, if aisd would reintroduce physical education into the school system, especially young folks.
>> I'm not a representative of aisd, about I have o. -- but I have worked with the Austin school health advisory council, which advises their school board on issues regarding physical activity and nutrition among other health related issues for the students. Aisd over the years has become a leader in state for the changes they've made in their curriculum. A number of changes have been driven by changes in state legislation that are requiring a given number of minutes of physical activity at the elementary level and now in the last year with legislative changes they are increasing the level of physical education at the middle school level. My position on the shack, the school health advisory council, we were able to observe the really incredible improvements in their curriculum that they've made over a period of about five years. So I think that the situation at aisd is faced with a situation that all districts in particularly our large urban districts are faced with, are being challenged by time spent working on test related materials and how much time do they provide for physical education as well? That's always an internal struggle over there, but because they do have a committee that reports to the board, they do have now a coordinator position and administrative level position for pe as well as an administrative level position for health services that the whole visibility of child health has been raised over a period of years and continues to be an area of focus for the board.
>> okay. I'm -- I just brought that up as a point of reference. As far as health of our children.
>> it not to say that the final solution has been attained, but there is clearly effort and attention now over there. What's expanding now is also areas of social and emotional areas for the kid. That's probably the newer growth area that's getting a lot of attention.
>> the city of Austin has been invited to join?
>> we're still in conversation with them, as with david escamilla. Right now my conversations are primarily with david smith, the city attorney, to work with some of the historic legal concerns and working with the tuna. And I believe we're close to working those out.
>> okay. I guess everything really turns on whether or not you use the information that you get. That's the challenge for us. There are many areas where the information really would help us do a better job of targeting programs and services, but you've got to act on that, provide them, then try to follow up and evaluate impact to use the information.
>> and that's why the membership of the board is so important because we tried to be very intentional about putting the leadership around that table so when we bring this information forward it's compelling and it drives the critical decision makers to say, we're going to do something about that. We're going to direct our agencies to that issue. And really hold ourselves accountable as a board to seeing if we can't link and leverage our resources to the hot spots.
>> I guess there would be two ways to do it. One is whether Travis County uses the information. The other one would be whether the other partners use the information in such a way that we receive direct or indirect benefits. And if you're looking at all of Travis County residents, if other partners really take actions that benefit them based on information, I guess we're the beneficiary of those programs and services.
>> one example, I believe you all, Travis County is a funder for any baby can.
>> we contract with them.
>> contract with them.
>> for services.
>> prior to them being able to access this technology, when they were looking at where to direct the services, they were looking at the zip code level. And I think jim alluded to earlier their primary focus was southeast Austin. When I had a chance to look at some of the criteria that they used to determine whether they need to direct their services and looking at the neighborhood level, they in thed that there was some hot spots flat near high school level that had gone unabdomen until that point in time. So now they are directing their services also in that area. So that's an example that goes to your question, Commissioner eckhardt, of being able -- it's not a test to see whether or not you're doing what we do, but it does give you another indicator of the impact on this of the work that's being done. So I think that's just one example and I think we would see that from the other participants and users of this technology and initiative.
>> that's a good point to raise, ashton. It's not that I should really change my phraseology from performance measure to resource distribution because it really is an issue of resource distribution.
>> if the partnership is able to generate sufficient funding from outside sources, ie, robert wood johnson foundation, other foundations, would the membership fees or dues continue?
>> the board is not -- the board has not talked about what that would do or whether the dues would continue or not. I think a lot of it would depend on what we're able to really prove in three years the value of what we're doing and the scaleability. One of our fears is that as we are able to produce these maps and take action that the -- there will be more and more agencies that will want to give us data and want to do more and more of this kind of work. So depending on if that's true, and I hope it is, then the funding will be needed to meet the scaleability of the work that's being asked by agencies. So what we're hoping is more and more agencies will want to contribute dollars, and we haven't even talked about whether we're going to -- if we have four agencies that come to us and say we really want to look at this and here's our data, are we going to price that and are we going to charge for that? Will that be the sustainability? We're just not sure. So I think you can look at this as an incubation period where we're trying to teach this community how to work collaboratively and how to use opportunity mapping for these kinds of initiatives, hoping that it's going to spark so much value and demand that others will want to fund it and it will be sustainable beyond dues and even if there are ongoing dues, it will be a small amount shared by the larger number of contribute irs.
>> if we were to become a partner and then later decided not to, would feelings be shurt or would the board understand that?
>> I think if you can do that, I think there's something in our ability to deliver what is of value, and no, I think --
>> our ability to use it.
>> yes. We think it will have very compelling opportunities for its use. A lot of it is creativity. A lot of it is being engaged at the table. I think about the work we're doing with behavioral health and the stakeholders. As we deviled in with you and others at the table, we've really been able to leverage. And that's just with our intuitiveness. So if we could add some really good data sharing, over lay it on maps, I think we could impact a lot more because of the way that we've structured that stakeholders group. I'm hoping that optimal health will be the same.
>> what percentage of the -- after the real mapping has taken place and let's say you have got a particular provide that provide a service, a certain type of service in the community, I don't want to call any names, and the real mapping, the realtime situation shows that there is an increase in the service that they provide in another area. Have they decided what percentage -- let me call it hot bed area. Have they decided in what level and the increase of that need for service in that area, have they decided will it be 50% more than where they're at or will it be 75% of what they can provide in another area? S that that been basically dirmd. Is that an individual service provider's concern? After they realize that, hey, we are in an area that no longer for a service that is screaming and hollering for the same need. So how is that determined leaving one area to go to another area based on demand.
>> I think that children's optimal health is going to be the -- the agency is going to be the keeper of or the process keeper for doing the appropriate merging of data and showing the picture to the community. There are many levels of that information that can be used. For your particular question that's the any baby can or whatever agency, whoever, that agency's executive director and their board, they're going to get this data and it's for them to figure out, wow, should we be here, should we move? Should we fund raise to spread so we can have a larger representation? That's going to be agency. We think that our data is going to be able to drive some helpful, fine tuning agency by agency. We think it will drive some new opportunities for agencies coming together on things appeared we also think it could influence advocacy in some public change. It might bring up things we never saw that would compel our public agencies to do what their doing on are fund differently. The children's optimal health will not be responsible for making those changes. What we're responsible for is the data and the way in which it tells the story and the way in which it feeds back whether the intervexes and the collaborations within and out of children's optimal health are making those improvements that we want to make.
>> so you're just the messenger.
>> would you say that's true?
>> you're the messenger and being the messenger, folks need to hear what you're saying and then after the message has been delivered, then it's up to the individual provider to live with that message.
>> one thing I would add on to that is that the coh board is botd the messenger, but also the entity responsible for making sure something happens. Both that the especially tire responsibility for something that doesn't get laid on one entities doorstep, but that entities take responsibility for cooling off the hot spots or directing resources to the hot spots we didn't know about before. Whether that appropriately falls on a nonprofit, on an agency, on a government becomes the value add of the board membership. But the data is the data. The content is going to drive the discussion. And raise the questions why. Not why does this exist then you've got to delve into it. If that makes sense.
>> it does. I just wanted to make sure that other than being the messenger, what you're saying in addition to that, the added value is to ensure that it gets somebody's attention of the need.
>> that's right. That's the value of shared leadership.
>> the messenger -- okay. I'm just putting it all in perspective. Thank you.
>> I move that we indicate our desire to join the partnership and ask legal to try to figure out a way for us to do so.
>> I'm going to need another week.
>> and ask legal how to figure out a way to do so and legal will take some time to do that.
>> I'll second the motion knowing that it will take some time before it comes back for consideration.
>> I'm going to need another week.
>> this is just indicating intention.
>> I need to check some things out.
>> you need a week?
>> yeah.
>> there's a motion and a second.
>> we may not be able to do in anyway. Legal may come back and say we can't. I would think you not only would have a week, you will have probably three or four weeks, right?
>> I don't know. There are some things I need to get -- to check on. That's why I requested it.
>> that's a motion and a second. Any more discussion? All in favor? Show Commissioners eckhardt, huber, yours truly voting in favor. Commissioner Davis --
>> I need another week.
>> need another week. Move that we recess to 1:30.
>> thank you very much.
>> all in favor? That passes by unanimous vote.
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Last Modified:
Tuesday, January 27, 2009 2:03 PM