Travis County Commissioners Court
February 16, 2010,
Item 11
>> 10 and 11 come together?
>> yes, they do.
>> you expect action from the court at roughly the same time?
>> yes, sir.
>> on 11, I got -- I was contacted and I represented that, in my view, the court should discuss 11 today internally and that, if there were presentations to be made, we'd accept them next week.
should I call 11 up?
>> yes, sir.
>> yes, sir.
>> consider and take appropriate action regarding star flight program overview and proposals regarding the housing of available star flight aircraft at their locations.
a.
seton family of hospitals.
and -- b.
st.
david's healthcare and st.
david's foundation.
>> what I'd like to do in this particular agenda request is to provide this in two parts, and it goes back to that perspective, again, and that is to see where we are, but, also, where we might want to go.
not only as a county but also as a community.
and, so, in order to be able to highlight that, I've listed for you, of course, the star flight purpose statement, which is to preserve life, improve health and improve public safety through a community-based delivery program, providing a multi-mission public safety response for the residents of Travis County and the counties reserve.
it emphasizes it's a multi-mission program.
to the history highlights, quickly, we began the program may 16th of 1985.
if anybody wants to understand what star stands for, it stands for shock trauma air rescue.
it is an air medical program that began between the city of Austin and Travis County and started with one pilot and one flight paramedic.
but I want you to notice the timing of this as to when we did become regional.
in the fall of 1985, we established a relationship with a local hospital, which is brackenridge hospital, and there we began interfacility transmissions with a nurse from the er.
in early 1986, we had request for assistance from outside of the county and began to serve areas outside of Travis County and central Texas, and then, if you move on, you will see in early 1990, you bought new aircraft, and we also, then, began to expand beyond just doing medical, but we also began to expand in search and rescue, law enforcement fire suppression.
another element I didn't try to express because I didn't want to play the card and scare people, but it's one we must include, and that is, one reason we have our aircraft is for homeland security, and we've never had to actually use it.
we came close this past year.
fort hood, when they had their situation, we were notified we might be called.
of course, if you remember, during that event, there was aircraft used, and people were actually taken to different hospitals all over the state.
and because we do live in a major city in Texas, we are the capital of Texas, then I don't want us to ever forget the value of having the star flight air medical program in our midst.
moving on, if you then look at the fall of 1999 is when we actually formed the m.s.
system that allowed us for the first time to have a program manager in star flight.
mid 2000, star flight began to do specialty missions starting with seton medical center of brackenridge.
we were proud in April of 2001 to become accredited.
in fact, star flight becomes the first public safety helicopter program to obtain accreditation.
in fact, star flight remains today the only public program in the united states to seek and obtain canes accreditation.
in spring of 2006, you the court approved two new ec-145, and along with that came some safety enhancements -- night vision goggles, color weather radar, storm scope and autopilot capabilities.
that's why I say today we stand strong in having the finest aircraft available for our representatives.
in spring of 2007, we did an expansion of the specialty missions to where we included other hospitals.
and this particular case, st.
david's.
in fall of 2008, we've developed a business plan because we felt like we needed to have that perspective.
we needed to see where we are and where we wanted to go with the program.
and in fall of 2009, you approved the one-time funding.
in January 2010, you approved the latest of the lift-off fees, again, mainly due to accommodate medicare.
as far as the aircraft base of operations, and this is the most important part I can now enter into with you as far as this discussion, and that is it benefits Travis County and the citizens an residents of our community from our historical arrangement of how the star flight aircraft and crews at local hospitals.
the primary aircraft, as you know, has been operated out of what is now called university medical center brackenridge, but was originally called brackenridge.
so there are advantages I've outlined in my memo to you as to why having that partnership is so important.
one is reduced costs for us because, as you know, we have a hangar, and we could have our folks out there, but it actually saves us money by being able to have living quarters at the hospital.
we also see that it would be a relocation expense and an operational hassle to always be stationed at the hangar and always having to transport patients and going back observe forth.
you see advantages as far as trained.
just being at the hospital, you're around people and experts and you learn from that.
we get comments where children especially love to see star flight landing and love to see people in the blue uniforms.
that's the advantage we have in star flight, is it's not something you have to market.
it's in the air every day.
and when people look up, I get the feeling that -- and I get it from feedback from people -- is when they see star flight, they see hope and they see somebody that's being taken care of in a critical situation.
that is star flight.
star flight is not just a joy ride, it's not something that is something we just want to have as a toy.
it means the difference between life and death when it's flying and those people are doing their job.
they're out there to save a life.
so it's the most critical of situations, even with fire sup suppression and law enforcement.
i made a commitment to you that our main mission is medical, and it is, that we not do things that we've done in the past in regards to fire and law enforcement, and, so, we curtail to where it's the most critical of the critical we go, but, as you know, we serve both the Austin police department as well as the Travis County sheriffs and other law enforcement in Travis County.
as far as hospital considerations, you've received two proposals.
i'll be very careful how I do this today because it's important that they be able to give a presentation to you next week and to be able to give you their perspective on where they are and where they want to go in regards to how they conduct business.
i'm giving you my perspective today in regards to star flight and its purpose and its meaning and its future, but also I'll give you my perspective today in regards to housing, and that is I would encourage us, regardless of which proposal you choose to go with, that it is important that we be at hospitals and that we be housed there and that that partnership continue to exist as it was started many years ago.
if you'd like for me to, I could, before I give you my recommendation, is to outline for you how we got here today, and that is, when we did the business plan and started the business plan, during that transition, I got a call one day that I was invited to a meeting at one of the hospital.
and in that particular meeting, it was discussed that it might be good to have an aircraft at that location, housed at that location.
when we're talking about housing, a lot of people are surprised that, well, how does that work?
well, in order to be able to house an aircraft, you need two helipads, because then you're able to have aircraft come in and out.
it's also important to have people, if they can, to live there or be able to stay there so that they're ready to respond to all calls.
now, housing -- and this is what's interesting about this particular partnership I'm proposing here today -- has really nothing to do, in our minds, from an operational standpoint, has nothing to do with how we deliver service.
just because we're housed, and that has been proven by being where we are with our 24-7 aircraft, is that we still, and the hospitals understand that, respond to any and all calls.
so it isn't just serving that hospital.
we're serving the entire community and we're serving other hospitals.
you say, well, how does all that work?
well, certain protocols are set up at dispatch, and they're worked through our medical director as well as our staffing.
same thing works that way with ground operations as to how things are responded to.
and, of course, the citizens have a say in this, too, and that is they can also choose where they want to go and how they want to be treated.
now, there are some things, though, that are called in the field and, of course, with many of our situations, the particular resident that's in need is not in the condition to be able to do a lot of talking, and, so, we base our medical direction based upon what their need is, and, so, that's why we have specialty hospitals and, of course, we have trauma hospitals.
we have heart hospitals.
we have burn centers.
so the protocols are lined up that way.
but what happened is, after I had that conversation, I was invited to another hospital and had a similar conversation on wouldn't it be neat if you are -- again, our phase two proposal was to go and purchase a third aircraft.
so in order to be able to have a third aircraft and, if you were going to add staff to it at that time -- this is where everything else hit -- is it would be good to prepare and plan housing for that aircraft.
and, so, I talked with the second hospital and a third hospital, and, so I went out and spoke with those people.
in fact, with all three of those hospitals, we -- -- we sent people out there because they wanted information on how to do the helipads and other information, so we provided them with that information.
we discussed the options with each hospital and had good discussions with them.
i can't think of a better year and a half or two years where the hospitals want to have open discussion and talk with us about the future of the from program.
so I want to say, first of all, that I've enjoyed that conversation.
what occurred, though, is, as we saw the transports go down due to the economic conditions and different things that we had going on, our economy, then we realize that the potential of a third aircraft about a year ago was not going to go forward and we were not going to recommend it and told the hospitals that.
and, so, it was really put on hold for a while.
then one of the hospitals came up and said, you know what?
we might be willing to donate, contribute funding for a third aircraft.
well, being the person that I am, wanting to take advantage of anything that someone might offer, I thought that was just tremendous, because that might give us the assistance that we needed during our economic times, where we could actually continue the business plan.
based upon that, I then ran that up a flag pole in several ways, and that really wasn't enough.
so the suggestion was, well, why don't you go to the other hospitals?
see what they want to do.
and I said, well, okay.
and I don't know if that particular person thought I would do it, but I did it.
and, so, I went, and basically, I went, first of all, with the person who offered it.
i said, this isn't going to be enough, but I think what y'all might do -- you know me, I'm a collaborator and a person who likes to do partnerships, so I had this idea about how about if I talk to the other hospital and ask for the same donation, and they were a little bit reluctant, but they said, okay.
i said, can you imagine a community benefit that might bring, all have a press conference together, and we all be not singing kumbaya, but basically just having a real, good, positive statement to the community.
and, so, I went over and gave that presentation the best way I knew to give it.
and basically, it went several meetings, and basically came back and said our plans are that we really need to have two aircraft at our hospitals.
and it was a business decision on their part.
my heart sank because, again, I'm a community person, but I began talking with them about that, realizing that I now was not going to be able to do that particular option and, so, I started working with that particular hospital to see what they would propose, and you have that proposal in front of you.
i would then immediately -- contacted the other hospital that came up with the first recommendation donation and told them, to my regret, I wouldn't be able to go forward because I wouldn't have the money if I only went with the one hospital.
there was another special note that I needed to make sure that you're aware of and that is, the person I was working with, who I think is tremendous -- in fact, they're all tremendous -- had a personal family matter occur, and, so, he and I were not able to talk and, in fact, he and I still have not spoken together.
but I did express my regrets.
so, today, what I have for you is two proposals.
but I wanted you to understand that the one proposal -- and they'll explain it better next week in their own way in their own perspective, but I'm here today to take the next best steps I think are for the star flight program and, so, from my perspective, the recommendation would be to go with seton and not only does it offer an unrestricted gift of $3.2 million but also enhancements to both helipads as well as enhancements to one living quarter as well as the refurbishment or putting together living quarters at the other.
now, next week, the -- court, they're going to come in and give you speer perspective and proposal.
i would love it if between now and next week, they would get together, come in, and have a proposal together.
but if that's not the case, then I have to go with what I consider to be the best proposal for us, and that would be the one that I just recommended to you.
i could go through each one, if you'd like, or, judge, whatever you feel would be necessary.
if they're coming next week, it might be better to have them do it in fairness to them so I don't mess it up.
>> st.
david's did have a monetary amount, though?
>> I have to the $1.6 million.
>> okay.
>> and they also had a very detailed description of a proposed helipad addition as well as living quarters.
there is one statement at the back of theirs that says they k"jaj sttttu to gettingo be permission to build that particular helipad, but they've done a very thorough job in regards to putting together what it would take to have living quarters and an additional helipad.
>> they would expect the money to be spent how?
>> as far as seton, it's an unrestricted gift, so we would spend it in regards how we felt it was best for the program.
and I think the budget office decided that it's in our best interest to, if we're going to buy an aircraft, that we do that separately, so there's not entanglement between money and an aircraft.
>> $3.2 million over five years?
>> over five years, which would be payments, basically, of, I think -- let me get it here.
>> $640,000.
>> $640,000.
now, the one thing, if you look at their proposal, besides the enhancements, they're also saying they would like to have exclusive right as far as the aircraft at their home bases, at the two medical centers when they're available.
they also realize that this is not, again, in any way tied into directly servicing them.
it's a community aircraft.
and then, also, they recognize that -- and acknowledge that the continuation of the operation of the second helicopter and expansion of the operations 24-7 will be at the sole discretion of the court in the budget process based on budget call and revenue.
the last statement in their proposal we'll be talking about during this decade, a ten-year period, and we'd also be looking at possibly making additional contributions and resources to star flight program.
again, in fairness to st.
david's, I've not spoken to them in regards that particular matter.
they gave you their proposal, I think based on the original or last option I had with them.
>> two quick questions.
if one hospital were to ask for the proposal submitted by the other one, that is a matter of public record now.
and we have made this available as part of the agenda backup for all who ask to see it.
>> that is correct.
>> and in my view, seems to me we aught to give each an opportunity to make a presentation to the Commissioners court as it sees fit at our meeting next week and indicate our intention to take action on items 10 and 11 next week.
they'll have different numbers, but on both of those.
>> yes, sir.
>> Commissioner Davis?
>> that was the part, the last part you just laid out, I was going to bring it up.
it just appeared to me that we should have both persons, seton and st.
david's, here to give their proposal.
then you never can tell.
it may not be something that's basically etched in stone.
there may be changes that may occur between here and when we meet them.
i don't really know.
i just know that we should hear them before we decide which one we want to do, because I think there's room here, I think, maybe, to look at further enhancement of these two particularly proposals to use star flight as some of their service air ambulance providers.
that was my main concern.
and, again, danny, with this, let's say that you mentioned something earlier that, when you -- when star flight goes out and picks up an individual for services, first of all, it's a person who's in no kind of condition to define preference, preference meaning where they would like to go for medical attention.
can you tell me the hospital that we have here now within Travis County that would be able to accommodate that particular request?
>> well, again, it depends on the medical condition, Commissioner.
and that's the most important thing for us is determining what their medical condition is and where they can best receive the help to help them with that condition.
we're fortunate because -- and that's something that's also in the report that I failed to mention to you, and that is that we have more hospitals in the area and more coming forward in the area, which will better accommodate our representatives as well.
right now, there are two hospitals that are level one hospitals, and that's dell children's hospital and seton medical center brackenridge, as far as in Travis County.
but you're beginning to see all the other hospitals, though, that are now beginning to come up to speed in regards to what they can provide, and the specialties they can provide.
but, again, the call is always made, Commissioner, by what specific condition they have, what hospital has the particular equipment and doctors that can accommodate that condition, and that's where we go.
>> okay.
another thing, everything is broken down as far as offsetting costs toward the county.
of course, I can it's something that needs to be really hammered and really given strong consideration before the court makes a decision is what are -- as far as monetary -- what are you going to put on the table.
so I have no problem with waiting for us to decide 10 and 11 next week, seeing there are still things we need to review.
>> what we can do is post this item on the agenda next week, and I guess I'm inclined to schedule it for 10:00 to let everybody know, and we'll try to call it up as close to 10:00 a.m.
as possible.
>> anything else today?
on 10 or 11?
thank you for all those fantastic meetings and for doing a yeoman's job on this project.
>> thank you.
The Closed Caption log for this Commissioners Court agenda item is provided by Travis County Internet Services. Since this file is derived from the Closed Captions created during live cablecasts, there are occasional spelling and grammatical errors. This Closed Caption log is not an official record the Commissioners Court Meeting and cannot be relied on for official purposes. For official records please contact the County Clerk at (512) 854-4722.
Last Modified:
Tuesday, February 16, 2010 6:05 PM
