Travis County Commissioners Court
Tuesday, July 20, 2010,
Item 13
Item no. 13 is to receive and discuss the presentation from central health and community care, on the following. A, central health's five year report card. B, central health's community planning initiative, central health connection. C, service expansion by central health and community care. And, d, central health's fiscal year 2011 preliminary budget direction.
>> judge and commissioners, my name is christie garvey, chief communications and planning officer for central health.
>> john stevens the chief financial officer for central health.
>> larry wallace, chief service delivery office for central health.
>>
>> [indiscernible]
>> coo for community care.
>> good morning, it's a pleasure to be with you this morning. We would like to start the presentation this morning by reviewing the first five years of the district's inception. We in -- in the spring have -- have put together a five year report card. Covering central health's first five fiscal years, we have been taking the information out to the community to review some of the achievements that we believe that we have accomplished during the first five years of the district. I would like to go over this briefly with you. You have a report card in your packet that looks like this. And i'm going to start with enhanced emergency care. As many of you know, when the district was created, there were some issues around emergency care and a goal of achieving level 1 trauma status with university medical center at brackenridge. And in 2009, that level 1 trauma status was achieved for our community. In addition, as a bonus, the dell children's hospital also achieved level 1 trauma status. So we now have the widest away of trauma care services available anywhere in the united states right here in travis county. We have also covered more people through our medical assistance program. The medical assistance program enrollment has increased by nearly 80% in the five years of the creation of the district. Enrollment has gone from 8,000 to
>> [indiscernible] at the end of fiscal year 2009, the current enrollment it's well over 17,000 enrollees. We've also been working and our chief service delivery officer larry wallace and his crew have been working very diligently to provide more providers and better access to care. This is shown through our increase in primary care visits, which has increased over 25%. In those first five years. We are seeing not only more coverage but better access to care. In addition, another issue that was to be addressed by the creation of the district was expanded mental health care. And you all have been a partner with us in the collaborative with the psychiatric stakeholders group that was convene understand 2005. And out of that collaborative, has come -- has come an array of services that we now have that were not there before. Including crisis stabilization in patient beds, intensive outpatient care, expanded emergency services for psychiatric emergencies, and new crisis rest sit care. And central -- respite care. Central health is now funding mental health services at $5.2 million per year and there are an increased number of services available to individuals. And lastly, we have worked increasingly to -- to make the enrollment into either the medical assistance program or access to sliding fee scale programs simpler and easier. We have options now for the medical assistance program enrollees to mail in for re-enrollment. We have some virtual enrollment sites at provider sites, which help people to get into the program more quickly and get the care that they need. I'm very excited to announce central health connection, which is our community planning initiative, that officially launched in -- in the spring with -- with some baseline research that we have been doing through focus groups and telephone and internet surveys. We are now up with our website, central health connection.net and we have online surveys, a blog by our medical director, dr. Glen, and a variety of ways for people to interact with us and we are attempting to engage central texans to talk and imagine and act to create a model healthy community. We will be taking all of this input that we are receiving through this community listening exercise and reporting back to the community about what we've heard. We will be taking that information through the fall and through next year to -- to create further public dialogue and to work on the development of a score card for our community around health. The last thing that i'm going to address to you has to do with our very large first capital project, which is the north central health center. As you know, the district purchased land on braker in december of 2008. And this project is -- is to build a new health center with -- with a total estimated budget of $18 million. We are projected to finish by 2011. It is two story, approximately 50,000 square feet. We have engaged in a leed silver status, incorporated into the design plan, which indicates leadership in energy and environmental design, which is the green building rating system.
>>
>> [indiscernible] what type of
>> [indiscernible] will it be?
>> we will endeavoring to go for the silver status.
>> silver?
>> yes.
>> okay.
>> we have also engaged in coordination and communication, ongoing with the neighbors and the neighborhood associations in that area. Western hosting a re-- we are hosting a reception on august 5th from 6:30 to 8:30 p.m. At the parish hall to unveil and announce to the community the -- the site plan, our building design drawings, to educate the community a little bit further about the leed silver status and also to highlight the services, health care services that will be offered there at the site.
>> this -- this item had come before the court and especially with -- with the selection and placement and location of this particular health community center, there were -- there were several neighborhood groups, i guess, that came down initially and echoed their -- some echoed opposition, i guess, to the location of this facility. My question to you at this time is have there been any continued attempt to show and demonstrate that -- that this particular facility -- as far as the services that are render and things like that, has there been any attempt to make sure that the outreach has continued to be extended to these particular neighborhoods who -- who feel that they have been impacted negatively? What have you done on that end?
>> we have been working and meeting with them on and off since august of 2009. And even before that. But when we were working on the design criteria manual, we were meeting with -- with leaders of the neighborhood associations for input into that manual and then since these design build firm has come on, in february of 2010, we have been continuing to meet to look over the site plan, to get recommendations from the neighborhood associations and they have been bringing that information back to their association membership and bringing feedback to us. It's been an ongoing dialogue. In addition, we continued to communicate through letters to individuals who live within 500 feet of the property. We also have an e-mail listserv that communicates to all of the individuals who are interested and have signed up on our website, which is well over 200 individuals. So the engagement process has been ongoing since -- well, actually before the purchase of the property and since that time.
>> david, c.e.o., i would like to add something. Good morning, which and commissioners, we had the opportunity to sit down with the neighborhood and talk very specifically about the kind of services that we provide. As an fqhc and have clarified any concerns as presented to us in terms of the services and clientele that we serve as well through this community engagement process.
>> okay.
>> and that also regard there were instances that -- that as far as questions are childrenned, that some of the folks that -- are concerned that some of the folks have suggested that if this particular facility was built there, then we would lose participation from -- from various segments of the community. I guess my question then, well, for the services of this health center. That there are folks, an example, of springdale -- off springdale, over at the h.e.b. Shopping center for an example, the folks in that area were -- will not be able to participate in the new location being discussed here this morning. My question to you from that -- from that is where have the fqac association have notified anyone that may want to participate as far as providing -- may not like that participate as far as providing services in that area, have you communicated with them to assure them that there are fqac services providers in the immediate area? Have that also been done?
>> well, we determining where we will move the site and move the north central center, a great deal of due diligence in talking and looking to see that site was appropriate to determine that, that many of the folks would have access to that -- to the new site. But -- but a caveat, i think in addition to -- to the move -- the move of the site, we -- we were colorado compelled by the district board to see what services we can continue or provide in that area going forward. So notification to the -- to the users of the facility have been accomplished? We have done -- that's what you are telling me?
>> we -- one round will be further communication as we move forward down the time line of getting the new center built.
>> before we move patients, we will actually contact patients to see if the new site is preferred by them, if one of our other locations is preferred or as we are developing what may stay in more directly the current location. So patients will be notified and have an opportunity to pick a site that will work best for them.
>> okay. That was my gist of my questions.
>> it's a little early to get to that point yet until we have a final move out date and we can give them that array. But that communication is --
>> right. I want to know if it's in the pipeline.
>> absolutely.
>> that's what i'm concerned about. All right. Go ahead, i'm sorry, go ahead.
>> i think this is a great segue into the next section where david --
>> [indiscernible]
>> so is there a written invitation or announcement of the august 5th event?
>> yes, there is.
>> can we get a copy of that?
>> yes.
>> what i would do is sends it to -- send it to the handful of people that contacted me in opposition to the project. Years ago -- i guess a couple of years back.
>> couple of years at least.
>> we will make sure that they get invited --
>> yeah, i want to make sure that they are --
>> that would help with the outreach.
>> absolutely, thank you for that.
>> so i think this is a good segue to the community care section of this report, where they're going to talk about some of their expansions of service.
>> we are very excited about the opportunity to have a new facility that will be a premiere site for the kind of services that we provide. And as you may have heard, in the news as a result of health care reform, fqhc's are the bell of the ball. Because of the kind of services, wrap around service that's we provide, the federal government has decided to invest some $11 billion over the next several years and in fqhc's across the country. We are very excited about that. I believe that will result in our opportunity to create expansion, academic opportunities in terms of training and ensure that we have providers that are able to meet the needs in our community for primary care and the kind of service that's we provide. The north central expansion does represent a significant additional capacity to travis county in our system, with an additional -- 17 additional medical and dental providers. Professional staff will increase to about 56 additional staff. And we will -- we will be the medical home providing 11,450 additional patients in a year, generating around 44,000 new clinical visits, encounters as we call them. As typical, our services include pediatrics, women's health, family medicine, internal medicine, specialty care, a very critical need, dental, behavioral health, nutrition and clinical pharmacy. All of those activities will occur at the central -- the new central site. We have as a result of the early round of funding through the federal government, through the recovery act, received $1.9 million to upgrade, renovate our new currents infrastructure that we have on the east side at the east clinic. And down on south first street at the south site and we are using local design firms, keeping those dollars local, putting folks to work. We expect renovations to be completed sometime around at the end of this year in december for the south site and then in april for april this upcoming year for the east renovation. And again, this will create -- this -- these projects create 16 new additional health care jobs when completed.
>> in south austin, what we're planning on doing is taking advantage of some administrative space we currently have that's doing the old paper medical records as we have gone totally electronic with our medical records. This is freeing up some space in order to create new clinical space. With that we will create a new pediatric unit which will be two new providers providing care in our community down at south, almost 3,000 new patients being served with an additional almost 9,000 visits on an annual basis because of this renovation project. At the east austin site, again, taking advantage of former medical records space and some layout efficiencies that we can create, we're going to be able to provide two new medical providers at this site as well? Focus is going to be on pediatrics and women's health expansions and increase another 3,000 patients and another 9,000 visits as we totally renovate the site down there at east austin.
>> what's the location of that site?
>> east austin? Comal street basically and cesar chavez. Second street -- sniefts
>> i was wanting to get that clear because we've several -- go ahead, as far as where the renovation is going to take place, thanks.
>> no problem. In 2009 we did significant expansions, we added four new health care sites. One at red river, one at rundberg and two with the u.t. School of nursing and through an affiliation agreement, one on i-35, basically across the street from st. David's, and one out in del valle at the children's wellness center. With these sites, that's almost 17,000 additional primary care visits that we saw last year. Versus the previous year. And with the help of the recovery act, we got almost a million dollars to add more f.t.e.'s to provide additional care for last year and for this year. Between the renovations that we just spoke about, between the new north central site, the renovations at east and at south, these new additional sites that we have brought on, we will in very short order have expanded our capacity at community care by about 50% in the course of four years, where we can see 50% more patients than we have in the past. It's been a great investment by central health to expand primary care --
>> that means what as far as numbers. Numbers.
>> > from about 50,000 patients that we were taking care of to about 75,000.
>> through investments made by central health and by the federal government. As david alluded to we plan on continuing to look at new opportunities to expand services in the community. Also with health care reform reform.
>> health care reform has certainly prettiened our horizon in terms of our ability to bring services. In addition to that, our transition from the city of austin to non-profit health care organization back in march of '09 has really provided us an opportunity to leverage this valuable fqhc fairly qualified health care center status to be able to create partnerships that will allow greater access. I really can't emphasize this enough. I speak for my board and very likely the district board when we say that we are keenly aware of the opportunity that we have before us and want to make some exciting things happen. One of those to partnership through funding with the st. David's foundation, along with our colleague, fqhc, lone star circle of care to open up a new dental clinic. As you know, dental services are very scarce, unfortunately, for folks that we serve on ben white. This project again is an example of different health care organizations and funders working together to create access. And in -- at the end of the year, somewhere in -- i'm sorry, rather in mid september, we will open up this new location, be able to serve about 3,000 additional patients, generating 5900 new dental encounters. We will also be expanding our dental clinic at the rbj site there on festival beach in central -- the area, that will be in october of 2010. We are very excited about these expansion opportunities.
>> so what's the total number of people receiving dental?
>> we --
>> is it in addition --
>> we generate currently about 25,000 visits, 25 to 28,000 dental visits a year, these are in addition to that total number that we provide.
>> we also are working with seton and looking at our specialty care around high risk ob patients. They currently operate a site at brackenridge that will be becoming part of the fqhc, this will be an opportunity to really link the delivery of our patients that are pregnant as well as the specialty services that sometimes pregnant women require into our network so that we can have better communication between the primary care and the delivery of those newborns. So we are looking at that opportunity as well, likely around september 1st.
>> we thank you for your time and attention as we presented our part. I know that i speak for leslie and the executive team at community care, we are very thankful for the support that we have received from the from central health in terms of the funding, opportunities to expand and look forward to continuing our reach in travis county.
>> i would like to also acknowledge that we have two members of the central health board of managers here with us today, dr. Tom coopwood and rosy mendosa and our approximated and c.e.o., patricia young brown is also here with us.
>> and your financial advisor, lad patillo.
>> you know, i looked at some things here and i have some concern that's i may need to -- concerns that i may need for express. Especially not having some of the things, may be coming fort later. I'm used to looking at line item stuff. In other words, for example, your payment of your salaries as far as your personnel is concerned. I would like to see that broke down. I know this may not be the time to get it from what i understand. It would help me a lot to see exactly the increased expenditures that's paid to personnel in the budget cycle, of course, then getting it in a timely manner to see exactly where the money and how it's being spent. This report just kind of hitaround it. Kind of looks like it's rolled into certain programs and things like that when you really look at the budget as far as the report i guess is what you are suggesting here. But then there is some things like an example, a car allowance, i didn't know that we allowed for car allowances, that's the first that's been brought to my attention that you have car allowances. Of course that kind of struck, you know, a nerve with me. I said well wait a minute, a car allowance? So it would be good to see how things are broken down and the sooner the better for me. That way i can see that everything is on course. You have suggested tax increases here that you are proposing between this year and last year, seem to be appearing an increase. So all of these things in my mind, although you are bringing it to us, which is fine, but there are things that i really want to circle the wagon on and to make sure that i get a full understanding and justification of the why of the increases and then -- then some of the things that i feel may not -- may not be in the best interests, i don't really know. But until i see that more detailed, outlay of what you are really doing here. Right now it's kind of generic to some degree because i think things are continually changing, the numbers are changing as you go through the process and that's understandable. But again for my -- for my purpose, i would like to get as much detailed information, line item, detailed information from you, so that i can exactly, see exactly what comparing last year's budget to this year's proposed budget per se. I don't have that right now. I know it's a little early, but i would like to look at it in time enough to where i'm able to ask the appropriate questions to see if i agree with you or not. So -- that's where i'm at -- this -- this morning, but i think y'all are doing a great job. You laid out some things that i think is very necessary, health care delivery is very important in this community. Under health care community why are we change the name so many times? I know health care, hospital district, now it's health care district, now it's changed to health care i mean what's -- what's the deal with so many changes as far as the name is concerned?
>> [one moment please for change in captioners]
>> after we went along with the health care piece of it for awhile, we decide that had central health was a good representational name for the way that we operate because our model here in travis county is so unique and innovative that we decided to have our name help explore and further explain what it is that we do, which is partnering and collaborating with the public here and the private sector to better ensure health care for all. That's the reason we did that and we're sticking with central health.
>> have we been able to actually -- i guess have there been any instances of persons using the district -- i said district again there. I go. You explained, but at one time we asked questioned questions to see what kind of tracking mechanisms would be in place, especially when you have folks from other counties using the services and as far as getting those counties to ante up for the services that we render to the persons that have come from other counties to acquire the type of services that you may render. Is that something that you are faced with? I'm just posing a question.
>> through the medical assistance program and eligibility process an individual has to be screened as a resident of the county in order to receive supported funding for the health plan from central health. And that is also true for the sliding fee services that are provided. If an individual does go to the emergency room and they're outside of the county and they're not a resident, then tharl risk is borne -- then really that risk is borne by whatever hospital emergency room that they have entered into.
>> okay. All right. Thank you.
>> let me take just a moment to walk you through our --
>> if i could just add to that a little bit to clarify. The funding -- trish young, president and ceo of central health. And commissioner, it's perfectly fine to continue to call us the district. We have not changed our legal name. Our legal name is still travis county health care district, but we're doing business as central health.
>> so d/b/a.
>> yes, sir.
>> d/b/a.
>> you will hear me all the time call it the district.
>> d/b/a. D/b/a. All right. But the funding which is provided by central health to seton family of hospitals for operation of brackenridge hospital is intended to cover the residents of travis county. There are costs that are incurred by that hospital from residents outside of the county, and it is incumbent upon that hospital to seek that funding from the other counties that to the maximum extent by the law. But the funding that we provide is -- because it's coming from taxpayer residents, it's only intended to cover the cost of travis county tax paying residents. I just wanted to clarify that.
>> i'm glad you clarified that because it's the only point. When i looked at owe on just like the possible proposed tax increase from fiscal year '10 to fiscal year '11, is there going to be an increase? That's borne by all the property taxpayers of travis county.
>> that's correct.
>> and since that's the case, i was wondering and i'm glad you cleared it up because i didn't want travis county taxpayers to end up having to pay for persons that are receiving care out of county, especially when they come to those particular settings just as you just mentioned. I'm glad you cleared that up because i think the public wouldn't appreciate us doing it, i think.
>> yes. And really that's our mandate. Those funds can only be used for travis county residents. Mr. Stevens is actually going to walk through the high level -- a very high level preliminary budget presentation. I just wanted to refresh all of our memories. I think commissioner huber, you may not have been here last summer when we did our first budget or was it two years ago? I've really lost track of time. Ic i'm here now.
>> i'm trying to remember if you've been through a preliminary budget review with us. My memory is not as great as it once was. In july of every year since inception of the district, we've come forward to you with a very high level. This is what we're thinking, this is what our think our revenue looks like, this is where we think our major expenses looks like. In that presentation we take into account everything we have committed today, and continuing -- and are committed to continuing the following year. And just as you mentioned, commissioner davis, we go through a process of iterations to see what sort of expansions are changing. And there will be several changes to what we present to you in a high level today. By the time we actually bring you lient item detailed budget in august, and that is to schedule at which we bring you and you will get the full finite detail. We present that to you as a preliminary budget in august prior to taking it to the public for a review. So what we're presenting to you today is the very -- kind of the policy driven aspects, and mr. Stevens is going to talk a bit about the tax rate because we are suggesting that that will -- we are proposing this point that that becomes the effective tax rate. I'll let it over to mr. Stevens.
>> thank you.
>> let me start off by orienting you first to our new mission, which is central health creates access to health care. For those who need it most. Simple, straight forward i think and easy to remember. I want to recap for just a moment some of the information that you've already heard, but in comparing where we were as of march of this year to where we were in 2008, we have made i think some significant strides in helping to create access. We've increased the monthly average map enrollment by 70% over 2008 levels. We've increased the number of primary care medical visits in totally 31%. The number of dental visits by 19%. The number of integrated behavioral health visits by 51%. And in particular i think we're proud of the fact that we have increased the number of inpatient psychiatric hospital admissions by 321 percent over 2008 levels. This next slide shows you again a very high look at our 2011 draft budget. We are expecting to bring in about a million dollars in additional property tax revenue; however, let me add or let me reiterate what trish said. We are proposing at the effective tax rate our tax rate at this point we estimate as calculated by the travis county tax office, and based on tcad assessed value that we got back in april, we estimate that our tax rate, the effective tax rate will go up from 6.74 to 7.24 cents per 100 valuation. Excuse me. But that again is proposing at the effective tax rate. And on average means no tax increase for the tax roll. We are expecting to bring in same amount of revenue in 2011 as we're expecting this year from our seton lease, about 29 and a half million. We're expecting a slight increase in interest or tobacco settlement revenue, and we are proposing to use 7.8 million of the reserves that we will have on hand at the end of this year to expand, to continue to expand access to health care. Looking at an overview of the draft budget, the uses of funds -- this is in the current format that you're used to looking at. The summary page of the current format shows our personnel expenses aggregated, our operating expenses, tax collection and health care delivery. So in comparing our 2011 budget to the 2010 budget, we are expecting an increase of about 800,000 in personnel expense, 1.3 in operating expense, but most of -- even under this old format, most of the increase will be to our health care delivery program. We have provided each of your offices with some information on the change that we're recommending, which you see on the next page, and that is to make the summary page of our budget presentation on a program format where we essentially track the two programs that we use to benchmark ourselves. Our health care delivery and our administration costs. And in looking at the changes from 2010 to 2011 with this new program format, the change in health care delivery is 8.6 million and the change in administration is about 300,000.
>> what's the assumption as to the tax collection? The rate.
>> we are assuming 100% right now, but we do not budget for delinquent property tax collections, for example.
>> we're using our historical experience.
>> yes.
>> which i believe is the same experience as the county.
>> to give an example, judge --
>> we dropped ours a percent or two. This is 100%?
>> we budget normally at 100%. And we did the same thing this year, and we were 400,000 overbudget right now for property tax collections as of the end of june.
>> who collects taxes for y'all?
>> [ laughter ]
>> we have an excellent tax collector.
>> i thought we use the same one.
>> they do a great job.
>> [ laughter ]
>> all right. It's working.
>> okay. I'm going to briefly talk about our plans for the future. We think -- we believe and i think what you've heard in these reports, in our last fiscal year we made significant progress in our efforts to expand our reach to this community with health care. With health care reform looming, we have a lot of questions, and the one thing we do know is that more people will have coverage and as a result we're going to need more resources to meet those needs. Our position is even though we may not have the full book completed, the fact that we do know we're going to respond and begin putting the appropriate tools in place so that we can advance, create new access, figure out how we can expand our network of providers, develop ease of entry into coverage, and provide all the help we can to our community. As we continue our efforts around expansion, it's really influenced by m.a.p. Enrollment and the capacity of our contracted providers. Community care continues to provide the lion's share of our primary care, but over the last year we did enter into some additional contracts with other providers and we'll continue to do that. And out of that we resulted in an additional 18,000 visits that we didn't have before. And we'll continue to reach out to partners who are willing to work with us and provide services for our patients. And just before i left the office i did peek in to eligibility. Christie gave a figure at 17,000 or thereabouts. As of today we have already capped 18,000 enrollees. So we expect that number to continue to grow. We continue to explore what's needed to adequately care for our enrolled population. And as i said earlier, we'll continue to work with our existing contractors. We position ourselves so that as our contractors develop new capacities and capabilities to see more patients, then we're in a position to respond to that. Our contracts are structured in such a way that if they come to us through the middle of the year or any time and say we're going to add another doctor, another provider, we're going to create some additional exam rooms so we can see more people, we're in a position to respond to that. And we want to support all the safety net providers and the people that we work with so that we can provide the revenue of sorts as they try to develop business models for expansion. Lone star circle of care, their budget has been increased an additional $800,000. It's almost $500,000. And again, when our providers come to us and say, we can do more, then that results in us asking our board for approval for additional funds, and we're able to get that. We're also developing agreements with private sector providers. We're reaching anybody and everybody who is willing to help us meet our needs. We've set aside a million dollars for this year to expand specialty care. Again, we're working with our traditional partners, but we're expanding our reach. Under dental services you've heard a lot about dental. As we look at our last year in dental care, it was pretty flat as far as our increase, but that's because of capacities. But you heard david talk about some further investments that have been made in community care to expand existing sites, develop new sites, and we're working with the capital area dental foundation who have a reach into the entire community and we would like to work with dentists who are willing to see our patients in their offices. So we believe that over the next year that's going to give us a tremendous opportunity to expand our capacity around dental care, which is woefully underserved at this point. We've added $600,000 that has been set aside really for the work around the dental society, and we've added 104,000 as it relates to primary care, dental and specialty care dental, which is over and above what we're doing with the dental society.
>> this slide is one that we've shown to our board a couple of times. It shows a little red-haired girl who is about the same age as the district, five, and she is -- she knows that national health care reform has been implemented and she's trying to figure out what that's going to mean for us. So larry is going to talk a little bit about how we're planning to transition to the health care reform.
>> before we move to that, i just have one question. In knowing where we are now and where we want to be, reflecting on your comments and you were talking about the 17,000 enrollment number. Do you have any way of estimating or knowing what your -- what the pool is out there for your target, the total numbers that might be needing these services?
>> i think we have -- we have estimates of what -- who might potentially be eligible. What's difficult is to try to predict how many will actually seek your services. And i don't have that with me today, but that's something we could definitely provide to you. It's now going to be a work in progress because we're trying to analyze and anticipate how the new coverage possibilities are going to effect those individuals that may now seek the medical assistance program services. The folks that are currently enrolled in the medical ace sense program or might potentially be enrolled or eligible to enroll as well as folks that are paying on what we call the siding fee scale, which means they're paying at a discounted rate, many of those people will potentially be covered under health care reform. It's a big guess right now what that might be. We'd be happy to share what we have with you and keep you performed as to where those projections are going in future.
>> i'm sure it's an he will lewis sieve number and the criteria change for evaluating it.
>> i think that the most difficult part is just understanding who is going to seek your services at what time because you can understand who is potentially eligible, but there's so many factors that influence who comes to your door. And sometimes it's simply driven by their health care needs at the time. Health reform is a much larger unknown.
>> so is there a waiting list for non-emergency seekers?
>> i think in term of folks getting in for eligibility appointments, that's pretty rapid. We've made very significant changes in how people get processed for eligibility screening. There's now a call have str in place that is the first frontline. People call, some of the work is done over the phone. There's mail-in options. It's a very efficient service and that has -- i'll let larry speak a little bit about that.
>> i would only add that we're also enlisting our partners through what we call a virtual eligibility, using technology so that people don't actually have to make a visit. But you can go through our provider, whether it be one of ours or one of our contracted providers, provide the information. We're able to receive it and process it. So those are some of the things that we've done, as trish said, that's really improved our ability to get people eligible and within our system.
>> i think if i had sto describe the overarching goal of our changes, it was to compress the time where people are seeking coverage and match that when they're getting services because the way the process worked before is you had to seek the coverage. That was your first step. And you may not seek coverage until you're ill and that didn't guarantee necessarily an appointment with a provider after you went through eligibility. So we're trying to combine those, compress that time. As larry said, if you good to your provider and get an appointment, they can do that screening for you at the same time so you're not doing a two step process. That has resulted in much better access to care. And also setting expectations for people, because it's one thing to be screened, but unless you can get an appointment for care, that screening doesn't really mean much to you. So we're trying to do a better job of matching people to care at the same time.
>> community care is also included in this change where they can provide that service at their sites as opposed to going to one office and then, as trish said, going to another office for health care. If it can all be done in one place, that's really convenient and that's really what our target, where it's appropriate. So preparing for the future. This year we'll continue to develop our strategies around expanding our network. It's really important that we pay attention to specialty care, primary care drives specialty care, so you can't do one without the other. So they go hand in hand. We're very concerned about behavior health and dental. We've talked to you about some of our plans around that. But more importantly we have to really change our operating model that it can respond to health care reform. So what that means is looking at our skill mix, looking at the end of employees we have, looking at what we lack so that we're able to manage in this new environment. So we'll be making some change changes even in that regard. We want to be able to take advantage of the additional funding that's going to be given to us because of our fqhc status, the grants. We want to be positioned really to take advantage of all those resources. So as a result, we'll have some internal changes so that we can be able to respond. So that's pretty much it for next year and then for 2012 and 2013 it will be more of the same. As we learn more about health care reform, we'll be able to respond.
>> let me go back a little bit i guess under b. I'm trying to determine if someone was to ask me today, commissioner, i understand you brought up the issue as far as the new community health care location and why it's located and all of that. However, commissioner, when will the groundbreaking of that facility take place and when will it be ready for public use? That question will probably come to me sooner or later and i would like to tell the folks something when they ask me that. So what can you tell me today, if possible, ballpark -- doesn't have to be accurate. You said this thing is steadily unfolding, but there ought to be a ballpark somewhere in somebody's mind on the when of all of this. So can anyone express that to me this morning?
>> commissioner davis, the groundbreaking is scheduled for sometime in september, so next month.
>> september.
>> september of 2010. And then the facility is planned to be completed by the end of the year 2011.
>> 2011.
>> yes, sir.
>> so i can safely say that and nobody will throw rocks at me. And if they do, i'll tell them to throw them at you.
>> that sounds good.
>> of course you will be receiving invitations.
>> all right. I needed that information because i'm quite sure that's going to come up. And at least we'll have the -- court will have an answer that we can go on record to suggest those dates.
>> and i believe that you will also be receiving invitations to the open house if you are interested. There will be some really lovely information shared about the facility. We're very excited and we think that the surrounding neighborhoods are pleased with the plans that we've come up with for the building. It's going to be a lovely building. The grounds are going to be just really, really nice. We're very excited about it.
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, July 20, 2010 1:25 PM
