Travis County Commissioners Court
Tuesday, February 1, 2011,
Item 3
Item number 3 is to consider and take appropriate action on the following matters related to the Travis County health care district board of managers, h, short list for interviews to fill current county-appointed vacancy.
b, proposed questions for interviews with candidates.
and c, review schedule and other related issues.
ms. Fleming?
>> good morning, judge Biscoe, Commissioners, sherri fleming, executive manager for health and human services and veteran service.
and actually, I think my subcommittee may be carrying this report this morning.
>> sherri has been sick and dealing with power outages at the Pflugerville community center.
so we'll be happy to carry it.
>> so you're going to defer to me.
>> [ laughter ]
>> pass the buck.
>> I知 passing the buck.
>> you can pass it back.
>> we met last week and we had short listed -- for purposes of the committee -- eight that met the requirement of looking at what the void was on the board that -- of professional skills that we hope to fill.
Commissioner Eckhardt and I have divided those up and we're in the process of doing a telephone interview on those to determine whether or not we could make that list even shorter.
>> two items. The first is that the subcommittee had asked staff to draft a letter and we did do that.
I have that today or we can take that up next week.
if that's the court's pleasure, I don't think there's a sense of urgency.
it's just that we wanted to make sure that it was on the court's radar because the subcommittee was interested in having the full court sign the letter.
the second would have to do with the questions that you would ask --
>> a letter regarding?
>> a letter thanking those folks who applied and notifying them that they're not -- they would not be moving to the next phase of the process.
so once your short list is complete, everyone else would get a letter indicating, you know, that they would not be moving to the next phase of the process.
>> so for those like the county judge interested in knowing who the lucky eight are, who are they?
>> shouldn't we say that today?
>> judge, we probably -- I would suggest that we continue to try and winnow the list, but we will say that the criteria that we used was that we first looked at the skill sets of the people who were currently on the board, determined that with only one physician currently on the board it would be good to look at physicians and rn's.
and so we winnowed the list to just physicians and rn's and decided to then make phone calls to those individual and ask the questions two, three and four on the current draft list of questions and also ask them a question regarding any actual or potential conflicts of interest that might hamper their ability to serve or the number of items on which the health care district's board must pass that they could way in on.
we thought it would be best to winnow that list before announcing the smaller list so that we wouldn't put people in any kind of uncomfortable position, particularly in the candid conversations about any kind of conflict they may have.
but we can tell you who they are if you would prefer to do that.
>> well, if it's physicians and rn's, I can figure out who it is, if you narrowed it to those two.
>> that's what we did.
>> but looking at those two got you down to eight?
>> yes.
>> looking at those and then we got input from the health care district with regard to any actual conflict of interest that we would want to consider.
not to whoa with with any conflict of interest.
>> and we define that as?
>> if an individual had active managerial participation with an entity for whom the health care district had contractual relationships.
>> one of the reasons that we felt like we needed the rest of this week to finish these is that it's challenging to get ahold of medical professionals.
in fact, I worked on the list very hard over the weekend.
they're every bit as in demand as we are.
>> is beth reid the attorney for the health care district.
>> she's primarily assigned for that caseload.
>> beth assisted us with conflict of interest analysis.
>> can you share that letter and draft with the rest of the court?
>> yes.
actually, we have it today.
in addition, I would remind the court too, if you have any feedback for staff on the questions, this may be even more jermaine at this point because the subcommittee will be asking several of the questions that are currently on the list in their screening process.
so that may reduce your list of available questions by those three or four that your short list of candidates will have already answered.
so you may want to consider whether or not you want to reask those questions so that the full court can hear those responses or you replace those questions with something else or, you know, use the remaining questions as they are.
so any feedback from staff on that would be appreciated.
>> remind me of who appointed the physician that's currently on the board?
>> dr. Coopwood.
dr. Coopwood I believe is a city appointment.
I don't have that with me, but we can send you an e-mail.
dr. Patrick was our appointment, and I am just drawing a blank on coopwood at this point.
>> we're chatting with the city about what we're doing and why?
>> with the city?
>> we have not chatted with the city.
>> because there are concerns that residents have expressed that I知 not sure having a physician or nurse on the -- another physician or a nurse rn on the board would address those concerns.
I mean, I just think they were serious enough for us to try to address them at some point.
but I don't know that we have to take on the full responsibility.
it seems to me that the city and county ought to work together to try to address them.
and they really come from residents who believe that they are not included in the decision-making process.
these are more people at the grassroots rank and file level.
>> you're talking about patient advocacy?
>> well, I知 talking about something a lot broader than that really.
>> dr. Coopwood was the city council appointment.
reappointed in 2007.
>> okay.
so from the beginning we've had two physicians on there.
I guess I sort of feel that we should have narrowed that early on.
our problem was that we got zero applications and our language broadened the qualifications necessary to be seriously considered.
and those who heard that call and put applications in we sort of sum marily are rejecting them by deciding that we need a physician or an rn on there.
if that had been our case, I mean, I think we should have touched base with those two communities and tried to get applicants.
but, you know, we are where we are today.
so we're kind of applicant rich.
and I guess we have to use some criteria to try to decide of the 23 that we have which one do we choose?
>> well, in the scope of the applicants, I would suggest that you're applicant rich in the medical professionals.
I would say at least half are in some way affiliated with the medical profession, either doctors, nurses or I think you have a couple of health care executives as well.
>> so when we say rn, remean an rn current owe on owe we mean an rn working or practicing or do we mean somebody that possesses that certification?
>> I知 referencing somebody that possesses the nursing level certification, not necessarily whether they're currently practicing.
>> what we had looked at with regard to the composition of the board currently is that there's one physician -- one rn who is not currently practicing, so we also put her as medical business because she works in the Texas department of insurance.
then we had two business people, two medical business people and two lawyers.
so it seems in the field of individuals that we had with regard to skill set, we had a fairly substantial representation from the business community, adequate representation from the legal community and felt that it was probably in the medical community that we needed to add skill set.
>> and as I recall, judge, when we first put out the call, I know I was aware that we were looking for someone in the health care profession, but we didn't get the response, so we broadened it just in the event that the second go round we didn't get the response.
but I think from -- at least from my perspective from the git-go, we've known that the health care profession was the targeted area we had hoped to identify an appropriate individual from.
>> so when I look through the information submitted by the applicants, if I see physician or registered nurse on the employment professional experience, I should conclude that that person is in?
if I don't see one of those --
>> I believe there was one that we eliminated based upon the recommendation of conflict of interest.
>> okay.
all right.
the letter you just gave us is to act on next week?
>> that would be fine, judge.
>> okay.
>> and with regard to client representation as well as neighborhood representation, we do have two questions on the list of proposed questions that go to that for us to ask the applicant.
and there's also some comfort in the fact that many of the physicians, applicants and rn applicants have considerable experience in treating the population that the clinic system draws from.
we have representations that includes school nursing, va hospital, family practice.
>> those applicants that indicate participation in project access, that's a volunteer pool of physicians that work with the clinic system.
I believe it's a program of the Travis County medical society.
if I知 quoting that correctly I am.
several have talked about participating at various times in project access.
so that would also give you an indication that they're familiar with the populations that are being served by the health care district.
>> I would ask that we ask again 2, 3 and 4 for the benefit of the court to hear the answers because I had quite a diversity in the answers that I have gotten or received from those that I致e interviewed on the telephone.
>> 2, 3 and 4?
>> of the ones that we had segmented out for our telephone interviews.
but I think that it's important that y'all hear those answers.
we've all been asked that question so we have more time to think about it.
>> there were people who complained to us about the process used to decide the site for a health facility.
>> [one moment, please, for change in captioners] and you really don't ensure that that voice is represented by having another physician or another r.n.
however, you know, we don't have to do that this time.
it's important we try to address that, but we means city and county.
that's why I suggested if we're chatting with them, they ought to know that in my view, in the county judge's view, that voice is not on the board at this point and it's been brought to our attention that the people expressing that concern don't believe that voice is being heard.
>> although --
>> and I do agree with them and think we ought to be a bit more proactive and ensure that we get that voice presence basically.
>> judge, although since the circumstance that we had regarding the braker lane clinic well, had two new appointees who very much were in reaction to that circumstance.
anthony haley, who is a lawyer, who also was chief -- I believe chief of staff to representative garnet coleman and had done substantial work both in his capacity in representative coleman's office but also in his private practice doing neighborhood outreach and change management, as it were, for deciding issues and neighborhood issues and I think we selected him in large part based on that experience.
and the city selected katrina daniel, wide experience in community outreach on big policy decisions that affect constituents, so --
>> their heart is in the right place.
their history, experience, use of clinics are not, is the point I知 making.
and I know both of those well and one we chose and the other one we didn't.
I advocated for anthony haley and it was a good choice, but when I articulated my concerns a minute ago and the ones I heard, I agree with those who voiced it that anthony or haley doesn't fill that void.
as one person said he's been a good friend of mine for a long, long time and we were lucky to get him, but he doesn't fill the void I知 talking about.
>> are you thinking the citizens consumer representative on the board?
>> I知 thinking either that or just a regular, down-home neighborhood resident.
who brings nothing special except a deep concern for the people that the health care district serves.
that person is not represented there.
the nine members, I assume, try to represent that interest, as do we.
but that's one of those voices that ought to be on the board, in my view, because that's the reason for the existence of the health care district.
so early on we were trying to be as creative as we could about creating the district and there were interests that we needed represented because we were not sure what obstacles the district would encounter.
but here we are, what, more than five years later and it's fairly smooth sailing except for this one void that exists.
we ought to feel duty bound to fill it.
I don't know that we ought to feel duty bound to fill it this time.
my second concern was I would not have broadened the qualifications if I had not meant to use them.
and what we're doing really is because we're applicant rich, we're sort of narrowing those qualifications.
you know, when we came up with zero applications, we said, okay, let's just get somebody health related.
and so what I was hoping is at least we would have had one or two of those people in the pool that was interviewed.
we don't know how they will stack up against physicians and nurses as to how they would benefit the health care district without giving them an opportunity to demonstrate what they bring.
>> we could revisit the pool and include -- because we do have applicants who may be the kind of citizen neighbor representative that we could --
>> if I could --
>> [inaudible] I would have me one or two.
>> okay.
>> now, we did appoint the subcommittee, and as john hilly will tell us, we empowered the subcommittee to do the right thing.
but in our discussion last week, we thought the right thing was, you know, let's interview one or two from each category and, you know, see how they shake out.
now, we all are generally familiar with the eight that are currently on the board.
and, you know, maybe a more specific understanding of what each of the eight brings would help us.
I can live with physician and nurse.
I would feel better if we had somebody a little bit more -- was experienced a little bit more working with needy people, with the consumers here.
and if I were doing it, if we interview five or six, I would have the least one with that background if not two.
I mean, if we are looking for a physician, I don't know that interviewing three or four of those is necessary.
seems to me that we would try to get the best two and interview them.
see what I知 saying?
so that's two.
and if r.n.
is one of the backgrounds we're looking for, I don't know that I would interview four or five.
I would short list down to maybe one or two, maybe two.
but if that's four, I mean I would have me one or two that -- whose background demonstrated a bit more experience with just -- I知 talking about everyday, just down-home consumers.
>> judge?
>> yes, sir.
>> and I think, number one, let me thank the subcommittee for doing what they've done.
they've narrowed it down to --
>> their additional pay doesn't make up for the hard work they put in.
>> I still recall some of the discussions that we've had here before when there were certain issues that were brought up before the board of Commissioners -- well, before the board, health district board, members, as I guess their meetings and then those folks brought those concerns right here to the court and we all recalled those.
it would just seem to me that we need to maybe head in that direction.
I have no qualms with that at all, but I think what the judge is suggesting to get, you know, a person that he just described -- I think he did a eloquent job of describing that.
not saying that you haven't done a good job.
I don't want to come across like the subcommittee hasn't done an adequate, a good job, but I just think there may be room for additions in this process as I think the judge described.
also, is there -- I guess I can ask staff this question.
what is the time line on what -- as far as this process?
is there a drop down date as far as we must be complete with this process by an attorney date or how long do we have?
>> well, your appointees' term expired December 31.
and I think -- 2010.
>> okay.
>> so you officially have a vacancy.
>> right.
>> it's my understanding that during the budget season, he was continuing to participate as appropriate and as needed, but your appointee, I think, you know, certainly had personal reasons why he was trying to move on.
>> exactly.
I understand that.
>> so I think it's best to consider it vacant.
so it's vacant until you fill it at this point.
>> okay.
well, since that's the case, and I just wanted to lay out the scenario, you did a good job, I think we have time to address those concerns, addendums or additions to what we are looking for.
and I think the community will be served better by that voice.
so -- and again, don't throw rocks at me.
you have done a heck of a job, really, really, you really did.
but it's advertise that I think we need to probably look at and I wanted to hear what staff had to say about the time line.
it is a vacancy we need to fill.
if we're going to do it, let's do it all the way.
that's where I知 basically coming from in support of what the judge is saying.
>> well, then, making that decision, let's just ask the committee, subcommittee to consider that.
>> yeah.
>> and whatever number you all come back to interview, we'll interview.
>> now, we may -- in order to find that individual, we may have to do additional recruiting because I believe during the recruiting process we did put the word out -- I don't think we were specific about recruiting for that specific skill set.
so would you all like to reopen the application period in order to solicit?
>> I wouldn't.
and I think that we come as close as we can and if we don't think we have an applicant that fits it, then it's even easier.
now, I thought I saw two or three that touched on that.
you know, that -- but I mean it may be that you look at them and conclude that hey, that person is not here, next time we'll be a bit more proactive.
>> I also think that based upon one of the telephone interviews that I had that perhaps we may have some who don't show that component of their -- their history in working because it came out in one of the telephone interviews I had that that was a component of her work.
>> okay.
>> so I don't know if we should perhaps revisit with that question those we have already talked to.
>> I would not open it back up.
23 is -- we are applicant rich, so -- I think we owe it to those who expressed those concerns to us at least an effort to try to meet it.
and -- but that's our best effort.
so if it -- if we are not able to meet it this time, so be it.
but I would let -- I would let the city of Austin know what we're thinking so when they have a vacancy they will -- we really out to be together on this and our appointments ought to compliment one another.
there are nine opportunities and so I知 thinking that we should at some point be able to directly address that.
>> okay.
I値l make sure we pass that on.
so in terms of -- I think I知 clear on the committee's next steps.
in terms of next week's agenda, staff will bring back to you the letter you have a draft of right now.
we will also send it to you electronically.
if you have suggestions, I believe you can communicate directly with me and we'll make those changes.
in addition to that, based on your discussion today, staff with your permission will try to draft a question that speaks more specifically, I think, to some of the concerns raised by the judge and so you'll have that before you in your list of questions next week.
and hopefully that along with other questions will help you hear the experience that each of your potential appointees will bring should they be appointed.
so that sounds like what our homework is for next week.
>> between now and then, we'll try to circulate email communication regarding a good day for us to interview.
>> February 17th was where you landed last week, and I have not heard any further discussion on that date.
now, I would put my subcommittee on the spot to see with our new assignments today do we think we can still meet that deadline.
because we do want to provide appropriate notice for your --
>> that's a Thursday, right?
>> that is a Thursday.
>> okay.
after court that day I was notified that one member of the court is unavailable.
>> oh, okay.
>> we really ought to try to get all five of us there.
if we have to do it on a Tuesday, so be it, we'll identity in the afternoon.
>> okay.
>> really I think 15th, February 15th turned out to be a better day if we're ready to do it.
>> okay.
so we'll look at 15th and then maybe my office can help to determine a secondary date just in case we need one.
>> yeah, 15th it would be the afternoon.
that would be a Tuesday so we would be regular court business that morning and try to free up the afternoon for the interview.
>> okay.
we are so directed.
>> anything else on this item today?
>> yes, with regard to the questions, it looks like that we will have a minimum of five to interview.
two doctors, two nurses, one consumer neighbor representative applicant, at least, so I would ask the members of the Commissioners court to -- how would you all like to address the list of questions because it appears that it may be too lengthy and there might be some questions that are similar, and if we're adding questions, which I think we probably -- that we should with regard to consumer input and client -- neighborhood participation, then we might want to revisit the questions and put a cap on the overall number.
do you all feel comfortable with a cap on the questions?
>> well, sometimes, Commissioner, when you are doing interviewing, and I know in the past when we've interviewed persons for different positions that we want them to fill, sometimes when we do that, sometimes there are some questions that are not on the list.
>> exactly my reason for asking.
>> so in other words, I would hate not to have a question I think that's just burning -- a burning question that I would like to ask that may not be onthe list.
sometimes after you ask questions they lead to other questions.
>> I知 not talking about the ad hoc questions each individual member might want to bring up.
I知 talking about the standard list we make sure we ask each one of the applicants in order to give us some more flexibility in time.
that if we limited that standardized list to which we asked each applicant to five, how do you all feel about that?
>> I think --
>> let's try to get there.
so five questions the individual members can ask whatever additional questions they have.
>> ad hoc.
they call them ad hoc questions.
that's a good response, Commissioner.
ad hoc.
I like that.
>> okay.
>> in the past you have -- we have scheduled the interviews in 45-minute intervals, 45 minutes per candidate.
so does that seem like a good plan for us to stay within so that we can figure out how much time you all will need to interview the number of candidates we finally settle on, or are there any concerns about that block of 45 minutes?
more time, less time?
>> at five minimum, that's a five-hour commitment to interviewing.
>> I壇 say 30 to 40 minutes.
if the subcommittee has done some telephone interviews, that helps, I think.
although the other three members of court are not there.
I would just plan to expedite them.
>> okay.
>> we have basic information on all of them anyway, right?
>> absolutely.
>> so the key may be to ask the right questions.
>> okay, well, we will make sure that we have made the necessary additions so any questions we get in the time period between this week and next we will add to the list and have those available for you to make your final cut with some recommendations maybe from the subcommittee on the five or so questions that we think might be most important to ask.
so any other staff direction?
>> we didn't give you enough this morning, ms. Fleming?
>> oh, I致e got pages and pages, but I致e got a little space right here, judge.
>> thank you very much.
see you next week.
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Last Modified:
Tuesday, February, 2011 2:19 PM
