Travis County Commissioners Court
Tuesday, November 8, 2011 (Agenda)
Item 7
7.
receive presentation from crime lab design consultants regarding needs analysis and financial feasibility study for the Travis County medical examiner's office.
>> thank you very much.
I am danny hobby, and I am the county executive for emergency services and it's my pleasure today to introduce some representatives from crime lab design who are here for the purpose of presenting to you information and service scenarios which we asked them to do based on a scope of work that was provided to them and they accepted, along with providing a feasibility plan to determine the best long-term solution to growth and space issues.
and it is now time for us to look at the medical examiner's office and its future and I think today you are going to see a presentation outlining some scenarios for us along with cost and you should have a powerpoint in front of you and I will ask them to go ahead and start.
I would like to introduce who they are, and that's lu hartmann, the main principal for the firm along with susan who will make the slides go quicker.
I told them they have 30 minuteses, judge, otherwise you get uneasy.
we will try to stay within that time frame and we dr. Delinack, the chief medical examiner as well as sarah scott who is the chief administrator officer for that office.
so lu or susan, whoever would like to begin, you may start.
>> if you don't mind having a timekeeper and give a ten minute mark and use your time efficiently.
so judge, Commissioners, thank you for having us here today.
first thing I want to talk a little bit about, what objectives are on this presentation so you can walk away understand what we are doing here today.
I want to give you introduction f you are not familiar with the actual organization of the Travis County medical examiner.
the second will be a discussion of any critical issues that are currently facing the medical examiner's office.
understanding the four scenarios we are presenting here in this report and understanding the methodology that we utilize in order to get to those four scenarios are and what the recommendations and findings are and at the end there will be a summary of the recommendations and findings.
the first thing I want to talk about is the medical examiner.
they were established in 1997 and governed by the code of criminal procedures which is the code that sets forth what happens in a death scenario, what the justice of the peace are to do?
a death scenario and what decedents are to be autopsied and the Texas government code chapter 7-91, that is the piece that sets forth the inner local appropriates between the municipalities.
they moved to current facility in 1996 which was designed for three medical examiners.
they currently have five on staff and we will go into some more of those in a minute, about deficiencies and the departments of this group include administration, pathology, the forensic autopsy assistants, toxicology laboratory and investigation.
any time that I may say something that may be too, like some kind of lingo you don't understand, please let me know.
I am happy to understand that.
I want to make sure it is understandable to everyone.
a little bit about the service areas at the Travis County medical examiner services.
obviously they handle Travis County.
they also handle the cap cog areas which is a capital area council of governments which are the counties listed here, and also the star flight counties, several of the star flight counties as well as plethora of other countries so total of sum of counties are travis and 42 other counties throughout the state of Texas.
the critical objective -- critical challenges that are occurring right now with this particular facility.
are insufficient staff acation.
in -- insufficient staffaccommo.
it was built for three and we currently have five on staff and we actually need more than we have.
there was accreditation which we will talk about momentarily they are accredited by the medical board examiners and forensic toxicology and there is individual certifications for the death investigation group as well.
one of the critical challenges they face right now is the courtyard/sallyport area that leads into the medical examiner facility is so small that the taxis used to navigate the area, hursts, have been, it is hard for them to move and also the decedent and drop off area, although they haven't experienced an issue, several of the clients and medical examiners throughout the country have been involved in high profile cases where you get the press standing there at the fence and to have some sort of a privacy area for that drop-off, also for the respect of the decedents would certainly be a benefit.
there is also limited number of autopsy stations for the pathologists that are required.
as I state earlier, there are currently five pathologists on staff.
only two autopsy stations for the five pathologists in all of the cases being performed today.
the triage area as a decedent enters the facility is quite tight and only accommodates one decedent per processing and this is the central bottleneck of the facility where all decedents are coming in and out and being processed in or processed out.
cooler capacity, while the capacity for a standard requirement is doing fairly well right now, their capacity for surge situations is insufficient as long as mass casualty potentials and the infrastructure that is supporting, for example, the toxicology laboratory is really at maximum and while they have a number of very high grade instruments and that infrastructure is there to support them, there isn't really anywhere else to go with more instrumentation that they will need to continue to cover more cases as time progresses.
there is also an issue in the current facility of the mechanical system with offensive odors permeating the building in certain areas and while many of us in the business may not notice it so much, there are people coming in from the outside that are very sensitive to that and do notice that.
>> offensive odors caused by?
>> decedents.
>> okay.
I can go on but --
>> no.
no.
>> okay.
lack of filing supply storage.
at current because they are accommodating so many more staff than the building was prescribed for, a lot of staff is moved into what were storage areas so now quite a number of boxes of storage items are in the hallways because there isn't anywhere for those and they are prescribed by national accreditation standards to have five years of files on site.
the investigation's group is particularly hampered with the size of their location.
they are ha 24 hour organization and it is very difficult to operate in the small space they have now and they don't have any kind of accommodations for the 24 hour operation, such as a real kitchenette to be there or a bunk quarter if they have to be there for 24 or more hours.
just to go a little bit through the scenarios, we have identified four scenarios that we utilized in this report.
the first scenario is the baseline scenario or scenario number one and that scenario is servicing all of the areas of the Travis County medical examiner's office is currently servicing.
the second scenario is what happens if Travis County medical examiner is only servicing Travis County.
the third scenario is Travis County plus the capcog counties, and then the fourth scenario is servicing all of the count counties with the exception of Williamson county.
>> do they have their own set up?
what is the reason for that.
>> they don't have their own set up.
>> what is the deal with Williamson county?
>> I will answer that.
there is several scenarios with them.
number one is the -- remember the university of a&m came in and established a medical school in Williamson county so as a result of that also a relationship between Williamson county and the medical school and one of our primary customers and so because of the relationships that they could -- that could exist between a medical school, then we decided to put them in.
however, publically, we want to continue to work with Williamson county.
their population projections also are indicators that, due to their growth, that they could look at potentially things of their own.
so that's why we brought them in.
however, I will be visiting with all of the counties and going over these scenarios and I just want to say publically that we do want to continue to have a relationship with Williamson county.
>> okay.
yes.
because I saw that and I just wondered about it, because I know we have outreached to several counties and then I say, wait, a minute, without Williamson county, what is going on with that.
so.
okay.
you explained it.
that explained it.
thank you.
>> so understanding how the report is built, it's really very much pyramidal in shape where we start with population caseload and then off of that build what the staffing requires which then builds into what side of the facility will we need to construct to house this staffing, and then what are or the operational costs on top of that for the total project cost and that's what this report will cover.
so understanding the population for the state of Texas, you will notice that here around the Travis County area, the population has increased greatly in the last ten years in the census.
in particular, in the areas that the Travis County medical examiner is servicing, have increased and are projected to continue to increase.
and you will see the four different colors denoting the four scenarios, all of those are indicating a population increase which is time frame from 2010 to this which is our projection and also, the caseload will continue to increase, based on population.
and we did project our values on our cases based on the historic data from each of these individual counties and how that would project forward from the population we were able to ascertain from the census figures but there is a sum of every million in population, a thousand medical examiner cases will come out of those and 70-80% of those will be autopsied and so we use that rule of thumb to verify that the projections we are getting are indeed accurate.
this graph shows probabilitied number of cases and you can see the steady increase.
the projected number of staff, the population begets the caseload and the caseload then speaks to the number of pathologists, investigation, toxicology the histology, but then they start to determine our forensic and the administration to get to the staffing and then requirements.
the medical examiners is the major accreditation body that would accredit the entire facility, not just the pathology section be but we build first and foremost of the number of pathologists, so there are two types of requirements in the national association of medical examiner requirements and those are phase one and phase two.
phase two, you must comply with phase two.
you may not -- you may not go beyond this one pathologist for 325 autopsies and they would like to see preferred, like one pathologist for every 250, and there is a recent version of the policy version and procedure manual which they are looking to push phase two standards to be the in out and phase out the lesser version.
so, for an for example, right now in 2010 we had 628 autopsies in the service area.
if we divide that by the 250, we would need 7 pathologists, by the 325, we need five.
in actuality, if you go out to the thousandths digit, we need 6 and this was in 2010 so you can see right now we are in possibility of going beyond compliance in 2011 with those cases.
this also shows projected numb of staff.
again, a steady increase.
so understanding a little bit about right sizing, where I spoke earlier here about the number of pathologists we need, if we talk about currently philosophy which is 14,410 gross square feet and currently 36 full-time employees that work in this philosophy, if we were to look at that facility today and we right size it and we already said they are cramped and can't deal with the number of staffing to take the 2010 staff and the facility, we are saying it should be in the amount of 32,000 gross square feet and about 41 full-time employees in order to service this area.
is there something you wanted to add, lu?
>> yes, and I guess one of the points to recognize is that even given the situation today, without any of the projected growth, the visit facility is too small to continue servicing and operating the current operation of the medical examiner.
>> so we have 36ftes today and do they work three shifts?
>> there is portions of the operation that work three shifts.
the investigators, the pathologists, the administrative staff are there on a normal work hour day.
>> about how many work the mall work hour would that be 8-5 or there abouts?
how many ftes work during that period?
>> there are --
>> eleven.
>> there is -- there are 11 investigators -- these are the right sized numbers, so -- so a my quarter of them are working that shift.
>> thirty-six of them includes pathologists, administrators, yes.
>> yes.
>> so we are looking at 11 plus 5 during the normal workday?
or just 11?
>> eleven is the number that are working the 24 hour shift so out of those 36 people, 11 of those people are working in the three phase, 24 hour scenario, the rest of the inhabitants or or the staff of the building with are working regular 9-5 shift.
>> thirty-six less 11?
>> yes.
a little bit about program and construction costs.
one thing -- in order to ascertain the size of the building, the first thing we did with each one of the sections is talk about their facility and what types of facility needs they have that may not currently be met so the doing so we generated these diagrams which talk about the facilities and they are in the complete report in the appendix.
understanding pyramid construction costs, utilizing the various spaces we worked out in the diagrams with the sections.
we were able to, then, look at what the -- what the sections are and how big those need to be.
so we based that based on our staff numbers here, in this column, and then we utilized a certain kind -- kind of a planning scenario to estimate, then, how large the facility needs to be, and if you see it on here, a tote gross square foot and put a construction value on that so we can estimate how much total construction cost would work in each one of those scenarios.
I will go through a summary here because I know the numbers are difficult to read.
through each one of the scenarios, we have projected -- not only -- let me go back here a moment -- the construction costs, so the actual costs of building the building and paying the contractor to build your building.
the second portion of that is the total project cost.
that would include your other fees, as you will see the left-hand column here, as to that construction -- adds up to that construction cost and the right hand is nonconstruction sites such as security, different liens or fees.
I don't think land is part of this.
>> yes, this construction costs, project costs assumes the building is built on county-owned site and a normal situation applies with relative utilities available like that.
>> so for each one of these scenarios we are gone through and they are slightly different based on -- it is all based on the number of staff which affects the building size which then affects the construction cost and the total project cost so I will skip through these very quickly, to go to the summary here, so that we can really see that.
the baseline scenario, then, is looking at a total building size, and this is for a building up to -- to house the facility up to 2045.
you will notice the right sized building was around 31,000 gross square feet.
we are saying a building that would support the facility up to the year 2045 would need to be around 51 to 54 gross square feet with a construction of 20 million and a total project cost of 27.
and then scenario two, as you read through here, total project costs are still anywhere from 20 million to 27 million, and you will notice that the area square foot comparison, the second root there using baseline scenario is 100% that the size -- or relative size of each one of the scenarios as well as a relative construction cost comparison there on the bottom.
>> one thing to note that is important on this slide is the range of construction cost is fairly small, from services just Travis County, to servicing the whole 42 county area, and when we first got started on the study, we expected that to be of much bigger difference between the two, but recognize and remember that there is a little bit over $6 million or so associated with the increment of Travis County only service area and supporting the full service area currently being taken care of.
so the next part of this is looking at the cost and revenues that were associated with the different scenarios.
I will walk through a couple of them in a little more detail and then sort of skip through others because a lot of the data is presented in the same fashion and it should be clear to you as you are looking through it.
under baseline scenario, there is projection of the staff that is required as we extend over the time frame of the study and then the cost which are associated with personnel and with operating costs are, then, projected out over the time frame of the study, along with the Travis County indirect costs, which is the -- sorry, general overhead costs of Travis County, for a total cost of operating the department over the time frame.
the services that are provided other than Travis County are fee for service.
the medical examiner collects revenues from performing the autopsies for the outlying counties.
those revenues are reflected in here for a net total annual operating cost for Travis County or the different time frames involved with them.
go to the next slide.
so on the revenue portion of the analysis, you know, we are sort of looking at the revenue that's generated from autopsies that are being performed.
so there is some that are done for Travis County.
others that are done for the out counties.
there is a projection of what the autopsy costs should be based on allocation of the direct costs being experienced as performing that work.
and a portion of this study was to take a look at the -- all of the personnel that are in the medical examiner's office, the amount of time they spend on doing in-county activities.
the amount of time they spend doing out of county activities, and then allocating the sort of direct personal costs between in county and out of county as well as the operating expenses being allocated between in county and out of county activities and from that it generates a and works back to a cost per autopsy which would be -- is used, then, is what -- is the revenue source from the service work they are doing for the out counties.
let me just try to see this for a minute.
so there is a total revenue projection in each of the years.
an allocated cost projection, so each of the components of the allocated costs are tracked with a net revenue, which the goal in the net revenue is it breaks even against the allocated cost.
you aren't doing this to make a profit.
you are providing this as a service to the other counties but recovering a cost of providing those services.
one line item to note on this is tc indirect costs which are allocated to out of county services being provided, the indirect costs are being recovered, and it is a net benefit to the county.
so as you think about the incremental incremental costs of just Travis County versus building one which is large enough to take care of the baseline scenario, that incremental cost of construction is essentially paid for through the indirect costs that are being recovered as part of the service fees that are being collected.
>> so we have been collecting indirect costs in the past?
>> yes.
it has been part of the formula for the service charges, the service fees for the autopsies.
>> okay.
and that $468,000 is an actual number for 2010?
>> yes.
>> as well as total autopsies, 4,628?
>> yes.
>> okay.
>> the reason I ask that is because I had been working with the figure of 1500 per year with roughly half of those being Travis County.
>> those are close numbers.
about half of the autopsies are Travis County.
>> but these are actual?
>> yes.
>> since we -- so the name accreditation folk work at workload for the number of autopsies to determine how many pathologists you have on -- you should have, or do they look at workload plus population?
>> they look at workload purely, how many cases do you have.
>> okay.
>> yes?
>> I guess I am getting a little confused, but I am trying to make sure that what we are discussing here, thepublic kind of understands what we are doing.
just looking at it and listening to this, if I was on the outside, not knowing anything about a lot of this, I guess there will be several questions that would pop intomy mind.
one would be that here we -- of course, Travis County has not always been accredited.
we worked hard to receive accreditation for our medical examiner and of course at some point, with the growth, which also looks at workload potentially as far as accreditation is concerned, if we are projecting the number of cases that -- the number of space, the number of ftes, all of those kinds of things to ensure that we maintain and not jeopardize accreditation, I guess my question ask, what time line would be place -- my question is, what time line would be placed on the table at this point to make sure that we are staffed properly and also looking at population and we are servicing the counties, other than Travis County?
what time line would you suggest that would be the appropriate time line to make sure that we do not interfere with our accreditation as we go through this process?
we don't want to jeopardize it, of course, but I guess I need an answer to that, if somebody can help me out a little bit.
>> sure.
dr. Dollen, chief medical examiner, in terms of the autopsy work lead and name accreditation -- and the main accreditation standards, currently, we are towing the line.
we are very close to doing more work than the name would suggest is the requirement.
>> how close is that?
when you say we draw a line and we are close?
I want to get down to the nitty-gritty of this issue to make sure we are ahead of the curve instead of behind it.
that's what I am trying to assess right now.
>> right.
the -- just to review a alittle bit, the national association of medical examiners sets two autopsy workload numbers, 250 a year per doctor, and 325 a year per doctor.
if a doctor performs more than 250 autopsies a year, it's a deficiency, but that is acceptable.
if it's greater than 325 a year, then that eliminates the chance of name accreditation being granted.
right now, as of the beginning of November, my doctors are performing -- well, our caseload indicates we are right around 325, projected for 2011.
>> 325.
>> so we are projected right at the upper limit.
>> right.
right.
>> okay.
>> may I add, the name accreditation is a five-year cycle and which have other clients we have been working with that have been facing this accreditation issue and the accrediting body is typically very -- it looks kindly upon extending accreditation based on, that they know you are doing something about it.
that there is a project in the works.
they have been pretty generous with some of our other clients of getting that -- taking that into consideration for their accreditation.
>> oh, okay, so contingency in factors of that nature play a role as far as the folks that deal with the accreditation aspects of what we talked about here today.
I guess my other question would be that, you know, we paid for services and I know a lot of this, the autopsy situations are within Travis County, but what -- has that been a spike increase, of all of the other counties we contract with as far as their services?
if so, do we have to adjust to fees according for that -- that is related to that service?
is there -- through our interlocal agreement are we looking at fee adjustment as well?
are there increase in workload?
workload?
>> I think I can answer that, Commissioner, one of the things we will be looking at as a result of this study is our current fee, and whether or not it should be adjusted.
our last fee increase was in 2008, I believe.
>> okay.
>> and so based upon that, we now have this information, which we have been waiting on.
>> right.
>> and we will be evaluating that.
the other thing I will be doing along with the office is taking this information and having, as I said earlier, having contact with all of our outside counties to discuss with them these scenarios, but also the options of financing and seeing where they are in regards to their future and our relationship.
>> okay.
>> as I said earlier, we are hoping we can continue our relationship as it is, where we feel like we have good relationships with all of the counties, but there are different scenarios you have to look at.
>> right.
well, some things -- still some rocks that need to be turned to get some answers.
but, again, I know -- those are just some of the questions.
there are others, but those are just some of the questions as far as what you put on the table today and they have a chance to look at those things.
I want to make sure we are ahead of the curve instead of behind it as much as possible and I think that's what this mostly is about, especially with the workload situation.
it is pretty critical, thank you.
>> let me ask a question.
now we have five pathologists in space de -- in a space designed for two.
do we have the ability to add one more pathologist without enlarging space?
>> yes.
we -- we are planning on making accommodations to be able to accommodate an additional pathologist to help bridge the gap, time line wise to hopefully a new office, larger office in the future.
again, we have been making accommodations in the past few years, past five years, with our existing facility, including a major renovation but almost weekly accommodations to manage the increased workload and all the other services and aspects that go with that.
there is going to be a time when we can no longer afford to make more accommodations.
that is, we are bulging at the seams as is.
at some point, something is going to give, and as Commissioner Davis, I believe correctly pointed out, we don't want to get behind the curve on this too much.
we have been trying to accommodate as best we can, and we have, but at some point that's going to run out.
>> so if I put my name accreditation hat on, would I be more concerned about a shortage of pathologists or a shortage of space?
>> those are two very prominent and interrelated questions, concerns.
the pathologist is a big concern.
that's an immediate -- it -- the workload is high enough that's an immediate disqualification for name reaccreditation, but space is required for that extra pathologist to be able to work adequately and space requirements is something that name does take into consideration.
it is not as concrete as 325 autopsy workload.
it is a little more subjective, but it is still part of the name evaluation.
>> did I hear you say that as to the space, name wants a plan.
as to pathologist, they want action?
>> I am not saying a physical plan.
but they want to know, we have had other people who have been in this same, behind the 8 ball scenario before, and if they can say to the accrediting body, we, you know, this is our plan and, you know, in January we were able to pass this bond issue, so in February we are starting construction and kind of have this -- have a plan down abwhat they are doing to emiliate the issue then the accrediting body has been pretty good allowing that to go forward but provisionally, they will put a provisional okay and then they will go back and check, are you doing what you actually said you are doing with this plan.
>> okay.
thanks.
>> I think we need to continue the slides.
>> okay.
so that was the cost projections and t e baseline revenue analysis, baseline scenario.
the documents you have, the data you have for all four scenarios, which were part of the planning exercise.
I won't try to walk through those in detail.
I will tell you in scenario 2, when you look at revenue portion of that, since it is Travis County only, that is one which has a zero line item revenue as part of that.
and I will scroll through the rest of these.
this tries to summarize the notion between the different scenarios that there are a market difference with scenario two, where there is no revenue component of that.
>> go ahead.
>> go on.
>> the discovery is what we have been talking about right here, where the existing facilities operating limit and we are trying to do something to work towards emileirating that and then the population is growing which is impacting staff cases and so on and then the failure to work with that or to do something about this growth is going to impact the accreditation.
>> as we went through the revenue analysis, the fees that are being collected in the indirect costs that are being recovered in providing out of county services is enough revenue that it supports building incrementally larger building, from a 20 million-dollar one to a 27 million-dollar one.
it is our recommendation that if scenario -- which would be of the most benefit, would be the one where you continue on a path where you are providing service to the countieses as you are other counties as you are today.
and there is a component to that which I think is important to recognize.
and that's that the autopsies that are being provided for the -- for other counties, as you proceed with the project, there is some possibility that one of the counties may build their own facility, may choose to take some other course, so we started to look at different impacts that would have on the feasibility of the incrementally larger building, from the 20-27 million-dollar building, and the first one is taking a look at the sort of recoupment of that incremental investment cost and this is assuming there is no attrition, that all of the counties using Travis County medical examiner officer for their service will continue using them, and it also is based on the projected service fees per autopsy.
the bottom shaded area is the retirement o.
incremental debt -- the retirement of the incremental debt of the financing cost of the $7 million, and then the area above that is sort of the benefit to Travis County from the revenues being collected on the indirect costs that are part of the autopsy fee.
so that's what -- that's 100% participation, looked at that and said, well, if -- well, the out of county autopsies were reduced, whereas only 75% participation, what is the impact of that.
it still is one which retired the incremental debt from the revenue being collected.
also looking at that, 60% participation level and it still looked like it was working out well, so sort of from a sensitivity analysis of moving for ward with a decision to build a larger building, it seems that there are scenarios from attrition from countieses using the Travis County medical examiner today, that it still is a good deal for the county to proceed with the larger building.
and then I didn't realize there is one more and then the final one of 50% participation.
>> [one moment, please, for change in captioners] yes, there are other states that do this, but every state has such a different way at which they approach this, it's hard to compare apples to apples.
>> so in small areas that cannot afford a medical examiner's office and sufficient pathologists, I mean what do they do if they don't contract with an urban --
>> it would depend if they even have the regulation.
the state a may not have the regulation that it needs to be investigated, depending on that state.
>> okay.
>> but that's what that first that we discussed set forth in the state of Texas.
>> my final question today is do we still charge for Travis County autopsies requested by families or insurance companies and I guess those would be cases in which the death did not occur in suspicious circumstances that would trigger the law, right?
>> right.
we do not currently perform any autopsies in which the death does not fall under our jurisdiction as a medical examiner office.
>> that's down to zero.
>> excuse me?
>> that's down to zero, by choice.
>> right.
>> I guess that's good news.
I didn't know that.
because we used to do a few, right?
>> yes, in the past before I became the chief medical examiner, they would occasionally perform autopsies on private contractual basis when families desire it.
>> okay.
>> but currently we're just doing the ones that are required by law for us to investigate.
>> thank you, doctor.
>> thank you.
>> Commissioner Huber.
>> I just have one question.
given the fact that we're pretty close to out of space and that the population and workload growth are what we see here and that we've yet to lock on a scenario, we really looked at how long one set scenario isni selected, it would take to get a facility in place, constructed, designed.
I'm a little concerned about our timing with this.
>> yeah, let me, if I can, briefly go over that.
there's several things that have to initially take place before we actually get to the design, and I'm hopeful that we can actually by the time that we get to the end of April when I need to turn in a budget, that we have a better grasp on which scenario we might be leaning toward.
and so what I've got to do between now and then is work with the office, work with all of our outside counties.
we've already sent a letter to them telling them about this presentation, telling them about what it is that we're looking at as far as the need for future growth.
and so I will be then following that up with a phone call and trying to set up meetings with them to discuss this particular report.
that input that I get back will then be valuable to us because we kind of get to see also where are they and where are they looking at as far as their future.
and even though you see that there are 42 outside counties, you'll see if you look at the numbers a lot of those counties have very few autopsies, but as the judge just mentioned, the way the state of Texas is set up, those smaller entities actually look toward us as well as they do other medical examiner's office around the state because they can't afford to build their own and hire their own pathologists.
so there is a need to make sure we don't neglect or throw away folks that really need our help.
but at the same time we don't want to build a facility that is oversized and all of a sudden we do not have the participants.
so that's very important that we have those meetings.
the other thing we need to do is also look at the fee, as I mentioned to Commissioner Davis awhile ago, and that is where are we now in regards to fee because that also has impact on the number of autopsies per pathologist.
because we have shown if we increase a fee, then we have a tendency to dip in the number of cases based on the increase of the fee.
so we'll be reviewing this information and coming back to court and that will be done rather quickly as to whether or not we need to increase our fee.
as I mentioned, it has not been raised since 2008.
so we have the fee analysis, we have the talking with the outside folks.
I'll be working with facilities in regards to -- and also with p.b.o.
in regards to submitting as our next step a design phase, once we come back to court and discuss the scenario.
one other thing that I need to mention though with the scenario is we've got to get back to the site selection because as was mentioned by lou and susan, that is not mentioned here in this report.
and if you remember, if you go back, we went through a long process, even went and got a broker where we looked at county owned property, noncounty owned property and came up with analysis there and came up with recommendations and we prioritized those.
and so that's another thing I need to do is come back to the court and we need to revisit that to see if you want that updated and also decide because it's also important before you ever want to design something where are you going to put it.
the other thing that's also mixed in with this which we're delighted is mix understand is the potential for a medical school here in this area and that's recently been given by senator watson and his plan.
in fact, it was in the paper I believe this morning.
and the judge actually sits on that committee.
so we don't want to come across as if we're just going to do our own thing when we also, as I think the doctor will tell you, it's really beneficial for our community to have the medical examiner's office connected to a medical school.
and so we want to also make sure that we're working with that process as well.
but Commissioner Huber, you just hit on it.
we can't wait.
that's why we're doing this, conducted this study is we have got to March along.
and leslie, you are here, I don't know if -- I think we first have to do the design phase which would be next year, and then we would actually then -- what would your projection be, three years, five years before we could actually build something?
this is leslie strickland.
I'm going to have to have her come up here.
>> thank you, danny.
actually I would pass this back to crime lab design who has experienced advising other Texas urban counties and elsewhere in the country on designing and building similar size facilities because this is a very specialized type of building.
it takes more time to design and to build it.
so back to you.
>> sure.
well, I would expect at least in sort of general terms the design phase of this would be about a year in duration.
there would be sometime for the contracting portion of that and then there would be about a two-year time frame to construct the building.
>> and you are assuming a design bid build scenario?
>> yeah, it would be a conventional delivery process.
>> but I guess what dan is suggesting is that you will bring back to the court the -- after you have done your due diligence and checked with everybody you possibly can check with and come forth with some recommendation so we know exactly where we are, how to get there and when to get there.
so those are the things I'm hearing here and now and then how you also interface that into the medical arena even under watson and stuff like -- senator watson.
and judge I guess was sitting on that committee.
but I just want to make sure all the is are crossed and ts are crossed and it appears there is a lot of work to do.
dan, you mentioned April coming back with the first phase of that but that doesn't mean other stuff can't be looked at.
>> there is another scenario, in fact, we almost came forward with it during the budget hearings, and that is we may need to look at a sixth pathologist.
if we continue to grow and if we continue to increase our caseload, then there is the potential that we might need to come and ask that we add a doctor to the medical examiner's office sooner than later.
>> in the meantime.
okay.
>> but that's a lot more doable than the facility itself.
>> yes, sir.
>> I should add to the mix that at the meeting yesterday of the medical school committee, I guess is what we're called, I asked the question what rough timetable are we on.
and the answer was none.
the intention is to let the process unfold.
and so that doesn't bode well for us, not looking at the numbers that we are, but it would be easy to add a pathologist, a whole lot easier than to build a new facility.
the other thing is that we're on city of Austin property and they asked us to return that property three years or so ago.
and in a weak moment I said we would.
>> [laughter] so they have been reminding me of that kind of periodically.
we've got to deal with that issue too.
now, the mayor is part of that committee and he was hitting to my right yesterday -- sitting to my right yesterday so he heard the same thing.
at some point in our planning we've got to factor that in.
>> but at least they know that you brought up the issue of the medical examiner issue, you know, along with the medical school so it's not going to be a surprise to anybody when we say that we're -- we've got to think about that as well.
>> it would be a critical piece.
we've got to construct one nay and we've got to pay for it.
and it could be a learning opportunity for the medical school.
and it looks like in urban areas a lot of the forensic centers are in medical schools.
which is important.
we thank you all so much for doing this analysis for us and we have your contact information, right, danny?
>> yes, sir.
>> just in case we need to contact you further.
>> if you need more precipitation, let me know.
>> anything wet we appreciate.
>> [laughter]
>> thank you all.
thank you very much for a good presentation.
>> now, there's an executive session item regarding parking mobility, number 25.
we have some residents who would like to address us on this issue in open court and so I told them that we would call it up pretty close to 11:00.
what I would like to do is for us to take their comments at this time and then we would be ready to go into executive session fairly soon anyway, but whether it's this morning or this afternoon, we would be able to take our time in executive session.
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.
