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CITY OF AUSTIN CITY COUNCIL WORK SESSION.UH, IT IS TUESDAY, APRIL 11TH, 2023, AND IT IS 10 21.
UH, A FULL COUNCIL IS PRESENT.
[E. Executive Session]
WE ARE GOING TO GO INTO EXECUTIVE SESSION, UH, A CLOSED SESSION TO TAKE UP FOUR ITEMS PURSUANT TO SECTION 5 5174 OF THE GOVERNMENT CODE.THE CITY COUNCIL WILL DISCUSS THE FOLLOWING PERSONNEL MATTERS, E ONE, EVALUATE THE PERFORMANCE OF AND CONSIDER COMPENSATION AND BENEFITS FOR THE CITY CLERK.
E TWO, EVALUATE THE PERFORMANCE OF AND CONSIDER COMPENSATION AND BENEFITS FOR THE CITY AUDITOR.
E THREE, EVALUATE THE PERFORMANCE OF AND CONSIDER COMPENSATION AND BENEFITS FOR THE MUNI, THE MUNICIPAL COURT CLERK.
ALSO, PURSUANT TO SECTION 5 5171 OF THE GOVERNMENT CODE, THE CITY COUNCIL WILL DISCUSS LEGAL ISSUES RELATED TO ITEM E FOUR, CITY OF AUSTIN 2023, LABOR CONTRACT NEGOTIATIONS.
IS THERE ANY OBJECTION TO GOING INTO EXEC EXECUTIVE SESSION ON THE ITEMS ANNOUNCED? HEARING NONE, THE COUNCIL WILL NOW GO INTO EXECUTIVE SESSION.
IN CLOSED SESSION, WE DISCUSS PERSONNEL MATTERS RELATED TO ITEMS E ONE, E TWO, AND E THREE, AND LEGAL ISSUES RELATED TO ITEM E FOUR.
SO WE ARE RECONVENING THE WORK SESSION OF THE AUSTIN CITY COUNCIL.
[B1. Update on the operations of the Sobering Center.]
THE FIRST OF TWO BRIEFINGS.THE FIRST ONE'S GOING TO BE THE UPDATE ON THE OPERATIONS OF THE SOBERING CENTER, HONORABLE CITY COUNCIL.
I AM THE CURRENT CHAIR OF OUR AUSTIN TRAVIS COUNTY SOBERING CENTER.
UM, I AM SO HAPPY TO BE STANDING HERE WITH YOU TODAY TO PROVIDE YOU WITH AN UPDATE.
WE ARE ENTERING INTO OUR FIFTH YEAR.
WE ARE IN OUR FIFTH YEAR OF OPERATIONS.
AND, UM, WE WANTED TO, ACCORDING TO OUR I L A, COME BY AND BRIEF YOU ALL ABOUT, UH, HOW THINGS ARE GOING AND, UH, ALSO WHERE WE'RE HEADED IN THE FUTURE.
UM, OVER THIS FIVE YEAR PERIOD THAT WE'VE BEEN IN OPERATIONS, WE HAVE SERVED ALMOST 8,000 PEOPLE SAVING VALUABLE RESOURCES FROM OUR POLICE AND EMS SYSTEMS. UH, TODAY I'M HERE WITH OUR EXECUTIVE DIRECTOR, LAURA ELMORE.
UH, WE WOULD LIKE TO, UH, PRESENT YOU AGAIN WITH SOME INFORMATION ON WHERE WE'RE AT, UH, AS OUR I L A CALLS FOR, AND ALSO TO LET YOU ALL KNOW THAT VERY SOON IN THE NEAR FUTURE, WE WILL BE COMING TO YOU TO AGAIN RENEW OUR INTER INTERLOCAL AGREEMENT.
SO WITH THAT, I'LL TURN IT OVER TO LAURA.
THANK YOU ALL FOR YOUR TIME AND CONTINUED SUPPORT.
SO, JUST, UM, I WANTED TO EDUCATE YOU GUYS A LITTLE BIT ABOUT THE, UM, AUSTIN, TRAVIS COUNTY SOBERING CENTER.
FOR THOSE OF YOU WHO ARE NEW TO THE COUNCIL AND HAVEN'T BEEN TO THE CENTER, UM, IT IS OUR MISSION TO ENHANCE PUBLIC HEALTH AND SAFETY BY PROVIDING A SAFE PLACE FOR PEOPLE WHO ARE PUBLICLY INTOXICATED TO SOBER UP AS AN ALTERNATIVE TO EMERGENCY ROOM OR JAIL, AND WHERE APPROPRIATE TO PROVIDE A BRIDGE TO RECOVERY.
LIKE JANICE SAID, WE'VE UM, DONE OVER 8,000 INTAKES SINCE OUR INCEPTION ABOUT FIVE YEARS AGO, AND IT'S, UM, PART OF OUR AGREEMENT THAT WE UPDATE THE CITY COUNCIL AND THE COMMISSIONER'S COURT AS TO OUR PROGRESS AND KIND OF OUR NEXT STEPS AT THE SOBERING CENTER, THERE'S A LITTLE PICTURE OF KIND OF WHAT ONE OF THE DORMS LOOKS LIKE.
UM, THE INDIVIDUALS WHO COME TO US DO NOT, UM, GO TO JAIL OR THE ER, THERE ARE NO CITATIONS OR FINES OR MEDICAL BILLS.
THERE'S NO COST TO THE CLIENTS.
UM, WE ARE ONE OF THE ONLY PLACES THAT IS OPEN 24 7.
WE HAVE COMPLETE CONFIDENTIALITY.
WE'RE A HIPAA PROTECTED FACILITY, UM, AND WE CONNECT PEOPLE WITH COMMUNITY RESOURCES AND SERVICES AS APPROPRIATE BASED ON AN ASSESSMENT WHEN THEY'RE DISCHARGING FROM OUR FACILITY.
WE CAN ALSO ASSIST AN ASSIST WITH COORDINATING TRANSPORTATION HOME.
WE HAVE A VAN AND, UM, AND ALSO CAN JUST KIND OF HELP PEOPLE FIND A SAFE RIDE.
OUR ADMISSION CRITERIA, WE DON'T SERVE ANYONE UNDER 18.
UM, THE PERSON HAS TO BE SUSPECTED OF ALCOHOL OR DRUG INTOXICATION OR IN AN ACTIVE WITHDRAWAL PERIOD AND NOT HAVE ANY KIND OF OBVIOUS MEDICAL ISSUE THAT WOULD REQUIRE IMMEDIATE ATTENTION FROM A DOCTOR.
SO, UM, SEIZURES, POTENTIALLY, UM, INJURIES AND THINGS LIKE THAT FROM POTENTIAL ASSAULTS OR OTHER MEDICAL PROBLEMS THAT MIGHT COME WITH CHRONIC INTOXICATION.
WE HAVE, UH, ADAPTED OUR ADMISSION CRITERIA A LITTLE BIT AROUND MENTAL HEALTH.
UM, WE SEE A LOT OF DUAL DIAGNOSIS CLIENTS, SO WE SEE A LOT OF PEOPLE WHO COME IN THAT ARE INTOXICATED, BUT THAT ALSO HAVE SOME KIND OF MENTAL HEALTH ISSUE.
SO, UM, WE WILL TAKE PEOPLE WHO HA ARE EXPRESSING SOME KIND OF SUICIDAL OR HOMICIDAL IDEATION, BUT THEY'LL HAVE TO BE CLEARED FIRST BY A MENTAL HEALTH PROFESSIONAL.
SO THAT MIGHT BE INTEGRAL CARE.
UM, WE HAVE TELEHEALTH CAPACITY FOR THAT, OR IT MIGHT BE SENDING THEM
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OVER TO DEL SETON TO BE CLEARED BY A PSYCHIATRIST.UM, WE HAVE A GREAT PARTNERSHIP WITH DEL SETON, SO THERE ARE OFTENTIMES WE'LL BE, UH, CLEARING SOMEONE AND THEN RETURNING THEM BACK TO US TO SOBER UP SAFELY OUTSIDE OF THE HOSPITAL.
SO THE CLIENT IS REFERRED OR TRANSPORTED TO US, TYPICALLY BY LAW ENFORCEMENT OR E M S.
UM, THAT'S BEEN, WHEN WE FIRST OPENED, THOSE WERE OUR ONLY REFERRAL SOURCES WAS YOU HAD TO COME TO THE SOBERING CENTER IN A SIREN VEHICLE.
UM, WE HAVE NOW ADDED IN THE, SINCE I'VE BEEN THERE IN ABOUT TWO AND A HALF YEARS, ABOUT 60 OTHER REFERRAL PARTNERS, AND I'M GONNA TALK ABOUT THAT A LITTLE BIT MORE LATER.
UM, BUT OUR INTAKE MEDICS, WHEN SOMEONE COMES IN, DOES A SCREENING TO MAKE SURE IT'S SAFE FOR THAT CLIENT TO BE IN OUR FACILITY.
THEN OUR RECOVERY SUPPORT SPECIALISTS WILL MONITOR THE PATIENT AND CONTINUE TO ASSESS THEIR NEEDS, MAKE SURE THEY'RE SAFE, AND THEN OUR EXPERT COUNSELORS WILL CONDUCT AN ASSESSMENT AND AT THAT POINT DETERMINE KIND OF, IS THIS THIS A ONE-TIME THING OR IS THIS MORE OF A CHRONIC ISSUE? EITHER WAY THAT CLIENT GETS SOME KIND OF INTERVENTION.
MAYBE IT'S JUST EDUCATION ABOUT BINGE DRINKING AND SAFETY AND PUBLIC HEALTH, AND MAYBE IT IS A MORE LONG-TERM ACCESS TO TREATMENT.
SO, AS JANICE SAID, WE WERE FOUNDED IN 2018.
OUR INTERLOCAL AGREEMENT IS BETWEEN THE CITY AND THE COUNTY.
THE CITY IS FUNDING THE OPERATIONS OF THE SOBERING CENTER, AND THAT'S THROUGH A CONTRACT WITH AUSTIN PUBLIC HEALTH.
THE COUNTY IS DONATING THE FACILITY, WHICH IS THE OLD MEDICAL EXAMINER'S OFFICE ON 12TH AND SABINE.
SO THE COUNTY IS TAKING ON ALL THE COSTS FOR THE FACILITY.
AUSTIN PUBLIC HEALTH IS PAYING OUR OPERATIONS.
THIS, UM, AGREEMENT IS GOING TO EXPIRE IN SEPTEMBER OF 2023, WHICH IS WHY WE'RE HERE TODAY TO KIND OF UPDATE YOU ON THE OPERATIONS AND LET YOU KNOW WHAT WE'VE BEEN DOING, HOW IT STARTED, HOW IT'S GOING, WHERE WE'RE HEADED.
SO, LIKE I SAID, WHEN WE FIRST OPENED, IT WAS, UM, WE OPENED IN A KIND OF A CAREFUL WAY BECAUSE WE DIDN'T WANT TO, UM, OVERDO IT.
AND WE KNEW THAT THERE WAS SOME KIND OF OPPOSITION TO STARTING THE SOBERING CENTER, AND WE WANTED TO DO IT VERY SAFELY, AND WE DIDN'T WANT ANYBODY TO BE CONCERNED ABOUT IT, ESPECIALLY THE NEIGHBORHOOD AROUND.
SO IT WAS ONLY LAW ENFORCEMENT AND THEN ONLY LAW ENFORCEMENT AND EMS. IT WAS ONLY ALCOHOL AT FIRST, AND THEN IT WAS ALCOHOL AND OTHER DRUGS.
SO NOW WE'RE TAKING ANYBODY ON ANY SUBSTANCE FROM LAW ENFORCEMENT OR EMS CAN BRING TO US.
WE ALSO TAKE REFERRALS DIRECTLY FROM THE HOSPITALS, FROM EMERGENCY ROOMS. AND THEN WE HAVE A LIST, LIKE I SAID, OF OTHER REFERRAL PARTNERS.
WHEN I CAME TO THE SOBERING CENTER IN JUNE OF 2020, THAT WAS THE MOST COMMON QUESTION I WAS ASKED WAS, HOW DO YOU GET TO THE SOBERING CENTER? AND AT THE AN, THE ANSWER AT THE TIME WAS, WELL, YOU HAVE TO BASICALLY CALL 9 1 1, LIKE YOU HAVE TO BE TRANSPORTED BY SOME VEHICLE WITH A SIREN.
AND, UM, AT THE TIME, IT JUST SEEMED LIKE THAT SHOULDN'T BE THE ONLY PATH IN.
AND SO WHAT WE STARTED DOING WAS STRATEGICALLY ADDING REFERRAL PARTNERS.
SO THERE'S NO WALKUPS TO THE SOBERING CENTER, BUT THERE ARE PHONE CALLS MADE BY OTHER ENTITIES.
SO SAY INTEGRAL CARE IS A REFERRAL PARTNER, CAPITAL METRO IS NOW A REFERRAL PARTNER.
THE UNIVERSITY OF TEXAS IS A REFERRAL PARTNER.
UM, SAFE ALLIANCE, LIFEWORKS, OTHER COMMUNITY ENTITIES CAN CALL US AND SAY, WE HAVE SOMEONE HERE'S TOO INTOXICATED, FOR INSTANCE, TO CONSENT TO A RAPE EXAM, TO INTOXICATED FOR US TO REALLY PLACE THEM INTO A PROGRAM OR A SHELTER.
AND THEN WE CAN SORT OF SAFELY SOBER THEM UP AND RETURN THEM TO THAT PARTNER IN ORDER TO CONTINUE THEIR CONTINUUM OF CARE.
WE, UM, THIS IS, THIS IS A BIG BUSINESS MODEL CHANGE THAT WE MADE STARTING IN 2020, UM, AND KEEPS GOING.
WE ALSO WILL DO HOLDOVERS FOR TREATMENT CENTERS OR SOBER HOMES.
SO PLACES WHERE MAYBE PEOPLE ARE GOING TO TREATMENT FOR ACTIVE ADDICTION AND THEY HAVE MAYBE RELAPSED OR FALLEN OFF THAT TREATMENT CENTER, OR THAT SOBER HOUSE MAY SAY, WELL, THIS PERSON HAS BROKEN THE RULES OF OUR PLACE.
THEY CAN'T STAY HERE, BUT WE DON'T WANNA KICK THEM OUT TO THE STREET, WHICH IS KIND OF WHAT WAS HAPPENING BEFORE.
AND SO WE OFFERED THOSE PARTNERS A SAFE PLACE FOR THEM TO COME AND STAY WITH US FOR 24 TO 48 HOURS, AND THEN WE RETURNED THEM BACK TO TREATMENT.
SO, UM, THE OTHER BIG CHANGE WE MADE TO OUR BUSINESS MODEL WAS THAT PATIENTS, LIKE I, I SAID, ARE ABLE TO KIND OF HOLD OVER FOR SERVICES.
THIS WAS SOMETHING THAT HAPPENED IN THE SUMMER OF 2020.
UM, WE HAD A PATIENT WHO WAS PICKED UP BY EMS 75 TIMES IN 135 DAYS, WHICH IS ABOUT EVERY OTHER DAY, THE WHOLE SUMMER.
AND AFTER WE SAW HIM ABOUT A DOZEN TIMES, WAS, UH, WE FINALLY CONVINCED HIM TO TALK TO US.
AS YOU CAN IMAGINE, SOME OF THESE INDIVIDUALS WHO ARE CHRONICALLY INTOXICATED, CHRONICALLY ILL, AND LIVING ON THE STREET FOR AS LONG AS THEY HAVE, THERE'S A LOT OF TRUST BUILDING THAT HAS TO HAPPEN FIRST.
SO WE IN ENDED UP INTERACTING WITH HIM ENOUGH TIMES WHERE HE FINALLY AGREED TO GO TO TREATMENT.
BUT THERE IS NO SUCH THING AS GOING TO A MEDICAL DETOX FOR ALCOHOL ON A SUNDAY MORNING AT 8:00 AM IF YOU DON'T HAVE INSURANCE OR IF YOU'RE HOMELESS.
AND THE ONLY OPTION REALLY WAS FOR HIM TO GO BACK ON THE STREET AND DRINK, OR PRETTY MUCH DIE ON THE STREET.
YOU CAN DIE FROM ALCOHOL WITHDRAWAL.
YOU CANNOT DIE FROM, SAY, CRACK WITHDRAWAL.
SO WE DECIDED TO HOLD HIM AS LONG AS POSSIBLE UNTIL WE GOT HIM INTO TREATMENT.
THAT ENDED UP BEING ABOUT FIVE DAYS.
THE SOBERING CENTER IS NOT DESIGNED FOR THAT.
IT'S NOT A RESIDENTIAL FACILITY.
WE DON'T HAVE A KITCHEN, UM, BUT WE DO HAVE FROZEN DINNERS AND BOTTLED WATER AND SHOWERS
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DECIDED THAT ETHICALLY, MORALLY, IT WAS THE RIGHT THING TO DO TO JUST HANG ON TO HIM UNTIL WE COULD GET HIM A BED, WHICH WE DID.AND THAT WENT SO WELL THAT WE KEPT DOING IT, AND WE WROTE IT INTO OUR AUSTIN PUBLIC HEALTH CONTRACT AS A PILOT.
AND THEN IT BECAME A CON, A CONTINUOUS PART OF OUR SERVICE.
SO IT IS NOW KIND OF THE JUUL IN OUR CROWN.
WE ARE CALLING IT OUR HOLDOVER PROGRAM.
UM, IF WE CAN GET SOMEONE TO STAY, THEN WE CAN GET THEM INTO TREATMENT ABOUT 95% OF THE TIME.
UH, IT'S NOT EASY, BUT IT DOES HAPPEN.
SO WE, UM, SO I'VE STARTED TO THINK OF OURSELVES KIND OF LIKE PUTTY IN THE CRACKS OF A BROKEN SYSTEM.
THERE'S NOT EASILY ACCESSIBLE SUBSTANCE USE TREATMENT.
UM, SO WE'RE, WE'RE REALLY JUST KIND OF TRYING TO MAKE IT WORK WITH WHAT WE HAVE WHEN WE HAVE PATIENTS WHO WILL STAY LONG ENOUGH TO TRUST US AND TALK TO US, AND THEN WE GET THEM INTO LONGER TERM SERVICES.
THIS IS A, A SNAPSHOT FROM FY 22.
SO IN FY 22, WHICH IS OUR LAST FISCAL YEAR, THAT'S COMPLETE WITH ALL THE DATA.
WE SERVED 2032 PEOPLE IN INTAKE.
WE ADMITTED 93% OF THOSE PEOPLE.
SO WE HAVE A VERY SMALL, UM, NUMBER THAT WE ACTUALLY DON'T ADMIT.
THE ONLY REASON WE WOULD NOT ADMIT THEM IS IF THEY WERE VIOLENT IN INTAKE OR IF THEY HAD A MEDICAL PROBLEM THAT WAS BIGGER THAN WE COULD HANDLE.
SO, UM, WE DID A TOTAL, UH, DIVERSIONS FROM JAIL WAS ABOUT ALMOST 1800 PEOPLE.
SO ABOUT 88% OF THOSE THAT COULD HAVE GONE TO ER JAIL CAME TO US.
OUR SUCCESSFUL DISCHARGES ARE ABOUT 51% OF THOSE THAT WE ADMITTED.
THE NUMBER OF INTAKES IS BIG, AND THEN THE NUMBER ADMITTED, AND THEN THE NUMBER SUCCESSFULLY DISCHARGING, SUCCESSFULLY DISCHARGING.
WE COUNT THAT NUMBER VERY CONSERVATIVELY.
UM, LOTS OF PEOPLE WILL LEAVE AND WE WON'T COUNT THEM AS A SUCCESSFUL DISCHARGE, BUT THEY WILL LEAVE PRETTY MUCH SOBER AND NOT AT RISK TO THEMSELVES OR OTHERS, BUT WE COUNT AS SUCCESSFUL DISCHARGES, LIKE THEY ACTUALLY SAT THROUGH A CONVERSATION WITH A COUNSELOR AND ASSESSMENT AND THE WHOLE PROCESS.
NOT EVERYBODY IS WILLING TO DO THAT.
UM, AND WE'RE ABSOLUTELY NOT DETAINING FOLKS.
SO, UM, WE THINK IT'S PRETTY GOOD THAT ABOUT HALF OF THEM WILL GO THROUGH THAT FINAL PROCESS WITH US.
THE, THE HOLDOVER PROGRAM I MENTIONED THERE WERE ABOUT 144 PEOPLE THAT STAYED IN THAT PROGRAM, AND 96% OF THEM, WE DID A WARM HANDOFF TO TREATMENT.
SO THAT MEANS WE PUT THEM IN OUR VAN AND DROVE THEM DIRECTLY TO THE DOOR OF THE TREATMENT PROVIDER, THE SOBER HOUSE, THE OUTPATIENT CLINIC, WHEREVER WAS THEIR LEVEL OF CARE THAT WAS NEEDED.
UM, SO LIKE I SAID, IT'S A, A FUNNEL.
THE NUMBER THAT WE'RE AT, AT, YOU KNOW, INTAKING IS 2000.
THE NUMBER THAT ACTUALLY IS SEEKING TREATMENT IS ABOUT 144 OUT OF THOSE.
AT LEAST THAT'S READY AT THAT PARTICULAR TIME.
AND IF THAT'S THE CASE AND THEY'RE WILLING TO STAY, THEN WE'RE ABLE TO CONNECT THEM TO CARE.
WE DID, UH, 80 HOLDS FOR REFERRAL PARTNERS.
AND THAT MEANS WHAT I SAID EARLIER ABOUT TREATMENT CENTERS OR SOBER HOUSES OR PLACES WHERE PEOPLE HAVE RELAPSED AND THEY NEED A BREAK, THEY NEED TO BE KICKED OUT OF THAT PROGRAM, SO TO SPEAK, BUT DON'T HAVE ANYWHERE ELSE TO GO.
WE HOLD THEM, SOBER THEM UP, RETURN THEM.
80% OF THOSE WENT BACK TO THEIR ORIGINAL CARE RATHER THAN BEING KIND OF KICKED OUT ONTO THE STREET.
SO WHAT WE HAVE DONE, AND THIS IS KIND OF HOT OFF THE PRESSES, SO, UM, Y'ALL CAN, UM, I WILL BE DOING MY BEST TO GO THROUGH THIS WITH ACCURACY.
HERE WE ARE IN THE MIDDLE OF A HUGE OUTCOMES EVALUATION AND WITH AN EQUITY LENS AND A COST BENEFIT ANALYSIS.
SO WHAT I'VE BROUGHT YOU IS KIND OF THE HEADLINES OF WHAT WE KNOW SO FAR SO THAT YOU CAN KIND OF SEE WHAT YOUR INVESTMENT IS PRODUCING ON THE OTHER SIDE.
SO THIS IS A LITTLE BUSY, BUT WHAT YOU'LL SEE HERE IS SOME, SOME OF THE DIRECT COSTS AND THEN WHAT THE, WHAT IT IS PER DIVERSION.
SO THE DIRECT COSTS S SC AT THE TOP NUMBER ARE COSTS BY THE SOBERING CENTER.
WHAT THAT REALLY IS IS COST BORN BY AUSTIN PUBLIC HEALTH.
SO THAT IS THE CITY'S INVESTMENT INTO THE DIRECT PROGRAMMING OF THE SOBERING CENTER.
IT'S NOT THE TOTAL CITY'S INVESTMENT AT THE VERY BOTTOM, IT'LL SAY THAT COST BENEFIT ANALYSIS INCLUDES ONLY DIRECT PROGRAM COSTS.
THE FULL BUDGET IS 2.2 MILLION FOR THE SOBERING CENTER.
WHAT WE DID WAS WE, UH, THE RESEARCHER LOOKED AT OUR AUDITED FINANCIALS.
IT TOOK OUT ALL, ALL EXPENSES FOR LIKE FUNDRAISING, MANAGEMENT, MANAGING OF THE BOARD, ANY KIND OF LIKE ADMINISTRATIVE COSTS, AND TOOK THAT OUT AND LOOKED JUST AT THE PROGRAM COSTS.
SO WHAT'S ACTUALLY HAPPENING ON THE FLOOR WITH, WITH THE CLIENTS.
THEN YOU HAVE THE DIRECT COSTS BORN BY THE COUNTY, AND THAT'S, UM, BASICALLY FOREGONE RENT.
SO THEY'RE DONATING THE BUILDING AND THIS IS AN ESTIMATE OF WHAT THEY COULD BE MAKING ON THAT BUILDING IF WE WEREN'T USING IT.
AND THEN YOU HAVE DIRECT COSTS FROM EMS FOR TRANSPORT.
UM, EMS, EMS REFERRING TO US IS SOMETHING THAT IS VERY, VERY RARE.
THE ENTIRE COUNTRY ASKS ME ABOUT THIS EVERY TIME I SPEAK NATIONALLY ON THIS ISSUE.
PEOPLE SAY, HOW DID YOU GET EMS TO REFER TO YOU? THEY CAN'T GET EMS TO REFER TO SOBERING CENTERS ALL OVER THE COUNTRY BECAUSE OF A COST REIMBURSEMENT ISSUE, CUZ EMS DOESN'T GET PAID UNLESS THEY TAKE SOMEONE TO A HOSPITAL.
AUSTIN, TRAVIS COUNTY EMS TAKES PEOPLE TO US AND JUST ABSORBS THE COST.
THEY USED TO HAVE IT SOMEHOW GRANT FUNDED, AND I'M NOT SURE HOW THEY ARE DOING IT NOW, NOW, BUT THEY ARE DOING IT REGULARLY.
SO THERE IS A COST TO THEM, SMALL COST, THERE ARE DIRECT COSTS FOR A P D FOR THE SAME THING TO TRANSPORT, UM, CLIENTS THAT
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TO JAIL THAT WE MAY HAVE TO CALL THEM BACK FOR IF SOMEBODY IS VIOLENT, AGGRESSIVE OR SOMETHING.AND WE CALL A P D BACK TO THE CENTER.
THERE'S A SMALL COST A P D AND THEN INDIRECT COSTS TO EMS ARE, UM, FOREGONE COSTS THAT THEY MIGHT HAVE GOTTEN RATHER THAN TAKING THEM TO A HOSPITAL.
SO EVERYBODY IS HAVING A LITTLE BIT OF COST HERE.
THE BENEFITS THOUGH, ARE PRETTY SUBSTANTIAL.
SO YOU CAN SEE THAT THERE'S ER DIVERSIONS, THERE'S JAIL DIVERSIONS, AND THEN THERE'S A REDUCTION IN FUTURE ER UTILIZATION.
THIS STUFF IS BASED ON LIKE CONSUMER PRICE, INDEX MEDICAL, UM, NUMBERS THAT ARE PUBLISHED IN THE LITERATURE ABOUT WHAT WE THINK THAT DIVERSION SAVES AND, UM, THE NUMBER OF ER DIVERSIONS WE DID AND THE NUMBER OF JAIL DIVERSIONS WE DID.
AND THEN THE NUMBER OF PEOPLE THAT DID OUR DISCHARGE THAT INTERACTED WITH AN EXPERT PROCESS, WHICH STANDS FOR SCREENING OF BRIEF INTERVENTION AND REFERRAL TO TREATMENT.
THE RESEARCH SHOWS THAT YOU WILL IMPACT THEIR FUTURE U ER UTILIZATION AS WELL.
AND SO WHAT WE'RE SEEING HERE IS A BENEFIT OF LIKE 2.3 MILLION.
SO WHAT YOU SEE REALLY IS A COST RATIO BENEFIT HERE OF 1.4.
SO WHAT THAT MEANS IS FOR EVERY DOLLAR YOU'RE PUTTING INTO THE SOBERING CENTER, YOU'RE GETTING BACK A DOLLAR 40 IN THE COMMUNITY.
AND THEN THIS IS ACCRUAL BY PARTIES.
SO YOU CAN SEE THAT MOST OF THE, MOST OF THE COSTS IS GOING TO BE BORN BY THE SOBERING CENTER, WHICH IS REALLY BORN BY AUSTIN PUBLIC HEALTH.
UM, BUT MOST OF THE BENEFIT IS ACTUALLY SEEN ON THE SIDE OF THE HOSPITAL.
THAT'S, THEY'VE GOT A 90% BENEFIT THERE.
SO WHAT THAT MEANS IS THAT WE'RE SAVING THE HOSPITALS A LOT OF MONEY BY TAKING FOLKS OUT OF THEIR ER THAT ARE JUST WAITING TO SOBER UP.
SO, UM, THIS IS A REALLY IMPORTANT DATA FOR US, I THINK, TO LOOK AT TALKING TO HOSPITALS ABOUT POTENTIALLY SUPPORTING THE SOBERING CENTER AND, AND DIVERSIFYING REVENUE IN THAT WAY SO THAT THE CITY ISN'T COMPLETELY RESPONSIBLE FOR THE OPERATIONS.
UM, BUT YOU CAN SEE THAT THE COSTS ARE PRETTY LOW FOR TRAVIS COUNTY, UM, AND FOR THE EMS AND THE PD, BUT THE BENEFITS ARE STILL THERE.
OTHER BENEFITS THAT ARE DIFFICULT TO QUANTIFY AND THEREFORE NOT REALLY ABLE TO BE INCLUDED IN THIS ARE THE INDIVIDUAL BENEFITS THAT YOU CAN IMAGINE FOR THE PEOPLE, THE PATIENTS FOR NOT GOING TO JAIL OR THE HOSPITAL IN TERMS OF AVOIDING A RECORD, AVOIDING SIGNIFICANT COSTS, UM, AND KIND OF CARNAGE IN RELATIONSHIPS AND, AND EMPLOYMENT, AND THEN LONG-TERM BENEFITS TO THE SYSTEM AND INDIVIDUALS RELATED TO THE ORGANIZATION'S ROLE IN CONNECTING PEOPLE TO TREATMENT.
SO WHAT WE KNOW IS THAT IF PEOPLE CAN GO TO LONG-TERM CARE FOR SUBSTANCE USE DISORDER, THEY'RE GOING TO IMPROVE THEIR HEALTH DRASTICALLY.
UM, WE ARE HOPING THAT THERE WILL BE REDUCED CRIME RATES AND GENERALLY REDUCE MORTALITY AS A RESULT OF LONG-TERM CONNECTION TO CARE.
YOU GUYS, UM, MIGHT KNOW THAT WE HAVE SOME, WE HAVE GOT NATIONAL RECOGNITION FOR THIS MODEL.
UM, WE WERE ASKED, MYSELF AND CHIEF CHACON WERE ASKED TO GO TO DC AND PARTICIPATE IN A ROUND TABLE OF FIVE SOBERING CENTER CEOS AND FIVE POLICE CHIEFS AND ARE PART OF A CASE STUDY AND A TOOLKIT THAT'S BEING DEVELOPED BY THE INTERNATIONAL ASSOCIATION OF CHIEFS OF POLICE.
AND THE POINT OF THAT IS TO LOOK AT THE RELATIONSHIP BETWEEN THE POLICE DEPARTMENT AND SOBERING CENTER AND HOW THE POLICE FEEL THAT THIS IS A, A BREAK FOR THEM.
UM, FOR EXAMPLE, IT TAKES MANY HOURS TO BOOK SOMEONE INTO THE COUNTY JAIL.
IT TAKES ABOUT EIGHT MINUTES TO BOOK SOMEONE INTO THE SOBERING CENTER.
SO THERE ARE ALSO AVOIDED COSTS THERE WHEN WE ARE PUTTING FIRST RESPONDERS BACK INTO THEIR ROLE SO THAT THEY CAN DO POLICING ON THE STREET, UM, RATHER THAN MANAGING PUBLIC INTOXICATION CLIENTS.
SO, UM, WE WENT TO DC THIS WAS ABOUT A YEAR AGO, AND, UM, SINCE THEN HAVE BEEN PART OF THEIR RESEARCH, THE INTERNATIONAL ASSOCIATION OF POLICE CHIEFS RESEARCH AND, UM, THEIR TOOLKIT THAT THEY'RE DEVELOPING FOR OTHER CITIES IN ORDER TO DEVELOP SOBERING CENTER MODELS THAT WORK WITH THE POLICE DEPARTMENTS AS WELL AS WE ARE DOING HERE.
UM, THE OTHER PIECE IS THAT WE HAVE REALLY, UM, INVOLVED OURSELVES IN THE NATIONAL SOBERING COLLABORATIVE, WHICH IS A NONPROFIT ORGANIZATION THAT IS MADE UP.
THE BOARD OF DIRECTORS IS MADE UP OF OTHER CEOS OF SOBERING CENTERS ACROSS THE COUNTRY.
AND WE, UM, I'M THE SECRETARY OF THE BOARD, WE'RE WORKING ON DEVELOPING A, UM, SOME BEST PRACTICES AND POTENTIALLY EVEN AN ACCREDITATION FOR SOBERING CENTERS ACROSS THE COUNTRY SO WE CAN KEEP UP A STANDARD OF CARE THAT MATCHES ACROSS THE BOARD.
SO, LIKE I SAID, WE ARE SEEN AS, UM, BEING INNOVATIVE HERE.
WE'RE SEEN AS BEING COLLABORATIVE HERE.
WE'RE SEEN AS A MODEL FOR EXCELLENCE THAT OTHER STATES OFTEN COME AND VISIT THE AUSTIN SOBERING CENTER AS A, A GUIDE FOR THEM STARTING THEIR OWN CENTER.
SO THIS HAS BEEN, UM, REALLY GREAT RECOGNITION.
THIS IS A SNAPSHOT OF OUR STRATEGIC PLAN.
UM, OUR BOARD OF DIRECTORS JUST APPROVED THIS IN DECEMBER.
SO THIS IS OUR FIVE YEAR STRATEGIC PLAN FOR US THAT KIND OF SHOWS WHAT OUR VALUES ARE.
NONE OF THAT IS REALLY NEW, OUR MISSION, BUT OUR GOALS ARE THERE IN THE MIDDLE.
AND WHAT WE'RE WANTING TO REALLY DO IS TO MAXIMIZE THE USE OF THE SOBERING CENTER AS A FIRST LINE RESPONSE TO INTOXICATION.
WHAT WE KNOW ABOUT THAT COST BENEFIT ANALYSIS IS THAT, THAT THOSE DIRECT PROGRAM COSTS ARE JUST KIND OF THE, THE MEAT AND POTATOES OF WHAT WE DO.
THE ADMIN COSTS ARE KIND OF STABLE.
SO LIKE, FOR EXAMPLE, AN ADMIN COST IS LIKE PAYING FOR THAT EVALUATION TO
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BE DONE, RIGHT? OR PAYING ME TO GO OUT AND DO OUTREACH OR TALK TO PEOPLE OR TRY TO WRITE GRANTS AND RAISE MONEY.UM, BUT IF WE COULD, THE, THE MORE PEOPLE WE SERVE, THE MORE THAT COST BENEFIT ANALYSIS IS GONNA GROW BECAUSE WE COULD DO MORE.
THE SOBERING CENTER IS NOT AT CAPACITY THAT WE COULD DO MORE WITH THE BEDS THAT WE HAVE.
WE COULD DO MORE WITH THE SPACE THAT WE HAVE, WHICH IS PROBABLY NOT SOMETHING YOU HEAR VERY OFTEN,
UM, AND THAT'S BECAUSE WE'RE OPEN 24 7 AND WE'RE HOLDING IT OPEN 24 7.
AS YOU CAN IMAGINE, PUBLIC INTOXICATION BECOMES MUCH MORE OF A PROBLEM LIKE SATURDAY AT TWO IN THE MORNING THAN IT DOES ON TUESDAY AT 11:00 AM.
SO I THINK THAT WE COULD BE A LOT MORE CREATIVE WITH WHAT WE'RE DOING WITH THE SOBERING CENTER AS A FIRST LINE RESPONSE TO INTOXICATION.
MAYBE IT'S NOT ALWAYS TRADITIONAL PUBLIC INTOXICATION THE WAY YOU THINK.
MAYBE IT'S ALSO INTERVENING IN DIFFERENT WAYS WITH THE PUBLIC FOR ISSUES OF DRUG USE AND SUBSTANCE USE THAT WE HAVEN'T THOUGHT OF YET.
WE WOULD LIKE TO BE DEVELOPING INTO AN ESSENTIAL HUB FOR A MORE INTEGRATED SYSTEM OF CARE.
UM, WE WOULD LIKE TO BE WORKING WITH CENTRAL HEALTH AND THE COUNTY AND OTHER ENTITIES AROUND TRYING TO GET, BUILD UP THE INFRASTRUCTURE OF TREATMENT IN THIS COMMUNITY BECAUSE IT IS SO DIFFICULT FOR US TO GET PEOPLE INTO DETOXIFICATION AND TO RESIDENTIAL TREATMENT FOR SUBSTANCE USE.
UM, WE, WE JUST DO NOT HAVE THE TREATMENT BEDS HERE.
AND SO THAT HAS BEEN A MAJOR CHALLENGE FOR OUR STAFF AND, UH, WE WOULD LIKE TO BE PART OF THE SOLUTION THERE.
UM, WE WOULD LIKE TO FOSTER A SUSTAINABLE MODEL FOR SERVICE DELIVERY AND ACCESS, RESPONDING TO OUR COMMUNITY NEEDS.
UM, WHAT I THINK IS IMPORTANT ABOUT THAT IS THAT WE WE'RE DOING AN ANNUAL STAKEHOLDER SUMMIT EVERY OCTOBER AND GATHERING OUR, OUR FOLKS TOGETHER THAT ARE REFERRAL PARTNERS, OUR COMMUNITY PARTNERS, TO ASK FOR THEIR FEEDBACK AND DO FOCUS GROUPS ABOUT HOW'S IT GOING, HOW COULD WE DO BETTER? UM, AND WE WANNA EVOLVE AND RESPOND TO THOSE NEEDS.
AND, UM, WE'RE ABLE, WE'RE ALREADY ABLE TO DO THAT AND BRAINSTORMING MORE WAYS TO DO THAT CREATIVELY.
AND THEN, LIKE I SAID, WE WANNA LEAD AS A CENTER OF EXCELLENCE AND INNOVATION BOTH LOCALLY AND NATIONALLY, WHICH WE'RE ALREADY DOING.
HERE'S OUR IMMEDIATE NEXT STEPS AND WHAT WE WANT TO DO.
THIS HAS BEEN A HUGE THING FOR ABOUT A YEAR AND A HALF, IS THAT I'VE BEEN TRYING TO FIGURE OUT A WAY THAT WE COULD STOCK MEDICATIONS AT THE SOBERING CENTER IN ORDER TO STAVE PEOPLE OFF OF THE WITHDRAWAL PROCESS FROM BOTH OPIATES AND ALCOHOL.
THIS IS IN RESPONSE TO THE OPIATE OVERDOSE CRISIS EVERYONE KNOWS ABOUT, BUT ALSO I THINK THAT WAS A HIDDEN CRISIS IS THE ALCOHOL ISSUE IN TRAVIS COUNTY, IN ITS CITY OF AUSTIN, WE HAVE A HUGE BINGE DRINKING COMMUNITY HERE.
UM, WE ALSO HAVE, UH, LOTS OF ALCOHOL RELATED INJURIES AND DEATHS AND ALCOHOL IS SOMETHING YOU CAN DIE FROM, RIGHT? SO WE BRIDGE MEDICATIONS.
WHAT THAT MEANS IS THAT WE WOULD NOT BE NECESSARILY A DETOX CENTER OR A TREATMENT CENTER, BUT THAT WE WOULD HAVE MEDICATIONS ON BOARD IN ORDER TO SLOW DOWN THE PROCESS, STABILIZE PEOPLE, BUT KEEP THEM OUT OF THE HOSPITAL OR THE JAIL WHILE DOING THAT.
IN ORDER TO DO THAT, THERE WAS A WHOLE BUNCH OF STEPS WE NEEDED TO GO THROUGH, UM, IN WHICH INCLUDED GETTING LICENSED BY THE STATE AS A FIRST RESPONDER ORGANIZATION, WHICH WE DID, AND THEN GOING TO THE DEA AND TRYING TO GET APPROVAL TO STOCK MEDS AND INVENTORY MEDS AT THE CENTER.
IT TURNS OUT THROUGH ALL OF THAT, THAT THE DEA AND THE STATE WERE KIND OF CONFUSED ABOUT WHAT WE DO BECAUSE THE SOBERING CENTERS IN TEXAS HAVE NEVER DONE THIS BEFORE.
SO AGAIN, WE'RE TRYING TO INNOVATE, BUT IT BECOMES A LITTLE CHALLENGING WHEN SYSTEMS HAVE NEVER DONE THIS BEFORE.
SO WHAT WE'VE DONE IS KIND OF DECIDED TO FORM A MORE FORMAL RELATIONSHIP WITH THE COMMUNITY HEALTH PARAMEDICS THROUGH EMS BECAUSE THEY'RE ALREADY DOING A LOT OF THIS.
THEY'RE ALREADY INITIATING BUPRENORPHINE AND SUBOXONE IN THE COMMUNITY.
THEY'RE ALREADY BRINGING PATIENTS TO US OUT OF HOMELESS CAMPS THAT WE CAN MONITOR FOR SAFETY AND THEY CAN DO THE MEDICATIONS FOR.
SO WHAT WE'RE WORKING ON IS A PILOT PROJECT WITH EMS AND THE CHIP MEDICS SO THAT THEY WILL BE ABLE TO, ABLE TO BRING US THE MEDICATIONS, DO ALL THE STOCKING AND INVENTORY OF IT.
WE ALREADY SHARE A MEDICAL DIRECTOR.
AND SO THAT WOULD BE A RESOURCE KIND OF, UM, LEVERAGING FOR US.
AND, UM, SO THAT WE WOULD BE ABLE TO, WE HAVE 24 7 PARAMEDICS AND EMTS AS WELL AS COUNSELORS AND TECHS.
ABOUT 70% OF OUR STAFF ARE IN RECOVERY.
SO, UM, WE MAKE A GREAT SAFE PLACE TO INITIATE WITHDRAWAL MEDICATIONS.
SO THAT'S KIND OF A NEXT STEP THAT WE'RE WORKING ON WITH THE CHIEF OF EMS. UM, IN TERMS OF MENTAL HEALTH DIVERSION, I THINK THAT YOU GUYS HAVE PROBABLY HEARD THIS COME UP A FEW TIMES.
I WAS JUST TALKING TO AUSTIN PUBLIC HEALTH ABOUT IT AS WELL.
UM, THE COUNTY COMMISSIONERS ARE REALLY INTERESTED IN MENTAL HEALTH DIVERSION.
THEY'VE APPROACHED THE SOBERING CENTER ABOUT POTENTIALLY BEING A PARTNER IN THAT OR POTENTIALLY PILOTING SOMETHING AT THE SOBERING CENTER AND OR POTENTIALLY BEING PART OF SOME MORE LARGER COLLABORATION IN THE FUTURE AS THEY POTENTIALLY BUILD A NEW DIVERSION CENTER FOR MENTAL HEALTH.
I THINK WHAT'S IMPORTANT FOR YOU ALL TO KNOW ABOUT THAT IS THAT IT IS A LITTLE BIT OF A MYTH THAT WE COULD SEPARATE SUBSTANCE ABUSE FROM MENTAL HEALTH VERY CLEARLY.
UM, OFTENTIMES YOU WILL NEED MANY DAYS TO DIAGNOSE AND ASSESS WHAT IS A SUBSTANCE USE ISSUE, WHAT IS A MENTAL HEALTH ISSUE.
UM, WE SEE MENTAL HEALTH ALL THE TIME.
IF WE WERE GOING TO DO MENTAL HEALTH DIVERSION, WE WOULD NEED TO STAFF IT SOMEWHAT DIFFERENTLY AND PROBABLY RENOVATE THE BUILDING SLIGHTLY DIFFERENTLY.
[00:25:01]
COUNTY COMMISSIONERS ARE AWARE OF THAT.UM, SO I SEE US POTENTIALLY BEING INVOLVED IN THAT CONVERSATION.
UM, AND WE'RE HAPPY TO F FIGURE OUT WITH THE COUNTY OR THE CITY HOW YOU GUYS WOULD LIKE TO PROCEED IN MENTAL HEALTH DIVERSION.
WE DEFINITELY WANNA BE PART OF THE CONTINUUM OF CARE.
SO OUR STRATEGIC PLAN, I JUST SHOWED YOU A SNAPSHOT OF, UM, WHAT WE'RE BASICALLY DOING IS MORE OF THE SAME OF THIS.
UM, WE WANNA DO THE BRIDGE MEDS.
WE WANT TO BE BETTER AT CONNECTING PEOPLE TO TREATMENT.
WE WANNA BE ADVOCATES FOR THE INFRASTRUCTURE BEING BUILT OUT IN THE COMMUNITY FOR THERE TO BE TREATMENT BEDS.
BECAUSE A BIG PART OF THIS CONVERSATION, I FEEL LIKE NOW THAT WE'RE ALL ON THE SAME PAGE ABOUT DIVERSION, WE WANNA DIVERT FROM JAIL FOR SURE.
WE WANNA DIVERT FROM THE HOSPITAL FOR SURE.
WE WANNA AVOID THAT TRAUMA, THE COLLATERAL COSTS OF THAT, THE FINANCIAL COST OF THAT.
IF WE'RE GOING TO DO DIVERSION, WELL WE HAVE TO DIVERT SOMEWHERE.
AND SO WHERE ARE THE TREATMENT BEDS? WE'RE GONNA HAVE TO BUILD THAT.
AND, UM, WE WANNA BE ADVOCATES FOR THAT AND PARTNERS IN THAT PROCESS AS PART OF OUR NEXT FIVE YEARS.
JUST WANTED TO CALL OUT A FEW PIECES OF GRATITUDE TO YOU GUYS AND LET YOU KNOW WHAT I NEED FROM YOU AS A CITY COUNCIL.
UM, KATHY TOVO WAS OUR FIRST INAUGURAL CITY COUNCIL MEMBER ON OUR BOARD.
OUR, OUR BYLAWS AND OUR INNER LOCAL AGREEMENT REQUIRES A CITY COUNCIL MEMBER ON OUR BOARD.
SHE WAS A FOUNDING MEMBER, SHE WAS A HUGE ADVOCATE FOR US.
UM, AND SHE WAS EVEN REVIEWING THIS PRESENTATION LAST NIGHT,
SO I REALLY APPRECIATE HER TIME.
UM, SHE WAS AN EXTREMELY COMMITTED, RESPONSIVE, AND, UM, KNOWLEDGEABLE BOARD MEMBER.
AND, UM, SHE'S BEEN REPLACED BY JOSE CHITO VELA, WHO HAS BEEN AWESOME AND ENTHUSIASTIC AND SUPPORTIVE FROM THE BEGINNING.
AND I REALLY, REALLY APPRECIATE THAT.
UM, IT MAKES A HUGE DIFFERENCE TO ME AS AN AN EXECUTIVE DIRECTOR TO HAVE CITY COUNCIL REPRESENTATION ON OUR BOARD.
UM, SHOUT OUT TO ADRIAN STIRRUP AND THE, THE AUSTIN PUBLIC HEALTH STAFF WHO MANAGE OUR CONTRACT.
UM, THIS HAS BEEN A HARD CONTRACT FOR THEM TO MANAGE.
IT'S TOTALLY DIFFERENT THAN ALL THEIR OTHER CONTRACTS.
SO THERE'S OFTENTIMES LITTLE SNAFUS AND HICCUPS AND CONFUSION AND IN THAT PROCESS, AND THEY'VE BEEN REALLY SUPPORTIVE, UM, ADVOCATES FOR US AS WELL.
THE TWO THINGS I NEED FROM THE CITY COUNCIL IS THIS, THIS INTERLOCAL AGREEMENT'S GOING TO COME ACROSS YOUR DESK FOR RENEWAL.
AND SO FOR THE SOBERING CENTER TO CONTINUE TO EXIST, WE HAVE TO RENEW THAT INTERLOCAL AGREEMENT.
UM, SO THAT WILL BE COMING YOUR WAY.
AND SO I WANTED YOU GUYS TO ALL KNOW, HAVE THE OPPORTUNITY TO COME TOUR THE SOBERING CENTER IF YOU'D LIKE, BUT TO HEAR FROM ME KIND OF HOW WE'VE BEEN DOING AND WHERE WE'RE HEADED.
THE OTHER SMALL PIECE TO THAT IS, UM, IS JUST THAT WE MAKE SURE THAT, AND WHEN WE GO FORWARD IN THE BUDGET, I THINK WHEN WE FIRST STARTED OUT, WE WERE ASKED TO GIVE AUSTIN PUBLIC HEALTH LIKE A 10 YEAR FORECAST OF OUR BUDGET, WHICH IS VERY HARD TO DO IN 2018.
AND THEN EVEN BECAME KIND OF RIDICULOUS IN 2020, RIGHT? EVERYTHING KIND OF CHANGED WHAT WE'D LIKE TO DO NOW.
UM, AND I THINK WHAT KATHY WAS ADVOCATING FOR WAS FOR US TO BE IN A COLLABORATIVE KIND OF CONVERSATION WITH AUSTIN PUBLIC HEALTH ABOUT WHAT ARE THE NEEDS OF THE SOBERING CENTER? WHAT IS AUSTIN PUBLIC HEALTH WILLING TO DO, ABLE TO DO, AND HOW CAN WE WORK TOGETHER TO CRAFT A BUDGET EVERY YEAR GOING FORWARD? WE DID PUT TOGETHER KIND OF A DRAFT OF A FIVE YEAR BUDGET, ASSUMING NO MAJOR CHANGES, BUT WE'D LIKE TO BE IN KIND OF CONSTANT COMMUNICATION WITH AUSTIN PUBLIC HEALTH THROUGH THAT PROCESS.
THAT'S WHAT I HAVE FOR YOU TODAY.
WHAT QUESTIONS DO YOU HAVE FOR ME? ONE, I SEE A HAND UP COUNCIL MEMBER HARPER MADISON, OR COUNCIL MEMBER BAYLA, DID YOU HAVE YOUR HAND UP? AND THE CITY MANAGER.
YEAH, I JUST, UH, ONE QUICK, I MEAN, I THINK THAT CERTAINLY WE'D WANT TO, AUSTIN PUBLIC HEALTH WILL WANT TO SIT DOWN WITH YOU AND WORK THROUGH THE APPROPRIATE BUDGET FOR THE NEW FISCAL YEAR FOR THE NEW HER LOCAL, RATHER.
ONE OF THE THINGS THAT YOU MENTIONED, AND I I WOULD URGE US TO REALLY FOCUS ON IS THAT THIS IS REALLY A HEALTH ISSUE.
THE CITY OF AUSTIN IN 2004 DIVESTED ITS ASSETS, ITS PRIMARY CARE ASSETS TO CENTRAL HEALTH.
AND SO I SIMPLY WOULD URGE YOU TO SIT DOWN AND BEGIN TO WORK WITH CENTRAL HEALTH TO SEE WHAT THEIR PROPER ROLE IS IN THIS.
CERTAINLY THE CITY'S NOT GONNA ABANDON ITS ROLE, BUT I THINK IT'S APPROPRIATE FOR US TO SAY TO THEM, WHAT ROLE DO YOU PLAY IN THIS? YOU TALKED ABOUT MENTAL HEALTH.
THAT'S A HUGE ISSUE, NOT JUST FOR THE PEOPLE IN THE SOBERING CENTER, BUT IN THE HOMELESS CAMPS THAT THAT EXISTS THROUGHOUT THIS CITY.
THE BEHAVIORAL HEALTH IS A HUGE ISSUE AND, UH, THERE'S A LOT OF PEOPLE WORKING ON A LOT OF DIFFERENT VENUES, BUT, UH, I WANT TO COMMEND THE WORK THAT YOU'RE DOING AND WE'RE CERTAIN, CERTAINLY WILLING TO, TO, TO ENTER INTO THOSE NEGOTIATIONS OF GOOD FAITH AND ASK YOU TO REALLY BEGIN TO VISIT WITH, UH, MIKE GELAN AND OTHERS AT CENTRAL HEALTH ABOUT WHAT THEIR PROPER ROLE IS IN THIS.
AND I HAVE MET WITH CENTRAL HEALTH SEVERAL TIMES.
UM, I THINK THAT'S SOMETHING THAT'S AN ONGOING CONVERSATION THEY'VE ASKED ME BEFORE TO GIVE THEM DATA TO GIVE THEM FINANCIAL DATA.
UM, YOU KNOW, ABOUT 30% OF OUR PATIENTS ARE, ARE MORE THAN ONE TIME VISITORS, YOU KNOW, THAT ARE CHRONIC USERS.
UM, BUT ABOUT 70% OF OUR PATIENTS
[00:30:01]
ARE ONE-TIME VISITORS, WHICH IS KIND OF SURPRISING TO MOST PEOPLE, I THINK.SO I THINK WE GET ALL OF IT RIGHT.
WE HAVE THE PEOPLE WHO ARE DEFINITELY LIVING ON THE STREETS AND USING IN A REALLY CHRONIC WAY AND NEED THAT LOW-INCOME HEALTHCARE.
AND THEN WE ALSO HAVE PEOPLE WHO ARE TOURISTS WHO ARE IN TOWN FOR SOUTH BY SOUTHWEST.
UM, BUT I 100% AGREE THAT THAT IS PART OF THE ROLE OF CENTRAL HEALTH, AND WE'LL BE CONTINUING TO INVESTIGATE THAT RELATIONSHIP.
COUNCIL MEMBER HARPER MADISON.
UM, I ACTUALLY HAVE BEEN GETTING VERY INTERESTED IN, FROM A BEHAVIORAL HEALTH PERSPECTIVE, KIND OF GETTING OUT IN FRONT OF, UM, SUBSTANCE USE DISORDER.
AND I WAS LISTENING TO THIS PODCAST ONE TIME WHERE THEY TALKED ABOUT THE CONCEPT OF ARRESTED DEVELOPMENT MM-HMM.
AND A LOT OF THOSE FOLKS ARE WHO WE'RE DEALING WITH THAT ARE COMING TO THE SOBERING CENTER THAT ARE EXPERIENCING HOMELESSNESS, CHRONIC EXTENDED HOMELESSNESS.
I KEEP THINKING ABOUT, EXCUSE ME.
SO LIKE IN PHILLY FOR EXAMPLE, THEY HAVE THIS REALLY GREAT RECOVERY HIGH SCHOOL MM-HMM.
SO WHAT THEY'RE DOING IS THEY'RE CATCHING IT BEFORE A PERSON HAS HAD 40 YEARS TO ACCUMULATE 40 YEARS WORTH OF SUBSTANCE USE DISORDER.
AND SO ALL OF THE STAFF, ALL OF THE FACULTY, EVERYBODY IN THE BUILDING IS A PERSON IN RECOVERY.
AND SO WHEN THEY LEAVE, YOU KNOW, RECOVERY CENTERS, THEY GO STRAIGHT INTO THIS RECOVERY HIGH SCHOOL, THEIR CHANCES OF RECURRENCE ARE NEXT TO ZERO.
YOU KNOW, I, I MEAN, I THINK ABOUT IT A LOT.
AND SO THAT SAID, I WONDER, I'VE BEEN THINKING ABOUT WHO ARE THE POTENTIAL EDUCATION PARTNERS, BUT I WONDER HOW MUCH OF THAT ALSO NEEDS TO BE COMBINED WITH AN INITIATIVE LIKE A SOBERING CENTER.
I WONDER IF THAT'S SOMETHING THAT, YOU KNOW, AS YOUR BUSINESS MODEL CONTINUES TO GROW AND EXPAND MM-HMM.
THERE IS A SOBER HIGH SCHOOL IN AUSTIN.
IT'S CALLED UNIVERSITY HIGH SCHOOL, AND IT KIND OF GOT, UM, I DON'T KNOW IF YOU GUYS REMEMBER THIS.
THERE WAS A MERGER OF AUSTIN RECOVERY AND UNIVERSITY HIGH SCHOOL AND A, AND A YOUTH SERVING SUBSTANCE USE GROUP CALLED KEYSTONE A COUPLE YEARS AGO.
UM, AND SO IT MAY BE UNDER THE NAME NOW OF AUSTIN RECOVERY OR AUSTIN RECOVERY NETWORK, BUT IT DOES EXIST, BUT IT'S VERY SMALL.
UM, AND THEY'RE LOCATED ON THE UT CAMPUS, ACTUALLY IN THE BASEMENT OF A CHURCH THERE.
AND THERE, THERE'S DEFINITELY OPPORTUNITIES TO PROBABLY PARTNER OR EXPAND ON THAT.
I THINK THAT IS ONE THING THAT'S REALLY CRITICAL ABOUT OUR SERVICES IS THAT YOU HAVE TO BE 18.
AND THAT'S NOT TRUE EVERYWHERE IN THE COUNTRY, BUT MOST PLACES IT IS.
SO THERE, IT'S DEFINITELY TRUE THAT IF YOU'RE 16 OR 17 AND YOU'RE PUBLICLY INTOXICATED, YOU'RE PROBABLY GONNA GO TO JAIL, YOU KNOW, UH, OR SOME KIND OF FACILITY LIKE THAT, OR GARDNER BETS OR, OR THE HOSPITAL DEPENDING ON WHAT'S GOING ON.
BUT I HEAR THE SAME THING, AND AS A MOM, IT'S LIKE TERRIFYING TO HEAR SOME OF THE STUFF THAT IS GOING ON ON CAMPUSES.
WHAT IS THE REASONING BEHIND 18? IS IT THAT THEY CAN SELF ADMIT VERSUS A MINOR? YEAH, IT, I, I THINK A LOT OF IT WAS ALSO ABOUT JUST SETTING, UH, SETTING UP REALLY NARROW OPERATIONS AT THE BEGINNING, BECAUSE WE HAD NEVER DONE THIS BEFORE AND IT WAS NEW AND EVERYBODY WANTED IT TO BE KIND OF VERY PREDICTABLE AND EASY TO MANAGE.
SO TECHNICALLY THEY VOLUNTEER TO GO.
AND SO I THINK WITH A KID, YOU'D PROBABLY HAVE TO HAVE CONSENT OF THE PARENTS AND IT, IT BECOMES A WHOLE NOTHER KIND OF SERVICE MODEL.
BUT THAT IS, THAT WAS PROBABLY THE ORIGINAL REASONING.
COUNCIL MEMBER VILLA AND THEN COUNCIL MEMBER FUENTES.
WELL, THANK YOU VERY MUCH FOR THE PRESENTATION.
AND, UH, I HAVE A BIG, UH, SHOES TO FILL WITH, UH, KATHY.
I KNOW HOW ENGAGED AND HOW HARDWORKING SHE WAS.
UH, BUT I'VE REALLY ENJOYED, UH, WORKING WITH YOU AND, AND, AND BEING ON THE BOARD.
UH, YOU KNOW, YOU TALKED ABOUT LIMITING WHEN, WHEN THE SOBERING CENTER WAS FIRST ESTABLISHED, YOU, YOU WANTED TO LIMIT ITS SCOPE BECAUSE, UH, AS YOU HAD MENTIONED IN PREVIOUS CONVERSATIONS, UH, THERE'S A NATURAL MISSION CREEP TO IT WHERE EVERYBODY WANTED YOU TO DO EVERYTHING FOR ANYBODY AFFECTED BY A SUBSTANCE ABUSE, BUT YOU NEEDED TO KEEP IT, UH, LIMITED TO GET OFF THE GROUND.
UM, HOW ARE YOU SEEING, I MEAN, LOOKING FORWARD, WHAT AREAS DO YOU THINK THAT THE SOBERING CENTER COULD JUMP INTO OVER THE, YOU KNOW, THE NEXT YEAR AND THE NEXT BUDGET CYCLE? WHAT, WHAT ARE YOU, UH, LOOKING AT? SO, UM, YEAH, IT, IT WAS DEFINITELY, UM, THE BOARD'S INTEREST TO LIMIT IT, PARTLY BECAUSE THERE WAS FEAR, I THINK, OF IT LOOKING LIKE WHAT THE ARTS USED TO LOOK LIKE, RIGHT.
THAT PEOPLE WOULD JUST LINE UP OUTSIDE OR THAT PEOPLE WOULD BE DRINKING EXCESSIVE AMOUNTS IN ORDER TO FIND A SHELTER BED AND THINGS LIKE THAT.
SO WE WANTED TO KEEP IT REALLY NARROW IN SCOPE TO KIND OF SEE WHAT IS THIS LIKE
[00:35:02]
NOW THAT WE'VE LEARNED SO MUCH AND WE, AND IT HASN'T BEEN THAT WAY.UM, WE'VE, WE'VE REALLY KEPT THE OPERATIONS REALLY, UM, CLEAR.
THE PROTOCOLS ARE REALLY CLEAR UPON ADMISSION.
WE DON'T CURRENTLY TAKE WALKUPS.
I'M NOT SURE THAT WE WOULD WANT TO TAKE WALKUPS NECESSARILY, BUT I DO THINK THAT THERE'S A HUGE ISSUE IN DIFFERENCE BETWEEN THE ISSUE OF PUBLIC INTOXICATION AND PRIVATE INTOXICATION.
SO IF YOU LOOK AT OUR DEMOGRAPHICS AND OUR, THE, UH, SUBSTANCES WE SERVE, IT'S GONNA BE 75% MEN AND 75% ALCOHOL.
BUT WE KNOW THAT THAT'S NOT ALL THAT'S GOING ON IN THIS COMMUNITY.
WE KNOW THAT THERE'S A LOT OF OPIATE USE.
WE KNOW THAT THERE'S A LOT OF METH USE, METH IS NUMBER TWO FOR US, BUT STILL IT'S WAY BEHIND ALCOHOL.
SO WHEN YOU THINK ABOUT PUBLIC INTOXICATION, YOU THINK ABOUT MOSTLY MEN DRAWING ATTENTION TO THEMSELVES, MOSTLY USING ALCOHOL, BUT OPIATES AND WOMEN TEND TO USE PRIVATELY.
AND IF YOU ARE GONNA DO OPIATE OVERDOSE, THAT'S GONNA BE A PRIVATE THING AS WELL.
YOU'RE NOT USUALLY AT A PARTY DOING THAT.
SO I THINK THERE'S OTHER PLACES FOR US TO GET INTO HERE, AND IT MAY BE THINGS THAT I'VE THOUGHT OF ARE SORT OF INTEGRATING MORE WITH 9 1 1 INTER INTEGRATING MORE WITH EMS. LIKE HOW COULD WE GO OUT POTENTIALLY ON CALLS THAT MAYBE, MAYBE WE GO WITH THE POLICE DEPARTMENT, MAYBE WE GO WITH INTEGRAL CARE AND WE TRY TO HELP ASSESS AT THE SCENE.
SO, AND WE HAVE A VAN AND WE CAN TRANSPORT PEOPLE.
WE'RE DOING OUTREACH ON SIXTH STREET, SO WE'RE DOING A LOT OF PUBLIC HEALTH AND AWARENESS OF JUST LIKE SAFETY AND GIVING OUT WATER, MAKING SURE PEOPLE HAVE SAFE RIDES HOME.
I THINK WE'RE PROBABLY PREVENTING DWIS DOING THAT, BUT CAN'T, CAN'T COUNT IT, DON'T KNOW HOW TO MANAGE THE, THE DATA OF IT.
UM, AND THEN THE OTHER BIG THING IS THAT BRIDGE MEDICATIONS PIECE.
I THINK INTEGRATING WITH EMS TO WHERE WE HA WE CAN GIVE PEOPLE MEDS TO STABILIZE THEM AND KEEP THEM FROM CLIMBING THE WALLS WHILE WE'RE TRYING TO TALK TO THEM.
YOU CAN'T REALLY RATIONALIZE WITH A DRUNK PERSON OR A PERSON WHO'S BEEN ON METH FOR SEVEN DAYS AND HASN'T SLEPT.
SO IF WE CAN KEEP THEM LONG ENOUGH, BUILD THE TRUST LONG ENOUGH TO HAVE THE TREATMENT CONVERSATION WITH THEM, SOMETIMES THAT REQUIRES MEDICATION.
SO WE'RE GONNA NEED, WE'RE GONNA NEED TO BECOME MORE AND MORE MEDICAL.
AND LIKE THE CITY MANAGER IS SAYING, THIS IS A PUBLIC HEALTH ISSUE.
THIS IS A, THIS IS A, A DISORDER OF THE BRAIN THAT NEEDS TO BE ADDRESSED, LIKE WITH THE NEEDS OF THE BRAIN.
I SEE US POTENTIALLY GETTING INTO, WE COULD GET INTO THE AREA OF DETOX OR TREATMENT IF WE REALLY WANTED TO, IF THE BOARD WANTED TO.
UM, THAT WOULD REQUIRE A PRETTY SIGNIFICANT CHANGE IN THE BUILDING.
YOU HAVE TO BE LICENSED, AND THERE'S RULES ABOUT HOW THAT WORKS BY THE STATE.
UM, IT WOULD ALSO CHANGE OUR STAFFING.
AND SO RATHER THAN HAVING PARAMEDICS AND EMTS, WE'D HAVE TO HAVE NURSES WOULD BE A DIFFERENT MODEL.
UM, I ALSO HAVE THE SAME QUESTION OF IS THAT, IS THAT A FUNCTION OF THE SOBERING CENTER OR IS THAT A FUNCTION OF CENTRAL HEALTH? UM, OR IS IT BOTH? IS IT A PARTNERSHIP SOMEHOW? MM-HMM.
BECAUSE HISTORICALLY WE'VE JUST INCARCERATED THOSE PEOPLE.
WE HAVEN'T REALLY EFFECTIVELY TREATED THESE ISSUES.
AND SO NOW AS A REALLY GOOD TIME FOR A PARADIGM SHIFT TO SAY WHO IS GOING TO TAKE UP THAT, THAT ROLE, I THINK THE SOBERING CENTER HAS A KEY ROLE TO PLAY IN THAT IT DOESN'T HAVE TO BE ALL THINGS TO ALL PEOPLE, BUT WE COULD DEVELOP OUT THE INFRASTRUCTURE.
WE'VE ALREADY BUILT THE GOVERNANCE MODEL OF THAT WORKS REALLY, REALLY WELL.
LIKE HAVING THE BOARD BE JOINTLY APPOINTED BY THE CITY COUNCIL.
AND THE COMMISSIONER'S COURT HAS BEEN GREAT.
IT'S GREAT FOR ME BECAUSE I HAVE ACCESS TO THE, THE FOLKS THAT ARE INFLUENTIAL THAT CAN MAKE DECISIONS QUICKLY.
AND THAT'S NOT A TYPICAL NONPROFIT MODEL.
YOU KNOW, WE'RE A NONPROFIT ORGANIZATION, SO WE CAN TAKE DONATIONS, BUT WE'RE ALSO A LOCAL GOVERNMENT CORPORATION.
SO I THINK THERE'S SOMETHING THERE WITH THE INFRASTRUCTURE THAT'S ALREADY BUILT, THAT WE DON'T HAVE TO REINVENT THE WHEEL IF, IF LEADERSHIP IN LOCAL GOVERNMENT OR, UM, THE COMMUNITY IN GENERAL WANTS TO INVEST IN CREATING MORE TREATMENT BEDS THAN JAIL BEDS, THAT'S GONNA BE A LONG-TERM PROCESS.
AND WE'RE GONNA HAVE TO REALLOCATE SOME RESOURCES.
AND I THINK THE SOBERING CENTER COULD PLAY A HUGE ROLE IN THAT.
BUT AGAIN, IT DOESN'T HAVE TO BE THE TREATMENT PROVIDER FOR EVERYTHING.
WE SOMEHOW HAVE TO BRING TREATMENT MORE, MORE TREATMENT BEDS TO AUSTIN.
AND ASSUMING THAT YOU COULD GET LICENSED AND BUILD OUT THE, THE FACILITY TO ADD A SUBSTANCE ABUSE COMPONENT, UH, WHAT, WHAT KIND OF CAPACITY DO YOU THINK THE, AGAIN, JUST WORKING WITHIN THE EXISTING FOOTPRINT OF THE BUILDING THAT, THAT YOU HAVE, WHAT KIND OF CAPACITY DO YOU THINK THERE WOULD BE FOR, FOR BEDS FOR A SUBSTANCE ABUSE TREATMENT OR, OR DETOX FOR THAT MATTER? WELL, THERE'S CURRENTLY 16 BEDS ON THE FIRST FLOOR.
UM, WHAT I WOULD LOVE TO DO, MY NEXT STEP IN TERMS OF THE BRIDGE MEDS PIECE AND THE THE HOLDOVER PROGRAM IS I WOULD LIKE TO RENOVATE THAT SECOND FLOOR TO WHERE IT BASICALLY MATCHES THE FIRST FLOOR TO WHERE WE'D HAVE AT LEAST DOUBLE THE CAPACITY.
I THINK THAT BUILDING IS REALLY POORLY UTILIZED.
WE'RE CURRENTLY, IT HAS THE HOMELESS OUTREACH STREET TEAM ON THE THIRD FLOOR HAS SOBERING CENTER ADMIN ON THE SECOND FLOOR.
AND THEN WE'RE ONLY USING THE FIRST FLOOR FOR DIRECT CARE.
SO THIS IS SOMETHING I'M TALKING TO THE COUNTY ABOUT, IS COULD WE RENOVATE THE BUILDING TO WHERE WE USE HOLDOVERS, WE PUT HOLDOVERS ON THE SECOND FLOOR BECAUSE
[00:40:01]
THEY'RE SOBER, THERE'S WAITING TO GO TO TREATMENT.WE USE IT ALMOST LIKE A RESPITE AND THEN USE THE FIRST FLOOR FOR ALL THE PUBLIC INTOXICATION PIECE.
BUT IF WE DID MORE OUTREACH, LIKE IF WE DROVE THE VAN AROUND, WE COULD FIND PEOPLE THAT NEED HELP.
YOU KNOW, IT'S JUST WAITING FOR US TO, FOR THEM TO BRING TO US IS ALSO KIND OF A PASSIVE MODEL.
WE COULD BE MORE ACTIVE IN THE COMMUNITY.
SO I THINK WE COULD DOUBLE THE CAPACITY EASILY.
WE COULD PROBABLY DO MORE IF, IF THERE WAS SOMEPLACE ELSE FOR HOST TO BE, I DON'T KNOW.
AND, AND RELATED TO THAT, I UNDERSTAND THAT IN YOUR PRIOR, UH, UH, PROFESSIONAL ROLE, YOU, UH, MANAGED, UH, SUBSTANCE ABUSE CENTER.
UH, SO I GUESS FROM MY PERSPECTIVE, WE SEEM TO BE VERY WELL POSITIONED TO MOVE INTO THAT ROLE, GIVEN THAT WE HAVE THE SPACE, THE NEED IS THERE, THE DIRECTOR HAS EXPERIENCE IN MANAGING THAT TYPE OF FACILITY.
UH, SO I WOULD LIKE TO, UH, MOVE, YOU KNOW, RELATIVELY AGGRESSIVELY TO ADD THAT.
IS THERE ANY SUBSTANCE ABUSE TREATMENT AVAILABLE FOR UNINSURED FOLKS RIGHT NOW? IN, IN TRAVIS COUNTY, THERE IS VERY, VERY LIMITED NUMBER.
SO, UM, YOU'VE GOT A NEW ENTRY AND YOU HAVE CENTOR, AND THAT'S ABOUT IT.
AND WHAT WOULD BE THE WAIT LIST, FOR EXAMPLE, IF I WANTED TO GET INTO A SUBSTANCE ABUSE TREATMENT PROGRAM AND I'M INDIGENT, WHAT, WHAT, UH, WHAT TIMELINE AM I LOOKING AT? UM, IT DEPENDS.
I THINK IF YOU'RE GOING, GOING THROUGH A TRADITIONAL, LIKE THE OSR PROCESS WHERE YOU HAVE TO GET ON A WAIT LIST AND YOU DON'T HAVE ANYBODY KIND OF HELPING YOU THROUGH THE PROCESS, IT COULD BE WEEKS, IT COULD BE MONTHS.
UM, WE'RE ABLE TO DO IT IN A NUMBER OF DAYS, BUT THAT'S BECAUSE WE'VE DEVELOPED RELATIONSHIPS AND WE ALSO KNOW THE SYSTEM REALLY WELL.
SO WE CAN KIND OF KNOCK DOWN THOSE BARRIERS REALLY QUICKLY TO HELP GET SOMEBODY, GET THEIR MEDICATIONS, HELP SOMEBODY GET THEIR ID, YOU KNOW, GET, GET IT ALL INTO PLACE.
AGAIN, THOSE WERE THINGS THE SOBERING CENTER WAS NOT DESIGNED TO DO.
WE STARTED DOING THOSE THINGS MOSTLY BECAUSE I'M A SOCIAL WORKER, AND WHEN I CAME IN IN 2020, I WAS LIKE, WHAT ARE WE DOING HERE? LIKE, WE CAN SOBER PEOPLE UP AND SEND THEM OUT, BUT LIKE, SEND THEM OUT TO WHERE, AND SO WE STARTED KIND OF DOING THIS HOLDOVER AND THIS BRIDGE AND, AND ALL THAT.
SO WE'VE BEEN SLOWLY BUILDING IT WITH THE RESOURCES THAT WE HAVE.
UM, BUT IT'S KIND OF A, IT'S KIND OF FRAGMENTED.
LIKE, YOU CAN'T BE LIKE, OKAY, COME BACK IN TWO WEEKS.
YOU KNOW, LIKE, YOU, YOU'LL LOSE THEM.
SO I, I JUST, I, I THINK THAT REALLY SPOKE TO ME OF THE NEED, UH, ESPECIALLY SINCE SO MANY FOLKS ARE ALREADY PASSING THROUGH YOUR DOORS AND YOU HAVE, UH, ESSENTIALLY THE EXPERTISE AND THE, AND THE ABILITY TO TAKE FOLKS IMMEDIATELY AND PUT 'EM INTO TREATMENT.
I, I JUST REALLY FEEL COMPELLED, UH, TO, UH, TAKE ADVANTAGE OF THAT.
AGAIN, VERY MUCH NOTING THE CONCERNS OR THE, THE FINANCIAL, WE, WE NEED TO SPLIT THE YEAH.
THE, THE COSTS AMONG OTHER FOLKS THAT ARE ALSO RESPONSIBLE FOR, UH, THIS TYPE OF, UH, TREATMENT, YOU KNOW, CENTRAL HEALTH, UH, UH, AND, AND OTHERS AS WELL.
BUT, UM, BUT WE HAVE A GREAT OPPORTUNITY AND, AND, UH, I WOULD REALLY LIKE THIS COUNCIL TO MOVE FORWARD IN, IN, IN, IN THAT DIRECTION.
I THINK FROM THE PERSPEC, FROM MY PERSPECTIVE AS A, AS A NONPROFIT LEADER, IT HELPS A LOT WHEN THE BOARD, UM, AND OR THE, THE GOVERNING ENTITIES OF OUR BOARD, WHICH IS THE CITY COUNCIL, AND THE COMMISSIONER'S COURT ARE ABLE TO GIVE ME THAT TYPE OF INFORMATION, RIGHT? LIKE, THIS IS WHAT WE'VE INVESTED ALREADY IN CENTRAL HEALTH.
THIS IS THE ROLE OF CENTRAL HEALTH.
THIS IS WHAT WE KNOW, HOW WE KNOW THE HOSPITAL SYSTEMS BENEFIT FROM THIS.
AND SO BEING ABLE TO, AS LEADERS GO TO THOSE SYSTEMS WITH ME AND SAY, HEY, WE, HOW DO WE SPLIT THE COST OF THIS? YOU KNOW, VERSUS ME TRYING TO LIKE BANG ON THE DOOR OF CENTRAL HEALTH AND GO, HEY, CAN WE DO A CONTRACT? CAN WE DO A LITTLE SMALL THING? IT, IT TAKES LONGER AND IT'S, UM, NOT AS EFFECTIVE, I THINK.
ANY IDEA WHAT EXPANSION INTO SUBSTANCE ABUSE WOULD COST IN TERMS OF, UH, AGAIN, I KNOW THIS IS VERY PRELIMINARY, BUT JUST THE GENERAL SCOPE OF, UH, THE AMOUNT OF FUNDS YOU WOULD NEED TO OPERATE, YOU KNOW, UH, A SMALL SUBSTANCE ABUSE TREATMENT.
TO GO INTO LIKE, TREAT THE TREATMENT BUSINESS.
THE BUDGET OF AUSTIN RECOVERY WAS ABOUT 8 MILLION, AND WE HAD ABOUT 52 RESIDENTIAL BEDS.
UM, BUT WE ALSO HAD OUTPATIENT SERVICES, UM, AND AFTERCARE AND THINGS LIKE THAT.
SO THAT'S KIND, KIND OF A BALLPARK MM-HMM.
UM, THERE WERE TIMES WHERE WE WERE RUNNING A DETOX AND TIMES WHERE WE WEREN'T.
MEDICAL DETOX IS SUPER EXPENSIVE.
THAT'S WHY PEOPLE DON'T WANNA DO IT BECAUSE IT'S VERY EXPENSIVE.
UM, MEDICAID WILL PAY $96 A DAY, AND WE'RE EXPECTED TO DO THE SAME SERVICE.
SO THAT'S WHY THERE'S NO DETOX FOR INDIGENT BECAUSE THE BUSINESS MODEL DOESN'T WORK.
[00:45:01]
REIMBURSEMENTS FROM THE STATE ARE TERRIBLE.AND SO WE, NOBODY CAN FIND A PAYER FOR IT.
THAT'S THE, THAT'S THE TROUBLE WITH IT.
IT'S VERY EXPENSIVE, BUT IT, IT'S VERY ACCESSIBLE IF YOU HAVE MONEY AND IF YOU HAVE GREAT INSURANCE, YOU CAN GO TO DETOX ANYTIME YOU WANT.
THERE'S TONS OF FOR-PROFIT TREATMENT CENTERS IN THIS CITY.
NO, THANK YOU VERY MUCH AND LOOK FORWARD TO CONTINUING WORKING WITH US.
AND I JUST WANTED TO SHOUT, GIVE A SHOUT OUT TO JANNA ORTEGA ALSO THE, THE, THE DIRECTOR OF THE BOARD WHO I'VE KNOWN AND WORKED WITH, AND WHO I, I REALLY ENJOY SPEAKING WITH AND, AND LOOKING FORWARD TO WORK WITH YOU ON THE OPENING CENTER BOARD.
DID YOU NEED TO SAY SOMETHING BEFORE WE GO TO COUNCIL MEMBER FUENTES? IT JUST REALLY, I MEAN, I THINK SHE'S, SHE'S OUTLINED THE ISSUE, UH, A TREATMENT CENTER WOULD BE EXPENSIVE.
AND I DO THINK THERE'S A LOT OF PEOPLE THAT HAVE, UH, SOME ROLE TO, TO EVALUATE.
FOR INSTANCE, WHEN WE RAN R BRACKENRIDGE THEN, AND THEN, UH, DEL SEATON, UT THOUGH I WAS THERE LESS TIME FOR THAT, WE WOULD HOLD PATIENTS IN AN INPATIENT CAPACITY, EVEN THOUGH THEY, THEIR MEDICAL TREATMENT WAS DONE.
BUT THEY WERE THERE FOR OTHER REASONS.
LONG-TERM CARE, REHAB CARE, ALL THOSE THINGS.
THE INDIGENT JUST HAVE A, A REAL TOUGH TIME GETTING THOSE EXTENDED SERVICES BE BEYOND THE ACUTE CARE.
AND THAT'S WHY I SAY, I MEAN, PART OF IT'S A NEED TO PLAN AND THEN WHAT THE ROLE IS OF THE VARIOUS AGENCIES IN TERMS OF HOW YOU BRING THAT PLAN TO LIFE.
AND IT, IT, IT IS EXPENSIVE AND IT'S GONNA TAKE A LOT OF, A LOT OF PARTNERS TO KIND OF FIGURE OUT THE, THE PUZZLE.
ANY OTHER QUESTIONS? ALL RIGHT.
I THINK COUNCIL MEMBER FUENTES SAID HERS WERE ANSWERED.
WE REALLY APPRECIATE THE WORK YOU'RE DOING IN OUR COMMUNITY.
THANK YOU SO MUCH FOR YOUR TIME.
[B2. Update on the City’s emergency management plans and responses]
ITEM OF THE DAY, WHICH IS A BRIEFING UPDATE ON THE CITY'S EMERGENCY MANAGEMENT PLANS AND RESPONSES.PRO TEM, I'M, I'M GONNA ASK KEN TO COME ON UP AND LET ME JUST DO A COUPLE OF, UH, INTRODUCTORY REMARKS.
WE'VE COMBINED THE, UH, EMERGENCY MANAGEMENT AND ENERGY, UH, EMERGENCY MANAGEMENT PLANS TOGETHER FOR PURPOSES OF THIS WORK SESSION.
AND WE'VE TRIED TO MOVE AS FAST AS WE CAN WITH THE, WITH THAT BIAS FOR ACTION.
YOU KNOW, WHAT WE'VE SEEN IN AUSTIN IS, UH, A SERIES OF STORMS THAT WE THINK OF ARE GONNA HAPPEN MORE FREQUENTLY, AND ONE THAT WE PERHAPS IN THE PAST HAVE NOT QUITE BEEN PREPARED TO MANAGE IN AN APPROPRIATE WAY.
WE THINK THIS IS GONNA HAPPEN.
I SAID IT IS GONNA HAPPEN MORE FREQUENTLY.
WE, WE'VE NOTICED THAT OUR PREPARATION JUST HASN'T BEEN WHAT IT'S NEEDED TO BE.
AND SO ONE OF THE THINGS THAT WE WANT TO FOCUS ON TODAY, AND WE'RE GONNA GET INTO SOME DETAIL, IS FIRST, HOW WE OPEN UP THE EMERGENCY CENTER, UH, AND, AND WHO NEEDS TO BE AVAILABLE AT THAT EMERGENCY CENTER SO WE CAN BRING THE CITY'S RESOURCES TO BEAR ON THAT SPECIFIC EMERGENCY.
THE SECOND IS HOW WE COMMUNICATE AND MAKE SURE THAT THE COMMUNICATION IS COORDINATED IN A WAY THAT DELIVERS TO THE COMMUNITY EXACTLY WHAT'S HAPPENING, WHAT NEEDS TO BE DONE, AND WHAT THEY CAN DO TO PREPARE THEMSELVES FOR THAT EMERGENCY.
AND FINALLY, HOW EACH DEPARTMENT CAN ASSESS ITS OWN ASSETS ABOUT WHAT, HOW, WHAT THEY CAN BRING TO THE TABLE TO BE ABLE TO RESPOND TO THAT EMERGENCY.
AND SO ALL OF THOSE THINGS ARE ONGOING RIGHT NOW SO THAT WE CAN HAVE A MORE FOCUSED APPROACH.
AND I THINK THE BRIEFING TODAY IS GONNA GIVE YOU AN INSIGHT INTO THAT.
AND WE LOOK FORWARD TO THE AFTER ACTION REPORTS IF WE GET INTO DETAIL.
THIS IS JUST A PRELIMINARY SNAPSHOT AND WE'RE GONNA GET INTO A LOT MORE DETAIL HERE IN THE FUTURE.
AND WITH THAT, LET ME TURN IT OVER TO KEN.
GOOD AFTERNOON, MAYOR PRO 10 COUNSEL, THANK YOU FOR YOUR TIME.
GUIDED BY THE THREE PRINCIPLES OUTLINED BY INTERIM CITY MANAGER GARZA ACROSS THE ENTERPRISE.
WE HAVE STARTED THE PROCESS OF IMPROVING THE CITY'S RESPONSE TO EMERGENCIES.
AND FUNDAMENTAL TOOL TO THAT WILL BE THE AFTER ACTION REPORT PROCESS, AN AFTER ACTION REPORT PROCESS, UH, OR AN AFTER ACTION REPORT IS A TOOL THAT ALLOWS US TO QUICKLY ASSESS OUR PERFORMANCE, UH, AND UNDERSTAND WHERE WE CAN GET BETTER, UH, IN OUR OVERALL EFFORTS.
THAT PROCESS IS GONNA PLAY OUT OVER A FIVE PHASE, UH, STRUCTURE.
THAT STRUCTURE WILL BEGIN WITH A DEPARTMENTAL PRELIMINARY ANALYSIS THAT WILL ALLOW US TO TAKE A LOOK AT WHAT WE'RE DOING IN EACH INDIVIDUAL DEPARTMENT.
UH, IT WILL ALSO INCLUDE, UH, WHAT I'LL TALK ABOUT IN AN UPCOMING SLIDE, OR SHARE BRIEFLY, UM, A HOT WASH.
WE'LL TALK ABOUT IN THROUGH THAT PROCESS WENT WELL, WHAT WERE SOME OF OUR CHALLENGES AND WHAT ARE AREAS THAT WE CAN IMPROVE ON? PHASE TWO WILL IN INCLUDE A PRELIMINARY AFTER ACTION REPORT.
UH, AS YOU ALL KNOW, THE FULL AFTER ACT AFTER ACTION REPORT TAKES, UH, QUITE A BIT OF TIME TO COMPLETE.
UH, BUT I WANNA BE CLEAR, WE'RE ALREADY WORKING ON THESE ISSUES.
WE'RE NOT WAITING UNTIL THE COMPLETION OF THE ACT AFTER ACTION REPORT.
PHASE THREE IS A JOINT AFTER-ACTION REVIEW WITH TRAVIS COUNTY AS ONE OF OUR PRIMARY PARTNERS.
[00:50:01]
UNDERSTAND HOW WE WORK TOGETHER, WHETHER WE'RE WORKING, UH, WELL TOGETHER OR NOT.UH, ARE THERE ADDITIONAL OPPORTUNITIES TO IMPROVE UPON THAT? PHASE FOUR IS, UH, THE IMPROVEMENT PROCESS THAT WILL ALLOW US TO REALLY DIVE DEEPLY INTO THE SOLUTIONS PORTIONS FOR SOME OF THE MORE COMPLEX, UH, ISSUES.
AND THEN PHASE FIVE IS THE COMPLETION OF THE, UM, THE, UH, AFTER ACTION REPORT.
THIS IS, THIS IS AN EXAMPLE OF A, UH, HOT WASH FROM ONE OF OUR CITY DEPARTMENTS.
UH, YOU MIGHT NOTICE, UH, FOR EXAMPLE, ON CHALLENGES ON ITEM ONE, UH, THEY'VE IDENTIFIED SI UH, SILOS AND OVERLAPPING OBJECTIVES AS ONE OF THE THINGS THAT'S CAUSING PROBLEMS OR CONTRIBUTES TO ISSUES AS THEY MOVE FORWARD.
UH, AND JUST AS A AN EXAMPLE HERE, WE WANT TO MAKE NOTE THAT THIS IS HAPPENING, UH, ACROSS THE CITY IN PRETTY MUCH EVERY DEPARTMENT AS WE WORK TO GET BETTER.
PART OF MY CHARGE WHILE ON ASSIGNMENT IS TO CONDUCT AN ASSESSMENT OF THE HOMELAND AND SECURITY EMERGENCY EMERGENCY MANAGEMENT OFFICE.
AND OVER THE LAST TWO WEEKS, AS PART OF THAT PROCESS, I'VE HAD A CHANCE TO MEET, MEET WITH THE MAYOR'S OFFICE, AS WELL AS EACH COUNCIL OFFICE.
AND I WANNA TAKE A MOMENT TO THANK ALL OF YOU WHO TOOK TIME TO MEET WITH ME, UH, TO SHARE YOUR THOUGHTS, UH, ON THAT PROCESS, UH, OR HOW WE COULD GET BETTER.
UM, AND I HOPE I WASN'T TOO PUSHY AND, UH, AND DEMANDING YOUR TIME, BUT I JUST WANNA MAKE CLEAR THAT, UM, THIS ISSUE HAS BEEN REALLY, UM, FRONT AND CENTER FOR INTERIM CITY MANAGER, GARZA, UH, AND ALL THE, ALL OF THE OTHER CITY LEADERS, AS WE WANT TO MAKE SURE THAT WE'RE SUPPORTING THE PEOPLE OF AUSTIN IN THE, THE MOST BENEFICIAL WAY POSSIBLE.
THE, BY FAR, THE MOST COMMON TOPIC THAT I HEARD FROM EACH OF YOU WHEN WE MET, UH, REVOLVED AROUND COMMUNICATIONS.
UM, WE TALKED SPECIFICALLY ABOUT THE STRATEGY FOR DIGITAL COMMUNICATIONS.
WHAT HAPPENS WHEN WE DON'T HAVE THE ABILITY TO COMMUNICATE THROUGH OUR NORMAL CHANNELS? I E WHEN THERE ARE EXTENDED POWER OUTAGES, WE MAY NOT BE ABLE TO USE OUR TRADITIONAL METHODS OF COMMUNICATIONS, UH, THINK CELL PHONES, ET CETERA.
UM, WE ALSO TALKED ABOUT THE FREQUENCY FOR COMMUNICATIONS.
WHAT IS THE, UH, BEST, UH, PRACTICE IN THIS SPACE? COMMUNICATIONS AND PROTOCOLS FOR ELECTED OFFICIALS.
MANY OF YOU WANTED TO KNOW, WHAT EXACTLY IS IT THAT I'M SUPPOSED TO DO DURING AN EMERGENCY? HOW CAN I HELP? WHERE CAN I BE OF MOST BENEFIT? SHELTERS WAS ALSO A HUGE TOPIC.
THE STRATEGY FOR MESSAGING AND PROTOCOLS WAS SOMETHING THAT CAME UP FOR MANY OF YOU AS, UM, A, A, A POINT OF, UM, CLARIFICATION THAT NEEDED TO BE MADE THERE.
WE WERE NOT CLEAR IN MANY CASES, UH, WHEN SHELTERS WERE OPENING, UH, WHICH SHELTERS WERE OPENING WHEN, UH, AND THEN ALSO, UH, BACKUP POWER.
UM, MANY OF YOU SHARED CONCERNS ABOUT THE FACT THAT WE HAVE, UH, OR DON'T HAVE, UH, BACKUP POWER AT MANY OF THE LOCATIONS THAT HAVE BEEN IDENTIFIED FOR, UH, BACKUP SHELTERS OR EMERGENCY SHELTERS.
TRAINING WAS ANOTHER AREA THAT WAS, UH, MENTIONED QUITE OFTEN.
UH, COMMUNITY PREPAREDNESS AND RESILIENCY WAS A TOPIC.
UH, AS AUSTIN STARTS TO EXPERIENCE STORMS MORE OFTEN AND, AND WEATHER ISSUES MORE OFTEN, UM, COUNCIL MEMBERS AND ELECTED OFFICIALS WANTED TO KNOW, UH, WHAT ARE WE DOING TO PREPARE OUR COMMUNITIES? CLARIFICATION ON ROLES OF ELECTED OFFICIALS DURING EMERGENCY WAS ALSO, UH, A TOPIC AS IT RELATES TO, UM, WHAT KIND OF TRAINING WOULD WE HAVE AVAILABLE FOR ELECTED OFFICIALS SO THAT THEY UNDERSTAND WHERE THEY MIGHT BE OF MOST BENEFIT PRACTICE.
UH, THERE'S ALSO A DESIRE TO HAVE FREQUENT PRACTICE.
UM, THERE'S ONE THING TO TRAIN, BUT IF WE DON'T PRACTICE, WE DON'T GET A CHANCE TO REALLY HONE OUR SKILLS AND SEE WHERE WE CAN BE BETTER, UH, TO, TO BECOME MORE PROFICIENT WITH THE TRAINING.
AND SO THAT'S GONNA BE IMPORTANT, UH, GOING FORWARD.
AND, UH, DIVERSITY OF EXERCISES.
WHILE THE HOT TOPIC RIGHT NOW, UH, CENTERS AROUND WINTER STORMS, THERE WAS ALSO A DESIRE TO HAVE DISCUSSIONS, UH, AND TRAINING AND PRACTICE AROUND WHAT DO WE DO WHEN THERE ARE FLOODS? WHAT DO WE DO IF THERE ARE FIRES? AND WE'RE ASKING PEOPLE TO LEAVE THEIR HOMES AT 1:00 AM IN THE MORNING? WHAT DOES THAT PROCESS LOOKS LIKE? SO WE WANT TO HAVE A, UH, PORTFOLIO OF TRAINING EXERCISES THAT ALLOWS US TO PRACTICE, UH, MANY OF THE ISSUES THAT WE MIGHT RUN INTO IN OUR COMMUNITIES.
AND LASTLY, UM, THE ROLE OF THE HOMELAND SECURITY AND EMERGENCY MANAGEMENT OFFICE.
UM, EACH OF YOU WANTED TO KNOW, UH, A LITTLE BIT MORE ABOUT WHAT IS UNDER THE PURVIEW OF THAT OFFICE, AND, UH, IF THERE ARE THINGS THAT ARE THERE THAT MAY NOT BE, UM, WITHIN THAT SCOPE, WHERE SHOULD THEY BE AND WHO'S IN CHARGE OF THOSE, THOSE, UH, ACTIONS.
AND THAT CONCLUDES THE PORTION OF THE BRIEFING, AND I WILL TURN IT OVER TO STUART RILEY FROM AUSTIN ENERGY.
GOOD AFTERNOON, MAYOR PRO TIMM COUNCIL MEMBERS.
I'M STUART RILEY, INTERIM GENERAL MANAGER OF AUSTIN ENERGY.
AND, UM, SOME OF THIS WE'VE COVERED AT A AUSTIN
[00:55:01]
ENERGY UTILITY OVERSIGHT COMMITTEE MEETING, BUT I JUST WANTED TO FOLLOW UP ON WHAT KEN SNIPES MENTIONED.OUR AFTER ACTION REVIEW AT AUSTIN ENERGY IS FOCUSED ON OUR RESPONSE TO THE WINTER STORM IN ORDER TO BETTER UNDERSTAND OUR ACTIONS AS THEY PERTAIN TO OUR RESPONSE TO THE WINTER STORM.
IDENTIFY FACTORS THAT CONTRIBUTED TO ANY PROCESS BREAKDOWNS, AND IDENTIFY EFFECTIVE STRATEGIES FOR RESPOND, RESPONDING TO FUTURE EMERGENCIES GOING FORWARD.
AND OUR AFTER ACTION APPROACH CONSISTS OF FIVE STEPS, PLAN, DISCOVER, ANALYZE, IMPROVE, AND REPORT.
WE'VE COME THROUGH THE DISCOVER PHASE.
WE HAVE OVER 150 PRELIMINARY FINDINGS FROM THAT DISCOVER PHASE.
WE ARE CURRENTLY IN THE ANALYZE PHASE.
AND SO AS WE'RE LOOKING IN THIS PHASE, WE WILL ADDRESS THOSE CRITICAL QUESTIONS AND LOOK AT ROOT CAUSES FOR ANY OF THOSE PRELIMINARY FINDINGS AND ENSURE THAT WE HAVEN'T MISSED ANYTHING.
OH, UM, JUST TO LET YOU KNOW SOME OF WHAT THAT DISCOVER PHASE CONSISTED OF ON THE LEFT SIDE, UM, WE HAVE A GRAPHIC THAT JUST POINTS OUT THAT WE HAVE OVER 200 INCIDENT COMMAND PARTICIPANTS AT AUSTIN ENERGY THAT HAVE BEEN INTERVIEWED.
UM, OUR CORPORATE QUALITY SERVICES GROUP IS LEADING THAT EFFORT TO DO OUR AFTER ACTION REVIEW PROCESS.
WE'VE HAD OVER 20 CROSS-FUNCTIONAL MEETINGS.
AND I ALSO WANT TO POINT OUT THAT OUR CORPORATE QUALITY SERVICES GROUP THAT'S LOOKING AT OUR PROCESS HAS ALSO GONE TO LOOK AT EVERY COUNCIL WORK SESSION AND AUSTIN ENERGY UTILITY OVERSIGHT COMMITTEE MEETING, AS WELL AS ANY OF THE QUESTIONS AND COMMENTS THAT WE RECEIVED FROM COUNCIL MEMBERS.
BECAUSE, YOU KNOW, THE INPUT THAT YOU PROVIDE US AS THAT CONDUIT TO YOUR CONSTITUENTS IS AN IMPORTANT PART OF OUR, UH, OF OUR PROCESS AS WELL.
OVERALL, THE PRELIMINARY FINDINGS THAT WE HAVE FROM THIS DISCOVER PHASE ARE LISTED IN THE MIDDLE HERE.
UM, THINGS THAT ROSE TO THE TOP, RESTORATION, OPERATIONS, TECHNOLOGY PLANNING, INCIDENT COMMAND, LOGISTICS, AND PUBLIC INFORMATION.
A LOT OF AREAS ROLL UP UNDER THAT RESTORATION OPERATIONS SECTION.
SO ONCE OUR REPORT IS REALLY, ONCE WE'VE COMBED THROUGH ALL THOSE FINDINGS AND OUR REPORT STARTS TO BE SYNTHESIZED, WE WILL HAVE THAT BROKEN DOWN INTO DIFFERENT AREAS, UM, FROM WHAT YOU SEE HERE.
OH, AND I, I'LL ALSO MENTION THAT, UM, AS WE'RE EN ENTERING INTO THIS ANALYZE PHASE, UM, WE'RE, WE'RE RECEIVING THAT INFORMATION, WE'RE SYNTHESIZING THAT DATA AND WE'RE LOOKING FOR ANYTHING THAT WE COULD HAVE MISSED, UM, PERHAPS ANY DUPLICATES OR ANY HIGH LEVEL FINDINGS.
BUT WE'RE LOOKING FIRST AT, AT THE, AT THE REALLY IMPORTANT ITEMS THAT HAVE BUBBLED UP TO THE TOP.
AND HERE WE HAVE, UH, ON THIS SLIDE, JUST SOME OF THE MAJOR ISSUES THAT HAVE RISEN TO THE TOP.
NO, NOTHING, UH, IS GOING TO SURPRISE YOU HERE.
UH, IN TERMS OF THE OUTAGE MAP, UM, WE KNOW THAT THE OUTAGE TEXT ALERTS CONFUSED CUSTOMERS AND SENT THEM INTO AN OUTAGE REPORTING LOOP.
AND WE'VE ALREADY, UM, MADE SOME IMPROVEMENTS TO THOSE TEXT ALERTS, INCREASING THE TIMEOUT THRESHOLD.
UM, BUT THERE'S MORE WORK TO DO THERE FOR SURE.
ALSO, CUSTOMERS COULD NOT ALWAYS IDENTIFY THEIR OUTAGE ON THE OUTAGE MAP.
SO WE KNOW ALREADY WE NEED TO WORK WITH OUR VENDOR TO IMPROVE THE USER EXPERIENCE IN THAT COBRA OUTAGE MAP PLATFORM.
IN TERMS OF RESTORATION, COORDINATION, A LOT OF OUR FINDINGS, AS I MENTIONED, ARE IN THIS AREA, PARTICULARLY AROUND DOING THE ASSESSMENTS.
UH, A LOT OF OUR FINDINGS IN DIFFERENT AREAS, WHETHER IT'S THE RESTORATION, COORDINATION OR COMMUNICATIONS, HAS REALLY POINTED TO, UH, A PROCESS IMPROVEMENT THAT WE HAVE, UH, THAT'S NECESSARY FOR DOING A SYSTEM-WIDE ASSESSMENT OF WHAT THE SITUATION IS OUT ON THE, OUT IN THE FIELD, TO BE ABLE TO COMMUNICATE BOTH INTERNALLY WITH OUR MUTUAL AID CREWS AND WITH THE PUBLIC AS TO KIND OF WHAT THE SITUATION IS OUT THERE.
SO WE KNOW WE HAVE A LOT TO DO THERE.
COMMUNICATIONS, WE ALREADY KNOW THAT THERE WERE INSUFFICIENT COMMUNICATIONS WITH US AND THE, AND OTHER DEPARTMENTS, UH, AND WITH US IN THE PUBLIC.
AND SO WE ARE PART OF THAT CITYWIDE PROCESS IN LOOKING AT CITYWIDE EMERGENCY COMMUNICATIONS, AND WE'LL CONTINUE OUR WORK THERE.
ALSO, A BIG ONE THAT'S RISEN TO THE TOP IS THE INCORRECT SYSTEM-WIDE ESTIMATED TIME OF RESTORATION.
I MENTIONED THAT IN, UH, IN RELATION TO THE SYSTEM-WIDE ASSESSMENT PROCESS THAT WE NEED.
AND WE KNOW THAT THAT CAUSED A BIG CHALLENGE FOR OUR CUSTOMERS.
AND, UH, OF COURSE, VEGETATION AND INFRASTRUCTURE, THE EXTREME WEIGHT OF ICE ON TREES, BROKEN, UH, POLES, BROKEN CROSS ARMS DOWN WIRES.
UM, WE WILL BE EXAMINING OPPORTUNITIES TO UPGRADE AND REPAIR OUR EXISTING DISTRIBUTION INFRASTRUCTURE AND INVEST MORE IN RESILIENCY OVERALL.
ON THESE ITEMS, THOUGH WE'RE NOT YET INTO THE IMPROVED PHASE, WE ALREADY KNOW WE NEED TO TAKE ACTION ON GRID RESILIENCY.
AND WE ARE, ARE, WE'RE NOT WAITING TO TAKE ACTION ON SOME OF THE THINGS THAT WE'VE IDENTIFIED HERE ALREADY.
UH, WE ARE LOOKING AT OUR PREPAREDNESS, OUR COMMUNICATION, AND OUR RESTORATION PRACTICES.
SO GOING FORWARD, OUR NEXT STEP AS WE GET INTO THE IMPROVED PHASE, WE WILL IDENTIFY EFFECTIVE STRATEGIES, WILL HAVE TANGIBLE TIMELINES, SPECIFIC TARGETS FOR ALL OF THOSE ITEMS. WE
[01:00:01]
WILL EXECUTE A THIRD PARTY REVIEW TO LOOK AT OUR AFTER ACTION PROCESS TO ENSURE THAT THERE'S A THOROUGHNESS AND COMPLETENESS, AND WE WILL INTEGRATE THIS INTO THE OVERALL CITY OF AUSTIN.AFTER ACTION REPORT, WE'LL FINALIZE OUR REPORT AND WE WILL ISSUE IT ALSO AS A STANDALONE, UH, REPORT IN ORDER TO BE REVIEWED BY OUR INDUSTRY PARTNERS AND ANY REGULATORS.
AND THAT IS OUR PRESENTATION, AND WE ARE HAPPY TO ANSWER ANY QUESTIONS.
WAS, UH, PUBLIC OR PUBLIC WORK'S GONNA MAKE SOME STATEMENTS OR THIS IS IT.
SO ANY QUESTIONS FOR OUR, OUR DEPARTMENTS? I HAVE A QUESTION FOR, UH, CITY MANAGER.
I BELIEVE YOU ALSO HAD SENT SOME, A MEMO OUT RECENTLY OUTLINING COMMUNICATIONS REGARDING OUR EMERGENCY, UM, RESPONSE.
SO IT MIGHT BE GOOD TO HIGHLIGHT, UM, THAT INFORMATION.
WELL, I, I THINK IN ESSENCE, UH, COUNCIL MEMBER, IN ESSENCE, WHAT WE WERE TRYING TO SAY IS THAT, UH, WHEN, WHEN WE COMMUNICATE, UH, ABOUT AN EMERGENCY, THAT IT NEEDED TO BE ACCURATE, THOROUGH, AND ALSO BE ABLE TO EXPLAIN TO PEOPLE WHAT WAS HAPPENING.
SO THERE WOULD BE NO SURPRISES IN TERMS OF, UH, THE TYPE OF EVENT WE WERE EXPERIENCING.
AND, UH, AND ALSO TO NOT INDICATE IN THE COMMUNICATION THINGS THAT WE COULDN'T, THAT WE COULDN'T ACTUALLY KNOW FOR SURE.
I THINK ONE OF THE THINGS THAT HAPPENED DURING, UH, STORM, UH, MARA, IS THAT WE TRY TO ANSWER A QUESTION IN, IN GOOD FAITH WHEN WE MAYBE NOT, DIDN'T HAVE THAT IN THAT INFORMATION, BUT, BUT IT'S NOT JUST THE INITIAL COMMUNICATION, IT'S THE ONGOING COMMUNICATION SO THAT WE'RE ACCESSIBLE TO THE VARIOUS SOCIAL MEDIAS THAT ARE, ARE OF VARIOUS MEDIA PLATFORMS THAT ARE OUT THERE, SO THAT THOSE INDIVIDUALS CAN GET THE INFORMATION THEY NEED.
AND AS KEN MENTIONED IN HIS PRESENTATION, WAS THAT WHEN YOU HAVE A POWER OUTAGE, YOU'RE GONNA HAVE TO THINK ABOUT OTHER KINDS OF, UH, ASSETS THAT YOU USE TO GET THE WORD OUT TO THE COMMUNITY.
AND THE OTHER QUESTION I HAD, UM, IS FOR EITHER OF YOU, UM, BUT IF YOU WANTED TO TOUCH ON THE DUAL LANGUAGE COMMUNICATIONS, THE SPANISH COMMUNICATIONS AS PART OF OUR RESPONSE, ANYTHING THAT BUBBLED UP, UM, ANY STRATEGIES OR COMMITMENTS THAT YOU WOULD LIKE TO, TO SHARE OUT AT THIS TIME? COUNCIL MEMBER, THANK YOU FOR THAT QUESTION.
UM, NO COMMITMENTS AT THIS POINT, BUT THAT ISSUE DID BUBBLE UP AS ONE OF THE ITEMS ON THE LIST.
UM, SO I'M DEFINITELY TRACKING THAT.
AND WE WILL WORK ON MAKING SURE THAT THE LANGUAGE ACCESS PIECE IS COVERED COMPLETELY, UM, FOR, UH, ANY ISSUES GOING FORWARD.
UH, IN FACT, UH, WE'VE ACTUALLY HAD A, A CONVERSATION SPECIFICALLY ABOUT THAT.
SO, UM, WE'RE, WE'RE ON THAT ONE.
I APPRECIATE THE PRESENTATION.
I KNOW, UH, WE'VE HAD THE OPPORTUNITY TO SIT DOWN WITH YOU AND SO WE'RE, UH, APPRECIATIVE OF THAT.
UM, I, AND MY TEAM HAD BEEN THROUGH BOTH STORMS AS AN ELECTED OFFICIAL, AND SO THEY, THEY WERE QUITE DIFFERENT.
I THINK THAT'S WHAT, EVEN THOUGH THEY INVOLVE AUSTIN ENERGY, YOU KNOW, ONE WAS ABOUT POWER NOT COMING THROUGH THE LINES BECAUSE YOU WEREN'T ABLE TO DISTRIBUTE IT, THE OTHERS, BECAUSE THE LINES WERE BROKEN.
AND THOSE WERE VERY DIFFERENT SITUATIONS THAT THE CITY HAD TO RESPOND TO.
BUT I'M ALSO LOOKING FORWARD TO, UM, THE INFORMATION AND JUST ABOUT WHAT ARE THE EXPECTATIONS FOR THE ELECTED OFFICIALS.
I THINK A LOT OF US WOULD JUST LOVE TO BE ABLE TO SHARE THE EXACT INFORMATION THAT WE'RE ALL GETTING IN ALL THE PLATFORMS AND NEWSLETTERS THAT WE HAVE ACCESS TO.
UM, BUT IF THERE'S ANYTHING WE CAN DO TO BE MORE HELPFUL, THAT IS ACTUALLY TRYING TO TRACK DOWN RESOURCES THAT CAN BE OF ASSISTANCE.
I THINK A LOT OF US KNOW THE COMMUNITY MEMBERS REALLY WELL AND CAN HELP TRY TO FILL IN ANY GAPS, BUT OFTENTIMES DURING THESE WINTER STORMS, EVERYONE'S JUST TRYING TO DO EXACTLY WHAT THEIR CONSTITUENTS ARE ASKING OF THEM ALL THE TIME.
AND ANYWHERE WE CAN ELIMINATE DUPLICATION AND STREAMLINING THESE, UH, SITUATIONS, I THINK WILL BE HELPFUL.
DID YOU SAY WHEN YOU EXPECT THE REPORT TO BE FINISHED, DID I MISS THAT THE REPORT IS SCHEDULED TO BE FINISHED IN LATE JUNE? LATE JUNE, YES.
APPRECIATE US HAVING THIS OPPORTUNITY, UH, TO SPEAK ABOUT THIS.
AND, AND I BELIEVE WE ALSO HAVE A AFTER IACT ACTION, UM, REPORT COMING TO THAT AND FINANCE COMMITTEE, UM, FOR OUR APRIL MEETING, UH, RELATED TO THE AUDIT THAT WE DID AFTER YURI.
UM, SO I APPRECIATE THIS CONVERSATION BEING HERE AS WELL.
I HAD A QUESTION ABOUT HR, UM, AND PARTICULARLY THE EMERGENCY MANAGEMENT DEPARTMENTS LEVEL OF STAFFING RELATIVE TO WHAT WE HAD AUTHORIZED AND WHERE THAT IS AT NOW, UM, AND WHAT'S BEING DONE TO MAKE SURE THAT THOSE POSITIONS ARE FILLED.
COUNCIL MEMBER, THANK YOU FOR THAT QUESTION.
WE ARE PRIORITIZING THOSE POSITIONS.
I THINK IN THE LAST BUDGET CYCLE, I BELIEVE IT WAS 17 POSITIONS THAT COUNCIL COMMITTED AND WE'RE WORKING TO EXPEDITE, UH, RIGHT
[01:05:01]
NOW HIRING OF FOUR OF THOSE POSITIONS AND THEIR TOP PRIORITY RIGHT NOW.UM, I JUST MET WITH, UH, HR YESTERDAY TO TALK ABOUT THE STATUS FOR THOSE POSITIONS AND, UH, WHEN THE LATE PHASES OF MOVING FORWARD WITH THE HIRING PROCESS FOR THOSE FOUR.
SO BETWEEN JUNE AND AUGUST OF LAST YEAR, WE AUTHORIZED 17 POSITIONS.
HOW MANY OF THOSE ARE NOW FILLED NOW THAT WE'RE IN APRIL OF 23? I, I BELIEVE? IS THERE ARE ANY I DON'T THINK WE FILLED ANY OF THOSE.
SO I, I BRING THIS UP, CITY MANAGER BECAUSE WE HAD A SIMILAR SET OF ISSUES IN OUR AUSTIN WATER AUDIT THAT THE INABILITY TO FILL THE POSITIONS.
AND I, AND I SUSPECT IF WE DRILLED FURTHER DOWN, WE WOULD FIND THAT THERE WERE HURDLES FROM OUR HR PROCESS THAT WERE MAKING, WHAT IS A COMPLICATED TASK WITHIN A DIFFICULT HIRING ENVIRONMENT, MUCH HARDER THAN IT NEEDS TO BE.
UM, I THINK SIX OF THOSE 17 WERE RECLASSIFICATION POSITIONS THAT TOOK MORE THAN SIX MONTHS TO GET, UM, RECLASSIFIED ALONE.
UM, SO THESE, THESE ISSUES ARE RELATED ACROSS, YOU KNOW, THE VARIOUS AFTER ACTION REPORTS OR AUDITS THAT WE'RE GETTING BACK AND, AND WE REALLY NEED TO MAKE SURE THAT WE HAVE THE STAFF IN PLACE TO ADDRESS THE EMERGENCIES.
UM, WHAT WE LEARNED FROM THE AUSTIN WATER, UM, AFTER ACTION REPORT WAS THAT IF YOU'RE GONNA BE PREPARED FOR THAT 1% CASE, WHEN YOU HAVE THE EXTREME EVENTS, NOT HAVING ENOUGH STAFF IS IN EXTREMELY PROBLEMATIC SITUATION TO BE IN.
UM, AND IT, IT ALSO LEADS TO PROBLEMS WITH MANAGEMENT AND OPERATIONS THAT MAKE YOU LESS LIKELY TO BE ABLE TO PIVOT IN THE TIME OF EMERGENCY.
UM, SO I, I REALLY WANT THAT PIECE OF IT TO BE RECTIFIED, UM, AS WE MOVE FORWARD AND TO BE LEANING IN.
UM, SO WE CAN'T EXPECT OUR EMERGENCY DEPARTMENT TO BE PREPARED IN BETWEEN THE EVENTS WHEN, FIRST OF ALL, WE HAVE VERY LITTLE TIME WHEN WE'RE NOT IN AN EVENT, BUT THEN WHEN THEY DON'T, THEY'RE NOT GETTING THE STAFFING, UM, TO BE ABLE TO DO WHAT WE'RE BEING, WHAT THEY'RE BEING ASKED OF THEM, WE'LL CERTAINLY EVALUATE THAT AND FIGURE OUT HOW A WAY TO EXPEDITE.
UM, AND THEN WITH RESPECT TO THE EMERGENCY COMMUNICATIONS, UM, TO WHAT EXTENT ARE WE GOING TO, GOING BACK TO THE VERY BASICS OF EMERGENCY COMMUNICATIONS, I'VE HEARD JESUS ARTICULATE SOME OF THE KINDS OF THINGS THAT YOU NEED TO BE ABLE TO COMMUNICATE DURING AN EMERGENCY.
UM, BUT I THINK BECAUSE WE'VE BEEN IN EMERGENCY OPERATIONS AND MODE FOR SO LONG, I THINK WE'VE, WE'VE LOST THAT MUSCLE TO, TO STEP BACK AND SAY, OKAY, WE'RE IN AN EMERGENCY AND THESE, THIS IS HOW, IT'S EXTREMELY IMPORTANT THAT WE COMMUNICATE IN THAT SITUATION.
SO ARE YOU GONNA BE GOING BACK TO THOSE BASICS? UH, YEAH.
I THINK THAT'S, THAT'S A, THAT IS THE CASE.
AND I THINK, UH, WHAT I'D ALSO ADD IS THAT WE, THAT, THAT WE'RE LOOKING AT THE STRUCTURE, WE HAVE A VERY DECENTRALIZED COMMUNICATION, UH, STRUCTURE.
MANY DEPARTMENTS HAVE THEIR OWN COMMUNICATION OFFICES.
UH, THERE, THERE'S NOT A ROBUST CONNECTION BETWEEN ALL THOSE PIECES.
UH, WE HAD ONE HA EXAMPLE JUST THIS WEEK, IT'S NOT AN EMERGENCY, BUT THERE WAS SOMETHING THAT WAS KEY THAT WAS HAPPENING WITHIN THE DEPARTMENT, AND THE CENTRAL OFFICE WASN'T EVEN AWARE OF IT.
SO WE'RE, I MEAN, PART OF IT IS WE, WE'VE GOTTA BUILD A MUSCLE OF A ONE, ONE FAMILY, ONE CONNECTION SO THAT WE ALL UNDERSTAND WHAT, WHO'S, WHO'S PLAYING WHAT ROLE.
UM, AND THEN FINALLY, IT'S REALLY NOT JUST THE INITIAL COMMUNICATION SO THAT IT'S CLEAR, IT'S, IT'S UNDERSTANDABLE.
IT'S IN THE VARIOUS MEDIAS THAT NEED TO BE THERE, THE VARIOUS LANGUAGES.
IT'S WHAT HAPPENS AFTER THAT INITIAL COMMUNICATION SO THAT WE DON'T ALLOW, ALLOW THERE TO JUST BE A, A BLANK WHERE PEOPLE KIND OF HAVING TO FIGURE OUT STUFF ON THEIR OWN.
AND I THINK, UH, THAT'S WHY WE'RE GONNA NEED TO DO THE, I GUESS THE, THE TABLETOP EXERCISE TO KIND OF EXERCISE THAT MUSCLE.
BUT I THINK IT'S SOMETHING THAT WE KNOW WE NEED TO PAY A LOT OF ATTENTION TO.
SO ONE OF THE THINGS THAT WE'RE GONNA BE LOOKING AT, UM, WHEN THEY COME BACK AND AUDIT AND FINANCE IS KIND OF WHAT THEY'VE COMPLETED FROM THE EARLIER AFTER ACTION REPORTS.
AND, AND WE DON'T ALWAYS COMPLETE THINGS FROM AFTER ACTION REPORTS.
SO I HOPE THAT THERE WILL BE A CLEAR IMPLEMENTATION PLAN, RIGHT, FOR THIS AFTER ACTION REPORT.
AND THAT AS PART OF IT, YOU'RE ALSO LOOKING AT SOME OF THE RECOMMENDATIONS THAT GET KIND OF REPEATED OVER INCIDENT, OVER INCIDENT, BUT WE HAVEN'T MANAGED TO ADDRESS, BUT YET THEY REAR THEIR HEAD AGAIN AND AGAIN.
AND THE LANGUAGE ACCESS IS ONE OF THOSE THAT, YOU KNOW, RIGHT.
HAS COME UP AGAIN AND AGAIN AND AGAIN.
NO, THERE, THERE ARE A SERIES OF, OF FINDINGS THAT HAVE BEEN, THAT HAVE COME OUT IN THE AFTER
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ACTION REPORT IN THE, OR BOTH STORMS. I MEAN, THE ONE PRIME EXAMPLE THAT WE'RE, UH, I'M NOT SAYING WE'RE STRUGGLING WITH IT, WE KNOW IT NEEDS TO GET DONE, BUT WE KNEW IN 21 WE NEEDED TO FIGURE OUT HOW TO GET GENERATORS TO THE WARMING CENTERS.UH, SO IN, UH, 23, WE DIDN'T HAVE, WE DIDN'T HAVE THAT QUITE FIGURED OUT.
AND SO THAT IN THAT TWO YEAR PERIOD, WE WEREN'T ABLE TO DELIVER.
AND THERE'S A LOT OF REASONS FOR THAT.
UM, BUT WE SHOULDN'T BE MAKING EXCUSES.
WHAT WE'VE SAID TO ALL THE INDIVIDUALS THAT ARE INVOLVED IN THIS, UH, EFFORT IS THAT IT ISN'T AN ISSUE OF RESOURCES.
IT'S AN ISSUE OF SOMEBODY STEPPING UP AND TAKING RESPONSIBILITY AND THEN DRIVING IT HOME.
AND I THINK THAT'S WHY KEN'S IN THE ROLE HE'S IN NOW, IS TO BE IDENTIFYING CLEAR ROLES AND RESPONSIBILITIES FOR FOLKS, AND THEN TO HAVE THE AUTHORITY TO DRIVE IT.
AND WHEN THAT DR WHEN HE'S NOT ABLE TO DRIVE IT, HE'S GONNA BRING IT TO THE PROPER ATTENTION TO THE RIGHT LEVEL SO THAT IT CAN BE TAKEN CARE OF.
I DO HOPE THAT DURING THE BUDGET PROCESS THOUGH, IF THERE ARE RESOURCE NEEDS THAT THOSE ARE MADE APPARENT, AND IF WE'RE DECIDING NOT TO FUND THEM, THAT THAT IS MADE OF APPARENT TO COUNSEL.
UM, I ALREADY HAVE A BUDGET QUESTION READY TO ASK YOU.
YOU, WHAT, WHAT DID THEY ASK FOR THAT THEY DIDN'T GET? SO IT'D BE GREAT IF YOU CAN, YOU KNOW, IF THEY'RE, IF WE'RE TAKING VERY SERIOUSLY THE REQUESTS, I UNDERSTAND THAT NOT EVERY REQUEST MIGHT GET PRIORITIZED.
UM, BUT IN THE PAST, ONE OF THE CHALLENGES WE'VE HAD IS THAT THERE HAVE BEEN NEEDS FOR EMERGENCY PREPAREDNESS THAT THROUGH THE PROCESS OF THE BUDGET WHERE WE'RE, WHERE WE'RE BEING ASKED NOT TO ASK FOR NEW MONEY, THEY'RE NOT BUBBLING UP TO THAT.
AND THEN WE DON'T EVEN KNOW THAT THESE NEEDS HAVE BEEN IDENTIFIED, UM, FOR US TO MAKE CHOICES ABOUT THOSE.
YOU KNOW, I, ONE OF THE THINGS THAT I'LL, I'LL BE INTERESTED IN TO SEE WHAT, UH, WHAT KEN AND AND BRUCE PULLED TOGETHER IN TERMS OF THESE AFTER ACTION REPORTS, IS THAT UNDER A UNIFIED COMMAND STRUCTURE FOR AN EMERGENCY, ALL OF THE CITY'S ASSETS ARE AT THE DISPOSAL OF THE HOMELAND SECURITY EMERGENCY DEPARTMENT.
ALL OF THE ASSETS, NOT, NOT JUST SOME OF THEM, ALL OF THEM.
AND THEN THEY'VE GOTTA MAKE THE DECISION OF WHAT ASSETS ARE GONNA BE NEEDED IN THAT IMMEDIATE EMERGENCY AND THOSE THAT MIGHT BE NEEDED 20 FOURS HOUR HOURS OUT, OR 48 HOURS OUT.
AND, AND WE HAVE A LOT OF ASSETS IN THE CITY.
AND SO NOT, NOT, YOU KNOW, NOT THAT THAT I WANT TO BE KNOWN AS SOMEBODY WHO, UH, IS FRUGAL, TOO FRUGAL WITH MONEY.
I WANNA MAKE SURE THAT, THAT WE'RE SPENDING MONEY IN A WISE WAY FOR THE NEEDS AND, AND, YOU KNOW, NOT HAVE, UH, KIND OF DUPLICATION THROUGHOUT THE ORGANIZATION THAT MAY NOT BE NECESSARY TO REALLY BE EFFECTIVE.
SO THAT'S AN EVALUATION THAT WE'LL MEET YOU DO.
ANY FURTHER QUESTIONS? AND I'M GONNA NEED SOME HEALTH SERVICES HERE IN A FEW MINUTES.
WE LOOK FORWARD TO THE NEXT STEPS CENTRAL HELP.
PLEASE