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I JUST REMEMBER

[00:00:01]

NOW.

[CALL TO ORDER]

HELLO EVERYBODY.

UM, THANK YOU FOR JOINING US.

TODAY IS SEPTEMBER 11TH, AND THIS IS THE REGULAR SEPTEMBER MEETING OF THE PUBLIC SAFETY COMMISSION.

UM, I BELIEVE WE HAVE QUORUM, SO WE'RE GONNA GO AHEAD AND GET STARTED, UM, WITH A ROLL CALL.

UM, COMMISSIONER HOLMES PRESENT.

COMMISSIONER KOFF IS NOT JOINING US.

COMMISSIONER HALL MARTIN IS ALSO NOT JOINING US.

COMMISSIONER NGUYEN, I NEED TO UNLOCK YOUR IPHONE FIRST.

OH BOY.

SORRY, MY PHONE IS GOING AWAY.

UM, UH, COMMISSIONER NGUYEN MIGHT BE JOINING US ONLINE.

IS HE ONLINE BY ANY CHANCE? OKAY.

UM, COMMISSIONER ORR HERE.

COMMISSIONER PENA.

HERE.

COMMISSIONER RUTAN PRESENT.

COMMISSIONER SMITH HERE.

COMMISSIONER BERNHARDT PRESENT.

AND I AM ALSO HERE, .

AND WITH THAT, UM, WE'LL GO AHEAD AND GET STARTED.

DO WE HAVE ANYONE ONLINE FOR PUBLIC COMMUNICATION? SHE DOES NOT CALL.

IS SHE, UM, SPEAKING TO A SPECIFIC ITEM? NO.

OKAY.

JUST GENERAL.

OKAY.

SO WE'LL JUST TAKE, WILL WE JUST TAKE THEM IN BETWEEN WHENEVER THEY COME ON? SHE'S ABLE, IF SHE'S ABLE.

OKAY.

OKAY.

IS NOW I APOLOGIZE.

UM, OKAY.

SO WITH THAT, WE'LL MOVE

[APPROVAL OF MINUTES]

ON TO THE APPROVAL OF MINUTES.

MS. JACKSON CIRCULATED THOSE.

UM, CAN I GET A MOTION TO APPROVE THE MINUTES FROM ANYONE? I'LL MOVE THAT.

OKAY.

COMMISSIONER HOLMES.

AND A SECOND.

I SECOND THAT.

OKAY.

DO WE HAVE ANY DO CHANGES, ADDITIONS? LEMME JUST TAKE, GIMME 30 SECONDS JUST TO GLANCE OVER 'CAUSE IT WAS A LATE EMAIL OUT ON THE MINUTES.

OKAY.

BUT APOLOGIES.

OKAY.

OKAY.

WITH NO CHANGES, I'LL GO AHEAD AND I DO NEED TO TAKE A VOTE ON ADOPTING THE MINUTES, SO I'M GONNA GO AROUND THE TABLE.

COMMISSIONER ORR? YES.

COMMISSIONER HOLMES? YES.

COMMISSIONER SMITH? YES.

COMMISSIONER PENA? YES.

COMMISSIONER BERNHARDT? YES.

COMMISSIONER RUTAN? YES.

AND I WILL, UM, VOTE YES AS WELL.

OKAY.

AND AFTER THAT WE'RE GONNA MOVE ON TO

[2. Staff Briefing to provide follow up responses to questions presented at August 3, 2023 meeting.]

STAFF BRIEFINGS.

UM, I DID NOT CIRCULATE ADDITIONAL QUESTION, LIKE ANY FOLLOW-UP QUESTIONS FROM THE AUGUST MEETING TO, TO ANYONE.

UM, BUT I DID WANT TO RESURFACE JUST SOMETHING THAT'S BEEN ON THE LIST FOR A WHILE AND THAT'S THE, UM, RESPONSE TO RESISTANCE REPORTS.

UM, I THINK I FIRST ASKED IN APRIL FOR WHEN THE 2021 AND 2022 REPORTS WOULD BE, UM, POSTED.

I THINK WE GOT AN UPDATE THAT 2021 IS COMING SOON.

UM, AND SO I JUST, IF WE COULD, UM, I JUST WANNA PUT ON THE RECORD SO THAT WE COULD RECIRCULATE THAT WITH FOLLOW UP QUESTIONS FOR NEXT MONTH.

OKAY.

AND I THINK THAT IS IT.

CAN I ASK? YES.

UM, SO I, I BELIEVE I ASKED IN MAY ABOUT THE AMOUNT OF, UM, OVERTIME THAT, UH, SWORN OFFICERS WERE DEDICATING TO COVERING SHIFTS, UH, IN THE NINE ONE ONE CALL CENTER MM-HMM.

.

UM, AND I DON'T BELIEVE WE'VE GOTTEN THAT DATA.

IT'S RELEVANT TO TODAY'S CONVERSATION.

UM, I JUST WANT TO MAKE SURE THAT IT DOESN'T GET LOST.

OKAY.

THANK YOU FOR REMINDING ME OF THAT.

YES.

AND I DON'T BELIEVE THAT THAT'S IN THE, I GUESS WE'LL SEE IF IT'S IN THE OVERTIME A P D REPORT, BUT I DON'T BELIEVE IT IS.

OKAY.

ALL RIGHT.

WITH THAT, WE WILL MOVE ON TO, UM,

[3. Public Safety Quarterly Report given by Teresa Gardner – Austin Travis County EMS (Sponsors: Commissioners Ramírez and Bernhardt)]

I BELIEVE IT'S EM S'S TURN FOR QUARTERLY REPORT.

YES.

GOOD AFTERNOON COMMISSIONERS.

UH, MY NAME'S WESS HOPKINS.

I'M AN ASSISTANT CHIEF FOR AUSTIN, TRAVIS COUNTY E M S.

I WILL BE GIVING THE THIRD QUARTER REPORT FOR CHIEF GARDNER, WHO IS ABSENT THIS AFTERNOON.

[00:05:01]

IF WE MOVE TO THE FIRST SLIDE, UH, WE'LL SEE THE CURRENT E M S DEPARTMENT STAFFING FOR AUSTIN TRAVIS COUNTY E M SS.

WE HAVE AN AUTHORIZED STRENGTH OF 665.

UH, FIELD SWORN IS 528.

WE'VE GOT 137 VACANCIES.

THIS IS THROUGH THE END OF JUNE, OF COURSE.

UH, AND WE HAVE A CURRENT ACADEMY THAT GRADUATES ON FRIDAY, SEPTEMBER 22ND, WHICH WE'LL TALK ABOUT HERE IN A SECOND.

IT PUTS OUR Q THREE, UH, Q THREE AVERAGE AT 20%.

AND I JUST GOT THE CLICKER, SO WE'LL SEE HOW THIS GOES.

THERE WE GO.

UH, SWORN SEPARATIONS.

YEAR TO DATE, UH, WE'VE HAD 29 THAT HAVE RESIGNED AND WE HAVE SEVEN RETIREMENTS THAT HAVE OCCURRED, UH, BREAKING THIS DOWN BY A SWORN TENURE AT SEPARATION.

WE CONTINUE TO SEE THE MAJORITY OF THESE SEPARATIONS COMING FROM THE FIVE TO 10 YEAR RANGE, FOLLOWED BY THE ONE TO FIVE YEAR RANGE.

UH, VACANCY RATES, BOTH SWORN AND CIVILIAN.

CIVILIAN VACANCY RATE HOVERING AT 15% SWORN VACANCY RATE AT THAT 20%.

UH, WE WILL GRADUATE 30 CADETS ON FRIDAY, SEPTEMBER 22ND, 22 OF THOSE BEING EMTS AND EIGHT OF THOSE BEING PARAMEDICS.

OUR NEXT ACADEMY IS SLATED FOR OCTOBER WITH 16 EMTS AND ONE COMMUNICATIONS MEDIC.

ADDITIONALLY, WE HAVE 21 MEDICS ARE IN OUR IN-HOUSE PARAMEDIC PROGRAM.

UH, THEY WILL COMPLETE THAT IN JANUARY AND BE ELIGIBLE TO CREDENTIAL AT THAT CLINICAL SPECIALIST LEVEL.

UH, E M S TURNOVER RATE, UH, ON THIS SWORN SIDE CONTINUES TO BE LESS THAN 1% OF BOTH IN MAY AND IN JUNE.

AND THEN GETTING TO OUR OPIOID OVERDOSE E M S DATA, UH, YOU CAN SEE THAT THE BLUE LINE NOTATES OPIOID ALERTS, THE NUMBER OF OPIOID OR OVERDOSES WE'VE HAD IN THE 9 1 1 SYSTEM.

UH, THE GRAY LINE TRACKS THE NUMBER OF PILLS THAT WE'RE SEEING ON THOSE OVERDOSES.

UH, WE'VE ADDED A NEW LINE, WHICH IS THAT ORANGE LINE, WHICH IS THE ADOLESCENT AGE, WHICH IS UNDER THE AGE OF 18.

UH, MUCH LIKE I TALKED ABOUT WHEN I SPOKE TO YOU IN JUNE, WE'VE SEEN A SIGNIFICANT INCREASE IN OPIOID OVERDOSES.

UH, WE SAID WE'D HAVE THE SPRING AND SUMMER SPIKE, AND WE HAVE, UH, DEFINITELY SEEN THAT REACHING A RECORD HIGH IN AUGUST.

UH, WE'VE HAD OUR FIRST CONFIRMED CASES OF XYLAZINE DEATHS IN TRAVIS COUNTY, BUT POSITIVELY WE'VE ENROLLED OUR FIRST ADOLESCENT IN OUR BUPRENORPHINE BRIDGE PROGRAM TO DO, TO GET THEM INTO A MEDICATION ASSISTED TREATMENT PROGRAM.

SO JUST A LITTLE BIT OF POSITIVITY THERE.

AND THEN WE'LL TALK ABOUT OUR OPIOID RESCUE KIT DISTRIBUTED BY AUSTIN, TRAVIS COUNTY E M S.

AND SO THE GRAY LINE IS THE NUMBER OF, UH, NARCAN KITS THAT WE'VE DISTRIBUTED.

AND SO ONE OF THE CHANGES WE'VE MADE HERE AS OF LATE IS THAT WE'VE ALLOWED THOSE NARCAN RESCUE KITS TO GET ON OUR DISTRICT COMMAND VEHICLES.

THAT'S A POSITIVE BECAUSE THE FIRST TIME SOMEBODY OVERDOSES, THAT'S WHEN WE KNOW THAT THEY HAVE A PROBLEM.

AND SO GETTING THAT RESCUE KIT IN THEIR HANDS OF THE PATIENT AND THE FAMILY AND BYSTANDERS IS GONNA BE HELPFUL IF THEY HAVE A, A RELAPSE OR A SECOND OVERDOSE.

AND SO OPIOID RESCUE KITS PRIOR TO E M S ARRIVAL WAS AT A RECORD HIGH.

SO THIS ENCOMPASSES THE POLICE, FIRE FAMILY AND BYSTANDERS WAS 82 OUT OF 162 KITS.

SO NOT JUST BY THE MONTH, BUT FOR THIS THIRD QUARTER WE'VE HAD A GREATER THAN THAN 50% IN THAT NARCAN RESCUE KIT BEING UTILIZED.

AND THEN BREAKING IT DOWN TO JUST FAMILY AND BYSTANDERS.

UH, AGAIN, IT'S ANOTHER RECORD HIGH 37 OUT OF THE 162 KITS WERE WERE USED IN AUGUST OF, OF 2023.

UM, I WILL TAKE ANY QUESTIONS THAT YOU HAVE, BUT IN THIS QUARTERLY REPORT, I'M ACTUALLY GONNA BRING UP TWO OF MY COLLEAGUES AND, AND WE'RE GONNA GIVE A HIGH LEVEL OVERVIEW OF OUR COLLABORATIVE CARE COMMUNICATION CENTER OR C FOUR LINE AS PART OF THIS REPORT.

THAT'S GREAT.

UM, I DID HAVE A QUICK QUESTION JUST ABOUT THE BYSTANDER AND FAMILY USE OF THE RESCUE KITS.

YES, MA'AM.

UM, DO WE KNOW WHERE FAMILY MEMBERS, LIKE WHAT, WHAT ARE SOME PLACES THAT FAMILY MEMBERS AND PEOPLE IN THE COMMUNITY CAN PICK UP KITS? 'CAUSE THAT'S A, THAT'S A LARGE, THAT'S A LARGE AMOUNT OF KITS THAT ARE BEING USED.

AND SO JUST HAVING MORE KNOWLEDGE ABOUT WHERE THOSE ARE WOULD BE HELPFUL.

IT IS A LARGE AMOUNT.

UH, WE ARE ACTUALLY IN THE PROCESS OF ROLLING OUT OUR BREATHE NOW CAMPAIGN.

AND SO WHAT'S IMPORTANT ABOUT THIS IS THAT NARCAN IS PRETTY PRECIOUS RIGHT NOW IN HOW WE GET IT, AND IT ALSO EXPIRES.

AND SO WE WANNA MAKE SURE THAT WE'RE GETTING IT IN THE HANDS OF FOLKS THAT NEED IT.

SO THAT'S ONE PIECE OF THIS.

UM, BUT WE CAN ABSOLUTELY KINDA GET THAT INFORMATION TO YOU AND, AND NAVIGATE THAT.

WE WANNA MAKE SURE THAT WE HAVE ENOUGH, UH, NARCAN THROUGH, UH, THE HARM REDUCTION FOLKS, BUT ALSO COMMUNITY HEALTH PARAMEDICS AND THEN POLICE AND FIRE AS WELL.

OKAY.

BECAUSE ON THOSE OVERDOSE CASES, WE, WE KNOW WE HAVE A PROBLEM THERE.

SO WE REALLY ARE WORKING TO ADDRESS

[00:10:01]

THOSE.

OKAY.

SO YOU, YOU, THERE AREN'T STANDARD PLACES WHERE YOU GUYS LEAVE THEM RIGHT NOW OR THERE ARE CORRECT.

THEY'RE NOT STANDARD PLACES.

WE, WE LEAVE THEM, UH, WE ARE WORKING TOWARDS IDENTIFYING BY ZIP CODE AREA, UH, BUSINESSES AND SHOPS WHERE OVERDOSE OCCUR BECAUSE IF WE'VE GOT MORE THAN ONE OVERDOSE AT A BUSINESS, THEN WE WANT TO DEFINITELY GET THAT TR STAFF TRAINED AND DEPLOY THOSE KITS OVER THERE.

OKAY.

AND SO WE ARE, WE ARE ON THE 10 YARD LINE OF, OF GETTING THAT ROLLED OUT.

OKAY.

GREAT.

THANK YOU.

COMMISSIONER BERNHARD.

UM, THE, UM, NEW DRUG, THE, UM, XYLAZINE XYLAZINE, I WAS GONNA BUTCHER THAT.

UM, UH, ARE PEOPLE TAKING THAT INTENTIONALLY OR IS IT LIKE FENTANYL AND SOME OF IT FALLS INTO THE CATEGORY OF UNINTENTIONAL INGESTION AND INTENTIONAL? I DO NOT BELIEVE THAT IT'S AN UNINTENTIONAL INGESTION.

OKAY.

I THINK THEY'RE PURPOSEFULLY USING IT.

UM, ONE OF THE THINGS THAT, THAT, THAT WE KNOW IS THAT, UM, WE HAVE XYLAZINE BUT THEN WE ALSO HAVE KIND OF A COMBINATION OF DRUGS WHERE YOU HAVE MAY HAVE XYLAZINE MIXED WITH FENTANYL AND THINGS LIKE THAT.

SO WE THINK THAT THESE ARE ARE INTENTIONAL OVERDOSES.

UM, I JUST, AS WE WALKED IN AND I'LL INTRODUCE HIM INTO SECOND DIVISION CHIEF STEVE WHITE MENTIONED THAT WE HAD SOMEONE OVER THE WEEKEND THAT WAS ACTUALLY SMOKING FENTANYL.

AND SO WE WERE ABLE, THEY HAD A, A NARCAN RESCUE KIT ON SITE AND THEY DEPLOYED MULTIPLE, YOU KNOW, PRIOR TO FIRST RESPONDER GETTING THERE.

AND SO, SO THAT WAS A SUCCESS STORY FOR US.

SO CERTAINLY, UH, TACKLING THIS PROBLEM, BUT IT'S A, IT'S A DIFFICULT NEEDLE TO THREAD.

AND DO YOU, AND THIS, I'M SORRY TO ASK YOU THIS QUESTION 'CAUSE UM, ANYWAY, I JUST WANTED TO KNOW, IS THERE A DON'T USE ALONE HOTLINE THAT OPERATES FOR TRAVIS COUNTY? I DON'T KNOW IF HARM REDUCTION DEPLOYS THAT OR NOT.

DO Y'ALL HAVE ANY KNOWLEDGE OF THAT BY CHANCE? NO, NO.

NOT THAT I'M AWARE OF.

I'LL, I'LL ASK THE FOLKS THAT.

THE HARM REDUCTION COALITION.

IT'S A REALLY GOOD QUESTION.

THANKS.

OH, COMMISSIONER SMITH? YES, MA'AM.

UM, JUST FOR, UM, MY OWN, UM, DUE DILIGENCE, I WOULD ALSO SUGGEST THAT YOU LOOK INTO NOT ONLY BUSINESSES, BUT ORGANIZATIONS THAT ARE ON THE FRONT LINE.

I KNOW SPECIFICALLY DURING INCLEMENT WEATHER RESPONSE, THOSE THAT ARE OUTSIDE, UM, IN OUR UNHOUSED ARE LOOKING FOR ANY TYPE OF RELIEF.

AND SO WHILE THEY'RE DOING THEIR ACTIVITIES AS FAR AS GETTING, YOU KNOW, BLANKETS AND THINGS OF THAT NATURE OUT TO PEOPLE, WE DO STUMBLE ACROSS SOMEONE WHO'S ACTIVELY, UM, IN, IN THAT SITUATION.

SO JUST AN F Y I ON THAT.

AND THEN I WAS ALSO WONDERING, ON SLIDE SEVEN, UH, WE KNEW WE WERE GONNA HAVE THAT PEAK IN THE SUMMER.

UM, CAN YOU TELL ME ANYTHING ABOUT HOW WE'RE COMPARED TO NATIONALLY OR ARE, ARE WE KIND OF IN PAR WITH THAT SPIKE? OR IS OUR SPIKE HIGHER THAN OTHER CITIES PER CAPITA? IF YOU, IF YOU CAN, IF YOU, IF YOU HAVE THAT KNOWLEDGE, HOW DO WE STACK UP BASICALLY? YEAH, I THINK IT'S A FANTASTIC QUESTION.

I, I DON'T HAVE THAT DATA IN FRONT OF ME, BUT CERTAINLY SOMETHING TO LOOK AT.

WE REALLY HAVE BEEN TRYING TO GET A HANDLE ON THINGS LOCALLY HERE.

UM, WE CERTAINLY UTILIZE, UH, A, A PLATFORM CALLED OD MAP.

MM-HMM.

SO WE LOOK AT THINGS IN, IN TEXAS, I JUST DON'T HAVE THAT, BUT I'VE NOT LOOKED NATIONALLY AND I JUST DON'T HAVE IT IN FRONT OF ME.

I APOLOGIZE.

NO, NO, NO, NO NEED TO APOLOGIZE.

JUST MAYBE NEXT TIME IF I COULD HAVE A YELLOW LINE OR SOMETHING JUST SO I CAN TRACK THAT.

NATIONAL AVERAGE COMPARATIVELY.

THAT'D BE AWESOME.

THANK YOU.

OKAY.

DO YOU HAVE ANY OTHER QUESTIONS? OKAY.

SO WITH THAT, I'M GONNA INTRODUCE TWO OF MY ESTEEM COLLEAGUES HERE.

I'VE GOT DIVISION CHIEF, UH, STEVE WHITE RIGHT HERE.

AND I'VE GOT COMMANDER GABE WEBER AND THEY RUN OUR COLLABORATIVE CARE COMMUNICATIONS CENTER.

AND SO WE WANT TO GIVE YOU A HIGH LEVEL OVERVIEW OF THAT AND LET THEM TALK ABOUT SOME OF THE GOOD THINGS THAT WE'RE DOING THERE.

SO WITH THAT, I WILL, UH, AND YOU KNOW WHAT, I WILL, UH, I WILL PASS THIS OVER TO YOU.

CLICK IT.

IT'S THE RIGHT ONE.

YEP.

THAT'S IT.

THANK YOU.

GOOD AFTERNOON.

UH, MY NAME IS STEVEN WHITE.

I'M A DIVISION CHIEF OVER AT INTEGRATED SERVICES HERE AT AUSTIN.

TRAVIS COUNTY E M SS.

UH, THANK YOU FOR YOUR TIME THIS AFTERNOON.

I'M VERY EXCITED AND SOMETIMES I'LL START TALKING WITH MY HANDS WHEN I START TALKING ABOUT THE C FOUR.

UH, IT IS OUR COLLABORATIVE CARE COMMUNICATION CENTER.

UM, IT IS HOW WE ARE APPROACHING A MODERN DAY E M S, UH, IN EMERGENCY MEDICAL SERVICES.

WE SPEND MOST OF OUR TIME, MOST OF OUR TRAINING, UM, TRAINING FOR HIGH ACUITY PATIENTS, UH, THE LIFE AND DEATH, UM, PATIENTS WHERE OUR INTERVENTIONS ARE GONNA MAKE A HUGE DIFFERENCE IN IN THE SURVIVAL OF THAT PATIENT.

UH, FOR THIS CONVERSATION, WE ARE TALKING ABOUT LOW ACUITY PATIENTS, UH, THROUGHOUT COVID AND, AND EVEN A FEW YEARS BEFORE COVID,

[00:15:01]

WE'RE FINDING THAT OUR CALL VOLUMES ARE GOING UP BECAUSE WE ARE THE ACCESS POINT TO HEALTHCARE FOR MANY PEOPLE IN OUR COMMUNITY.

UH, THEY KNOW THAT IF THEY CALL 9 1 1, UH, WITH A MEDICAL COMPLAINT, THAT WE WILL SHOW UP.

WHAT WE'RE TRYING TO DO WITH THE COLLABORATIVE CARE COMMUNICATION CENTER IS REALLY TAILOR OUR RESPONSE SO THAT WE GET THE RIGHT RESOURCE TO THE RIGHT PATIENT AT THE RIGHT TIME.

AND THAT MAY NOT NECESSARILY ALWAYS THE BEST RESOURCE MAY NOT ALWAYS NECESSARILY BE AN AMBULANCE.

IF WE GO TO THE NEXT SLIDE.

OH, I GOT THE CLICKER.

ALRIGHT.

SO WHEN WE TALK ABOUT THESE LOW ACUITY PATIENTS THAT WE'RE ADDRESSING, WE SPEND SO MUCH TIME TRAINING FOR HIGH ACUITY PATIENTS THAT WE ACTUALLY HAVE TO SPECIFICALLY TRAIN PARAMEDICS AND CREDENTIAL THEM, UH, FOR THESE LOWER ACUITY PATIENTS.

UH, IN 2019, WITH C OVID 19, THIS WAS YOUR COVID HOTLINE, THIS IS THE ORIGINS OF THE C FOUR TEAM.

UH, WHEN EVERYONE IN PUBLIC SAFETY WAS USING THIS COVID HOTLINE TO GET THEIR INFORMATION, WE MANAGED A LOT OF THE WORKFORCE AND PUTTING PEOPLE OFF SICK AND GETTING THEM BACK ON DUTY, UH, MAKING SURE THAT WE'RE FOLLOWING, UH, THE MOST RECENT C D C GUIDELINES.

AND IN DOING THAT, WE EXTENDED THAT OUT TO THE PUBLIC AND FOUND THAT THERE WERE A LOT OF, UH, PROBLEMS AND ISSUES THAT WE COULD DEAL WITH, UH, JUST OVER THE PHONE WITHOUT HAVING, UH, TO SEND A RESOURCE OUT TO THAT SCENE.

SO THEN IN 2021, WE WENT AHEAD AND CREATED THE, UH, INTEGRATED SERVICES DIVISION.

UH, THAT ENCOMPASSES NOT JUST THE C FOUR LINE, BUT ALSO OUR COMMUNITY HEALTH PARAMEDICS AND NOW OUR AIRPORT PROGRAM AS WELL.

SO WITH ALL THOSE TEAMS WORKING TOGETHER UNDER INTEGRATED SERVICES, WE'RE ABLE TO REALLY FOCUS ON THOSE LOW ACUITY CALLS, WHICH THEN FREES UP THE ACTUAL AMBULANCES TO RESPOND FOR THE HIGHER ACUITY CALLS.

ONE OF THE APPROACHES THAT THE C FOUR HAS TAKEN IS THIS MULTIDISCIPLINARY APPROACH TO WHERE IT'S NOT JUST A PARAMEDIC.

WE TRY TO INTEGRATE OTHER HEALTHCARE SPECIALTIES AS WELL.

SO WHEN WE ARE LOOKING FOR THE RIGHT RESOURCE FOR THIS PATIENT, IT MAY BE A PARAMEDIC, UH, IN A SINGLE PERSON RESPONSE UNIT, RESPONDING BY THEMSELVES.

IT MAY BE A, UH, PHYSICIAN'S ASSISTANT OR ONE OF OUR PARAMEDIC PRACTITIONERS, UH, GOING OUT TO ASSESS A PATIENT.

IT MAY BE ONE OF OUR PHYSICIANS GOING OUT TO ADDRESS A PATIENT.

AND IN ALL OF THESE CASES, THEY CAN COLLABORATE WITH EACH OTHER.

WE USE, UH, SOME PRETTY NEAT TECHNOLOGY THAT ALLOWS US TO DO TELEHEALTH CONSULTATIONS TO, UH, GET PRESCRIPTIONS DELIVERED.

UH, AND AS WE SAW IN THAT PICTURE JUST A SECOND AGO, WE CAN EVEN DO STITCHES AND SMALL PROCEDURES OUT IN THE FIELD.

UM, SOME OF THE, UH, OTHER DISPOSITIONS THAT WE'VE BEEN ABLE TO DEVELOP INSIDE THE C FOUR ALLOW US TO SKIP THE HOSPITAL AS A STEP.

SO THERE ARE CERTAIN SITUATIONS WHERE LONG-TERM CARE IS NEEDED.

POST-ACUTE MEDICAL CARE, LIKE IN A SPECIALTY HOSPITAL, EVEN HOSPICE CARE, UM, WE CAN ADMIT PATIENTS DIRECTLY INTO THOSE PROGRAMS WITHOUT THEM HAVING TO GO TO THE HOSPITAL FIRST.

AN EMERGENCY ROOM IS SET UP MUCH LIKE AN AMBULANCE, IT'S SET UP FOR THE PEOPLE WHO ARE VERY SICK AND CLOSE TO DYING.

SO, UH, IF WE CAN SKIP THE AMBULANCE PART, WE CAN SKIP THE HOSPITAL PART.

IT'S A MUCH BETTER OUTCOME AND THE PATIENTS ARE MUCH MORE COMFORTABLE BECAUSE THEY'RE GETTING THE RESOURCE THAT THEY NEED DIRECTLY.

UM, ONE OF THE OTHER THINGS THAT WE'VE IMPLEMENTED IN THE C FOUR THAT'S SOMEWHAT NEW IS, UH, WE HAVE ALTERNATE DESTINATIONS.

UH, PREVIOUS TO THIS PROGRAM, THE HOSPITAL IS PRETTY MUCH OUR ONLY OPTION.

IF YOU, IF YOU WANTED TO SEEK MEDICAL CARE, YOU COULD ONLY GO TO A HOSPITAL.

UH, WE NOW HAVE PARTNERSHIPS WITH, UH, DIFFERENT CLINICS AND, UH, DIFFERENT PROGRAMS WHERE, UH, IF WE DO A TELEHEALTH WITH YOUR DOCTOR, WE WILL TRANSPORT YOU TO THE CLINIC AND YOU CAN SEE YOUR DOCTOR AT THAT TIME, UM, AND SKIP THE HOSPITAL ALTOGETHER.

AND THAT KIND OF DECISION IS MADE IN CONSULTATION WITH NOT JUST THEIR PRIMARY PHYSICIAN, BUT ALSO WITH ONE OF OUR PHYSICIANS AND THEN ONE OF THE PARAMEDIC NAVIGATORS.

SO IT OPENS UP A LOT OF AVENUES FOR PEOPLE TO STAY PLUGGED INTO THEIR PRIMARY CARE PHYSICIAN SYSTEM, UH, INSTEAD OF HAVING A TREATMENT PLAN WITH THEIR PRIMARY CARE PHYSICIAN AND THEN GOING TO A HOSPITAL.

AND THEN THAT TREATMENT PLAN CHANGES AND

[00:20:01]

THEN THAT COMMUNICATION NEVER GETS SHARED.

SO THEY GET A MUCH BETTER, UH, TREATMENT PLAN BY STAYING WITH ONE DOCTOR.

SO THE C FOUR RECEIVES, UM, PATIENTS THROUGH THREE MAIN ROUTES OF ENTRY.

ONE IS IF AN AMBULANCE IS ON SCENE WITH A PATIENT THAT THEY RECOGNIZE MAY NOT BE BEST SERVED IN AN EMERGENCY ROOM, THEY CAN CALL IN AND CONSULT WITH THE C FOUR, WHERE WE WILL TRY TO THEN CONNECT THEM OR PROVIDE RESOURCES.

UH, OUR COMMUNITY HEALTH PARAMEDICS ALSO CAN USE THE C FOUR, AND THAT RELATIONSHIP REALLY WORKS BOTH WAYS.

UM, OUR COMMUNITY HEALTH PARAMEDICS AND CASE MANAGERS DO A GREAT JOB OF CONNECTING PEOPLE TO RESOURCES, AND THEY ARE OFTEN THE RESOURCE WE TURN TO IN THE C FOUR, UH, FOR HELP.

BUT WHAT WE'VE BEEN DOING RECENTLY IS WE'VE BEEN ABLE TO IDENTIFY A SMALL PERCENTAGE OF 9 1 1 CALLS, UH, THROUGH OUR TRIAGE PROCESS THAT WE CAN SEND DIRECTLY TO THE C FOUR WITHOUT EVER SENDING AN AMBULANCE.

WE'RE GONNA SEND SOMETHING, IT MAY BE A PARAMEDIC IN A SINGLE RESPONSE UNIT, WE MAY BE ABLE TO SOLVE THEIR ISSUE OVER THE PHONE, UH, BUT IT'S GOING TO SAVE THAT AMBULANCE AS A RESOURCE FOR THOSE HIGHER ACUITY CALLS.

AND THEN THE C FOUR HAS BEEN CRITICAL IN, UH, ITS PARTICIPATION AND IN THE RESPONSE THAT IT HAS TO LARGE SCALE INCIDENTS.

WHEN WE HAD ALL OF OUR ICE STORMS, HURRICANES, UM, OUR HEAT WAVES, UH, THEY'RE REALLY IN A VERY GOOD POSITION OF OVERWATCH IN THE 9 1 1 SYSTEM TO SEE WHERE PEOPLE ARE COMING IN AND OUT AND TO REALLY IDENTIFY SOME OF THE ISSUES AND THEN ADDRESS THEM.

ONE OF THE GREATEST EXAMPLES OF THAT IS DURING, UH, THE LAST WINTER STORM WHEN WE LOST POWER FOR A WHILE, WE WERE ABLE TO IDENTIFY PATIENTS THAT NEEDED OXYGEN BECAUSE THEY DIDN'T HAVE ANY POWER.

AND THEN WE WERE ABLE TO, UH, FIND THAT OXYGEN, DELIVER THAT OXYGEN, TRACK THOSE BOTTLES, REPLENISH THEIR BOTTLES, AND GET THEM, UH, OVER THE HUMP UNTIL WE GOT OUR POWER RESTORED AND THEIR OXYGEN CONCENTRATORS COULD TURN BACK ON.

UM, THIS IS A QUICK HEAT MAP OF KIND OF WHERE THE C FOUR INTERACTS WITH THE, WITH OUR COMMUNITY.

AND YOU CAN SEE WE HIT THE ENTIRE CITY.

UH, WE ARE FOCUSED ON THE HIGHER POPULATION AREAS, UH, ALONG I 35, BUT WE HAVE A VERY, VERY HIGH CONCENTRATION OF PATIENT CONTACTS, UH, JUST EAST OF 35, UH, FROM ABOUT RUNDBERG ALL THE WAY DOWN TO WILLIAM CANNON.

ONCE WE GET DOWN INTO THE DOVE SPRINGS AREA, UH, WE'VE SEEN THAT THAT DENSITY LIGHTENS UP A LITTLE BIT.

UM, AND SO WHAT WE'RE ABLE TO DO IN SITUATIONS LIKE THAT IS WORK WITH OUR COMMUNITY HEALTH PARAMEDICS.

AND THEN WE WENT AHEAD AND WENT INTO THAT COMMUNITY LAST MONTH AND DID A POP-UP RESOURCE CLINIC TO TRY TO PROVIDE MORE, MORE RESOURCES FOR PEOPLE IN THAT COMMUNITY THAT MIGHT HAVE A HIGHER NEED.

UH, WE AVERAGED ABOUT THREE TO 400 PATIENTS A MONTH UNTIL WE, UH, STARTED THIS EXPANDED TRIAGE IN THE 9 1 1 SYSTEM WHERE WE WE'RE TAKING THESE LOW ACUITY CALLS OUT OF THE SYSTEM.

NOW WE'RE AVERAGING, YOU KNOW, BETWEEN 900 AND A THOUSAND CALLS, UM, COMBINED, THE C FOUR PROGRAM, UH, IS AVERAGING ABOUT 700 CALLS THAT WE DON'T HAVE TO SEND AN AMBULANCE TO OFF THE SYSTEM, UH, WITH A GOAL OF TRYING TO REACH ABOUT A THOUSAND CALLS A MONTH THAT WE CAN RESPOND TO WITH AN ALTERNATIVE RESOURCE OTHER THAN AN AMBULANCE.

THE IMPACT HAS REALLY BEEN ON THREE DIFFERENT.

UM, THE IMPACT OF THE C FOUR HAS REALLY COME ABOUT, UH, IN THREE DIFFERENT AREAS.

THE FIRST ONE IS AMBULANCE AVAILABILITY, UM, THEN IN HOSPITAL AND EMERGENCY ROOM, UH, AVAILABILITY.

AND THEN THE FINANCIAL IMPACTS FOR THE PATIENTS.

WHEN, UH, WE TALK ABOUT AMBULANCE AVAILABILITY, WHEN WE'RE ABLE TO, UH, KEEP THOSE AMBULANCES FROM HAVING TO RESPOND TO THOSE CALLS BY USING SOME OTHER ALTERNATIVE RESOURCE, UH, IT REALLY HAS SOME DOWNSTREAM EFFECTS THAT WE WEREN'T REALLY CONSIDERING.

LIKE IT REDUCES THE USE OF LIGHTS AND SIRENS IN THE CITY.

UM, AND, UH, IT IS REALLY, UM, COOL AND INTERESTING TO WATCH HOW WHEN WE START TAKING OFF THESE LOW ACUITY, UH, CALLS THAT THE UTILIZATION HOURS START, UH, COMING DOWN ON THE UNITS.

SO IF WE'RE GONNA LOOK AT UTILIZATION HOURS HERE FOR JUST A SECOND, THESE ARE NOT HOURS IN A DAY.

THESE ARE UTILIZATION HOURS WHERE, UH, LET'S TAKE, UH, LAST MONTH FOR 831, THAT'S 831 HOURS THAT AN AMBULANCE OTHERWISE WOULD NOT HAVE BEEN

[00:25:01]

ABLE TO RESPOND IN THAT MONTH.

BUT BECAUSE OF THE C FOUR PROGRAM, UH, TAKING THESE LOW ACUITY CALLS, AN AMBULANCE WAS AVAILABLE TO RESPOND FOR 831 MORE HOURS THAN IT WAS, UH, WITHOUT THE C FOUR PROGRAM.

SO THAT IS A SIGNIFICANT TIME SAVINGS NOW FOR EVERY PATIENT THAT WE DON'T HAVE TO RESPOND OR TRANSPORT.

THAT ALSO HAS A SAVINGS IN THE EMERGENCY DEPARTMENTS.

AND FOR FISCAL YEAR 2023, UH, THE COLLABORATIVE CARE COMMUNICATION CENTER HAS SAVED LOCAL EMERGENCY ROOMS IN THE CITY OVER 6,500 HOSPITAL BED HOURS.

HOW THAT AFFECTS, UM, E M S IS THAT OFTENTIMES WHEN WE GO AND WE TAKE A PATIENT TO THE HOSPITAL, THERE ARE NO BEDS FOR US TO PUT THAT PATIENT IN.

UH, WE ARE VERY FORTUNATE IN THIS COMMUNITY.

UH, SOME OF MY, UM, COHORTS IN, IN TENNESSEE, FOR EXAMPLE, THEIR AVERAGE HOLD TIME IN A HOSPITAL IS THREE HOURS.

SO THAT'S THREE HOURS THAT THEY DON'T GET THAT AMBULANCE BACK.

BUT IF THERE ARE BEDS AVAILABLE IN THE ER, THAT'S GONNA MAKE OUR TURNAROUND TIMES FASTER AND THOSE TRUCKS WILL BE BACK IN SERVICE AND AVAILABLE FOR CALLS EVEN SOONER.

AND THEN THERE'S A FINANCIAL IMPACT ON OUR PATIENTS.

IF WE DON'T HAVE TO GIVE THEM A BILL FOR A TRANSPORT AND THEY DON'T HAVE TO PAY A BILL FOR WALKING INTO THE EMERGENCY ROOM, UH, THAT MONEY CAN ADD UP VERY, VERY QUICKLY.

UM, AND ABOUT 54% OF ALL THE PATIENTS THAT WE ENCOUNTER IN THE C FOUR ARE EITHER UNFUNDED COMPLETELY OR UNDERFUNDED IN THEIR, UM, HEALTH INSURANCE.

BUT IF WE ADD UP THE COST SAVINGS BETWEEN NOT TRANSPORTING THE PATIENT AND THE PATIENT DOESN'T GET THE BILL, THIS IS THE COST SAVINGS TO THE PATIENT BY NOT TRANSPORTING AND THEN THE BASE PRICE FOR JUST WALKING INTO EMERGENCY ROOM, NO TESTS.

THEY HAVEN'T SEEN A DOCTOR, NOTHING'S HAPPENED.

UH, FISCAL YEAR TO DATE, WE HAVE SAVED OUR PATIENT $6.8 MILLION.

WE HAVE A GOAL TO REACH $8 MILLION BY THE END OF THE FISCAL YEAR, AND I THINK WE'RE GONNA BE VERY, VERY CLOSE.

WHAT'S NEXT FOR THE C FOUR? WELL, RIGHT NOW OUR HOURS OF OPERATION ARE FROM 7:00 AM TO 10:00 PM WE WOULD LIKE TO INCREASE, UH, THIS PROGRAM TO 24 HOURS A DAY.

WE THINK THAT THERE IS A NEED AND WE THINK THAT THE BENEFIT IS GREAT.

UM, RIGHT NOW WE CAN STAFF ONE TO TWO OF THESE SINGLE, UH, PARAMEDIC RESPONSE UNITS PER DAY.

WE WOULD LIKE TO INCREASE THAT OUT TO ABOUT FOUR.

UM, AND THEN A FURTHER INTEGRATION WITH OUR COMMUNITY HEALTH PARAMEDICS, ESPECIALLY IN THEIR, UM, CASE MANAGEMENT SIDE OF THE COMMUNITY HEALTH PARAMEDICS, BECAUSE IT'S GONNA MAKE IT EASIER FOR US TO CONNECT PEOPLE TO SERVICES.

UH, AND THEN WE WANT TO, UH, REALLY TAKE A LOOK ALSO AT OUTCOMES FROM THIS PROGRAM.

WHEN WE'RE TALKING ABOUT TRADITIONAL E M S AND PEOPLE GO TO THE HOSPITAL, IT'S VERY EASY TO GET OUTCOMES FROM THAT HOSPITAL.

WHEN WE ARE NOT TAKING THEM TO THE HOSPITAL, OUTCOMES BECOME A LITTLE BIT MORE DIFFICULT.

SO WE'RE, UH, WORKING WITH SOME PARTNERS AT UT, UH, THROUGH OUR MEDICAL DIRECTION.

UH, WE'RE GONNA START DOING, UH, SURVEYS FOR, UM, OUTCOME DATA TO SEE, FOR INSTANCE, DID YOU GO GET YOUR PRESCRIPTION? DO YOU FEEL BETTER? DID YOU HAVE TO CALL BACK AGAIN? THAT KIND OF DATA IS VERY HARD TO TRACK WHEN THEY'RE NOT TRANSPORTED.

SO, UH, DOES ANYONE HAVE ANY QUESTIONS? UM, HOW I KNOW THAT, UH, SORT OF THE NUMBER ONE CALLS FOR, UM, A F D ARE ALSO MEDICAL CALLS.

UM, IS THERE ANY SENSE OF HOW THIS PROGRAM AFFECTS, UH, THE FIRE DEPARTMENT IN TERMS OF RESPONDING TO CALLS AND STAFFING? SO THESE ARE THE LOW ACUITY CALLS THAT KIND OF FALL IN BETWEEN TWO LAYERS.

UM, OUR OUR PARTNERS IN THE FIRE DEPARTMENT RESPOND WITH US ON THESE HIGH ACUITY CALLS.

OKAY.

UH, AND THEN THEY ALSO RESPOND TO WHAT WE CALL LIFT ASSIST ASSIST, WHICH ARE ALSO LOW ACUITY.

THESE CALLS KIND OF FIT THAT, THAT MIDDLE GROUND IN BETWEEN THOSE TWO, AND THEY DON'T OVERLAP A WHOLE LOT.

OKAY.

SO THEY'RE, YEAH.

OKAY.

THANKS.

UM, UH, THIS SECOND QUESTION IS A A LITTLE BIT MORE COMPLICATED.

UM, SO I UNDERSTAND THAT THERE'S BEEN SOME, UM, SKEPTICISM ABOUT, UM, THIS PROGRAM, UM, YOU KNOW, IN CITY HALL, UM, SORT OF COMING FROM THE, LIKE, THIS ISN'T OUR JOB PERSPECTIVE.

[00:30:01]

UM, AND, UH, AND I'M CURIOUS, UM, WHAT THE, UM, EFFORTS HAVE LOOKED LIKE OR WHAT Y'ALL THINK WOULD BE MOST EFFECTIVE, UM, IN TERMS OF, UM, CONNECTING, UM, THE, YOU KNOW, CENTRAL HEALTH, UM, UH, INTO THIS IN A WAY THAT, UM, MOTIVATED THEM TO GET BETTER AT THEIR JOBS.

FRANKLY.

WELL, I WILL TELL YOU THAT, UH, I SPEND A LOT OF MY TIME ANSWERING THE QUESTION WHY E M S.

UH, I THINK THAT, UH, WE MIGHT HAVE A LITTLE BIT OF A PR PROBLEM AND THAT PEOPLE STILL IMAGINE EMERGENCY MEDICAL SERVICES, UH, RESPONDING TO PURELY LIFE THREATS.

HOWEVER, UH, THE NUMBER OF CALLS, THE PERCENTAGE OF OUR CALL VOLUME THAT ARE TRUE LIFE THREATS STAY IN THE SINGLE DIGITS.

UM, MOST OF THE CALLS THAT WE ENCOUNTER ARE EITHER LOW ACUITY OR AN INTERMITTENT ACUITY WHERE WE CAN DO SOME GOOD.

UM, BUT WE'RE BEING USED AS AN ACCESS POINT TO THE HEALTHCARE SYSTEM.

UH, WE USED TO BE TRANSPORT TO THE HEALTHCARE SYSTEM AND NOW WE'RE A PART OF THE HEALTHCARE SYSTEM, ESPECIALLY COMING OUT OF COVID.

OUR CAREERS AND OUR TRAJECTORIES HAVE CHANGED.

SO WHEN WE TALK ABOUT HOW CAN WE BETTER SERVE OUR COMMUNITY, THIS IS HOW WE CAN DO IT, IS BY SHIFTING OUR FOCUS A LITTLE BIT AND SHIFTING OUR TRAINING, UH, TO DEAL WITH THESE LOW ACUITY CALLS AND, UH, WORKING WITH PARTNERS, UH, YOU KNOW, IN THE CITY, IN THE COUNTY, UH, TO DEVELOP THE RESOURCES THAT WE NEED TO HAND PATIENTS OFF TO.

UM, AND JUST TO EXPOUND ON THAT, WE ARE IN THOSE DISCUSSIONS RIGHT NOW.

AND SO WE WILL CONTINUE THOSE AT THE BEGINNING OF FISCAL YEAR 24, AND WE'RE HAPPY TO COME BACK AND GIVE A REPORT ON THAT.

BUT THOSE ARE ONGOING.

UM, YEAH.

THANK YOU.

THAT WAS HELPFUL.

MM-HMM.

, DO YOU HAVE ANY OTHER QUESTIONS? COMMISSIONER RUAN? UM, SO THANK YOU FOR ALL THE WORK ON THIS.

I THINK IT'S INTERESTING BECAUSE OF US WHO WORK IN THIS WORLD WOULD BE SHOCKED THAT ANYBODY WOULD EVEN QUESTION THE VALUE OF IT.

UM, SO I'D BE CURIOUS.

SO ONE QUESTION FIRST AND THEN ANOTHER ASK, UM, DO YOU GUYS INTERFACE WITH PEDIATRIC PATIENTS? IS THAT WITHIN THE SCOPE OF THIS, UM, PROJECT YET? WE DO.

OKAY.

AND IS THERE ANY MECHANISMS IN TERMS OF TO PROVIDE TRANSPORT WHEN THAT IS NECESSARY, BUT NOT NECESSARILY BY E M S TRANSPORT? WE LIKE TO TRANSPORT IN AMBULANCES.

UM, THERE ARE TIMES DURING, UM, YOU KNOW, CRISIS LIKE, LIKE IN IN THE ICE STORE WHERE WE WOULD NEED TO TRANSPORT WITH SOMETHING OUTSIDE OF AN AMBULANCE.

BUT IF YOU WERE GONNA GO TO A HOSPITAL, YOU'RE GONNA GO IN AN AMBULANCE.

YEAH.

YEAH.

I, I DO KNOW THAT'S A POTENTIAL AREA TO EXPLORE FOR AN ADDITIONAL COST SAVINGS.

I, WELL, IT, IT, IT'S A VERY COMMON, UM, CONCERN THAT WOULD POTENTIALLY BE BENEFICIAL TO PATIENTS AS WELL AS OUR E M S TRANSPORT SYSTEM.

UM, AND MY OTHER QUESTION IS, WHAT DO Y'ALL NEED FROM US AS A PUBLIC SAFETY COMMISSION TO HELP TO MOVE THIS PROGRAM FORWARD AND EXPAND IT UP TO 24 HOURS? SO IN THE FISCAL YEAR 24 BUDGET, WE ENDED UP, WE DO HAVE THE, THE FTES FOR THAT, AND WE'RE WORKING ON THAT FUNDING PIECE, MUCH TO YOUR QUESTION.

SO I THINK MORE TO FOLLOW ON THAT, LET US DO OUR DUE DILIGENCE AND CONTINUE THAT WORK.

AND WE'RE HAPPY TO COME BACK AND, AND, AND LET YOU KNOW EXACTLY WHERE, WHERE THIS, YOU KNOW, COMMISSION COULD BE HELPFUL.

OKAY.

WE, WE'VE GOT SOME WORK TO DO ON OUR SIDE.

COMMISSIONER SMITH.

YEAH, THAT'S A GREAT SEGUE.

NUMBER ONE, I WANNA COMMEND YOUR EFFORTS WELL DONE.

UM, AND NUMBER TWO, WITH THE DUE DILIGENCE ON Y'ALL SIDE MAKING C 4 24 HOURS.

'CAUSE I'M ALSO, I THINK IT'S BEAUTIFUL THE WORK YOU GUYS ARE DOING.

I'D BE, UM, PARTICULARLY INTERESTED IN ENSURING THAT THERE'S ENOUGH MARKETING AND COMMUNICATIONS DOLLARS IN ORDER TO ENSURE THAT THE COMMUNITY KNOWS WHAT A WONDERFUL TRIAGE YOU ARE.

THAT IT'S KIND OF EMS PLUS NOW WE HAVE A DIFFERENT REALITY.

SO IN THOSE CONVERSATIONS, JUST MAKING SURE, YOU KNOW, DIFFERENT DIALECTS, DIFFERENT LANGUAGES, A FULL REACHING, UM, UM, OUTREACH PROGRAM WOULD BE, UM, PREFERABLE.

AND THEN ALSO IN YOUR OUTCOMES, DID WE GET, DID YOU ALL GET MONEY FOR THE DATA PART OF WHAT YOU ALL WANT, THE SURVEYS AND ALL THAT GOOD STUFF? SO WE DID GET SOME FINANCIAL IMPACTS TO OUR FISCAL YEAR 24 BUDGET ON OUR, ON THE DATA TEAM WITHIN E M S, WHICH WILL HELP WITH THAT AS WELL.

OKAY.

I WOULD BE PARTICULARLY INTERESTED IN THE LONG-TERM OUTCOMES.

DID WE GET THEM INTO H M I S? YOU KNOW, I, I LOVE THE SHORT-TERM OUTCOMES, LIKE DID YOU GET YOUR MEDICINE FOR SURE.

BUT CONSIDERING YOU GUYS ARE SUCH AN AMAZING TRIAGE THAT PEOPLE DO LOOK TO, IT'D BE NICE IF WE COULD UNDERSTAND HOW THE LONG-TERM IMPACTS OF THE C FOUR ARE WORKING AS WELL FOR YOUR NEXT REPORT OUT.

CURRENTLY, EVERY PATIENT THAT WE INTERACT WITH GETS A FOLLOW-UP, UH, THAT IS, UH,

[00:35:01]

DETERMINED MOSTLY BY THE PHYSICIAN.

THE PHYSICIAN CAN TAILOR IT FOR SIX HOURS, 12 HOURS, 24 HOURS.

UH, THIS WOULD BE A LONGER TERM OUTCOME FOLLOW UP.

MM-HMM.

, UH, YOU KNOW, MAYBE THREE, FOUR WEEKS LATER.

YEAH, THAT'S EXACTLY WHAT I WAS THINKING.

JUST A LONGER, YOU GUYS HAVE, YOU GUYS ARE SUCH A GREAT, UM, DATA CAPTURE, UM, BEING ON THE FRONTLINE LIKE THAT, IT'D BE REALLY COOL TO SEE OVER A LONG PERIOD OF TIME HOW THIS SPECIFIC INCISION IN OUR SOCIETY IMPACTS LONG-TERM INCOME OUTCOMES.

OKAY.

AND WITH THAT, I THINK I HAVE TO BE THE CLOCK WATCHER.

SO WE'RE MOVING ON , I, I APOLOGIZE, , IT IS TIME TO MOVE ON.

THANK YOU.

THANK YOU.

AND WE LOOK FORWARD TO HEARING SOME MORE.

THANK YOU.

THANKS.

AND I THINK NEXT WE'RE

[4. Discussion of Austin Travis County EMS, Austin Fire Department and Austin Police Department’s overtime use (Sponsors: Commissioners Ruttan & Nguyễn)]

JUST GONNA BE TALKING ABOUT, UM, OVERTIME USE ACROSS ALL THE DEPARTMENTS.

UM, I BELIEVE A P D HAS A PRESENTATION, E M S HAS A PRESENTATION AND FIRE, YOU GUYS DON'T HAVE A PRESENTATION, BUT, UM, I DID DISTRIBUTE, UM, THE OVERTIME AUDIT REPORT THAT YOU GUYS DID IN JUNE FOR EVERYBODY TO SORT OF LOOK OVER.

AND I'M HOPING WE CAN USE THIS AS A BASIS FOR SOME QUESTIONS.

OKAY.

AND SO WITH THAT, WHOEVER WANTS TO GO FIRST, I'LL LET YOU GUYS DECIDE.

WELL, I'M RIGHT HERE AND I HAVE THE CLICKER, SO I DON'T MIND TALKING ABOUT, UH, E M SS OVERTIME EXPENDITURES.

THAT'S FINE.

YOU KNOW WHAT, HERE, I'LL HAND IT DOWN IF IT'S EASIER IF IT'S ALREADY LOADED.

WHATEVER YOU'D LIKE TO DO.

SORRY.

WE'LL GO.

YEAH.

ALL RIGHT.

WELL GOOD AFTERNOON EVERYBODY.

UH, I'M GONNA TALK ABOUT THE A P D OVERTIME.

YEAH.

ALRIGHT.

UH, SO THE FIRST SLIDE TALKS ABOUT A P D OVERTIME.

UM, AND ALL OF OUR A P D OVERTIME IS, IS LOCATED, UH, ONLINE IN OUR GENERAL ORDERS.

AND IT'S UNDER OUR SECONDARY EMPLOYMENT AND IT'S UNDER SECTION 9 49.

BASICALLY, WE USE OVERTIME FOR TWO MAIN, UH, FUNCTIONS.

UH, RIGHT NOW IT SAYS ON THE SLIDE 329 VACANCIES, BUT SINCE THIS SLIDE WAS UH, PUBLISHED, IT IS NOW 341 VACANCIES.

SO, UH, A LOT OF THOSE VACANCIES ARE FILLED TO BACKFILL THOSE OFFICERS.

'CAUSE EVERY TIME ANYBODY LEAVES AT ANY RANK, IT AFFECTS, UH, OFFICERS ON THE STREET.

SO WE HAVE TO BE ABLE TO BACKFILL THOSE.

UM, WE ALSO USE BACK BACKFILL FOR OUR OVERTIME, RATHER FOR OUR DISPATCHERS AND NINE ONE ONE CALL TAKERS.

AS YOU KNOW, WE'VE, UH, HAD A NUMBER OF PEOPLE LEAVE THERE UNFORTUNATELY.

UM, BUT WE'RE, WE'RE ABLE TO, WE HAVE A PLAN TOGETHER AND WE'RE SLOWLY ENCROACHING AND GETTING BETTER ON THAT, UH, AS TIME TIME GOES ON AND GETTING PEOPLE BACK, BACK TO WORK AS DISPATCHER 9 1 1.

BUT THAT'S OUR TWO MAIN RESOURCES OR, UH, ALLOCATIONS FOR, FOR OVERTIME FOR A P D.

UH, AS YOU KNOW, WE'RE A 24 7 OPERATE 24 7 OPERATION.

UH, AND WE USE OVERTIME TO FILL DAY EVENINGS AND NIGHTS.

UH, WE ALSO USE OUR, UM, UM, A P D OVERTIME TO STAFF SPECIAL EVENTS ACROSS THE CITY.

AND I'LL GET INTO MORE OF THAT.

AND THAT'S IN THE SECOND PRESENTATION.

AND THEN, UH, CURRENTLY WE DO NOT, UH, NO OFFICER IS REQUIRED TO WORK OVERTIME.

IT'S ON A, AND IT'S ON A BASIS WE CANNOT MANDATORY THEM TO DO SO.

UH, CIVILIAN STAFF, WE DO NOT MANDATORY THEM UNLESS WE GET TO A, UH, SITUATION, UH, WHERE WE'RE, WE'RE SO LOW ON LEVELS THAT WE HAVE TO HOLD PEOPLE OVER TO BE ABLE TO ANSWER 9 1 1 CALLS.

SO THEY DO, UNFORTUNATELY GET MANDATORY TO BE ABLE TO STAY OVER BECAUSE WE JUST HAVE TO HAVE PEOPLE TO BE ABLE ANSWER THE PHONES TO GET THE NINE ONE ONE CALLED OUT TO THE, TO THE OFFICERS.

UH, SO IF YOU LOOK AT, UM, AND, AND A LOT OF THESE, A LOT OF THIS WAS IN RESPONSE TO THE QUESTIONS THAT THAT CAME ACROSS.

UH, SO IT'S DETAILED AS WELL AS THE NEXT PRESENTATION IS VERY DETAILED.

UM, APPROXIMATELY 95% OF OUR WORKFORCE, OF OUR SWORN OFFICERS, AS WELL AS OUR, UH, NINE ONE ONE AND DISPATCHERS CALL TAKERS, UH, DO SOME FORM OR SOME TYPE OF OVERTIME, UH, IN ADDITION TO THE REGULAR 40 HOURS, WHAT THEY WORK FOR, UH, THE POLICE DEPARTMENT.

UM, MOST OF OUR OVERTIME IS PAID AT TIME AND A HALF.

UM, AND, BUT WE DO HAVE, UH, WE HAVE APPROVED, IT WAS UNDER CHIEF HAN, AND NOW CHIEF HENDERSON HAS CONTINUED US, IS TWO TIMES OVER OVERTIME.

UH, AND THAT'S DUE TO, DUE TO THE FACT THAT OUR SWORN AS WELL AS CIVILIANS ON THE NIGHT SHIFTS, WE WERE HAVING A VERY DIFFICULT TIME BEING ABLE TO FILL THE OVERNIGHT HOURS.

WE JUST WEREN'T GETTING ANYBODY TO SIGN UP.

SO, UH, WE STARTED OFFERING ON THE OVERNIGHT SHIFT HOURS, UH, TO BOTH THE CALL CENTER AND, AND, UH, POLICE OFFICERS ON THE STREET AND IT STARTED FILLING UP

[00:40:01]

AND WE'RE HAVING NO PROBLEMS RIGHT NOW, BEING ABLE TO FILL, BE ABLE TO FILL THOSE, UH, UH, THOSE VACANCIES OVER OVERNIGHT HOURS.

UM, AS YOU CAN SEE, UH, THESE ARE THE, THE NUMBER OF HOURS, UH, SWORN OVERTIME IS 3 4 6 6 71.

AND YOU CAN SEE THE TWO EXPENDITURES FOR, UH, THE SWORN DOLLAR AMOUNT AS WELL AS THE CIVILIAN OVER, OVER AMOUNT THERE.

UM, THESE DO NOT INCLUDE, UH, REIMBURSEMENT TIME.

UH, AND THAT'S KIND OF IN MY NEXT PRESENTATION WITH SPECIAL EVENTS.

BUT THE REIMBURSED OVER TIME IS LIKE WHEN VENDORS SPONSOR, UH, AND LIKE A C L OR, OR A RACE, AND THEY PAY US BACK, SO TO SPEAK, UH, FOR THE TIME THAT THE OFFICERS ARE THERE TO BE ABLE TO PROVIDE THOSE SERVICES FOR BLOCKING A ROAD OR PROTECTION OR WHATEVER SECURITY, ET CETERA.

UH, SO THESE, THESE, THESE ARE JUST PURE OVERTIME HOURS THAT OFFICERS ARE DOING ON THE STREET.

UH, IN THIS SLIDE, UH, WAS ALSO ANOTHER REQUESTED SLIDE, BUT YOU CAN SEE OVER THE PAST FOUR YEARS OF, UM, EXACTLY WHERE, HOW MUCH WE SPENT IN OVERTIME.

UH, AND IT'S, UH, DEFINITELY INCREASED IN THE AMOUNT OF COURSE TAKE OUT THE ANOMALY FOR, UH, UH, 2020.

BUT YOU CAN SEE, YOU KNOW, IT, IT WENT FROM 14 AND NOW WE'RE UP TO RIGHT NOW CURRENT TO DATE.

WE'RE IN THE, IN THE 29.

WE DO, UH, THE GENERAL ORDERS DOES, UH, GOVERN HOW MANY HOURS AN OFFICER CAN WORK PER WEEK.

UM, ANY, THEY CANNOT EXCEED MORE THAN 76 HOURS IN ONE WEEK PERIOD, UH, WITHOUT OVERTIME OR WITHOUT A SUPERVISOR APPROVAL.

AND THAT'S VERY FROWNED UPON.

OF COURSE, WE ALL NEED TIME OFF AND IT'S JUST DANGEROUS IF WE GET TO THAT LEVEL.

UM, BUT, UH, BASICALLY IF THEY, IF THEY WORK REGULAR, THEIR REGULAR SHIFT FOR 40 HOURS, THEY CANNOT HAVE ANY MORE THAN 36 HOURS OF OVERTIME.

NOW THAT DOESN'T MEAN THAT THEY CAN'T HAVE MORE THAN 36 HOURS BECAUSE WHAT SOME OFFICERS WILL DO AND CAN DO IS IF YOU TAKE, UH, VACATION FOR YOUR REGULAR, THEN YOU CAN WORK THAT TIME IN EXCESS OF 36.

BUT IT CAN'T, IT CAN'T GO ON BEYOND THE 76 HOURS, UH, IN, IN TOTAL.

SO, AND THE WAY WE MONITOR THAT IS ALSO THROUGH GENERAL ORDERS.

UH, EACH SUPERVISOR AS WELL AS THE OFFICER IS REQUIRED TO MAINTAIN A LOG.

UH, AND THAT LOG, UH, DETAILS OUT HOW MUCH OVERTIME THEIR, THEIR, UM, UM, THEY'RE OCCURRING.

AND THEN A SUPERVISOR'S SUPPOSED TO, UH, REVIEW THAT WEEKLY AND THEY DO REVIEW IT WEEKLY TO MAKE SURE THAT THEY'RE NOT, NOT IN ABUSE OF THAT, OF GOING OVER THAT.

SO THAT'S HOW, THAT'S HOW THAT IS, IS, UM, MONITORED.

SO, UH, LOOKING FORWARD, UM, THERE HAS BEEN SEVERAL OVERTIME STUDIES, UH, THAT WERE DONE.

UH, AND I THINK THESE WERE BACK IN LIKE 2012, AND IT WAS THE PROOF REPORT AND THE MATRIX REPORT.

UH, HOWEVER, I'M TALKING TO DR.

CREN, I KNOW HE'S REVIEWED BOTH OF THESE.

UH, THERE WERE NO, UH, STAFFING RECOMMENDATIONS THAT WE'RE ABLE TO IMPLEMENT.

AND HONESTLY, IT'D BE OUTDATED NOW BECAUSE THAT WAS ASSUMING FULL STAFFING AND OF COURSE WE'RE 341 OFFICERS DOWN RIGHT NOW.

SO, UM, NOT TO MENTION THE 150 SPOTS THAT WERE VACANT THAT COUNSEL HAD, UH, TAKEN AWAY FROM A P D.

SO, UM, I WILL TELL YOU THAT, UH, UNDER CHIEF JACON AND NOW UNDER CHIEF HENDERSON, THAT WE DO HAVE AN AGGRESSIVE RECRUITING PLAN.

UM, HAPPY TO SAY THAT WE GRADUATED 19 OFFICERS THIS PAST FRIDAY.

UM, AND SO BASICALLY WE HAVE TWO CLASSES IN SESSION AT ALL THE TIME.

WE HAVE A CLASS OF, I BELIEVE, I BELIEVE IT'S 39, THAT'S, THAT'S BEEN IN SESSION.

AND THEN TODAY WE STARTED A CLASS OF 49 THAT STARTED THIS MORNING.

SO BASICALLY THERE'S ALWAYS TWO CLASSES IN, IN, IN SESSION AND GOING AND CONSTANTLY GRADUATING AND CONSTANTLY STARTING THE NEW ONE ON THE NEXT MONDAY TO KEEP CLASSES GOING, KEEP OFFICERS BACK ON THE STREET.

SO, UM, SO, SO THAT'S A GOOD THING AND WE'RE GONNA CONSTANTLY DO EVERYTHING POSSIBLE WITHIN OUR POWER TO BE ABLE TO RECRUIT MORE OFFICERS.

UH, WE HAVE THE SIGNING BONUSES OUT THERE, UM, AND THEN BE ABLE TO AGGRESSIVELY GET THEM TO BE ABLE TO, YOU KNOW, COME AND JOIN A P D AND BE ABLE TO PROTECT OUR WONDERFUL CITY.

SO DO YOU WANNA ANSWER QUESTIONS NOW OR DO YOU WANT TO GO TO, I THINK IN THE INTEREST OF TIME, LET'S GET THROUGH ALL THE PRESENTATIONS AND THEN, BECAUSE I THINK A LOT OF THE QUESTIONS WILL APPLY TO EVERYONE.

YEAH, THAT'S IT.

TALKING ABOUT, UH, AUSTIN, TRAVIS COUNTY E M S SWORN OVERTIME EXPENDITURES SINCE FISCAL YEAR 2018, UH, OVERTIME EXPENDITURES HAVE INCREASED OVER TIME.

UH, WE'VE SEEN SOME PAY INCREASES.

UH, WE'VE ALSO SEEN INCREASES IN VACANCIES CREATED BY NEW POSITIONS AND ATTRITION, WHICH HAVE ATTRIBUTED TO THAT.

UH, SWORN OTS INCREASED APPROXIMATELY 16% FOR FISCAL YEAR 23.

UH, PAY SCALES HAVE INCREASED FIRE MEDICS IN THIS, UH, IN THIS LAST YEAR AS WELL.

UH, WE WERE PAYING THE TWO X OR WE WERE PAYING THE, THE DOUBLE TIME FOR EXTRA DUTY AT THE BEGINNING OF THE FISCAL YEAR, BUT WE ARE NOT CURRENTLY DOING THAT

[00:45:03]

THERE IT IS.

UH, THIS IS JUST A, A GRAPH THAT SHOWS THE OVERTIME PRE, UH, PERCENT OF ALL HOURS SINCE, UH, JANUARY OF 2019, UM, AS REQUESTED, CIVILIAN OVERTIME EXPENSES FOR FISCAL YEAR, UH, 2018 HAVE INCREASED AS WELL, UH, SINCE PRE PANDEMIC TIMES.

UM, INCREASED PAY RATE ON OUR NON-SWORN SIDE VACANCIES DUE TO ATTRITION ADDED POSITIONS.

UH, WE'VE ALSO HAD A FAIR AMOUNT OF ORGANIZATIONAL NEEDS.

WE HAD OUR REVENUE COLLECTION OR A BUILDING BACKLOG THAT WE'VE BEEN WORKING TO ADDRESS WITH INSURANCE PROVIDERS.

UH, E M S SCHEDULING OPERATIONS HAS GENERATED SOME CIVILIAN OVERTIME FOR US.

AND THEN JUST ADDITIONS IN, IN HUMAN RESOURCES WORKLOAD TO HELP OUR MEDICS, UH, CIVILIAN OVERTIME.

UM, EXPENSES JUST DUE TO PAY RATE AND VACANCIES IN OUR SCHEDULING HAVE CONTRIBUTED TO THAT RISE AS WELL.

WE HAVE SOME DRIVERS OF OVERTIME, UH, AND EXTRA DUTY FOR OUR STAFF ON THE CIVILIAN.

WE HAVE VACANCIES.

SOME OPERATIONAL NEEDS LIKE WE'VE TALKED ABOUT, UH, THE BILLING SIDE, SCHEDULERS, HUMAN RESOURCES, OUR SUPPORT STAFF, WHETHER IT BE LOGISTICS, OUR SUPPLY WAREHOUSE FOR, FOR MEDICAL SUPPLIES, UH, FLEET, ESPECIALLY DURING EVENTS TO KEEP ALL OF THE ASSETS THAT WE DEPLOY TO THOSE, YOU KNOW, ON, ON TRACK.

UH, MUCH LIKE THE CIVILIAN SIDE, THE SWORN SIDE VACANCIES HAVE BEEN A DRIVER OF THAT.

ON THE SWORN SIDE, UH, THE NUMBER OF OF SPECIAL EVENTS, UH, WE'VE HAD SOME PILOT PROGRAMS THAT HAVE GENERATED OVER TIME, UH, THE AIRPORT MEDICS THAT HAS SINCE BEEN FUNDED, SO, SO THAT'S NO LONGER AN AN OVERTIME DRIVER, BUT, BUT IT CERTAINLY WAS WHEN WE PULLED THIS, UH, DEPLOYING MEDICS ON, ON RAINY STREET TO ADDRESS THE NEEDS OVER THERE.

BEEN A DRIVER.

AND THEN ALSO OUR CAST MED WHERE WE PARTNER WITH THE AUSTIN POLICE DEPARTMENT, UH, YOU KNOW, TO PUT MEDICS WITH OFFICERS FOR ANY KIND OF VIOLENCE DOWNTOWN, WHETHER THAT BE SHOOTINGS OR STABBINGS OR THINGS OF THAT NATURE.

AND THEN EMERGENCY CONDITIONS, WEATHER, UH, WINTER STORM URI MARA, UH, THIS HEAT WAVE.

AND THEN, UH, PANDEMICS AS WELL HAVE BEEN DRIVERS SWORN OVERTIME HOURS, UH, BY EXPENDITURE OF THE 245,356 HOURS ARE ENCOMPASSED IN THAT 12.5 MILLION SPENT IN OVERTIME FOR FISCAL YEAR 23.

UM, ALL OF OUR SWORN STAFF HAVE SOME AMOUNT OF CLOCKED OVERTIME.

OF COURSE, THEY'RE ON A 42 HOUR WORK WEEK, SO THAT'S GONNA GENERATE A LITTLE BIT OVERTIME.

UM, THEIR OVERTIME RATE IS PAID AT THAT 1.5 TIMES THEIR HOURLY RATE.

CURRENTLY, YOU KNOW, AGAIN, EARLY PART OF THE YEAR WE DID PAY THAT TWO TIMES THE HOURLY RATE, BUT THAT PRACTICE HAS BEEN DISCONTINUED.

UH, WE FOUND IT WAS HELPFUL FOR A WHILE AND THEN, AND THEN IT, IT WAS NOT HELPFUL FOR US.

AND WE DO HAVE SOME POLICIES, UH, AND GUIDELINES FOR OUR OVERTIME.

UM, WE HAVE NO DEFINED LIMIT OF OVERTIME, BUT OUR SUPERVISORS ARE RESPONSIBLE FOR MONITORING THAT.

OUR FIELD AND COMMUN COMMUNICATION STAFF ARE BOTH ASSIGNED AN AN ON CALL PERSONNEL DAY.

IT'S ONCE A MONTH THAT'S PAID AT FIVE TIMES AN HOUR, UH, FOR THE DAY THEY REMAIN ON CALL.

IF THEY'RE CALLED IN, WE PAY THAT AT ONE AND A HALF TIMES THEIR HOURLY RATE BASED ON THEIR PRODUCTIVE HOURS ON THE WORK WEEK.

AND THEN WE DO HAVE A SCHEDULING OPERATIONS GUIDELINE THAT SAYS THAT PERSONNEL MUST HAVE AN EIGHT HOUR REST PERIOD BETWEEN A DUTY ASSIGNMENT.

UH, WE DO ALLOW OUR DIVISION CHIEFS TO APPROVE THAT ON A CASE BY CASE BASIS.

IF YOU WERE PARTICIPATING IN, UH, SOME OVERTIME TO TRAIN CADETS, THAT WAS MAYBE AN HOUR OR TWO, THAT WAS A, A PRETTY EASY LIFT AND YOU WANTED TO PICK UP SOME OVERTIME, WE WOULD PROBABLY APPROVE THAT.

BUT IT IS ON A CASE BY CASE BASIS.

UM, AND THEN WE'VE SEEN, YOU KNOW, WORKLOAD AND, AND STAFFING CHANGES IN NEEDS.

UH, WE'VE REDUCED THE MANDATORY USE OF OVERTIME TO STAFF AMBULANCES.

UH, WE USED TO HAVE WHAT WE CALL AN CUMULATIVE OR CUMULATIVE LIST WHERE WE MIGHT CALL YOU IN ON TOP OF YOUR ON CALL DAY, UH, IF THINGS GOT DIRE AND WE NO LONGER DO THAT PRACTICE.

AND WE'VE ALSO WORKED REALLY HARD TO REDUCE OUR, OUR ON CALL DAYS FOR OUR MEDICS FROM TWO TO THREE TIMES A MONTH TO ONCE EVERY 28 DAYS.

UM, AND THEN, YOU KNOW, STAFFING IS NEEDED TO KIND OF AFFECT THESE OVERTIME DOLLARS BOTH ON THE COMMUNICATION SIDE AND IN OUR CLINICAL SPECIALTY, UH, VACANCIES.

ALL RIGHT.

UM, DID FIRE WANNA ADD ANY SORT OF OVERARCHING COMMENTS AND JUST IN TERMS OF HOW OVERTIME IS USED? UM, JUST ANY SORT OF, OF MAJOR POINTS.

SO YEAH, ABSOLUTELY.

I'LL JUST GIVE A QUICK OVERVIEW.

SO OVERALL, UH, WE DO HAVE MANDATORY STAFFING.

WE HAVE MANDATORY STAFFING OF, OF FOUR PERSONS ON EACH TRUCK.

AND SO WE, UH, USE OVERTIME PRIMARILY TO FILL OUR TRUCKS.

AND SO EVERY DAY WE MAKE SURE THAT WE HAVE OUR MANDATORY STAFFING.

AND SO THAT'S THE PRIMARY DRIVER.

RIGHT NOW, WE'RE IN A LOT BETTER POSITION IN THAT WE ONLY HAVE 15 VACANCIES IN THE DEPARTMENT, SO THAT'S ALLOWED US TO, TO, UH, THE WAY OUR, OUR OVERTIME WOULD TYPICALLY WORK IS FOLKS WOULD SIGN UP ON THE LIST AND THEY WOULD BE PICKED BASED ON, UH, YOU KNOW, THE, THE, THEIR ABILITY TO BE UP, UM, WITH, WHEN WE DO HAVE TO RUN THE MANDATORY OVERTIME, IT'S, UH,

[00:50:01]

SET UP WITH THE SCHEDULE AND, AND FOLKS HAVE A DECENT IDEA AT THIS POINT, UH, WHETHER THEY WOULD BE PICKED FOR MANDATORY.

BUT LIKE I MENTIONED BEFORE, WE'RE REALLY NOT RUNNING INTO MUCH MANDATORY RIGHT NOW BECAUSE WE'RE, UH, WE'RE STAFFING, UH, BECAUSE OF OUR LOAD NOVEMBER VACANCIES.

IN ADDITION TO THAT, SOME OF THE THINGS THAT DRIVE SOME OVERTIME FOR US, UH, BEYOND, YOU KNOW, THE THINGS THAT ARE MENTIONED BY, BY THE OTHER FOLKS IS, IS, YOU KNOW, WITH WEATHER EVENTS LIKE WE HAVE RIGHT NOW, WE HAVE DRY WEATHER, WE'RE STAFFING, YOU KNOW, ON RED FLAG DAYS AND HIGH FIRE RISK DAYS, WE'RE STAFFING ADDITIONAL BRUSH TRUCKS.

SO WE MAY, YOU KNOW, PAINT ADDITIONAL 10 TO 12 TO 16 FOLKS TO STAFF BRUSH TRUCKS OR, UH, YOU KNOW, THIS TIME OF YEAR THAT'S WHAT IT IS.

AND SOMETIMES WE CAN, WE CAN UPST STAFF FOR OTHER EVENTS LIKE, YOU KNOW, A FREEZE OR, UM, THINGS LIKE THAT.

BUT IN GENERAL, OUR, OUR PRIMARY DRIVER FOR OUR ADDED TIME IS, IS JUST STAFFING TRUCKS ON A REGULAR BASIS.

AND, AND, UM, WE DO SOME OTHER THINGS, THE RTFS, THE RESCUE TASK FORCES AND SOME OF THOSE OTHER THINGS THAT ARE, UH, YOU KNOW, UNFUNDED PROGRAMS. WE WERE AWARDING ADDITIONAL $2 MILLION THIS YEAR IN OUR BUDGET TO COVER SOME OF THOSE UNFUNDED PROGRAMS. SO, UM, WE'RE ALWAYS LOOKING FOR WAYS TO, TO STAFF WITH, UH, WITHOUT PUTTING THE EXTRA BURDEN ON OUR FOLKS.

UH, YOU KNOW, THEY'RE CURRENTLY STILL WORKING.

OUR FOLKS DO WORK A 53 HOUR WORK WEEK STILL.

SO, UM, AND YOU KNOW, IN ADDITION TO THE 53 HOURS WHEN WE HAVE TO DO MANDATORY OUTTA TIME, IT GETS, IT GETS TOUGH ON THE STAFF.

SO, UM, WE'RE GLAD WE ARE WHERE WE ARE RIGHT NOW, WHERE WE'RE ABLE TO FILL THE TRUCKS WITH THE FOLKS THAT WE HAVE AND FOLKS THAT ARE SIGNING UP.

WE DO HAVE A, ANOTHER CADET CLASS SCHEDULED TO START IN JANUARY, SO HOPEFULLY THAT WILL ALLOW US TO KIND OF STAY UP WITH THE STAFFING AS WE OPEN A COUPLE OF ADDITIONAL STATIONS OVER THE NEXT COUPLE YEARS.

SO WE'RE EXCITED ABOUT THE OPPORTUNITIES, UH, AND REALLY EXCITED THAT, UH, WE'RE GONNA BE ABLE, UH, BE ABLE TO STAND TO OUR BUDGET THIS YEAR.

SO.

OKAY.

UM, I THINK IF ANYBODY WANTS TO GIVE A PLUG FIRST, I THINK JUST KIND OF TO START OFF, UM, WE, OF COURSE WE'RE CURIOUS ABOUT EXPENDITURES, BUT WHEN WE LAST TALKED ABOUT SORT OF OVERTIME PAY A FEW MEETINGS AGO, UM, THERE WERE JUST CONCERNS ABOUT THE OVERALL HEALTH OF OUR PUBLIC SAFETY SWORN STAFF.

UM, THE NUMBER OF HOURS THAT EVERYONE WAS HAVING TO WORK, UM, 76 HOURS IS A LOT .

UM, AND JUST HOW THAT IMPACTS, UM, YOU KNOW, EVERYBODY'S ABILITY TO DO THEIR JOB WELL.

UM, AND JUST I THINK THAT WAS SORT OF THE BASIS FOR HAVING A FOLLOW UP.

AND SO WITH THAT, DOES ANYBODY HAVE QUESTIONS? COMMISSIONER SMITH? YEAH, RIGHT.

IN LINE WITH THAT, I WOULD LIKE TO KNOW, UM, NUMBER ONE, IF THERE ARE OTHER TRIGGERS OUTSIDE OF A SUPERVISOR WEEKLY DETERMINING IF YOU'RE WORKING TOO MANY HOURS THAT THE SUPERVISORS ARE TRAINED ON, RIGHT? YES, I THINK IT'S RIGHT.

IT DEFINITELY GIVES ME HEARTBURN IF SOMEONE'S WORKING CLOSE TO THAT 76 HOUR MARK, BUT EVEN IF SOMEONE'S DOING A PROLONGED 50 TO 60 HOURS, THAT'S ALSO A LITTLE BIT OF A WORRY FOR ME.

AND SO I WOULD LIKE TO KNOW IF THERE'S ANY INTERNAL TRAINING, AND IT'S OKAY IF NOT, IF THERE ARE ANY TRAININGS OR TRIGGERS BY WHICH WE SAY, OKAY, WE NEED TO TAKE A STEP BACK AND REALLY LOOK AT THIS PERSON HOLISTICALLY.

FOR, FOR ANY OF THE, FOR ANY OF OUR FIRST RESPONDERS.

I LIKE ALL OF YOU TO ANSWER HONESTLY, I'LL GO FIRST.

UM, SO FOR US, WE DO HAVE A 48 HOURS.

SO WITH THE, THE SHIFT WORK WE DO AT A 24 HOURS, AT 48 HOURS, UH, THEY'RE KNOWN AS WHAT'S IN THE RED.

SO THE SUPERVISORS AUTOMATICALLY PUSH THEM TO THE END OF THE LIST, AND SO THOSE FOLKS WOULDN'T BE SELECTED.

AND THEN WE ALSO HAVE A 96 HOUR OVER A ROLLING 10 SHIFTS WHERE WE TRY TO MINIMIZE THE AMOUNT OF OVERTIME THEY HAVE.

AND SO, UM, THE TRIGGERS ARE THERE, THE SHIFT COMMANDERS, UH, DO THE DAILY STAFFING AND THEY WATCH THOSE TRIGGERS.

AND, AND, YOU KNOW, MOST OF THE TIME WE'RE ABLE TO STAY UNDER IT.

LAST YEAR WHEN THINGS WERE REALLY DIRE WITH COVID AND EVERYTHING, IT FELT LIKE WE WOULD GET INTO THAT, THAT DANGER AREA A LITTLE BIT.

BUT OVERALL, I THINK WE'RE ABLE TO MAINTAIN, UH, FOLLOWING THOSE TRIGGERS AND KEEPING OUR FOLKS, UH, YOU KNOW, STILL WORKING A LOT OF HOURS, BUT IN AN AREA THAT WE FEEL IS SAFE.

SO NO ADDITIONAL TRAINING, BUT YOU KNOW, THAT'S THE REASON WHY FIRST SHOW UP AND THEY GO THROUGH THERE EVERY SINGLE DAY BEFORE THEY, THEY GO OUT ON THE STREET, IS TO MAKE SURE THE, THE SUPERVISORS, THE CORPORAL SERGEANTS AS WELL AS THE LIEUTENANTS, YOU KNOW, EVALUATE EACH ONE OF THE OFFICERS AS THEY TALK TO 'EM, UH, AND GET THEM TO INTERACT AND MAKE SURE THAT THEY'RE WITHIN SOUND MIND AND THEY'RE NOT TOO TIRED, ET CETERA, LIKE THAT.

SO IT'S JUST THE KEY AREAS ABLE TO BEING A SUPERVISOR TO BE ABLE TO DETERMINE IF THEY, THEY ARE OF RIGHT MIND TO BE ABLE TO BE OUT THERE ON THE STREET.

AND OF COURSE WHEN THEY, YOU KNOW, THEY, THEY HEAR 'EM ON THE RADIO, THEY, THEY, THEY SEE THEIR ACTIONS ON THE STREET AS WELL, YOU KNOW, ANY INDIVIDUAL CALLS AND IF THEY HAVE TO, THEY CAN PULL 'EM OFF, YOU KNOW, AND, UH, SEND THEM HOME OR WHATEVER.

BUT YOU KNOW, BESIDES THAT, THERE'S, THAT'S HOW THEY DETERMINE BESIDE THE LOG OF HOW, HOW THEY'RE WORKING, HOW MUCH THEY'RE WORKING.

SO, AND I'LL SAY MOST OF THE MAJORITY, NOT ALL, BUT MAJORITY OF THE OFFICERS SAY, YOU KNOW, BECAUSE WE WORK 10 HOUR SHIFTS, THEY WORK A 10 HOUR SHIFT AND THEY GO HOME, THERE'S NOT THAT MANY THAT GO AFTER THAT 10 HOUR SHIFT TO GO WORK AN OVERTIME ISSUE.

I'M NOT SAYING ALL, BUT SOME MAYBE HAVE AN HOUR OR TWO GIG WHERE THEY GO AND WORK THAT AND THEN THEY GO HOME.

BUT MAJORITY OF 'EM ARE DOING THEIR 10 HOUR SHIFTS,

[00:55:01]

BUT THEN THEIR, THEIR OVERTIME IS DONE ON THEIR THREE DAYS OFF, SO THAT'S WHEN THEIR TIME IS BEFORE THEIR, THEIR NEXT CYCLE COMES FOR THE NEXT WEEK FOR THEIR 40 HOURS.

SO YEAH.

AND THEN FOR E M S, AND WE REALLY RELY ON OUR FRONTLINE SUPERVISORS AS THEY DO THOSE STATION VISITS.

WE, WE LOOK FOR THINGS LIKE, ARE THEY CALLING OFF SICK FOR THEIR NORMAL DUTY ASSIGNMENT AND THEN PICKING UP OVER TIME.

AND SO THEN THEY PASS THAT UP TO THE SHIFT CHIEF WHERE WE'LL HAVE DISCUSSIONS WITH THOSE EMPLOYEES ABOUT, YOU KNOW, WORKING YOUR BASE SCHEDULE AND HOW YOU SCHEDULE THAT OVER TIME.

THAT THOSE ARE JUST SOME OF THE MECHANISMS THAT WE UTILIZE TO WATCH FOR THAT.

I KNOW, LIKE WHAT ABOUT ACTUAL, NOT ACTUAL, BUT WHAT ABOUT SUPPORTS? I HEAR CHECKING, BUT I DON'T HEAR RESOURCE PROVISION.

IS THAT PART OF WHAT WE DO IN, IN THOSE, AND THEN I CAN BE DONE.

SO, SO OUR PEER SUPPORT, UH, ARE WELL CONNECTED WITH OUR OFFICERS AND, UM, I'VE NEVER HEARD THEM NOT TURN DOWN A CALL OR BE ABLE TO RESPOND TO A SUPERVISOR'S REQUEST.

SO, UM, THAT'S ONE THING THAT, UM, THAT, THAT STARTED BY SEVERAL CHIEFS AGO OF THE PEER SUPPORT SYSTEM AND, UH, TO MAKE SURE THAT WE HAVE THAT TYPE OF, UH, SUPPORT, UH, PROGRAM IN PLACE.

SO THEY'VE BEEN VERY INFLUENTIAL.

IF SOMEONE'S HAVING PROBLEMS AND THEY'RE VERY CONFIDENTIAL, UH, THAT THEY CAN, THEY CAN TAKE CARE OF, THAT'S ALL A SUPERVISOR HAS TO DO TO GIVE A CALL AND THE SUPPORT'S THERE FOR THEM.

UM, SAME IS TRUE FOR E M S.

WE'VE GOT A VERY ROBUST PEER SUPPORT TEAM.

UH, WE HAVE TEAM LEADS ON THAT PEER SUPPORT, AND THEN ALSO THEY HAVE A, A NUMBER THAT THEY CAN CALL 24 HOURS A DAY THAT WE'LL, WE'LL ANSWER TO GET THOSE RESOURCES TO THOSE MEDICS SHOULD THEY NEED IT.

YEAH, FOR US, WE HAVE THE SAME, WE HAVE A, A GOOD PEER SUPPORT TEAM.

WE HAVE MEMBERS ASSIGNED TO EACH BATTALION AND EACH OF THE SHIFTS, UH, THAT, THAT ARE PEER SUPPORT CONTACTS.

AND SO FAIR, FAIRLY COMFORTABLE THAT FOLKS ARE REALLY CONNECTED AT THIS POINT.

DO WE HAVE ANY OTHER QUESTIONS, COMMISSIONER BERNHARDT? OKAY.

UM, JUST FOR CLARIFICATION, AND THIS IS A QUESTION FOR FIRE, UM, HAVE, DO Y'ALL HAVE A, AN ASSESSMENT OF SORT OF ON AVERAGE WHEN SOMEONE'S ON A 24 HOUR SHIFT, UM, HOW MUCH OF THAT TIME IS LIKE ACTIVELY IN THE FIELD VERSUS, YOU KNOW, TAKING CARE OF EQUIPMENT IN THE, UM, IN THE HOUSE, YOU KNOW, DOING OTHER STUFF? IT VARIES SO WIDE FROM STATION TO STATION.

WE HAVE STATIONS WHERE I'M, UH, CONFIDENT THAT A MAJORITY OF THE TIME THAT THEY'RE THERE IN THE 24 HOURS THEY'RE ENGAGED IN SOMETHING.

UM, BUT WE ALSO HAVE STATIONS THAT ARE SLOW.

ONE OF THE THINGS THAT WE DO AS AN OPTION IS IF SOMEBODY'S WORKING A 48, PUT 'EM AT A SLOWER STATION ON THE SEC