* This transcript was created by voice-to-text technology. The transcript has not been edited for errors or omissions, it is for reference only and is not the official minutes of the meeting. [COVID-19: Update Alternate Care Site] [00:00:12] GOOD AFTERNOON. I'M KALILLE BN AND I WILL BE THE MODERATOR FOR TODAY'S MEDIA AVAILABILITY REGARDING THE ALTERNATE CARE SITE. SPANISH INTERPRETATION OF THIS MEDIA AVAILABILITY IS ON ATX AND THREE START DR. MARK S. SCOTT, INTERIM AUSTIN, TRAVIS COUNTY HEALTH AUTHORITY WILL FIRST SAY A FEW WORDS FOLLOWED BY DR. JASON PICKETT, WHO IS THE AUSTIN, TRAVIS COUNTY, ALTERNATE HEALTH AUTHORITY, AND THEN CHIEF MEDICAL OFFICER FOR THE ALTERNATE CARE SITE. DR. JASON . AND THEN WE'LL OPEN IT UP TO THE POOL REPORTER WHO ASKS MEDIA QUESTIONS FROM MEDIA ADDRESS, SCOTT. GOOD AFTERNOON. AND THANK YOU FOR JOINING US. UH, I'M EXCITED TO BE JOINED BY MY COLLEAGUE TO TALK MORE IN DETAIL ABOUT THE ALTERNATE CARE SITE. THIS IS A SITE THAT, UH, THAT WE STOOD UP, UH, BECAUSE WE WERE IN A TRAJECTORY THAT WAS VERY CONCERNING, UH, AND THAT, UH, PUT US IN A POSITION THAT WE MAY HAVE OVERRUN OUR HOSPITAL SYSTEM. I'M HAPPY TO SAY THAT, THAT WE CONTINUE TO BE IN A PLATEAUS SITUATION TODAY. WE'RE GOING TO SEE FURTHER DECREASES IN OUR NUMBER OF INDIVIDUALS HOSPITALIZED IN THE AUSTIN MSA. UH, WE'RE SEEING A DECREASE IN OUR NUMBER OF ADMITTED ICU PATIENTS, BUT WE HAVE TO KEEP IN MIND THAT WE'RE STILL IN A VERY SERIOUS SITUATION IN OUR JURISDICTION AND ACROSS THE STATE OF TEXAS, WE SAW A RECORD WEEK THIS WEEK IN TERMS OF DEATHS IN THE MSA, UH, IN TERMS OF DEATHS ACROSS TEXAS, WE'RE STILL SEEING SOUTH TEXAS BEING, UH, REALLY HIT VERY HARD BY, UH, COVID-19 WITH THEIR HOSPITALS OVERWHELMED. SO WE MUST STAY IN A POSITION THAT WE CAN, UH, PROVIDE A BUFFER FOR OUR HOSPITALS AND THAT WE CAN PROVIDE, UH, SERVICES IF NEEDED TO OUR NEIGHBORS ACROSS THE STATE OF TEXAS. UM, WE HAVE TO STILL CONTINUE THOSE EFFORTS, THOSE PROTECTIVE EFFORTS, THE SOCIAL DISTANCING, THE MASKING AND THE PERSONAL HYGIENE. WE HAVE TO DO IT NOT ONLY FOR OUR HOSPITALS, BUT ALSO FOR OUR CHILDREN. WE SIMPLY MUST BE IN A BETTER PLACE IN TERMS OF DISEASE SPREAD IN ORDER TO GET BACK TO SCHOOL AND, AND BACK TO A LIFE WHICH IS RELATIVELY NORMAL. AND WE CAN DO THAT BY WORKING TOGETHER BY CONTINUING TO DO THOSE THINGS, WHICH WE KNOW LEAD TO DECREASE RATES OF TRANSMISSION AND WILL IMPROVE OUR CHANCES OF GETTING BACK TO MORE NORMALCY SOONER. AND WITH THAT, I'LL PASS IT BACK OVER TO DR. PICKETT FOR SOME TIME. IT'S GOOD AFTERNOON, EVERYONE. SO WE'VE BEEN WORKING ON THE PLANS FOR THIS ALTERNATE CARE SITE FOR THE PAST FEW MONTHS, AND WE'VE GOT A GREAT TEAM OF PEOPLE FROM A DIFFERENT CITY AGENCIES AND DEPARTMENTS WORKING TOGETHER TO CREATE THIS RESOURCE. IT IS MY HOPE THAT WE DON'T EVER HAVE TO PUT A PATIENT HERE. UH, AND I BELIEVE THAT THE HOSPITALS AND WORKING WITHIN THEIR SEARCH PLANS CAN PROVIDE THE BEST CARE POSSIBLE FOR THE PATIENTS THAT AND NEEDED, BUT IN THE CASE THAT THEY GET OVERWHELMED, THEN WE'RE HERE TO HELP TAKE THAT PRESSURE OFF. NOW, THIS IS A REGIONAL RESOURCE THAT IS NOT SO, UH, SOLELY FOR THE CITY OF AUSTIN OR FOR TRAVIS COUNTY, AS WE LOOK AT OUR HOSPITALS AND, UH, WE SEE WHAT THEIR, UH, THEIR BED STATUS, HOW MANY PEOPLE THEY HAVE ADMITTED AND, UH, HOW THEY ARE IN THEIR SURGICAL PLANS. UH, THAT IS A REGIONAL PICTURE THAT WE HAVE. AND THIS IS A REGIONAL REASONS THAT WE HAVE HERE. OUR PERFECT GOAL HERE IS TO TAKE CARE OF PATIENTS WHO ARE LOWER ACUITY THAT ARE NOT INTENSIVE CARE TYPE ACUITY PATIENTS. UM, BUT THAT REQUIRE MEDICATIONS THAT REQUIRE OXYGEN SO THAT WE CAN HELP TO TAKE SOME OF THAT PRESSURE OFF OF THE HOSPITALS THAT ARE SURGING WITH THE PATIENTS AND, UH, AND WORKING SO HARD TO TAKE CARE OF FOLKS WITHIN THEIR WALLS MORE THAN THEY NORMALLY ARE USED TO TAKING CARE OF. UH, WITH THAT, I WOULD LIKE TO PASS IT OVER TO DR. PHONE. THANK YOU, DEREK. YOU PICK IT. AND SO I'M THE NEW PERSON HERE? UH, JUST A LITTLE BACKGROUND ON, I AM TYPICALLY AN INTERNAL MEDICINE DOC IN TOWN. I WORKED IN THE HOSPITAL SYSTEMS. I WORK IN NURSING HOMES AND IN THE SYSTEM ALL AFFECTED BY COVID. UH, MY GOAL IS TO NOT LEAVE THIS FACILITY. I WOULD LOVE FOR US TO NEVER HAVE TO USE IT, BUT FOR ME, IT'S AN INSURANCE POLICY FOR THE COMMUNITY, NOT ALL THE STATE, BUT THE SURROUNDING AREAS IN CASE DO NEED IT. IT'S THERE CAUSE TO BE ABLE TO, UH, PROTECT OUR CITIZENS. THANK YOU NOW TO OUR POOL REPORTER, BETTY CROSS. YEAH, [00:05:01] GOOD AFTERNOON EVERYONE. AS SHE SAID, I'M BETTY CROSS WITH CBS AUSTIN. AND THE FIRST QUESTION IS I GOT TO TOUR THE FACILITY EARLIER TODAY AND LOOKING AT IT IT'S PRETTY EXPANSIVE. AND SO MY, ONE OF MY FIRST QUESTIONS WAS WHAT DOES THE COST PER BED AVERAGE OUT TO AT THE ALTERNATE CARE SITE AND WHAT IS THE COST TO LEAST LEASE THE EXHIBIT HALLS THAT ARE BEING USED FOR THE FIELD HOSPITAL AND THE STORAGE AREA. I'LL TAKE THAT. I DON'T HAVE AN EXACT FIGURE FOR YOU OF, FOR RIGHT NOW BECAUSE THE, UH, WHAT YOU SAW TODAY IS THE FIRST 100 BEDS. NOW THIS IS EXPANDABLE OUT TO 1500 BEDS. SO WE COULD HAVE AN ADDITIONAL 14 WARDS BEYOND WHAT YOU SAW HERE TODAY. UH, THE COST PER BED, IT VARIES BY UTILIZATION. THERE ARE SOME SERVICES THAT, UH, HAVE, UH, THIS INITIAL STARTUP COSTS, BUT THEN ONLY SMALLER INCREMENTAL COSTS. SO IT REALLY DEPENDS ON THE, ON THE UTILIZATION OF THE FACILITY. IT DEPENDS SOMEWHAT ON OUR, UH, OUR STAFFING, WHAT WE HAVE MODELED CERTAIN STAFFING RATIOS WITH A NUMBER OF PHYSICIANS, NUMBER OF NURSES, UH, PARAMEDICS AND TECHNICIANS AND RESPIRATORY THERAPISTS. THERE IS SOME FLEXIBILITY IN THERE. AND SO I CAN'T GIVE YOU AN EXACT FIGURE IF YOU CAN'T GIVE AN EXACT FIGURE. I COMPLETELY UNDERSTAND THAT. IS THERE A BALLPARK? LIKE THIS IS WHAT WE'RE KIND OF, IF WE WERE TO TAKE IT AND AVERAGE IT OUT, THIS IS WHAT WE WERE OR MOST LIKELY TO SPEND PER BED OR POOR PER TYPE OF BED, BECAUSE I DID SEE THREE DIFFERENT TYPES OF BEDS THAT WERE THERE. I'M AFRAID I DON'T HAVE A FIGURE FOR YOU. ALL RIGHT. THE NEXT QUESTION IS FROM UNIVISION. ARE THERE ANY PLANS FOR PATIENTS FROM THE RGV RIO GRANDE VALLEY OR EL PASO TO BE BROUGHT TO THIS FACILITY, HAVE HOSPITALS IN THE RIO GRANDE VALLEY REACHED OUT ABOUT THIS POSSIBILITY, UH, BETTY, WE HAVEN'T INTENDED THIS FOR, FOR USE, FOR A DELIVERY OF PATIENTS FROM REMOTE DESTINATIONS. UH, THERE ARE OTHER SERVES FACILITIES AROUND THE STATE OF TEXAS, SOME OF WHICH ARE SUPPORTED BY THE STATE AND FEDERAL GOVERNMENT. OUR GOAL WITH THIS FACILITY IS REALLY TO ACT AS A BUFFER FOR OUR REGIONAL HOSPITALS, IF THEY EXCEED CAPACITY AND NEED TO OFFLOAD SOME OF THOSE LOWER ACUITY PATIENTS. UH, SO AT THIS STAGE WE DON'T INTEND TO TAKE REMOTE PATIENTS. AND, UH, YOU KNOW, IF WE, IF WE TAKE TRANSFERS OF PATIENTS FROM DISTANT LOCATIONS, THOSE WOULD LIKELY GO DIRECTLY TO OUR, OUR HOSPITALS WITHIN THE MSA RATHER THAN TO OUR SEARCH FACILITY. SO WHEN YOU TALK ABOUT REGIONAL, ARE YOU TALKING ABOUT JUST CENTRAL TEXAS THEN? YEAH, IT'S PRIMARILY OUR, OUR FIVE COUNTY MSA. UH, CERTAINLY, UH, OUR HOSPITALS CARE THAT ARE BEYOND THE FIVE COUNTY MSA. UH, BUT YOU KNOW, BASICALLY THOSE INDIVIDUALS MAY GO TO A HOSPITAL FOR THE ACUTE PHASE OF THEIR TREATMENT. UH, BUT THEY MAY STILL HAVE SOME MINOR NEEDS OXYGEN NEEDS OR, UH, IV FLUID NEEDS. AND THAT COULD BE MANAGED IN A FACILITY LIKE THE ALTERNATE CARE SITES SO THAT WE CAN FREE UP THAT BED FOR, UH, AN INDIVIDUAL WHO REQUIRES MORE INTENSIVE CARE. THE NEXT QUESTION IS FROM THE STATESMAN, HOW LONG WILL THE SITE REMAIN OPERATIONAL WITH NUMBERS, TRENDING DOWNWARD? IS THERE A THRESHOLD AT WHICH FACILITY COULD BE CLOSED? AND HOW WILL THE SITE OPERATE IN CONJUNCTION WITH ISOLATION, HOTELS? SO WE INTEND TO STAY, UH, STAY OPERATIONALLY READY, AS LONG AS THE HOSPITALS ARE STILL FUNCTIONING IN THEIR SEARCH PLANS. SO AS THE HOSPITALS ARE WORKING IN THOSE SEARCH CONDITIONS AND WE PLAN TO HAVE THIS READY RECEIVE PATIENTS, UH, HOWEVER WE DO NOT HAVE, IF WE DON'T HAVE PATIENTS, WE DO NOT HAVE MEDICAL STAFF IN THE FACILITY AT THE TIME. AND THAT'S AN IN ORDER TO SAVE ON COST AT THE TIME THAT WE DECIDE TO SHUT EVERYTHING OFF AND, UM, AND REMOVE ALL THE VETS WE HAVE NOT YET DISCUSSED THAT. WE CERTAINLY WANT TO SEE SEVERAL WEEKS OF DECLINING NUMBERS AND HOSPITALS BACK TO THEIR NORMAL CAPACITY BEFORE WE MAKE THE DECISION TO DO THAT. AND THE FINAL PART OF THAT QUESTION WAS HOW WILL THIS SITE OPERATE IN CONJUNCTION WITH ISOLATION HOTELS? SO THE ISOLATION FACILITY THAT WE, UH, THAT WE HAVE, WHICH, UH, WHICH IS A HOTEL THAT IS DESIGNED FOR PATIENTS WHO DO NOT REQUIRE ANY MEDICAL CARE, UH, THEY ARE PEOPLE THAT WOULD OTHERWISE ISOLATE AT HOME, BUT THEY DON'T HAVE A SAFE PLACE TO ISOLATE. SO THEY LIVE IN CLOSE CONFINES WITH OTHER FAMILY MEMBERS THAT MAY BE HIGH RISK, UH, OR THEY LIVE IN A, UH, UH, A GROUP LIVING ENVIRONMENT SUCH AS A HOMELESS SHELTER [00:10:01] OR A GROUP HOME. THE, AT THE ISOLATION FACILITY, THERE IS NOT ANY ONGOING CARE IN THIS FACILITY HERE AT THE ALTERNATE CARE SITE. UH, WE HAVE NURSES AND PHYSICIANS AND THERAPISTS, UH, TO CARE FOR PATIENTS TO ADMINISTER MEDICATIONS. SO IT'S REALLY MUCH CLOSER TO A HOSPITAL OR NURSING CARE FACILITY. THE ISOLATION FACILITY IS MORE OF A HOTEL WHERE THEY DO HAVE SOME ONSITE MEDICAL SERVICES AVAILABLE, BUT PATIENTS THERE, OR, OR GUESTS THEY'RE RATHER, UH, ARE LARGELY ABLE TO CARE FOR THEMSELVES. THE NEXT QUESTION IS FROM KVU ONCE A PATIENT IS ADMITTED TO ACS, HOW WILL THE CARE COMPARE TO A REAL HOSPITAL? AND WHAT DOES THE ROAD TO DISCHARGE LOOK LIKE? KIND OF LIKE, DO YOU WERE TALKING A LITTLE BIT ABOUT THAT JUST A SECOND AGO? YEAH. AND I CAN TAKE THAT ONE IF YOU'D LIKE, UM, FROM THE STANDPOINT OF WHAT HAPPENS WHEN SOMEBODY IS ADMITTED, UM, THEY WILL COME IN THE PROCESS, UH, THEY WILL BE SEEN BY THE PHYSICIANS, THE NURSES, ET CETERA. UM, THAT LEVEL OF CARE IS NOT QUITE AT THE SAME LEVEL OF A HOSPITAL BECAUSE THE HOSPITAL INVOLVES A LOT MORE THAN THAT. BUT FROM A STANDPOINT OF THE QUALITY OF CARE THAT THEY WILL GET WITH THE THERAPY WITH THE DOCTORS, WITH THE NURSES, WITH THE AIDS THAT WILL ALL BE HIGH QUALITY CARE. UM, AND THEN THE PROCESS OF, OF GETTING FROM HERE TO HOME OR WHEREVER THEY MAY LAND. ONE OF THE BIGGEST THINGS THAT WE DON'T REALLY THINK ABOUT WITH COVID IS HOW PEOPLE HAVE SIGNIFICANT DISABILITY AFTER THEY HAVE THIS ILLNESS, ESPECIALLY IF THEY'VE BEEN IN AN INTENSIVE CARE UNIT ENVIRONMENT, THEY END UP BEING PROFOUNDLY WEAK, AND OUR GOALS ARE TO STRENGTHEN THEM TO THE POINT WHERE WE CAN GET THEM HOME SAFELY. SO ARE YOU SAYING THE HOSPITAL, THE ALTERNATE CARE SITE WOULD BE AS MUCH FOR USE FROM SOMEONE ELSE ON THE, THE FRONT END OF THEIR ILLNESS AND ALSO ON THE BACKEND? NO, NOT AT THE FRONT END. UH, SO THE GOAL IS FOR PEOPLE TO STABILIZE FIRST, WHEN SOMEBODY FIRST COMES IN WITH COVID, WE DON'T KNOW WHICH WAY THEY'RE GOING TO GO. A CERTAIN PERCENTAGE GET A LOT WORSE AND THEN A CERTAIN PERCENTAGE STAY STABLE AND THEN ULTIMATELY IMPROVE. UH, SO, UH, WE WOULD PREFER, AND WE HAVE TO CHANGE THIS IF THE CONDITIONS EVER GOTTEN EXTREME IN OUR TOWN, JUST LIKE THEY DID IN NEW YORK CITY, BUT WE WERE PREFERRED TO TAKE PATIENTS, UH, WHEN GOTTEN TOWARDS THE LATTER PART OF THEIR HOSPITALIZATION WHEN THEY, THEY STILL HAVE MEDICAL NEEDS, BUT NOT INTENSE MEDICAL NEEDS. AND WE KNOW THAT THEY'RE PRETTY DARN. OKAY, THANK YOU. THAT'S A GOOD CLARIFICATION. ALL RIGHT. THIS IS FROM FOX SEVEN. WHY HAS IT TAKEN SO LONG TO SET UP THE CONVENTION CENTER? HOW MANY STANDARD BEDS WILL BE SET UP AND HOW MANY ISOLATION TENTS WILL BE SET UP? AND THIS KIND OF GOES TO THE THREE DIFFERENT TYPES OF BEDS THAT I SAW, I GUESS THIS REPORTER IS ASKING FOR KIND OF A BREAKDOWN OF THOSE MOST BASIC, AND THEN THE LEVEL TWO BEDS. AND THEN THOSE, I THINK IT WAS JUST TWO TENTS, BUT Y'ALL DO CORRECT ME WITH THE ICU TYPE FACILITIES. SURE. I'LL, I'LL HANDLE A PORTION OF THAT QUESTION. UM, SO RIGHT NOW WE HAVE A A HUNDRED BEDS AND THERE ARE DIFFERENT TIERS OF, OF AREAS DEPENDING ON PEOPLE'S OXYGEN NEEDS. UH, THOSE TWO ICU BEDS ARE FOR PATIENTS THAT ARE, ARE GETTING WORSE RATHER THAN BETTER. SO WE WOULD HAVE THOSE AVAILABLE TO BE ABLE TO, TO STABILIZE THEM. AND THEN IF THEY NEED TO BE TAKEN TO THE HOSPITALS FOR, UH, TRUE INTENSIVE CARE, UH, PURPOSES THAT WOULD BE AVAILABLE, UM, FROM A STANDPOINT OF ISOLATION, OUR FACILITY IS ALL COVID PATIENTS. SO, UH, EVERYBODY WHO DOES COME HERE WOULD BE BY DEFINITION A COVID PATIENT. UH, SO EVERYBODY WILL BE AN ISOLATION PATIENT. OH, GO AHEAD, PLEASE CONTINUE. AND EXCUSE ME. UM, I'LL SAY THE OTHER PART OF THAT WITH, UH, THE LENGTH OF TIME IT'S TAKEN US TO SET UP THE, UH, THE FACILITY HERE IS BECAUSE WE HAVEN'T NEEDED IT. UH, AND THE HOSPITALS HAVE BEEN FUNCTIONING WELL WITHIN THEIR SURGE PLANS. UM, WE'VE ONLY MORE RECENTLY SEEN THEM EXCEED THEIR NORMAL CAPACITY AND PUSH INTO THEIR SURGE CAPACITY. SO THERE HAS NOT BEEN A NEED FOR THIS FACILITY AS OF YET. UH, AND I SEE THAT AS A GOOD THING BECAUSE WE'RE ABLE TO SOFTLY MOVE FORWARD WITH PLANNING THIS FACILITY IN A, IN A WAY THAT EFFICIENT, IN A WAY THAT, UM, WE'RE BEING GOOD STEWARDS OF TAXPAYER DOLLARS. UH, WE DID SEE OTHER JURISDICTIONS WHICH STOOD UP FACILITIES VERY RAPIDLY EARLY ON AND ENDED UP NOT UTILIZING THEIR FACILITIES. UM, AND, UH, THOSE WERE VERY LARGE EXPENDITURES. WE WANTED TO AVOID DOING THAT AND WANTED TO MAKE SURE THAT WE WERE READY TO GO WHEN NEEDED, UH, BUT NOT, UM, POURING A LOT OF MEDICAL STAFF INTO IT MONDAY MORNING. AND I THINK, UM, RUDY WAS ALSO ASKING IF THERE'S TWO ICU BEDS, [00:15:01] A HUNDRED TOTAL, TWO ICU BEDS, HOW DOES THE REST OF IT BREAK DOWN WITH THOSE MOST BASIC BEDS? AND THEN KIND OF THE IN BETWEEN ONES WE SAW LEVEL TWO, MAYBE I WOULD CALL IT. SURE. UM, AND I CAN TAKE THAT. SO OUR HIGHER OXYGEN REQUIREMENT PATIENTS, UM, AND, AND THIS IS PARTIALLY SET UP FOR THE FUTURE BECAUSE OUR INITIAL PATIENTS ARE GOING TO HAVE LOWER OXYGEN REQUIREMENTS. UM, IF WE HAVE TO EXPAND, WE HAVE THAT CAPACITY, BUT THE HIGHER OXYGEN, UH, REQUIREMENT PATIENTS ARE IN ONE AREA. AND THAT WOULD BE PEOPLE THAT IF THEY NEEDED UP TO 10 LITERS, WE CAN SUPPLY THAT AS YOU GO FURTHER DOWN THE FACILITY AND CLOSER OR FURTHER AWAY, RATHER FROM THE ICU AREA, IT BECOMES LESS ACUTE. SO OUR HOPE IS THOSE SORTS OF FOLKS ARE PEOPLE THAT ARE NOT OXYGEN OR ON VERY SMALL AMOUNTS OF OXYGEN. UM, SO THAT'S HOW IT'S SET UP NOW. ULTIMATELY, IF WE GOT BUSIER AND BUSIER AND WE WOULD HAVE TO REFINE THAT FURTHER, WE WOULD HAVE TO HAVE AREAS OR, UH, PATIENTS THAT HAD OTHER PROBLEMS, FOR INSTANCE, UH, PEOPLE THAT HAD DIFFICULT TO CONTROL DIABETES, HYPERTENSION, ET CETERA, BUT FOR NOW THE FOCUS IS ON THE OXYGEN REQUIREMENTS. AND THAT'S REALLY HOW IT STRATEGY. THANK YOU. THIS QUESTION IS FROM KUT. UM, HOW IS CONTINGENCY MEDICAL STAFFING BEING DONE AND WHAT KIND OF MEDICAL PERSONNEL WOULD NEED TO BE HIRED AND ON STANDBY, SUCH AS, YOU KNOW, UM, JUST DIFFERENT TECHNICIANS, NURSES, DIFFERENT PEOPLE, YOU MIGHT NEED TO STAFF THIS AND, AND HOW ARE YOU FINDING THOSE PEOPLE? SO THE, WE HAVE A MEDICAL STAFFING PLAN AND, UH, BUTTERFLY CAN PROBABLY EXPAND ON THE, THE RATIOS AND NUMBERS, UH, OF, OF EACH TYPE OF, UH, OF A PROVIDER THAT ARE NEEDED HERE. UH, BUT WE ARE USING STAFFING AGENCIES. WE HAVE CONTRACTS WITH STAFFING AGENCIES, THE CITY OF AUSTIN DOES, UH, AND WE USE THEM TO, UH, TO FIND AND VET, UH, QUALIFIED INDIVIDUALS TO MAKE THAT, TO PROVIDE THAT CARE. YEAH. SO TO ADD ONTO THAT, UH, THE DIFFERENT UNITS WILL HAVE SLIGHTLY DIFFERENT STAFFING. SO IF MORE, A SICKER PATIENT, THERE'S GOING TO BE MORE NURSES PER PATIENT, UH, OR FEWER PATIENTS PER NURSE RATHER, UH, FOR THOSE FOLKS. UH, AND IF YOU'RE LESS ACUTELY ILL AND IT WILL BE A SMALLER RATIO. SO TO KIND OF GIVE YOU AN IDEA OF THE FOLKS WE'RE GOING TO HAVE HERE, WE'RE GOING TO HAVE A RESPIRATORY THERAPIST ON SITE 24 SEVEN, UH, NURSING STAFF RANGING FROM A FLOOR NURSE TO A CHARGE NURSE, TO AN ICU LEVEL NURSE THAT ARE GONNA BE AVAILABLE. UM, WE'RE TARGETING 24 HOUR PARAMEDICS. SO IF SOMEBODY DOES GET SICK, WE HAVE PEOPLE THAT ARE VERY FAMILIAR WITH, UH, THE, THE PROCESSES THAT GO INTO STABILIZING, THOSE SORTS OF FOLKS. I'LL JUST ADD ON TO THAT. YOU KNOW, WE'VE BEEN FORTUNATE TO HAVE STRONG PARTNERSHIPS, UH, THROUGHOUT THIS PROCESS, INCLUDING AUSTIN, TRAVIS COUNTY, EMS, WHO, UH, DONE REMARKABLE WORK AT, AT SUPPORTING THESE EFFORTS AND OTHER EFFORTS INVOLVED WITH A PANDEMIC. ANOTHER PARTNER THAT HAS BEEN FANTASTIC IS THE TRAVIS COUNTY MEDICAL SOCIETY, UH, WHO HAS GENERATED A ROSTER OF VOLUNTEERS TO FURTHER SUPPLEMENT STAFFING IF NEEDED. UH, WE ARE, WE ARE VERY FORTUNATE TO HAVE AN ENGAGED COMMUNITY IN THIS PROCESS, NOT ONLY FOR THE ACS, UH, BUT FOR THE HEALTHCARE NEEDS, UH, ACROSS THE COMMUNITY. AND I THINK THIS EXEMPLIFIES, UH, AUSTIN AND TRAVIS COUNTY AND, AND THE SURROUNDING COUNTIES, UH, AND IN THEIR ABILITY TO, TO REALLY COME TOGETHER TO FIGHT THIS PANDEMIC, THANK YOU FROM KX A N WHAT IS THE THRESHOLD OR TRIGGER POINT THAT HOSPITALS WOULD NEED TO REACH IN ORDER TO GIVE THE ACS THE TWO DAY WARNING REQUIRED TO PREPARE TO OPEN? SO WHEN THE HOSPITALS ARE INTO PHASE TWO OF THEIR SURGE PLANS, AND THEY REACHED 90% OF THAT CAPACITY, UH, THEN THAT'S WHEN WE KNOW THE DOORS HAVE TO OPEN THE 80% MARK OF THAT CAPACITY GIVES US AN IDEA THAT WE'RE HEADING THAT DIRECTION, BUT WHEN THEY HIT 90%, THAT'S THEIR, THEIR TOTAL AVAILABLE SEARCH CAPACITY. THEN WE KNOW WE HAVE TO OPEN OUR DOORS HERE, ALL RIGHT. TO HELP OUT PEOPLE A LITTLE BIT. I'M GOING TO THROW THIS IN THERE. WHEN WE LOOK AT THAT SEVEN DAY ROLLING AVERAGE OF NEW HOSPITAL ADMISSIONS, WHERE DOES THAT FALL IN THERE? JUST SO WE ALL ARE ON THE SAME PAGE ON WHAT COULD TRIGGER THIS, GO AHEAD, DR. PICKETT, [00:20:04] THE NUMBER OF THAT SEVEN DAY ROLLING AVERAGE, UM, THAT VARIES THAT TRIGGER POINT VARIES ANYWHERE FROM 70 TO ABOUT 130, BUT THERE ARE SEVERAL OTHER FACTORS THAT GO INTO THAT. UH, THE RAPIDITY OF THE RISE OF CASES, HOW FAST CHASES ARE ACCUMULATING IN THE HOSPITAL, UH, WILL, UH, WILL HELP TO INFORM THAT, UH, THAT TRIGGER AS WELL. AND AS WELL AS, UH, HOW THE HOSPITALS ARE DOING IN TERMS OF STAFF. I KNOW THAT THIS VIRUS AFFECTS, UH, STAFFING LEVELS. AND AS PEOPLE CALL IN SICK, UH, THEY HAVE FEWER STAFF AVAILABLE FOR THEIR BEDS. AND SO THOSE ARE ALL FACTORS THAT ARE CONSIDERED IN THE NUMBER OF STAFFED BEDS THAT HOSPITALS ABLE TO PROVIDE. THE NEXT QUESTION I ACTUALLY GOT WHEN I WAS ON THE TOUR IN TALKING TO A DOCTOR, TALKING ABOUT MOCK DRILLS, BEING DONE TO MAYBE BETTER PREPARE FOR PATIENTS, IS, IS THAT GOING ON RIGHT NOW? OR IS THAT SOMETHING THAT YOU SEE HAPPENING IN ORDER TO MAKE SURE THAT YOU ARE READY, IF YOU SHOULD HIT THAT LEVEL WHERE YOU NEED TO OPEN? ABSOLUTELY. I'LL ANSWER THIS BECAUSE WE'VE ALREADY SPOKEN TO THIS. UH, SO, UH, IT STARTED REALLY WITH TABLE TOP DISCUSSIONS. SO WE WOULD RUN THROUGH SCENARIOS, UH, AND NOW WE'RE TO THE POINT WHERE WE HAVE ESSENTIALLY PEOPLE ACTING THE PART OF PATIENTS, UH, PEOPLE COMING IN AND, AND ACTING AS IF THEY'RE IN DISTRESS WITH THEIR BREATHING, ACTING AS IF, UM, THEY ARE GOING THROUGH WITHDRAWALS FROM, FROM VARIOUS SUBSTANCES, ACTING LIKE THEY'RE AGITATED AND WE'RE STRATEGIZING AND GOING THROUGH THOSE DRILLS TO FIGURE OUT HOW TO, TO DEAL WITH THAT WHEN THEY ACTUALLY OCCUR. AND THOSE ARE ONGOING, WE KEEP DOING WHAT'S, UH, FROM A STANDPOINT OF, OF THAT, THAT'S, THAT'S VERY HELPFUL. UM, IT'S NOT QUITE THE SAME AS HAVING REAL PATIENTS IN REAL BEDS DOING WHAT THEY DO, BECAUSE ULTIMATELY PATIENTS WILL SURPRISE YOU ONE WAY OR ANOTHER, SOMETIMES GOOD, SOMETIMES BAD. RIGHT. UM, BUT WITH THAT, UH, YOU KNOW, HAVING REAL PATIENTS, UH, THAT'S THE NEXT LEVEL RIGHT NOW, WE'RE, WE'RE NOT QUITE TO THAT. IS THERE EVER A POSSIBILITY WHERE YOU MIGHT TAKE PATIENTS THERE BEFORE WE HIT HIT THAT 90% CAPACITY FOR HOSPITALS? OR IS IT REALLY JUST A SITUATION WHERE YOU WOULD WAIT FOR THAT? AND ONLY AT THAT POINT, TAKE A FIRST PATIENT? WELL, FROM MY PERSPECTIVE, UH, THERE THERE'S SOME BENEFIT TO, TO THIS SORT OF A THING, BECAUSE IF WE WOULD END UP TAKING IN PATIENTS, THE BENEFIT OF GOING THROUGH REAL LIFE DRILLS, IF YOU CAN GET HIT WITH A LARGE AMOUNT OF PATIENTS OVER THE COLD AND FLU SEASON WOULD BE, UH, QUITE SUBSTANTIAL. UM, THAT'S SOMETHING THAT, THAT KIND OF IS, UH, BEING DISCUSSED, BUT WE HAVE NOT HAD ANY DECISION ON THAT ONE WAY OR THE OTHER BETTY, LET ME ALSO ADD TO THAT AND SAY THAT, THAT WE'VE HAD THE PIVOT MANY, MANY TIMES THROUGHOUT THIS PANDEMIC DUE TO CHANGING CIRCUMSTANCES IN DATA, UH, THIS FACILITY STANDS READY FOR WHATEVER THE HOSPITALS CALL AND SAY IT'S NEEDED. UH, RIGHT NOW WE THINK THAT'S 90% TO, INTO THE, THE, UH, STAGE TWO OF SEARCH CAPACITY THAT COULD CHANGE, UH, THAT COULD CHANGE BASED UPON, UH, ISSUES LIKE STAFF ILLNESSES OR ABSENTEEISM. UH, SO WE HAVE TO BE READY AND, AND I'M GRATEFUL FOR THE, THE TEAM YOU HAVE HERE PICKET AND DR. FOUGHT, UH, AND, UH, ALL THE PEOPLE BEHIND THE SCENES WHO HAVE ENSURED THAT, THAT WE ARE IN A POSITION TO RESPOND IF NEEDED. THANK YOU FROM THE STATESMAN, HOW FULL ARE HOSPITALS IN TRAVIS COUNTY RIGHT NOW, WHAT PERCENTAGE OF THEIR CAPACITY HAS BEEN REACHED AS OF TODAY AND HOW CLOSE ARE WE TO THAT 90% MARK. SO RIGHT NOW THE HOSPITALS ARE, YOU KNOW, THERE'S, THERE'S VARIATION BETWEEN HOSPITALS OVERALL, THE SYSTEMS SEEM TO BE AROUND, UH, YOU KNOW, THE 80% MARK IN TERMS OF, OF TOTAL BEDS OCCUPIED. UH, THE ICU IS, ARE, ARE MORE LIKE 80, 85%, UH, SOME, A LITTLE BIT HIGHER, UH, BUT THINGS SEEM TO BE, UH, PLATEAU. AND, UH, AND IN SOME CIRCUMSTANCES IMPROVING, UH, AGAIN, YOU KNOW, WE WANT TO SEE IMPROVEMENT OVER A SUSTAINED PERIOD OF TIME BEFORE WE, WE STARTED ANY CELEBRATIONS. UH, BUT RIGHT NOW THEY'RE HOLDING. AND, UH, YOU KNOW, THE STAFFING SITUATION SEEMED TO BE IMPROVING A BIT, UH, THE WORD THAT WE'RE GETTING FROM THE HOSPITAL SYSTEMS ARE THAT, UH, REQUESTS FOR CONTRACTS TO FILL STAFFING POSITIONS ARE IMPROVING AS WELL. [00:25:01] SO WE'RE HOPEFUL THAT, THAT WE'RE GETTING INTO A BETTER SITUATION LOCALLY, BUT STILL VERY, VERY CONCERNED ABOUT THE OVERALL SITUATION ACROSS THE STATE OF TEXAS AND ACROSS THE UNITED STATES. UH, WE'VE GOTTA BE VERY CAREFUL GOING INTO THE FALL, PARTICULARLY AS WE FACE OTHER THREATS, SUCH AS, UH, AS INFLUENZA. AND, UH, IT'S GOING TO BE IMPORTANT FOR US TO ENSURE THAT, THAT WE HAVE OUTREACH FOR INFLUENCE VACCINATIONS TO TRY TO PREVENT, UH, THE CHALLENGES ASSOCIATED WITH DEALING WITH A SURGE OF COVID AND A SURGE OF FLU. YEAH, I THINK CAVE YOU NOW IS LOOKING MAYBE FOR SOME CLARIFICATION, Y'ALL HAVE TALKED A LITTLE BIT ABOUT THE FACT WHAT IT WOULD TAKE TO TRIGGER THE ACS AND WHAT OTHER CITIES MIGHT IT BE AVAILABLE TO. BUT I THINK MAYBE THEY'RE LOOKING FOR CLARIFICATION HERE FROM THAT. YOU'LL TALK ABOUT THE REGIONAL FIVE COUNTY AREA. IS THAT PRETTY MUCH WHERE YOU SEE THE LIMIT BEING FOR THIS FACILITY, AS FAR AS TAKING PATIENTS IN? I THINK THIS FACILITY AND, AND I'LL, I'LL GIVE THE OTHERS AN OPPORTUNITY TO RESPOND. THIS FACILITY IS REALLY DESIGNED FOR A HOSPITAL OVERFLOW WITHIN OUR MSA, UH, AND, AND CERTAINLY WITHIN OUR, OUR TRAUMA SERVICE AREA. UH, AGAIN, THERE ARE OTHER CONTINGENCY PLANS FOR OTHER REGIONS OF THE STATE OF TEXAS. SO AT THIS STAGE, I DON'T ANTICIPATE THAT THIS SITE WOULD NEED TO BE USED, UH, FOR OR OUTSIDE OF THAT AREA. UH, YOU KNOW, AGAIN, IF WE RECEIVE PATIENTS FROM A DISTANCE, UH, FROM, FROM SOUTH TEXAS, FOR INSTANCE, OR, OR WEST OR EAST TEXAS, UH, I IMAGINE THAT THOSE WOULD GO INTO THE HOSPITALS FIRST. AND, UH, AND THEN AS DR. FOX SAID, IF THEY GET INTO A SITUATION WHERE THEY'RE IMPROVING AND THEY CAN STEP DOWN TO A EPISODE LIKE THE ACS, UH, THAT WILL BE ABLE TO ACCEPT THEM THAT WAY. THIS IS A QUESTION FROM FOX SEVEN, WITH HOSPITALIZATION RATES STABILIZING. UH, DO YOU REALLY FEEL LIKE THE ALTERNATE CARE SITE IS NEEDED AT THIS TIME? UH, AGAIN, BETTY, UH, WE DON'T NEED TO OPEN IT TODAY. UH, WE DON'T NEED TO STAFF IT, UH, TO PREPARE TO RECEIVE 100 PATIENTS ON MONDAY. UH, BUT IT IS NEEDED. THE INFRASTRUCTURE NEEDS TO BE THERE. WE NEED TO HAVE THAT BUFFER WE'VE REALIZED HOW QUICKLY WE CAN GET INTO A SITUATION WHERE OUR HOSPITALS ARE DOING OKAY. AND, AND THEN TRANSITIONED TO ONE WHERE THEY'RE IN A SUBSTANTIAL STRESS. UH, SO WE NEED TO HAVE THAT BUFFER THERE. WE NEED TO BE READY TO GO. AND, UH, YOU KNOW, AGAIN, OUR HOPE IS THAT THAT WE NEVER HAVE TO RECEIVE PATIENTS THERE, BUT WE HAVE TO BE READY TO, I'D LIKE TO ADD TO WHAT DR. SCOTT SAID THAT THE HOSPITALS ARE OPERATING ON IN THEIR SEARCH PLANS RIGHT NOW THEY'RE UNDER SEARCH CONDITIONS. SO IT IS NOT A VERY BIG LEAP FROM BEING IN SEARCH CONDITIONS TO BEING COMPLETELY UNDERWATER. RIGHT? SO THE, UH, THIS HAS TO BE READY TO GO, I THINK, AS WE'VE SEEN BECAUSE OF THE PLANNING INSTEAD OF TIME, BUT IT'S SAYING THAT IF THIS WAS ALL TAKEN DOWN AND THEN WE HAD A COUPLE OF DAYS WARNING TO SET ONE OF THESE FACILITIES UP THAT, UH, THAT WOULD BE EXTREMELY DIFFICULT TO ACCOMPLISH. YEAH. AND IN MANY WAYS I CAN DO THIS AS, UH, AS I DO MY OWN, UH, AUTO INSURANCE POLICY. I HOPE I DON'T HAVE TO LOSE IT, BUT IT'S THERE IF I NEED IT. SO THE SAME CAN BE SAID FOR THIS FACILITY, WE'VE GOT A BIG POPULATION HERE WITH REALLY KIND OF STILL UNKNOWN DISEASE AND POPULATION BEHAVIOR. THAT VARIES. IT SEEMS LIKE YOU HAVE, AND PEOPLE IN THE CITY AND SURROUNDING AREAS THAT ARE, ARE FOLLOWING THE WORLD A LOT MORE. UM, BUT WE'VE SEEN THAT HAPPEN. WE'VE SEEN THAT BREAK DOWN. AND IF THAT BREAKS DOWN, WE NEED TO BE ABLE TO HAVE SOMETHING THAT'S AVAILABLE, BECAUSE IF WE DON'T, THE SURGE HAPPENS, WE DON'T WANT TO SEE SCENARIOS LIKE WE DID IN NEW YORK AND OTHER PLACES IN THE WORLD. THANK YOU ALL NOW FROM KUT. UM, THE REPORTER SAYS HE CAN'T RECALL IF THIS WAS, UH, ACTUALLY ASHLEY SAYS, CAN'T RECALL IF THIS WAS COVERED, BUT WHAT PERCENTAGE OF FUNDING FOR THIS IS COMING FROM FEDERAL EMERGENCY RELIEF VERSUS CITY AND COUNTY FUNDS? UH, BETTY, I, I DON'T HAVE THE BREAKDOWN FOR THAT. I'M SURE THAT WE CAN GET, UH, GET YOU BETTER INFORMATION ON THAT FROM, UH, FROM THE EOC. UH, WHO'S [00:30:01] MANAGING THE LOGISTICS AND THE FINANCES FOR THIS FACILITY. SOME OF THAT MAY CHANGE AS THE, UH, THE CITY AND THE COUNTY SEEK REIMBURSEMENT FROM THE FEDERAL GOVERNMENT, UH, IN THE FUTURE FOR OUR EFFORTS HERE LOCALLY. ALL RIGHT. AND THIS IS OUR LAST QUESTION IT'S COMING FROM KX. AND WHAT ARE THE ACCOMMODATIONS BEING MADE FOR PATIENTS TO TAKE CARE OF PERSONAL HYGIENE NEEDS, INCLUDING SHOWERING USING THE BATHROOM? WILL THEY BE TRACKED AND MONITORED WHEN USING THOSE FACILITIES? AND I CAN TAKE THAT ONE. UM, SO, UH, WITH, WITH PATIENTS, WE DO HAVE SHOWER TRAILERS AVAILABLE, BOTH FOR PATIENTS WITH, AND WITHOUT, UH, NEEDS FOR ACCOMMODATION. UM, YOU'RE GOING TO HAVE SUPERVISION AT SOME LEVEL. UH, CERTAIN PEOPLE MAY NEED HIGHER LEVELS OF SUPERVISION. SOME MAY NEED LESS SUPERVISION, UM, BUT WE WANT TO RESPECT PEOPLE'S PRIVACY AS MUCH AS WE CAN WHILE MAKING SURE IT'S A SAFE THING. WELL, THAT WAS THE LAST QUESTION. I APPRECIATE YOUR TIME, ALL THREE OF YOU, AND THANK YOU. THANK YOU. THANK YOU, BETTY. AND BEFORE WE WRAP UP FOR THE DAY, WE'LL GO THROUGH ANY CLOSING REMARKS. UH, THANK YOU. I JUST WANT TO READ YOUR EIGHT REITERATE THE IMPORTANCE OF CONTINUING THE EFFORTS, UH, THAT HAVE BROUGHT US TO THIS STAGE OF, OF BEING IN A BETTER POSITION, UH, IN AUSTIN AND TRAVIS COUNTY. UH, YOU ALL HAVE DONE A GREAT JOB. THE SOCIAL DISTANCING, THE MASKING, THE PERSONAL HYGIENE, UH, THE STAYING HOME, WHEN YOU DON'T HAVE TO GO OUT IS REALLY HELPING, BUT WE HAVE TO CONTINUE THOSE EFFORTS, UH, TO, TO PROTECT THIS COMMUNITY, TO PROTECT OUR HEALTHCARE WORKERS. AND FIRST RESPONDERS ARE INDIVIDUALS, UH, RESIDING IN NURSING HOMES AND LONGTERM CARE FACILITIES, AND ULTIMATELY TO GET OUR KIDS BACK IN SCHOOL, UH, YOU KNOW, WE ALL WANT TO RELAX. WE ALL WANT TO REDUCE THESE PROTECTIVE MEASURES, BUT WE SIMPLY CAN'T IF WE WANT TO ACHIEVE THOSE GOALS. SO WE MUST CONTINUE THE VIGILANCE SO THAT WE CAN BE IN A BETTER PLACE FOR THE FALL AND TO ADD ONTO WHAT DR. SCOTT SAID, OH, I'M GLAD TO SEE THAT WE'RE IN A BETTER POSITION RIGHT NOW, BUT, UH, WE ARE SHORTLY COMING INTO FLU SEASON AND GETTING YOUR FLU VACCINE IS GOING TO BE SO IMPORTANT TO HELP, TO PROTECT THE HOSPITALS, TO PROTECT THEIR ABILITY, TO TAKE CARE OF PEOPLE AND TO PREVENT THE SPREAD OF FLU, WHICH WILL ONLY FURTHER COMPLICATE OUR MANAGEMENT OF THE CORONAVIRUS PANDEMIC. AND FROM MY STANDPOINT, I'D LIKE TO TAKE THIS OPPORTUNITY TO THANK THE FRONTLINE PROVIDERS. UH, THE NURSES, NURSE PRACTITIONERS, RESPIRATORY THERAPISTS, NURSES, AIDS THAT ARE ALL OUT THERE AND WORKING REALLY HARD. I KNOW THIS IS VERY CHALLENGING FOR THEM. UH, THEY'RE AFRAID OF TAKING DISEASE BACK TO FAMILIES, BUT THEY'RE COMING IN DAY IN, DAY OUT DOING THE WORK AND LIFTING VERY HEAVY LOAD. AND FOR THAT, UH, THE CITY AND I PERSONALLY, WE SHOULD ALL BE GRATEFUL. THANK YOU SO MUCH. THAT CONCLUDES OUR MEDIA AVAILABILITY FOR TODAY. THANK YOU TO DR. MARK SCOTT, DR. JASON PICKETT, DR. JASON VOTES AND THE FULL REPORTER FOR JOINING US TODAY. WELL, NOW WE'LL BE ROLLING FOOTAGE OF THE ALTERNATE CARE SITES SO YOURS CAN SEE WHAT THE ULTIMATE CARE SITE LOOKS LIKE FROM INSIDE. THANK YOU, AND HAVE A GOOD AFTERNOON. [00:35:58] . * This transcript was created by voice-to-text technology. The transcript has not been edited for errors or omissions, it is for reference only and is not the official minutes of the meeting.