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Some City Council members are still unsatisfied with explanations of how city-backed reproductive services will be handled through the proposed “Hospital within a Hospital” at Brackenridge as an anticipated agreement looms less than a month away.

Thursday, January 10, 2002 by

The Council is set to vote on a revised contract with the Catholic Seton Health Care Network the last week of January, or possibly the first week of February. Yesterday, staff members from the city’s human services and financial departments, along with Assistant City Manager Betty Dunkerley, laid out the broad terms of the latest contract negotiations, including the cost of hospital renovations. A public hearing on the revised contract, which had been scheduled for tonight, has been moved to Jan. 17.

Mayor Pro Tem Jackie Goodman was concerned with the protocol hospital employees would use to direct women who might want to consider reproductive services. Those services might also include emergency contraceptive services for women in situations such as rape. The majority of rape victims are seen at St. David’s Hospital, although some have been directed to Brackenridge Hospital.

Goodman was clearly frustrated by the lack of specifics about how women who walked into the Emergency Room seeking reproductive services would be handled. She told city staff they had plenty of time to articulate guidelines about access points and access to information—tremendously important to the community—in a draft for Council members to consider.

“All along my frustration is that I and the public know virtually nothing about what you are discussing,” Goodman told city staff members. “Folks in the public have more information than I have had.”

Revising the contract in this controversial, difficult and sensitive area, Goodman said, is a significant undertaking and one that should be carefully considered by the Council. Goodman said she would not be satisfied until she was certain that no woman would be turned away from Brackenridge accidentally or not given the help she needs.

“It seems to be so simple, it ought to at least be in draft form long before this meeting,” Goodman said.

Patricia Young, of the city’s Community Health Clinics, said the city had been in constant negotiations with Seton. She added that what was being negotiated were the broad terms of a lease agreement; how employees spoke to patients would likely be defined in protocols that would be developed between the two agencies. City Manager Jesus Garza made it clear that Council members would have complete and total access to all aspects of the changes intended for Brackenridge before the final contract was approved.

Under the agreement, the fifth floor of Brackenridge would be eliminated from the Seton lease. That fifth floor would be renovated, at an estimated cost of $9.3 million, by July 2003. The cost, under a complicated financial agreement between Seton and the city, would be split between the expansion (the renovation of the physical facility) and non-expansion (licensing) costs. The fifth-floor hospital would be a fully accredited facility run by city staff, said Young.

Under a proposed patient flow chart, all patients from the city’s Community Health Centers would determine in advance whether they would be booked into the second or fifth floor of Brackenridge. All births not requiring a tubal ligation would be referred initially to the second floor, run by Seton. Those seeking a sterilization procedure would be directed to the fifth floor. Doctors at Brackenridge would have privileges at both hospitals.

The city would bear the brunt of the $6.8 million expansion costs, which would be deducted from Seton’s annual rent payment to the city. Seton has agreed to pick up the $2.5 million in non-expansion costs through a reduction in city payments to Seton for charity care. If the city were to decide in the third year that the partnership did not work, Seton would pick up the construction costs and the city would be at liberty to take the $3.4 million it set aside for reproductive services and contract with another outside agency, explained John Stephens, director of financial services for the city.

Under the current lease, the city pays Seton $5.6 million for charity care, far less than the actual cost of care given to the indigent in Austin. Seton pays $1.8 million in rent each year for Brackenridge. As long as the city continues to operate the hospital within a hospital, up to $3.4 million will be deducted from the annual charity care payments the city makes to Seton.

Council Member Will Wynn expressed concern about the hospital within a hospital passing accreditation. He was assured the city had spoken at length with the Joint Commission on Accreditation of Healthcare Organizations . Hospitals within hospitals are not uncommon, Young said, but are typically confined to rehabilitation rather than reproductive services.

A conditional use permit for the city’s new Homeless Shelter, Resource Center and Health Clinic at 500 East 7th Street has received approval from the Zoning and Platting Commission (ZAP). The item was originally posted for action in December, but was postponed because of questions about the building’s restroom facilities.

A nearby business owner had suggested the building offer public restrooms accessible after the facility stops admitting homeless individuals each night. They would then be available to homeless individuals not staying at the facility, but would also likely attract patrons of nightclubs and restaurants from nearby 6th street. Making that accommodation would have required substantially altering the plans for the shelter and would have affected the programs offered to the clients.

Assistant City Manager Betty Dunkerley told commissioners that there was simply not enough space for after-hours public restrooms. “We looked at the idea of putting public restrooms that would be accessible to the outside in this building,” Dunkerley. “But . . . every square inch of that building has been programmed very deliberately to get the most for our remaining dollars.” She told In Fact Daily that the cost of constructing the shelter had escalated since it was planned, so the size had to decrease accordingly.

Dunkerley also advised ZAP members that having public restrooms in the building could pose security and maintenance problems. “The people who work with us on the homeless issue . . . believe very strongly that this is an incompatible use for the building,” she said. “At this time—although we support the need for downtown public restrooms—we don’t think this is the building or the location for one,” Dunkerley said. “We think we’ve given it strong consideration over a number of years.” The building will have restrooms for workers and clients, but those facilities will not be available to the general public after the shelter closes its doors.

The City Council approved money for the new homeless shelter last year. (See In Fact Daily, March 23, 2001. ) It will contain 100 beds, a kitchen, a health clinic and a day resource center to help clients access social services. The total cost is estimated at $7.8 million. The shelter is scheduled to open in 2003.

Criticism of the Travis County Sheriff Department’ s handling of a recent drug raid that left a 19-year-old man dead took odd turns at yesterday’s Commissioners Court meeting.

Antonio Martinez died last month in a drug raid on a Del Valle mobile home. Mike Hansen, who has already declared himself a candidate for Commissioners Court, said Sheriff Margo Frasier’ s policies are “getting us killed and getting our officers killed.” He went on to describe the raid as “posse-type attacks,” turning “peace officers into military thugs with the attitude of shoot now, talk later.” Many of those who joined Hansen expressed similar sympathies, but sometimes the discussion strayed from the topic. Hansen, for one, expressed anger that his daughter was dragged into juvenile court for a truancy charge he thought was unfair.

Flo Urtie supported Hansen’s comments, telling Commissioner Ron Davis and County Judge Sam Biscoe that the Sheriff’s policies gave the government an excuse to treat black children like hard-core criminals. Commissioners did not respond to the criticism of their fellow elected official.

Then Mary Aleshire got up to say it was “one thing for a SWAT team to come into your house, but another thing for strangers to invade your body and do experiments on you without your permission.” She told commissioners it was conspiracy, not coincidence, that Bob Bullock and Gonzalo Barrientos were arrested on their respective birthdays. She went on to promote Whitley Streiber’s newest book. (Streiber is the best-selling author who gained fame writing about his abduction by aliens.)

2001 In Fact News, Inc. All rights reserved.

City Hall granted waiver . . . The ZAP Commission approved a site plan waiver for the new City Hall’s parking garage. grilled a city employee for a while about the need for the waiver, but decided not to fight over the relatively inconsequential issue. The Land Development Code requires trucks using the designated loading or unloading zone to be able to complete their maneuvers without blocking the public right-of-way, but the designers of the parking garage want to allow trucks to use part of Lavaca Street for turning during off-peak hours because of limited space. The city’s case manager for the project maintains it will cause few traffic delays on Lavaca . . . City Council to hear Villas on Guadalupe case today . . . Last month the City Council gave the developer of the controversial Villas on Guadalupe project a postponement, so the case seems likely to go forward today—unless neighbors decide to ask for a similar delay. According to backup material on the zoning case, protesting neighbors have a valid petition against the requested MF-6 zoning. Since the Brackenridge Hospital hearing has been postponed—it was previously scheduled for 6pm—the meeting could be over after the 5:30 music and proclamations. On the other hand, zoning cases have a funny way of dragging on. If last month’s turnout was any indication, there could be 50 or more interested citizens attending the Villas hearing . . . Cedar happy, others miserable . . . Have pity on those afflicted by cedar fever. Send visions of chicken soup.

© 2002 In Fact News, Inc. All rights reserved.

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