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Hospital board makes tough decision

Friday, January 21, 2005 by

The Travis County Hospital District has finally begun to fulfill a key part of its mission—spending money on programs to enhance indigent health care delivery—but the District’s Board of Managers remains sharply divided over just how to accomplish that goal.

The Board voted last night to approve purchasing services from two local programs – the Travis County Medical Society’s Project Access, and the Austin/Travis County Community Care Services. The Board voted to fund Project Access for 9 months at $225,000 and Community Care Services for 7 months for $145,250. Project Access will use the funds to provide primary and specialty care appointments for indigent patients, while Community Care Services will recruit additional nurses, hygienists, and dentists to serve a growing client base.

Four months into its official existence, and more than 10 months after voters approved creation of the District, its managers are still grappling with the issue of how to spend $5 million in its budget earmarked for “health care system enhancements.”

Board Member Donald Patrick said that while both projects were very worthy, they did not meet the criteria the board had previously discussed for funding additional programs. “So, we are not sticking to our original plan?” he asked. “It looks like we decided a while back how we were going to do this and now we are going to do it differently. As I understood our discussions, we were not going to buy recurring services that would tie up our ability to fund different programs in the future.”

Board members have been told that Project Access would be shut down unless it secured the additional funding, and that was also a concern for Patrick. “It appears they will go out of business if they don’t get money from us,” he said. “What about next year, and the next year, and the year after that? It just doesn’t meet my understanding of the criteria of what we want to do to enhance health care programs.”

Other board members pointed out that while there has been much discussion of what criteria to use in fund programs, nothing has been adopted as an official policy by the District.

Board Member Tom Young agreed that they needed to use caution in not getting locked into recurring funding obligations, but said the programs they were backing did fit many of the District’s goals, particularly Project Access. “The risk if we don’t fund it is substantial,” he said. “It is a valuable asset in indigent care in our community. There is no commitment to future funding in what we are proposing, and we will specify requirements we want them to meet. But this is a valuable asset that will leverage a higher return on what we spend on it.”

Manager Frank Rodriguez said the program currently has about 900 physicians volunteering to provide primary and specialty care appointments for uninsured and underinsured patients. “We need to negotiate this contract to provide us with some flexibility, so we don’t tie the hands of any future administrators. But, with our funding, Project Access is projecting that they will be able to provide 4,200 patient encounters this year. That’s more than double what they did last year. It’s part of a national program with a documented track record of cutting overcrowding in emergency rooms.”

The board voted on accepting the two projects, approving the contract with Community Care Services on a 9-0 vote, and approving Project Access on a 8-0-1 vote, with Patrick saying he abstained because he is a member of the medical society. Jim Collins, the district’s interim manager who doubles as its attorney, says it will take two to three weeks to complete negotiations on contracts for the two programs.

County panel wrestles with growth, preservation

A county-appointed panel is still in the process of determining just how it can use state law to preserve Western Travis County’s “historic Hill Country character, natural beauty and environmental quality,” as suggested in the draft vision statement for the Southwest Travis County Growth Dialog.

The dialog began with the Lower Colorado River Authority’s agreement to build a water pipeline to Dripping Springs. Over the last eight months, a 16-member panel that represents economic interests and conservation concerns, as well as neighborhood representatives and property owners have been discussing the issue.

About a dozen people addressed the panel at the first of two hearings last night. Some spoke of traffic headaches, others talked about water woes and a few talked about the “bigger picture” of just what long-term planning means.

Jesus Moulinet, a private land use planner, came to Texas from Washington State. Moulinet said Travis County had yet to deal with the density and water quality issues that faced Washington during its high-growth phase.

“You discussed your vision of a charming place with Hill Country flavor, low-density, high-density, cluster and town centers,” Moulinet said. “But you want to be very, very careful when you are defining those terms and making those clear. Everyone, including property owners and the entire community, need to understand clearly what you mean or we’re going to run into problems when we begin to implement that policy.”

Environmental Officer John Kuhl said the decisions of the Southwest Travis County Growth Dialog ultimately would affect the development regulations in the county. The panel has its vision statement and its wish list for future development. How that’s going to play out in terms of specific regulations is still yet to be decided.

“We’re figuring out what the test case is going to look like,” Kuhl said. “It could be a series of incentives to get at conservation. I don’t know. We’re just not there yet because of the nature of the process. We’re getting input before we make decisions.”

Travis County is given broader authority under Senate Bill 873, but the bill isn’t completely clear, says Kuhl. For instance, SB 873 does not give the county the ability to regulate density but it “does give an impression” that the county can take some measures to protect water quality and setbacks from creeks, Kuhl said.

And the panel is yet to be united on just how the “Hill Country” vision can be preserved. Amy Wanamaker, who works for the Trust for Public Land, supports the concept of the creation of conservation easements, possibly funded by the county.

Fellow Panelist Robert Kleeman, who practices real estate law, does not agree. Conservation easements are a short-term solution without real long-term stability. Kleeman says the answer, whatever it is, should create a stable regulatory environment.

“We’ve been through 25 years of war here between developers and environmentalists. Why don’t we learn some lessons from it? We don’t gain anything by doing that,” Kleeman said. “My point is that we don’t need to pursue extreme agendas. The only people who benefit from that are the lawyers and the lobbyists.”

©2005 In Fact News, Inc. All rights reserved Austinites protest Bush . . . Ever the blue city in the midst of a red state, about 1,500 people gathered on the Congress Avenue Bridge Thursday evening for a protest against the inauguration of President George W. Bush. Among them were City Council candidate Margot Clarke, spotted talking to potential voters, and members of the Tobacco-Free Austin Coalition who were gathering signatures for their petition to put a new "smoke-free" ordinance on the ballot this May . . . Davis incensed by race track flier . . . Travis County Commissioner Ron Davis told promoters of the proposed Austin Jockey Club in Pflugerville yesterday that he objects to “the committee’s selective quotation” of his remarks to the Texas Racing Commission. Davis released a letter to Cliff Avery, treasurer of the pro race track group Support Pflugerville, which said, “I take exception to Support Pflugerville using two sentences selectively to promote the Jockey Club in this misleading way.” He also released a letter to Jody Brockhausen of Pflugerville Pfamilies Pfirst, noting his opposition to “this misleading use of my testimony” and authorizing her to publicize his position on the matter. Avery was not available for comment last night . . . Clarke kick-off next week . . . Margot Clarke will officially launch her campaign Tuesday evening at Jovita’s, 1619 South First. Her invitation says she wants to continue the legacy of Council Members Jackie Goodman and Daryl Slusher by preserving the environment, neighborhoods and the local business community. Clarke is vying for Goodman’s seat along with Mandy Dealey, Jennifer Kim and Gregg Knaupe . . . CAMPO meeting Monday . . . As usual, the CAMPO policy-makers will meet at 6pm at the Joe C. Thompson Conference Center, but on Monday, they will change rooms, moving downstairs to the Auditorium . . . Four finalists for Hospital District . . . The Travis County Hospital District is in the home stretch of hiring its first permanent executive director. Personnel Committee Chair Carl Richie says that after a marathon session of telephone interviews of the top 9 candidates last week, they have narrowed the list down to four finalists: Norman Andrews, senior vice president of operations for the Antelope Valley Healthcare District in Lancaster, Calif.; Robert Prehn of Mandeville, La., a consultant with Cawley-Johnson Group of Atlanta; David Small of Meriden, Conn., a health care consultant with D.R. Small & Associates; and, Patricia Young of Austin, CEO of Community Care Services, which contracts with the Austin/Travis County Health Department. The board plans face-to-face interviews with the finalists on January 29, with a decision to follow shortly thereafter for the $175,000 a year job. . . . Gardeners’ alert . . . The city’s Grow Green program is advertising soil tests at reduced rates to help gardeners learn about what types of nutrients their lawns and gardens might need this spring. Texas A&M is offering tests at six nurseries around Austin beginning now through Valentine’s Day. Results will be available in March. For a list of locations, click here: http://www.growgreen.org . . . Dancing our cares away . . . Allison Orr’s newest choreographic project Transit – a dance for two women in their 30s and two women over 65 – will debut at the McCullough Theater on the University of Texas campus on Jan. 28 and Jan. 29. Orr is known for her unusual choreography, which features everything from Austin firefighters to Venice gondoliers. In Transit, the performers will explore the theme of aging… on roller skates. Transit will be part of an evening of contemporary dance work. Tickets are $16 for general admission and $10 for students and seniors. Orr also happens to be the cousin of In Fact Daily reporter Kimberly Reeves. For more ticket information, call 477-6060.

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