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County still hopes for health care help

Monday, June 27, 2005 by

Despite getting no help from the Texas Legislature this year, Travis County Commissioners are still looking for ways to get neighboring counties to pay their share of indigent health care expenses incurred by the Travis County Hospital District. Mainly through high-dollar trauma care, patients from outlying counties annually rack up about 20 percent of the district’s caseload, with only a small percentage of that ever being reimbursed.

District Administrator Trish Young, along with Chairman Clarke Heidrick and Budget Chairman Thomas Young, presented a base budget for the hospital district to county commissioners at a work session on Thursday afternoon. Revenue this year, which will include tobacco settlement dollars and assorted investment returns along with property tax revenue, will total $67.6 million. That’s $3.1 million over last year’s budget, based on an effective tax rate that’s just slightly below last year’s rate of 7.8 cents.

Commissioner Gerald Daugherty reminded board members that two strong themes during the hospital district election campaign were the contributions of outlying counties and the inclusion of health care services .

Daugherty described the out-of-county contributions as the “why buy the cow when the milk is free” argument. State law only obligates outlying counties to pay for the poorest of poor residents, even though the residents of outlying counties now make up about 20 percent of the hospital district’s caseload. That leaves Travis County footing the bill on patients that are poor, but not poor enough, to be eligible for reimbursements.

A “fair share” bill filed by Sen. Royce West (D-Dallas) went nowhere during the session, even failing to get a hearing in committee. That appeared to reflect the Legislature’s lack of receptiveness to the idea. In the 55 years of the existence of county hospital districts, such legislation has rarely appeared to be popular in the Legislature.

“I don’t think we have enough lobby dollars to get this passed, ever,” Daugherty admitted to Young. “I don’t think we’re going to go to Hays County and the other surrounding counties and get them to participate.”

Daugherty said he was more than willing to provide some friendly pressure on outlying counties to up the ante on their contribution to the hospital district’s budget. The county judges of Williamson, Hays and Caldwell counties are no strangers to Travis County officials, Daugherty said. Most sit on boards with Travis County officials.

Chairman Clarke Heidrick said the strategy in the hospital district’s initial year of operation was to see how far legislation would go. Long term, the district’s board of managers envisioned a strategy that was both a carrot and stick approach, with the legislative strategy being more of the stick. The carrot would be the benefits that could be created if a regional collaboration was formed, Heidrick said.

“This is not a war among the counties,” Heidrick said. “It needs to be a collaborative process.”

At a retreat last month, the hospital district’s board of managers set out a vision and mission for the district, along with a number of goals. Among those goals was the intention to strengthen the region’s mental health services. Daugherty raised questions about that goal, saying that the scope of just what the hospital district intended to provide in terms of mental health services was raisedduring the election.

Heidrick said the hospital district’s goal was not to take on the county’s mental health services. Instead, the hospital district saw itself as a catalyst or convener of mental health service providers, in an attempt to define gaps and needs in the community. Providers will be brought together to talk about the needs and services in the community.

Commissioner Karen Sonleitner pointed out the county, like it or not, was wed to providing mental health services to a large population in Travis County.

“It may or may not be a good thing, but right now our jails are the largest provider off mental health services in the county, whether that becomes embedded in the city or the county’s services,” Sonleitner said. “It’s not just a criminal justice issue.”

Young, the one-time administrator at Brackenridge Hospital, said separating services for mental health and physical health was difficult. The two had plenty of overlap and that it was important to make sure that the district gets the most efficiency in the delivery of both, rather than viewing each as a separate service.

In other hospital district updates, Young said the district had spent $2.3 million of the $5 million it set aside for “enrichment” in the district’s first-year budget. The district also is likely, with the help of the county, to meet its proposed $15 million in reserves next year.

Mueller neighbors optimistic about UTMB

Neighbors of the old Robert Mueller Airport are optimistic about the possibility of a new campus of the University of Texas Medical Branch (UTMB) on the site of the former airport. RMMA plan commission Chair Jim Walker told Council Members last week that neighborhood groups had some concerns about the possible traffic impact of a 30-acre medical campus, but that early studies indicate the facility would not have a severe impact on traffic flow on the north side of the site.

"The idea of a UTMB expanded medical presence at Mueller, which in the Master Development Agreement, is contemplated on the site. It's not a done deal yet, but the negotiations are very positive and we are impressed with the way this is going about," said Walker.

Recent discussions with the Mueller Neighborhood Coalition and UTMB officials, Walker said, had focused on the possible construction schedule for the proposed campus and how the projected 1,300 employees would affect traffic in the area. "It's the No. 1 unifying concern of all the neighborhoods," Walker said of the traffic issue. "We looked at the Traffic Impact Analysis. The effect of the UT facility is within the margin of error, under three percent. We feel good about that."

Also reassuring to the neighborhoods, Walker said, was a promise by UT that a new medical facility would not grow to take over an inordinate amount of the Mueller site. "UT is working to memorialize a commitment to not expand beyond 25 acres," he said. "On the north side of 51st, which is the Windsor Park Neighborhood Association, they are entering into neighborhood planning this fall, so we feel good with the cooperation of UT that they can work out the 51st Street corridor to everybody's satisfaction."

UT and UTMB officials are interested in the location because of its proximity to the new Children's Hospital, which is scheduled to open in 2007. Construction of a new UTMB facility could take up to 12 years if it is eventually approved by the UT Board of Regents, and require approximately $100 million in private funding.

As other work continues at the old Mueller site, the City of Austin's Water and Wastewater Utility is working on plans for a reclaimed water tower just north of the project on 51st Street near the location of Austin Studios. Officials from the utility have already made presentations to the surrounding residents, according to neighborhood representative Rick Krivoniak. "The pictures they've shown us…it's not a pretty water tower," Krivoniak said. "We're looking for some help in getting the project to be a part of the Art in Public Places Program. One way or another, I'd really like to see the city get a designer, an artist, an architect…someone involved early in the process so that we could probably save some money in getting a more attractive tower for what is going to be a landmark not only for Mueller, for Windsor Park, but for the film studios." Krivoniak also said the neighborhood understood the utility's need for the tower and appreciated the promise to appoint a citizen's advisory committee on the project.

Council OKs quality of life proposals

Opinions vary on city's responsibility in cultural areas

Opinions are not hard to find around Austin about the City Council’s adoption of a set of quality of life guidelines for African Americans last week. On radio talk shows, at coffee houses and on the editorial pages, people are reacting to the city’s plan to fund and implement a set of 60 recommendations brought to the Council by a coalition of African American civic and cultural groups.

After an extensive presentation last Thursday, the Council unanimously embraced the findings of a city-sponsored study entitled “ The Quality of Life for African Americans,” and instructed city staff to create a first-year budget and develop an implementation plan for the short, medium, and long-term recommendations.

Led by NAACP Director Nelson Linde r, the civic leaders presented a 16-page report containing the 60 recommendations aimed at improving the quality of life for Austin’s black community. The recommendations were laid out in several categories, including art, culture and entertainment; business and economic development; employment and education; health care; neighborhood issues; and police and safety.

Police and safety issues were at the top of the group’s agenda in the wake of the Daniel Rocha shooting by a police officer. Linder urged the Council to adopt a new policy for the Austin Police Department of non-escalation and use of disarming techniques rather than deadly force against unarmed black and brown youngsters.

“If we don’t address these incidents, we can’t increase our quality of life,” Linder said.

The recommendations in the position paper were from input from a variety of forums held in the community since the original report was released on May 26. However, much of the final report was drawn from a June 11 Town Hall meeting at Huston Tillotson University, sponsored by groups such as the Austin Area Urban League, Capital City African American Chamber of Commerce, National Association for the Advancement of Colored People, and others.

According to the position paper, three main goals emerged at the meeting: the theme of unity, which they titled “ One Team, One Dream,” developing effective policies and programs, and; ensuring accountability to achieve maximum results.

Some of the major recommendations included:

• Police and safety: Develop and implement official APD policy of disablement, not deadly force; cultural sensitivity training for officers; and implement screening to identify problem officers.

• Arts, culture and entertainment: Market Austin’s signature African American events; and develop an African American cultural fund and heritage district.

• Business and economic development: Enforce existing M/WBE ordinance and monitor compliance; and ensure input from African American businesses and groups when considering economic development plans.

• Health Care: Seek federal funding to build clinic in African American community; create medical team to improve access to primary and preventative care; and recruit more African American health care professionals to the city.

• Neighborhoods: Mitigate the negative effects of gentrification; bring the infrastructure of East Austin up to par with the rest of the city; and create incentives for building affordable housing.

• Employment: Review city hiring practices to ensure fair treatment; and encourage businesses to offer ex-offenders life and job skills training, as well as jobs.

Community reaction depends, somewhat predictably, on whom you ask. Younger minorities feel that there are still vestiges of racism in Austin that need to be addressed, while older minorities welcome the steps but point out the progress that has been made since the 1950’s and ‘60s.

For example, Ben, who identified himself as a 27-year-old African American, told a local talk show, “I still see areas where the city can and should do more to make Austin’s great quality of life more available to minorities. I-35 is still a major cultural dividing line between whites and people of color in Austin. That needs to change.”

But many, both whites and some minorities who phoned the talk show questioned the need for the city to spend tax dollars to enhance the quality of life of one minority group to the exclusion of others.

“Is the city really responsible for spending money to develop, market and promote the culture, entertainment and economic interests of African Americans?” said Karen, who identified herself as a 37-year-old South Austinite on the same talk show. “Certainly city government has a responsibility to all of its citizens in these areas, but many of the issues they are asking the city to solve are issues that should be left to the free market, like the creation of entertainment venues, job creation and housing issues. There are some problems that government isn’t really designed to solve.”

In approving the recommendations, the Council instructed City Manager Toby Futrell and Assistant City Manager Michael McDonald to meet with staff to study the recommendations and to develop mechanisms to measure the city's success in implementing them. The first year budget must be in place by October 6.

©2005 In Fact News, Inc. All rights reserved.

A few days off . . . Jerry Rusthoven, who served as aide to Mayor Pro Tem Jackie Goodman and has been helping new Council Member Jennifer Kim through the transition, is off to Disney World with the family. His boss is also taking a few days off . . . Today’s meetings. . . The Cap Metro board of directors will meet at its East Austin offices at 4pm. The agenda includes approval of various contracts, including one for a sole source engineering design services contract to the Urban Design Group, for the Leander Park & Ride facility in an amount not to exceed $114,000. Council Member Raul Alvarez will take his seat on the board today . . . The city’s Design Commission will meet at 5:45pm in Room 1101, the Boards and Commissions Room of City Hall . . . The Historic Landmark Commission will meet at 7pm in Room 325 of One Texas Center . . . The Library Commission will meet at 7pm at the Ruiz Library, 1600 Grove. Items of interest include a discussion on the city budget process and how to best provide input to the Council and an update on the central library . . . Appointments. . . The Council appointed Albert Black to the Child Care Council and reappointed Decker Ayers and Howard Lennett, as an alternate, by consensus to the Building and Standards Commission. Also reappointed by consensus were John Limon to the S altillo District Redevelopment Project Community Advisory Group and Lark Anthony to the Solid Waste Advisory Commission . Council Member Betty Dunkerley reappointed Joan Hyde to the Design Commission. Other reappointments included Jose de la Fuente to the Ethics Review Commission(McCracken), William Harris, Jr. to the Plumbing, Mechanical and Solar Board (consensus) and Clint Small to the Parks and Recreation Board (Wynn) . . . Our annual summer vacation coming. . . The dog days are upon us. In Fact Daily will publish for the rest of this week but will take off next week, which includes the Fourth of July holiday. . . . Cisco’s NOW Van in town. . . . Cisco's Network on Wheels Van "the NOW Van" rolls into Downtown Austin Tuesday for one day to showcase the latest in IP telephone and unified communications, wireless/mobility solutions and network and building security. The van will be open all day Tuesday at the Bank of America Center at 6th and Congress. In addition to the demos, a press conference will be held at 1pm Tuesday in the lobby of 515 Congress where T. Stacy & Associates and Cisco Systems will make an announcement relating to Downtown Austin. Mayor Will Wynn, DAA Executive Director Charlie Betts and Gary Farmer, chair of Opportunity Austin, will all be on hand for the announcement.

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