[CALL TO ORDER] [00:00:17] >> THIS MORNING'S INVOCATION BY JAVIER FROM CENTRAL HOSPICE TEXAS. IF YOU WILL PLEASE ALL RISE. >> LET US PRAY. FATHER GOD, WE GATHER ONCE AGAIN ASKING FOR YOUR PRESENCE AND DIRECTION OVER EVERY ITEM ON TODAY'S AGENDA, OVER THE DISCUSSIONS, THE DECISIONS THAT WILL IMPACT IN EVERYONE OUR COUNTY. LORD, GIVE US GUIDE ABS. HOLY SPIRIT, WE ALSO ASK FOR PEACE, FORTITUDE -- GUIDANCE -- AND PROTECTION EVERY PUBLIC SERVANT HERE AND IN OUR COMMUNITY AS THEY SERVE OUR COUNTY WHILE ALSO CARING FOR THEIR LOVED ONES AND FOR THEMSELVES. WE ASK ALL OF THESE THINGS IN JESUS' NAME, AMEN. >> AMEN. >> I PLEDGE ALLEGIANCE TO THE FLAG OF THE UNITED STATES OF AMERICA AND TO THE REPUBLIC FOR WHICH IT STANDS, ONE NATION UNDER GOD INDIVISIBLE, WITH LIBERTY AND JUSTICE FOR ALL. HONOR THE TEXAS FLAG. I PLEDGE WILL LIEGE ANSWER TO THEE, TEXAS, ONE STATE UNDER GOD ONE INDIVISIBLE. >> DOCTOR PLEASE CALL THE ROLL. >> COMMISSIONER INGALSBE. >> HERE. >> COMMISSIONER JONES. >> HERE. >> COMMISSIONER SHELL HERE. >> COMMISSIONER SMITH. >> HERE. >> JUDGE BECERRA. >> HERE. THOSE IN THE AUDIENCE WHO HAVE [PUBLIC COMMENTS] SUBMITTED A PUBLIC PARTICIPATION WITNESS FORM WILL NOW HAVE THREE MINUTES TO SPEAK ON NONAGENDA RELATESED TOPICS. UNFORTUNATELY, NO ACTION MAY BE TAKEN BY THE COURT DURING PUBLIC COMMENTS AS WE ARE EXPECTED NOT TO RESPOND. ANY QUESTIONS WILL BE TAKEN AS RHETORICAL. ALL COMMENTS AND OPINIONS ARE OF THE SPEAKER AND NOT MEANT TO BE NECESSARILY CONSTRUED AS TRUTH PLEASE KEEP YOUR COMMENTS AND LANGUAGE CIVIL OR YOU WILL FORFEIT THE REMAINDER OF YOUR TIME. IN THE SPIRIT OF RESPECT PLEASE SILENCE YOUR CELL PHONES. AND I'M LOOKING FOR THE LIST OF SPEAKERS AND THERE IT IS. THANK YOU, MA'AM. FIRST UP TO SPEAK IS MR. DAN LYON. >> THANK YOU, JUDGE BECERRA AND COMMISSIONERS, GOOD MORNING. I DON'T KNOW MAYBE BY NOW Y'ALL HAVE RECEIVED THE NEWS IMPACT NEWSPAPER ON PAGE 26 IN BOLD LETTERS QUOTE COUNTY PARK WOULD NOT HAVE ANY TAX IMPACT UNQUOTE. FURTHER SAYS THE ADVISORY BOND IS SPLIT IN TIERS WITH TIER ONE BEING HIGHLY RECOMMENDED AND TIER TWO BEING FUNDED AT SOME LEVEL. COUNTY OFFICIALS DO NOT EXPECT THE BOND TO IMPACT PROPERLY WITH TAXES UNQUOTE ARE. YOU JOKING? ALL RIGHT. WHERE WOULD THEY GET THAT IMPRESSION FROM? WAIT A MINUTE I KNOW MARK KENNEDY HAYS COUNTY GENERAL COUNCIL SAID THE BOND WOULD NOT IMPACT THE COUNTY'S PROPERTY TAX RATE AND REMAINING BALANCE NEEDED TO COMPLETE PLANNED PROJECT ESTIMATED AT $915 MILLION WOULD BE PROVIDE BY THE COUNTY BUDGET THROUGH THE ORGANIZATIONS PARTICIPATING MUNICIPALITIES AND OTHER SOURCES. HAVE YOU EVER TRIED TO GET A STRAIGHT FRANCE A LAWYER? WOULD YOU HAVE A BETTER CHANCE OF CATCHING A SLIPPERY HE'LL WITH YOUR BEAR HANDS WHILE IT IS TRUE THE TAX RATE WILL NOT BE AFFECTED BECAUSE IT'S ALREADY VOTED ON THE EFFECTIVE TAX RATE WILL BE AFFECTED AND THIS IS WHAT WE ALREADY PAY. IF YOU HAVE TO DECEIVE PEOPLE IN ORDER TO PASS A BOND THE BOND PROPOSAL IS NOT A GOOD ONE IN THE FIRST PLACE. WHEN WILL WE BE ABLE TO ENJOY THESE PARKS? WELL LET'S TAKE A LOOK. I THINK WOULD BE OPEN WITH SOME OF THE PROJECTS IN AS LITTLE AS 1 1/2 TO TWO YEARS AND OTHERS WOULD TAKE LONGER KENNEDY SAID. QOET QUOTE COLEMAN'S CANYON IS A GOOD EXAMPLE. IT WON'T TAKE LONG TO ESTABLISH SOME PRIMITIVE TRAILS ON THAT OPEN SPACE SO WE COULD PROBABLY OPEN THE ASPECTS OF IT RIGHT AWAY. QUOTE AGAIN OTHER PROJECTS COULD [00:05:06] TAKE CONSIDERABLY LONGER AND KENNEDY NOTED SOME PROJECTS INCLUDED IN THE COUNTY'S 2007 PARKS BOND TOOK UP TO TEN YEARS TO COMPLETE UNQUOTE. THE PARKS BOND IS TOO EXPENSIVE NOT WELL THOUGHT OUT AND THE PUBLIC IS NOT WELL INFORMED BECAUSE IT WAS RUSHED THROUGH AT THE LAST MINUTE. WE HAVE ALSO NOT BEEN INFORMED AS TO HOW MUCH IT WILL COST. I URGE EVERYONE TO VOTE NO ON THE PARK PROPOSAL UNTIL WE CAN MAKE AN INFORMED CHOICE. IF YOU FORWARD TO THE BOND THE PROPOSAL IS LIKE DRACULA. IT WILL RISE UP AGAIN AT THE NEXT ELECTION AND NO ONE CAN AFFORD THE SILVER STAKE WITH WHICH TO KILL IT BECAUSE WE HAVE TO PAY PROPERTY TAXES. THANK YOU VERY MUCH. >> THANK YOU MR. DAN LYON AND HE'S THE ONLY INDIVIDUAL SIGNED UP TO SPEAK DURING THE PUBLIC COMMENTS PORTION OF OUR COURT. [1. Update from the County Judge and staff regarding the Local Disaster Declaration and COVID-19. Possible discussion and action may follow. BECERRA] SO NEXT WE'LL GO TO AGENDA ITEM ONE. PLEASE START CARDENAS. >> NUMBER ONE UPDATE FROM THE COUNTY JUDGE AND STAFF REGARDING THE LOCAL DISASTER DECLARATION AND COVID-19. POSSIBLE DISCUSSION AND ACTION MAY FOLLOW. >> WE ARE SAD TO REPORT WE HAVE TWO FATALITYIES IN YESTERDAY'S NUMBERS. IT'S ALWAYS A HARD THING TO SEE TO WATCH AND TO REPORT. I THINK WE HAVE MR. SHRILL LA LOBOS TO -- VILLALOBOS COMING UP TO THE PODIUM TO GIVE US FURTHER INFORMATION. >> WELL THERE'S A LOT OF DETAILS WITH REGARDS TO -- THIS IS ALEX VILLALOBOS CHIEF OF STAFF. THERE'S A LOT OF DIFFERENT DATA GOING OUT FROM THE DIFFERENT LOCATIONS FOR TESTING AT THIS POINT WE'RE TAKING A TOTAL OF 11,761 TESTS IN TOTAL FOR HAYS COUNTY. JUST RECENTLY PROVIDED TO ME. I KNOW SOME OF THE AREAS WE HAVE SPECIFIED FOR TESTING THEY ARE TESTING IN THOSE AREAS AND NEWER ONES ARE COMING UP. WE'RE TWEAK THE LOCATIONS AND GETTING NEW AGREEMENTS. I KNOW THE TRIANGLE HAS GOT OFF THEY WERE DOING PAST WEEKENDS -- TESTING AND FAIRLY CONSISTENT WITH PEOPLE GETTING TESTED. THE STUDENT AT TEXAS STATE THEY ARE GETTING QUITE A BIT OF DATA COMING IN I BELIEVE THEY ARE UTILIZING THAT WHEN THEY ARE MAKING POLICY DECISION THERE'S. OUTSIDE OF THAT IT'S TEST, TEST, TEST. WE DON'T HAVE ANY OTHER SIGNIFICANT ITEMS TO REPORT OTHER THAN THOSE MOBILE BANDS ARE TRANSITIONING THROUGHOUT THE COUNTY AND MOVING WHERE NEEDED. THERE'S ALSO SOME PLACES WHERE WE'RE GOING TO HAVE TO READJUST THE LOCATION AS WELL. >> YOU HAVE BEEN SAYING IT THE WHOLE TIME BUT WILL YOU SAY IT AGAIN THE NAME OF THE PRIVATE ORGANIZATION? >> CURATIVE. IT HAS AN AGREEMENT WITH AS DEPARTMENT TO DEPLOY TESTS PURCHASED BY THE GOVERNMENT. >> OK. COMMISSIONERS ANY QUESTIONS FOR MR. VILLALOBOS? >> I JUST HAVE ONE, ALEX. THE LOCATION OF THE SAN MARCOS AREA IS THAT UP AND RUNNING? >> WISH STILL ADDRESSING THE PARK BUT WE DON'T HAVE IT THERE AND I WOULD IMAGINE WE'LL HAVE TO ADJUST THE LOCATION FOR THAT ONE AGAIN JUST BECAUSE OF THE WAY THE AGREEMENT HAS BEEN SET UP IN THAT LOCATION WAS THERE ANYTHING SPECIFIC? >> THEY CAN'T DO TESTING WITHIN THE ORGANIZATION THE LOCATION IN ITSELF I'M NOT SURE WHY WE HAVEN'T SOLIDIFIED A DATE FOR TESTING THERE. >> ANYBODY HAVE AN UPDATE? >> COMMISSIONER, THE MID-PARK LOCATION WE FELT WAS PROBABLY NOT PRUDENT TO HAVE STAFF COME OUT THERE AND WE HAD FREE TESTING GOING ON WE ARE KEEPING THAT LOCATION OUT LOOKING FOR OFFICE WORK AS WELL AS SOME STORES IN CLIMATE CONTROL ADDITIONALLY WE'LL HAVE THAT TOO. IF THINGS CHANGE WE COULD AUTOMATICALLY OPEN THAT UP TO ADDITIONAL TESTING AND WE HAVE THE TESTS READY TO GO AS WELL. >> ARE YOU SAYING WE'RE KEEPING THE MID-PARK LOCATION FOR OTHER PURPOSES? >> JUST THE SAME PURPOSES OF [00:10:03] TESTING VACCINE QUESTION DIDN'T FEEL LIKE IT WAS A GOOD IDEA FOR TESTING IN THE COUNTY AND WE HAD TESTING AT THIS POINT. >> SPECIFIC INSTRUCTIONS? >> NO, NOT REALLY. I JUST WANTED TO ENSURE THAT WE WERE DOING TESTING IN THE SAN MARCOS AREA. >> MISS CRUMLEY YOU WANT TO ADD SOMETHING. >> OUR TESTING OF HEALTH DEPARTMENT AT LIVE OAK WE HAVE HAD NO TESTING IN THE LAST WEEK. MAYBE WE HAVE TESTED ONE PERSON. THEY ARE JUST NOT COMING WITH THE LOCATION OF THE FREE TESTING AVAILABLE. >> SO COMMISSIONER JUST TO CLARIFY, TESTING IS AVAILABLE AND IT IS THROUGH PRIVATE OH, FOR EXAMPLE LIKE JONES BROUGHT UP PREMIER ER WHICH WEFB DOING A LOT OF WORK THROUGH THAT PRIVATE ORGANIZATION. COUNTYWIDE WE HAVE THE GOVERNOR'S OFFICE HELPING US THROUGH THE TEXAS DIVISION EMERGENCY MANAGEMENT. SO AT THING IS OUT THERE AND IT IS AVAILABLE. IT HAS A DIFFERENT LEVEL OF ENGAGEMENT. IS THAT A GOOD SUMMARY. >> YES. IT'S STILL AVAILABLE. THE HEALTH DEPARTMENT THROUGH LIVE OAK THEY ARE JUST NOT TAKING ADVANTAGE OF THAT WITH THE CURATIVE TESTING THROUGHOUT THE COUNTY. >> I WOULD LIKE TO ADD A PERSONAL NOTE. I FEEL THAT IMPART BECAUSE A CURATIVE TESTING NOT BECAUSE IT'S A PRIVATE COMPANY, BUT BECAUSE THE CURATIVE TESTING DOESN'T GET INCORPORATED INTO OUR DAILY NUMBERS AND I WANT TO SAY POSITIVE ABOUT IT BUT I THINK AMAY HAVE SOMETHING TO DO POTENTIALLY WITH HOW AND WHY PEOPLE MAY OR MAY NOT BE GOING TO GET TESTED. THERE'S A POSSIBILITY OF THAT. >> WE ABOUT THE OVERALL NUMBERS. IT'S THE ONES CONSIDERED AND EFFECTIVE THERE'S A FOLLOWUP WITH REGARDS TO TESTING. OVERALL NUMBERS THEY ARE TRACKING THE OVERALL NUMBERS THE ONES THAT ARE POSITIVE AS A FOLLOWUP. IF THEY ARE NEGATIVE SHOWING SYMPTOMS WE SEND THEM OVER IT TO GET TESTED AND THOSE GO INTO THE ACTUAL NUMBERS FOR THE INFECTED RATE. >> THOSE POSITIVES IT IS THE TYPE OF PCR TESTS. THOSE GO INTO IMMEDIATE PODSTIVE RESULTS. >> THAT'S A CHANGE BECAUSE THEY WEREN'T ORIGINAL. THE ONES THAT WERE PROVIDE, WERE NOT ORIGINALLY PROVIDE. LISTEN. >> WE HAVE BEEN GIVEN DIFFERENT INSTRUCTIONS. THOSE ARE NOW POSITIVE TESTS. >> I'M ALL TESTING. I'VE ALWAYS SAID THERE'S NO ONE SILVER BULLET TEST. NO TEST HAS 100% ACCURACY AND WE HAVE ONE TYPE OF TEST THAT WILL TELL IF YOU YOU HAVE COVID AND ONE TYPE OF TEST THAT WILL TELL YOU IF YOU CURRENTLY HAVE IT. I THINK THEY ARE ALL USEFUL AND ALL NECESSARY AND I DON'T WANT MY COMMENTS TO BE MISCONSTRUED SAYING IT'S A NEGATIVE IN ANY KIND OF LIGHT OR SETTING. TESTING, TESTING, TESTING IS WHAT I BELIEVE. I BELIEVE IN THE NATIONAL INSTITUTE OF HEALTH I STILL BELIEVE IN THE CENTRAL CDC CENTER FOR DISEASE CONTROL AND I DISPUTE THE IDEA THAT DR. FAUCI IS WHAT WAS THE WORD HE USED? THAT HE'S A LUNATIC OR SOMETHING I CONTINUE TO DO THOSE THINGS, HAYS COUNTY. I WANTED TO KNOW THAT'S HOW I THE. >> TO CONTINUE WITH THE NUMBERS PROVIDED BY THE UNIVERSITY TODAY AND YESTERDAY. THERE'S BEEN 1217 TECHTS PERFORMED IN STOOD ENTER HEALTH CENTER 11 POSITIVE 98 NEGATIVE 106106 POSITIVE RATE. CURRENT ACTIVE CASES AND. >> OVERALL OUR NUMBERS ARE DOWN THROUGHOUT THE COUNTY AS FAR AS TESTING WAS CONCERNED THAT WE SAW MAYBE IN THE PAST MONTH OR SO. >> IF YOU COMPARE TO WHAT WOULD BE IN THE PAST COMMISSIONER YES THEY ARE DOWN SIGNIFICANTLY COMPARED TO. WE HAD 700 AND SOME ODD FOLKS COME OUT FOR THE SCHOOL EVENTS. CONVERSELY OVER 11,000 HAVE BEEN [00:15:03] TESTED AND PRETTY CLOSE TO THE PERCENTAGES THAT MR. VILLALOBOS WAS TALK ABOUT WE HAD POSITIVES OUT OF THAT SAN MARCOS NUMBER. SO I THINK WE'RE DOING THE RIGHT THING OUT THERE. WE'RE HAVING BETTER NUMBERS VERSUS THAN WHAT OUR PARTNERS ARE AND NEIGHBORS NEXT DOOR. >> I THINK IT MAY BE HARD TO TELL BUT WITH THE WINTER COLD MONTHS AHEAD I WONDER IF WE'RE ANTICIPATING AN INCREASE IN THOSE NUMBERS. >> OF COURSE MA'AM. THE OTHER CONDITIONS THAT ARE FLULIKE SYMPTOMS THIS IS ANOTHER REASON TO PUTS THAT PLUG INTO TO GET YOUR FLU SHOT. >> THAT'S RIGHT. GOOD REMINDER. THE WORD I WAS LOOKING FOR HAD A DISASTER. DR. FAUCI IS A DISASTER THE BELIEVE HE'S A DISASTER. I CONTINUE TO FOLLOW HIS GUIDANCE AND DIRECTIONS AND I BELIEVE HIS COUNTY HAS DONE A GOOD JOB AS A WHOLE THE CITIZENRY FOLLOWING THE SOCIAL DISTANCING, MASKING AND GUIDELINES AND THINGS WE HAVE PROMOTE. THAT IS WHY AS A WHOLE MR. JONES HIGHLIGHTED. I BELIEVE WE'RE ON THE RIGHT COURSE LAST WEEK WE FOLLOWED THE GOVERNOR'S CUE TO ALLOW BARS TO OPEN. ALL THE THINGS GOING ON AND CORONAVIRUS IS ACTUALLY ONE OF THE STRAINS IS THE COMMON COLD WE ARE STEPPING. >> REPORTER: THAT WINTERTIME PEAK THIS COMMUNITY IS DOING ON THIS FRONT AS WELL AS IT'S DOING IT AS KNOWING AS IT MAY BE. IT'S WORKING AND MASKS WORK AND THEY DO HELP AND I'M GLAD THAT THIS COMMUNITY IS BEING RESPONSIBLE AND JUST GRATEFUL. I WANT TO SAY THANK YOU TO HAYS COUNTY. COMMISSIONER ANY OTHER QUE QUESTIONS? COMMISSIONERS ANY QUESTIONS? COMMISSIONERS? >> AS WE LOOK AT THOSE NUMBERS AND THEY START TO GO UP WITH THOSE NUMBERS IN OUR TESTING FACILITY CAN WE START GETTING NUMBERS WITH EACH ONE OF THOSE CURATIVE LOCATIONS? AND GET THOSE OUT? MY OTHER QUESTION IS DO WE HAVE ANY IDEA AT THIS POINT HOW QUICK AROUND THE TESTING IS? I'VE BEEN ASKED THAT I SENT PEOPLE TO THE TRIANGLE OR SAN MARCOS. >> IT'S ABOUT 24 HOURS. >> OK, PERFECT. THANK YOU. >> THANK YOU FOR YOUR UPDATE. TAMMY, MIKE. WE APPRECIATE THE WORK YOU GUYS ARE ON THE FRONT LINE ON A REGULAR BASEY. I'VE BEEN ASKED TO PULL AGENDA ITEM NUMBER 11. IS THERE ANYONE HERE INTERESTED IN AGENDA ITEM 11 IF YOU ARE YOU MADE THE TRIP PLEASE OPEN AGENDA ITEM TWO. [2. Adopt a Proclamation declaring October 30, 2020 as Weatherization Day. INGALSBE] >> TWO ADOPT A PROCLAMATION DECLARING OCTOBER 20TH 20, 20 AS WEATHERIZATION DAY. WHEREAS THE COMBINED COMMUNITY ACTION INC. PROVIDES AN ECONOMIC BOOST FOR LOW INCOME INDIVIDUALS FOR REDUCED ARREARAGES AND WHETHER AS WEATHERIZATION IS A COST EFFECTIVE FOR TAXPAYER DOLLARS. FOR EVERY ONE DOLLAR INVESTED WEATHERIZATION RETURNS OVER $4 IN ENERGY, HEALTH AND SAFETY BENEFITS TO THE HOUSEHOLD AND SOCIETY, AND WHEREAS THED COMMUNITY ACTION INC. WEATHERIZATION ASSISTANCE PROGRAM USING FEDERAL STATE AND LOCAL PRIVATE DOLLARS BENEFITS HOUSEHOLDS AND COMMUNITIES ACROSS OUR COUNTY BY PROVIDING COST EFFECTIVE, ENERGY EFFICIENT RETROFITS TO HOMES OCCUPIED BY ELIGIBLE LOW INCOME TEXANS, AND WHEREAS HEATING COSTS ARE REDUCED BY 30% ON AVERAGE SAVING FAMILIES AT LEAST $283 PER YEAR THEREFORE, HOUSEHOLD MONEY IS MADE AVAILABLE FOR OTHER BASIC NECESSITIES SUCH AS GROCERIES, DOCTOR BILLS, PRESCRIPTIONS AND OTHER NEEDS THEREBY MAKING THEM MORE SELF-SUFFICIENT AND WHEREAS HOUSEHOLDS THAT HAVE BEEN WEATHERIZED EXPERIENCE HEALTH AND SAFETY BENEFITS, IMPROVED AIR QUALITY AND RECEIVE SMOKE DETECTORS AND CARBON NONE OXIDE DETECTORS IF -- MONOXIDE DETECTORS IF THEY ALREADY NOT PRESENT THROUGHOUT THE HOUSE WHERE THIS IS THEY PROVIDE CARBON DIOXIDE WHILE ALSO MAKING LOW INCOME COMMUNITIES MORE RESILIENT TO THE EFFECTS OF CLIMATE CHANGE AND WHEREAS WEATHERIZATION CRITICAL AMID AT THE COVID PANDEMIC BECAUSE IT [00:20:02] MAKES INDOOR ENVIRONMENTDS HEALTHIER SAFER AND MORE COMFORTABLE FOR VULNERABLE INDIVIDUALS AND WHERE THE COMBINED WEATHER ACTION ASSISTANCE PROGRAM PROVIDES AN ECONOMIC BOOST FOR COMMUNITIES BY PROVIDING IMPROVED ENERGY EFFICIENT HOUSING STOCK AND NEIGHBORHOOD CONDITIONS. WHERE AS IN YEARS THE CUMULATIVE TOTAL FEDERAL EXPENDITURE FOR HAZE COUNTY IS $27,034 AND HAS ASSISTED 30 HOMES LOCATED IN KYLE, SAN MARCOS NOW THEREFORE, BE IT RESOLVED THE HAYS COUNTY COMMISSIONERS COURT DOES HERE BY PROCLAIM OCTOBER 30TH, 2020 ASIZATION DAY ADOPTSED THIS THE 20TH DAY OF OCTOBER 2020. >> SO MOVED. >> SECOND. >> WE HAVE A MOTION AND A SECOND ANY COMMENTS? >> JUDGE I WANT TO THANK COMBINED COMMUNITY ACTION TO PROVIDING THIS SERVICE TO SO MANY FAMILIES IN HAYS COUNTY. IT'S GREAT. >> THANK YOU. HEARING THE PROCLAMATION AS WRIT SEN A GREAT REMINDER OF ALL THE BENEFITS OF BEING EFFICIENT. SOME OF THAT IS VERY WELL SAID. DR. CARDENAS PLEASE CALL THE ROLL. >> COMMISSIONER INGALSBE. >> YES. >> COMMISSIONER JONES. >> HERE. >> COMMISSIONER -- I MEAN YES. >> COMMISSIONER SHELL. COMMISSIONER SMITH. >> YES. >> JUDGE BECERRA. [3. Presentation by Susan Dawson with Austin Area Research Organization (AARO) regarding Hays County Breast Cancer Initiative. INGALSBE/SMITH] >> YES WILL YOU PLEASE OPEN AGENDA ITEM NUMBER THREE. >> NUMBER THREE PRESENTATION BY SUSAN DAWSON WITH AUSTIN AREA RESEARCH ORGANIZATION REGARDING HAYS COUNTY BREAST CANCER INITIATIVE. >> SO MOVED. >> SECOND. >> THERE'S NO -- IT'S JUST A PRESENTS. >> WONDERFUL THESE BRAND NEW FACES TO OUR COMMUNITY, IF YOU WILL PLEASE STATE YOUR NAME FOR THE RECORD. [INAUDIBLE] >> GOOD MORNING JUDGE AND COMMISSIONERS. DANIEL -- [INAUDIBLE] >> COMMISSIONER SUSAN DAWSON JOINING REMOTELY. THANK YOU FOR HAVING US THIS MORNING. [INAUDIBLE] -- FROM TEXAS STATE. >> -- GRAHAM FROM TEXAS STATE. >> DR. SMASHT, ARE YOU READY? >> I AM READY. >> PROGRAM DIRECTOR FOR TEXAS STATE. >> DOCTOR ONE MORE NEW FACE IN THE COMMUNITY. >> I'M JUST JOKE BECAUSE EVERYONE HERE IS SO WELL ESTABLISHED AND DOES WELL IN THE COMMUNITY. >> THANK YOU. IT'S A PLEASURE TO BE HERE. THANK YOU TO THE COURT AND TO COMMISSIONERS INGALSBE AND SMITH FOR ADDING US TO TODAY'S AGENDA TO TALK ABOUT AN INITIATIVE RELATED TO BREAST CANCER SERVICES FOR UNDER AND UNDERINSURED INDIVIDUALS FOR HAYS COUNTY. AS I SAID I'M A PROFESSOR AT TEXAS STATE AND MEMBER OF THE HAYS COUNTY LIAISON FOR THE AUSTIN AREA RESEARCH ORGANIZATION WHICH IS A NONPARTISAN NONPROFIT ORGANIZATION OF 110 CIVIC MINDED BISHOP, CALDWELL AND HAYS COUNTY. THE ORGANIZATION FOCUSES ON LONG-TERM CHALLENGES AND SOLUTIONS TO ENHANCE THE ECONOMIC AND SOCIAL WELL BEING OF ALL CENTRAL TEXANS. HERE TO TALK ABOUT A REGIONAL COLLABORATIVE UNDER WAY ARE TWO EXTRAORDINARY LEADERS WITH PERSONAL EXPERIENCE WITH CANCER AND DEDICATED TO HELPING OTHERS. HE'S A FORMER SAN MARCOS MAYOR, A GRADUATE, A TIRELESS LEADER IN THE AREA AND 39-YEAR CANCER SURVIVOR JOINING US IS SUSAN. SUSAN IS A REGIONAL NONPROFIT COLLABORATIVE THAT HAS BEEN NATIONALLY RECOGNIZED FOR ITS GROUNDBREAKING WORK IN SYSTEMATIC EDUCATION AFTER HER OWN CANCER DIAGNOSIS IN 2016 SUSAN HAS BEEN WORKING TO INCLUDE CANCER RESEARCH CLINICAL CARE AND INFRASTRUCTURE IN CENTRAL TEXAS. SHE'S THE FOUNDER AND CO-CHAIR OF CENTRAL TEXAS ADDRESSING CANCER TOGETHER A BROAD COALITION CREATED TO REDESIGN THE ECOSYSTEM FOR INDIGENT CARE AND CENTRAL TEXAS. I WILL TURN THE PROGRAM OVER TO SUSAN. [00:25:04] >> THANK YOU SO MUCH DOCTORS. I'D LIKE TO START WITH THE AGENDA WE'LL BE TALKING ABOUT CONTEXT AND HOW WE GOT HERE AND SOME STATISTICS WHERE WE COME FROM OVER THE LAST COUPLE OF YEARS. DANIEL WILL BE SHARING PROGRESS THAT WE ADD IN HOW WE TALK ABOUT HAZE COUNT ANY PARTICULAR BROADER LEADERSHIP WILL BE INVOLVED AND WE'LL HAVE TIME FOR Q & A THE AT THE END. NO PROBLEM. I'LL BE WILLING TO DO THIS. THIS IS OK, VALERIE? I'LL ALMOST WHISPER. NO PROBLEM. SO LET ME START WITH SOME BASIC STATISTICS WHICH ARE TRULY ALARMING. FIRST IS THAT WE FIND THAT CANCER IS THE NUMBER ONE KILLER IN CENTRAL TEXAS AND THIS IS A UNIQUE STATISTIC CENTRAL TEXAS DURING THE STATE AND MOST OF THE COUNTRY HEART DISEASE IS THE NUMBER ONE KILLER NOR SOME CASES HEART DISEASE AND CANCER ARE NECK AND NECK. CENTRAL TEXAS IS THE ONLY STATISTICAL AREA IN THE STATE WHEREBY FAR CANCER IS THE NUMBER ONE KILLER. AS YOU OF COURSE KNOW BECAUSE SO MANY OF US ARE IMPACTED BY FAMILY MEMBERS AND FRIENDS AND NEIGHBORS WITH CANCER IT MAKES A HUGE DISTANCE WHEN YOU ARE DETECTED TO HAVE CANCER. SO WHEN LOOKING AT BREAST CANCER DIAGNOSES THOSE WOMEN AND MEN DETECTED AT STAGE ONE CANCER HAVE A 99% FIVE-YEAR LIFE EXPECTANCY RATE WHILE THOSE DIAGNOSED AT STAGE FOUR HAS 27% FIVE-YEAR LIFE EXPECTANCY. WHEN LOOKING AT LIFE EXPECTANCY THE DIFFERENCE BETWEEN TEXAS AND CENTRAL TEXAS IS HUGE. WE'RE VERY LUCKY TO HAVE A STRONG ECOSYSTEM SO THOSE CANCER PATIENTS IN CENTRAL TEXAS WHO ARE INSURED HAVE A LONGER LIFE EXPECTANCY IN OTHER PARTS OF THE STATE WHERE THEY MAY NOT BE THE INFRASTRUCTURE TO SERVE. THOUFER DOES NOT SERVE UNINSURED PATIENTS WITH CANCER IN TEXAS HAVE JUST OVER HALF OF THE LIFE EXPECTANCY OF UNINSURED CANCER PATIAENTS CROSS THE STATE OF TEXAS AGAIN THE DIFFERENCE OF DIAGNOSES STAGE IS VERY DEPENDENT ON THE INSURANCE OF A PATIENT. IF YOU ARE UNINSURED YOU ARE SIX TO EIGHT TIMES MORE LIKELY TO BE DIAGNOSED WITH LATE STAGE BREAST CANCER. FINALLY THERE ARE DIFFERENCES THERE AS ARE IN SO MANY AREAS OF OUR LIVES SO A BLACK WOMAN IN CENTRAL TEXAS HAS TWICE THE MORTALITY RATE AS HER WHITE PEERS. SO I WANT TO DO JUST A LITTLE BIT OF BACKGROUND ON CENTRAL TEXAS ADDRESSING CANCER TOGETHER WHICH DR. SMART MENTIONED. THIS IS A COALITION OF OVER 75 MEMBERS OVER ORGANIZATIONS INCLUDING RESEARCHERS FUNDERS AND EVERY MAJOR HOSPITAL PROVIDER AND QUALIFIED HEALTH CARE CENTERS ALL COMING TOGETHER COMMUNITY LEADERS WORKING TOGETHER TO IMPROVE CANCER CARE FOR PATIENTS. CENTRAL TEXAS HAS BEEN WORKING TOGETHER ON THIS ISSUE FOR OVER TWO YEARS. DURING THAT TIME WE HAVE COLLECTED DATA SOME OF THE DATA AND STATISTICS BUT MUCH MORE ON WHAT THE NEEDS ARE AND WHAT THE STRATEGIES AND TRARGHTS TO ADDRESS. WE HAVE DEVELOPED CONSENSUS ON DESIGN PRINCIPLES FOR WHAT IT LOOKS LIKE TO TURN AROUND THE SITUATION I'VE JUST SHARED WITH YOU. WE'VE CHOSEN BREAST CANCER ATZ INITIAL TARGET. THE INTENT IS TO ADDRESS ALL CANCERS FOR ALL HIGH NEEDS POPULATIONS IN THE ENTIRE CENTRAL TEXAS REGION. HOWEVER WE'VE CHOSEN TO START WITH BREAST CANCER BECAUSE IT IS THE NUMBER ONE CANCER WITH WOMEN AND WE HAVE ASSETS TO BUILD ON AT BREAST CANCER RESOURCE CENTER BUT IMPORTANTLY ONE OF ONLY TWO CANCERS WHERE THEY ARE DEDICATED FEDERAL DOLLARS, SO THAT IF WE DO START TO DETECT MORE CANCERS WE CAN BRING FEDERAL DOLLARS TO OUR COMMUNITY TOOF THE NEEDS. [00:30:03] WE HAVE FORMED STRUCTURES WITH WORKING GROUPS. I CAN'T GO INTO ALL THE DES BUT WE'LL SEE SOME OF THE OUTCOMES TODAY THAT HAVE BEEN WORKING ON PATIENT CARE MODELS AND OTHER AREAS AUSTIN AREA RESOURCE ORGANIZATION HEALTH COMMITTEE WHICH I CHAIR IS ONE OF THOSE WORKING COMMITTEES UNDERNEATH THE SO THE STRATEGIES ARE FIRST IT FOCUS ON DIAGNOSIS SO TO TO REACH TO GET MORE WOMEN INTO SCREENINGS TO GET CANCER IDENTIFIED TO LOWER THE BREAST CANCER DIAGNOSES AND IN DOING SO REDUCING DEATHS AND PRODUCTIVITY AS OUR COMMUNITY AND ALSO TREATMENT COSTS BECAUSE WHEN A WOMAN PRESENTS AT ER WITH LATE STAGE CANCER THE COST TO TREAT IT IS DRAFLTALLY HIGHER THAN, WE CATCH IT EARLY. SO HOW DO WE DO IT BY SHIFTING UPSTREAM WHERE CANCERS ARE NOT ONLY LESS DEADLY BUT AL LOW INDICATING PATIENTS ACROSS ALL AND TAKING ADVANTAGE IN INSURANCE OPTIONS AND OTHER WAYS TO PAY FOR IDENTIFYING CANCERS. SO AGAIN LOOK AT WHERE WE ARE TODAY AND THE SERVICE MODEL WE WANT TO OVERLAY. IT'S A VERY DIFFERENT SITUATION IF A PATIENT IS UNINSURED IN TRAVIS COUNTY. IN TRAVIS COUNTY BECAUSE OF THE CENTRAL HEALTH CARE DISTRICT. IF YOU ARE UNINSURED YOU QUALIFY FOR A MAP CO-ASSISTANCE PROGRAM AND THERE ARE PATH FOR DEDICATED RESOURCE ABLE TO ADDRESS DIAGNOSE CANCERS. HOWEVER IN THE SURROUNDING COUNTIES IT'S A VERY DIFFERENT SITUATION. TYPICALLY IT VARIES A LITTLE BIT COUNTY BY COUNTY THERE ARE INDIGENT DOLLARS BUT ONLY 20% OF THE PROPERTY LEVEL WILL QUALIFY AND IF YOU DO THE MAXIMUM QUALIFICATION FOR ALL HEALTH NEEDS NOT JUST CANCER IS TRULY $30,000 A YEAR WHICH IF YOU HAVE LATE STAGE CANCER IS BARELY SCRATCHING THE SURFACE YOU NEED ABOUT. 40% OF THE WOMEN WHO ARE IN SURROUNDING COUNTIES AND IDENTIFIED CANCER BELOW 200% OF THE FEDERAL POVERTY LEVEL WILL QUALIFY FOR THE FEDERAL DOLLARS I REFERRED TO BEFORE WHICH IS CALLED MEDICAID FOR BREAST CANCER OR NBCC. SO 40% OF THOSE WILL BE IDENTIFIED. WE DON'T HAVE TO PAY FOR THEY BEG FOR CARE WHICH IS SOMETIMES NOT AVAILABLE OR SOMETIMES KNOWING BECAUSE I HEAR THIS ALL THE TIME FROM MY ONCOLOGY FRIENDS THEY SIMPLY DIE SO WE HAVE BEEN WORKING TO PROVIDE A MUCH MRE MODEL WORKING WITH EVERY MAJOR PROVIDER IN THE SYSTEM AGAIN OUR FEDERALLY QUALIFIED HEALTH CARE CENTERS FEDERAL STATE AND LOCAL RESEARCHERS, ALL WORKING TOGETHER TO DEFINE BET,ER WAY TO ADDRESS THE NEEDS OF THESE PATIENTS. AND IT HAS TO START WITH GETTING SUCCESSFUL REFERRALS. ONLY ABOUT 40% OF THE UNINSURED POPULATION TODAY GETS MAMMOGRAPHY ON THE SCHEDULE THAT'S RECOMMENDED BY THE FEDERAL GOVERNMENT. SO WE NEED TO HAVE OUTREACH TO BRING IN WOMEN TO REFERRED TO AS SCREENING HEALTH WITH -- HELP THEM WITH EXCESS TRANSPORTATION WHATEVER IT IS THAT THEY NEED TO GET THAT SCREENING. WE NEED TO WORK ON ELIGIBLE QUALIFICATIONS BECAUSE THERE IS ANOTHER PROGRAM CALLED BCCS BREAST AND CERVICAL CANCER SERVICES WHICH WILL PAY FOR SCREENINGS AND DIAGNOSTICS AND WE CATCH WOMEN EARLY AND COMPLETE THIS ELIGIBILITY. GET THEM INTO THE SCREENING WHATEVER THAT IS AND A FIX ON COMMUNITY CLINTONICS THAT HAVE MAMMOGRAPHY SERVICES OR THE NEWLY LAUNCHED BIG CAKE BUS WHICH ROLLING IN FEBRUARY. COMPLETING DIAGNOSIS, WHICH COULD BE A DIAGNOSTIC MAMMOGRAM BIOPSY AND FOR THOSE WOMEN WHO DO HAVE A POSITIVE DIAGNOSIS GETTING THEM TO TREATMENT AND THEN AS QUICKLY AS POSSIBLE BEING ABLE TO GET THEM ONTO [00:35:04] INSURANCE SO THAT WE HAVE INSURANCE TO PAY FOR THE TREATMENT. SO THAT WE HAVE MORE MODEL AND MUCH MORE MUCH MORE HAPPENING WITH ANYONE BUT IT HAS TO WORK FOR THE ENTIRE PIPELINE OF REFERRAL TREATMENT AND COVERAGE. SO PROGRESS TO DATE. WE DO HAVE A BUSINESS MODEL, A PATIENT COST MODEL AND I'LL SHOW YOU JUST THE SUMMARY OF IN JUST A MINUTE. WE'VE MAPPED THE COUNTY RESOURCES WE KNOW COUNTY BY COUNTY EXACTLY WHERE SURGERIES AVAILABLE, WHERE SCREENINGS ARE AVAILABLE WHERE RADIATION IS AVAILABLE. ONE OF THE RESOURCES WE CAN BRING MORE POPULATION THE NOT CONCENTRATED IN ANY ONE PROVIDER OR ANY ONE SITE. WE'VE HELD FOCUS GROUPS WITH HARD TO REACH WOMEN INCLUDING OUR AFRICAN-AMERICAN WOMEN WORLD POPULATIONS WHO ARE NOT RECEIVING SCREENINGS TODAY OR EVEN IF THEY DO HAVE THE HIGHER MORTALITY RATES. AS I MENTIONED WE'RE GETTING READY TO RELAUNCH THE BUS TO PROVIDE MAMMOGRAPHY TO WOMEN WHO HAVE ACCESS ISSUES BECAUSE OF TRANSPORTATION OR LACK OF TRUST IN THE SYSTEM. WE HAVE THREE SURROUNDING COUNTIES INCLUDING HAYS THAT ARE LOOKING TO PARTNER WITH US TO TEST THIS IMPROVED MODEL FOR UNINSURED CANCER CARE AND WE'VE DRAFTED WITH PROVIDERS A DETAILED PATIENT FLOW TO ENSURE WE DON'T LOSE PATIENTS IN THE CRACKS. THE SUMMARY LEVEL OF PATIENT AND FINANCIAL MODELS SO IF WE FOCUS HERE ON HAYS OUR TARGET POPULATION ARE ALL WOMEN 50 TO 74 UNDER 100% OF THE FEDERAL POVERTY LEVEL WHO ARE UNINSURED AND ADDITION WOMEN HO ARE HIGH RISK AND UNINSURED. THAT TOTES AL POPULATION IS 151 WOMEN IN HAYS COUNTY TO REACH OUR TARGETS WHICH IS TO IMPROVING SCREENINGS FROM EACH YEAR WE'LL HAVE TO SCREEN 1243 PATIENTS WOMEN IN HAYS COUNTY EVERY YEAR WE ESTIMATE THAT'S GOING TO BE 14 DIAGNOSED AND SIX WILL BE FEDERAL DOLLARSED ABOUT EIGHT OF THOSE WE'LL HAVE TO COVER WITH LOCAL DOLLARS. THE ESTIMATED TWO-YEAR COST INCLUDING ALL SCREENINGS DIAGNOSES, TREATING PAYMENT FOR INSURANCE ALL COSTS IN IS JUST A LITTLE OVER A MILLION DOLLARS OVER TWO YEARS TO ROLL OUT AND ESTABLISH THIS MODEL AND BY DOING SO, WE WILL BE ABLE TO START TO SHIFT STAGE IDENTIFICATION EARLIER SO THE SYSTEM WILL START TO ADDRESS COLON CANCER LUNG CANCER AND OTHER CANCERS AS WE DEVELOP A MODEL TO KEEP OUR COMMUNITIES HEALTHIER TO ADDRESS MORE HEALTH NEEDS A MORE EFFICIENT WAY I'M GOING TO TURN IT OVER TO DANIEL TO TALK ABOUT THE PROGRESS WE HAVE HAD WITH VARIOUS COUNTIES. >> THANKS SO MUCH FOR SHARING SUCH WONDER INFORMATION WITH REGARDS TO WHAT ALREADY HAS BEEN DONE. I THINK IT'S POIGNANT THAT SUSAN'S MICROPHONE WAS AMPLIFIED SO WIDELY A MOMENT AGO BECAUSE THIS WAS A CAUSE AND AN ISSUE THAT SHE HAS WORKED SO TIRELESSLY TO AMPLIFY THROUGHOUT NOT JUST TRAVIS BUT THE ENTIRE CENTRAL TEXAS AREA AND WE'D LIKE TO SHARE WITH YOU WHAT OTHER COMMUNITIES HAVE DONE. BASS TROUT COUNTY HAS BEEN WORKING WITH COUNTY LEADERS AT THE BUSINESS LEVEL AND LOCAL LEVEL AND WITH PRIVATE INDIVIDUALS TO RAISE MONEY IN A VERY SHORT PERIOD OF TIME. A SMALL GROUP OF DEDICATED CITIZENS RAISED $25,000 ON THEIR OWN TO START MOVING IN THE DIRECTION TO SUPPORT THIS EFFORT AND THE WOMEN IN NEED OF THIS TYPE OF TREATMENT AND SUPPORT IN THEIR FIGHT AGAINST BREAST CANCER. IN MORNING ALONE WILLIAMS COUNTY COMMISSION IS ADDRESSING AN ISSUE THAT IS VERY SIMILAR TO WHAT WE'RE SHARING TODAY AND LOOKING AT THE TEN SHALL OF ALLOCATING ABOUT $940,000 TOWARD THIS EFFORT TOED ADRESS THE ISSUES THEY ARE HAVING IN WILLIAMS COUNTY. TODAY WE'RE NOT HERE TO ASK FOR A PARTICULAR NUMBER. WE'RE NOT HERE TO ASK YOU FOR A SPECIFIC NEED. WE'RE HERE TO SHARE THE DATA AND THE RESOURCES AND LET YOU KNOW A LOT OF WORK HAS ALREADY GONE IN PLACE TO HELP SUPPORT OUR COMMUNITY, OUR PEOPLE HERE IN HAZE COUNTY TO DO IT COLLECTIVELY THROUGHOUT CENTRAL TEXAS. [00:40:01] WHAT WE'RE SEEKING FROM YOU ARE OUR HAYS COUNTY GOVERNMENT LEADERS TO BE CHAMPIONS. HELP US SPREAD THIS WORD. HELP US CREATE THE MOMENTUM AND TO CONTINUE THE SYNERGIES THAT WE NEED TO BE ABLE TO BE SUCCESSFUL IN OUR GOAL. WE'RE ASKING FOR OPPORTUNITIES TO GUIDE US INTO POTENTIAL COLLABORATION WLZ IT BE IN THE GOVERNMENT WITH BUSINESS OWNERS WITHIN THE COMMUNITY THAT CAN ASSIST US IN BEING ABLE TO GET TO THE RIGHT PEOPLE RAISE THE APPROPRIATE FUNDS NECESSARY SUPPORT THESE WOMEN THAT SUSAN IDENTIFIED AS BEING IN NEED MUCH SERVICE. WE'RE LOOKING AT COMMUNITIES TO PROMOTE. YESTERDAY WE HAD A BRIEF MEETING FROM LYDIA FROM COMMUNITY ACTION. WE SHARED A WIDE ARRAY OF INFORMATIONING WITH US ABOUT HER DAILY BATTLES AND WHEN SHE'S DOING TO ACCEPT HORP THE WOMEN WHO ARE EARLY AND LATE IDENTIFIED AS HAVING BREAST CANCER ONE OF THE STORIES SHE SHARED WITH US WAS TWO WOMEN ALONE HAVE BEEN DIAGNOSED AND UNINSURED BECAUSE OF A LACK OF RESOURCES MOVE TO TRAVIS COUNTY. WE'RE LOSE RESOURCES BECAUSE WE DON'T 1R THE RESOURCES HERE THAT ARE MAPPED OUT BUT WE NEED THE GUIDANCE TO HELP THE SYNERGIES AND BRING THE RESOURCES TOGETHER AND ELABORATE AND DEMONSTRATE THE LEADERSHIP WE ALL HAVE TO SACH LIVES. WE APPRECIATE YOU SHARING IT DATA. WE HOPE YOU ASSIST US IN BEING THE COLLABORATOR AND HELPING US MOVE THE SYNERGIES TO MOVE FORWARD TO HELP PEOPLE MOST IN NEED HAVING BEEN DIAGNOSED WITH CANCER. WE THANK YOU FOR THE TIME YOU PROVIDED WITH US THIS MORNING. I'M SURE SUSAN AND MYSELF ARE HERE TO ANSWER ANY QUESTIONS. >> I KNOW YOU KNOW MY WIFE'S PASSION AND LIFE'S WORK TO HELP VETERANS WITH PROSTHETICS. I'M GRATEFUL AT THE HOUSEHOLD ARE FRONT AND CENTER ON THIS VERY TYPE OF EFFORT THAT YOU GUYS ARE PROMOTING AND CHAMPIONING SO WELL HERE. AND I'M JUST GREAT SEE THE WAY YOU AR TAKE LATEDS A GROUP AND HOW WE NEED TO CATCH UP BECAUSE I FEEL THE SAME WAY AND IT'S ESSENTIAL THAT WE MODIFY OUR CURRENT IND JEBT CARE PROGRAM EBB HANS IT IMPROVE IT AND EVERYTHING ELSE WE CAN TO PROVIDE ADDITIONAL AND MORE ESSENTIAL BENEFITS TO THE COMMUNITY AND IT'S AN EXCELLENT EXAMPLE OF JUST HOW WE AFFECT LIVES ABSOLUTELY SQUARELY INSIDE OUR FOOTPRINT SO THANK YOU SO MUCH FOR WHAT YOU'RE DONE HERE TODAY. COMMISSIONERS DAN. >> REPORTER: DANIEL THANK YOU SO MUCH FOR BEING HERE. SUSAN I WANT TO THANK YOU. I KNOW WE'VE MET BEFORE IN THE PASTMENT I'M GRATEFUL YOU THAT CAME HERE TO COMMISSIONERS COURT TO SHARE WITH EVERYBODY THE WORK THAT NEEDS TO BE DONE TO BEGIN THAT EFFORT THAT PARTNER. I KNOW WE HAVE SO MANY CARING INDIVIDUALS, JUDGE, IN OUR COUNTY THAT I WOULD IMAGINE THAT WOULD BE MORE THAN WILLING TO RAISE FUNDS AND BE ABLE PROVIDE THESE FUNDS. I'D LOVE TO BE ONE OF THOSE INDIVIDUALS TO HEM CHAMPION THIS CAUSE AND IF THE COURT WANTS TO TAKE SOME ACTION TO APPOINT A COUPLE OF US I'D BE WILLING TO HELP IN THAT EFFORT. >> WONDERFUL POINT, REMINDER AND I WOULD LOVE TO SHADOW YOU ON THAT FRONT BECAUSE THIS IS A VERY PASSIONATE THING FOR US. COMMISSIONER? >> THANK YOU FOR BRINGING THIS. IT'S A LOT OF INFORMATION AND I APPRECIATE THE WORK Y'ALL ARE PUTTING INTO THIS AND I HOPE WE CAN BE PART OF IT IN SOME WAY. >> THANK YOU. >> I'D LIKE TO THANK EVERYBODY FOR THE TIME THEY SPENT ON THIS AND DANIEL THAK YOU. THANK YOU FOR WORKING ON THIS BECAUSE I KNOW IF THERE'S ANYBODY THAT CAN HELP SOLVE THE PROBLEM IT'S YOU. Y'ALL DID MENTION A DETAIL ANALYSIS AND I WOULDN'T MIND IF Y'ALL COULD SEND THAT TO THE COURT MEMBERS AND WE COULD TAKE A LOOK AT THAT AND IT WOULD BE GREAT TO SEE. I AGREE WITH COMMISSIONER INGALSBE THAT YOU HAVE BEEN CHAMPIONS ACROSS THE COUNTY SO I'M ANXIOUS TO GET STARTED AND GET PEOPLE ONBOARD. >> ANXIOUS TO YOUR RESPONSE. SUSAN CAN CERTAINLY PROVIDE THAT DATA TO YOU AND IF THERE'S EVER AN OPPORTUNITY TO BE ABLE TO EITHER MEET VIRTUALLY AND BE CERTAINLY THE MASTER OF ALL THINGS WITH IT COMES TO THE NUMBERS AND THE ROAD MAP. [00:45:03] >> THANK YOU. >> THANK YOU DANIEL. THANKS AGAIN AND I WANT TO THANK MY COLLEAGUES FOR SPONSORING THIS WITH ME. THANK YOU FOR APPROACHING US. THIS IS SOMETHINGS VERY IMPORTANT TO ME. I LOST MY MOM IN 1998 TO CANCER, AND IT'S A VERY PERSONAL. I APPRECIATE THE EFFORT THAT Y'ALL HAVE PUT IN NOT ONLY IN OUR COUNTY BUT IN REGIONWIDE, AND I THINK THAT A MORE COORDINATED EFFORT TO ADDRESS SOME OF THE AREAS I KNOW YOU AND I TALKED ABOUT A LITTLE BIT WHERE WE DON'T NECESSARILY HAVE THE FACILITY AND THE TRANSPORTATION. SPECIFICALLY ON THE WESTERN SIDE OF THE COUNTY IT'S A REAL ISSUE THAT EXACERBATES THE PROBLEM YOU'VE ALREADY OUTLINED. I'D BE MORE THAN HAPPY TO WORK WITH YOU COMMISSIONER AND I WOULD LOVE TO FOR US TO TRY TO ADDRESS THIS FURTHER. >> AND CERTAINLY. THANK YOU SO MUCH TO ALL OF YOU. CERTAINLY 15 MINUTES IS NEVER ENOUGH TIME TO BE ABLE TO SHARE THE DEPTH AND OPPORTUNITY TO AVAILABLE HERE. WE CERTAINLY WELCOME THE OPPORTUNITY TO SHARE MORE INDIVIDUALLY AND IF THERE'S AN OPPORTUNITY FOR AN UPDATE IN THE FUTURE AS WE SEE A GREATER UNDERSTANDING OF WHAT'S TAKING PLACE THROUGH THE ENTIRE QUARTER SUSAN DR. SMART AND DOCTOR, AND EVERYBODY THAT'S ON THE TEAM CHAT RIGHT NOW WILL BE HAPPY TO SHARE. SUSAN OR DR. MARTINEZ, ANYTHING ELSE TO SHARE BEFORE WE WRAP UP? >> NO, THANK YOU SO MUCH FOR THE OPPORTUNITY. LOVE TO CONTINUE THIS AS DANIEL SAID. >> AS YOU CAN SEE WE HAVE A -- COURT ON THIS MATTER AND WE APPRECIATE YOUR TIME. >> THANK YOU JUDGE. SHE MAY NOT WANT TO BUT I KNOW DR. -- HERE AND WANTED TO MAKE AN OPPORTUNITY TO SAY A FEW WORDS IF SHE WOULD LIKE. SHE'S BEEN A STRONG LEADER IN OUR COMMUNITY AND -- [LAUGHING] >> YOU WERE 12 WHEN YOU WERE TEACHING. [LAUGHING] >> WELL THANK YOU. YES. THANK YOU FOR THE OPPORTUNITY. NOT ONLY THIS ONE OF MY PASSIONS I WASN'T RILE GOING TO SHARE THIS AT THIS TIME, BUT I AM A CANCER SURVIVOR MYSELF. 28 YEARS AGO SO. NOT BREAST CANCER BUT REGARDLESS IT JUST, YOU KNOW, IN 1993 WHEN I WAS DIAGNOSED WITH IT WAS STILL SCUSHING TO ME. VERY SCARY TO EVEN SAY THE C WORD, OK. WE'VE COME A LONG WAY, BUT WE JUST HAVE AN ABUNDANCE OF RESOURCES HERE. AS A MEMBER OF ARROW THE ORGANIZATION THAT IS VERY MUCH BEHIND THIS SUSAN DAWSON I'VE WORKED HER ON OTHER EDUCATIONAL ACTIVITIES, PROJECTS THE ATRIAL ALLIANCE IS ONE. IN FEBRUARY IS WHEN I MET HER BECAUSE SHE'S BEEN TO HAYS COUNTY ALTHOUGH SHE WAS DIAGNOSED IN TRAVIS COUNTY. THANK YOU FOR YOUR TIME AND KNOW THAT, YOU KNOW THAT THERE IS CHB ABUNDANCE OF RESOURCES AND AN ABUNDANCE OF INDIVIDUALS THAT I KNOW WHO CAN MAKE SAN MARCOS CONTINUE TO THAN QUALITY OF LIFE AND I APPRECIATE THE TIME THIS MORNING. >> THANK YOU, DR. VALLE AND THANK YOU EVERYONE THAT'S JOINED [Items 4 - 7] US. THANK YOU. WHAT WE'RE GOING TO DO IS QUICKLY MOVE THROUGH THE CONSENT AGENDA ITEMS SINCE IT'S SHORT LIST AND WE'RE GOING TO CHERRY PICK AS WAS PULLED FOR WITH OUR BAILIFF. WILL YOU PLEASE OPEN 4-76789? FOUR APPROVE PAYMENTS OF COUNTY INVOICES. FIVE, APPROVE THE PAYMENT OF UNITED HEALTH CARE CLAIMS -- 4-7. SIX APPROVE COMMISSIONERS COURT MINUTES THROUGH OCTOBER 14TH, 2020. SEVEN, AUTHORIZE THE EXECUTION OF AMENDMENT NUMBER TWO TO THE GENERAL LAND OFFICE CONTRACT NUMBER 18-421-000-B130 COMMUNITY DEVELOPMENT BLOCK GRANT DISASTER RECOVERY PROGRAM HOUSING PROJECTS NONRESEARCH AND DEVELOPMENT 2015 FLOOD ALLOCATION. >> SO MOVED. >> SECOND. >> WE HAVE A MOTION AND A SECOND. ANY COMMENTS? PLEASE CALL THE ROLL. >> COMMISSIONER SHELL? >> YES. >> COMMISSIONER JONES. >> YES. >> COMMISSIONER SMITH. >> YES. >> COMMISSIONER INGALSBE. >> YES. >> JUDGE BECERRA. >> YES, WILL YOU PLEASE OPEN [8. Approve amendment to the Hays County Purchasing Policy, Section 4.5-Category 5, to formalize Federal Requirements 2 CFR 200 are included in all formal solicitations. INGALSBE] NUMBER 8. >> NUMBER EIGHT, APPROVE AMENDMENT TO THE HAYS COUNTY PURCHASING POLICY SECTION 4.5 CATEGORY FIVE TO FORMALIZE FEDERAL REQUIREMENTS 2 CFR 200 INCLUDED IN ALL FORMAL SOLICITATIONS. >> JUDGE. >> SO SNUFD SECOND. >> WE HAVE A MOTION AND A SECOND. SER INGALSBE, THIS IS YOUR AGENDA ITEM. >> IT IS, ISN'T IT? I THINK LIKE MARK OR SHERRY OR SOMEONE -- NOT SHERRY, BUT SOMEBODY CAN COME UP AND EXPLAIN [00:50:09] WHAT WE'RE DOING. >> NUMBER EIGHTS. >> COMMISSIONER? THAT'S JUST SO WHENEVER WE HAVE FEDERAL FUNDING WE HAVE FEDERAL FUNDING WE INCLUDE THE TWO CFR WHICH ARE THE FEDERAL GUIDELINES AND CONTRACTS NEED TO HAVE. WE GENERALLY INCLUDE ALL THOSE DOCUMENTS IN THE BID DOCUMENTS HOWEVER, ONE OF OUR AGENCIES WOULD LIKE THE POLICY IT ACTUALLY HAVE IT THE POLICY THAT WILL INCLUDE THE DOCUMENTS, SO THAT IS WHAT THAT UPDATE IS IS, UPDATING THE POLICY TO INCLUDE THAT WE WILL INCLUDE TWO CFR DOCUMENTS IN ANY CONTRACTS WE ENTER WHICH ARE FEDERAL DOLLARS INVOLVED. >> AND RELATES TO THE PURCHASES OVER $50,000. >> YES, MA'AM. >> SO ANY TIME I SEE THE AGENDA ITEM ON PROCUREMENT I ALWAYS PERK UP BECAUSE ONE OF THE THINGS THAT I'VE HAD LOTS OF FOLKS BENDING MY EAR ABOUT IS THAT VERY ITEM OF PROCUREMENT. IS THIS AN OPPORTUNITY. TO WE HAVE AN OPPORTUNITY WITH MODIFYING PROCUREMENT TO NOT DO BUSINESS WITH ORGANIZATIONS ENGAGED IN BAD BUSINESS PRACTICES? DO WE HAVE THAT OPPORTUNITY TO INCLUDE THAT INTO THIS SOMEHOW? TO COME TO MIND. AMERICAN STRUCTURE POINT INDICTED FOR BRIBERY OF AN ELECTED OFFICIAL WAS UNDER FEDERAL INVESTIGATION FOR RACKETEERING. HOW CAN WE NOT? HOW CAN WE NOT. >> WILL YOU STOP INTERRUPTING FOR JUST A MOMENT. YOU'LL HAVE ALL THE TIME YOU NEED. YOU'LL NOT BE INTERRUPTED IF YOU PROVIDE THE SAME COURTESY. I KNOW THAT WE HAVE HAD FENCE LADY IN SAN MARCOS HAVE CREATED SOME HEADLINES AND TROUBLES MY HOPE IS WE INTERACT IN WAYS THAT ARE MOST UNDERSTANDABLE AND SO WHAT CHANGES DO WE EXPECT TO SEE FROM ALL OF THIS SINCE ONE OF OUR COMMISSIONERS A LOBBYIST SHOULD WE EXPECT SOMETHING DIFFERENT AFTER WE DO THIS.PHOWR OVERALL CURRENT PROCESS. >> THIS WAS OUR PRACTICE BEFORE A SIMPLY POLICY IF YOU REFER TO SECTION I OF THE POLICY REFERS TO DEBARMENT AND SUSPENSION IF A COMPANY REACHES A LEVEL OF NONCOMPLIANCE OR A LEVEL OF CONCERN THAT THE COMPANY WOULD LAND ON THE DEBARMENT AND HOWEVER IT DOES NOT GIVE US FREE REINTO DISCUSS A WIDE VARIETY OF PROCUREMENT ISSUES THIS. IS AN ISOLATED SINGULAR ITEM. SO OK. >> COMMISSIONER. >> ABSOLUTELY THE MIKE IS YUMPLTZ I CAN TALK ABOUT THIS FOR DAY BUT GO FOR IT. >> IF YOU WANT IT TAKE A SWID SWIPE AT MY CHARACTER JUDGE YOU'RE MORE THAN WELCOMED TO DO THAT BUT I WISH YOU WOULD ADDRESS ME DIRECTLY. I APPRECIATE. THAT YOU BROUGHT UP THE FACT I'M A FEDERALLY REGISTERED LOBBYIST IN. THAT PROCESS THERE'S A DIRECT PROCESS THAT I HAVE TO COMPLETE TO DO THAT. EVERY THREE MONTHS I NOT ONLY TELL EVERYONE ON EARTH WHO I LOBBY FOR. I HAVE TO FILL OUT PAPERWORK WITH WHICH THE U.S. SENATE THAT SAYS WHAT ISSUES I LOBBIED ON HOW MUCH MONEY AND SPECIFICALLY DOWN TO THE BILL AND WHAT OFFICE. THOSE THINGS ARE AWED I HADED FAIRLY OFTEN. THE JUSTICE DEPARTMENT HAS ONLY AUDITS THOSE THINGS SO I'M MORE THAN HAPPY IT'S PUBLIC RECORD. I HAVE TO FILL IT OUT. I'D BE MORE THAN HAPPY TO SHARE IT WITH THEM. MOST OF MY CLIENTS NOT ALL OF THEM BUT MOST OF MY CLIENTS HAVE ACTUALLY GIVEN PRESENTATIONS TO MY CHURCH AND SIFIC GROUPS ON WHY I DO IT, WHO THEY ARE AND THE GOOD WORK THAT THEY DO I'M MORE THAN HAPPY TO DO THAT. IF YOU TWOOCHBT TALK ABOUT SPECIFIC PRACTICES I'M MORE THAN HAPPY TO BECAUSE THERE'S ONLY ONE MEMBER THAT'S UNDER FBI INVESTIGATION. THERE IS ONLY ONE MEMBER THAT IS UNDER INVESTIGATION. IF WE WANT TO TALK ABOUT THE PARTICULARS I'M MORE THAN HAPPY TO. AND IF YOU WANT TO PUT AN AGENDA ITEM ON WE CAN HAVE A LONG AND ARDUOUS ZBUTION IT THAT I'M SURE ALL OF US FLB THAT CONVERSATION. [00:55:05] >> I THINK THAT'S A GREAT IDEA AND I WOULD LIKE TO DO THAT FOR NEXT WEEK TO CREATE AN AGENDA ITEM TO DISCUSS HOW WE CAN GRAB THE ORGANIZATIONS THAT HAYS COUNTY IS DOING BUSINESS WITH, SIGNING CONTRACTS FOR AND ISSUING TAXPAYER DOLLARS TO AND CREATING OUR OWN BECAUSE I KNOW WE CAN HIDE BEHIND FEDERAL GUIDELINES IN CREATING OUR OWN DO NOT GIVE TAXPAYER DOLLARS TO LIST. I WOULD LOVE. THAT I WOULD LOVE THAT SO COUNT ON 2. WE WILL HAPPILY. HAPPILY DISCUSS THIS NEXT WEEK. SO WE HAVE A MOTION AND A SECOND. ARE THERE ANY OTHER COMMENTS? PLEASE CALL THE ROLL. >> COMMISSIONER JONES. >> YES. >> COMMISSIONER SMITH. >> YES. >> COMMISSIONER INGALSBE. >> YES. >> COMMISSIONER SHELL. >> YES. >> JUDGE BECERRA. >> YES. PLEASE OPEN 9 THROUGH 10. [Items 9 & 10] >> NINE, AUTHORIZE THE EXECUTION OF A QUOTE WITH AXON ENTERPRISES INC. RELATED TO THE SHERIFF'S OFFICE IN CAR AND BODY-WORN CAMERA PROGRAM FOR ADDITIONAL QIPT APFLUFD THE FQ 2021 BUDGET. TEN APPROVE THE REAPPOINTMET OF WALT SMITH TO THE BOARD OF DIRECTORS OF THE WEST TRAVIS COUNTY PUBLIC UTILITY AGENCY TERM ENDING SEPTEMBER 30TH, 2024. -- EQUIPMENT APPROVED. >> WE HAVE A MOTION AND A SECOND. ANY COMMENTS. COMMISSIONER COMMENTS ON NUMBER TEN. >> NO, SIR. >> I APPRECIATE THE ABILITY TO SERVE SINCE ITS INCEPTION THE COMMISSIONER FOR PRECINCT FOUR SAT ON THE WEST TRAVIS -- IT'S A GREAT PARTNERSHIP. I THINK IT'S INTERESTING THE WAY THAT IT WAS FORMED AND OVER TIME I THINK THAT THEY PROVIDED A GREATS SERVICE SPECIFICALLY FOR THE NORTHWESTERN PORTION OF OUR COUNTY THAT OTHERWISE WE WOULDN'T HAVE BEEN ABLE TO HAVE. SO THANK YOU. >> I BELIEVE IN THE ORGANIZATION AND EFFORTS AND THE PERSON OF THE PARTNERSHIP BUT MY VOTE WON'T REFLECT ANY OF THAT. IT'S A TRUST ISSUE FOR ME. PLEASE CALL THE ROLL. >> COMMISSIONER SHELL. >> YES. >> COMMISSIONER INGALSBE. >> YES. >> COMMISSIONER JONES. >> YES. >> COMMISSIONER SMITH. >> YES. >> JUDGE BECERRA. >> NO. [23. Discussion and possible action to adopt an order authorizing the issuance of the “Hays County, Texas, Special Assessment Revenue Bonds, Series 2020 (La Cima Public Improvement District Neighborhood Improvement Areas #1-2 Project)”; approving and authorizing an indenture of trust, a bond purchase agreement, a limited offering memorandum, a continuing disclosure agreement, an amended and restated service and assessment plan, and other documents in connection therewith; making findings with respect to the issuance of the Bonds; and providing an effective date. SHELL] PLEASE OPEN UP NUMBER 23. >> 23, DISCUSSION AND POSSIBLE ACTION TO ADOPT AN ORDER AUTHORIZING THE ISSUANCE OF THE HAYS COUNTY TEXAS SPECIAL ASSESSMENT REF KNEW BONDS SERIES 2020 LA CIMA PUBLIC IMPROVEMENT DISTRICT NEIGHBORHOOD IMPROVEMENT AREAS NUMBER ONE THROUGH TWO PROJECT. APPROVING AND THORDSING AN INDENTURE OF TRUST, A -- AUTHORIZING -- A BOND PURCHASE AGREEMENT, A LIMITED OFFERING MEMORANDUM, A CONTINUING DISCLOSURE AGREEMENT, AND AMENDED AND RESTATED SERVICE AND ASSESSMENT PLAN AND OTHER DOCUMENTS IN CONNECTION THERE WITH MAKING FINDINGS WITH RESPECT TO THE ISSUANCE OF THE BONDS AND PROVIDING AN EFFECTIVE DATE. >> SO MOVED. >> SECOND. >> WE HAVE A MOTION AND A SECOND. AND WE HAVE SOMEBODY AT PODIUM. IF YOU'LL PLEASE STATE YOUR NAME ANDIT TO WILL FOR THE RECORD. >> GREAT. THANK YOU, JUDGE COMMISSIONERS DAN WHITE MILLER WITH SPECIALIZED PUBLIC FINANCE FINANCIAL ADVISER TO THE COUNTY THIS. ITEM I JUST WANTED TO ADDRESS THE BONDS THAT WERE SOLD YESTERDAY FOR YOUR CONSIDERATION TODAY WAS 9.345 MILLION OF SPECIAL ASSESSMENT REVENUE BONDS. THOSE BONDS ARE SECURED BY AN ASSESSMENT OVER THE SPECIFIC AREA OF CIMA. THEY ARE NONRATED BECAUSE THEY DO NOT CARRY ANY SUPPORT FROM THE COUNTY TAX BASE OR ANYTHING LIKE THAT THE INTEREST RATE AN THOSE BONDS PRICED YESTERDAY MUCH 4.11% INTEREST RATE REFLECTS A NUMBER OF THINGS GREAT EFFORT BY FMS WHO UP REPRESENTATIVES IN THE ROOM FROM FMS THAT SOLD THE BONDS YESTERDAY IT ALSO REPRESENTS THAT ARE VERY MUCH MORE IN THE MARKETPLACE THAN THEY WERE A FEW YEARS AGO ON THE INITIAL -- WERE SOLD. THESE BONDS ARE SOLD WELL BELOW THOSE INITIAL LEVELS ALSO BECAUSE OF MARKETS AT HISTORIC LOW POINTS AS WE DISCUSSED A FEW WEEKS AGO. SO THIS 4.11% IS NEARLY 300 BASIS POINTS LOWER THAN WHAT THE ISHL TRAUNCH. IT'S -- INITIAL. WITH THAT I'D BE GLAD TO ANSWER ANY QUESTIONS ON IT. JULIE HOUSTON YOUR BOND COUNCIL IS HERE TO WALK YOU THROUGH ANY PARTS OF THE ORDER YOU MAY HAVE QUESTIONS ON AND THAT'S THE PRESENTATION. >> COMMISSIONERS? >> THE JUDGE ALSO MR. KENNEDY RECUSES HIMSELF ON THESE ITEMS INVOLVING LA CIMA SO MAKE SURE THE COURT HAS ANY QUESTIONS FOR HER OR GENERAL COUNCIL. >> DAN, CAN YOU JUST CURIOUS, WHAT WAS THE INITIAL INTEREST RATE? >> RIGHT AROUND 7%. >> WOW, OK. SO IT'S -- BOTH AGAIN THE INTEREST RATES ARE LOWER. BUT BONDS ARE ALSO THEY ARE MORE [01:00:07] INVESTORS STEPPING UP WHICH COMPETITION IS GOOD ON THAT FRONT TO HAVE MORE INVESTORS BUYING BONDS. >> THANK YOU. >>. >> NO. OK QUITE A BIT OF MATERIAL FOR VERY LITTLE CONVERSATION WE HAVE A MOTION AND A SECOND. ANY OTHER NO OTHER? OK. PLEASE CALL THE ROLL. >> COMMISSIONER INGALSBE. >> YES. >> COMMISSIONER SHELL FOO YES. >> COMMISSIONER JONES. >> YES. >> COMMISSIONER SMITH. >> JUDGE BECERRA. >> YES. [16. Discussion and possible action to authorize the County Judge to execute a Professional Services Agreement between Hays County and LJA Engineering, Inc. to provide Right-of-Way Acquisition services for Darden Hill/Sawyer Ranch Road Intersection Round-About project in Precinct 4 as part of the Road Bond Program; authorize a discretionary exemption pursuant to Texas Local Government Code Section 262.024(a)(4) and amend the budget accordingly. SMITH/BORCHERDING] >> PLEASE OPEN AGENDA ITEM NUMBER 16. >> 16. DISCUSSION OF POSSIBLE ACTION TO AUTHORIZE THE COUNTY JUDGE IT EXECUTE A PROFESSIONAL SERVICES AGREEMENT BETWEEN HAYS COUNTY AND LJ ENGINEERING INC. TO PROVIDE RIGHT OF WAY ACQUISITION SERVICES FOR DARDEN HILL SAWYER RANCH ROAD INTERCEPTION ROUNDABOUT PROJECT IN PRECINCT FOUR AS PART OF THE ROAD BOND PROGRAM, AUTHORIZE A DISCRETIONARY EXEMPTION PURSUANT TO TEXAS LOCAL GOVERNMENT CODES 262.024-A 4 AND AMEND THE BUDGET ACCORDINGLY. >> SO MOVED. >> SECOND WE HAVE A MOTION AND A SECOND WE HAVE ONE PERSON SIGNED UP TO SPEAK. MR. DAN LYON. WE'LL START THE TIMER. >> THANK YOU, ONCE AGAIN JUDGE BECERRA. THE REASON THAT I'M UP HERE IS BECAUSE ON THE BACK OF ON PAGE 98 SAID, QUOTE, SCHEDULE WILL BE INSERTED AT THE TIME OF AGREEMENT SLASH CONTRACT EXECUTION UNQUOTE. THAT IS THAT'S EXHIBIT BVMENT I KNOW I'VE BEEN UP HERE BEFORE ABOUT THESE THINGS AND I'M HERE AGAIN. -- BEFORE. ANYWAY, I BELIEVE THIS IS ABOUT TRANSPARENCY, AND I KNOW IT'S BEEN SAID THAT THE TWO COMMISSIONERS HAVE -- THAT YOU COMMISSIONERS HAVE THE INFORMATION. SO YOU ACT LIKE IF YOU HAVE IT THE PUBLIC HAS IT. THAT'S JUST NOT TRUE. THERE IS NO LEGITIMATE REASON THAT THE PUBLIC SHOULD NOT HAVE THE SAME INFORMATION. I WAS ALSO TOLD THAT I COULD SUBMIT A FREEDOM OF INFORMATION ACT REQUEST TO GET THIS INFORMATION BUT THAT WOULD TAKE UP TO TWO WEEKS AND THE AGENDA WAS POSTED LATE FRIDAY OF THIS PAST WEEK, SO I COULDN'T POSSIBLY HAVE IT BY COURT TIME. I WANT TO ASK THE QUESTION, COULD IT BE THAT MOST PEOPLE LISTED ON LGA SPEED SCHEDULE MAKE $100 PER HOUR OR MORE. WHEN MANY IN HAYS COUNTY CITIZENS DON'T MAKE $100 A DAY. IF THIS INFO OR THIS INFORMATION COULD SOMEHOW BE USED BY THEIR COMPETITION, YOU COULD GIVE ME INFORMATION AT BEGINNING OF TUESDAY. ALSO, THERE WAS NO FEAR FROM LGA OF THEIR COMPETITION UNTIL I READ THE FEE SCHEDULE RIGHT HERE IF COMMISSIONERS COURT. SO I BELIEVE THAT THIS ARGUMENT IS TOTALLY BOGUS. YOU REALLY HAVE NO LEGITIMATE REASON TO KEEP THIS INFORMATION FROM ME. THANK YOU VERY MUCH. >> THANK YOU FOR YOUR CONTINUED VIGILANCE, MR. LYON, AND I GENUINELY APPRECIATE YOUR COMMENTS, AND I'D LIKE TO SINCE THIS IS A DIFFERENT SETUP AND A DIFFERENT MOMENT THAN PUBLIC COMMENTS, I WOULD LIKE TO GIVE COMMISSIONER SMITH THE OPPORTUNITY TO ADDRESS THAT. >> SURE. AND ACTUALLY, I'M GOING TO TURN IT OVER FOR A MOMENT IN MR. KENNEDY BECAUSE THERE ARE SOME VERY DIRECT RULES UNDER PROCUREMENT POLICIES NOT JUST OUR PRO THE POLICY BUT ON HOW THOSE THINGS HAVE TO BE RELEASED AND I THINK I'LL CLAIRE THAT A LITTLE BIT. >> SURE. I'LL REMIND MR. LYON THE LAST TIME HE BROUGHT THIS UP THE COURT REQUESTED AND WE HAVE OFFERED AND CONTINUED TO MAKE AVAILABLE THE INFORMATION THAT HE WANTS, ONCE THE COURT IS VOTED ON IT. HE CAN GO DOWNSTAIRS TO JANIS JONES IN MY OFFICE AND PROVIDE SAME DAY. IT'S NOT A TWO-WEEK OR TEN-DAY, TEN BUSINESS-DAY WAITING PERIOD. IT IS SNAG COULD BE MADE AVAILABLE UPON REQUEST. IN THE SAME BUILDING ON THE SAME THAT THE VOTE HAPPENS. THE REASON WE DO NOT PUT THAT IN BACKUP AND I DON'T MIND REPEATING IT CHAPTER 2254 PROVIDES -- THIS IS GOVERNMENT CODE, BY THE WAY -- PROVIDES FOR A TWO-STEP PROCESS FOR CERTAIN [01:05:04] KINDS OF PROFESSIONAL SERVICES ARCHITECTURE, ENGINEERING AND SURVEYING, AND WHEN THAT IS BEING VOTED UPON THE COMPANY IS FIRST SELECTED FOR ITS QUALIFICATIONS. AND THEN PRICE IS NEGOTIATED THEY SAY THAT THIS CULMINATES IN A CONTRACT ONCE A SUCCESSFUL CONTRACT IS NEGOTIATED. QUOTES GET TO SAY IT'S A SUCCESSFUL CONTRACT HAS GOSHTED. YOU ALL GET TO SAY THAT YOU ALL WILL VOTE WITH THREE OR MORE VOTES TO CONFIRM A SUCCESSFUL CONTRACT FOR THAT REASON SINCE PRICE ISN'T DISCLOSED AT THAT MOMENT WE DON'T PUT THE RATE SHEET IN BACK OF WE PROVIDE THAT BY OTHER MEANS. SO THAT IS JUST HAPPY TO ANSWER QUESTIONS. >> THANK YOU. I THINK THAT IMPORTANT IS THAT. >> WE HAVE A PROCESS THAT IS STATED HOW IT WORKS. ONCE PREQUALIFICATIONS ARE MADE IT'S PURSUANT FOR US TO NOT PUT KNOWS THERE FOR A VERY REAL REASON. THE REAL REASON IS THAT SOMEONE GIVING US A QUOTE THAT IS UNDER -- IT MAY BE UNDER QUALITY JUST TO MAKE IT UNDER BUDGET. WHAT HAPPENS IS SOMEBODY WILL TRY TO SELL A GOVERNMENT ENTITY SNAG ISN'T NECESSARILY WHAT THE QUALIFICATIONS CALL FOR AND JUDGE, YOU BROUGHT UP IN THE PAST YOU DON'T WANT SOMEBODY WOULD IS GOING TO GIVE US AN INITIAL BID AND THEN TURN AROUND AND KILL US WITH CHANGE ORDERS. THAT'S WHAT THIS GROUP HAS. THIS IS A -- WHENEVER YOU NEGOTIATE THESE CONTRACTS AND AGAIN, WE ARE NOT A PART OF THAT NEGOTIATION PROCESS. THE CONTRACT IS NEGOTIATED, WE HAVE THE ABILITY TO ACCEPT OR REZWLECT APROCESS. IN THE PAST I CAN TELL YOU AS FAR AS I KNOW NONE OF US ARE IN THE PROCESS. WE LEAVE THOSE TO THE PROFESSIONALS THAT ARE IN THE COUNTY WHO ACTUALLY WORK ON A DAY-TO-DAY BASIS ON THIS PROJECT AND THAT'S THE WAY IT SHOULD BE SO WITH THAT I WITH MOVE FOR ACCEPTANCE. >> SO WE ALREADY HAVE OUR MOTION AND SECOND. WHAT I WOULD LIKE TO DO IS BASED ON THE PREVIOUS CONVERSATION WE CAN AGGRESSIVLY DISAGREE AND REMAIN PROFESSIONAL AND I APPRECIATE THAT NECESSITY ESPECIALLY AS THE CHAIR OF THIS COURT. WHAT I WANT TO DO BECAUSE THERE'S CLEARLY MISUNDERSTANDINGS OF OUR PROCUREMENT WIDESPREAD AND RAMPANT, I WOULD LIKE TO OFFER FOR THE VIEWING PUBLIC A WORKSHOP FOR NEXT TUESDAY ALLOCATE A SMALL WINDOW OF TIME SO WE CAN FERRET OUT DETAILS AND UNDERSTANDING, THAT WAY WE CAN INVEST INTO A CLEARER UNDERSTANDING OF WHAT TO EXPECT, HOW THINGS GO AND ALL. SO I'M COMMITTED TO SHEDDING LIGHT ON THAT ON THAT WAY AS WELL. SO WE HAVE A MOTION AND A SECOND. >> JUDGE? MAY I MAKE A RECOMMENDATION? IF THE COURT WANTS TO HAVE A WORKSHOP ON PROCUREMENT IN GENERAL I WOULD SUGGEST YOU SPEND A LITTLE TIME SUBMITTING QUESTIONS QUESTIONS TO THOSE STAFF BHOBZ ARE RESPONSIBLE FOR THAT THAT WOULD BE THE AUDITORS OFFICE PURCHASING AND MY OFFICE AND WE CAN PROVIDE MORE OF A PRESENTATION OF ANSWERS TO THOSE THINGS. IF YOU'RE JUST THROWING AN ITEM ON THAT IS VERY GENERAL AND NOT SPECIFICALLY POSTED AND THERE ARE NO QUESTIONS ASSOCIATED WITH IT WE MAY NOT BE PREPARED TO ANSWER THOSE QUESTIONS. >> VERY FAIR GOOD. JOB AND GOOD IDEA. >> I JUST WANT TO MAKE SURE IF THE AUDITOR WAS ALL RIGHT IF THEY COULD BE READY FOR NEXT WEEK, IF THEY WOULD RATHER DO IT THE FOLLOWING WEEK. >> I THINK THE IDEA IS JUST WORK WITH ME. >> I THINK THE IDEA WILL BE BROAD STROKES JUST TO HELP CLARIFYED PACIFY AND GENERATE UNDERSTANDINGS. I'M NOT MAKING THIS UP. MY EAR IS CROINGALLY BENT ON COUNTY DOLLARS. >> I'M NOT DISAGREEING WITH YOU. I JUST WANT TO MAKE SURE WE'RE AS PREPARED AS WE CAN BE SO WE ONLY HAVE TO DO IT ONCE. >> IF COULD YOU EXPLAIN THE TWO-STEP PROCESS WITH ENGINEERING AND THOSE PROFESSIONAL SERVICES. >> WHAT I WOULD LIKE TO DO IS AFTER COURT IS MAYBE HAVE YOU SWING BY MY OFFICE AND WE CA ARTICULATE THE PIECES THAT I GET MOST QUESTIONS ABOUT. THEN WE COULD IN THE SPIRIT OF TRANSPARENCY SHARE AND CIRCULATE ALL THE INFORMATION THAT IS BEING ASKED. I DON'T WANT TO PLAY GOTCHA. I DON'T WANT TO SURPRISE ANYONE AND I WANT TO GIVE PEOPLE THE COMMUNITY AN IDEA OF HOW THINGS TAKE PLACE. THANK YOU FOR YOUR WILLINGNESS. >> I JUST WANT TO INFORM THE COURT I ACTUAL DO I HAVE A LIVE TRAINING VICKI AND INTERNAL MANAGER HAVE THE COUNTY AWED TOWARDS FALL CONFERENCE WHICH STARTED TODAY THIS MORNING THROUGH THURSDAY. SO IF IT'S MORE OF A LIMITED SCOPE THAT WOULD HELP US WORK OUT OBVIOUSLY. AROUND THIS SCHEDULE AND ON THE WEEKEND. >> IDEALLY IT'S NOT ABOUT [01:10:06] HIGHLIGHTING -- NOT CREATING BUT HIGHLIGHTING MORE ABOUT WHAT WE DO. LIKE HERE'S HOW THAT HAPPENS. HERE'S HOW THIS HAPPENS. I THINK IDEALLY IT'S NOTHING TO REVAMP ANYONE BUT JUST SHED LIGHT ON WHAT WE'RE CURRENTLY DOING. COMMISSIONER, DID YOU HAVE A COMMENT? >> YEAH, I WAS JUST GOING TO SAY GIVEN THAT'S THE WAY YOUR SCHEDULE LOOKS WOULD THIS BE BETTER SERVED THE SECOND WEEK OF NOVEMBER? >> OK. ADDRESS THE DETAILS LATER SO WE DON'T HAVE TO KEEP DOING THIS HERE AND WE'LL HAPPILY COMMUNICATE EVERYONE ELSE. >> RIGHT, RIGHT. I THINK LIMITED SCOPE IS CEESMT I THINK THAT WILL BE GOOD. >> ELECTION IS PROBABLY THE DRIVING REASON FOR THAT. >> I THINK IT'S A GOOD IDEA IT POINT OUT TO PEOPLE WHAT IS GOING ON AND JUST HOW DO YOU THINGS. PLEASE CALL THE ROLL. >> COMMISSIONER JONES. >> YES. >> COMMISSIONER SNOOIG YES. >> COMMISSIONER SHELL. >> YES. >> COMMISSIONER SMITH. >> YES. >> JUDGE BECERRA. >> YES. AND MISS MILLER ASKED ME TO JUMP NUMBER 19 SO PLEASE OPEN AGENDA [19. Discussion and possible action to approve changes to the FY 2021 healthcare plan as recommended by the Insurance Committee. INGALSBE/SHELL/MILLER] ITEM NUMBER 1. >> 19. DISCUSSION POSSIBLE ACTION AND APPROVES CHANGES TO THE FY 2021 HEALTH CARE PLAN AS RECOMMENDED BY THE INSURANCE COMMITTEE. >> SO MOVED. >> SECOND. >> WE HAVE A MOTION AND A SECOND. MISS MILLER, IF YOU'LL STATE YOUR NAME AND TITLE FOR THE RECORD. >> THANK YOU. JUDGE AND COURT COMMISSIONERS. HR DIRECTS OR AND I HAVE BACKING ME UP HERE SCOTT YARBOROUGH FROM THE YARBOROUGH AGENCY AND -- INSURANCE THE COUNTS HE CONSULTS WITH SCOTT AND AARON ON THE INSURANCE COMMITTEE COMPOSED OF EMPLOYEES AND ELECTED OFFICIALS FROM AROUND THE COUNTY. SO IT'S TIME FOR OUR RENEWAL INFORMATION FROM UNITED STATESED HEALTH CARE THAT TO VIDS OUR DENTAL SERVICE. SO THE RENEWAL CAME TO US THIS SUMMER FROM UNITED HEALTH CARE AND SCOTT, AARON, MYSELF ARE BENEFITS MANAGER AND ISAAC IN OUR OFFICE HAVE BEEN POURING OVER THE DETAILS GOING A LITTLE BIT BACK AND FORTH WITH THE UNITED HEALTH CARE ON SOME OF THE ADMINISTRATIVE FEES, SO I'M HAPPY TO PRESENT RECOMMENDATIONS FROM OUR INSURANCE COMMITTEE AND YOU'RE RECOMMENDING SOME PLANNED CHANGES THAT SOME WILL SEE IN TERMS OF HOW SOME OF THEIR CLAIMS ARE PROCESSED. WE ARE NOT RECOMMENDING AT THIS POINT PREMIUM CHANGES TO THE AMOUNTS THAT ARE DEDUCTED FROM OUR EMPLOYEES CHANGES FOR HEALTH CARE SO AND I THINK I SAY THIS EVERY YEAR. THEY ARE COMING BUT THIS IS NOT THE YEAR YET. WE HAVE SOME SAVINGS BACK TO THE COUNTY IN SOME OF THE RECOMMENDED CHANGES. SO I'LL JUST GO THROUGH THIS. I'VE GIVEN KIND OF THE SUMMARY FIRST OF ALL THE ADMINISTRATIVE FEES WHICH FEES THAT THE COUNTY PAYS UNITED HEALTH CARE TO PROCESS OUR CLAIMS ARE GOING TO REDUCE THIS YEAR AT 2.4%. THAT GIVES US A LITTLE BIT OF SAVINGS THERE. THE FEES ARE PER EMPLOYEE PER MONTH. THAT'S WHAT THE FEE STANDS FOR DOWN 12.61. DOWN 12.61, AN EMPLOYEE FROM THIS YEAR'S 12.92. SO A LITTLE BIT OF SAVINGS THERE. AND THEN OUR STOP LOSS WHICH IS THEY ARE GOING TO JUMP IN HERE WHENIVE STRUGGLED WITH EXPLANATION. WHEN EMPLOY EARS -- EMPLOYEES HAVE CLAIMS THAT REACH $1,000 AMOUNT THE MEMBER HAS THEIR CO-PAYS AND DEDUCTIBLES PORTIONS ABOUT $6700 RIGHT NOW. WHEN THOSE CLAIMS REACH $165, THEN THE COUNTY'S OBLIGATION FOR THOSE CLAIMS STOP. SO WE PURCHASE STOPOFFS INSURANCE TO COVER AMOUNTS GREATER THAN 165. FREJS OUR CONSULTANTS ANALYSIS OF OUR CLAIMS AND FROM THE UNITED HEALTH CARE IS THAT WE MAKE A MOVE AND INCREASE THAT STOP LOSS TO 200,000. SO IT INCREASES THE COUNTY'S LIGHT TO PAY THE DIFFERENCE NOW. THE COST FOR THAT IS DOWN TO [01:15:10] $92.47. SO REDUCED PREMIUM FOR US FOR INCREASED STOP LOSS AMOUNT. WE WILL RECOUP SOME SAVINGS AND IT'S ALL PROJECTIONS. WE DON'T HOW MANY CLAIMANTS ARE GOING TO REACH THAT AMOUNT. IT'S ANTICIPATE THE BASED ON CLAIMS HISTORY THAT WE MAY HAVE ABOUT FOUR CLAIMANTS REACH THE 200,000 BUT WE DON'T KNOW WHAT TODAY OR TOMORROW BRINGS FOR OUR MEMBERS. ASSUMING THAT WE HAVE JUST THE FOUR OR LESS THAN WE'LL EXPERIENCE SAVINGS IN OUR PLACHBLET THE NEXT RECOMMENDATION DEALS WITH HOW OUR CLAIMS ARE PROCESSED FOR MEMBERS THAT USE INTENTIONALLY USE OUT OF NETWORK PROVIDERS SO NOT ALL PROVIDERS NOT ALL MEICAL OR ANESTHEIOLOGISTS OR SURGEONS IN NETWORK SOME. CHOOSE TO NOT ACCEPT INSURANCE AT ALL. SO PROCESSING THOSE OUT OF NETWORK CLAIMS HAVE HISTORICALLY BEEN ON WHAT IS CALLED A SHARED CLAIM HITS UNITED HEALTH CARE, UNITED HEALTH CARE ENGAGES HAD A NEGOTIATION PROCESS WITH THE PROVIDER ON BEHALF OF THE MEMBER TO GET THE BILL DOWN TO A REASONABLE AMOUNT FOR THE MEMBER AND WHAT HAPPENS THEN HOW UNITEDED HEALTH CARE HAS BEEN PAID IS BASED ON THAT SAVED AMOUNT THAT NEGOTIATED AMOUNT. HAYS COUNTY HAS PAID 29% BACK TO UNITED HEALTH CARE FOR DHOOG NEGOTIATION. THERE IS A NEW PILOT PROGRAM UTILIZING A COMPANY THAT IS IN THE BUSINESS OF NEGOTIATING MEDICAL BILLS CALLED NAVAGARD AND 2020 IS THE PILOT TIME PERIOD IN TEXAS THROUGH UNITED HEALTH CARE. IT'SED BOTH FROM THE COMMITTEE -- RECOMMENDED BOTH FROM THE COMMITTEE CONSULTANTS AND UNITED HEALTH CARE THAT HAYS COUNTY TRANSITION TO UNITED LIESING THIS NAVIGUARD PROGRAM FOR OUT OF NETWORK CLAIMS. WHAT HAPPENS IS WHEN OUT OF NETWORK CLAIM HITS UNITED HEALTH CARE THE MEMBER WE GET IN OUR MAILBOX A VERY SIMPLE CLEAR LETTER THAT SAYS WE HAVE A CLAIM WE ARE BEING CHARGED X AMOUNT BUT WE ARE BEING CHARGED THIS AMOUNT CALL NAVIGUARD. IT'S SIMPLE TRANSITION SOME OF THE RESPONSIBILITY FOR SOMETHINGING OUR OWN CLAIMS IN AMONG OURSELVES. CERTAINLY YOU ARE STAFF WILL BE ABLE TO HELP EMPLOYEES BUT MUST REACH OUT TO NAVIGUARD TO GET ASSISTANCE TO MANAGE THE CLAIM. A NAVIGUARD SERVICES WILL BE EDUCATIONAL. IT'S WHAT APPEARS THEY MAY EDUCATE OUR EMPLOYEES AND MEMBERS ON HOW IT READ THE DOCUMENTATION ON HEALTH INSURANCE HOW TO READ INVOICES HOW TO DISCERN WHAT THEY REALLY SHOULD PAY OR SHOULDN'T PAY AND HELP THE MEMBER INFORM GATE THROUGH WHAT IS REASONABLE CUSTOMARY AND PAYMENT FROM THE WHAT IS RECEIVED. >> I APPRECIATE US GETTING ON A CALL YESTERDAY BECAUSE I WASN'T CLEAR. I DON'T BELIEVE SOME OF US ON THE COMMITTEE WERE CLEAR ABOUT WHAT THIS ACTUALY DOES FOR THE COUNTY AND HOW IT SAVES AND I ASKED A QUESTION. COULD YOU JUST EXPLAIN IF WE HAD THIS PAST OR LAST YEAR WHAT THE COUNTY WOULD HAVE SAVED IN THOSE COSTS. >> CERTAINLY. THANK YOU FOR REMINDING ME TO BRING THAT OUT. LAST YEAR WE PAID UNITED HEALTH CARE $263,000 FOR THE SHARED SAVINGS PORTION OF THE PROGRAM. THEY NEGOTIATESED OVER $900,000 SAVINGS FOR OUR MEMBERS FOR OUT OF NETWORK SERVICES. THE 29% OF THAT WAS AROUND $263,000. THIS NAVIGUARD PROGRAM PERCENTAGE GOES AWAY NAVIGARD WILL COST US 263 EMPLOYEE PER MONTH APPROXIMATELY $30,000 A YEAR. SO WE WOULD HAVE NOT SPENT 236,000 OUT OF THE 26 3. IT WAS NOT THE COMMITTEES. I'LL TELL YOU IT WAS NOT THE [01:20:07] COMMITTEE'S INITIAL RECOMMENDATION TO MOVE TO NAVIGUARD. WE WERE UNSURE HOW IT WOULD WORK AND WE WERE UNSURE HOW IT WOULD IMPACT OUR STAFF IN HELPING EMPLOYEESING IN PROCESS. SO YESTERDAY WE REACHED OUT AND AGAIN IT OUR UNITED HEALTH CARE WRAP WE RECEIVED A COPY OF THE LETTER WHICH HELPED US TREMENDOUSLY UNDERSTAND THAT THIS IS A VERY SIMPLIFIED PROCESS FOR EMPLOYEES SO THERE IS NEVER AN INTENT TO MAKE HEALTH CARE MORE COMPLICATED AND WE JUST WANT TO BE SURE OUR EMPLOYEES ARE AWARE OF UTILIZATION. SOMETIMES WE DON'T HAVE THE OPPORTUNITY TO CHOOSE OUR PROVIDERS. IF WE'RE IN AN EMERGENCY SITUATION AND AN AMBULANCE GETS US AND WE GO TO THE ER WE DON'T GET IT PICK AND CHOOSE WHO SERVICES NEWS THOSE SITUATIONS. SO NORMALLY THOSE CLAIMS ARE OUR MEMBERS ARE NOT HELD RESPONSIBLE FOR THAT OUT OF NETWORK BILL AMOUNT. >> BEFORE YOU GET TOO FAR I HAVE A QUICK QUESTION FOR YOU. IN THE WHOLE NAVIGARD EFFORT AND UNITED HEALTH CARE HELPING US AS A COUNTY TO GET THE BEST VASMT I VISUALIZE IT AS SQUEEZING PROVIDERS TO GET A BETTER DISCOUNT -- BEST VALUE. I'M ALL FOR SAVING MONEY, BUT I HAVE THE UNIQUE OPPORTUNITY TO SEE THINGS A LITTLE MORE HOLISTICALLY THAN SOME MAY. MY BROTHER-IN-LAW IS A CRITICAL CARE PULL MONDAYOLOGIST WO HAS BEEN ON THE FRONT LINES OF COVID SINCE IT HIT TEXAS. MY FIRST COUSIN JUST PASSED AWAY FROM COVID A CARDIOLOGIST, AND SO MY QUESTION TO YOU IS HOW DID WE KNOW? HOW CAN WE ENSURE THAT UNITED HEALTH CARE IS -- HEALTHCARE ISN'T BILLING MEDICAL PROVIDERS INTO UNREASONABLE EXPENSES, FOR EXAMPLE, THE COST OF A HEART SURGERY IS REIMBURSED VERY OFTEN AT A LOWER RATE THAN THE MEDICINES. SO I'M JUST WONDERING WHAT ARE WE DOING AS FAR AS PRACTICES WITH THE PROVIDERS AND WHEN CAN WE SQUEEZE ON IF WE'RE SQUEEZING WITH REGARDS TO PHARMACEUTICALS WHO HAVE A MORE ROBUST PROFIT MARGIN. >> WE'LL TALK ABOUT PHARMACEUTICALS NEXT. IN TERMS WHAT UNITED HEALTH CARE DOING TO NOT BULLY THE PROVIDER I THINK THAT THERE ARE REASONABLE AND CUSTOMARY CHARGES FOR SERVICES. IF THE PROVIDER IS CHARGING GREATER THAN THAT THEN IN HELPING A OUT OF NET CLAIM THE UNITED HEALTH CARE AND NAVIGUARD WILL IF BE MOVE TO THAT PROGRAM ASSIST. >> CAN I STEP IN? >> HAPPILY. IF YOU WILL -- I KNOW WHO YOU ARE BUT IF YOU'LL ADDRESS YOUR NAME AND TITLE FOR THE VIEWING PUBLIC AND PLEASE ADDRESS THE QUESTION. I'M GRATEFUL FOR YOU STEPPING UP. >> -- I'LL START. THERE AARON PRATT WITH ROTH INSURANCE. MY QUESTION BACK TO YOU IS THAT A GENERAL REFERENCE REGARDING THE OUT OF NETWORK PULLET POINT OR IS IT MORE IN GENERAL NETWORK CONTRACTING OR OUT OF NETWORK. >> MY QUESTION IS MORE SPECIFICALLY BROAD IN PRACTICES AS TO HOW UNITED ON OUR BEHALF GRABING THAT PRACTICES ICB 10 C0ED WHATEVER THE RUBE RICK OR -- ICB 10 CODE THE 2C3W50ID LINES MAY THAN WE'RE PAYING TO OUR TEAM AND NOT HAVING MEDICAL PROVIDERS SAYING OH, BROTHER THIS IS A COUNTY EMPLOYEE. WE DON'T WANT TO SEE HIM BECAUSE WE'RE GOING TO GET $12 FOR HAD PROCEDURE. >> I DON'T KNOW THAT WE CAN ANSWER THAT BROADLY. IT'S A GOOD QUESTION, BUT I CAN ANSWER IT GENERALLY OK? UNITED HEALTH CARE IS THE SECOND LARGEST PROVIDER IN THE UNITED STATES. TEXAS IS THE SECOND LARGEST INSURER OF OUR CITIZENS. BLUE CROSS IS THE LARGEST. SO THE BULLY ON THE SBLOK BLUE CROSS WHO IS ABLE TO LEVERAGE -- BLOCK IS BLUE CROSS WHO IS ABLE TO LEVERAGE THE MOST AMONG PROVIDERS IN. GENERAL UNITED HEALTH CARE PROBABLY GOVERNMENT ACHIEVED AND NETWORK DISCOUNTING CONTRACT COMPARISONS THEY PAY 7% HIGHER THAN BLUE CROSS THE BOTH PAY ABOUT 40% HIGHER IN MEDICARE JUST TO GIVE. A REAL GENERAL STATEMENT, RIGHT, IT IS CERTAINLY MORE FRUITFUL FOR A PROVIDER TO SEE A PATIENT -- THIS IS NOT OUR EXPERIENCE IS [01:25:11] THAT THE PROVIDER COMMUNITY WE DON'T EXPERIENCE THE PROVIDER COMMUNITY HAVING DISSENSION OR FRUSTRATION. IT'S CERTAINLY NEEDLES IN THE HAYSTACK BUT THE GENERAL HEALTH CARE PROVIDER NETWORK CONTRACTS SOLID AND STRONG. COMFORTABLE FOR THE PROVIDERS. AN OUT OF NETWORK PAYMENT FOR THE COURT WHEN AN OUT OF -- WHEN A PERSON FIRST OF ALL MANAGED CARE MANAGED CONTRACT WHICH UNITED CONTRACT INCENTIVIZES THE CONSUMER I THINK WE ALL KNOW THAT. IT BENEFITS MY POCKET WORK. WHEN I KNOWINGLY CHOOSE TO LEAVE THE NETWORK AND SEE SOMEONE WOULD DOESN'T CONTRACT, THEN I HAVE A DIFFERENT SITUATION. AND HOW THE INSURANCE CARRIER PAYS IS ABOUT 40% MORE THAN THE MEDICARE BASEY ABOUT. 140% MEDICARE IS WHAT WE PAY REGARDLESS OF WHAT THE PROVIDER BILLS IT. CAN BILL WHATEVER THEY WANT BECAUSE THEY ARE NOT UNDER CONTRACT. SO THE PAYMENT THEY WILL GIVE WHICH WILL BE PARTIALLY THE INSURED. THE PATIENTS' DEDUCTIBLE AND OUT OF POCKET EXPENSE. THAT WILL BE A PIECE. THEN THE 140% OF MEDICARE, AND THEN ARE CAN BE A LEFTOVER, RIGHT? THAT'S WHERE REALLY THE OLD PROGRAM SHARED SAVINGS STEPS MANY OR NAVIGUARD STEPS MANY ON THAT LEFTOVER AND TRIES TO AT THE PROVIDER NOT TO ACCEPT THAT. THE PROVIDER DOESN'T HAVE TO BECAUSE THEY ARE NOT UNDER CONTRACT BECAUSE MOST OF THE TIME PROBABLY BETTER THAN 90% OF THE TIME IT'S SUCCESSFUL IN WIPING THAT AWAY OK. AND SO IT WOULD BE REAL SIMPLE SQUEEZE OF THIS IS, IS THAT UNITED HEALTH CARE WAS CHARGING US THE COUNTY 20% SUCCESSFUL OF ALL THE NEGOTIATIONS AND INSURED EMPLOYEE NOT ON BEHALF THE COUNTTY SELF IT'S ON THE EMPLOYEE. THE EMPLOYEE WINS BY THE SUCCESSFUL NEGOTIATION THE COUNTY PAYS NAV ZBARD A FAT FEE FOR THOSE WHO DOES IT FOR THEM IT IS WHERE THEY DISSED CERTAINLY PRUDENT TIME PARTICIPATE IN THE NAVICOMWARD TIE THE PROL GRAM. WE CAN ALWAYS GO BACK. >> BEFORE YOU WALK AWAY. >> BALANCINGED BILLING IS ONE OF THE PIECES YOU'RE TOUCHING ON. CAN YOU DESCRIBE TO THE VIEWING PUBLIC WHAT BALANCED BILLING IS AND HOW LEGAL THAT IS IT? >> YEAH. SO THERE ARE TWO DIFFERENT WAYS TO ANSWER. THIS ONE IS IF SOMEBODY HAS IF SOMEONE HAS GHO AN WITH A CONTRACT FACILITY AND UNIQUE PROVIDE HEAR IT THE INSURED DIDN'T GET TO CHOOSE IT WAS SUDDENLY PROVIDING SERVICES CONTRACT OUT OF CONTROL OF THE PATIENTS. THAT IS ONE UNIQUE CIRCUMSTANCE AND LAWS HAVE BEEN PASSED IN THE STATE OF TEXAS WHOLE HARMLESS THAT SOLVED THAT BALANCED BILLING PROBLEM ON BEHALF THE CLIENT LEAVING THE CLIENT HELD HARMLESS. THAT'S INVOLUNTARY OR SIMPLY ACCIDENTAL USAGE OF AN OUT OF NETWORK PROVIDER. I DIDN'T HAVE ACCESS TO IT I KNOW STEP OUTSIDE OF THE CONTRACTING THAT MY INSURANCE COMPANY HAS WITH PROVIDERS AND I'M STANDING IN THE OPEN EXPOSED SO THE BALANCED BILLING PART OF IT IS IF YOU'RE OUT OF NETWORK THE CONTRACT WE JUST DISCUSSED NO LONGER HAS ANY TEETH BUT THE POLICY WILL PAY 140%, SO THAT PAYMENT AND THE OUT OF POCKET EXPENSE TO THE EMPLOYEE AND THAT EMPLOYEE FROM THE EVEN ASSURANCE CARE CULMINATES AND IS SENT TO THE PROVIDER. IN A SENSE ASKING THE PROVIDER TO PAYMENT IN FULL. PROVIDER WOULD HAVE THAT LEFTOVER THAT INSURED PERSON WHO VOL UNTASHL USED THE NONCONTRACT PROVIDER FACILITY WHATEVER R RIGHT? AND GIVE THEM A CHANCE TO PURSUE THAT INSURED FOR THE ADDITIONAL FUND IF THEY SO CHOSE. SO BALANCED BUILDING IS THE [01:30:01] PRACTICE OF BILLING WHAT IS U IT USUAL CUSTOMARY BILLING PRACTICES AND 40% OF MEDICARE IS USUALLY THAT LITMUS TEST IN THE COMMERCIAL SPACE RIGHT COMMERCIAL INSURED SPACE IN THE GOVERNMENT INSURED SPACE. SO DOES THAT GENERALLY ANSWER YOUR QUESTION OR DO YOU WANT ME TO TAKE IN A DIFFERENT DIRECTION. >> I'M CLEAR WITH IT. I WANTED TO GIVE FOLKS BECAUSE YOU WERE TALKING ABOUT IT IN SOME LIGHT WAY YOU PASS BY IT AND I WANTED FOLKS UNDERSTAND SOME OF THE BILLS THEY GET IN THE MAIL ARE NOT NECESSARILY THINGS THEY HAVE TO PAY BECAUSE THEY ARE STILL NEGOTIATION POTENTIAL INVOLVED AND WE ALWAYS HEAR IT BECAUSE WHERE HE MORE ALIKE THAN WE ARE NOT ALIKE AS A PEOPLE. I BELIEVE PEOPLE ARE INTRINSICALLY GOOD I WANTED IT USE THIS TO REMIND FOLKS NEVERTHELESS THOSE WOULD ARE, THAT WHEN THEY SEE A BILL WHETHER IT'S A COUNTY EMPLOYEE OR NOT THAT'S A MEDICAL BILL IT DOESN'T NEED TO BE THEIR FAMILY'S DEMISE THAT THEY SHOULD PURSUE ALL AVENUES INCLUDING NEGOTIATIONS. >> ABSOLUTELY. >> YOU GAVE ME AN OPPORTUNITY TO TOUCH ON THAT. >> AND YOU DON'T HAVE TO USE NAVIGARD OR SHARED SAVINGS YOU CAN NEGOTIATE ON YOUR OWN. >> THANK YOU VERY MUCH. MISS MILLER. >> THANK YOU. RECOMMENDATION FROM UNITED HEALTH CARE AN OPPORTUNITY TO ADDRESS OUR PHARMACY PLAN. SO RIGHT NOW WE ARE IN WHAT'S CALLED FLEX BASE A PREFERD DIRECT LIST. THIS WILL INCLUDE ANALYSIS OF OUR DIRECT LIST THAT ARE INCLUDED IN OUR PLAN THAT WE PAY A 10, 20,OR 40 CO-PAY FOR. WHAT THIS DOES IS LOOK AT DRUGS AND THERE ARE 25 DIFFERENT DRUGS RIGHT NOW ON THE LIST THAT THE BECOME EXCLUDE. THOSE ARE THE DLAUGZ WILL BECOME EXCLUDED THAT WE HAVE MEMBERS UTILIZING. THERE ARE THE REASON THESES WILL BE EXCLUDED THEY ARE HIGHER COST DRUGS. THE REBATE TO THEM IS LESS FOR THE COUNTY AND THERE ARE ALTERNATIVES EITHER OTHER PRESCRIPTION MEDICATION OR OVER THE COUNTER FOR SOME OF THE DLAUGZ ARE ON THIS PARTICULAR LIST. THIS GIVES US AN OPPORTUNITY TO NOT PAY FOR THE HIGHER COST DRUG AS A MEMBER UTILIZING ONE OF THESE DRUGS. TO ENGAGE WITH OUR PHYSICIANS, OUR PRESCRIBERS OF THE MEDICATION SO SEE IF THERE IS AN ALTERNATIVE. PRESCRIJS DRUG OR OVER THE COUNTER THAT WE COULD USE OR REACT -- PRESCRIPTION -- THE SAME WAY FOR WHATEVER IT IS WE'RE TAKING THE MEDICINE FOR AND NOT PAY AS MUCH. IF THE ALTERNATIVE IS IN A LOWER -- IS A $10 CO-PAY AND WE HAVE BEEN PAYING $40 THEN WE ARE PAYING LESS OUT OF OUR POCKETS AND THE COUNTY IS PAYING LESS FOR THE DIFFERENCE IN THE DRUG. >> BEFORE YOU GET TOO FAR AWAY SORRY MISS MILLER. I WANT TO CHIME IN ON THAT SPACE. I KNOW THAT YOU AND I HAVE HAD CONVERSATIONS ABOUT PHARMACEUTICALS AND WITH OUR COUNTY PAID EVER SINCE I GOT ELECTED. ONE OF MY FIRST QUESTIONS TO YOU WAS TO PLEASE PROVIDE ME A LIST OF THE PHARMACEUTICALS THAT WE CONSUME AS A COUNTY AND WHAT THE COST OF THOSE ARE BECAUSE I HAVE ALWAYS BEEN AFTER SAVING OUR TAXPAYERS AND OUR EMPLOYEES BOTH BY DEFAULT AS MUCH AS POSSIBLE. BUT WHEN I HEAR EXCLUDING DRUTIONS THAT ARE OUR EMPLOYEES ARE UTILIZING TIED IT UNITEDED HEALTH CARE I'M MILDLY I DON'T WANT TO SAY FEARFUL, BUT CONCERNED THAT INSURANCE COMPANIES MAYBE DICTATING CARE INVIEDERS AJD I KNOW MENTAL HEALTH IS A HUGE ISSUEESS SPECIAL WLI COVID IN OUR COMMUNITY. I KNOW THAT CERTAIN BRANDS WILL HELP WITH CERTAIN MENTAL HEALTH ISSUES IN SUCH A WAY THAT A GENERIC MAY NOT. AND I WOULD I WOULD CAUTION THE COURT AND I WOULD BE VERY, VERY CONCERNED WITH US PULLING THINGS OFF. IN BECAUSE OF INSURANCE NUMBERS AND SOME TYPE OF WAY I BELIEVE CARING FOR OUR POPULATION IS THE HIGHEST PRIORITY AND WE HAVE MANY OPPORTUNITIES TO -- MONEY [01:35:06] ON MANY FRONTS, AND I WOULD HATE TO PEEL OFF EVEN PERSON THERE SOMETHING THAT A DOCTOR HAS PROVIDED. AND I THINK YOU SAID THAT 35 ARE BEING MOVED. >> APPROXIMATELY 25. >> 25 DIFFERENT DRUGS. >> 25 DIFFERENT DRUGS ARE RECOMMENDED TO BE REMOVED FROM THIS LIST. AND I JUST -- I WANT IT SEE IF YOU GUYS CAN COMFORT ME BECAUSE I'M VERY NERVOUS ABOUT LIKE ITEMS. WE KNOW THAT JIFY IS JUST AS GOOD AS HILL COUNTRY FAREWELL. NO, IT'S NOT TO SOME PEOPLE SO. I JUST WANTED TO SEE IF I WOULD SAY WE HAVE THE SAME CONCERNS OUR INSURANCE STAFF AND COMMITTEE. THIS IS SOMETHING WE DO NOT TAKE LIGHTLY JUST TO SAY THAT I THINK THE APPROXIMATE SAVINGS IS AROUND $100,000. THE DRUGS THAT WE KNOW THESIC DRUGS AND WE DO 1R MEMBERS UTILIZING EACH OF THOSE DRUGS THAT ARE IDENTIFIED. WHAT HAPPENS IS STANDARD OR NOT. THEY ARE ANNUALLY REVIEWED BY UNITED HEALTH CARE AND THERE MAY BE DRUGS THAT MAY BECOME EXCLUDE. SO OUR MEMBERS BECOME INCLUDED WITH YOU'RE TAKING DRUG ABC SO BEGIN YOUR CONVERSATION WITH YOUR PHYSICIAN AS TO ALTERNATIVES STEP THERAPY AND BEGIN IF SOMEONE HAS A REACTION WITH OR INTERACTION THAT THE POSITIONS CAN GO BACK TO HEALTH CARE AND SAY THIS IS THE ONLY DRUG THAT WILL WORK FOR THIS PERSON FOR THIS CONDITION. >> WITH THAT SAID DO YOU HAVE THE NUMBERS OR THE STATS AS TO HOW MANY TIMES DOCTORS HAVE REACHED OUT WITH THAT EXAMPLE YOU'VE DESCRIBED AND HOW MANY TIMES THEY HAVE AGREED AND HOW MANY TIMES THEY HAVE BEEN DECLINED? >> NO, I DO NOT KNOW. THAT IS PERSONAL INFORMATION. >> DATE OF BIRTH. IF YOU GIVE THOSE NUMBERS I'D LIKE IT HAVE SUBSTANCE BEHIND IT. >> I HAVE NO IDEA HOW MANY TIMES THAT'S HAPPENED WITH OUR MEMBERS AND EMPLOYEES. THAT'S NOT SOMETHING THAT YOU ENGAGE OUR EMPLOYEES WITH. TELL US HOW IT WORKS OUT FOR YOU. >> I THINK WE SHOULD INCORPORATE SOMETHING THAT SAYS HEY WE PULLED THIS PHARMACEUTICAL OFF YOUR ROSTER AND YOU'LL HAVE TO DEAL WITH A NEW ONE AND TELL US HOW IT WORKS. THAT SHOULD BE PART OF THE PROED CONVERSATION. I THINK HE WANTS TO WEIGH IN WEIGH IN A LITTLE. >> SO WE CRUT NIZ THIS REAL YOU PARTICULARLY JUST FOR YOUR COMFORT. >> SO THE FLEX BASE IS THE MOST ROBUST PROGRAM. IT'S PROBABLY IT'S ALMOST BENEVOLENT. IT'S A NARROW SCOPE OF PEOPLE THAT ONE IS ONE PERSON. SO THREE WOULD BE AN IMPROVEMENT. CHANGE WOULD AFFECT THE JOBS IN THE PROGRAM SO THE 22 WOULD BE DRUGS THAT WOULD BE APPROVED IT WOULD ONLY BE REMOVED BY ALLOWANCE BY THE FDA. EACH ONE OF THESE DRUGS WOULD HAVE ALTERNATIVES TO BE FOUND EFFECTIVE EACH AND THOUGH NOT EVERY HUMAN REACTS THE SAME WAY TO EVERY DRUG. THAT IS ABSOLUTELY NOTABLE. SO HERE'S WHAT I'M GOING TO USE SHERRY'S WORDS AND CLARIFY. THIS IS A SELF-FUNDED PROGRAM. THE COUNTY IS THE INSURER. THE STOP LESS IS THE STOP LOSS. SO THERE WOULD BE 54 PEOPLE WHO WOULD BE AFFECTED BY THESE DRUGS RIGHT? THE MAJORITY OF WHICH WOULD SWITCH TO AN ALTERNATIVE AS SOON AS THEY REALIZE THAT'S THEY HAVE BEEN TAKING NO LONGER AVAILABLE. IF IN A RARE CIRCUMSTANCE SOMEONE HAS A REACTION AND TWO OR THREE OR FOUR DIFFERENT [01:40:01] ALTERNATE DRUGS AVAILABLE AND AREN'T AS EFFECTIVE. THEY AREN'T SUCCESSFUL SINCE THIS IS A SELF-FUNDED PROGRAM THE COUNTY CAN MAKE A IMMEDIATELY CAN MAKE A DECLARATION TO THE PROGRAM UNIFORMLY NOT JUST TO THE ONE INDIVIDUAL BUT UNIFORMLY TO THE ENTIRE COUNTY AGAIN BASED ON THAT CIRCUMSTANCE. THAT'S WHAT GAFS THE COMFORT IS THAT THERE'S GOT TO BE A LITTLE SUBTLE PUSH FROM AN EXPENSE STANDPOINT TO GET ADDITIONAL PRUDENCE INTO THE PHARMACEUTICAL PROGRAM. THERE IS ANOTHER BULLET POINTS WE'LL DISCUSSION IN A MINUTE. THIS IS CATALYST OF STEWARDSHIP THAT WAS REASONABLE ENOUGH AND NONDISRUPTIVE ENOUGH TO STRONGLY CONSIDER. $93,000 IF WE FELT WOULD HAVE AN IMPACT ON A PERSON IN IMPOSING WAY WE PROBABLY WOULDN'T TREMED. >> YOUR COMMENTS AS MONITOR IN PIECE HAVE BEEN VERY COMFORTING TO ME COMPARED TO WHAT I JUST HEARD THAT WE DON'T TOUCH THAT SPACE. SO I FEEL GOOD AS A WHOLE KNOWING WE'RE WORKING ON IT AND I'M NOT TRYING TO SAY WE'RE TRYING TO VIOLATE HIPA IN ANY WAY BUT I WANT TO MAKE SURE WE'RE STAYING VIGILANT AND NOTHING MORE. >> SURE. UNITED HEALTH CARE HAS MULTIPLE PROGRAMS YOU HAPPEN TO BE IN THE MOST OUT OF ONE. >> MISS MILLER DOES A WONDERFUL JOB. >> I'M CLARIFYING SHE JUST PROBING FOR QUESTIONS. >> ASKING EMPLOYEES ABOUT THEIR MEDICATION NOT SOMETHING WE WILL ENGAGE IN. >> I DON'T WANT YOU TO. >> COME TO US WITH QUESTIONS ABOUT THEIR MEDICATIONS WE WILL GIVE THEM HELP AS THEY NEED HELP REFERRING THEM TO THEIR PHYSICIAN. OFTEN TIMES WHEN THE -- FORMILARIES ARE CHANGED WE DO HEAR FROM EMPLOYEES. WHY CAN I NOT GET THAT? IT GIVES US AN OPPORTUNITY TO EXPLAIN AND ENCOURAGE OUR EMPLOYEES WITH THEIR PHYSICIANS AND UNITED HEALTH CARE. >> I WOULD LIKE TO EYE TAL SIZE, UNDERLINE AND HIGHLIGHT IT WE -- ITALICIZE -- THAT WE CREATE SOME MECHANISM NOT JUST IT SAY HOW'S IT WORKING FOR YOU BUT IT WE'RE MAKING THESE CHANGES. THIS IS WHAT WE'VE DONE. REST ASSURED WE ARE HERE FOR YOU THIS IS INTENDED TO IMPROVE AND SUPPORT YOU. IF THERE'S ANYTHING THAT CAN BE DONE HERE'S AN ANONYMOUS LINK REACH OUT TO YOUR PROVIDER I WOULD LIKE IT SEE EXTRA DOUBLE DOWN EFFORT BECAUSE MANY PEOPLE YOU KNOW MISS MILLER YOU'RE A LONGTIME PROFESSIONAL. MANY PEOPLE WILL BITE DOWN TAKE WHAT THEY ARE GIVEN TIE THEEN THEIR BELT AND MODIFY THE NEW RULES AND NOT SEE THE TRUE BEN FISTS THE PREVIOUS DECISIONS SO I WANT TO MAKE SURE WE PROVIDE ACCESS TO FEEDBACK OF COURSE HIPA COMPLIANT WAY. >> ABSOLUTELY. >> CAN I SAY A FEW WORDS? THIS HAS BEEN ISSUE. ANY TIME WE REUP WITH OUR PLANS OR CHANGE PLANS WORKING WITH THE PHARMACY PLAN IT DOES THAT PLAN CHANGES EVERY YEAR OR TWO I BELIEVE. SO THERE ALWAYS CAN BE SOMETHING THAT COMES ON AND OFF AND WE'VE ALWAYS BEEN COGNIZANT OF WE DON'T WANT AN EMPLOYEE IT NOT CONTINUE TO TAKE THEIR MEDICATION THAT'S VITAL FOR THEIR HEALTH WHICH THEN IN TURN HAS THE RAMIFICATIONS MAY BE BAD FOR THEIR HEALTH SO THAT'S ONE THING I KNOW IT GAVE US THAT ABILITY TO OURSELVES DECIDE TO MOVE ONE OF THOSE MEDICATIONS TO THE OTHER COLUMN IN THE EVENT THAT WAS HAPPENING AND I KNOW MERCEDES IS HERE SHE'S PROINL THE PERSON THAT GETS THE CALL WHEN THEY GO TO THE THE DOCTORAGE SAYS WE'RE GOING TO CHANGE YOUR PRESCRIPTION. I'M SURE MERCEDES IS THE INDIVIDUAL THAT GETS THOSE CALLS FROM THE EMPLOYEES. I DON'T WANT TO MAKE IT SOUND LIKE THERE'S NO ONE TO TO I KNOW SHE'S HELPED NAVIGATE THAT PROCESS WITH THE INDIVIDUALS AND CONTINUES TO FOLLOW UP. IN THE EVENT WE COME ACROSS THOSE SITUATION WHERE'S ONE OF THOSE EMPLOYEES ARE PUT INTO A SITUATION THAT THEY CHOOSE A MED DHATION IS NOT WORKING WITH THE WAY -- I WOULD BE ALL FOR TAKING THAT MEDICATION AND PUTTING BACK. >> THAT'S EXACTLY WHAT I'M HOPING FOR AND THAT'S WHAT I'M BEING REASSURED BY AND I APPRECIATE THE COMMENTS AND I [01:45:06] THINK THAT IT'S UNIVERSALLY CLARIFIED NOW AND THANK YOU. >> JUDGE, PEOPLE ARE SHARING US ON I THINK THAT THE MESSAGE THAT IT'S GOING TO BE VERY IMPORTANT HOW WE GET THE WORK OUT TO OUR EMPLOYEES TO ENSURE THAT THEY FULLY UNDERSTAND WHAT WE'RE PROPOSING, YOU KNOW. WE TALK ABOUT THAT EVERY YEAR WE HAVE TO GET THAT MESSAGE OUT IN A WAY THEY UNDERSTAND WHAT WE'RE DOING. I JUST ALSO, I SAW MERCEDES HERE AND I REALLY WANTED TO TAKE THE OPPORTUNITY SINCE COMMISSIONER SHELL ALREADY MENTIONED HER TO JUST THANK YOU MERCEDES FOR THE MANY YEARS THAT YOU HAVE DEDICATED TO OUR COUNTY AND THE WORK YOU DO. I KNOW AOUR OFFICE CALLS YOU REGULARLY, YOU KNOW? AND IT'S GOING TO BE HARD, YOU KNOW, IT MOVE AWAY FROM THAT. WE UNDERSTAND THAT. YOU ARE A REASSURING VOICE TO SO MANY OF OUR EMPLOYEES SO THANK YOU SO MUCH. >> THIS IS, AFTER ALL, YOU'RE RIGHT THANK YOU MERCEDES. THIS IS FOR THE PEOPLE AND THAT'S WITH A YOU'RE DOING AND WE'RE ALL HELPING TO REPRESENT. SO THANK YOU. >> I FOLLOW YOUR COMMENTS WITHOUT MERCEDES. WITHOUT MERCEDES IN OUR BENEFITS ROLE FOR THE LENGTH OF TIME SHE HAS BEEN HER KNOWLEDGE AND THOUGHTFULNESS EXPLORING ESPECIALLY THESE PARTICULAR CHANGES HAVE BEEN RECOMMENDED IN ENSURING WE CAN DOWN IN OUR EMPLOYEES AND UNDERSTAND AND KNOW WHAT CHANGES ARE RECOMMENDED AND HAD YOU THEY RECOMMENDED THE PLAN I WOULDN'T HAVE IT ANY OTHER WAY. SO LASTLY VIRTUAL VISITS WE HAVE CONTINUED TO PROMOTE VIRTUAL VISITS. I THINK THAT WE'VE PROBABLY SEEN AN UPTICK IN THE USAGE OF OUR VIRTUAL SYSTEM TO SEE OUR DOCTORS SINCE MARCH. A LOT OF COVID HAVE OCCURRED OUR EMPLOYEES HAVE PAID OUR MEMBERS HAVE PAID $15 PER VISMT YOU GET TO THE DOCTOR ON THE PHONE AND SEND A PRESCRIPTION AND GET WHATEVER YOU NEED -- PER VISIT. NOT EVERYTHING IS ESSENTIAL FOR A VIRTUAL VISIT. BUT WE TO LIKE IT SEE A GREATER NEED FOR VIRTUAL VISITS FOR THOSE APPROPRIATE TIMESED SITUATIONS. RIGHT NOW THE VIRTUAL VISIT COSTS THE COUNTY $49. SO THE CLAIM PROCESSING THE CLAIM STRUCTURE IS A FLAT 49 DLRB AND OUR MEMBER PAYS $15. WE WOULD LIKE TO MOVE TO A NO CO-PAY FOR OUR MEMBERS SO THEY GET TO THE DOCTOR. THEY DON'T HAVE TO PAY FOR THE AMOUNT AND THE COUNTY PAYS $4 MILLION BE THINK WOULD LESSEN THE USAGE FOR EMERGENCY ROOMS, URGENT CARE FACILITIES OR EVEN THE POP-UP I DON'T KNOW WHAT YOU CALL THEM THE EMERGENCY FLOOM A BOX THAT A LOT OF PEOPLE GO INTO BECAUSE THEY THINK THERE'S NOT A LINE OR THEY THINK THERE'S A CLINIC, AND THEY GET THIS EMERGENCY ROOM OUT OF NETWORK BILL OR SOMETHING SO TAKING AWAY THAT SIMPLE $15 CO-PAY THAT THE MEMBER PAYS HOPEFULLY WILL INCREASE THE UTILIZATION AND DECREASE THE UTILIZATION OF THE MORE EXPENSIVE ALTERNATIVES. >> THAT IS A WONDERFUL PIECE OF INFORMATION I FEEL REQUIRES A LITTLE CONVERSATION. WHAT YOU'RE DESCRIBING IS ALSO ESPECIALLY DURING THESE TIMES OF COVID REFERRED TO AS TELEMEDICINE, YOU KNOW, IT'S MEDICAL PROFESSIONALS R SITING BEFORE YOU HOPING TO AVOID A TRIP AND EXPOSURE DURING FLUS AND COVID COLDS AND EVERYTHING ELSE THE PIECE YOU BROUGHT UP ABOUT VERY EFFORT LUSLY BY THE DOOR THEY WALK INTO OSH SOME SMALL I HAD VO SIN CROSSY THAT THEY WEREN'T MADE AWARE OF WILL DETERMINE HOW THAT ORGANIZATION THE POP-UP ER WILL BILL OR COME AFTER FUNDING FOR SNAG COULD HAVE BEEN HANDLED REMOTELY THROUGH THE VISIT YOU'RE DESCRIBING MANY PEOPLE ARE VICTIMS -- I WILL USE THAT WORD I THINK IT'S WONDERFUL WE'RE ADDRESSING IT IN THIS WAY COMMISSIONER YOU WANT TO ADD [01:50:06] SOMETHING? IT'S OK. >> I IS ONE WE NEED TO GET WORD OUT. >> ABSOLUTELY. >> WENL GAUGE IN OPEN ENROLLMENT A WEEK OR SO ONCE DECISIONS ARE MADE HERE TODAY SO WE'LL HAVE THAT COMMUNICATION AND OTHER IDEAS FOR ADDITIONAL COMMUNICATION IN ADDITION TO THE NEWS LETTERS AND E-MAILS. >> KIM DOES A WONDERFUL JOB OF CREATING PIECES. SHE'S DONE AN EXCELLENT JOB AND I WOULD LOVE TO SEE HER STEP IN THIS BASE AND WORK TO BROADCAST AGAIN AS A COURT WE'RE DOING HAD FOR THE PEOPLE AND WE WANT TO MAKE SURE THE PEOPLE UNDERSTAND WHAT'S GOING ON. I REAL YOU APPRECIATE IT. >> COMMUNICATE WITH HER. LASTLY THIS IS NOT A DECISION HAD A NEEDS TO BE MADE BUT JUST TO LET YOU KNOW THAT OUR FARMLY REBATE PROGRAM WITH SUCCESSFUL COMMUNICATION. I DON'T KNOW IF THERE WAS BULLYING INVOLVED OR NOT BUT UNITED HEALTH CARE HAS COME BACK WITH US WE HAD COMMUNICATIONS WITH UNITED HEALTH CARE ABOUT THE PHARMACY REBATE WHERE IT STOOD AND IF WE COULD DO WETTER THEY HAVE FOUND A PROGRAM IN ADDITION TO FEE CREDITS WITH PHARMACY UTILIZATION ADDS DIGAL REBATES IT THE TUNE OF 103,000 FOR OUR CURRENT UTILIZATION. SO IT'S A MATTER OF ASKING AND EXPRESSING CONCERN WHERE OUR CREDITS ARE AT. IT'S A REGION AS WELL TO PUSH THE ENVELOPE A LITTLE BIT WE WERE VERY PLEASED WITH THAT. THAT IS IN PLACE THAT IS NOT SOMETHING THAT WILL BE IN PLACE THE OTHER ITEMS WE TO NEED SPECIFIC DECISIONS ON? CAN I ASK A BRIEF DISCUSSION JUDGE BECAUSE THE TERM GETS TOO -- TERM IT'S TOO GOOD TO BE T TRUE. THERE'S NO UNDERLYING ANYTHING RIGHT. >> WOULD YOU LIKE ME TO WEIGH IN? THIS IS KIND OF FUN. >> IN SIMPLE TERNS THERE'S A SUPER AWARENESS THE IN PROFITS. I WON'T GO ANY FURTHER. WE KNOW BALL THAT IN. THIRD PARTY MINISTERS THEY HAVE MAIFIS NEGOTIATION POWER WITH MASSIVE PHARMACEUTICAL -- SIMPLE LANGUAGE THIS. YEAR SCOTT AND I WENT BACK BECAUSE IN THE LAST FEW YEARS IN OUR INDUSTRIES IT'S BEEN APPARENT THAT THE PUBLIC HAS AN AWARENESS OF THE TREMENDOUS AMOUNT OF EXCESS FUNDS AND MONEY THAT CIRCUMSTANCE RATE IN THAT ROLE. WE WENT OUT IT THE MARKET IT TO GET A PRIVATE PHARMACEUTICAL TO REPLACE UNITED HEALTH CARE WONTS YOU KNOW IT. THEY CAME BACK AND SAID WE DEVELOPED A PROGRAM AWES SEE HERE I DON'T KNOW EVEN KNOW HOW THEY CAME UP WITH THE NAME OF THE HYBRID REBATE. I SAID WHAT DOES THAT MEAN. WHY HAVEN'T WE HEARD ABOUT IT BEFORE. IT WASN'T DEVELOPED. ALL OF THEM ARE UNDER DEEP PRESSURE. BASICALLY WHAT THEY SAID IS ALL THE REBATES SYSTEMATICALLY GHAKD AS FEES ON TOP OF THAT WE'RE GET [01:55:06] REGULAR BAIT MONEY. TAZAR RISE OF EACH QUARTER WE'LL AGAIN THE ADDITIONAL 173,000. THAT IS LAST YEAR REPEATED THIS YEAR THIS WILL WHAT THEY WILL ADD UP TO AROUND $58 PER DRUG. SO BOTTOM LINE WAS SOME BIG MONEY. THAT WAS MONEY UNITED HEALTH CARE WASN'T SHARING. IT DOESN'T CHANGE THE PHARMACEUTICAL PROGRAM. THE END USAGE CAN EXPLAIN THE NEXT COPAYMENT. THIS IS MONEY COMING BACK INTO THE COFFERS. >> THAT'S BEAUTIFUL. HV AND WAL-MART HAS CRAZY WONDERFUL PROGRAMS FOR THE PUBLIC I DON'T WANT IT TO SOUND GENERIC BUT IF THEY CAN DO IT WHY NOT US? I BELIEVE THIS IS A STEP IN THE RIGHT DIRECTION. WE'RE TIGHTENING THE BOLT FOR THE PHARMACEUTICAL AS A WHOLE AND I'M JUST GRATEFUL THAT WE ARE AT LEAST MAKING STRIDES IN THAT SPACE AND BRINGING IT BACK TO THE TAXPAYER SO THANK YOU FOR THAT. >> SO WITH THAT, THOSE ARE THE RECOMMENDED CHANGES OUR COMMITTEE RECOMMENDEDS CHANGING OUR STOP LOSS FROM 165 TO 200,000. CHANGING OUR FARM SAY PLAN AND ELIMINATING CO-PAY. >> BECAUSE OF THE BREADTH AND SCOPE OF THE CONVERSATION I WANT TO OPEN IT UP FOR COMMENTS. >> I APPRECIATE ALL THE WORK DID YOU ON THIS COMMITTEE THANK YOU SCOTT WE APPRECIATE ALL YOUR HELP WITH US. >> I JUST WANTED TO THANK AARON AND SCOTT ALSO AS SHERRY MENTIONED WE DON'T BRING OUR DECISIONS LIGHTLY AND THERE WAS GOOD DISCUSSION REGARDING THE PHARMACY PLAN BUT THERE IS THE OPPORTUNITY IF A CERTAIN DRUG DOESN'T WORK OR THAT THE GENERIC ONES WEKS ADD A DRUG BACK NO OUR PLAN THAT SHOULD BE A COMFORT I OUR EMPLOYEES. >> THANK YOU FOR THAT REMINDER. >> COMMISSIONER ANY COMMENTS? >> I APPRECIATE THE TEAM AND LIKE COMMISSIONER INGALSBE SAID SOME OF THESE DECISIONS AREN'T EASY AND EVERYBODY IS DOING THE BEST THEY CAN TO TAKE CARE OF THE EMPLOYEES AND TAXPAYERS. I APPRECIATE Y'ALL'S WORK. >> I WANT TO THANK OUR HR DEPARTMENT. AT END OF THE DAY WE KEEP OUR EMPLOYEES BECAUSE OF THE PROGRAMS. IT'S PRETTY OBVIOUS WHEN YOU LOOK AT BUDGETING ON AN ANNUAL BASEY AND WE LOOK AT WITH A WE PAY OUR EMPLOYEES FOR THOSE SAME POSITIONS AT THE END OF THE DAY WE MAY NOT MEET SOME OF THE SAME SAME LEVELS BUT WE FAR OUTPAY OUR COMPETITORS WITH THE PACKAGES. THAT'S HOW WE TAKE CARE OF THEM. I HAVE A CONCERN WHEN I LOOK AT THIS LIST. THERE ARE ALTERNATIVES BUT THERE ARE DIFFERENT DRUGS HAD A DO DIFFERENT THINGS I TAKE A DRUG ALMOST DAILYANS EXAMPLE. I WAS DIAGNOSE THE WITH A BRAIN TUMOR BACK IN 2005. THE DRUG I GET FROM ANDERSON BACK THEN I'M STILL ON TODAY WAS NEVER INTENDED FOR THAT BUT THAT'S WHAT IT'S USED FOR. SO I WANT TO MAKE SURE WHEN WE TALK ABOUT THE ALTERNATIVES MINE IS AN THE LIST SO I KNOW WE HAVE EMPLOYEES WHO MAY BE IN A SIMILAR SITUATION AND I WANT TO MAKE SURE EVEN IF IT'S ON THAT LIST WE HAVE THE FLEXIBILITY TO GO BACK AND LOOK THAT IT PUTS MY MIND AT EASE. >> THANK YOU COMMISSIONERS FOR THOSE GREAT THE, AND IT IS VERY WELL SAID AND VERY WELL STATED, AND WE'RE VERY GRATEFUL FOR THE WORK YOU HAVE DONE AND WE WILL CONTINUE TO LOOK FORWARD TO BEING A ROBUSTLY SUPPORTED HAYS COUNTY TEAM AND AS YOU KNOW, WE ARE ALL IN LINE LOCKSTEP BEHIND YOU WHEN YOU'RE DOING ALL THESE [02:00:05] WONDERFUL THINGS FOR THE COMMUNITY. THANK YOU ALL VERY MUCH FOR WHAT YOU'VE SAID AND DONE HERE TODAY. DR. CARDENAS PLEASE CALL THE ROLL. >> COMMISSIONER INGALSBE. >> YES. >> COMMISSIONER JONES. >> YES. >> COMMISSIONER SHELL. >> YES. >> COMMISSIONER SMITH. >> YES. >> JUDGE BECERRA. >> YES. WE WILL TAKE A TEN MINUTE RECESS. >> WE ARE BACK FROM A RECESS AND A CHANGE IN OUR BURN BAN HAS BEEN RECOMMENDED AND I WOULD [26. Discussion and possible action related to the burn ban and/or disaster declaration. BECERRA] LIKE TO ASK YOU PLEASE OCH AGENDA ITEM NUMBER OH, WHERE IS IT THANK YOU 26. 26 DISCUSSION OF POSSIBLE REACTION PLEASE STATE YOUR NAME FOR THE VIEWING PUBLIC. >> GOOD MORNING JUDGE. I'M THE COUNTY FIRE MARSHALL. ON FRIDAY I STARTED A DISCUSSION WITH THE FIRE CHIEFS LOOKING AT CURRENT NUMBERS GOING INTO THE WEEKEND WHAT THE MOIST CONTENT IN OUR WEATHER PREDICTIONS FORTHCOMING. THERE IS NO RAIN. THE TEMPERATURES ARE DROPPING WE'RE GOING TO SEE A COLD FRONT THAT WILL DRY OUT FASTER. THE HIGH IS OVER 600 AS A SPECIAL ORGANIZATION OF MYSELF AND AREA FIRE CHIEFS ARE RECOMMENDING A BURN BAN. WE HAD A WEEK OF HAVING IT OFF FROM THE RESOLUTION OF WHAT IT WAS BEFORE IN THE LAST PARAGRAPH TO THE BOTTOM THERE TO BE FURTHER RESOLVE ANY EXEMPTION BY THE HAYS COUNTY FIRE MARSHALL ALLOWED UNDER A SAID BURNING ALLOW ONE HOUR FROM SUVERN RISE TO ONE HOUR BEFORE SUNSET THAT FLOWERS THE STATE GUIDELINES WHEN WINDS ARE PREDICTED TO BE BETWEEN 6 AND ONLY AFTER PROPER EQUIPMENT IS TAKING PLACE. I MENTION THIS WE DID HAVE A REQUEST FROM SAN MARCOS TO HAVE A BURN THIS WEEK SO THERE ARE SOME EXCEPTION THAT'S WILL ALLOW PEOPLE TO DO A BURNING THIS THES. >> PUT THE BURN BAN BACK ON AS RECOMMENDED BID OUR FIRE MARSHALL. A MOTION AND A SECOND. JUST FOR THE VIEWING PUBLIC OUR FIRE MARSHAL HAS STATED THAT IF THERE IS A UNIQUE SITUATION THAT WHERE YOU FEEL YOU NEED TO BURN SOMETHING WITHIN THE BURN BAN THERE IS A ADMINISTRATIVE PROCESS WOVEN INTO THIS, SO THAT OUR FIRE MARSHAL COULD GRANT THAT AFTER ALL THE PRECAUTIONS SET IN PLACE PLEASE CALL THE ROLL. >> COMMISSIONER SMITH. >> YES. >> COMMISSIONER SHELL. >> YES. >> COMMISSIONER JONES. >> YES. >> COMMISSIONER SNOOIG YES. [Items 14 & 15] >> JUDGE BECERRA. >> YES AND THANK YOU SIR. >> THANK YOU. >> PLEASE OPEN NUMBER 14 AND 15. >> 14 DISCUSSION OF POSSIBLE ACTION IT AUTHORIZE THE EXECUTION OF SUPPLEMENTAL AGREEMENT NUMBER SEVEN TO THE PROFESSIONAL SERVICES AGREEMENT BETWEEN HAYS COUNTY AND HNTP CORPORATION FOR HAYS COUNTY INCREASING THE CAP FROM $1,000 TO $7,716,500 IT 7,715 -- $7,715,500 AND EXTENDING THE TERMINATION DATE OF THE CON CONTRACT. TO SEPTEMBER 30TH 20, 21. AUTHORIZE THE DISCRETIONARY EXEMPTION PURSUANT TO TEXAS LOCAL GOVERNMENT CODE SECTION 262.04. 15 DISCUSSION AND POSSIBLE ACTION TO AUTHORIZE THE EXECUTION OF SUPPLEMENTAL NUMBER [02:05:01] SEVEN TO A PROFESSIONAL SERVICES AGREEMENT TO BETWEEN HAYS COUNTY AND TB CORPORATION FOR 520,000 TO CONTINUE PROVIDING GENERALERING IN CONSULTANT PROGRAM MANAGEMENT SERVICES FOR THE HAYS COUNTY TXDOT PARTNERSHIP PROGRAM PROJECTS. AUTHORIZE A DISCRETIONARY PURSUANT TO TEXAS LOCAL GOVERNMENT CODE SECTION 226.024-A4. >> SO MOVED. >> SECOND. WE HAVE A MOTION AND A SECOND. COMMISSIONER JONES TWO OF THOSE HAS YOUR NAME AND ONE HAS COMMISSIONER INGALSBE NAME. WOULD YOU LIKE IT LEAD THIS. >> I'LL GO AHEAD AND START. JUDGE THIS OUR TWO CONTRACTS TO DO OUR BOND PROGRAM OVERSIGHTS ON BOND PROGRAM AND PARTNERSHIP PROGRAM WITH TXDOT. WHAT THIS WOULD DO IS EXTEND THE CONTRACT FOR ANOTHER SIX MONTHS. EXCUSE ME. DID I SAY SOMETHING WRONG? OK WE'RE GOOD. OK. SO ANOTHER SIX MONTHS STARTING IN JANUARY OR EARLY FEBRUARY WE'D LIKE TO PUT THIS CONTRACT OUT FORBIDS. I WANT TO DO THIS IN CASE THAT HTB COULD BE THE ONE WE GO TO OR MAYBE NOT BE SO IT GIVES US OVERLAP ON THE PROGRAM IT WOULD BE A GOOD TRANSITION. WE'D LIKE IT KEEP THIS LIKE I SAID FOR THE NEXT SIX MONTHS AND NOT DO ANY SWITCH AT THIS TIME. >> COMMISSIONER BRIG WE GO TO THE PODIUM. >> JUDGE I DON'T KNOW WE HAVE ANY COMMENTS QUITE YET. I'LL GO AHEAD AND LEAD. >> OK. IF YOU WILL PLEASE STATE YOUR NAME AND TITLE FOR THE RECORD. >> MIKE WEAVER WITH HNTB I THINK I MAY HAVE CONFUSED YOU I APOLOGIZE. THIS IS FOR THE PASS THROUGH PROGRAM PARTNERSHIPS THESE ARE ONE-YEAR RENEWALS THE BOND PROGRAM WHICH WILL PROBABLY BRING UP TO YOU UNTIL AFTER THE BECKS WILL BETH SIX MONTHS. >> I GOT YOU. >> I APOLOGIZE FOR THE CONFUSION. WE'RE TRYING TO GETS THREE OF THESE DONE AT ONE TIME. THESE ARE ONE-YEAR CONTRACTS PASS THROUGH AS WE FINISHED THE LAST PROJECT THE GOOD NEWS IS WE PAY THIS BACK AND PAID OFF AND SCOME AND TURNING OVER TO THE COUNTY AND WORK WITH THE AUDITOR'S OFFICE THE PARTNERSHIP PROJECT WRAPS YOU THE LAST THREE PROJECTS ALL OF WHICH ARE IN COMMISSIONER JONES 2001 AND A LITTLE BIT OF WORK ACTUALLY ON THE 150 AS WELL SO I APOLOGIZE AGAIN FOR THE CONFUSION. IS WANT TO MAKE SURE. >> GOOD. AND I SAW OUR AUDITOR TOUCHING THE MICROPHONE. MARISOL, DID YOU WANT TO ADD SOMETHING? >> OK. OK. I DO MY VERY BEST TO KEEP THE MOST FLUID AND RESPECTFUL ORDER IN THE MEETING, SO WHEN I HEAR AND SEE PEOPLE MOVING AROUND I THINK THEY WANT IT SAY SOMETHING. JUST SO YOU KNOW I DO MY VERY BEST TO GIVE EVERYBODY ALL THE TIME THEY NEED. >> APPRECIATE THAT, JUDGE. JUST WANT IT CLARIFY TO MAKE SURE THESE ARE ONE-YEAR CONTRACTS WHICH WILL BE BACK HOPEFULLY A WEEK OR TWO BEFORE THE ELECTION. >> THANK YOU MR. WEAVER AND THANK YOU FOR YOUR PATIENCE. GENERALLY APPRECIATE IT. >> ANY OTHER COMMENTS? >> JUDGE NO. WELL YES. I APPRECIATE THE CLARIFICATION BECAUSE I WAS WONDERING ABOUT ESPECIALLY ITEM NUMBER 14 NOT A CONCERN IT WAS THE AMOUNT WAS FOR $100,000. SO I'M GOOD, JUDGE. >> OK. THANK YOU PLEASE CALL THE ROLE FOR ITEMS 14 157ND. >> COMMISSIONER SHELL. >> YES. >> COMMISSIONER SMITH. >> YES. >> COMMISSIONER JONES. >> YES. >> COMMISSIONER SNOOIG YES. >> JUDGE BECERRA. >> YES. NOW I'M VERY CONSCIENTIOUS OF THE WHOLE COURTROOM SO I SEE OUR D.A. HERE AND I KNOW HE'S HERE FOR EXECUTIVE SESSION ITEM. IF WILL JUST CALL OUT WHATEVER ITEMS YOU'RE HERE FOR SO I CAN MAKE SURE WE GO IT THOSE FIRST. >> 21. [21. Discussion and possible action to execute a contract with the Community Supervision and Corrections Department (CSCD) related to the Hays County Pretrial Bond Program. SHELL/INGALSBE] >> 21. SO PLEASE OPEN AGENDA ITEM NUMBER 21. >> 21. DISCUSSION AND POSSIBLE ACTION TO EXECUTE A CONTRACT WITH THE COMMUNITY SUPERVISION AND CORRECTIONS DEPARTMENT RELATED TO THE HAYS COUNTY PRETRIAL BOND PROGRAM. >> SO MOVED. >> SECOND. >> WE HAVE A MOTION ANDED AND WE HAVE SOMEONE AT THE PODIUM IF YOU'LL PLEASE STATE YOUR NAME AND TITLE FOR THE RECORD. >> YES, SIR GOOD MORNING JUDGE AND COMMISSIONERS THANK YOU FOR HAVING US. I'M HERE. I'M LISA PACHECO WITH HAYS [02:10:02] COUNTY CORRECTION DEPARTMENT WHICH IS ALSO KNOWN AS DEPARTMENT OF PROBATION. I SERVE AS THE DEPUTY DIRECTOR AND I HAVE WITH ME CHIEF HARTMAN WHO IS THE DIRECTOR OF CALDWELL COLEMAN AND HAYS COUNTY CCSD. WE'RE HERE TO FORMALIZE AN AGREEMENT FOR A THIRD PRETRIAL BOND OFFICER THIS RECOMMENDATION WAS BROUGHT FORWARD THROUGH THE SUBCOMMITTEE VIA THE HAYS COUNTY SUBCOMMISSION. I WITH AS GOING TO PROVIDE SOME BACKGROUND WITH THE NUMBERS. I DON'T WANT TO BORE YOU. >> IT WOULD BE HARD IT BORE US. WE'RE USED TO IT. >> WE STARTED THIS AGREEMENT WE ALMOST BEEN FIVE YEARS. SO IN DECEMBER OF 2016 THE PRETRIAL BOND CASELOAD WAS 59 PRETRIAL DEFENDANTS AND A YEAR LATER DES OF 2017 IT INCREASED TO 61 IN DECEMBER OF 2018 IT INCREASED TO 175. SO FAR IN 2020 WE HAVE NUMBERS ARE FEBRUARY WHERE IT INCREASED TO 198. >> IS THAT FEBRUARY ONLY? >> WELL THROUGH FEBRUARY. >> OK JANUARY, FEBRUARY. >> YES. >> OK. >> THEN IN MARCH IT JUMPED UP TO 334. MIGHT HAVE BEEN COVID RELATED NOW IN SEPTEMBER OF 2020 WE'RE AT 320 SUPERVISED IN OUR DEPARTMENT. THAT WAS AN INCREASE OF 440% AND I THINK THAT'S WHAT LED TO THE RECOMMENDATION FROM THE SUBCOMMIT BASED ON THOSE NUMBERS YOU JUST PROVIDED WITH THE 40% INCREASE IN USE, WHAT CAN YOU SUMMARIZE IS HAPPENING FOR THE VIEWING PUBLIC WHICH YOU MAY HAVE NOT SAID. >> SEVERAL THINGS. WE HAVE MANY NEW POSITIONS WHERE EVERYONE IS WORKING VERY HARD TO REDUCE THE INMATE POPULATION AND I'M PROBABLY GOING TO FORGET SOME, BUT I KNOW THERE'S A NEW INDIGENT DEFENSE COORDINATOR. THERE'S A MAGISTRATE'S OFFICE. WE DID ADD A BOND OFFICER LAST YEAR, SO THAT WAS ANOTHER EDITION. -- ADDITION. I BELIEVE THAT THERE WERE SOME CHANGES MADE IN THE DISTRICT COURT LEVEL IN TERMS OF FUNDING FOR APPOINTED ATTORNEYS AND THINGS LIKE THAT. IT'S EVERYONE COMING TOGETHER IT MEET THE SAME GOALS. >> AND THAT'S BEAUTIFUL BECAUSE YOU'VE SUM ADVISED IT SO WELL. AND IN MARCH OF 19 WE HAD A LITTLE SUMMIT AND EVERYONE THAT TOUCHES OUR JUSTICE SYSTEM AS A WHOLE PARTICIPATED AND WE WERE LUCKY TO HAVE THE TEXAS INDIGENT DEFENSE COMMISSION AS ONE OF OUR SPEAKERS, INCLUDING KYLE CHIEF OF POLICE ETC. EVERYONE SHOWED THAT WILLINGNESS TO STEP UP IN A WAY THAT YOU'VE JUST DESCRIBED AND THESE ARE FRUITS OF THAT LABOR OF THOSE PASSIONATE PEOPLE SPACED IN THOSE COMMENTS IN THOSE UNIQUE OFFICES, AND AND I'M HUMBLED BECAUSE GUYS ARE HITTING BULL'S-EYE IS HOW I SEE IT. >> YES THAT'S RIGHT. >> ABSOLUTELY. THERE'S NO ONE COG THAT WILL MAKE THAT WHEEL TURN AND THAT IS THES COMPLEX THING AND THE MOST KALEIDOSCOPE TYPE WAY TO DESCRIBE IT IN MY OPINION IS TO SAY NO OFFICE IN EYE -- IS AN ISLAND AND THIS IS A MYRIAD OF ELECTED OFFICIALS WORKING TOGETHER FOR THE GREATER GOOD AND FOR THAT I AM ETERNALLY GRATEFUL. >> AND A LOT OF NONELECTED ORDERS. >> WELL OF COURSE. OF COURSE. OF COURSE. >> JUDGE, I JUST WANT TO THANK BOTH OF Y'ALL. I REALLY APPRECIATE ALL THE WORK THAT YOU HAVE DONE 6789 NOT ONLY ON THE SUBCOMMITTEE BUT THE WORK DO YOU DAILY. MR. HARTSMAN, THANK YOU SO MUCH AND LISA I REALLY APPRECIATE BOTH Y'ALL. AND WHEN I HEARD THOSE NUMBERS AT ONE OF THE SUBCOMMITTEE MEETINGS THAT I ATTENDED I WAS VERY SHOCKED AT HOW QUICKLY THOSE NUMBERS WENT UP, JUDGE SO. I THINK PROVIDING A BOND OFFICER WILL HELP US IDENTIFY ARE ELIGIBLE FOR BOND AND GET THAT SERVICE TO THEM. I THINK IS THIS IS ANOTHER GREAT OPPORTUNITY. I APPRECIATE THE COURT -- THE COURT'S SUPPORT DURING THE BUDGET PROCESS TO BUDGET THE FUNDS FOR THIS ADDITIONAL. >> THAT'S RIGHT. AND MISS PACHECO WHILE WE HAVE YOU I WANT TO BRING UP ANOTHER THING THAT'S BEEN BROUGHT UP TO THIS COURT. IS THE FOR LACK OF A BETTER PHRASE THERE MIGHT BE A MORE OFFICIAL NAME BUT ANKLE MONITORING EQUIPMENT. [02:15:06] CONCERNS HAVE BEEN BROUGHT UP TO THIS COURT RIGHT WHERE YOU STAND AND I WANT TO 1C HOW MAY OFFICE AND I SNEAK WE'VE ALL SHOWN IT AS COMMISSIONER INGALSBE HAS JUST SAID WE'VE ALL SHOWN IT ON THE AND OUR EFFORTS HOW CAN WE STEP THATS UP SO WE COULD HAVE A MORE ROBUST SYSTEM WHERE NO ONE FALLS THROUGH THE CRACKS ON THAT SPACE AND WEEP THINGS MOVING ALONG IN A WAY THAT'S MOST BENEFICIAL. >> THAT'S A BIG QUESTION JUDGE. >> THAT'S A GOOD QUESTION. FIRST YOU WOULD NEED AN ORDER WISHING THERE IS AN EXPENSE RIGHT NOW TO THE PARTICIPANT DEFENDANT WHATEVER YOU WANT IT CALL THEM. THAT 12C3E7BS SOMETIMES OUTWEIGHS THEIR ABILITY TO BE RELEASED OR SUCCESSFUL ON THE MONITOR. THEY CAN BE HELPFUL IN SUPERVISION ESPECIALLY WHEN THERE ARE VICTIMS INVOLVED THEY CAN BE KEPT SEPARATE FROM THE DEFENDANT HOWEVER THEY ARE ALSO IMPERFECT THAT IT IT TAKES SCISSORS TO TAKE THOSE OFF AND YOU NEED SOMEONE IMMEDIATELY AVAIL 24B8-7 TO FOLLOW UP ON THAT VIOLATION. RIGHT NOW THAT I KNOW OF THAT'S NOT AVAILABLE. >> MISS PACHECO, WILL YOU DO ME A FAVOR BECAUSE I'VE HAD SEVERAL MEET BUGS THIS VERY THING. I'LL SAY NUMEROUS MEETINGS ABOUT THIS VERY THING YOU ANDLY DESCRIBING AND DISCUSSING. SOME REALLY USEFUL ALTERNATIVES HAVE BEEN OFFERED AND I'D LIKE IT SEE IF YOU COULD REACH OUT TO ANITA AND MAKE AN APPOINTMENT BECAUSE I'D LOVE TO SHARE WITH YOU HOW WE'VE LEARN AND SEE HOW WE CAN INCORPORATE THE GREAT SUCCESS YOU'VE SHOWN SO FAR ON THESE FRONTS AND ADD JUST ANOTHER LITTLE MORSEL OF SUPPORT IT OUR JUSTICE SYSTEM. THANK YOU. SO MUCH. IF THERE'S NO OTHER COMMENTS? >> I'D JUST LIKE TO THANK LISA AND MIKE WE GOT AMAZING DEPARTMENTS AND THEY COVERED A LOT OF AREA. WE HAD THE ONE OFFICER GETING THIS PROGRAM STARTED FOR A FEW YEARS AND ONCE IT GOT GOING AND SAW HOW EVERYTHING WORKED WE'VE SEEN IT GROW AND THAT'S A LOT OF MANAGEMENT FOR THOSE THREE OFFICERS. I WANT TO POINT THAT OUT. THAT'S A LOT OF WORK MANAGING THAT NUMBER OF FOLKS. SO I JUST WANT TO LET YOU KNOW I APPRECIATE THAT AND TELL ALL THE OFFICERS WE APPRECIATE WHAT THEY ARE DOING AND IT'S MAKING A DIFFERENCE. WE SHALL PROUD OF THEM. >> SO WELL SAID. DR. CARDENAS PLEASE CALL THE ROLL. >> COMMISSIONER JONES. >> YES. >> COMMISSIONER INGALSBE. >> YES. >> COMMISSIONER SMITH. >> YES. >> COMMISSIONER SHELL. >> YES. >> JUDGE BECERRA. >> YES. THANK YOU. [12. Discussion and possible action to authorize the County Judge to execute a Professional Services Agreement between Hays County and Binkley & Barfield, Inc to perform Utility Coordination for the Windy Hill Road reconstruction project and amend the budget accordingly. JONES/BORCHERDING] SO 12. IF YOU'LL PLEASE OPEN AGENDA ITEM 12. >> 12, DISCUSSION OF POSSIBLE AUTHORIZE THE COUNTY JUDGE TO EXECUTE A PROFESSIONAL SERVICES AGREEMENT BETWEEN HAYS COUNTY AND HAYS COUNTY AND BINKLEY AND BARFIELD TOINK PERFORM UTILITY COORDINATION FOR WINDY HILL ROAD RECONSTRUCTION PROJECT AND AMEND THE SGHUGHT SECOND. >> SO MOVED. >> JUDGE, THIS WINDY PROJECT I DON'T KNOW IF THE REST OF THEM WILL REMEMBER IN 2016 IT DIDN'T MAKE OUR BOND PROGRAM. IT WAS LIKE $22 MILLION THAT TIME. WE HAVE BEEN OVER THE LAST THREE YEARS PIECING THIS TOGETHER INHOUSE. I THINK THE FIRST YEAR WE SPENT $700,000 ON ENGINEERING AND ABOUT A MILLION THE SECOND YEAR AND THIS WILL BE OUR THIRD YEAR ON THIS PROJECT. THIS IS UTILITY COORDINATION TO THIS PROJECT. >> CAN I DRIVE WINDY HILL AND. >> IT CONNECTS AND START UP 35 BETWEEN BUDA BOTH WHERE THE CITY LIMITS COMES TOGETHER AND CROSSES -- WHICH WE'RE IMPROVING HOPEFULLY STARTING THIS FALL AND MENTION A $20 MILLION PRO ZWRECT HILLSIDE TERRACE -- PROJECT. IT GOES TO 2001. WE HAD SEVERAL LARGE SUBDIVISIONS ALONG THIS ROAD. WE SHARED THE FIRST PART OF THIS ROAD THROUGH THE CITY OF KYLE ALSO. >> IT'S A VERY GOOD PROJECT AND AN AREA THAT NEEDS LOTS OF INVESTMENT AND I AM GRATEFUL THAT YOU PUT THIS FORTH THIS WAY. THANK YOU. ANY OTHER COMMENTS OR QUESTIONS? >> -- SAME PROJECT? [02:20:05] >> I'M FINE. WE CAN. >> PLEASE CALL THE ROLL. >> COMMISSIONER INGALSBE? >> YES. >> COMMISSION JONES. >> YES. >> COMMISSIONER SHELL. >> YES. >> COMMISSIONER SMITH. >> YES. >> JUDGE BECERRA. [13. Discussion and possible action to authorize the County Judge to execute a Professional Services Agreement between Hays County and Cobb Fendley, Inc to perform ROW Acquisition Services for the Windy Hill Road reconstruction project; authorize a discretionary exemption pursuant to Texas Local Government Code 262.024(a)(4). JONES/BORCHERDING] >> YES. >> PLEASE OPEN NUMBER 13. >> 13. >> DISCUSSION OF POSSIBLE ACTION TO AUTHORIZE THE COUNTY JUDGE TO EXECUTE A PROFESSIONAL SERVICES AGREEMENT BETWEEN HAYS COUNTY AND COBB FENDLEY INK TO PERFORM ROW ACQUISITION SERVICES FOR THE WINDY HILL ROAD CONSTRUCTION PROJECT AUTHORIZE A DISCRETIONARY EXEMPTION PURSUANT TO TEXAS LOCAL GOVERNMENT CODE 262.0224. >> SO MOVED. >> SNEAKED MOTION AND A SECOND. THERE'S A SNINTION WE ALSO DON'T WANT TO STAY THE SAME FOOTPRINT BECAUSE WE TALKED ABOUT THE GROWTH IN THERE THIS. NOT ONLY NEEDS TO BE A TOTAL RECONSTRUCT BUT ALSO IMPROVEMENTS AND CAPACITY IMPROVEMENTS ALONG THIS ROAD ALSO. THAT'S WHY WE'RE GOING TO HAVE TO DO SOME RIGHT OF WAY ACQUISITIONS. >> THANK YOU PLEASE CALL THE ROLL. >> THANK YOU COMMISSIONER SHELL FOOSER SMITH. >> YES. >> COMMISSIONER SNOOIG YES. >> COMMISSIONER JONES. >> YES. [EXECUTIVE SESSIONS] >> JUDGE BECERRA. >> YES. WHAT I'D LIKE IT DO IS OPEN THE EXECUTIVE SESSION ITEMS BECAUSE I WOULD LIKE TO ALLOW OUR DISTRICT ATTORNEY TO GO BACK TO WORK AND I FEEL BAD HE'S HERE THIS LONG. OPEN AGENDA ITEMS NUMBER 24 AND -- OK. IF YOU'LL M NUMBER 24 AND WE DON'T NEED TO OPEN NUMBER 25. IF YOU'RE NOT DIRECTLY TIED TO AGENDA ITEM NUMBER 24 I'LL ASK YOU LEAVE THE COURTROOM. >> 24 EXECUTIVE SESSION PURSUANT TO SESSIONS 551.071 AND 551.074 OF THE TEXAS GOVERNMENT CODE. CONSULT SITUATION COUNSEL AND DELIBERATION REGARDING ALL INDIVIDUAL POSITIONS IN THE INVESTIGATIONS DIVISION OF THE HAYS COUNTY CRIMINAL DISTRICT ATTORNEY'S OFFICE. POSSIBLE DISCUSSION AND/OR ACTION MAY FOLLOW IN OPEN COURT THE. >> AND WE ARE GOING TO GO INTO EXECUTIVE SESSION ABOUT HOW MUCH TIME DO YOU GUESS WE'LL TAKE MR. KENNEDY? BALLPARK? >> I CAN PROBABLY EXPLAIN WHAT OWE KNOW ABOUT TEN MINUTES. >> SO IN ABOUT 15 MINUTES WE SHALL RETURN IF EXECUTIVE SESSION. [27. Discussion related to the Hays County inmate population, to include current population counts and costs. BECERRA] >> AND WE ARE BACK FROM EXECUTIVE SESSION. PLEASE OPEN AGENDA ITEM NUMBER 27. >> DISCUSSION RELATED TO THE HAYS COUNTY INMATE POPULATION TO INCLUDE CURRENT POPULATION COUNTS AND COVTS. >> THE SHERIFF'S OFFICE WEEKLY SENDS ME A JAIL REPORT AND I WILL READ THAT NOW. OUR MAXIMUM JAIL CAPACITY IS 362 INMATES. JAIL STANDARDS RECOMMENDED HOLDING APPROXIMATELY 10% OF CAPACITY OPEN, WHICH LOWERS OUR CAPACITY TO 311. THE JAIL'S DAILY AVERAGE WAS 424. AND PEAK WAS 425 ON OCTOBER 25TH FOR THE WEEK OF OCTOBER 11 THROUGH 17, 2020. THE ESTIMATED COST FOR OUTSOURCING INMATES THIS WEEK IS $50,475. THE AVERAGE NUMBER OF OUTSOURCED MALES IS 11 AND FEMALES ARE ZERO. I CAN'T WAIT UNTIL THEY ARE BOTH ZERO. THIS WEEK INMATES WERE HOUSED IN THE FOLLOWING COUNTIES. BLANCO, BURNETT, FORT BEND, AND [17. Discussion and possible action to approve an Advance Funding Agreement for Voluntary Local Government Contributions to Transportation Improvement Projects (SH 21 at FM 1966) with No Required Match On-System and authorize the County Judge to execute the Advance Funding Agreement on behalf of Hays County. INGALSBE/BORCHERDING] GUADELUPE. WILL YOU PLEASE OPEN AGENDA ITEM 17. >> 17 DISCUSSION OF POSSIBLE ACTION TO APPROVE ADVANCED FUNDING GROO EMENT FOR VOLUNTARY LOCAL GOVERNMENT CONTRIBUTIONS TO TRANSPORTATION IMPROVEMENT PROJECTS SH 21 AT FM 1966 WITH NO REQUIRED MATCH ON-SYSTEM AND AUTHORIZE THE COUNTY JUDGE TO EXECUTE THE ADVANCE FUNDING AGREEMENT ON BEHALF OF HAYS COUNTY. >> SO MOVED. >> SECOND. >> WE HAVE A MOTION AND A SECOND COMMISSIONER INGALSBE? >> JUDGE, THANK YOU. OF COURSE, THIS IS A PROJECT THAT WE HAVE BEEN WORKING ON FOR SOMETIME NOW, AND WITH THIS ADVANCED FUNDING AGREEMENT WE WILL ACTUALLY REDUCE OUR COSTS. THE ESTIMATE -- ESTIMATED COST FOR CONSTRUCTION IS $500,000, WHICH WE PROGRAMED. THIS WILL NOW COST US 20,000. WHATEVER THAT AMOUNT WAS OR IS ON THE AGENDA ITEM. SO I APPRECIATE TXDOT WORKING WITH US AND AGAIN, JUDGE, IT WILL REDUCE OUR COST BY OVER $300,000. WELL OVER $300,000. >> THAT SOUNDS BEAUTIFUL. PLEASE CALL THE ROLL. >> COMMISSIONER SMITH. >> YES. >> COMMISSIONER SHELL. >> YES. >> COMMISSIONER JONES. >> YES. >> COMMISSIONER INGALSBE. >> YES. [18. Discussion and possible action to award contract for IFB 2020-B15 RM 150 Center Turn Lane Gap Project to Cox Commercial Construction. INGALSBE/BORCHERDING] >> JUDGE BECERRA. >> YES. PLEASE OPEN NUMBER 18. [02:25:01] >> 18, DISCUSSION OF POSSIBLE ACTION TO AWARD CONTRACTS FOR IFB-2020-B15 RM 150 CENTER TURN LANE GAP PROJECT TO COX COMMERCIAL CONSTRUCTION. >> SO MOVED. >> SECOND. >> WE HAVE A MOTION AND A SECOND. COMMISSIONER INGALSBE. >> THANK YOU. JUDGE, AND THE SUMMARY OF THE AGENDA ITEM THERE WERE BEFORE THE FOUR COMPANIES THAT SUBMITTED COVRM CONSTRUCTION CAME IN AS THE LOWEST BID -- COX -- EVEN THOUGH THEY CAME IN HIGHER THAN ANTICIPATED. THAT PROJECT FAIRLY SMALL, AND SO THEY FELT THAT THE REASON FOR THE COST BEING A LITTLE HIGHER THAN WE ANTICIPATED IS BECAUSE OF THAT, SO WE HAD A MISSION TO MOVE FORWARD WITH THE COMMERCIAL CONSTRUCTION FOR THE GAP PROJECT AT THE CENTER LANE IS THE 150. PLOO. >> REPORTER: PLEASE CALL THE ROLL? COMMISSIONER JONES. >> YES. >> COMMISSIONER SHELL. >> YES. >> COMMISSIONER INGALSBE. >> YES. >> COMMISSIONER SMITH. [20. Discussion and possible action to authorize Beckwith Electronic Systems, LLC to replace the 3-Series Control System for Government Center courtroom #1 and allow a discretionary exemption pursuant to Texas Local Government Code 262.024A (7)(D) and amend the budget accordingly. INGALSBE/T.CRUMLEY] >> JUDGE BECERRA. >> YES. PLEASE OPEN NUMBER 20. >> 20, DISCUSSION AND POSSIBLE ACTION TO AUTHORIZE ELECTRONICS SYSTEMS LLC TO REPLACE THE THREE SERIES TEXAS LOCAL GOVERNMENT CODE COURTROOM NUMBERED ALLOW A DISCRETIONARY PURSUANT TO TEXAS LOCAL GOVERNMENT CODE 2.2614-A 7 D AND AMEND THE BUDGET ACCORDINGLY. >> SO MOVED. >> SECOND. >> WE HAVE A MOTION AND A SECOND. >> COMMISSIONER? BATTER UP. >> AND I GUESS TAMMY WORKS YOU LIKE TO TAKE THIS ITEM? >> TAMMY CRUMLEY COUNTY WIDE OPERATIONS. THIS PIECE OF EQUIPMENT CONTROLS THE MICROPHONES AND TABLETS OF THE COURTROOM AND IT'S BEEN DOWN SEVERAL MONTHS SINCE JULY HASN'T BEEN NEEDED OBVIOUSLY THAT WE NEED TO GET THAT UP AND RUNNING. SEVERAL PEOPLE USE THAT COURTROOM OBVIOUSLY. QUESTIONS. >> ANY QUESTIONS FOR MISS CRUMLEY? THANK YOU, MISS CRUMLEY, AS ALWAYS. PLEASE CALL THE ROLL. >> COMMISSIONER SHELL? >> YES. >> COMMISSIONER JONES. >> YES. >> COMMISSIONER SMITH. >> YES. >> COMMISSIONER INGALSBE. >> YES. >> JUDGE BECERRA. [22. Discussion and possible action to execute an Interlocal Purchasing Agreement between Hays County and the City of San Marcos related to Cooperative Purchasing as authorized per Texas Local Government Code Subchapter F, Ch. 271. INGALSBE] >> YES. ONE MORE FOR COMMISSIONER INGALSBE. PLEASE OPEN NUMBER 22. >> 22 DISCUSSION OF POSSIBLE ACTION TO EXECUTE AN INTERLOCAL PURCHASING AGREEMENT BETWEEN HAYS COUNTY AND THE CITY OF SAN MARCOS RELATED TO COOPERATIVE PURCHASING AS AUTHORIZED PER TEXAS LOCAL GOVERNMENT CODE SUBCHAPTER F CHAPTER 271. >> SO MOVED. >> SECOND. >> WE HAVE A MOTION AND A SECOND COMMISSIONER SNOOIG WHAT KIND OF PURCHASING IS THIS THAT WE'RE REFERRING TO? >> -- COMMISSIONER INGALSBE. >> WELL MR. KENNEDY WILL BE COMNG UP. >> MR. KENNEDY IF YOU'LL PLEASE APPROACH THE PODIUM AND STATE THE NAME FOR THE RECORD. >> I KNOW WE WILL REALIZE SAVINGS BY PARTNERING WITH THE CITY SUN MARCOS. >> THIS CAME OVER FROM STEPHANIE AND AND I BELIEVE THE ORIGINAL INQUIRE OF THE CITY OF SAN MARCOS. THIS WILL GIVE THE CITY AND COUNTY THE ABILITY TO USE EACH OTHER'S PROCUREMENT ACTIVITIES. SCON TRACTS ESSENTIALLY CREATE A VERY LOCALIZED COOPERATIVE PROGRAM SIMILAR TO THE COOPERATIVE PROGRAM THAT WE HAVE STATEWIDE. >> MR. KENNEDY, WHAT TYPE OF PURCHASES WOULD YOU GENERALLY SAY ARE IN THIS SPACE? >> MY FEES PRIMARILY IF WE WERE DOING AN RFQ OR THE LIKE WE WOULD PROBABLY PUT OUT OUR OWN BECAUSE WE WANT TO RELY ON OUR OWN ASSESSMENT QUALIFICATIONS. POSSIBLY A MIXED BAG WITH RFP. >> OK THE ANYTHING ELSE? THANK YOU MR. KENNEDY. PLEASE CALL THE ROLL. >> COMMISSIONER INGALSBE? >> YES. >> COMMISSIONER JONES. >> YES. >> COMMISSIONER ZBRONZ HAD A YES. >> COMMISSIONER SHELL. >> YES. >> COMMISSIONER SMITH. >> YES. >> JUDGE BECERRA. >> YES AND IF THERE'S NOTHING ELSE I WILL ATTEND A MOTION TO ADJOURNED. >> SO MOVED. HAVE A WONDERFUL DAY. * This transcript was compiled from uncorrected Closed Captioning.