Tuesday, March 20, 2018

City Stumbles Over Increasing Nursing Fees

Staff stated the clear need for the city to recover the full cost of lab testing in proposing increased fees to City Council.  Finance Director Tina Diershke implied federal grant funds could not be used to subsidize lab testing for patients needing affordable access to healthcare with her statement.

“1115 Waiver grant is for costs associated with operating and maintaining the clinic”
City Council heard in its application for Section 1115 Waiver grant funding in December 2012:

Council must have been confused after learning the City did not need to charge every patient a price to cover city costs.  Health Department Director Sandra Villareal said the city needed to offer free testing to meet goals under the Section 1115 Waiver grant.

Tina and Sandra gave two very different descriptions of how the new testing fee would work.  It took Council time to discern who was correct.  Staff's explanation of testing charges went as poorly as the city's need to charge/not charge presentation.

There was no crisis for City Council to approve new nursing fees which likely will result in a miniscule incremental revenue for the city.  City Council could have sent staff back to rework the item.  Instead they voted unanimously to approve new testing fees for an area accounting documents show had nearly $700,000 in excess revenue over expenses for the last five years.

There appears to be a low bar for staff to hurdle for Council approval for price increases in an area where the state and federal government provide grants for citizens to obtain affordable access to care.

Monday, March 19, 2018

City Wants to Increase Nursing Fees

City Council will consider establishing fees for certain nursing services in their 3-20-18 meeting.  City staff omitted the Health Department is/has been the recipient of state and federal grant funds intended to help members of the public get access to affordable healthcare services.  In some cases the city has to match state and federal funding with local dollars.  The resolution for Nursing Services omits this major funding subsidy. 

Proposed language in the resolution would have City Council ignore this major consideration.

WHEREAS, the City Council has reviewed staff’s accounting of Health Services
Department, Nursing Division, patient related services costs and revenues
, and desires to establish fees for patient services that reasonably reflect the cost to the City of providing the services

The Health Services department is in a substantial five year surplus as of the end of FY 2016-17.  The City's Bluebook shows a five year surplus for Nursing of $195,924 and $492,531 for the Section 1115 Waiver grant which funded the re-opening of the city's Sexually Transmitted Disease clinic. Combined the two areas had excess revenues over expenses of $688,455 over the five year period ending 9-30-17. 

Staff failed to reference the major funding for Nursing Division is public grant money, thus they left out an important consideration City Council needs to make appropriate fee decisions. 

Also, the city is up over $800,000 year to date on Sales Tax Revenue.  For these reasons it seems prudent for Council to deliberate with excess grant funding as a major part of the public discussion.

Update 3-20-18:  City Staff did not bring up the five years in a row of excess revenue for both Nursing and the Section 1115 Waiver grant and City Council remained mum on this fact despite my writing every member in the limited window after agenda/background packet publication.  Council approved the proposed fee structure despite a disjointed and contradictory presentation by staff. 

Sunday, March 11, 2018

Update on Rejuvenating City Roads via Benedetti Equipment

In December 2016 San Angelo's City Council approved a $1.2 million Benedetti Phoenix machine to resurface city roads in ill repair.   That same month the city released a video on the new equipment.

This equipment allows for the City to rehabilitate entire roadways that are in disrepair or in poor condition. The equipment is part of a comprehensive restructuring of the street repair process as a result of Council's street priority.
In June 2017 the city solicited bids for 50,000 gallons of oil for street repairs.  That bid document stated:

The Street & Bridge Division of the City of San Angelo is requesting bids for the procurement of oil for street repairs. This oil will be used as the rejuvenating oil for the City’s Benedetti Phoenix and for the Bagela rejuvenating system, for rejuvenating the hot asphalt for the pot holes and water cuts.
Rejuvenating entire roadways is different than filling pot holes and doing road repair after water cuts.  One manufacturer cited the history of asphalt rejuvenation:

Early tests showed that crews that had been completing 1-2 patches per day with traditional repair methods were instantly doing 8-9 patches per day with what would later prove to be even greater durability. It wasn't long before full roads of up to a half-mile or more were being completed per day.
Prior to buying the Benedetti machine San Angelo had asphalt milling equipment.  It loaned its asphalt zipper to the City of Fredericksburg via a May 2016 Inter-local Agreement.  This loan saved Fredericksburg $100,000 on a $300,000 project based on 60 hours use.  San Angelo's asphalt zipper had a mere 8 hours on it when Fredericksburg  borrowed the equipment.

Fredericksburg went on to lease an asphalt zipper.  A Public Works official estimates significant savings, citing the unit has already paid for itself.  The official said Fredericksburg prides itself in having zero potholes.

San Angelo citizens suffer from widespread deteriorated roads.  One City Councilman asked for an update on the Benedetti machine and the use of road crews to optimize the city's $1.2 million investment.  Operations Director Shane Kelton is on deck to report, unless Public Works Executive Director Ricky Dickson reappears to speak before council.

It's been sometime since Dickson updated City Council on any Public Works projects.  The Benedetti machine and road crew staffing/training would be a good topic for San Angelo's top Public Works official. Council has five possible people to hear from on this issue.  Maybe all will show up to illuminate San Angelo's City Council.

Update 3-18-18:  City Council minutes from 3-6-18 state "Council Member Tom Thompson asked for a presentation and update on the Benedetti Asphalt Recycling machine."  It's not on the agenda for 3-20-18

Saturday, March 03, 2018

City Council to Hear about Intergraph/Hexagon?

City Council will entertain spending $150,405 on a maintenance contract for its police and fire emergency dispatch system.  The city council background for 3-6-18 states:

The City of San Angelo is in the process of migrating our CAD/RMS system back to our previous provider. The maintenance cost cover support and installation for the preparation of these servers prior to and after they go live.

On March 21, 2017 City Council approved spending nearly $2.4 million to replace the Spillman dispatch system by upgrading its ancient Intergraph system.  Hexagon bought Intergraph in 2010.  

The quickest, most reasonable path to a working system is to begin working with our previous vendor, Hexagon/Intergraph, to re-establish the functionality of our previous system.
Might City Council get a staff update on the Intergraph upgrade?  Not likely. 

The item is on the Consent Agenda.  A City Council member would have to pull the item for discussion.

Staff should want the public to hear how they addressed a system that placed people in jeopardy, the clear message a year ago.  Is the fix in and working? If not, when will the city get value for spending over $2 million on a system it ignored for decades?

Update 3-6-18:  No member of City Council pulled this item for public explanation.  It passed quietly in the consent agenda.

Sunday, February 18, 2018

Money Used to Hire PAWS Needed to Hire PAWS Again

Former Shelter Director James Flores sold contracting shelter adoptions to Concho Valley PAWS for $60,000 per year.  A year ago Flores justified the expenditure:

“Majority is coming from chemical medical …We no longer have a veterinarian. We no longer perform surgeries. Majority of money is coming from that line, chemical-medical.” 
Council members Lane Carter, Lucy Gonzales and Harry Thomas heard the above rationale given by staff January 17, 2017.

Unfortunately more changed than Flores represented.  Changes resulted in numerous shelter pets going without rabies vaccinations and spay/neuter surgery when adopters missed veterinary appointments.

City Council will hear a proposal for the city to pay PAWS $50 per pet for veterinary services.  The memo from Shelter Director Morgan Chegwidden indicated veterinary services would be for adopted pets.

It does not say if the fee applies to all adoptions or just unaltered pets.  If the $50 fee is only for unaltered pets the projected amount paid to PAWS is nearly $66,000.  If it applies to all adoptions PAWS would get roughly $88,000.  The difference amounts to $22,000.  Why would the city pay PAWS $50 if the pet only needs a rabies shot?  (Projections are based on 2017 Animal Shelter statistics)

Morgan's memo is silent on which organization pays for anesthesia, medical instruments, medical supplies, sterilization of equipment and post surgery pain medicine/antibiotics and IV fluids.  If these are the city's responsibility then chemical-medical costs return..

It is ironic the cost savings used to hire PAWS will return as expenditures under a different PAWS arrangement.

City staff needs to be clear regarding details of the proposed arrangement.  The memo is not a contract and the background packet does not contain contract language for City Council to review and approve.  The memo to Council lacks important details regarding the arrangement.

It is missing historical and projected expenditures for restoring in-shelter spay/neuter services, as well as historical and projected volumes.  This is odd given Morgan's background as Budget Manager for the City of San Angelo.

On 12-19-17 the city stated in response to a public information request:

100% of dogs adopted have had their rabies vaccination.
This statement came under question after area veterinarians cited a high rate of missed appointments for shelter pets.  Those appointments included vaccinations and spay/neuter surgery.

In December friends found two unaltered dogs whose microchips cited the City Animal Shelter.  One dog was no longer with their adopter.  He'd given the dog away, making followup problematic if not impossible for city staff.  No spay/neuter meant no rabies vaccination for these two dogs.  Area rescues received other unaltered, unvaccinated shelter pets in the last few months.

City ordinance states (per the 2-20-18 background packet):

All animals adopted from the animal shelter shall be spayed or neutered and microchipped prior to release.  No animal shall be eligible for adoption unless spayed or neutered and microchipped.
As I sought to confirm the city's assertion of 100% rabies vaccinations I learned staff had not held PAWS accountable.  The city does not have in its possession information on rabies vaccination compliance (Texas law) or spay/neuter compliance (local ordinance).  Nor has the city compelled contractor PAWS to produce such documents.

Animal Services has provided an update that this (rabies certificate) is not a document of the city – an external vendor provides these services.
The City has been unable to produce documentation supporting Morgan's statement to City Council on 1-23-18 regarding a "trusted reconciliation process that ensures all shelter pets are spayed/neutered."  The city said the reconciliation is "done digitally" and therefore "no documents exist."

Morgan's memo for the upcoming Council meeting shows the changes became standard practice for the city:

We currently contract with PAWS to provide adoption services which includes coordinating off-site rabies vaccinations, spaying and neutering of adoptable animals.
This is not what the city required in its initial RFP for Adoption Services.  It specified rabies vaccinations be given before the pet leaves the shelter.   Had the rabies shot been given in the shelter the certificate should be in the city's hands, not the contractor's.

The bottom line:  Morgan's memo confirms changes which result in no rabies vaccination when a spay/neuter appointment is missed.  The unresolved question remains how many shelter adoptions remain unaltered and unvaccinated?

I find it interesting the PAWS veterinary contract came before council so quickly after the issue of unvaccinated and unaltered pets came to the fore.  Damage control involves denying problems while working a rapid fix.  It feels like a rush to patch/repair in the midst of an obfuscation campaign intended to diminish legitimate compliance concerns.

Saturday, February 17, 2018

City Wants Television Studio in City Hall

The City of San Angelo issued an RFP for a new television studio.

Provider agrees to provide Services for the development of a television studio in the City Hall Annex, 301 W. Beauregard Ave., San Angelo, Texas. That includes a comprehensive and integrated system of audio-visual technology that enhances video productions broadcast on the City’s government access television channel and posted on the Internet; and to provide maintenance services for the A/V system for a period of five years.
A former City Council approved a new audio visual system from Rushworks in May 2015 at a cost not to exceed $325,000.  The Rushworks' system was installed in November 2015.

A portable system that includes four cameras, switching equipment and a wireless audio system will allow the recording of meetings in other locales, such as last year’s strategic planning session at Fort Concho. 
That rational did not apply to the Development Corporation's recent strategic planning meeting. No one in City Hall would accept responsibility for not recording this meeting in another locale.

Not long ago City Council added to this system by approving a new camera and audio equipment for SAPAC and the City Auditorium.  Media Rushworks got the nod to add to the current system.  The 1-9-18 memo from PIO Anthony Wilson stated:

The total cost of the video recording and streaming system in the Murphey Performance Hall in City Auditorium is $63,633. 
The new RFP due 2-6-18 requires:

1. The vendor will design a comprehensive and integrated audio/visual studio set-up in Suite 202A in the City Hall Annex. The City will use some of its existing inventory of cameras.
2. The system must include the following: remote camera controllers, switching equipment, easily manipulated on-screen graphics (such as titles), studio lighting that enhances broadcast quality, high-quality audio (including a mixing board), touch-screen technology, high-def screens and monitors, a connection to the computer server for the City’s Public Education and Governmental Channel (PEG) channel, and a sound booth for recording voiceovers.
3. The system must produce video files that will be compatible with the Public Information Office’s television channel server. Specifications for the server will be obtained at the mandatory site visit.
4. The system must provide for real-time live streaming from the studio on the City’s website and social media, and on its TV channel.
5. The vendor shall provide a five-year warranty and a maintenance agreement.
6. The proposal must be turnkey in nature, from the design to the equipping to the installation to the training and maintenance.
7. The installation must not interfere with the work of the Public Information staff in two adjoining offices. 

The project is expected to cost from $200,000-$300,000 and take 90 days to complete.

City Council will have spent $550,000 to $650,000 in three years on video recording equipment.  Style does have a price.

Update 3-3-18:  City Council will hear a proposal to spend $294,000 on its new TV studio.

Update 3-6-18:  City Council passed the item unanimously.

Monday, February 12, 2018

Proclaim Public Compliance Data on Spay/Neuter

City Council proclaimed February Spay/Neuter Awareness Month in its February 6th meeting.  Elements of the proclamation included:

Despite the declaration San Angelo's Animal Shelter changed processes which harmed the compliance rate for spaying/neutering shelter pets.  Shelter data from 4-1-17 to 11-30-17 revealed 688 dogs were unaltered and needed spay/neuter surgery by area veterinarians.  Two veterinarians cited numerous missed appointments for City adoptions, such that 100 pets missed their initial spay/neuter surgery and rabies vaccination.

Mayor Brenda Gunther asked for statistics on missed spay-neuter appointments and received a number of answers.  Shelter Director Morgan Chegwidden started off with "rare", said she might need to defer to PAWS, upped it to "occasional" and then referenced a trusted process with reconciliation on who needs to be fixed and who does not.  The Mayor did not get any statistics in response to her question.

The City does not have information to share from the trusted reconciliation process Chegwidden cited before City Council.  When asked to produce such information the city replied:

In accordance with the Public Information Act of the State of Texas, Animal Services has response that they do not have a record of the requested information.  The reconciliation process does not create a document.
Eight months of Animal Shelter 2017 data showed 75% of 988 dogs adopted left the facility unaltered.  Direct information from area Veterinarians and their staff produced the 100 dogs with missed appointments number.  That doesn't sound like a reconciliation process that one can do in their head. 

The question is what happened to those 100 dogs?  Did they go on to get another appointment, one the pet owner honored?  Did they die as implied by Morgan before City Council?  Did they not get spayed/neutered and are contributing to the animal overpopulation problem plaguing our city?

These questions remain unanswered despite efforts to obtain data/information from city staff.  I expect the city to ensure shelter compliance with State Law (Rabies) and City Ordinance (Spay/neuter) as part of any contract.  When asked for copies of rabies certificates for dogs adopted between 4-1-17 and 11-30-17 the city replied:

Animal Services has provided an update that this (rabies certificate) is not a document of the city – an external vendor provides these services.
This answer is odd given the RFP required pets get their rabies shot in the Shelter prior to adoption.  That would imply the shot record is the city's, especially as the agreement is silent on the matter of records, who keeps what and how those are maintained.

It's a poor answer for citizens expecting open and accountable government   Surely the City of San Angelo wishes to assure the community that all pets adopted from the shelter had their rabies vaccination, especially after the rabid skunk incident in PaulAnn.

It's disappointing the City is being so opaque on such a basic performance standard, Animal Shelter compliance with the law.

Update 2-16-18:  City Council will review Animal Control ordinances on 2-20-18.  Information in their background packet shows the following ordinance:  "All animals adopted from the animal shelter shall be spayed or neutered and microchipped prior to release."  Council failed to put to bed the issue of unvaccinated and unaltered pets leaving the City Animal Shelter in 2017.  Shelter Director Morgan Chegwidden defended the practice in the 1-23-18 City Council meeting.