Sunday, October 27, 2013

ASU to Improve College Experience with Donated Turf


An editorial by The Standard Times celebrated the installation of a $1.2 million turf and called the planned home game at the campus facility a worthwhile experiment.  In April the paper reported the San Angelo Health Foundation's contribution to the venture:

Angelo State University, $100,000 to install field turf on a practice field
Other donors included 1st Community Federal Credit Union, graduate Larry C. Clark and an anonymous contributor.  Apparently, these donors kicked in the other $1.1 million.  Several 1st Community board members have ASU ties.  Harlan Bruha once headed ASU's Small Business Development Center.  Former Mayor and ASU Assistant Professor Johnny Fender also sits on the 1st Community Board of Directors.

The field will be named after 1st Community Credit Union, while the LeGrande Sports Complex bears the name of another wealthy donor, neurosurgeon Dr. Bob LeGrande.  The editorial went on to highlight:

Big news to come out of the event was that ASU plans to start playing some of its football games at the stadium beginning next season. At least one game — on Sept. 13, against Western State of Colorado — will be played there.
The report stated new bleachers would need to be added, but did not identify the cost or who might foot the bill. 

ASU officials see value in playing football games on campus. Their goal is to boost enrollment to 10,000 in part by enhancing the college experience, and an element of that can be having football games — the biggest and most exciting communal events — on school grounds.

The editorial was silent on concessions, restrooms, sky boxes and other essential services associated with big time Texas football and wealthy alumni.

The San Angelo Health Foundation was formed in 1995 when Angelo Community Hospital, a nonprofit community hospital, sold out to Rick Scott"s Columbia/HCA .  It's current Board Chairman, Dr. Robert Patyrak spoke about the foundation's mission in 2011.

The intent of the Foundation is to remain in operation in perpetuity and to support community health in its broadest form. For over 15 years the San Angelo Health Foundation has served San Angelo and our Concho Valley neighbors by supporting the efforts of local nonprofit organizations and public entities.
Given the foundation's strong support of community health related projects since 1995, I'm surprised the City of San Angelo did not approach the Health Foundation when it "needed" to eliminate its sexually transmitted disease clinic and drastically cut immunizations for children and seniors.  Dr. Patyrak, as a pediatrician, would've appreciated the need to keep up children's immunizations. 

The City cut $138,000 from the health department budget in September 2012.  Ironically, San Angelo Mayor Alvin New, an Angelo State University alumnus and wealthy donor, drove the clinic's closing.  That action contributed to a more severe than normal flu season and a 300% increase in syphilis for our community. 

San Angelo will face more community health issues as the health care landscape is remade. Which experiments will contribute to the health of our community and which ones will degrade it?  

Saturday, October 26, 2013

Closed STD Clinic & 300% Increase in Syphilis



The City of San Angelo closed its Immunization and Sexually Transmitted Disease Clinic September 28, 2012.  San Angelo Live reported:

Since January of this year, San Angelo has seen a spike in sexually transmitted diseases, up 300 percent from 2012.

Mayor Alvin New and City Council prioritized a tax cut over children's health and controlling the spread of STD's.  Immunizations and STD testing and treatment at the most basic of public health services.  State data on our area's incidence of sexually transmitted diseases showed Tom Green County in the Top 25 for incidence of Chlamydia.

 
None of the three people in charge, Interim City Manager Michael Dane, Assistant City Manager Rick Weise or Health Director Sandra Villareal, shared any data with Council on consequences of shutting down the clinic.

Early identification and treatment helps stop the spread of sexually transmitted diseases.  Without this critical service, disease spread can become exponential. 

Oscar Hernandez, HIV/STD Manager for the DSHS in our region emphasized the severity of the outbreak in Tom Green County.

“For Syphilis itself, we have 26 cases of Syphilis from January till this date [Oct. 15],” Hernandez said. “If you do a comparison on what we got in 2012, we got 8 cases. For this year, we’re already well into the 20-something mark. So, is that a significant increase? Yes, drastically. We got about a 300 percent increase.”

Given this Syphilis spike and 2012 statewide infection rates, Tom Green could be in the Top 25 for both Chlamydia and Syphilis in 2013. 

City Council took a meat cleaver to immunizations in last year's budget, with palpable consequences.  Last fall/winter's flu season was more severe in the Concho Valley, in part due to the City's reducing flu shots.  This season's flu shots will be down 80% from historical levels.

The City of San Angelo cut both services to save money.  Oddly, this same council used a similar amount of funds for three purposes.  It gave a new employee holiday, hired a downtown master developer and gifted a half cent property tax cut.  Mayor Alvin New and City Council clearly stated their priorities and it wasn't public health.

The City reopened the STD clinic in August 2013, thanks to grant funding from the state of Texas and the federal government.  It tests and treats STD's three days per week.  The clinic has eleven months of STD's to catch up on. 

MedHab Keynote for ASU E-Day


Medhab CEO Johnny Ross will be the keynote speaker at Angelo State University's eDay conference.  The event will provide information for student entrepreneurs on starting a business. 

I'll venture students get a more complete picture of MedHab's status and business plans than San Angelo's City Council, which approved a $3.6 million economic development package under Mayor Alvin New.  At the time Mayor New owned a stake in MedHab and served on the Board of Directors. 

The machinations around MedHab's economic development award and subsequent actions are worthy of a business case. Should anyone care to mine these subjects, this blog has many posts on MedHab and CEO Johnny Ross. 

The good news is City Council returned to ethics standards that prohibit a sitting elected official with a substantial business stake in a venture from receiving economic development funds, either directly or indirectly.  Such ventures would be eligible for public funds six months after the elected official stepped down from public service. 

Thursday, October 17, 2013

ACAP Health: Next Furniture Fiasco?



When does the City of San Angelo actually purchase a product or service?  This became an issue more than once under Interim City Manager Michael Dane.  The Furniture Fiasco saw over $100,000 in furniture ordered and installed without required City Council approval.  Council honored West Office Supply's good faith effort in delivering product to newly renovated offices in City Hall.

David Toomey of ACAP Health would have Council and the public believe he has a better case, given City Council's May 2012 endorsement of the service concept with an explicit order to negotiate a contract and bring it back.  Human Resources Lisa Marley and Interim City Manager Dane could not complete Council's directive within the next five months.  At this point responsibility for the deal fell into new City Manager Daniel Valenzuela's lap.  Toomey said he worked hard to finalize the deal with no success for the last year. 

I have long disliked cost reduction sharing agreements in the health insurance arena.  First, the contractor has a strong incentive to optimize the system to maximize their payment.  Second, I've seen those selling the service stack formulas in their favor.  There's every indication ACAP Health did that in last night's presentation, especially in their 8% cost escalation vs. the 3% negotiated.  That's an annual 5% savings right off the bat.

Toomey suggested ACAP saved the City $3.9 million, only he drastically overstated 2013 savings by not annualizing January-August data and included 2014 savings of $1.4 million, which is yet to occur.


Using the City's claims data I find two year savings of $725,000.  That's $3.1 million less than ACAP claimed. 

Toomey gave a timeline purporting how his firm had been officially engaged:

9/11: City Leadership authorized work under a percentage of savings arrangement.  The City currently has a 30% and a 40% Shared Savings Contract for specific Aetna services.

How did City leadership authorize this work and with whom?   If the City already has a 30% and 40% Shared Savings Contract for specific Aetna services, those would need to be carved out of any agreement with ACAP.  The City would not want to double pay (60 to 80%) for savings, as that would virtually wipe out any savings benefit.

5/15/12: Council Meeting, Councilmember Hirschfeld motioned for Staff to formalize a contract on a percentage of savings basis; seconded by Councilmember Farmer, with unanimous approval Weekly outreaches to Staff to initiate contracting process 

Councilman Hirschfeld never met a health insurance dollar he liked.  The $500,000 savings credited to Hirschfeld at his retirement from public service should be reduced by whatever settlement amount is reached with ACAP Health.

Two years ago Holmes Murphy and ACAP consulted on the exclusive provider arrangement (EPA) with Aetna/San Angelo Community Medical Center.  City documents refer to this stage as Phase 1 of ACAP's work.  The EPA's fee structure likely drove the majority of savings.

Also, I can't imagine a health care consultant doing a large body of work (Phase 2) without a contract.  While Toomey was led to believe one was coming, the deal was never executed.  Also, it's not clear to me what clinical engineering services ACAP Health provided.  Of the work product listed on Slide 6, only one looks like it came post EPA establishment. 
Line by line claims analysis to assess actual claim savings results 

I don't consider that clinical engineering, not in the least.

The ACAP Health situation is representative of a Barney Fife City government the last few years.  In this case City Council indicated their pleasure, which staff ignored or failed to execute.  In other situations, like the Furniture Fiasco, City staff did what they wanted, then pointed fingers when discovered.  The City made good for West Office Supply.  How will they respond to ACAP Health?

Councilwoman Farmer can represent the unanimous vote to engage ACAP in May 2012.  Council could ask Lisa Marley and Michael Dane to illuminate the public on this issue.  Why did staff bring ACAP's proposal to Council?

The Standard Times reported:

There was a lot of verbal negotiating with ACAP, Lisa Marley said, but little hard documentation. City staff will bring whatever paperwork it has back to the council at a future meeting, she said.
“I’m pulling any information we have, including (work) with Holmes Murphy,” Marley said. “It’s in the council’s hands now. They will make a decision on how to handle it.”

I'd love to hear the behind the scenes story. 

Wednesday, October 16, 2013

City Leader Confesses to State/Federal Shakedown

City Council discussed Texas Department of State Health Services grant funding for the City's one day a week Immunization Clinic.  Health Department Director Sandra Villareal testified:

Yes, we did mention we were going to have to cut those two services, immunizations and STD's and we had no space to put them in, so the State came in and said here, we'll give you $20,000 if you will provide the one day Immunization Clinic.  So we still have the one day immunization.  I asked for an additional year and they said yes, that was fine.  Now, this coming year we have applied for the 1115 waiver which is not here, but that will also help pay for the lease space.  So if something happens to that $20,000 we should have funding to pay for space from the additional dollars we are expecting this year.

Assistant City Manager Rick Weise stated:

And those that she's speaking of that aren't on here today are more like a three to four year grant process and this is all stemming from Council's challenge last year, as y'all were cutting services and reducing things, the challenge to Sandra was to see how we can creatively keep these services alive and so that's what these are.  When she's talking about $20,000, that was last year's Sandra's due diligence with the state in lobbying for those additional funds that other cities are getting and that what we weren't.

Recall this council and professional staff reduced the personal property tax rate by an amount equaling the cut from City Health Services.  Later that year Council hired two Master Developers, one for Lake Nasworthy and the other for Downtown, and added another employee holiday.  In neither case did they identify a source of funding for the over $635,000 in additional spending.

Section 1115 Waiver funds require applicants offer new services to their community.  It's a stretch to cut a critical public health service with the clear intent to have the state and feds pick up the tab, including a new building.  Mayor Alvin New, City Council and paid staff have been clear on their intent.  It's on tape and well worth watching.

Update 10-23-13:  After cutting STD services Tom Green County's STD incidence soared 300%.   Be sure to thank Mayor Alvin New and Interim City Manager Michael Dane for this and an unnecessarily bad flu season in late 2012.  Public health in our area is a shell of its former self.

Update 11-2-13:  The minutes from October 15 represent Villareal and Weise's positions as:  "Responding to a question from Councilmember Farmer, Health Director Sandra Villarreal clarified and provided a brief history of the grant. She noted staff is aware the positions are grant funded and employment is contingent on grant funding availability. Ms. Villarreal noted staff is seeking other grant funding alternatives."

Tuesday, October 15, 2013

Fleet Equipment Leasing's The Canals at Lake Nasworthy


The party looking to develop single family housing around Lake Nasworthy is simply known as Fleet Equipment Leasing LLC in City of San Angelo documents.  The owner utilized SKG Engineering's Herb Hooker as its public face.

There are two Fleet Equipment firms in Eastland, Texas, the location of the phone number listed in Planning Commission documents.  Both have Marc W. Walraven as the registered agent.  Fleet Equipment Management Company Inc. lists three board members, President Joe L. Walraven, Vice President Marc W. Walraven and Secretary/Treasurer Regina K. Bosma. 

Realtor Rodney Fleming has owned/managed rental property around Lake Nasworthy and stands to profit from the sale of single family homes in "The Canals at Lake Nasworthy."  

The property abuts the walking loop of Gun Club Road/Hillside Drive.  Councilman Fleming placed that item on City Council's agenda.  For development to occur walkers and runners have to go.  Fleming called for the number to be minimized by eliminating parking.  This would be the second phase of reduced parking undertaken by the city to address "the problem" of local citizens exercising in an area of natural beauty. 

In the late 1980's I saw runners and walkers pushed out of Dow Park in Lake Jackson for high end housing.  Such changes happen in stages.  Will San Angelo be a repeat?  How will Gun Club Road residents react to heavy construction equipment, followed by increased traffic?  Will the Canals employ an exclusive real estate agent, one who helped them get the zoning change as a City Council member?  These things remain to be seen.

Correction 10-17-13:  The engineering firm on this project is SKG Engineering, not KSA Engineering as I originally stated.  My apology for this error.

Quality Control Missing at TTU's EthicsPoint


Report Submission Date
10/7/2013
Reported Company/Branch Information
Name Texas Tech University
Location Texas Tech University - Lubbock
150 Administration Bldg.
Box 42005
City/State/Zip Lubbock, TX, 79409

Violation Information
Issue Type

Other Human Resource Concerns
Relationship to Institution

Other/Anonymous
What is the general nature of this matter?

I would like to file a complaint regarding a previous Ethics Point "investigation." The "investigation" did not address any of a number of listed concerns regarding unethical leadership behavior at the top at Texas Tech University. I can only assume there are no standards for an Ethics Point investigation. The one I received seemed Ethics Point-less.
How did you become aware of this possible violation?

It happened to me
Where did this incident or possible violation occur?

In whichever office conducts EthicsPoint investigations or the offices above that one that ordered the investigator to avoid any stated issues and offer political sounding nonsense.
Please provide the specific or approximate time this incident occurred.

Sep 14, 2013, 3:53 PM
How long do you think this problem has been going on?

Don't know
What leads you to believe the problem has been ongoing?

The litany of false statements offered by Texas Tech administrators listed in my 8/27/13 complaint and the investigators complete avoidance of stating or addressing. I do know Chancellor Hance and President Nellis repeatedly ignored concerns submitted directly to them on the issue. I imagine it would have been very difficult for a lower level staffer to even ask questions that clearly revealed senior Tech administrators to be bald faced liars and bullies.
Please identify the person(s) you feel are engaged in this behavior.

EthicsPoint Investigator
Duane Nellis - President - Stuck head in sand
Kent Hance - Chancellor - ignored lies by Tech marketing people and intimidation by Facilities AVP
For the persons named above please indicate whether or not they are affiliated with Texas Tech.

All are affiliated with Texas Tech, unless Tech contracts out EthicsPoint investigations
Have you or someone else previously reported this problem to your supervisor or management? If so, by whom, to whom, when, and how?

Report Submission Date (My original complaint)
8/27/2013
Reported Company/Branch Information
Name Texas Tech University
Location Texas Tech University - Lubbock
150 Administration Bldg.
Box 42005
City/State/Zip Lubbock, TX, 79409
Violation Information
Issue Type
Inappropriate Supervisor Directive
Relationship to Institution
Other/Anonymous
What is the general nature of this matter?
Assistant Vice President Hugh Cronin of Facilities Management is purposefully barricading Texas Tech's Feral Cats under buildings without food or water, which is defined as animal cruelty under Texas law. Multiple times Cronin has said all cats have been removed and multiple times cats have been seen barricaded under buildings with no food or water.
How did you become aware of this possible violation?
Other
If other, how?
TTU employees and area animal service organizations
Where did this incident or possible violation occur?
Drane Hall over the last week, other buildings prior to this
Please provide the specific or approximate time this incident occurred.
Thursday evening August 22 all cats removed
Friday morning August 23 two cats sighted behind metal grate with no food or water
Friday evening Cronin orders sheet metal installed so cats cannot be seen
Monday August 26 - two more cats sighted after someone removed sheet metal.
Tuesday August 27 - one more cat sighted
How long do you think this problem has been going on?
1 to 3 months
What leads you to believe the problem has been ongoing?
A June 3rd Tech announcement said the University would partner with local animal service organizations on cat removal. This turned out to be a complete untruth. Hugh Cronin did not ask for and turned down numerous offers of aid on the safe and ethical removal of Tech's community cats.
Please identify the person(s) you feel are engaged in this behavior.
Hugh Cronin - Asst. VP
Chris Cook - Comm/Mktg
For the persons named above please indicate whether or not they are affiliated with Texas Tech.
Yes, they are affiliated with TTU
Have you or someone else previously reported this problem to your supervisor or management? If so, by whom, to whom, when, and how?
I wrote President Nellis on this very issue and received no reply
Do you suspect or know that a supervisor or management is involved?
Yes
If yes, then who?
Chris Cook wrote that PETA was involved in helping TTU address the issue. PETA officials, when contacted regarding Tech's animal cruelty, said they had not been contacted by TTU. Cook's blatant misrepresentation is an ethics violation.
What leads you to believe that a supervisor or management is involved?
Chris Cook wrote that PETA was involved in helping TTU address the issue. PETA officials, when contacted regarding Tech's animal cruelty, said they had not been contacted by TTU. Cook's blatant misrepresentation is an ethics violation.
Please identify any persons who have attempted to conceal this problem and the steps they took to conceal it.
President Nellis ignored it
Chancellor Hance ignored it
Details
There are many e-mails and pictures. The e-mails can be gotten internally via an IT search of Cronin's and Cook's communications. Pictures exist on the website for the Humane Society of West Texas and the State of the Division blog.

Follow-Up Notes
Sep 02, 2013, 12:38 PM - Reporter
A petition for TTU to install one way excluder devices instead of sheet metal barricades was submitted to President Nellis. This petition had over 330 signatures and was sent due to the urgent need to allow cats out of crawl spaces to obtain food and water.

The Humane Society of West Texas has a second petition with roughly 1,000 signatures asking TTU to reconsider its heavy handed, uncooperative stategies in regard to feral cat removal.

As of Labor Day 2013 cats have been barricaded under Drane Hall with no food or water for two weeks. TTU administration has shown no concern over the welfare of these animals and ramped up its intimidation of people on TTU's campus who are concerned about Tech's animal cruelty.

In one incident the TTU police were called and animal cruelty reported. Assistant Vice President Hugh Cronin was verbally abusive to the person making the report

Sep 11, 2013, 11:00 PM - Reporter
It's been two weeks since I submitted this concern. When might I hear something other than "we're looking into it?"

Oct 02, 2013, 10:14 PM - Reporter
Where do I file a complaint regarding this hapless ethics investigation? Are there no standards for an Ethics Point investigation? This one is Ethics Pointless.

Follow-Up Questions/Comments
Sep 02, 2013, 1:54 PM - TTU
Comment: Thank you for using the Ethics Point reporting system
and for your additional information. We are currently
looking into this matter.

Sep 04, 2013, 7:39 PM - Reporter
Reply: I request a formal reply to concerns stated in this report.

Sep 14, 2013, 3:53 PM - TTU
Comment: Hugh Cronin is no longer with the university. After his
departure, administration continued to seek
opportunities to partner with the campus and the
student organization in an effort to strengthen the
viability of the program intended to relocate the feral
cats away from residence halls, dining halls, and child
development center. Since your report, the university
has partnered with the campus feral cat caregivers to
ensure no cats are trapped under Drane Hall. During
this process, another opening was discovered in the
basement allowing cats to freely enter and exit the
building once again confirming cats had never been
completely trapped underneath the building. Before
the remaining opening is sealed, a university employee
will again put on protective hazmat gear and crawl
under the building to verify there are no cats. As soon
as the campus feral cat caregivers and anyone else
interested in this process witness the search and are
satisfied with the results, the opening will be
permanently sealed.

Thank you for using the Ethics Point reporting system.
Sep 15, 2013, 9:49 AM - Reporter
Reply: Finding a hole after the fact does not impact facilities management's behavior or intent in the handling of this situation. It promised to collaborate, then never did.

Your response did not address the unprofessional behavior of Hugh Cronin (verbal abuse) or Chris Cook (lying). It did not address President Nellis' or Chancellor Hance's ignoring the problem for weeks to months.

If this is the quality of investigation at a University level I am sorely disappointed. It confirms my assessment that corporate compliance programs exist for show.
Do you suspect or know that a supervisor or management is involved?

Yes
If yes, then who?

I know TTU Senior Leaders did nothing to make the Facilities AVP fulfill promises made. They covered up his unethical and pathological behavior with "after the fact" findings that had nothing to do with the AVP's intent or behavior.

It seems TTU leaders don't have ethics standards for communication if their top person can offer a bald faced lie and this not be addressed at all in the investigation. The university's response feels like the usual political speech that dismisses serious concerns. Done in a university setting, it's especially egregious.
What leads you to believe that a supervisor or management is involved?

Someone clearly botched an investigation. I believe this was due to fear of reprisal from TTU Senior Leaders for even asking my questions. That, or the investigator got nonsense speech from the parties involved and had neither the status or protection to challenge such.
Please identify any persons who have attempted to conceal this problem and the steps they took to conceal it.

EthicsPoint would need to look at who was contacted by the investigator and their replies.

The "investigation" itself is hapless. It completely avoids the cruel behavior of the AVP Facilities and the lie from the Marketing/Communications leader.
Details
      Having done many investigations over the years I could not believe the shoddiness of TTU's response to my initial EthicsPoint report. My concerns were not taken seriously and TTU's top leaders clearly endorsed the behavior of their underlings. Why did this occur?
Follow-Up Notes
There are no additional notes for this report.
Follow-Up Questions/Comments
Oct 09, 2013, 5:18 PM - TTU
Comment: This matter has been fully investigated. Texas Tech will continue to pursue best practices to ensure the health, safety and security of our students, faculty, and staff in cooperation with the appropriate organizations for the humane treatment of the feral cat population.

Chief Audit Executive and CPA
Texas Tech University System


Oct 10, 2013, 11:29 PM - Reporter
Reply: Horse hockey. What EthicsPoint supplied me was far from a full investigation. I welcome the complete investigation report, which shows an evaluation of Hugh Cronin's intimidating behavior and Chris Cook's lying. Both were completely ignored in the EthicsPoint reply to my initial concern.

Tech made numerous promises then never delivered. Your statement, in light of Tech representatives unethical behavior, is patently false. I'm sure there are obligations within the CPA code of ethics that you may wish to re-examine. Tech can lie and intimidate, but accountants are supposed to examine and report what they see.

------------------------------------------------------------------------------------end of report

I suggest retiring Chancellor Kent Hance's Leadership class take this up as a case study.  Students can evaluate the behavior of Hugh Cronin and Chris Cook.  They can judge the quality of TTU's two EthicsPoint responses, neither worthy of the title "investigation."  Compliance, the lawyerization of business, is itself a race to the bottom.  Hance's TTU team is clearly winning.

Sunday, October 13, 2013

ACAP Health Returns to Agenda after 17 Months


This Tuesday's City Council meeting will occur at 5:30 pm, giving interested citizens the opportunity to attend and have their voices heard.  One item I'd like to hear will occur in executive session.  Council will hear the following item outside public purview:

To consult with attorney on pending or contemplated litigation; (b) or a settlement offer to ACAP Health for clinical care engineering services for the City health insurance program.

Oddly, the first item following executive session is a presentation by David Toomey of ACAP Health.

A search of the city's website produced nothing on "ACAP Health" or "clinical care engineering."  While these two subjects are narrow and focused in nature, my recent experience finds City search producing nothing or virtually nothing on subjects that once populated a rich list of historical resources.

However, a search of State of the Division produced a piece on ACAP Health from May 2012.  It stated:

History:  ... Phase II of the ACAP Health services will be to work directly with the providers to attain high value, accountable care for plan participants. This direct relationship will provide the City with a better understanding of the quality performance of the providers and of the cost of the clinical care being rendered. Evidence has shown that higher quality health care actually costs less when the right processes are in place to avoid the unnecessary waste and the complications inherent in a fragmented care continuum.

Financial Impact:  The cost is to be negotiated as part of the contract. The savings will be measured based on actual claims
Last year I wrote:

ACAP will work solely with SACMC providers on Clinical Care Engineering.  I look forward to seeing what comes back to council from such negotiations. 
I didn't reveal my skepticism on this last year, but I was curious as to how ACAP would clinically re-engineer clinical practice at Community while working with but a subsection of the hospital's patients.  Also, when was the contract, with amounts and deliverables, executed and approved?  The May 15, 2012 minutes show:

DISCUSSION AND AUTHORIZATION FOR STAFF TO NEGOTIATE AN ADDENDUM TO THE HOLMES-MURPHY & ASSOCIATES CONTRACT WITH THEIR AFFILIATE COMPANY, ACAP HEALTH, FOR CLINICAL CARE ENGINEERING (CCE) SERVICES FOR THE HEALTH INSURANCE PROGRAM

Human Resources Director Lisa Marley, Holmes Murphy Representative Jared Wills, and ACAP Health Representative David Toomey presented background information. A copy of the presentation is part of the Permanent Supplemental Minute record.


General discussion was held on the plan savings, improvements, and the financial impact based on the amount of savings produced by the company.
 

Motion, to authorize staff to negotiate an addendum and present at a future meeting, as presented, was made by Councilmember Hirschfeld and seconded by Councilmember Farmer. Motion carried unanimously.
I did not see any negotiated addendum presented in the last seventeen months and City sponsored health insurance is something I watch closely. 
 
David Toomey's presentation could be an eye-opener.  How many vendors get to talk right after City Council met in executive session to consider suing their company?

My guess is the city purchased ACAP's expertise in some kind of shared savings agreement.  Companies have sold these in health care for decades and they're akin to snake oil.  In good experience years the parties pretend they did something and share the savings.  In bad experience years the parties point fingers at one another and say the other side didn't fulfill their obligations.

I'm not sure how many dice this Council rolled in the last year.  ACAP Health, in my opinion, was one roll.  I can't recall if they increased the limits for their stop loss coverage from $50,000 to $100,000.   If so that was a second toss.

From a historical perspective this issue could reflect two patterns.  The first is Councilman Hirschfeld's desire to wring out every possible health insurance dollar, no matter the impact on employees, retirees and dependents.  The second is Interim City Manager Michael Dane's not bringing important items back to Council for approval.  Dane was in charge during the Furniture Fiasco and city hall renovations.

Was the ACAP deal negotiated before City Manager Daniel Valenzuela became official?  If so, that's another item kept from Council resting on Dane's shoulders.

Update:  I found the 5-15-12 presentation on Slideshare


Thursday, October 10, 2013

Fleming Sets Sights on Gun Club Road Walkers


City Councilman Rodney Fleming asked for the following item to be discussed at the October 15 Council meeting.  Fleming asked to:

"Discuss the walkers and joggers out at the lake and the problem that it's become."
He said he would bring a video of walkers and joggers at Gun Club Road.  Councilwoman Charlotte Farmer asked for information on the cost to run the Nature Center.

These two concerns are tackled in Gateway Planning's proposal for Lake Nasworthy development.  The timing of these issues could setup support for Gateway's Nasworthy zones.

The public meeting on Lake Nasworthy development will be held October 21 at the McNease Convention Center.  Gun Club Road walkers should turn out if they wish to be heard.

Update 10-13-13:  Gun Club Road walkers/runners is item 27 on the agenda

Update 10-14-13:  Standard Times reported "Fleming has planned for members of the Lake Nasworthy Homeowners’ Association to assist him with the presentation."

Update 10-19-13:  Oddly very few Gun Club walkers or runners turned out at City Council to speak on keeping public access.  Council appeared to support Fleming's position, but no vote was taken as the item was informational.  It'll be interesting to see what happens when Parking Reduction Phase 2 hits City Council's agenda.

Wednesday, October 09, 2013

San Angelo's Public Health Has "Limited" Adult Flu Shots


A recent City of San Angelo press release stated:

The San Angelo-Tom Green County Health Department is offering influenza vaccines, although it has a limited number of adult doses.
Access to a flu shot from the City of San Angelo is already restricted to one day a week.  Prior to City Council cuts under Mayor Alvin New citizens could get flu shots any day of the week.

Last year's flu season was more severe due to elected officials' budget decisions.  I've seen little to no change in the just begun fiscal year.  A search of "immunization" in the approved budget produced nothing.

As San Angelo becomes more transient, public health seems part of our distant past.  There's really one administration and City Council to thank for this, the one headed by City Manager Harold Dominguez and chaired by Mayor Alvin New.

So far only $16,900 in new money has been added back.  It's not clear how much of this is local and how much is from the feds via the Section 1115 waiver.  At some point this blight will fall on City Manager Daniel Valenzuela and Mayor Dwain Morrison.

Monday, October 07, 2013

Lake Nasworthy Development Public Meeting Planned for October 21


A City of San Angelo press release stated:
Input on the draft of a plan to develop and improve Lake Nasworthy will be gathered at a public meeting at 6 p.m. Monday, Oct. 21, at the McNease Convention Center, 500 Rio Concho Drive. 

Citizens are encouraged to attend to share their feedback on the plan, which the City Council is expected to consider approving Nov. 5. The document can be viewed at cosatx.us/nasworthyplan. 

The blueprint calls for five development zones around Lake Nasworthy, one of the most popular weekend destinations in all of West Texas:
 • Zone 1: Action Sports. Zone 1 on Nasworthy’s western end would be developed for boat racing, wakeboarding, archery, mountain biking, trail running and camping.
 • Zone 2: Harbor Village. Nasworthy’s southern end around the marina could accommodate a new marina, an improved Mary E. Lee Park beach, restaurants, a hotel, aquatic businesses, a triathlon staging area, a splash pad and party boats.
 • Zone 3: Nature/Education. Enveloping Nasworthy’s northwestern and southwestern edges, programming would include a new home for the Nature Center and possibly a Family Entertainment Center.
 • Zone 4: Special Opportunity. The site of a former power plant and of Gun Club Hill/Hillside Drive, this area would allow for a walk/jog/bike trail, windsurfing, a zip line, a hotel, residential development, and commercial/retail outlets along Knickerbocker Road.
 • Zone 5: Natural Encounter. Nasworthy’s eastern shores and the site of a former hatchery would be the site of a birding center plus fishing, canoeing and kayaking. 

Gateway Planning, a consultant hired through a formal process, crafted the plan
following a series of meetings with the lake’s many stakeholders and with the public over a four-month span.

I attended the public meetings on Lake Nasworthy Development as well as Twin Buttes Recreation Plan sessions.  It's hard for me to see how my input was heard by either group.  That means I have to show up again and repeat myself.  I'd rather they listened the first time.

Wednesday, October 02, 2013

TTU's Cat War Goes Low Grade


Texas Tech President Duane Nellis failed to intervene when Assistant Vice President Hugh Cronin waged his cat cruelty campaign.  After Cronin the Barbarian's departure, language became more civil between Tech's facilities folks and area animal service organizations.  That didn't deter President Nellis from tightening the noose around more Tech Feral Cats.  More feeding stations have been removed, without informing faculty, staff and student caregivers. 

High octane, in your face, cursing Cronin is gone.  Public Relations' Chris Cook shut his yapper on the subject after lying through his teeth several times.  Nellis did nothing in response to either employee's ethical transgressions.  However, the war turned low grade under his leadership, which is off to a wimpy start. That should worry TTU employees when lying bullies can have their way.