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

City Council May 15, 2012 ACAP from City of San Angelo Texas

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.

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.

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.

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. 

Congress Drives Home Shutdown

Since all news is local:  Shannon Medical Center must be underwhelmed by all the support in getting more Concho Valley residents affordable health insurance coverage.   Rep. Mike Conaway may get the Wesley Soup Kitchen more business.  

Affordable Housing Collaborative Receives September 30 Eviction Notice

The City of San Angelo announced:

Over the past year, San Angelo Rental Housing Mediation Services (SARHMS) helped meet some real needs to educate the public about rental housing issues and to provide guidance to tenants and landlords toward settling rental housing issues. The program has operated as a partnership between Angelo State University and the City of San Angelo.

Due to federal funding cuts and competing priorities, however, funding for SARHMS is not included in current local budgets and there are no immediate plans to continue the service without a steady funding source.

SARHMS is currently winding down and will cease operating on September 30, 2013.

The project was first revealed to the public on December 12, 2012 in the Standard Times:

ASU's Community Development Initiatives is partnering with the city of San Angelo as well as with landlords, Realtors and other key local housing stakeholders to help alleviate disputes involving the community's lowest-income tenants. The San Angelo Rental Housing Mediation Services is a pilot project that takes a two-pronged approach.

This partnership lasted ten months in public view.  San Angelo has a current problem with affordable housing.  Housing rents on my street are multiples (up to 3 times) of what they were five years ago.

Neither the city or ASU's website offers much in the way of insight into the SARHMS' collapse.  The public only knew it was a pilot project and had no information on its funding source.  Apparently, that source withered.

This brings back memories of the City eliminating its immunization and sexually transmitted disease clinic, only to immediately request federal funds for reinstatement.  Uncle Sam bought into the City's shakedown and partially funded restoration of the clinic. 

The same year the City eliminated the STD clinic it:

1) Cut the tax rate by .01 per $1,000 valuation (roughly the same amount as the $138,000 health clinic cut)
2)  Approved a downtown master developer, estimated at $225,000 plus expenses (not in the city budget)
3)  Approved a $335,000 Lake Nasworthy master development plan (not in the city budget)
4) Offered $3.6 million in economic development assistance to a company where the Mayor served on the Board of Directors and had a declared financial conflict of interest (via two signed affidavits).
5) Approved a new employee holiday costing roughly the same amount at the clinic cut.

The City of San Angelo had funds to spend, just not on immunizations or STD diagnosis and treatment.  They did likewise this coming budget year with SARHMS.

San Angelo's roots included Miss Hattie's Bordello.  Ironically, a STD clinic would've directly supported economic development in those days.  But times are different and expansion is in the air.  We'll see how the city spends its expanding pot of money.  It hasn't been on public health services for quite some time.

San Angelo's housing is growing more unaffordable by the day.  We'll see if a white knight steps in and funds SARHMS.  If not, it'll be the latest community collaboration to bite the dust.