CITY OF AUSTIN, TEXAS MINUTES OF THE CITY COUNCIL CITY OF AUSTIN, TEXAS Special Called Meeting November 04, 1977 7:00 Ρ.Μ. Rosewood-Zaragosa Center The meeting was called to order with Mayor McClellan presiding. Roll Call: Present: Mayor McClellan, Councilmembers Cooke, Goodman, Mayor Pro Tem Himmelblau, Councilmembers Mullen, Snell, Trevino Absent: None PUBLIC HEARING ON REPORT OF HEALTH SYSTEMS TEAMS PEAT, MARWICK & MITCHELL JACK NEWMAN, Consultant with Peat, Marwick and Mitchell, through the use of slides presented a report summarizing the recommendations. VOLMA OVERTON, representing the NAACP, stated that the Plan did not address the major cost in the present operation. The NAACP strongly opposed the Plan and requested that the City continue its hospital operation. DR. DAVID WARNER, member, Brackenridge Hospital Board, spoke in opposition to the proposed plan. He made the following recommendation: 1. Create a hospital board with administrative control to hire and fire a hospital administrator and a clinic administrator. 2. Fund the hospital and clinic for one year to see how it works. Dr. Warner then responded to questions from the Council. Councilmember Trevino stated that it was his understanding that the Council did not have the authority to permit a hospital board to hire the administrator of the hospital. It would require a Charter amendment. DR. ELIZABETH GENTRY expressed the following concerns over the proposals stated in the Peat, Marwick and Mitchell Report: _ CITY OF AUSTIN, TEXAS November 4, 1977 1. Many prenatal patients seen in maternity clinics were not eligible for clinic cards, Medicaid, or Medicare, but were medically indigent. Under the proposed system, labor and delivery should be classified as an emergency and the women be admitted to Brackenridge Hospital. 2. 24-hour Clinic - Immediate care and follow-up care should be available in the Clinic or a part of it, such as from 4:00p.m. to 9:00 p.m. for individuals who have difficulty in going to a clinic between 9:00 a.m. and 6:00p.m. 3. Lack of Counseling - Counseling by a nurse associated with physician care was needed to insure that the physician's orders were understood and realistic. A health-informed interpreter was also needed for non-English-speaking individuals. 4. Quality Assurance - A nurse and social worker should be added to the physician-provider group since they are health providers also. DOROTHY TURNER, President, Black Citizens Task Force, felt that the City should retain Brackenridge Hospital as a City department. VELMA ROBERTS, President, Black Women for Progress, asked the City to keep Brackenridge Hospital. LARRY HILL, speaking as a member of the Gents Club and the Allied Club, asked the Council to stay in the hospital business. TEXANA HUFF, member, Clarksville Advisory Board, requested that a health facility be created in Clarksville. She read questions from a survey she conducted in Clarksville and stated that the results showed a need for the proposed health facility. JORGE GUERRA urged the City to cooperate more closely with local doctors to improve conditions at Brackenridge Hospital. He questioned the use of outside consultants to solve the Hospital's problems. He supported nighttime neighborhood clinics for working people. FATHER JOE ZNOTAS spoke in support of retaining Brackenridge Hospital. He also suggested that the Council meet with surrounding counties to work out the problem of debts incurred at the Hospital by residents of those counties. The Council agreed with the suggestion. Mayor Pro Tem Himmelblau thought that the County Commissioners and Judges in the CAPCO area felt that it was not their responsibility, that it was the doctor who admitted the patient. She thought that the Council should work with the Texas Medical Association. LONNIE BELL requested that the hospital be kept under the City. He was opposed to the use of outside consultants for the hospital. JEWELL THORNE supported Dr. Gentry's request for clinic cards. She urged the City to keep Brackenridge Hospital. ) CITY OF AUSTIN, TEXAS November 4, 1977 BETTY HUNT cited several reasons why she felt that the Peat, Marwick and Mitchell plan did not serve the people of Austin. Councilmember Snell expressed his appreciation to all of the people who were attending the public hearing. He felt the attendance reflected the people's interest in the Hospital. He assured the people that no decision had been made on the Hospital and that their views would be considered in making a decision. LOUIS STEWART, a Brackenridge Hospital employee, urged the City to keep the Hospital. DR. FRED HANSEN, member, Brackenridge Hospital Board, felt that the present form of management of Brackenridge Hospital was wasteful, inefficient and not responsive the medical needs of the citizens. He cited the following examples: 1. No OB facility in the new building, but support services were there, making it difficult to get to those services rapidly. OB remained in the old building. 2. ICU had 18 beds which were always full, but was staffed for 15 beds. 3. Brackenridge was the third most expensive hospital in Texas in 1976. 4. Salaries at Brackenridge were the highest in the state. 5. The Hospital nursery was understaffed. He made the following recommendations: 1. Adopt and implement the plan proposed by the consultants. 2. Put into the leasing contract a stipulation for an open emergency room. 3. Underwrite health care for the near poor. 4. Make eligibility changes now. 5. Complete the construction of the new hospital. 6. Use $1.7 million of the $2.3 million surplus to put the obstetrics facility in the new hospital. Dr. Hansen then responded to questions from the Council. JOE PINNELLI spoke in opposition to the leasing of the hospital. He suggested that a hospital district or authority be created to operate the hospital. ✓ CITY OF AUSTIN, TEXAS November 4, 1977 DELLA GREEN, a former Brackenridge Hospital employee, opposed leasing the Hospital. She recommended that salaries not be cut, but that waste could be eliminated. She felt that staff and equipment utilization could be improved. DR. CHARLES URDY did not believe that the City would save money by leasing the hospital. He also did not think that the Peat, Marwick and Mitchell report contained enough information for a decision to be made on the hospital problem. GALLA TOWERY, Supervisor of Orthopedics at Brackenridge Hospital, felt that she and other management personnel did not want to be wasteful at the hospital. The staff was making every effort to contain costs. She opposed leasing of the Hospital. Mayor McClellan stated that further hearings and work sessions would be held before reaching a decision on the hospital. ATTEST: ADJOURNMENT The Council adjourned at 10:07 p.m. City Clerk Cole Ketone Mayor