Back to Archives

Austin Emergency Readiness & EMS Billing Update

Wednesday, November 10, 2021 Audit and Finance Committee Regular Meeting
  • Winter Storm Uri Unpreparedness:

    An audit revealed Austin was ill-equipped for Winter Storm Uri, lacking severe weather planning, effective multilingual communication, and sufficient emergency resources.
  • Repeated Failures, No Action:

    Many past disaster recommendations, some years old, were never implemented, contributing to Uri's challenges. Council members voiced frustration over the city's slow response and lack of clear improvement plans.
  • Equity Gaps in Emergency Aid:

    The city's disaster response failed vulnerable communities, marked by delayed non-English alerts and an absence of formal outreach strategies for those most in need.
  • EMS Billing Backlog Clearing Up:

    Austin EMS is resolving a backlog of nearly 14,000 patient bills, a problem exacerbated by a new system and pandemic-related staffing shortages. A vendor will clear these by mid-December.
  • Urgent Call for Action:

    Council members pushed for immediate action on audit recommendations, stressing the need for quick implementation and resources before future climate events or emergencies.

Full Transcript

Audit and Finance Committee Meeting Transcript – 11/10/2021 Title: ATXN-1 (24hr) Channel: 6 - ATXN-1 Recorded On: 11/10/2021 6:00:00 AM Original Air Date: 11/10/2021 Transcript Generated by SnapStream ================================== Please note that the following transcript is for reference purposes and does not constitute the official record of actions taken during the meeting. For the official record of actions of the meeting, please refer to the Approved Minutes. [9:40:07 AM] >> I think we're still experiencing a little bit of technical difficulties getting council member pool in, but in the interest of time, we're going to go ahead and start and we'll check back in to make sure she's on before we're voting, hopefully. So, good morning. My name is Alison alter. I'm joined today by council members tovo and Kelly, and hopefully council member pool on the virtual dais. Mayor Adler is absent today. It's 9:40 A.M. And I'm calling this meeting of the audit and finance committee to order on November 10th, 2021, at city hall. We are going to go slightly out of order to make sure that we can vote on things with as many of us here, council member pool has a hard stop at 10:00 A.M. To work as a member of the cap metro board on the jpa in executive session. So, let me go through the order [9:41:07 AM] of how we're going to do things. We will take our public communication, which is Mr. Paul robins, first. Then we will tackle the three voting items, the October meeting minutes, our 2022 meeting dates, and the annual audit plan. And then we will take up the disaster preparedness audit, the Ms audit, and the economic recovery audit, closing out with future items. S I'd like to invite Mr. Robins up for public communication. You'll have three minutes. Hang on one second. I'm not sure if the microphone is working. >> We're live. Great, thank you. Council, I filed a nine-part complaint last night with the auditors office about the office of regulatory affairs regarding its conduct in the Texas gas service conservation rate case. [9:42:08 AM] Well, there are profound problems with the economics of the green wash conservation programs. The complaint is based on the manipulative process that has largely kept the issue from public view. I am an activist with over four decades of experience donating my time to the city. My seemingly cardinal sin has been to find wasted money that can be repurposed to assist poor people and help the environment. The regulatory office has deliberately manipulated process to keep my voice from being heard. On five different occasions, the head of the city's office of regulatory affairs stated in writing that this issue, conservation rates, would be brought before the council for a hearing and vote in November. Here are the dates and quotes, [9:43:10 AM] and I will forward the emails to you if you want to see them. Then after a close of business last Tuesday with virtually no time left to change the first posting of the council agenda, the office stated that this vote and hearing would not occur. I have spent weeks of donated time planning for this. Council, is it really okay for city staff to treat citizens they serve with this kind of contempt? Are volunteers who donate their time to the city to be despised? By ignoring this transgression, is council setting it up to happen again? And it gets worse, council. I'm not provided with adequate time to offer testimony. I cannot offer full testimony anyway, because some of my discovery questions go unanswered. [9:44:14 AM] And the regulatory staff has stated in writing that they have prejudged the economics, so my testimony will be ignored anyway, if I had adequate time to prepare it. In the remaining time, I'm going to read -- here it is. I'm going to read the nine points of my complaint. The lack of a formal hearing process, misleading statements that influence this case, predetermined outcome, refusal to mandate the gas company to provide information, failure to consider cost information that I did provide, failure to consider imprudent expenditures, failure to update cost effectiveness analysis, past and possible future harassment of myself when I intervene by the city attorney or will in the future, and manipulation of public process [9:45:17 AM] at the resource management commission. I appreciate your attention. >> Alter: Thank you, Mr. Rob bins. I know that my office have been having some -- and council member Kelly. We've been trying to understand things and we will keep you posted. >> I am your servant, council member. >> Alter: Thank you, Mr. Robins. I understand that council member pool is in the waiting room and needs to be moved over. So she can participate virtually. All right, council member pool, we see you're on the screen now. Are you able to share your video so you can vote? [9:46:28 AM] Great. Thank you, council member pool, for making it so you can be here to participate in these votes. So, we are going to start with the minutes, and there's one adjustment to spelling that we we need to make with Mr. Granof's name. There is one F. Council member Kelly motions, segueded by council member tovo. All in favor? I'm not hearing any objections to the minutes. Council member pool? Okay, she's got her hand up now. Okay. So we're all in favor of the minutes. Thank you. That was item 1. We are now going to move to discussion and possible action regarding audit and finance committee meeting dates. So I wanted to flag a couple things about these dates. [9:47:29 AM] First of all, I just ask committee members to make sure that my office and/or the auditor are aware if you're going to be missing a meeting as much in advance as possible. We do have pretty regular meetings, so it does happen if people miss, but it's much easier if we can plan for them. The meeting dates that are set, we already know that the mayor cannot attend in January and council member pool cannot attend in April. So those meetings in particular, please make sure that you do everything possible to attend. And then we are going to revisit the summer dates in March, particularly the June and July dates, we're hoping to be able to skip one or both of those, but we won't know that until March when we have a better idea of what's on our calendar. So what we're proposing today is go forward with a calendar that includes those dates and then we will adjust -- it's much easier to cancel a meeting than it is to schedule a meeting, so we are going to go ahead and have those [9:48:30 AM] dates on our calendar. So I'll entertain a motion for item 3 for the meeting dates. Council member Kelly makes that motion, seconded by council member tovo. All those in favor? Unanimous on the dais. Thank you. So item 4 is discussion and possible action regarding the calendar year 2022 audit plan for recommendations to council. Ms. Stokes, did you want to speak to this? >> Just a quick overview. We presented the proposed plan last month. We have not received additions or edits to that plan, so we are proposing the plan that was in front of you last month and is also today's backup, and that would move forward the council for the full council to weigh in on. >> Alter: Okay. Do you know if that would be going on next week's meeting or [9:49:31 AM] in December? >> It would probably not be next week. >> Alter: Okay, thank you. I understand that the mayor is not here today, may have an amendment. I have not seen the amendment. It's not clear to me whether it should be an amendment to the plan or a special project, et cetera. We will try and work that out before it comes to council. But for the mayor or for anyone else, if we are going to adjust the plan, we have to make sure we know what we're taking off because we only have so many resources in the audit office with everything else that is planned. So, if you are going to make any proposed amendments, a, I would ask that you please surface those as early as possible, and B, that you need to clarify what we're moving off of the plan because everything was very carefully chosen through a process where every council member had an opportunity to weigh in through that. So I will entertain a motion to approve the audit plan. [9:50:33 AM] Council member tovo makes that motion, seconded by council member Kelly. All those in favor? Moving that on to council. Council member pool, are you in favor? Okay. Thank you. I think there's some kind of weird time delay. So a unanimous vote on that. Is there anything else we need to vote on before we take up the disaster preparedness audit? Okay, thank you. So I want to invite up the auditors' staff to take up item 2, which is the disaster preparedness audit. I think at some point, we'll need to clarify the difference between this audit and the after action report. In was specifically asked for by resolution that council member tovo led on and I co-sponsored, and I'm not sure who else was on [9:51:33 AM] that. It's really, really important that we prepare for future emergencies, and one way that we do that is from learning from the past and taking action. This is a really important step in being better prepared. So I'm going to invite the auditors' staff to present, and after they present, we will give appropriate staff members an opportunity to respond to the audit, and then we will open it up for comments and questions. Thank you. Good morning. >> Thank you. Good morning, committee members. My name is Maria Stroth and I was the audit lead for this project. The objective of this audit was to determine the master planning and preparedness efforts position the city to respond equitably. As you know, the winter storm was an unusually severe event. In Austin, there were seven days below freezing and a recorded six inches of snow. [9:52:34 AM] Austinites experienced extended periods without electricity and were under a boil water notice for six days. City staff who responded to the storm put in an incredible amount of effort to respond to the storm and worked tirelessly for many days. In fact, these efforts are continuing as staff think about how to improve disaster responses in the future. The impact on the community was significant. As you can see in the graph on the right, Travis county had the second-most deaths in the state after Harris county. 21 of these were within the city limits and 16 involved hypothermia. Additionally, people who died skewed older than the general population. About 64% of people who died were older than 60. Also four people who died were experiencing homelessness. In our audit, we had four findings. The first was related to planning and preparedness generally, and the others were related to communication, resources, and equity. We found the city was unprepared to respond to winter storm uri for three main reasons. [9:53:34 AM] I'll discuss these reasons on the following slides, but at a high level, the city's planning efforts did not adequately consider the risks posed by a severe prolonged or widespread disaster. Also, the city had not implemented past recommendations that may have improved its response. And had not historically prioritized disaster preparedness and community resilience. The climate crisis is expected to result in more intense and more frequent weather emergencies, but the city hasn't adequately prepared for this. The city's plans acknowledge major or catastrophic events, but have little specifics for how to respond to them. City plans also acknowledge the potential of a winter storm, but not one with the impact we saw during winter storm uri. Plans anticipated a limited severity storm, one with short duration, no loss of life, and limited impact on city services like power and water. They also anticipated the needs to treat roads for ice, but not for snow removal. Of course, then cans of February's storm were much more severe than these planning [9:54:34 AM] assumptions. There are also a number of lessons learned that are discussed in our report, that if the city had acted on, may have improved its response. Again, these are in our report, so I'll discuss them at a high level. This included recommendations from past disasters where the city looked at what had happened before, and made recommendations to improve. A recommendation from the 2011 audit, where we recommended the city make sure all departments have continuity of operations plans on file to ensure they're able to respond and continue city services in a disaster. It also included recommendations from past trainings, including one on winter weather. And recommendations from city plans where the city had developed recommendations to mitigate hazards facing the city and increase resilience. Staff reported challenges with implementation, including a lack of staff time and resources, exacerbated by the covid-19 pandemic. But another challenge is the number of recommendations that have been made. In just the most recent three after-action reports for past [9:55:34 AM] disasters, there were over 400 recommendations. So this is definitely a challenge for the city. Prioritizing these recommendations based on those that would have the most impact would be beneficial. The city also has not historically prioritized or fund Ed disaster repairedness or community resilience initiatives. In may 2020, council directed city management to develop a comprehensive resiliency plan. Neither of these were acted on before the storm in February. However, city council recently approved $3 million for two resiliency hub pilot projects that are expected to be completed in the next two years. We made several recommendations in response to this finding. We recommended the city manager prioritize planning and also prioritize initiatives to increase disaster preparedness and community resilience, including the resiliency hubs I mentioned earlier. We also recommended the director [9:56:36 AM] of hesum plan for catastrophic events and prioritize, implement, and track past recommendations. Our second finding was related to communication. We found that the city did not communicate effectively with Austin residents in the days leading up to or during winter storm uri because the city was unprepared for such a severe winter storm, so residents were left without critical information that may have helped them stay safe. We had three main issues related to communication, which I'll discuss on the following slides. The city's early messages did not communicate the urgency of the situation to residents or adequately prepare them for possible risks, like widespread or prolonged power or water outages and impassable roads. Early messages, primarily focused on icy conditions and potential damage to pipes, such as the tweet on the right of the slide. But didn't prepare the cities for the unusual and severe nature of the storm, such as messaging about preparing for extended water or power outages and ensuring supplies were on hand like food and water. Even less preparedness [9:57:38 AM] information was provided between February 12th and February 14th. This was after the emergency operations center was activated and before snow began to fall in the Austin area. Additionally, minimal preparedness information was provided through the city's warning system, warn central Texas. The city communicated a winter storm weather warning had been issued through this system, but no other preparedness information. We also found that information about preparing for power and water outages was received after it was too late to be useful. This was because the city had not anticipated the possibility of these occurring. As you can see, on the slide, residents were made aware of possible power outages at 1:10:00 A.M. They were then made aware that power outages were starting at 1:25 A.M., just 15 minutes later. This occurred partly because the city didn't receive information from outside regulators with much advance notice. And information changed really quickly. For example, the time between ercot alerting the city about possible issues and calling for [9:58:39 AM] rotating power outages was only about an hour. But still, had the city anticipated the possibility of a prolonged power outage in its planning efforts, the city could have communicated better about preparing for this possibility early on. As I mentioned, information about preparing for water outages was also received after too late to be useful. As you can see on the slide, Austin water tweeted at 6:00 P.M. That there were no plans to disrupt water service. Later that night, Austin water said they were aware of water outages in southwest Austin, and they implemented a city-wide boil water notice the next day. The support didn't give residents enough time to prepare for these water outages. This occurred because the city hadn't thought through what communications they would need for such a significant or widespread event. Austin water staff said they had messaging and preparedness tips prepared for a typical one or two-day freeze, but not a week-long one. Planning for how to communicate in these sort of severe and prolonged disasters is critical, given the ongoing climate crisis. [9:59:39 AM] The city also communicated minimal information in non-english languages, and these communications were off less timely. This is particularly important, because when we look at the five most commonly spoken languages in Austin, there are at least 88,000 residents in the city who speak English less than very well. So many residents have the need to access information about disasters in languages other than English to stay safe. In fact, information during a disaster is known as being just as critical as food or water. The city's language access policy requires the city to send messages through one central Texas in Spanish and to make reasonable efforts to send those messages in other languages, but the city didn't communicate all of these messages in Spanish, and didn't communicate messages in any other languages through this system. As you can see on this slide, the first message sent through one central Texas was on February 15th. This was four days after an initial message was sent to English speakers on February 11th, three days after the emergency operations center was [10:00:40 AM] activated, and a day after snow began to fall in the Austin area. This was also the day power outages started for many. Staff reported it was difficult to access language access vendors because many of them are local and are also affected by the storm. We saw the main reason these issues occurred was the lack of preparation for communicating disaster-related information in other languages. After action reports have consistently identified language access as an issue. For example, the Colorado river flooding event recommended the city develop a language access plan for emergencies, but this has not been developed. Additionally, based on a review of communications related plans, the plans only address Spanish and American sign language and no other languages. As a result, the city was unprepared to serve residents with limited English proficiency. We made a couple of recommendations in response to this finding. We recommended the director of hesum conduct exercises for communicating during significant events and work with the [10:01:40 AM] director of the public information office to create and implement a language access plan for emergencies. Our next finding was related to resources. Even if the city's plans had anticipated a severe winter storm, the city likely would not have been able to respond effectively because the city lacked adequate resources to respond to such a complex disaster. Some departments have supplies on hand, but the city doesn't generally maintain an emergency supply stockpile and couldn't easily rely on other agencies for supplies due to the widespread nature of this event. The city also has no centralized inventory to track supplies across city departments that may be available to use during disasters. Staff reported we don't maintain supplies on hand because it could be -- it would be cost prohibitive and there's a lack of storage space. But this caused a lot of challenges during winter storm uri. The city didn't have supplies, like generators, tire chains, food, water, or snowplows, and had trouble accessing supplies from elsewhere. A cost benefit analysis to [10:02:41 AM] determine what to keep on hand would be beneficial. The city also doesn't have an effective process for ensuring staff are available and trained to respond to disasters. The city didn't have adequate staffing to respond effectively to the storm. This lack of staffing was a major challenge in the city's ability to respond. In a disaster, especially one like winter storm uri, the city needs to be able to rely on staff from across all city departments to come together and respond. What we heard throughout the audit was that it was difficult for hesum to find volunteers from city departments to meet the many needs they had, so staff who responded were working extremely long hours and being expected to do a lot. We recommended the city manager improve staffing processes to ensure the city is utilizing more of its staff from across the city to respond in disasters. We saw examples of these sorts of processes in Houston and fort Worth, which we mentioned in our report. We made a few recommendations in response to this finding. We recommended the city manager [10:03:43 AM] evaluate current hesum staffing and add staff if needed and update processes to ensure adequate staff from across the city are available and trained. We also recommended the director of hesum and ensure equipment is available for future disasters. We found that the city's preparedness efforts are not equity focused and as a result the city's response did not effectively serve all residents. The city's plans do not contain the specificity needed to help city staff directly serve populations who need it the most. Such as detail on how vulnerable populations will be reached during a disaster. We saw examples of plans acknowledging equity concerns exist, but little detail for how to how to manner these concerns. The city does not have a formalized process for engaging community stakeholders to assist with reaching vulnerable populations, even though this is recommended by best practices. The city relied on informal [10:04:45 AM] contacts that stack and city council members knew, rather than having an established list or database of community organizations. A more established approach would help the city better serve the community, but may also alleviate some of the strain on city resources during a disaster, which was a major challenge. There was a lot going on. This would also help the city focus on serving individuals who need assistance and resources the most. Lastly, the city does not know if it is reaching the most vulnerable members of our community because the city doesn't have a good way to measure its outreach efforts. The city has some measures, but they're community-wide and too broad to guide specific efforts and to understand who is not being reached with current information. Staff said the main limit to tracking and analyzing data is a lack of staffing, which has been particularly difficult during the covid-19 pandemic. We recommended the director take several actions to ensure the needs of vulnerable populations are met during a disaster and develop a formal plan for [10:05:47 AM] involving the community and disaster preparedness and planning. That concludes our presentation. We're happy to take questions. >> Alter: Thank you. I think we're going to allow the staff to respond and then we'll take questions. Thank you. >> Absolutely. >> Council member alter? >> Alter: Yes. >> Thank you for the opportunity to offer remarks on behalf of the city manager on this topic. Winter storm uri was a statewide catastrophic event layered on top of an already historic global pandemic that continues today. The city of Austin, like the state of Texas, was unprepared for such a complex disaster. Yet, our employees rose to the challenge and did their very best, many of them leaving their families to serve the community first. Speaking of community, we also saw community members and organizations working to help one another during this epic event. Today's audit report together with the after action report we [10:06:48 AM] presented to council last week will serve as the basis for staff's efforts to continue making improvements that will better serve the community. I would note for the committee and the public that efforts will take time and additional resources. In the case of a few key departments such as homeland security and emergency management, public health, they continue to be actively engaged in the covid- 19 as well. Making a plan, knowing their neighbors, and staying informed. Residents can visit readycentraltexas.org to help with tools for emergency preparedness. Residents are also encouraged to begin building emergency kits now, including enough water, food, batteries, radio, and first aid for up to seven days. As always, the city manager office recognizes the opportunities for improvement [10:07:48 AM] through the work of the city auditor and appreciates our working together on this and all audit reports. Thank you, and we're certainly open to questions the committee may have. >> Alter: Before I open up for questions from the committee, I did want to invite Katie up, if you could speak, or whoever would be appropriate, to just speak a little bit about putting this audit in context relative to the after action report. Then I want to make a few comments and I will invite my colleagues for questions. >> Sure, I can speak to that. I think y'all are pretty familiar with our work, but our charge was to look at this through a citywide lens and to really evaluate the kind of prior planning efforts that the city had put together, and whether or not that really set us up for success during this storm. I think they can speak to what their efforts are intended to [10:08:50 AM] do. But really I think they took sort of a different lens and there's a lot to look at here. So I think there's a lot of overlap in our results, but certainly their charge was different. >> Alter: Thank you. I really appreciate the thoroughness of this report. Before we get into conversation, I want to make it really clear that if we have a conversation about what we need to do better, where we need mistakes, that is not to discount the very heroic efforts that the staff who were able to respond took during that storm. We all are familiar with folks who went above and beyond who were juggling their own challenges at home being without power, et cetera. But, we do owe it to our employees and our citizens to examine what happened, where we took missteps, and how we can move forward. And so it's in that spirit that we are looking at this audit and [10:09:51 AM] talking about how we use this information kind of moving forward. So I think that's, you know, really important that we recognize that as a city council, it is our responsibility to work to improve our preparedness. It's our city management's responsibility to look towards that. There's a lot in this audit, and anyone who hasn't read it, I encourage you to read it. There's a lot of opportunities that were missed that we need to double down and move forward on. The audit speaks very eloquently to the numerous resolutions and reports that had recommendations of how we could be better prepared, many of which seem very prescient in light of the events. I would focus folks' attention on the FEMA 2020 February [10:10:55 AM] recommendations at the top of page 12. So we need to address sheltering for winter weather. We need to do an exercise involving not having any electric power. We need for non-operational departments to help operational departments. We need long-term staffing. Now, granted that came out just before the pandemic. But we know a lot of the things that we need to be doing. We have reports that said we needed to have access to language, et cetera. All of those are in there. We need to do better. I have to say as chair of the audit and finance committee that I have never seen a management response that was so defensive. In light of the magnitude of the challenge that's before us and the real possibility that something like this could happen again. And it's my hope that the city management will take these [10:11:55 AM] recommendations seriously and work with council to provide the resources moving forward. I want to now open up the floor to questions. I want to invite council member tovo, whose resolution led to this particular audit, if she wants to go first. >> Tovo: Thank you. I appreciate that. And I want to start in very much the same place you did, council member alter. I want to really acknowledge our staff throughout the organization, you know, from our individual council offices, to our public -- our emergency responders, our public safety staff, our parks department, our public health. There were really, as you said, council member alter, just heroic efforts throughout our organization from individual -- from staff members who were suffering through this storm as well, and whose families were suffering through this storm, and none of the following conversation discounts any of [10:12:57 AM] that extraordinary effort. I was on the phone over and over and over again with one of our city employees, only to learn days in that he had been having most of those conversations from his car, because he had no electricity in his home. And so we are -- there is no doubt that the heroic and, you know, ongoing efforts of all of our city staff who were involved in the response saved lives, as the audit notes, there were several real catastrophic events that were -- that did not happen. And did not unfold in our hospitals and some of the other places where they could have because of the actions of our city. That being said, you know, as a council member, very involved in lots of elements of that emergency response, from helping [10:13:57 AM] get water to constituents, not just in my district, but others and helping trying to stand up warning centers into so many other real important basic needs that were required during that period of time. I saw things that I had not seen in our emergency response in the past. And definitely, this was -- there were elements of this crisis that were unforeseen and a confluence of events that were unexpected to some extent and happening together was not contemplated. There were certain things that should have flown better. I'll name one of them. As a council member, we had limited communication. Almost no communication to our general communication to our council. A few updates. No identified contact for us. [10:14:59 AM] And so, you know, I think that's probably a conversation we need to have in the after action report, more than in this one, but I can tell you, as a council member, receiving phone calls and emails and other kinds of texts from constituents who were not sure they were going to be able to survive in their house for the next couple days, it was critically important to me to make sure that we never had a situation again where I didn't even know who to ask among the city staff for help, or to communicate those really dire potentially life-altering queries for help, too. So the resolution had three parts. One was to have an initial question and answer session, some workshops, some work sessions with our city staff so we could ask our initial questions. The other part was a community task force, which did a great job and there's a very useful report with some recommendations [10:15:59 AM] that I really believe align very well with the audit, with some of the findings of the audit, including, especially and importantly, language access. That came up again and again in the community conversations around this event. And the third part was this audit. The after action report is going to be very useful. I am appreciative to council member alter. The two of us are co-sponsoring a session, I'm not sure if that will be on our next work session or a different day, so we really have the time we need to ask question of the consultant about the after action report, and I hope will also have an opportunity to talk with our colleagues about the findings of the audit. They are very different in approach, and though there are some themes that happened in both, I think what has not -- I haven't really read the after action report and the level of detail I need to, but what it doesn't necessarily focus, at least in my review at this point on, are what of those recommendations have been made in the past. So your audit really clearly shows where several of those [10:17:03 AM] areas were aware multiple times in some cases, our emergency operations were told to have a language access plan, to have some of these resources in place, to talk about staffing, to talk about training across departments, and it didn't happen. And so, you know, iriano, I think you have an important message about personal preparedness, and clearly that needs to be part of our work as a city and preparing a resilient community. But we do need to answer, I think, to our constituents about why we were not preparing -- just for starters, why we were not providing that kind of information in a language they could understand. So one example, for example, is the water boil notice, which went out to non-english language speakers and was delivered in Chinese, Spanish, Vietnamese, and arabic one day after the water boil notice took effect. [10:18:04 AM] So could you please first -- I mean, I have a lot of questions, but I'll start there. Could you talk to us about language access? This has been a need identified in multiple reports, in after action reports. Can you talk generally about why those recommendations related to language access had not been implemented at the time of the weather event? And then, once the weather event happened, can you talk about why those emergency methods, both preparedness before the event, and response, including especially the water boil notice, once the event had taken place. >> Council member tovo, I do believe Jessica king from the communications and public information office, I see her standing there, can respond to that. >> Tovo: Oh, I'm sorry, Ms. King. I didn't see you over there. It's like knowing where to put our attention here. [10:19:06 AM] >> Good morning, council members. My name is Jessica king. I'm with the communications and public information office. Language access is a key tenet of what the cpio group works towards, and the reality is we actually did have -- and we do have language access plan in place for hsem. The challenge was that our staff who are the leads on language access did not have power, did not have internet access, and therefore had a challenge reaching the basic -- our vendors who provide this service. And so we were not able to access those services because we could not get a hold of those vendors to support us in that need. Keeping also in mind that the way our structure is set up for language access, we heard from many community members of the interest of utilizing local vendors to help with translation and interpretation needs, because, and it makes a lot of sense, many of our vendors, many of our local participants know the community. They can serve as ambassadors. [10:20:07 AM] They understand the language that is utilized here. And so, most of our vendors are here. Again, the challenge was they were experiencing the same difficulties that many of our staff and the rest of our community were experiencing. And so one of the responses and the way we'll need to address that is ensuring that our staff have access to power, even when power goes out, as well as reliable internet. Internet was going in and out throughout the course of the event. I'm sure many of you also experienced the same challenges. And so even though we might have had limited power, again, I know for a fact, my staff, again, were also working in their cars to send text messages, to send posts, and to try and contact our vendors to be able to help with translation. Translation is also something that doesn't occur overnight, and the event was a moving target in many ways, because the information we were receiving was occurring at the same time, especially regarding power. We were receiving it live as the public was receiving it. And so as that information was [10:21:08 AM] rolling down from energy providers at the state level, we were getting it, too. And it is difficult to translate that on the fly, when it then changes again. And so the challenge is how do we make sure that, one, our language access services are able to be accessed even if they are not -- are they experiencing the same problems, can we go national, can we look at different resources that we can access. But most importantly, our staff need power and internet access to secure those services. >> Tovo: Clearly, and thank you for identifying and talking us through the piece that was relevant after this storm happened and knocked out power. There were some moments -- some examples that our audit sites about messages not being translated into Spanish prior to the storm hitting, presumably before your staff lost power. Can you address that issue, please? >> I would want more detail on [10:22:09 AM] the specifics, because again, the storm was one that was a moving target. Rolling blackouts occurred -- or rolling outages occurred. We were notified in the morning hours, the early morning hours. And so the impact of those situations, they weren't really realized until the crack of dawn, for most people who are just waking up and realizing they're quite cold. So depending upon what the translation was, as soon as we were able to get people online, and aware of the situation, then we were able to move more quickly and we utilized staff that we had who had access to some power and to some internet resources to translate the material as quickly as we could. >> Tovo: Yeah. The plans going forward are going to have to account for a situation that hasn't presented itself before in this community, where your staff who are doing the work and need to be in contact with those vendors, are [10:23:10 AM] unable to get reliable access to electricity, to internet. That's clearly going to need a different kind of solution, and you've identified some options of having, you know, a priority for local vendors, but also those relationships with individuals and outside communities. I think it is the audit that suggests this as well, that also having some -- having a second or third tier team that may be outside of your office, but our other city staff members who can help, if they have access to those resources that your staff did not, you know, even if they're from other departments. I don't know if something like that exists currently. >> We do. I am a fan of ensuring that we have cross training among our team because I do not believe in one point of failure. So there are multiple staff who have access. But we have at least I think three to four tiers of those who can secure those vendors and reach them. We could not reach those staff [10:24:11 AM] because of pour and internet access failures. >> Tovo: So your team couldn't reach those other resources because you couldn't get in touch with them. >> It was in both directions. So my staff -- when we woke up, early in the morning and experienced this situation across the city, the immediate response is check in with staff. Who is available, who can help. Who can get online and start doing work. And so because we were virtual, we're in a covid environment, we're not in our office, we couldn't travel because of the roads, the best thing we can do is go through texts and calls. Many of our staff were not able to either secure their power on their phone or internet issues one way or another. So securing access to them to find out who can help, that was the first barrier. And then once we were able to get people ramped up, that's where the lag and delay and then translation occurred after that. [10:25:12 AM] So it is a sense of trying to hope and pray that your staff are okay when you don't hear from them. And then to rely on them to help get information out as you're also trying to bring everything else online and working, too. >> Tovo: And just to reemphasize that point that we stated at the beginning, I know the chair stated that I did as well, I think it's really important to go through to really talk about these in detail. At the same time, I want to commend you and your staff for the work that you did do, and I hope that you understand the spirit in which we're trying to understand what exactly happened and where the challenges were, so that we can make sure we've got plans B, C, and D, all the way up to Z, so that if we're in a situation like that again, there's -- everyone knows what that next step should be. Going back to before the storm, [10:26:13 AM] though, I will just say, I think that is a different -- that's going to require a different solution and frankly, a different response and I'm not necessarily understanding yet why those messages about emergency preparedness in the days before the storm hit were not translated into multiple languages. And more broadly, and maybe this is a conversation we can take up for the after action in our longer half day, day- long conversation, what steps have taken with regard to getting those messages out, especially about preparedness in advance of events in those languages that we know our neighbors need. >> Absolutely. We are in the works on that already. I do appreciate the spirit with which this council and this body is looking at changes. I do hope that you also understand that we lived through it as well, and staff is intent on making changes because we don't want to go through this [10:27:13 AM] again ourselves, and there's a commitment across the organization, and especially those of us who worked the many, many hours to make sure that this community could overcome such a devastating storm. We want to see those changes, too. So I hope that despite all the criticism, we can look towards those changes and the recommendation that staff moving forward can be implemented. >> Tovo: Thank you very much for that, for all of that. So I think I have more questions, but since I've been talking about this for a while, I still will need a better understanding of why those messages prior to the storm were not translated, and so I don't know whether there's a response you want to give now or after, Ms. King. I know our audit did identify that as an issue. >> I will certainly look into it. I want to look at all the storm information and the content. [10:28:14 AM] I do know that we have a database of pre-translated material, and we have accumulated that over time. So I want to look at that database and see whether or not we also need to make tweaks to the information, because as the storm started rolling in, this was layers of storm, if you recall. So one came in, and then it stopped, and then another came in, and it stopped. So we need to take a look at how the information that we've already pre-translated was whether or not it was actually helpful in anticipation of the event. >> Tovo: Good. Thank you very much. >> Alter: Thank you. Just for a time check, we do need to take up the ems item, which we can do closer to 11:00. If we need to continue this conversation at our next meeting, we can. We have about another half-hour that we can potentially keep [10:29:14 AM] talking about this today. >> Tovo: How long are we scheduled? I thought we were scheduled until 11:30 today; is that not accurate? >> Alter: No, it's until 11:30. But we can extend the discussion into December and whatnot. But I think we did have an hour-plus on this. So, council member, Kelly, did you want to go next? >> Kelly: Thank you. And I just want to say also, I echo the sentiments of my colleagues, as far as the heroic efforts that were done during the winter storm. But I'm hearing from the community overwhelmingly, especially people in my district, who think it's very concerning that the city is telling people to be prepared and this audit shows that we are unprepared. So I'd like to move forward, much like my colleagues, and make sure that we are able to implement these changes. In recommendation number 4, the auditor's report talks about [10:30:14 AM] corrective actions and implementations. My understanding is that hsem has an entry level employee who has no authority in his department or city to enforce compliance with corrective action plans, and it's my analysis that if that is accurate, which I think that Juan may be able to speak to, that that role should probably be given to one of the deputy directors who has authority to enforce those plans, because one of the recommendations says that that needs to happen. Can you speak to that for me? Maybe clarify what I've been told, or what I just talked about. >> Alter: Does that work for them to be speaking over there, or should we have them speak here? That works over there? >> Good morning, council member. We are looking into that, and we'll be making some adjustments in responsibilities, and clarifying the roles and it [10:31:15 AM] might have been a lack of awareness of what exactly the function needed to be, but we're looking at that recommends and making adjustments as we move forward. Coop is something that is very important. It's going to be vital for our departments to make sure that they have all of the capabilities ready to respond. >> Kelly: The continuity of operations planning is coop, right? >> That is correct. >> Kelly: Thanks. Al recommendation number 7, it talks about in the audit available supplies during disasters. I'd like to clarify this information as well. My understanding is that there has been an effort to create a three-person logistics team within homeland security and emergency management to manage the warehouse that you are leasing, where you store supplies. But I don't think that addresses the facility or existing plan to change staffing. So I'd like to understand if the contract staff now that's on hand could possibly be created into permanent positions or what your further plans are for that warehouse, if you could just briefly talk about that. [10:32:17 AM] >> Yes. Because of the pandemic, we've had to establish a longer or more robust logistical function. In previous disasters, the logistical function only stood out for a period of time to manage the disaster, but because of the pandemic, it's been going on for over a year now. And that has allowed us to expand and evaluate some of the additional things that we need to consider, ensuring that we have an adequate inventory management system that required temporary staff to be brought onboard. And it really has helped us kind of grab a hold of the resources that we have acquired from the pandemic, that we're also available to respond to the winter storm. And as we move forwarder as we look at these disasters being more complex, and the frequencies of disasters that we're having, it's something that we're looking at to evaluate the logistical necessary capabilities in order to ensure that we're able to respond. That will include staffing necessary to support those functions. >> Kelly: Thank you. So, prior for me -- before I was [10:33:18 AM] on council, I worked in emergency management, so I have a deep understanding of the work that you do, and I know that it is very complicated. In recommendation eight, it talks about the public information that goes out to the community. I was a single unit Pio resource at the bastrop county complex fire, and I know there are several different levels of vetting that happened at hsem. Can you explain that briefly? >> I'm sorry, can you read the question -- >> Kelly: Yeah, sorry. Could you explain the levels of vetting that go through before a message goes out from hsem through a disaster? I believe there's three levels of vetting that goes forward, which could add to the length of time that it takes to get a message out? >> Yes, exactly. And it's very important that the information that goes out to the public is timely and it's actionable and addresses the question we're trying to answer. And so we do go through a vetting process to ensure that [10:34:19 AM] we coordinate with the operational departments on the accuracy of the information, and then we go through a process to also include the eoc director and policy group to evaluate that information dissemination that's going to go out, as well to ensure that we get it out as quickly as we can in as many languages as we can. As Jessica king indicated, we were drastically limited in our abilities. This was a disaster different from other ones. And the information was constantly changing and that required us to restart that process. We want to make sure that information that goes out is accurate, as best as we can possibly make it, and as timely as we can get it out quickly. >> Kelly: Thank you. And lastly, I was particularly concerned during this severe weather event, because as a newly elected council member, I was still getting my footing, and my understanding was that [10:35:19 AM] council members get information to access so that they can talk to their constituents about what's happening. At one point, I became so frustrated because city staff was not reachable, or they just were doing other things that I went outside of our city to get access to that information at the capitol area council of governments. I needed the situation report reports. And I don't think that that's good practice, and I would like to see moving forward a much better flow of information to council and to city leadership, or from city leadership. So, thank you very much for all the work that you did. It was certainly -- you know, they don't call these types of events events, they're incidents because you can't put them on a calendar and schedule them. So thank you for all the work that you did during that time. >> Thank you. >> Alter: Thank you. I'm going to ask a couple questions and then invite council member Fuentes, who is not on the committee, if she has questions at that point. [10:36:21 AM] So we have 130-some recommendations from the after action report from Haggerty, plus whatever is in the specific ae and Austin water recommendations. Something over the order of 400 recommendations from past plans that need implementing or have been recommending. There will is obviously overlap across them. There are patterns of things where we've seen there have been problems as has been mentioned with language access and shelter et cetera. Mr. Ariano or Mr. Ortiz, help me understand how we are prioritizing among these recommendations. We just got a lot of these recommendations, some had been there. What I don't want to have happen is what has already happened, where we didn't act on recommendations from past reports. I mean, the number of [10:37:22 AM] recommendations that have been acted on with respect to the water boil event in 2018 is astonishing. So help me understand how we are prioritizing. I think we all understand the constraints and the unusual circumstances of February. What we're concerned about is not repeating those and making sure that we're prepared. So please speak to how we are going to prioritize among these different recommendations to move forward. >> Let me speak on that, and see if there's any information that the city manager may want to add. I think the challenge that our community has faced the last four to five years has been the fact that we -- there's been a high level of activity as far as disasters are concerned. [10:38:28 AM] In the last two years, in addition to the pandemic, we also responded to a major evacuation for hurricane Laura and the winter storm event. There has been work done to some of the action reports. Unfortunately, the frequency of the disaster securing has gotten in the way and seen some of those efforts that are under way. Some of these situations will require a little bit more time. The way that we're going to move forward. And that is to look at all of these corrective actions that we have addressed, even the previous ones that we have looked at that were resolved, but we've seen them come back again. And it's prioritizing based on what are the ones that we can [10:39:28 AM] address very quickly as well, and make sure that we have the commitment from not only the city and county departments, but as well as some of these are going to be partnerships with our community partners. And ensure that we provide the adequate level of attention, given the fact that we have an ongoing response to the pandemic. I think it is important that we look at what critical infrastructure needs to be strengthened, what emergency protective measures can be -- can be taken in order to ensure that we can limit the future impacts of disasters. And as well as look at what capabilities the city and the county need and the rest of the community need to develop to ensure that we have the tools to be able to respond. [10:40:35 AM] To make the assistance go a lot smoother. So there needs to be a broader communication that we need to engage to ensure that we're looking at what ways to prioritize that infrastructure adaptability, to ensure what capabilities we're building in city are able to be quickly utilized to minimize the disasters. We suffered a boil water crisis that impacted the facilities. We experienced the same during this winter storm. The water we need to in an easy manner to ensure they were able to provide the continuing services that they're providing to the community. It's not an easy challenge. I do know that we're committed to our partners, and look at [10:41:35 AM] that matrix of prioritization based on what needs to be done to save lives and protect property as best way that we can to move forward. >> Alter: Thank you. Mr. Ariana, did you want to add anything? >> Thank you, chair. I would just add that certainly, director Ortiz has done a good job already starting with the community task force recommendations and doing a side by side comparison with the after action report. Certainly, this would have the attention of the city manager's office to make -- to help with hsem as well as the other involved departments. >> Alter: I'm going to ask that at our special called meeting that you come prepared with really clear statement of how we're prioritizing and what that plan is, because that's what we need -- we can't understand what [10:42:36 AM] resources you need. With a massive 600 recommendations, many of which overlap, there's a lot of really important recommendations, some is low-hanging fruit, some is more complicated. We are taking every measure possible to make sure that this doesn't repeat. And I will just point out that it is November. February is not very far away. It is concerning about what has been done. I understand we are in a pandemic. I understand we have multiple disasters. But we have to figure out, as we did during covid, to iterate and move forward and learn from the stakes, take the recommendations, and implement them. The next question I have is some of the dates for implementation in this audit are alarming. [10:43:37 AM] 2023, 2024. Again, it's November. February is right around the corner. I would like to understand why we are waiting until the fiscal year '23 budget to be implementing things. Obviously, there's some things under the budget. Hsem has 15 staff members and we're still in a pandemic, et cetera. And we have also expectation that we're going to have climate events. We have to resource the department. We have to resource moving forward with those recommendations. And if we wait until August and we're waiting until October, it takes three months or four months to hire, et cetera. That's too late. So, help me understand why we're waiting until fiscal year 2023 and what we're doing now, because I just don't think there's that much wiggle room in hsem's budget or whoever else's budget to do that. [10:44:42 AM] >> I would briefly say certainly happy to look at opportunities for a mid-year budget adjustment. In the particular case of hsem's staffing, certainly we've been able to take advantage of temporary staffing to get us along in terms of us addressing the covid-19 pandemic and Juan Ortiz can talk a little bit more specifically about that. Again, I think some of these longer-term lead items that we've identified, at least in our initial management response, looks to how we might address each item comprehensively, and it will take time to do that. In the meantime, though, certainly open to taking a look at, as hsem has, how we might do things using temporary resources and doing as much planning as we can to get things moving. >> Alter: I think I just really want to underscore as a council member, I need to understand the level of priority these actions are having or we're going to have to start doing ifcs over particular elements of the after [10:45:45 AM] action report. And we have before us an audit that basically says we've done all these after action reports and we haven't followed through on them. Well, we can't keep doing that. We have to implement, you know, what is in here, or some combination of the different report and get moving on different pieces. It is extremely frustrating as a council member who sponsored a resolution in 2019 that said set up resilience hubs, said we're going to have these climate actions, we need to be organized and do these things. And to look at these various reports of action action reports and to think that we were implementing them. I think that -- you know, it's just, it's extremely frustrating and we need systems in place that don't let that happen again. I think that colleagues that are on the committee, we need to think about whether we want to be devoting sort of some regular time to be looking at, you know, [10:46:45 AM] particular pieces of these reports and how they're getting implemented and diving into particular pieces to draw attention to things that rise up for us. And then lastly, I want to take up the point that council member Kelly mentioned with respect to council members and having the training and the information that we need in order to do our job and to not get in the way of the response. So, what processes should exist going forward for a more formalized role for city council during disaster events? And what plans are there for us to have the emergency planning training that I even as a council member five years in have never received, never been offered. >> Let me start by saying there [10:47:49 AM] is a specific requirement for training as we look at required by state law for the chief elected official. In the area of -- that being the mayor or the county judge. Outside of that, from a regular la story standpoint, there really isn't much. There are some things that we are doing to make sure that we are all sharing the information that we can. No matter what eoc activation. What I can say is that we're going to look at how we were providing that information to you or how we can improve in providing that information to you as a council member, doing those eoc activations to ensure that you're aware of what's going on. And how you can disseminate that information to your districts and ensure that we are addressing those questions. I think that what you heard from [10:48:53 AM] us is a realization that winter storm uri, when everything else was going on, it stretches really thin. I think it allowed for some of those procedures that we had utilized in the past to communicate to council were spread very thin, and we need to look at how we can strengthen those. I'll leave it at that. >> Tovo: Can I just add something to the point about the recommendations before we lose that one? >> Alter: Sure. I think council member Kelly wanted to speak about the council piece. >> Tovo: This is real quick. If you'd like to have the same access to the web eoc, I'd be happy to share with you the information so you can get a log-in, and you can go to preparingtexas.org to do basic training on emergency preparedness. These are things that I do believe should be your role. I don't know if I can just direct you to provide that, but I think it's the consensus of this council that should be [10:49:53 AM] provided to incoming council members. It's vitally important that we have that information. >> Yes, ma'am. >> Tovo: There were things in there that I needed to tell my constituents about, and I didn't know, because I didn't have the information, which is why I went outside of the organization. I just want to make that very clear. Thank you. >> Alter: And before you take up your point, council member tovo, I think one thing I've learned in my five years, if there is a vacuum, council will fill it, and you create more work when we don't have the clear paths. When things don't happen, we try to make them happen in other ways. And so it is helpful for you to be able to do your job. I'm very aware that there were situations that council complicated things by asking certain things. You know, nobody comes out smelling like roses from what happened. Everyone took heroic steps. But we can still learn from that, and my experience from that as a council member is we [10:50:56 AM] need that opportunity to know who we're supposed to be talking to, who's going to answer stuff, and who's going to be able to help us with the different pieces, and absent that, we are going to create a maelstrom and that can be avoided and improved to help us meet the needs of our constituents, but allow other staff to focus on what they need to focus on. Council member tovo, and then if council member Fuentes has a question. >> Tovo: I would like access to the web eoc that you have mentioned. I have had a day-long disaster training. I can say it wouldn't have helped with what we experienced because of some of the other issues, but I can address that, because there are certain things I had no surety were going to happen if I didn't step out of our lane as a council office and council staff and do it. I think that speaks to the communications piece as well. [10:51:59 AM] But, again, I'll address that with relationship to the after action report that suggests and sort of implies that part of the issue is council not understanding its role. So to add to the request that our chair made about coming to the after action conversation prepared to talk about the prioritization of recommendations, I need to also understand as we have that conversation why that need wasn't advanced to council adds -- council as a need, and probably I need to hear that from the city manager. I'm really distressed from the audit finding that there was not a process in place for tracking recommendations, as well as prioritizing recommendations. I need to understand how -- what was the thinking behind how those recommendations would be implemented if there wasn't a system for tracking them and, you know, keeping track of what had been implemented, what the timeline was for implementation. I know we're running out of time [10:53:00 AM] here and I have zillions of other questions about training and shelter, which I know we're going to have the subject of in another audit, but it's important to this one. I have a slew of other questions, but just let me add that one to the request that we get a real clear answer from staff about why, if there were resources needed to do that really important work of tracking and prioritization, why that need wasn't identified and advanced and what was the thinking behind how those recommendations would be turned into action if there wasn't a tracking mechanism. >> If I can speak on that, and going back to council member Kelly's comments. I think another thing that can be done, and what I would recommend, we offer an eoc representative training that council can participate. We're doing it virtually now. It's about three or four hours long. I would urge council to -- [10:54:01 AM] yourself or your staff, engage in that training. I think it will help understand and address some of those questions of what's available. >> Kelly: I think that is the training that I referenced. But thank you for making that available to the whole council. >> And then also, I think what we found out, and this is from engage went the city auditors, is that in previous timeframes, there wasn't a time in between disasters where we were able to address those proactive actions. But because of the amount of disasters that we have that are so close to each other, there hasn't been enough time in between them to look at those and complete all of those corrective actions, and that really has caused congestion in what needed to be done, at the same time as we continued to [10:55:07 AM] respond. But we recognize because it's happened within the last two years. So we are saying that we need to develop and implement a system of tracking those implementation suggestions and plans to go beyond just one disaster, but to look at multiple disasters. Not just the corrective actions from one particular disaster, if I look at them from how they fit into previous disasters as well. So we recognize that as well. And they came about because of the amount of -- or the number of disasters that we're facing in the last two years. That really brought that to light. And we're committed to addressing it. >> Tovo: Thank you. Council member Fuentes. >> Fuentes: Thank you. [10:56:07 AM] I will reserve questions until we have our special called meeting. I just want to make a brief comment. First, thank you to the audit and finance committee chair alter for bringing this forward and for creating the space for us to have this conversation. Thank you to our city auditor coordinating your team for working on this. Part of the reason why I'm here today is we know that when disasters happen, not all communities are affected the same. And certainly for communities like mine, who are already in a vulnerable position, we often bear the brunt of disasters. An so it's important for me to hear and to get a deeper understanding of what's being presented today. It is troubling to see that we had recommendations that were part of previous after action reports that were never acted upon. It is really hard to go back to my community and to say, well, we knew what to do, we could have prepared better, but we didn't. But now we know what to do, and we're going to have action on it and implement these recommendations two years from [10:57:07 AM] now. It's not okay. I cannot do that. I cannot say, in 2023, we'll be implementing recommendations so that we never experience what we experienced during the winter storm. And so I just want to underscore the point of how important and urgent it is for us to move forward on these recommendations, to actually implement these recommendations. And as we look at rebuilding a system that is equitable, know that, you know, even the map that showed the registrations of austinites who are on the warn central Texas system, you will see there are significant disparities there. And austinites who live east of 35 are less likely to be registered on the warn central Texas system. And so I expect and I hope that we can have a conversation about what we can do to encourage more of our community to sign up on that alert system, because I know just how crucial it is during times of disaster. And so that's the brief remarks I wanted to provide. [10:58:08 AM] >> Alter: Thank you. Al and I just wanted to point out that even on the west side, the registration is not very high for warn central, so we as a immunity have a lot of work to do. The media who are here, I would encourage you to please regularly and often help us to encourage folks to be prepared. You have a role in helping us constructively get our community prepared, take the preparedness messages, get folks that information on warn central so that we can make sure that our community can do their part of being prepared. So we will have some continued conversations. Ms. Stokes, is it -- it sounds like we may want to have additional conversation in the committee, so I'm a little bit hesitant to approve the audit. But I wanted to just check if there were any complications with that for you, because I don't think it's about so much the questions about the audit and changing the audit as much as it is that we want to keep having communication. So as the auditor, I wanted to [10:59:09 AM] just ask you what your preference would be about how we approach that. >> Sure. I am fine either way. The audit is out. As y'all know, it's been posted as a draft. We'll finalize it and post it on our website. We can come back and answer questions later, if you want to hold off on that. If you want to do that at a later date, that's fine as well. >> Tovo: What would you like to do? >> Thanks very much. I would move that we accept the audit since we don't have concerns about the audit process, we just have further questions about the audit, and that we do so with a commitment to talking about it at our next audit and finance meeting, in addition to trying to find time within that after action report day to talk about it as well. So I move that we accept the [11:00:09 AM] audit. >> Alter: I'm going to accept that locking motion, and council member tovo moves to accept the audit, and council member Kelly seconds it. All those in favor. So, council member Kelly, council member tovo, council member alter, who are on the dais, accept the audit. Mr. Ortiz, did you want to say something else? >> No. >> Alter: So we will try to continue the conversation. I'm sorry that we don't have more time. We did have a budget that I authored during the budget process with respect to ems and sort of how we move forward with some of that ems is part of our emergencied preparedness. I do want to make sure that we're hearing some of that in a timely manner in case we do need to provide any guidance with respect to that process. Thank you to staff who are -- who participated in putting the audit together. Thank you to the staff who lead our emergency team. These are not easy conversations, but they're [11:01:10 AM] conversations that we need to have in order to be better prepared, in order for us to make sure that we don't have a repeat, and that you have the resources you need to do your job. And we can't understand where those gaps are without having these more in-depth conversations, so we appreciate that opportunity. I think our community is asking for and demanding that we have these conversations, and it helps to also help people be prepared that we can continue to keep with those messages. So thank you all for being here, and participating in what I hope will be constructive conversations. So, thank you. I'm going to invite up chief brown. I don't know for sure that we won't get to the economic recovery. Since you waited this long, if you can wait until 11:30, because I don't think it's going to take that long. But I just ask that you stay on until 11:30 and we'll see what [11:02:13 AM] happens on that, because I don't think there were many issues with that. So, chief brown. >> Good morning, council. Jasper brown, hearing chief at the ems. Waiting for the presentation to come up. So, I'm going to talk about the budget rider alter 1 that was sponsored during this year's fiscal budget. There were six pieces to the rider. We'll talk about four of those today. I'll briefly describe the last two. And to provide council with detailed plans to improve the billing system in the future and update revenue protections. 2, the city manager is directed to conduct a study regarding the cost of service for providing ems and report to updated figure to council by November 30th. [11:03:14 AM] The cost of the service should incorporate billable expenses of the office of the chief medical officer, which provides medical expertise and services to residents. Number three, the city manager also conducts a full evaluation, optimization opportunities within the fire and ems efficiency study, particularly opportunities related to updating to ensure the city recovers costs that is appropriate and make recommendations to city council on what is feasible, including potential fee schedule amendments. Number four, which we'll consider concluded today, is the city manager's directive to provide an update on billing. It is November. I think we tried to get on last mark but just missed the agenda. Number 5, the city manager is further directed to evaluate and bring forward to council a plan to achieve 12-person staffing at ems stations over the next four years, along with the projected costs, incorporating any changes made from items 1 through 4 to [11:04:15 AM] this rider and may accelerate the timeline. The city manager is further directed to assess where the additional resources are needed for the downtown station assuming 12-person staffing. Five and six I won't be addressing directly today. We plan to bring those forward with the city manager and the budget process and possibly amendments to this year if necessary. And six, we're working with the -- there is another directive council, directive on the safer sixth street initiative that we're working with that entire group on the plans, and I know a memo just went out about that to the council about the process of that. So we're working with the safer sixth street initiative there as well. I'd like to have a little bit of an understanding of what got us to the billing backlog. This chart, the top line represents the number of patient care records we receive on an annual basis. [11:05:18 AM] Fluctuates to -- in 2020, we had 99,000, our lowest over the last six years. It's about 100 to 105,000 patient care records per year. Our goal is to process a patient record within ten days for billing. Previous to 2018, you'd see we were at five days, five days. We got up to 12 todays. We were down to 11. In 2019, we implemented a new patient care record system for the field. We were already using electronic in the field, but this was a new system. And that produced a new patient care record to the building department that was different, in a different format. And so that started a little bit of a backlog. Our current staffing is only able to handle the exact number of patient care records we get [11:06:18 AM] on a daily basis. So anybody who is sick, we have somebody out for a day or a week, any period of time, already starts to get some backlog, because our current staff can only handle about the same number of billing records we get per day. So when we saw a little bit of a learning curve on the new billing process that came over, it obviously created a trend of going to a longer processing time. And then, of course, we had covid, which hit us, which all our staff went virtual. There was some setup time. Days missed as far as billing. That starts to create more of a backlog, because it creates more backlog. And then it just kind of snowballed from there. We have people out with covid themselves. They couldn't work even from home. Or they had other circumstances. We also -- during the time period, we had up to three people that were out because of vacancies, because they had moved on to other departments or other careers elsewhere. [11:07:25 AM] If we start missing staff, our billing backlog continues. >> Can you remind me of the billing system change? >> It was in 2019. >> Thank you. >> So, our current backlog of patient care records is 13,917. I was talking about our staffing concerns during the vacancies over the last 12 months. We had at one point initial vacancies of three people. We're currently, as of last week, fully staffed for the first time in some time, plus we hired an additional temp person. This will help with our consistency, and if somebody's out sick, at least it will be able to back fill in that spot and keep the number of bills we get per day able to be coded and sent out for the bill. That's not going to help us with our backlog, so what we've done is we've engaged a vendor to provide initial epcr coding. They have a process that's soul source, so we've gone to the [11:08:27 AM] sole source process, getting the financial impact. I signed off on the sole source documents, they're at purchasing. As soon as we get the word from purchasing, we have the funds within the department. It's going to cost us about $60,000, so we don't have to go back to council currently. It will be under the cap there to go and send out those previous bills and get those all done electronically at once. So what they do is they'll go through and start to match billing information. If you ensure whether we got all your insurance information, any secondary insurance, if you have a third and things like that, added to the patient's bill. And they're able to code the bill, and actual coding is we utilize language of either they have chest pain, maybe they have altered -- that has to be turned into a billing code that is sent to, whether it's medicare, medicaid, or Humana, blue cross, blue shield, whoever, that's what's payable is that billing [11:09:28 AM] code. And there's thousands of billing codes that could be used. And so this system is able to actually code the bill for us through the system. It will send those back to us. There will probably be a few errors, and we're sending all those bills at once for payment to the different payors, whether it be medicare, private insurance companies, or a private bill. We anticipate we should have everything taken care of through this month, through the sending of information and getting it all done in December and sending out those bills sometime in mid-december. Number two, the services conducted every five years by the department. The last cost of service was done in 2018. [11:10:30 AM] We'll be completed by January of '22. We'd like to have started a little earlier, but I took staff and others to direct it towards another portion, which I'll talk a little bit later. It slowed us down, plus this involves our finance department as well as others about this time. So they're working through closeout of the budget process and those things. So, conduct a full evaluation of optimization opportunities. There were several recommendations made. One of them was to revise our charity care policy and eligibility determination. We brought this to you in council, on September 2nd, you passed and added an additional things that we could write off under our charity care program. We added ten additional eligibility categories and we really feel that's going to help. For example, previous policy, we were able to write off about [11:11:31 AM] 1,700, and those were submitted, and we already received the check this month for about $1.2 million, and to date, the changes we made last time, we've written off about 11,000 bills instead of 1,700. So we're really going to potentially see an increase in the revenue there. We won't know that amount until August. And that amount doesn't come until October. So it won't come in time for us to prepare for the april-ish, may timeline. I don't know the timeline for when the manager delivers budget and revenue projections. We will try to project some of that, but we won't know a hard number until August, and the check comes in fy23. It will come in October. Conduct evaluation opportunities. Again, recommendation 13 was review billing practice to identify opportunities to capture revenue of both treatment and non- transferred allowable and recommendation 15 [11:12:31 AM] was considered reviewing commercial data regarding changes in payments by procedure code, commercial payers to ensure accurate reporting to identify opportunities to maximize revenues. This is in process. We've contracted with a company called Paige, burgh, and Werth. The team met with them, reviewed initial steps. We've provided a year's worth of documentation. That's all the transactions we've done with all our records for a year's worth, we sent them to them. They're going through them. And they'll start with the ready cycle management assessment in October. So we should have an on-site meeting with them in November or December. And again, they'll start to give us feedback on what we can approve our change in our billing process. You know, the previous audit and study, they asked for some information, but they didn't do the detailed work of looking through all our billing practices. They weren't able to do an [11:13:32 AM] on-site visit. It was during covid. So there's some information. We provided all the recommendations they gave us to also answer those questions, for commercial payers, whether we're getting what we can get from their commercial payers or not, so they'll be able to answer those questions definitively, and what things, if anything, we can do better. If there's something we can do better, we want to fix it, because it only helps us in our billing process, in our potential revenue capture. Schedule increases for ems transport. This is in process, obviously. Council is part of the approval of the budget. Increased our fee to our max allowed, which is our cost of current service. And we're doing the new cost of service and we'll make recommendations for potential fee increases then. Also created a non-resident fee, which was basically anybody [11:14:32 AM] that's non-resident goes to the max, whether they're advanced life support, transport, or basic life support transport, they go to the max of the allowed. So additional fee will be based on cost of study. So that's my update. I'll take any questions you have regarding any of it. >> Alter: So I really appreciate the work that went into this. Obviously would prefer we weren't in the situation that we had to do this in the first place. It does seem like you've put together, chief brown, a path forward to address the backlog. But also, to take a closer look at our billing system to find additional ways that we can generate the revenue that we can under state law appropriately with the safeguards in place, as we always do with respect to ems, for those who are lower income and don't have insurance. [11:15:36 AM] This is a really important process, because we've also, through covid, identified a need to have more ems staff in our stations. We have a goal, as a council, of being fully staffed, which I think is at 12, which was expressed in one of the other elements of the rider. I just want to reiterate the direction that was in that rider to you and to Mr. Ariano, that the goal is to do all these things to fix the billing system, and apply, you know, what's necessary to get us on the path over time, to get into those 12 medics. So in the timetable that we don't get the money until October, does that preclude an opportunity for us to begin the classes for the medics that would be needed? Because we have to train the medics. You know, because we could potentially have the money in place in October, but you still have to train them. [11:16:38 AM] Can you tell me a liability -- tell me a little bit about how you are thinking about that? I'm not saying that we're jumping -- ideally, we'd be jumping to get all 12 next year. But we had talked about a phasing process. >> Yes, ma'am. So, there was a discussion about a plan of adding ten per year over the next four years, which was discussed in the budget rider. If additions could be created in the next fiscal year's budget, knowing that moneys would be coming from these additional revenues, and additional enhancements or anything else happening, we could start hiring those personnel early, because we hire them as cadets with technically those positions have no moneys. They're funded through our budget savings. And it's once they graduate from the academy that it comes with more personnel, and we need a PCN, a place to put them, an actual fte. So we could start the process sooner. We start hiring earlier than that because it takes several months to go through the hiring process. It's starting an academy before [11:17:38 AM] then, even if it's one day into the new fiscal year, that's all we need. If that was the plan to go forward. So that's how we would do that, so that we wouldn't have to wait until October 1 to start that process. >> Alter: And when do you have to have more assurety of that to begin the recruiting process? >> We probably need assurety before we start an academy, which our academies are now -- we reduced them from 12 weeks to eight weeks. Probably in July, we wouldn't want to bring anybody in and tell them you're coming in for a job until we have some assurety in July or August. We could do the hiring process, create a list, we want to create the list as soon as possible and we notify personnel within 30 days so we have time to move employment and they'll start things when the academy starts. >> Alter: Okay. I would ask, you know, you and Mr. Ariano to make sure that we're on track, so that we'll be able to do that. My understanding is that there may even be, you know, more than [11:18:39 AM] sufficient money from the charity chair alone relative to what was in the budget last year, to get us to the 12-person staffing sort of right off the bat, if the estimates are correct. You know, whether that's the right way to do it logistically, and with the academies, I don't know. But what I don't want to see happen is us to have to wait even longer, you know, we need some flexibility in that staffing for ems that we have not had this year with covid, and I think it would be important for us to take those steps. Mr. Ariano, is that something that you can commit to looking forward to? >> Certainly, council member. These are items -- certainly, we have heard from you and other council members where you have a priority in terms of emergency medical services, whether it's here in ems or certainly for the office of the chief medical officer. [11:19:39 AM] So, during the budget process, certainly, we'll take this forward as priority items for consideration in the proposed budget. >> Alter: The other thing I ask, chief brown, is if you can work with my office for coming back to audit and finance at an appropriate time, whether it's February or March or January, you know, based on when that cost of study comes back so that we can be looking at that and taking the next steps. >> Yes, ma'am. I'd just like to comment. One of the other things, although -- to be in a good place of having a billing backlog, but finding this vendor, it's very unique what they do. That may set us up on a path to be able to utilize some sort of hybrid model, where we utilize them as a permanent basis for all bills coming in that does some initial work in coding. It would not remove our current staff, because there's always customer service, you know, problems that occur, that can't be resolved electronically. Those type things. [11:20:40 AM] And potentially, instead of coming and asking for additional staff, because we have proposed that in several past budgets about additional billing staff because our billing are increase S, but this would be a way to curb that. We currently use an electronic program that does some of the work, but not all of what they do. So we could possibly roll those funds that we currently use into this and reduce that cost. So we may be coming to you in the future as part of the budget process to say this is an increase. To do all our bills would be about $500,000. But given personnel versus this, and it's not a way to replace personnel necessarily. But it would be a way to enhance and keep us on track instead of getting into this billing backlog, because we're going to have people who are out, take vacation, get sick, and we can't continue to be in a billing backlog type of situation. >> Alter: Thank you. Does anyone else have questions? Council member tovo. [11:21:43 AM] >> Tovo: I missed a crucial piece of information toward the end of your presentation. Is the non-resident rate implemented, or is it in the process of being implemented? >> It is implemented. It is part of the schedule currently for anybody who is transported after October 1st. >> Tovo: That's terrific. I'm really glad to see that differential rate put into place. Thanks for the other changes that you've implemented. >> Alter: Thank you, chief brown. Appreciate that. Colleagues, we have about ten more minutes left in our scheduled meeting. I think we could do the economic recovery if folks are comfortable. We may have to go over five minutes, but I think we could get it done, and it's a positive report. Anyone, council member tovo, or Kelly, have any objections to trying to do that quickly? Okay, thank you. >> We need a few folks moved [11:22:45 AM] over. Looks like they're coming over now -- excellent -- for this item. I'm missing a couple folks that may need to jump back on. But we can go ahead and get started. This audit of economic recovery funds was managed by Keith Solis. This is Keith's first audit to present to you guys. He's a new audit manager. He's been in our office for a long time as an investigator. So there's Keith, or there went Keith. And so he was the manager on this project. Kelsey Thompson was the lead, and she is going to do a quick presentation and then we'll take y'all's questions. I believe we have staff from economic development as well as housing on the call as well. >> Thank you. My name is Kelsey Thompson, and I was the lead auditor for this project. Our objective was did the city [11:23:45 AM] effectively manage the distribution of economic recovery funds. Next slide, please. In March 2020, the covid-19 pandemic began affecting the Austin economy, and the city created and administered multiple relief programs to address this impact. Multiple departments have been involved in managing these programs and distributing this funding. And we looked at nine programs for the economic development department managed from April 2020 to March 2021. The economic development department distributed $47 million of both federal and local funding for these programs. We also looked at the housing and planning department's relief of emergency needs for tenets or rent program, which provides emergency rental assistance to Austin tenets. The housing and planning department distributed about $50 million on this program from may 2020 to June 2021, and the program is currently still ongoing with additional federal [11:24:47 AM] funding. Next slide. Our first finding is that the economic development department appears to have provided pandemic relief funding timely to eligible residents and organizations. Next slide, please. The economic development department managed nine programs, and these programs provided financial assistance to various community members, such as small businesses, non-profits, creative workers, childcare providers, and others. We reviewed four of these programs in detail marked in green on the slide. And the programs that we reviewed in detail accounted for about 70% of the total funding. Next slide, please. So on to what we found. We reviewed a 3% sample for each of the four programs that we reviewed in detail, and every applicant that we reviewed was eligible for funding, according to the program guidelines approved by city council. We also looked at a sample of applicants who are determined to be ineligible by the program administrators, and they were all deemed ineligible [11:25:50 AM] appropriately. Awardees received -- on average from the application close date and we saw that the economic development department considered equity when designing these program. Three program Dallas we reviewed in detail had an equity component to the selection process and for all three, there was a higher representation of black, indigenous, and people of color awardees that in the applicant pool. Next slide. Our second finding is that the housing and planning department has made improvements to the rent program over time to be more accessible to the community, and better aligned with best practices. Next slide, please. The housing and planning department managed different versions of the rent program throughout 2020, and 2021. Each version had different funding sources and other programmatic changes. We looked at the rent 1.0 program through rent 3.0 in this audit and rent 4.0 program was currently ongoing at the time of our report. Next slide, please. [11:26:50 AM] We looked at the Texas howsers principles for equitable rent relief, which say that rent relief should be several things. Rapid, accessible, accountable, targeted, and sustained. We found that the housing and planning department made changes to the rent program so that rent 3.0 is better aligned with these best practices and more accessible to the community. Changes were made to the rent 3.0 program to receive changes faster. The rent 3.0 program was more accessible by only requiring eligibility documents after selection into the program. The rent program has been accountable to the public by publishing awardee demographics online. The rent program has targeted people at or below 30% of the median family income through a weighted lottery, to serve those folks who need financial assistance the most. And then lastly, the rent 3.0 program was more sustained, as they increased the amount of assistance a tenant could [11:27:50 AM] receive from one month to up to 15 months. Next slide, please. We noted that the housing and planning department does not appear to have plans to offer emergency rental assistance without federal pandemic relief funding, so we have one additional observation in the report that the city could consider continuing the rent program past federal funding to serve as a more permanent solution to address the need for rent relief, which will likely continue after the city has spent its federal pandemic relief funding. Next slide, please. We issued no recommendations as a part of this audit. Next slide, please. And that concludes our presentation, and we're happy to take any questions. >> Alter: Thank you. There were no recommendations, but I did want to give EdD and housing staff an opportunity to respond if they wanted to. >> Olivia, did you want to go? Or do you want me to go? >> It was a pleasure to be able to provide resources to the groups that we served. [11:28:54 AM] >> I would say the same. This has been a tremendous opportunity for the city to be able to assist our citizens and residents that have had experienced hardships during the pandemic. The observation that the auditors brought forward about sustained emergency assistance program is one that we share and we actually had plans to work to incorporate before the pandemic hit. The pandemic just took it and we rode the tsunami of federal funds to get us to we are looking at the possibility of how we could structure additional emergency rental as stains moving forward. We're working with some partners housing works to help us establish what the need for rental assistance in Austin might be post pandemic. We hope to have some information about that likely toward the end of the calendar year. So we're excited about the opportunity of continuing this program and to ensure that it's [11:29:55 AM] right-sized. While the audit was taking place, we actually, I got word this morning, that the draw that was submitted by our vendor today will actually tap out all of the funds that we have available for rent 4.0, so we will be looking at how we can continue to sustain, you know, the delivery of the funds that are currently in the process of being deployed and to -- and to continue to tie up the program needs with paperwork and administrative expense. But we are at the tail end of our allocation program. >> Mr. Love, can you just say, I believe that the number on page 7 may not be the full amount that was allocated for rent 4.0, can you provide that information? >> Yeah, there was an additional 6.7 of budget stabilization reserves that went into the program, that was accessed at the beginning of this fiscal year, and that has already been [11:30:56 AM] drawn down. >> Thank you, so someone is trying in the media to total up the amounts, they need to add 6.7 for the rental part, and then similarly, sinovia, can you add how many was allocated from April 21 on ward, since this audit only covered through March of 2021? >> Yes, we have -- per the resolution that was approved by council, I believe that we have about 16 million. We have actually deployed two programs, 3.9, for our arts and nonprofit grant program. >> Great. So there's an additional amount of money to what is on page 4 of the audit, of the 6.9, was that what you said? >> Yes, that is correct. >> Okay, so that 47 million would be in addition to that. [11:31:56 AM] >> Yes. >> Thank you for clarifying those points. I want to say thank you to our staff and our vendors who really helped Austin get funding out the door to our businesses, our nonprofits, our child care, to our artists, to folks who needed the rental assistance. These were not processes that we knew how to -- we knew how to do exactly. There was a lot of inventing the wheel as we went, and I'm really proud in both cases, I think the success we have is also due to the fact that we were willing to iterate. We were willing to learn. We accepted, okay, we did this right, it was better to get the money out of the door, get it into people's hands. We're keeping at it. We're going to learn -- we're going to make sure that we have all of our controls in place. But we're going to -- we're going to reflect on what we did and move [11:32:57 AM] forward so we can be more effective, and I think in both the EdD programs and in the housing with the rent programs, we were very successful in doing that process of learning under difficult conditions, finding a way to partner with organizations in the community who had the capacity to help us get this money out the door. In each of these cases, in addition to the vendors, who actually ran the grant process, we had community partners who helped us to get out into the community, let as many people know. Very targeted. And I'd invite either of you to just really briefly speak to how -- it seems to me that we -- we take for granted because we got this out the door, and that we did this, that everyone is doing this, and what I've been learning more and more is that other cities [11:33:57 AM] are very far behind us. I know that the better business bureau, who is one of our key partners on getting the EdD is being asked by other cities to help them get the money out the door, but we've had money out the door for a really long time. We hear comments at the federal level about how rental assistance is not getting out to people and cities and counties are sitting on it. We have quite a bit of money, and we have gotten it out the door to the benefit of our cities. I would invite either of you if you have any information to close us out, unless there are other question, which there may be, with a sense of what's going on elsewhere, and how this success compares. >> Yes, I would say David gray, our project manager has been on the call with several cities wanting insight on how Austin was able to deploy so quickly. As a matter of fact, I think we have a meeting this week with another [11:34:57 AM] city from Colorado, if I'm not mistaken. So people are definitely calling us, wanting to see examples, and just how did we do it? And we always attribute to our leadership, our council, leading with the needs of the community. >> And to echo what sinovia said, we have -- we have the benefit of tremendous leadership from city council and from our city management, but we also have, for the purposes of our rent program, we have amazing partners, and I think much of the success and our ability to serve the community in the way we have, have been attributable to hoca and cbr and our partnership with them. We -- I was on a call this mornings as we were talking about how we move forward with next steps, we wait to hear if we get additional money, the era one dollars, which were [11:35:57 AM] rent 3.0, there was a deadline to spend that by September, and the agencies and organizations that were not able to spend the -- to meet that spending threshold were asked to submit remediation plans. We obviously were not one of those agency, but we were asked to submit and ask for additional funding to help meet our needs in the community that we know still exist. While some cities across the country are submitting remediation plans and trying to figure out how they can meet the 60% spending threshold, we're hoping that through that recapture of funds that we might get additional money that we can use to help support, you know, austinites. So we -- we've been successful because of the partnership, and because the tremendous staff we have within the city of Austin working on this, and I commend all of them, and appreciate the opportunity to be part of this program. >> Thank you, councilmember Kelly or [11:36:58 AM] councilmember tovo do you have any comment. >> I wanted to say thanks, I had an opportunity to speak to a group this morning, all of us have talked to constituents who benefited from this program, and I want to express my thanks to the directors and all of your staff, including those on the call making sure the money we were getting was being invested in immediate solutions for individuals who needed them. So thank you very much. I imagine it was -- I didn't do your job, so I don't know all the effort that was required, but I know it must have been a very extraordinary one for everyone on your teams, so thank you very much. >> As we -- we covered a lot of stuff today, in this meeting, and just as we talked about earlier with respect to the winter storm response, it is important for us to learn both from our mistakes as we talked about earlier, but also for when we do things right. [11:37:59 AM] And I think there were fits and starts, things could have gone faster or slower, but I am really excited to see that we've been able to get the money out the door and love hearing, Mr. Love, that we may received a additional funding to get out the door and that we have some additional funding going out, particularly for our arts community in the next several months, you know, these funds were designed to help our community. We were entrusted with them to get them out the door. And to -- we asked as a council for them to be distributed equitably and I think this audit is one signal beyond the many stories of folks who have been helped that's a testament to the hard work. So please thank all of your staff. I know with all of the full mutt that is going on with covid, we don't pause enough to say thank you. So thank you all for that work. So do I have a motion to accept the audit? [11:38:59 AM] Councilmember Kelly moves to accept, councilmember tovo seconds that. And I'm going to vote yes, so it's unanimous on the dais. The last item on our agenda is future items, we will continue the conversation in December about the after-action report. We have a pensions update and integrity unit annual report. Is there anything else? Stokes? >> Not at this time. >> Okay. Those are the items we're aware of and we'll check in with the various parties to make sure there is nothing missing there. >> Great. Thank you. I will just remind you that for January, we know that the mayor is at the mayor's conference during -- I believe it's the January 19th meeting, so if you are going to make sure that we can secure quorum and make sure we know what's going on, that would be much appreciated. So it is 11:39, I appreciate you staying [11:40:00 AM] ten minutes over, so we could complete our agenda. It's November 10th at 11:40, and I'm going to adjourn this meeting. Thank you.