Public Health Committee (PHC) Meeting Transcript – 8/6/2025 Title: ATXN-1 (24hr) Channel: 1 - ATXN-1 Recorded On: 8/6/2025 6:00:00AM Original Air Date: 8/6/2025 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. [10:01:44 AM] Good morning. My name is Vanessa Fuentes, chair of our public health committee. We are gathered today at 10:01 A.M. On Wednesday, August 6th, 2025. We are at the city hall council chambers. I'm joined here with the quorum of our public health committee, including our vice chair, duchen and council members, Velasquez and alter. Welcome everyone. We have a fairly short agenda today, which I hope is informative to the council as a whole, as a whole, especially as we consider our budget that we are slated to adopt next week. Today we will start with public communications. Then we'll move on to consideration of the approval of the minutes from the June 4th committee meeting. From there, our committee will discuss appointments related to the sobering center board of directors and then head into an executive session to have a conversation on that. We'll have a brief update on the marshaling yard, and then a update on the sobering centers expansion. Any questions or comments on today's [10:02:45 AM] questions or comments on today's agenda? Seeing none, we'll now welcome speakers from the community. May the clerk's office call the roll. >> We have Zenobia Joseph. >> Zenobia. Joseph. Okay. And that was the only one registered. All right. Thank you. We'll now move on to approval of the previous meeting. Minutes for item one. I have a motion from council member Velasquez, seconded by vice chair duchen. This is for consideration and approval of the June 4th, 2020 five minutes. Any objection? Seeing none. Those meeting minutes stand approved. Moving on to item number two. This is a actually, if y'all don't mind, I'll take that. We'll take the executive session item at the end, if that's okay. All right. We'll move now to the next item, which is an update on the city's marshaling yard. This is our temporary shelter to individuals experiencing homelessness. And this presentation will be [10:03:46 AM] this presentation will be provided by Greg Maccormack, program manager for the homeless strategy office. Welcome. >> Thank you. Chair. Thank you. Council members appreciate the opportunity to present a brief update on the marshaling yard. You guys are all familiar with the shelter, but this is just to give you some updates and let you know where we are with our services there. So as you're probably aware, the facility opened in August of 2023. Endeavors is our operator and has been our operator from the start. We used to have a capacity of 300 there. We now have a capacity of 282. I'll talk a little bit more about what that is, but basically the convention center needed some of the space back in there for storage of items from the convention center. And so we reconfigured the space a little bit. We've had 1323 individuals come through the marshaling yard since we have opened. So [10:04:47 AM] since we have opened. So significant number of individuals have come in there. I was just saying to Laura, with the sobering center that, you know, when we were envisioning and setting up the marshaling yard, it was our first foray into real, true congregate shelter, large warehouse space with beds. And I really was not sure how it would be received in the community and in the homeless community. But what we have found with our partnership with endeavors is that that people do want to go in there, and a lot of folks are getting housed out of there, and a lot of good things are happening. And so it is a model that is just one piece of the model that we need within our shelter system, but I think it's a very important one. Things that endeavors provides at the marshaling yards, daily transportation. It's not super conveniently located. And so they have vans that take people to the bus stop, as well as to door to door appointments, and so they can talk with the staff [10:05:48 AM] so they can talk with the staff there if they've got an appointment with integral care or community care, they can they can provide that transportation, like all of our shelters that provide the shelter provides three meals a day. The meals at marshaling yard are provided through a partnership with central Texas food bank. We really appreciate that partnership. It's been great. The shelter is a pet friendly shelter and we struggled with how to figure that out, but landed on a climate controlled conex, which is outside of the shelter. It has space for about 20 to 25 dogs, depending on sizes. I just wanted to point out that that really is about a 1 to 15 ratio. With the number of individuals we have in there. I went and toured haven for hope down in San Antonio recently. They've got almost 1500 individuals there, and they have about spaces for about 20 dogs. So about 1 to 75. They said one thing they would do over if they were redoing that, and if we [10:06:49 AM] were redoing that, and if we were doing something is to really expand and be prepared to expand that. As you guys know, many of the individuals we work with have pets and will not come into shelter without them. And so I think endeavors and the city has done a good job of providing space for pets there. Laundry service, laundry services are provided. It's a drop off pickup. People get their clothes done. It's daily. It's worked out really well because it wasn't built to be a shelter. We've brought in trailers for bathrooms and showers, and from all reports, that has worked well with some kinks of things breaking down and stuff like that. But otherwise there aren't lines for bathrooms or showers when I've ever been there, nor reports of it. Other wellness activities and areas for people to watch TV. There's a patio for outdoor activities and a smoking area. If you can, go to the next slide. So a picture of what it looks like with the beds in the [10:07:52 AM] looks like with the beds in the in the space there. Some of the same statistics here. One I want to point out is there are 244 individuals that when we pull it from miss, it will state it as positively exited. Those are housed individuals. There might be 1 or 2 in there that went back with family or something, but they're all housed just from may of 24 to may of 25, there were 87 individuals that were were housed out of marshaling yard. Do track with our shelters. The positive exit rates and the marshaling yard is at a 29% exit rate. Positive exit rate. Facility updates I talked about the layout a little bit, so we had to consolidate. We did we do have partitions for different areas. And so again, because it's a large warehouse space, we have men, women, lgbtq and mobility impaired. And so they all have partitions that kind of separate that and [10:08:53 AM] kind of separate that and provide some privacy. When we reconfigured that, we upgraded those partitions a little bit. And I think the space does provide some privacy for individuals within a warehouse space. Some staffing updates. We have nine case managers assigned there. It's a mix of endeavor staff as well as sunrise staff. And that I think I put it on another slide, but that basically is a ratio of about 1 to 30. We'd love to see that just a little bit closer to kind of 25, but we think that 1 to 30 does provide the ability for the case managers to work individually with each of the clients there. Endeavors now has hired an activity coordinator. And so trying to make sure that folks have things to do when they're staying at the shelter, it's been a great addition and think that it's something that we'll look at with other shelters. They've also hired a peer specialist, and I'll mention that in an upcoming slide. One of my favorite slides [10:09:54 AM] slide. One of my favorite slides I mentioned about the vans continue going to the bus stops every 15 minutes. We're trying to reduce the number of individuals walking up to the shelter by providing that. So some of the activities that are taking place at the shelter, the library, they do monthly visits and do book checkouts. They're also helping with the new library id cards, which some housing places will take as ids for when they are not able to secure something else, and pursuing housing. Community care has really stepped up and they're coming weekly and endeavors again is doing a good job of making sure that people know they're there and are utilizing their services when they're there. And so we love having them come there weekly. We've got a barber school that's coming for haircuts. Gen mobile is coming for phones. And so people who are eligible for free phones potentially have lost their phones can get them [10:10:54 AM] their phones can get them replaced. Trying to focus on workforce more. We've got goodwill coming on site for job fairs. Also, endeavors is providing other workforce and job related services trying to help people apply for jobs, looking for increasing their income and getting back to work. The peer support specialist that I mentioned conducts ongoing sessions and the new activity coordinator does have karaoke nights on Thursday on I guess. When is it on? I think it's on Fridays. So David gray has threatened to go out and start singing on those. So we'll see if he does that. So this is my favorite slide. Their peer support specialist was a client at marshaling yard. This is Sean's story a little bit. He allowed us to share this with you. He became homeless in 2009, struggled with many things. He entered marshaling yard in 2024, [10:11:56 AM] entered marshaling yard in 2024, and at that time, he really started making steps forward and expressed a desire at that point while he was there, really wanting to be able to give back and come back to marshaling yard. He secured housing in August, then earned his peer support specialist certification, then in October, and then did come back to marshaling yard and said, I'm here, I want to help out. And they hired him on and he's been great. Someone who can really help connect with the clients there, talk with them about their situation, let them know that you can get through it. And he's an example of that. So he's he's just great there. Have to make him go home each night to, to get ready for the next day. But I think it's been a great addition and I love to see when people have come through the program, gotten on their feet and want to give back, and then they're able to. Help. Next steps. So, you know, we're aware [10:12:58 AM] steps. So, you know, we're aware marshaling yard is not a permanent shelter. And so we continue looking for alternative shelters. We the money that has been identified for services for marshaling yard. Should we find when we find another shelter to replace those beds would follow those services. And so I want to make sure and clarify that we're always looking at different options. We're working with tuf, the other ones foundation. They are in the process of an expansion of 100 beds. We're hoping by possibly by the end of the year or the first of the year. And so we're working closely with them and see if that would provide an avenue for some at marshaling yard. Or we want to make sure that we don't lose the beds at marshaling yard without replacing them. And so we're working hard to do that. Thank you. Yep. >> And just on that note, so the truth is would be an additional 100 emergency beds in our overall system capacity. [10:13:59 AM] overall system capacity. >> That's correct. Yeah. And they're the standalone single units that they've had on the if you've been to on the left side, it's going to be on the right side. >> The right side. And that would be they're looking when that expansion take place. >> Well it's had lots of hiccups. But right now anticipated you know around the first of the year so soon ish okay. >> Thank you colleagues. Yes. Councilmember grauzer. >> I was hoping you could talk a little bit about you said there's been some reconfiguration because of the convention center. Are are they needing more space or have they been able to fit their needs in that reconfigured space and have told y'all you're good in your space? >> Yeah, we've ended our negotiations with the convention center, and so we've agreed on the space that they needed and were able to make the space that was left work for us losing a few beds. But it's worked out well. They've been a good partner. >> Okay. And so you anticipate it being 282 beds moving forward and that being the number correct? [10:14:59 AM] correct? >> Yeah. I don't anticipate that shrinking or expanding any. >> Originally y'all had asked for or the operating budget for the marshaling yard for the year was around $8 million. Will that decrease in beds have a I know it's slight, but will it have a slight decrease in the operating expense? >> It could it would be not a large decrease. It would be mainly, you know, kind of meals would probably be the only thing that I could see really that would be a tangible decrease. So not substantial. Okay, okay. >> And then when we talk about kind of where this shelter fits into the grand shelter plan, you know, under the plan, we've all been talking about 500 to 550 shelter beds over the next five years. You mentioned the 100 from the other ones foundation in phase two. They're phase three is to have another 425. So that by itself would cover that [10:16:01 AM] that by itself would cover that expanded need. But as you mentioned, the if we're transitioning from the marshaling yard to one of these other spots, then we might gain 525 beds but then lose 300. So really we've we've not met that Marc I did see in the bond master proposal, whatever we're calling that, a discussion of a new city shelter. Can you tell us and I know we're very in the infancy of that discussion, but what type of capacity do you envision for that? >> So I would hate to get ahead of myself on any of that, but we are talking about potentially with the bond proposal for next year of including a large shelter in that. If I were just speaking off the cuff, I would think 800 to 1000 bed availability within that, looking at what the needs are and looking at what what we're going to need to replace and [10:17:01 AM] going to need to replace and ongoing. >> How large is. San Antonio haven for hope? >> Haven for hope? Yeah, it's 1500. >> And then I know Dallas has a pretty large shelter. Do you have any sense of. >> Yeah. We visited the bridge I can't I think it was 706 or. >> 7 in the upper room. Okay. >> Yeah, great. >> Well, I appreciate it. Thank you for the update. >> Thank you for the briefing here. I have just a couple of questions. One is I appreciate you laying out some numbers here. Is there a way to. >> Get some additional numbers, such as the cost per bed that you're currently operating with right now or data like that? Would that be through David or you or who would I go to about that? >> Yeah, we've put that together as an office. And so I can make sure that David can ask if we can send that over. >> Okay. That'd be helpful. And then I know you highlighted a lot of and in the course of your briefing, you touched on a [10:18:02 AM] briefing, you touched on a couple of things. You know, we'd like to have more capacity for animals. We'd like to have reduced ratio for case managers. Where do you sense right now the biggest either challenges or needs. Or they might be two different things. If you can help me answer that. >> I mean, I think I'm not sure if I would have one single biggest challenge plural. Sure. I think case management is something that we could really focus on within our community and the skill sets and needs that we have there, not just ratio, but the work that's being done without case managers, people just are not going to get housed. And so I think really looking at how we're able to best provide that across the system would be one of the biggest things I would focus on. >> What does that mean in terms of not just the numbers but the skill sets? >> Well, I think you need to have a mix really. And so you need to have social workers who are trained to work with [10:19:04 AM] are trained to work with individuals. I think peer specialists and other folks like that who can really walk alongside someone as they're making that journey from shelter or from the streets into housing is key. >> Okay, so when you say the skill sets, you're really talking about a mix of professionals and peer specialists, correct? Yeah. Got it. Any other challenges that come to mind in terms of the things that you haven't touched on in the briefing or that we haven't talked about now in terms of animals, case management, convention center, taking some of your space, whatever those things are. >> Nothing else I can think of. I mean, you know, the Austin housing market is a is an ongoing challenge. And so housing individuals. >> And I'm sure you have a plan for that. >> Right. We're we're hoping that that that will ease up a little bit. It already is a little bit. >> Okay. >> Thank you. >> Yes. Councilmember Velasquez. >> Thank you for the presentation. Will the new proposed shelter be similar to the marshaling yard. >> The one that we're working through the bond. [10:20:06 AM] through the bond. >> I apologize, I should. >> Yeah, we don't have a scope for that yet. We're kind of in the beginning phases of that. So it'd be hard to describe what I envisioned. But it would be, you know, a large. >> Perfect. >> Thank you. >> Thank you. Colleagues, I, I have not visited the San Antonio New Haven for hope and just hearing the kind of I understand the need that we have for emergency shelter in Austin. But knowing that for us to plan for a bond proposal that would contain how many 800 to 1200. >> We're at the very beginning phases, stages of that. And so I would hate to. Yeah, could understandably. >> But just knowing I mean just putting that many individuals who need specialized services and care for me just sounds a little concerning. And so I don't know if anyone else has visited the San Antonio model. Perhaps, maybe later this year we could go to San Antonio as a committee and visit, just so I have a better understanding of when you have that many individuals, what it would take to provide adequate and [10:21:06 AM] to provide adequate and sufficient levels of service. I mean, we have even just struggled to provide adequate services at the marshaling yard, and that has less than 300, although I'm very pleased to see the additional case managers and peer support specialists, I'm glad that our ratio is slowly getting better, but that's just just some initial concerns I want to surface and really just a matter of understanding it better. But thank you for providing the example of a client that was served at the marshaling yard, who secured housing, who got certified as a peer support specialist and now works at the marshaling yard. That's an incredible success story, and I'm very pleased to hear that. Anything else, colleagues, when I have you here, I just saw not to put you on the spot, but we, the homeless strategy office just launched a new tool, the open now website. Would you mind speaking to that and what that resource will provide? [10:22:06 AM] resource will provide? >> Sure. So this is really and so much credit to Charles Lucien who has kind of spearheaded this. It's been a long journey to get here. And I'm not an expert on presenting on it, but it is. The goal is to provide accurate, up to date, immediate information about where resources can be found and things like water or things like needing to charge your phone or cooling center. And so this getting rolled out is very exciting and we're happy to be a part of it. >> Incredible. Just continue to incredible work from our homeless strategy office. Thank you and your team. And just really pleased to see the level of services and resources that we continue to provide for our unhoused community. Thank you, thank you, thank you, and welcome. Councilmember qadri joined us with that colleagues. We'll now move on to our next item. This is an update on the sobering center. We're going to welcome Laura leblanc, CEO of the sobering center. And she's going to provide us with an update on the planned facility [10:23:07 AM] update on the planned facility expansion. Welcome. >> Good morning. Thank you so much for inviting me, and congrats on your major win at the charity baseball game. You guys destroyed the county, you destroyed them and they were complaining about it a little bit. Thank you for the invitation. We are sobering. Center is in district nine and I live in district ten, so I'm glad to see council member duchen and council member qadri on this committee, so I will I have got a bunch of slides that some of them I'm going to use as reference, just so we don't run out of time. But I want to make sure we get to the questions that you have specifically since you invited me today. But for context, for those who are new, we are we're our mission has not changed. We opened in 2018. We are. We are focusing both on public health and public safety because we are providing a safe, sobering space for people who are publicly intoxicated as an alternative to jail or the emergency room when appropriate and when we can. We are trying [10:24:08 AM] and when we can. We are trying to connect people to a warm handoff to services. We have done 13,000 intakes and counting since our inception in the fall of 2018. Those numbers are going up and up. Started out pretty slow because we opened in the fall of 2018. It took a while for everybody to get their footing and for the first responders to learn how to use it. Then it closed during covid for about eight weeks. When I came on in June of 2020, it was pretty slow because it was a slow in the city in general, but we have really seen a massive increase in utilization in the in the last few years. In fact, last year we served 900 more patients than the year before. So we've seen a huge jump in utilization. As a reminder, we it is free to go to the sobering center there. Nobody goes to jail. There are no charges. There's no cost. It is totally confidential. We are following hipaa. We are never closed. We're open 24 over seven 365. And we are connecting people to warm handoff resources when we [10:25:10 AM] warm handoff resources when we can. We have also have a van and a second vehicle. We just got to help coordinate safe rides. We're serving folks that are 18 years and up with suspected drug and alcohol intoxication. We don't have, nor do the police or ems have like a lab. So we can't tell you exactly what people are using. A lot of it is going to be clinical presentation and self-report. We do have back testing so we can do blood alcohol concentration, and we do do that at intake. Most of our patients are drinking. About 75% of them are drinking alcohol. That being said, right behind that is methamphetamines, which it presents as a 180 degree difference than alcohol in terms of behavior and brain and all the ways that the folks show up there when they come in, they come in for a screening and we screen them to make sure that they don't have a head injury or any kind of seizure or like major medical issues, that would mean that they need to go to the [10:26:10 AM] mean that they need to go to the hospital if they have suicidal or homicidal ideation. That used to be a no go for us at the sobering center. But we have made we have opened our doors more and more and let more and more people in because of the need. And we will just do a telehealth clear with a mental health professional over at integral care, when we have this kind of patient presenting a quick run through of our process, the clients are referred by the by law enforcement or ems. There a big thing that that we've changed in the past few years is you used to only come to the sobering center in a siren vehicle. There was only one way there. So when I started there, people used to ask me all the time, well, how do you how do I refer to the sobering center? That sounds like a good place to get people connected to care. And the answer was, you have to call 911. You have to go in the back of a siren vehicle. So we added over the past five years we've added 90 referral partners. So that means that could be UT, it could be capital metro, it could be the Austin public library, it could be integral care, it could be safe alliance. It could be a [10:27:11 AM] be safe alliance. It could be a multitude of community organizations, places where people show up intoxicated, where they shouldn't be marshaling yards as an example, where people could call us and refer to us directly and not have to involve police or ems taking first responders away from their jobs or escalating the situation inadvertently, our medics will do a screening to ensure it's safe for them to stay, and then our staff will monitor the client and continue to assess their needs. When they are sobered up and ready to go, they can sit down with a counselor to do an assessment to figure out, is this a one time thing? Do we need to just do a little bit of education on binge drinking? We do get tourists and partiers and college students. We but we also get folks who are chronically homeless and have lived on the streets for decades. And those folks, we want to do a little bit more of a thorough assessment and connection to care. We've also been doing sixth street outreach. This is an example of the tent and what it looks like. We did recently did a campaign with the city, with nightlife [10:28:11 AM] with the city, with nightlife and entertainment for sip safely. We did like a bunch of drink covers and free back testing water bottles, education helping to prevent some of the more serious issues that happen downtown with alcohol, both with binge drinking but also with people having their drinks spiked. So we were excited to do that. The police like the sobering center tent because they can bring us people directly to the tent. We can transport them to the center and they can kind of go hands off on that. That started out as a private fundraising effort for us. We had people sponsor the booth. We haven't been able to do that in a while. And then we transitioned to the sip safely campaign, where we did. The city had a contract with us for about six months and that has ended, so we haven't been able to do six street outreach in a while, but that's something that we really enjoy doing and feel like is a great public service. Some context of history. We were founded in 2018. We were founded through an agreement between the city and the county. So it is an interlocal agreement. It the [10:29:12 AM] interlocal agreement. It the building is donated by the county. It is the former medical examiner's office. They renovated it for us and have now renovated it again for the planned expansion. The operating funds are to come from the city. That's what the Ila states is that the operating expenses are paid by the city. We're not city employees. We're an independent local government corporation as well as a 501, C three. And the first interlocal agreement was for five years. And we renegotiated that new agreement for another five years in 2024. How it's going is, like I said, law enforcement and ems are still our top two referral partners, but they're not our only ones. We have about 90 other ones. So there are multiple paths to the sobering center. Another big change we made back in 2021 or so. We had a patient who was picked up by ems 75 times in 135 days, which accounts to about every other day for an entire summer. That individual was chronically homeless, addicted to alcohol, [10:30:14 AM] homeless, addicted to alcohol, and an incredibly chronic and severe way. He went to the jail multiple times, went to the hospital multiple times, went to the sobering center multiple times over one summer before he finally agreed to talk to us, which took us about a dozen visits. When he did agree, he said, okay, I'm done, I'm ready. I need to go to medical detox, which oftentimes the general public doesn't know. You can die from alcohol withdrawal. You will not die from crack or meth or even opiate withdrawal. You will die from alcohol withdrawal. And that guy was going to die if we let him out on the street. There was no treatment bed for him. There was no medical detox for him because it was 8 A.M. On a Sunday and he was homeless and indigent. That reality five years ago is worse now. We have fewer detox beds now in in Austin we have no Austin recovery, which used to be our big nonprofit treatment center. That place has closed. Cenikor, which was our only option for medical detox, has closed their detox. Santa Maria, [10:31:15 AM] closed their detox. Santa Maria, which was the treatment center that was in Houston for women and children, that was to replace Austin recovery's women and children's program has delayed their opening and closed their detox. That's due to state and federal cuts. So we have fewer and fewer options, which is why the sobering center started holding people over for services. So what I did with that one guy five years ago was, he's going to have to stay here because he will die on the street and we have 24 over seven paramedics here, so why would we not keep him here? We didn't have a kitchen. We did not have. We are not a residential treatment center. We're not a shelter. We're not we're not any of those things. But we're safer than the street, and we're safer than, honestly, than the jail or the E.R. At that point. So we kept him for five days, and we ended up putting him on a bus outside of Austin to go to treatment, because there were more beds outside of Austin. And he came back 90 days sober, and we figured out that's really what we should be doing as much as possible. That was the first time we ever did that. We now do [10:32:17 AM] time we ever did that. We now do that about 200 times a year. If we can find a treatment bed. And honestly, a lot of times they end up staying with us for a long time. And so those folks that are holdovers, they're mixed in on the ground floor with everybody who's intoxicated. So we've got intoxicated folks and our small number of beds. They're on the first floor. And then we've got the holdovers who are sober and want to go to treatment but have nowhere to go. So we're keeping those folks. So that's what the planned expansion is for, is for us to move those sober folks up to the second floor, where we have 14 beds up there that the county has paid to renovate the building for. The other really awesome thing we're doing, which is essentially street medicine and a standing ambulance. Inside the sobering center is bridge medications. And what that means is that when someone is about to go into withdrawal, we, the community health paramedics, will come out to the sobering center and provide medications on site. This keeps people alive, keeps them from going into withdrawal. It keeps them stabilized in the center until we can get them into treatment, which is oftentimes a week or more with no real other option [10:33:18 AM] more with no real other option or payor. So the second floor expansion was done with county funds to the building. Those were leftover arpa dollars that we were able to get the county to agree to renovate. The third and the second floor of the sobering center so that the administration could move up to the third floor. The homeless outreach street team moved out to dac, and our second floor now has a large dorm, which used to be where our board and staff met, and it has three private rooms. Eventually, it would be amazing to have our own medical detox up there. That would not be a city funded endeavor, but what I need to do right now is just open the second floor at all so that we can put the sober patients up there and make room on the first floor for our first responders to continue using those beds for intoxicated individuals. Second floor is ready to go. The county paid to renovate the building and also to furnish it. Put security cameras in it, put technology in it. It's all ready to rock. We just have to hire the staff to open it. What's going on right [10:34:20 AM] open it. What's going on right now is our fy 26 budget request is in process. We submitted we our contract was under Austin public health for the first several years, about five years. Then it moved under ems. It is going to move again under downtown Austin community court starting in October. So our fy 26 budget request went to ems. And our what they asked us to do was to put together a status quo operating budget, which was to represent no cuts. And like that, we wouldn't have to make any cuts if we got this amount of money and then to put in our enhancements like what we would want in addition to that. So we submitted a $2.8 million request to the city with four enhancement packages. What ended up in the city manager's budget was no enhancement packages and a significant cut, which put the number in the city manager's budget is 2.4. So what has been happening since then is council member vela has taken that our actual operating expenses budget, which is 2.8, and the [10:35:21 AM] budget, which is 2.8, and the enhancements minus one, and put it all into the tax rate election budget, which will be coming to you next week. So that's where we are with the fy 26 budget request. The second floor expansion. We have taken out of that enhancement request and put it into a proposal to central health. One of the most common questions that I get from the council and or city management is where is central health in this picture? My answer to that is that at the very beginning of the sobering center, the agreement was the city would pay the operating expenses. At the time, central health was taking the position that substance use was not in their wheelhouse, and it was not their priority. They were not at the table, and they did not want to be at the table. The founding of the sobering center that has changed significantly. So we now have a contract with central health, and we are now billing them for anybody who is eligible, who stays with us past a certain number of days that is trying to get into treatment and has nowhere else to go, that contract will increase and central health is coming on board to help us open that [10:36:21 AM] board to help us open that second floor. The other enhancement packages are related to us having on call medics, medics, because when we don't have a medic, we can't do an intake and we have to stop intakes at the sobering center, creating problems for the first responders. The other big piece of our enhancement budget was that council member vela request the council's request for us to get everybody to $22 minimum wage. That's all wrapped into our budget request, so I can answer questions about that. There's more about the Ila and the budgeting process. There's also a cost benefit analysis, which I have several slides in here, but it's kind of time consuming. So I have that to go back to. But I wanted you guys to know that we know from an outside cost benefit analysis that we have a 2 to 1 ratio, which means that every dollar you invest in the sobering center gets $2 back to the community. Every diversion we do makes that happen. And the more diversions we do, the more the better that is. So when we put our numbers into this model that this public health researcher [10:37:23 AM] this public health researcher created and we say we did 100 diversions, it it makes the model like 1 to 1.6 or something like that. If we say we did 200 diversions, it goes up to one point to 1 to 2, 1 to 2 ratio. So what that means is our costs are fixed for us to stay open 24 over seven 365. We have to see a high utilization rate for us to justify the cost that the city is investing, which we have done. And now we can document that. Every time we do that, we save money. So we want to keep doing it and we want to make more space on the first floor. But we also want the holdovers to go up to the second floor and have a little space while they're kind of basically in a respite because there are no treatment beds for them. We are a national model, and what I want you guys to know about that is we were featured as a case study in the international association of chiefs of police as a prime example of how law enforcement can work with sobering centers and how positive our relationship is with APD. I'm on the board and will be the board chair of the national sobering collaborative next year, which is a group of all the sobering centers across [10:38:24 AM] all the sobering centers across the country. They come and visit us all the time because we're seen as a national model for excellence. The other really special thing about that is that we're one of the only sobering centers in the country. There's probably maybe one more that takes referrals directly from ems. That's because our austin-travis county ems system is incredibly Progressive. Most ems systems will not take to sobering centers because they don't get paid. Our ems system does, and has been at the table from the founding of the sobering center, which makes us really special. So when I go present at conferences, it's the most common question I get asked, how did you get ems to bring you patients? I'm like, I didn't. I lucked out because I have the best ems system in the country, but this comes up all the time. They want to they want to talk to our ems system about our collaboration. Even better than that, we share a medical director with ems. So my staff, when they call in the middle of the night to talk to a doctor, they talk to the ems medical director, and ems is in and out of our building all the time. Our chip medics come in and out and help us assess. They help us provide medications. They help [10:39:24 AM] provide medications. They help us keep people alive that would otherwise die of alcohol withdrawal. So we're definitely saving lives there. And you guys don't have a lot more resources anymore with regards to substance use. Unfortunately, we're we're treating it as an emergency care model when it's a chronic illness. But we don't have long term care treatment beds in this town. I need to express my gratitude out loud to Cathy tovo for being our champion from the very beginning on this. I know she's no longer on council, but she was the reason that our budget worked every single session because she took an amendment every single session. Council member vela stepped into her shoes, and I remember having this conversation with council member Fuentes about, there is never going to be a policymaker like Cathy tovo, but council member vela has really stepped up to the plate and he is amazing. And he remembers every little thing, and he's now carrying that torch for us so that we don't get forgotten about because we're small. We're not we're not a city department, but we're also not a social service contract. We're a special kind of category [10:40:26 AM] We're a special kind of category where the city created us, but we're not a city staff member. So we get left out. A lot of conversations that we have to rely on the council to help us kind of stay public and stay connected. What we really need right now is to get our the budget through the budget request that we asked for. We also really need to look at the budget process and the way the budget is negotiated. The way that the Ila is written is not working for us, and we need to go back to city legal on that. That's going to be a big project and we'll have to take that up once the budget is passed. What I'm really looking for from the council is support to be our champion for sustainability for this, because the city and county created this, they really didn't know how much it would cost. They really didn't know how it would be utilized if it would be successful. They gave me the keys to it and said, make this work. Make it utilized. Show us outcomes. Do a cost benefit analysis, tell us that this is the right model. And we did that. And so now we have to [10:41:28 AM] did that. And so now we have to really invest in keeping it sustainable, because we've lost so many other resources in the city. I'm concerned that with the state and federal cuts, that's just going to continue to get worse. And there are just really not any options for people with an addiction in the city right now for care. And we're kind of the most trusted resource. >> Thank you, colleagues who would like to kick us off. Yes, vice chair. >> I'm just curious. You mentioned and I know we probably talked about this, but just to clarify, whenever there are capital improvements, you go to the county, but whenever you need operational things, you come to the city. Is that generally is that a written rule, or is that an unspoken rule. >> That is written into the interlocal agreement? >> Okay. Got it. So we're always going to be looking to the city for the operational budget piece. We're always going to be looking to the county whenever you need further improvements. >> To the facilities. Yep. >> Okay. And I'll ask you the same question I asked the marshaling yard folks, which is [10:42:28 AM] marshaling yard folks, which is at this moment, other than obviously coming to us for funding, what would you what would you say is the biggest challenge the you're facing right now. >> Like administratively or operationally with. >> The other ones? >> The biggest challenge I am facing right now is the incredibly tedious process of getting our budget worked out, just what the numbers are versus what is in the Ila was supposed to be addressed a year ago and has not been addressed. That takes up an inordinate amount of my time that I don't think is a good use of your money. That whole issue just has to be readdressed. There's numbers in that interlocal agreement that are not based on data, that are based on old guesses at what the sobering center would cost, or old numbers that the contract used to be years ago. What what that means is that we go through an incredibly tedious projections process. The city [10:43:29 AM] projections process. The city asks us for forecasts, we do a lot of work around it. And then what gets in the city manager's budget is a number that is not anything. What we even not even an option on the table. So we start over every summer and it's like it's a very exhausting process for everyone that that could be fixed. The issue for me is not what the number is. It's the process of negotiating a budget that is reasonable, that is based on data. >> And is that rewriting the Ila? >> I think it must be. I thought it was. We rewrote the Ila and then we had the same exact issue again, and I, I, I can't understand what I can't understand because I'm not I'm not I don't work for the city, so I don't have any. It's been like this for years and it just continues to be like this. And it's like a completely not clear process to me. It every time we change city managers, we get told, that's crazy what you're going through. We'll fix it. And [10:44:30 AM] going through. We'll fix it. And then we the same exact thing happens. So I don't know what the answer is. I think it probably is rewriting the Ila, but we've gotten some. We're being told by city legal that it has to be this way, and I'm not sure why, because the numbers that they are using are not real numbers. And we've got to use real numbers based on real expenses. >> Okay. It sounds like that might be an offline conversation and also maybe involve city legal to try and make some sense out of that. Thank you. >> Kind of. On that related note, can you remind us that the county is covering the brick and mortar of the sobering center and the city's the operations? What is the kind of proportion of that? Is the county funding 50% and cities at 50%. >> What's the county's funding? Purely facilities. So like they gave us the building and they give it to us, but they lease it to us for like a dollar. They renovated it. So they paid like almost $1 million to renovate it in the very beginning in 2018. And then this past year, they [10:45:31 AM] And then this past year, they just finished in December, renovated it again, almost another million dollars. So they're putting the money into build what we need. So furnishing, you know, all of that stuff. >> The second floor. >> Expansion, second floor expansion. Right. So they set it all up for that so that we could then bring staff in to operate it. So what we request from the city is only the staffing, like the personnel, the benefits, the security, those types of things, patient supplies and that type of thing. >> So is the city. >> Funding for the operations of the sobering center? Is that 80% of your budget? How much? >> Oh, yeah, it's significant. It started out as the only funding stream for the sobering center. So it was 100%. Now that we have a tiny little grant from integral care, which is a subcontract, we have a small contract with central health. And then we have a little bit of private fundraising, but that is we can't really use the private fundraising because we have to use it for cash reserves for if we get paid late or anything happens because we have one revenue stream, which was the city. So it probably is more [10:46:32 AM] city. So it probably is more like 90% of the budget. The city funding. >> Good deal. And then as far as and thank you for the context around how important it is to have ems as a partner and being a referral agency. What is the proportion of referrals? I mean, I love that we're not taking partner referrals as well. What is the proportion of APD, ems versus partner? >> It's primarily so APD still is our first priority as well as our number one referral source. So it goes APD, then ems, then Dell, Seton medical center, the E.R, which is right across the street from us, and then all the other referral partners. So we're talking about probably 50% APD, you know, 40% like maybe a little smaller, maybe 40% APD, 30% ems. And then at the hospital and then the smaller referral partners, the smaller referral partners are like sober living. And, you know, they're like one off things like treatment centers, sober houses. [10:47:32 AM] treatment centers, sober houses. We might have someone who was sexually assaulted, for example, at safe alliance. They can't they're too drunk to consent to a rape exam. So they'll bring them to us. We'll sober them up, send them back to safe alliance. So we never then involve the first responders in that. We just do that with safe alliance directly. But that will be like a one time thing, right? Same is true for UT. Like UT is technically a referral partner. They will bring us people or people can just self-refer to us. It doesn't happen very often and UT doesn't want us to do a press release around that. So it doesn't happen very often. But so it's small numbers. The referral partners are small numbers. So you still have APD and ems as your number one and number two. >> Very good. Thank you colleagues. Thank you. Thank you for being here with us today. We appreciate it. >> Thank you. >> All right. Now, colleagues, I'm going to take us back to item number two. This is on the topic of sobering center, but related to the appointments that we make as a public health committee, we're going to take this item, this conversation up [10:48:33 AM] this item, this conversation up in executive session. So the committee will now go into closed session and take up one item pursuant to section 55 1.074 of the government code, the committee will discuss personnel matters related to item number six. Discussion and selection of members of the sobering center board of directors. Is there any objection to going into executive session? Seeing none, the committee will now go into executive session. Out of closed session session [10:57:27 AM] Out of closed session session and closed session. We discuss personnel matters related to item six, and just want to thank my colleagues for that conversation. With that colleagues. Any further discussion items for future topics for our committee? Any comments? Yes. >> I would like to request that we receive a briefing on older adults experiencing homelessness and services from family elder care. >> Oh, great. That's a great topic. Thank you. Okay. Thank you everyone for your participation and contributions. If no further business, I adjourn our committee meeting