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GO AHEAD AND GET STARTED[ NOTICE OF MEETING CITY OF GARLAND, TEXAS COMMUNITY SERVICES COMMITTEE Work Session Room 200 N. Fifth Street Garland, Texas March 27, 2025, at 10:00 a.m. A meeting of the Community Services Committee of the City of Garland, Texas will be held at the aforementioned location, date, and time to discuss and consider the following agenda items. NOTICE: The committee may recess from the open session and convene in a closed executive session if the discussion of any of the listed agenda items concerns attorney/client communication, including pending/contemplated litigation, settlement offer(s), and matters concerning privileged and unprivileged client information deemed confidential by Rule 1.05 of the Texas Disciplinary Rules of Professional Conduct. Sec. 551.071, Tex. Gov't Code. ]
ON THE COMMUNITY SERVICES COMMITTEE.UH, COUNCIL MEMBER CHRIS BEARD, UH, STAFF LIAISON, KEVIN SLAY.
AND WE HAVE, UH, NOT ON THE COMMITTEE, BUT HERE, UH, CHRIS OTT AND BJ SCIENCE IS DYLAN HEDRICK.
AND WE HAVE JOINING US HERE, UH, CARISSA DUTTON.
HAS EVERYBODY HAD A CHANCE TO APPROVE THE MINUTES? DO WE HAVE ANY QUESTIONS ABOUT THE MINUTES? ANYTHING TO REVIEW ON THEM OR CAN I GET A MOTION? I MAKE A MOTION TO APPROVE.
NO, UH, NOTHING TO DISCUSS ON THE MINUTES.
PERSONS WHO DESIRE TO ADDRESS THE COMMITTEE ON ANY ITEM ON THE AGENDA ARE ALLOWED THREE MINUTES TO DO SO.
TESTIMONY MAY BE HELD UNTIL THE ITEM IS CONSIDERED OR GIVEN AT BEGINNING OF ANY COMMITTEE MEETING.
DO WE HAVE ANYONE SIGNED UP TO SPEAK? OKAY.
OH, YOU DIDN'T DO A CARD? CARD? AH, YOU DON'T NEED, I DON'T THINK HE NEEDS A CARD.
DO I NEED ONE? YEAH, I DON'T THINK YOU NEED A CARD.
WELL, WE CAN, WE CAN, I KNOW HOW TO FIND YOU SO WE CAN GET ONE FROM YOU IN THE FUTURE IF WE NEED TO.
MOVING ON TO ITEM THREE ITEMS FOR, UH, INDIVIDUAL CONSIDERATION.
UH, WE'RE GONNA START WITH NIGHTTIME POPUP BUSINESSES ON PRIVATE PROPERTY.
WE'RE GOING TO DISCUSS THE SCOPE OF THIS.
THIS WAS BROUGHT FORTH BY COUNCIL MEMBER WILLIAMS. OKAY.
UH, VIJAY, YOU HAVE SOMETHING, UH, PREPARED FOR US.
WELL, UH, CHAIRMAN, MR. CHAIRMAN, UH, I, I DON'T HAVE ANYTHING PREPARED FOR THIS MEETING, BUT THERE IS MITCH.
UH, THERE HAS BEEN A RASH OF POP UP FOOD AND MERCHANDISE SELLING, AND PARTICULARLY AT NIGHTS AND WEEKENDS.
AND PARTICULARLY, UH, WE ARE BEING INUNDATED IN SOUTH GAR.
UH, UH, SO, UH, UH, MITCH IS WORKING WITH OUR CODE ENFORCEMENT AND, UH, HEALTH, THEY'RE WORKING, UH, ON SOME STRATEGIES AND HE SAID, UH, FOR THE NEXT MEETING, UH, THEY'LL COME TO THIS COMMITTEE AND, UH, DISCUSS THEIR STRATEGIES THEY'VE COME WITH FOR DEALING WITH THAT.
AND SO, DOES ANYBODY ELSE HAVE ANY, ANYTHING ON THIS THEY WANT TO DISCUSS RIGHT NOW? ANY QUESTIONS MAYBE TO, UH, ANY QUESTIONS FOR STAFF TO PREPARE? UM, I WILL SAY THAT IN DISTRICT SIX WE'VE ALSO HAD THE SAME ISSUE, UM, WITH PEOPLE SELLING FOOD OUT OF IGLOO COOLERS.
UM, AND THEN OBVIOUSLY WE'VE HAD THE OTHER MERCHANDISE, UH, SELLING ON THE CORNER.
SO I THINK THAT IF STAFF CAN JUST GIVE US DIRECTION ON WHEN, WHO DO YOU REPORT THOSE TO? BECAUSE I THINK THAT THAT'S BEEN AN ISSUE.
I DON'T KNOW IF, IF WE'VE HAD THAT CONFUSION AS WELL.
UM, AND JUST IF WE DON'T HAVE SOMEONE THAT WORKS OVERNIGHT IN WEEKENDS, THAT, OR NOT OVERNIGHT, BUT YOU KNOW, LATER IN THE EVENINGS AND WEEKENDS THAT, UM, CAN GET THOSE PEOPLE TAKEN CARE OF.
UM, MAYBE THAT'S SOMETHING THAT COUNSEL NEEDS TO LOOK INTO AND GET THAT.
'CAUSE I MEAN, IT'S, IT'S INSANE.
THERE'S A LOT OF, UH, THAT'S, THAT'S ACTUALLY A GREAT IDEA BECAUSE A LOT OF THE PROBLEM WITH ENFORCEMENT IS WHAT TIME IT TAKES PLACE.
SO MAYBE WE COULD HAVE STAFF LOOK AT, IF WE WERE TO DO SOMETHING, SAY THREE MONTHS, SIX MONTHS, SOMETHING LIKE THAT, JUST TO SHOW THAT WE'RE OUT THERE, UM, IN THE EVENINGS, UM, WHAT THAT WOULD LOOK LIKE AND, UH, YOU KNOW, AS FAR AS FINANCIAL RESOURCES AND STAFF RESOURCES.
THAT'S, THAT'S ONE OF THE POINTS, A GOOD POINT THAT, UH, I, I, I KNOW THAT MITCH AND HEALTH AND, AND CODE WORKING ON, THAT'S ONE OF THE ISSUES THAT THEY'RE, UH, GOING TO BRING TO US.
ALRIGHT, ANY FURTHER DISCUSSION? OKAY.
ITEM THREE B, DISCUSS THE OUTSIDE STORAGE OF TIRES AT BUSINESSES.
AND THIS ITEM WAS BROUGHT FORTH ALSO BY COUNCIL MEMBER WILLIAMS. ALRIGHT.
UH, WITH THE INCREASE IN NUMBER OF TAR SHOPS, UH, WE DON'T, WE HAVE ORDINANCES AGAINST DISPLAYING, UH, CLOTHING WEAR AND FOOTWEAR AND, AND, AND EVERYTHING ELSE OUTSIDE.
BUT, BUT I'M NOT AWARE OF ANYTHING THAT WE HAVE AND, UH, DISPLAYING TIRES, UH, NEXT TO THE, UH, BUILDING PREMISES IS ONE
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THING, BUT, UH, I'M SEEING STACKS OF TIRES, UH, EVEN SOME NOW OR AT FIRST, UH, THEY WERE, UH, TAKING EASILY TAKING THEM IN, UH, I GUESS TO KEEP THEM FROM GETTING SOMEBODY PICKING UP FREE TIRES.UH, BUT LATELY I'VE NOTICED SOME OF THE PLACES THEY'RE LEAVING 'EM OUT AT NIGHT.
AND, UH, THAT'S, UH, I, UH, THINK WHEN YOU LOOK AT THAT, I DON'T KNOW WHAT OUR EXISTING ORDINANCE IS, UH, COVERED IF IT COVERS THOSE TYPE OF BUSINESSES OR NOT, BUT, UH, I, I'D LIKE TO, UH, FOR US TO TAKE A LOOK AT THAT.
UH, NOT TO, MY GOAL IS, IS NOT TO, UH, DRIVE ANYBODY OUTTA BUSINESS, BUT I JUST WANT TO BRING SOME ORDER, UH, TO, BECAUSE YOU, YOU, THEY LOOK, YOU PASS ONE AND YOU PASS ANOTHER, YOU, I MEAN, WE'RE GETTING, UH, UH, MORE AND MORE LOOSE APPEARS AND WHAT WE, UH, WHAT'S GOOD FOR OUR CITY AND WHAT'S NOT.
SO I, I DON'T, NONE, I DON'T KNOW EXACTLY HOW MANY OF THOSE PLACES I'M SURE STAFF CAN, CAN BRING THAT INFORMATION, UH, TO US.
AND I DON'T KNOW THE LOCATION OF ALL OF THEM, BUT I KNOW THAT, AGAIN, THERE ARE PLENTY OF THEM IN SOUTH GARLAND.
UH, SO, UH, I'VE ASKED, UH, STAFF TO, UM, UH, ONE LOOK AT OUR CURRENT ORDINANCE ORDINANCES, UH, THREE, UH, A TWO, UM, SEE WHAT, IF ANYTHING WE CAN DO, AND THAT MAY THEN, AND OUR SOLUTION TO THIS, IT MAY INCLUDE TALKING TO SOME OF THE FOLKS WHO ACTUALLY OWN TAR SHOPS.
I MEAN, I, I WOULDN'T BE, UH, I WOULD BE RECEPTIVE TO THAT, TO HEARING WHAT THEY SUGGEST THAT, BUT WE'VE GOTTA, UM, DO SOMETHING, UH, TO, FOR, UH, TO BRING SOME ORDER TO THAT INDUSTRY IN OUR CITY.
AND MITCH SAID THAT'S A SECOND ITEM THAT HE, HE'S WORKING ON AND THEY'RE GONNA DISCUSS IT NEXT MEETING HE SAYS.
WE HAVE SOME DISCUSSION ON THAT AS WELL.
DO WE HAVE, UH, DOES STAFF HAVE THE INFORMATION ON THE CURRENT ORDINANCE FOR OUTSIDE TIRE STORAGE? I DON'T KNOW THAT WE'RE PREPARED TO DISCUSS THAT TODAY.
WE HAVE THIS KIND OF LISTED AS A SCOPING ITEM.
I THINK, UH, CODE COMPLIANCE FOR EXAMPLE, AS WELL AS THE HEALTH DEPARTMENT WILL BE COMING BACK NEXT MONTH TO ADDRESS THE PRIOR ITEM.
I THINK, UH, WE'D BE BETTER PREPARED TO ADDRESS THIS ITEM AT THAT TIME AS WELL.
THE FIRST THING TO LOOK AT IS OUR CURRENT CODE.
UM, ONLY QUESTION I HAVE POSSIBLY WOULD BE ALSO TO HAVE A, UM, MAKE SURE THAT WE HAVE A FIRM, UH, DEFINITION OF THE, OF THE, THE DIFFERENCE BETWEEN STORAGE AND DISPLAY.
WHETHER THAT BE BASED UPON, UH, HOURS OF, YOU KNOW, WHETHER, YOU KNOW, I WOULD SAY, YOU KNOW, FOR EXAMPLE, DISPLAY WOULD BE SOMETHING, UM, DURING HOURS OF OPERATION STORAGE WILL BE SOMETHING OUTSIDE OF HOURS OF OPERATION.
SO WE'LL JUST, DOES ANYBODY ELSE HAVE SOMETHING TO ADD FOR STAFF TO LOOK AT BEFORE THIS COMES BACK? I'D LIKE TO ASK MISS CITY ATTORNEY DID, ARE YOU AWARE OF ANYTHING THAT WE HAVE THAT CLOSE TO THAT MAY BEGIN THE PROCESS OF ADDRESSING THIS? ANY, DO WE HAVE ANY ORDINANCE ORDINANCES THAT RELATE TO THAT INDUSTRY? YES, WE PROBABLY HAVE AN ORDINANCE ALREADY IN PLACE THAT, THAT CAN BE USED TO ADDRESS THIS ISSUE.
WE HAVE A STORAGE OF, UH, OF OUTSIDE GOODS THAT WOULD PROBABLY ADDRESS IT.
NOW, THE STACKING FOR DISPLAY PURPOSES, IF THEY ROLL IT IN WHEN THEIR BUSINESS CLOSES IS IN THE EVENING, THAT MAY NOT ADDRESS IT, BUT, UM, UH, WE CERTAINLY HAVE ONE FOR ANY OVER, FOR WHEN THEY'RE LEAVING IT OVERNIGHT, LIKE AS YOU'VE DESCRIBED.
AND I, AND I'M, I'M NOT SURE WHETHER YOUR CONCERN WAS THAT, FOR EXAMPLE, THE DISPLAY 'CAUSE I KNOW WE, THEY STACK 'EM ON WHEN THEY'RE OPEN.
UM, DO WE WANT TO INCLUDE A DISCUSSION OF THAT AS WELL? YES.
SO WE, WE, SO THAT WE ARE ABLE TO MAKE SOME DISTINCTION BETWEEN THE TWO.
THEN I WOULD, UM, I WOULD, I WOULD DEFINITELY LIKE SOME REPRESENTATION FROM THE, THE TIRE COMMUNITY, UM, TO WHEN WE HAVE THE DISCUSSION ABOUT THE DISPLAY.
UH, 'CAUSE I CAN DEFINITELY UNDERSTAND A CONCERN ABOUT TIRE STORAGE BEING VISIBLE.
BUT ON THE DISPLAY, I MEAN, I, NOT IN MY PERSPECTIVE, I'M NOT A TIRE SHOP OWNER, BUT I WOULD, I WOULD SAY THAT WAS A INTEGRAL PART OF THEIR MARKETING.
SO I WOULD LIKE TO, UM, BEFORE WE, YOU KNOW, PASS ANY JUDGMENT ON THAT, I WOULD LIKE FOR THEM TO HAVE, UH, REPRESENTATION AND, AND DISCUSS THAT IF WE COULD REACH OUT TO SOME, A TIRE SHOP OWNER OR TWO TO HAVE, HAVE THEM COME IN TO DISCUSS THAT.
WELL I, I THINK WE, WE, WE, WE KNOW WHERE THE LOCATIONS ARE AND I'VE GOT A COUPLE OF, UH, OF TIRE
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OF OWNERS THAT I'D SUGGEST TO STAFF TO CONTACT, UH, TO BE HERE, UH, FOR THAT DISCUSSION.I THINK AT LEAST IF WE HAVE ONE, I'D BE SATISFIED.
I'M SURE THAT, I'M SURE, UH, I'LL, UH, KEVIN YEAH, I'LL, I'LL GET THAT NAME TO YOU AND, UH, AND, UH, SO THAT, UH, HE'S, HE PREPARED AND ONCE WE HAVE A MEETING DATE SET UP, HE'S, HE'S, HE'LL BE PREPARED TO, TO COME HERE.
ALRIGHT, COUNCIL MEMBERS, BAYARD DUTTON, ANYTHING ELSE? UM, KEVIN, DO YOU KNOW WHEN YOU SAID HEALTH, THE HEALTH, UH, DEPARTMENT WOULD BE WITH CODE COMPLAINTS? IS THAT YEAH, I WAS REFERENCING THE, UH, POPUP BUSINESSES ON PRIVATE PROPERTY.
YOU MEANT SERVING FOOD OUT OF AN I, YOU KNOW, OUT OF A THERMOS CONTAINER AND I JUST IMMEDIATELY THOUGHT ABOUT A HEALTH DEPARTMENT, SO.
SO THEY'LL BE HERE AT THE NEXT MEETING TO DISCUSS THAT PRIOR ITEM.
UM, 'CAUSE I WOULD ALSO, JUST WHILE WE'RE ON THE TOPIC OF TIRES, UM, SO ENVIRONMENTAL HEALTH STUFF, FIRE MY HOUSE YESTERDAY.
UM, GETTING READY TO DO MOSQUITO TRAPS.
SO I WOULD LIKE, UM, WHILE WE'RE TALKING ABOUT TIRES THAT WE ADDRESS, UM, THAT SITUATION, UH, 'CAUSE I DID NOT REALIZE LAST YEAR I WAS PART OF THE PROBLEM, UH, ALL BECAUSE OF A TIRE SWING.
I HAD A LITTLE, UM, MOSQUITO BREEDING GROUND.
AND SO, UM, THAT'S TO HELP WEST NILE, UH, STAY AWAY FROM US.
UM, THAT'S ONE THING I WOULD LIKE US TO TALK ABOUT.
BUT ALSO ON THE TOPIC OF TIRES, UM, YOU KNOW, WE'VE, WE'VE GOT A TIRE DUMPING ISSUE AROUND THE CITY.
UM, SO ONE THING WHILE, UM, I, I GOT TO RIDE ALONG WITH CODE COMPLIANCE, UH, WITH CHRIS HARRIS AND, UM, WE TALKED ABOUT TIRES AND DUMPING AND ALL OF THOSE THINGS.
SO ONE THING I WOULD LIKE TO SEE IF WE CAN ADD ON TO THIS TIRE TOPIC IS, UM, LIKE DUMPING TIRES.
OH, MAYBE THAT JUST NEEDS TO BE A SEPARATE MR. CITY ATTORNEY.
THAT WOULD BE A SEPARATE ISSUE THAT IT, YOU THAT, AND I THOUGHT WE COVERED THAT RECENTLY.
SO KIND OF, I KIND OF WANNA STRAY A LITTLE OFF OF THAT, BUT THEY'LL, SO I WOULD LIKE TO HAVE LIKE SOMETHING WHERE WE'RE EDUCATING TIRE SHOP OWNERS IN GETTING RID OF THEIR TIRES OR LIKE SOME KIND OF INFORMATIONAL, SOMETHING THAT WE CAN START AS FAR AS LIKE, HEY, DON'T DUMP YOUR TIRES, DO THIS.
OR WE'RE DOING, YOU KNOW, LIKE WE DO THE TIRE COLLECTION, UM, OCCASIONALLY AT THE COLLEGE, MAYBE THERE'S SOMETHING WE CAN ADD ON THERE FOR BUSINESS OWNERS, WHATEVER.
SO IF WE'RE OUT TALKING TO TIRE SHOPS, IT WOULD BE BENEFICIAL IF WE, YOU KNOW, DID IT ALL AT ONE TIME.
LIKE, HEY, YOU SPRAY FOR MOSQUITOES, DON'T DUMP YOUR TIRES AND, UH, PUT YOUR DISPLAYS IN AT NIGHT, IF THAT MAKES SENSE.
THAT'S WHERE MY BRAIN WAS GOING.
THAT'S, THAT'S GONNA BE A SEPARATE TOPIC, BUT WHAT WE CAN DO IS WE'LL HAVE STAFF REACH OUT TO YOU OKAY.
TO SEE MAYBE THAT'S SOMETHING THEY CAN DO BY POLICY, UM, UM, WHERE THEY CAN COME UP WITH SOMETHING TO SEND SOMETHING TO THE TIRE, TIRE SHOP SO THEY UNDERSTAND, BECAUSE I KNOW WE RECENTLY DID SOMETHING ON THE ILLEGAL DUMPING OF TIRES AND UM, UM, THIS IS RELATED TO THAT, BUT IT'S A LITTLE NARROWER IN THE SENSE THAT IT'S TALKING TO, UH, TIRE SHOPS SPECIFICALLY.
AND SO MAYBE STAFF CAN REACH OUT TO YOU AND, UM, UM, MAKE SURE THAT THEY'RE COVERING THE TOPIC THAT YOU WANT TO COVER ON THAT.
I JUST DON'T WANT US LIKE, UH, DOUBLE, YOU KNOW.
WASTE, WASTE EXTRA TIME IF WE'RE ALREADY RIGHT.
TALKING TO TIRE SHOPS AND STUFF.
UH, ITEM THREE C, DISCUSS MD HEALTH PATHWAYS CITIZEN HEALTHCARE.
THIS IS A SCOPING DISCUSSION BROUGHT FORWARD BY COUNCIL MEMBER OTT.
WELL THANK YOU, UH, MR. CHAIRMAN, THIS IS, UH, ALRIGHT.
I'M THRILLED TO BE HERE TO INTRODUCE THIS PARTICULAR PROGRAM.
IT'S SOMETHING THAT IS, OUR COMMUNITY DOES NOT, WE DO NOT HAVE A COMMUNITY HOSPITAL.
WE HAVE A LOT OF NEED IN OUR CITY AND, AND, UH, MYSELF AND, UH, JUDD AND UH, AND BRIAN ENGLAND.
WE ALL MET WITH MD HEALTH, UM, PATHWAYS ABOUT A MONTH AGO.
AND TO LISTEN TO A PROGRAM THEY'VE ROLLED OUT IN, UH, SOME OF THE, UH, SOME OF THE SMALLER COMMUNITIES THAT HAS PROVEN TO BE A VALUABLE RESOURCE.
IT'S SOMETHING THAT MAKES IT WHERE, UH, WHERE YOU HAVE AN APP BASED, UH, HEALTH ASSISTANT.
AND I BELIEVE THAT WE, WE HAVE, UM, REPRESENTATIVES.
WE HAVE, UM, MR. CHAIR, IS IT, IS YOUR MICROPHONE ON
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TAP ON THAT? NO, NO, NO.HIT THE BUTTON ON YOUR BOX THERE.
NO, I DON'T, I DON'T HAVE ANY CONTROLS OVER HERE.
UM, CAN YOU START OVER? NO, I'M KIDDING.
WELL, WE, WE HAVE REPRESENTATIVES HERE TO TALK ABOUT THAT.
HE'S, UH, HE, IT'S HIS BRAINCHILD AND I THINK THAT HE COULD INTRODUCE THIS PROGRAM BETTER THAN I COULD EVER GIVE IT JUSTICE.
BUT I JUST WANTED TO LET Y'ALL KNOW THAT THIS IS SOMETHING THAT I WHOLEHEARTEDLY ENDORSE AND I THINK THAT IT'S SOMETHING THAT WE REALLY NEED.
WELL, GOOD MORNING, UH, COMMITTEE CHAIR, UH, BASS, UH, THANK YOU.
COMMITTEE MEMBER, BEARD COMMITTEE MEMBER DUTTON, COUNCIL MEMBER WILLIAMS AND COUNCIL MEMBER HOT.
TITLES TOO, THAT DOESN'T HAVE 'EM QUITE OFTEN.
UH, WE ARE VERY EXCITED TO BE HERE TODAY.
UM, IT'S, IT'S, WE'RE EXCITED AND I THINK GARLAND SHOULD BE EXCITED.
THIS IS A, A PROGRAM, UM, THAT IS VERY MUCH NEEDED, NOT JUST IN THE CITY OF GARLAND, BUT IN EVERY CITY.
I, I FIRMLY BELIEVE THAT, UH, I'VE DEDICATED THE PAST 25 YEARS OF MY CAREER TO SERVING LOCAL GOVERNMENT.
SO I WORKED WITH, UH, FOR A DECADE WITH, UH, INTERNATIONAL CITY MANAGER ASSOCIATION WITH, UH, FOR 15 YEARS WITH THE NATIONAL LEAGUE OF CITIES.
I'VE SERVED ON, UH, NATIONAL NLC BOARDS AND ADVISORY COMMITTEES AND, AND THE LIKE.
AND I CAN TELL YOU THIS MORNING, THIS IS BY FAR THE MOST EXCITED I'VE EVER BEEN ABOUT ANY PROGRAM THAT I'VE EVER SEEN IN MY CAREER IN LOCAL GOVERNMENT.
UM, 20 YEARS AGO, I CAME TO NOT THIS NICE BUILDING.
I CAME TO ANOTHER BUILDING HERE CITY IN CITY HALL IN GARLAND.
AND I MET WITH THE GENTLEMAN BY THE NAME OF BILL DOLLAR.
AND I TOLD MR. DOLLAR THAT I COULD CHANGE THE WAY THAT THE CITY OF GARLAND DOES OUTBOUND NOTIFICATION TO THEIR COMMUNITY.
'CAUSE AT THE TIME, CITIES HAD A 16 LINE DIALER THAT WOULD ALLOW THE POLICE DEPARTMENT, FIRE DEPARTMENT TO LET EMERGENCIES BE KNOWN BY PHONE TO THEIR RESIDENTS.
AND I SAID, I CAN DO THAT AT 1600 CALLS A MINUTE.
AND BILL DOLLAR BELIEVED IN ME AND BELIEVED IN THIS LITTLE COMPANY OUTTA FLORIDA CALLED CODE RED.
AND THAT PROGRAM WAS USED FOR OVER A DECADE HERE IN THE CITY OF GARLAND.
AND HERE I AM 20 YEARS LATER WITH ANOTHER CRAZY IDEA, UM, THAT IS A, HAS ALMOST THE EXACT SAME AMOUNT OF CUSTOMERS THAT CODE RED HAD 20 YEARS AGO.
SO, UM, VERY, VERY EXCITED TO BE HERE.
UM, BECAUSE I HAVE BEEN IN THE BUSINESS FOR 25 YEARS.
I HAVE ACTUALLY, UM, MET THIS IS, I'VE BEEN IN OVER 1000 COUNCIL AND COMMITTEE MEETINGS.
AND SO, UM, THE BOOK IS COMING.
I'M I'M GONNA, I'M GONNA WRITE A BOOK 'CAUSE IT'S, IT'S, I'VE SEEN SOME STUFF.
WE'VE, WE'VE TALKED ABOUT THAT.
UM, BUT BECAUSE I'VE DONE THAT, I KNOW THAT OUT OF RESPECT, I LIKE TO RESEARCH THE, THE PEOPLE THAT I'M TALKING TO.
SO I KNOW THAT THAT COMMITTEE MEMBER BEARD, YOU'VE DEDICATED YOUR, YOUR PROFESSION TO HELPING THOSE WITH AUTISM.
YOUR A SL FLUENT, YOUR, SO, UM, YOU'VE HELPED WITH THE BLIND.
AND SO, UM, I KNOW THAT, UH, COMMITTEE CHAIR, BASS, UH, YOU'RE AN ENTREPRENEUR, BUT YOUR, YOUR WIFE IS A PHYSICIAN.
SO YOU KNOW WHAT IT'S LIKE TO HAVE A DOCTOR THAT CAN PRESCRIBE ILLNESS AND MEDICATION SEVEN DAYS A WEEK IN YOUR HOME.
UM, I, I KNOW THAT, THAT
AND, AND OUR, OUR PROGRAM WILL HELP WITH THAT.
UM, SO I, I JUST WANNA SAY THAT EVERY SINGLE BENEFIT OUR PROGRAM CAN BRING TO THE CITY OF GARLAND FITS INTO YOUR MISSION STATEMENT OF PRESERVING PUBLIC TRUST, DELIVERING QUALITY SERVICES, PROMOTING ECONOMIC GROWTH, PROTECTING YOUR COMMUNITY, AND ENHANCING THE QUALITY OF LIFE IN GARLAND.
SO I'M GONNA SHOW TWO SHORT VIDEOS, UM, OF COMMUNITY IMPACTS THAT THIS PROGRAM HAS ALREADY HAD IN THE CITY OF DALLAS AND IN THE CITY OF GARLAND.
UM, AND I WILL ALSO INTRODUCE DIRK PARROTT, WHO IS, UM, I, I CALL HIM A DECORATED GENIUS.
HE TRULY IS ONE OF THE SMARTEST PEOPLE I'VE EVER MET.
HE, UM, THIS VERY PROGRAM THAT WE'RE GONNA TALK ABOUT TODAY, HE WON A US CONGRESSIONAL AWARD FOR ROLLING IT OUT.
UM, HE'S CURRENTLY THE ROCKWELL HEALTH DIRECTOR,
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UH, COUNTY HEALTH DIRECTOR, AS WELL AS A PRACTICING, UM, ER DOCTOR IN NORTH TEXAS AT PRESBYTERIAN HOSPITAL.UM, AND THEN WE ALSO HAVE GERARDO WITH US WHO IS OUR, OUR ALL STAR.
AND I'LL, I'LL HAVE HIM AT THE END OF THE PRESENTATION EXPLAIN A LITTLE BIT ABOUT WHY HE'S WITH US TODAY AND WHAT HE'S PASSIONATE ABOUT.
PERT, COULD YOU CLICK ON THAT? YEP.
HERE'S WHERE WE HOPE TECHNOLOGY WORKS.
HI, MY NAME IS ROYA AND I LIVE IN DALLAS, TEXAS, AND I RECENTLY SIGNED UP FOR MD HEALTH PATHWAYS.
OH, LAST MONDAY I WAS HAVING SOME SYMPTOMS THAT I DIDN'T FEEL WERE THAT SERIOUS, BUT I REACHED OUT ANYWAY JUST TO MAKE SURE WHOEVER I WAS SPEAKING TO, HOWEVER CLEARLY UNDERSTOOD A LOT OF THINGS THAT I DIDN'T AND WAS VERY CONCERNED.
WITHIN MINUTES, I WAS ON THE PHONE WITH A DOCTOR WHO AFTER HEARING MY SYMPTOMS AND A LITTLE BIT OF MY MEDICAL HISTORY, INSISTED THAT I GO TO THE EMERGENCY ROOM RIGHT AWAY TO MY UTTER SHOCK.
I FOUND OUT THAT I HAD PNEUMONIA, HOWEVER, I WAS ABLE TO CATCH IT EARLY ENOUGH THAT THEY WERE ABLE TO TREAT ME WITH ANTIBIOTICS AND A SHORT HOSPITAL STAY.
I KNOW THAT THIS IS A PROGRAM THAT SAVES LIVES.
I KNOW THAT BECAUSE MY LIFE WAS SAVED.
JUST KNOWING THAT I HAVE ACCESS TO A DOCTOR JUST BY REACHING DOWN TO MY POCKET AND GETTING MY PHONE, IT GIVES ME A PEACE OF MIND THAT NO OTHER HEALTH SERVICE COULD POSSIBLY GIVE ME OR EVER HAS.
AND I'M REALLY, REALLY GRATEFUL TO THE SERVICE.
YOU NEED TO DO THE OTHER ONE OR JUST, YEAH.
HELLO, MY NAME IS JOSE RICO AND I LIVE IN GARLAND, TEXAS.
I RECENTLY SIGNED UP FOR MD HEALTH PATHWAYS AND CONTACTED THEM VIA TEXT MESSAGE FOR A SORE THROAT THAT I HAD, WHICH I BELIEVE WAS SHUT THROAT.
UM, SO WITHIN MINUTES I WAS ABLE TO GET AN ANTIBIOTICS AND PICK UP THE SAME NAME.
I THINK EVERY CITY SHOULD HAVE ACCESS TO THIS PROGRAM FOR THEIR RESIDENTS.
I TRULY BELIEVE THAT IT CAN SAVE LIVES AND ALSO HAVE PEACE OF MIND KNOWING THAT YOU HAVE A DOCTOR IN YOUR POCKET SEVEN DAYS A WEEK.
YOU HEARD THE LITTLE VIDEOS OF SOME PATIENTS THAT UTILIZED OUR SERVICE.
I WORK IN, UH, THE EMERGENCY DEPARTMENT AT BOTH PRESBYTERIAN, DALLAS AND ROCKWALL.
I WAS ON STAFF AT, UH, BAYLOR GARLAND, UH, FOR A NUMBER OF YEARS UNTIL IT WAS CLOSED DOWN AND ACQUIRED BY THE VA.
BEFORE I START AND TALK ABOUT OUR SERVICE I'D, I'D LIKE TO HAVE YOU GUYS ALL THINK ABOUT A QUESTION.
UM, AND, AND IT'S SOMETHING MOST PEOPLE DON'T THINK ABOUT TILL IT HAPPENS.
IMAGINE YOURSELF, MAYBE IT'S A FAMILY MEMBER, MAYBE, MAYBE OF CHILDREN OR GRANDCHILDREN, AND SOMEONE GETS SICK AND, AND FOR EXAMPLE, YOU, YOU PUT THE GRANDKIDS TO BED, ONE OF 'EM WAKES UP WITH A FEVER, A COUGH, AND WHAT YOU THINK MAYBE IS A LITTLE BIT STRUGGLING TO BREATHE, UH, IT'S 9:00 PM YOUR DOCTOR'S OFFICE IS CLOSED.
WHAT DO YOU DO? UM, MAYBE, UH, YOU ARE A WOMAN, UH, UH, HERE AND, AND YOU'VE GOT A BIG MEETING.
MAYBE IT'S A COUNCIL MEETING THE NEXT DAY THAT YOU'RE PRESENTING A PROJECT THAT YOU'RE PASSIONATE ABOUT, AND YOU'VE GOT, UH, SOME BURNING WHEN YOU URINATE, UH, YOU KNOW, YOU HAVE A URINARY INFECTION, YOUR DOCTOR'S OFFICE IS CLOSED, THE MEETING'S TOMORROW AT AT 8:00 AM WHAT DO YOU DO? UM, AND SO I'D LIKE YOU TO JUST THINK ABOUT THAT FOR A SECOND.
WHAT ARE YOUR OPTIONS? WHERE DO YOU GO? AND I THINK YOUR ANSWERS HERE ON COUNCIL ARE GONNA BE DIFFERENT THAN, THAN WHAT THE COMMUNITY'S ANSWER IS GONNA BE HERE ON COUNCIL.
I, I WOULD ASSUME ALL OF YOU HAVE ACCESS TO INSURANCE OR A DOCTOR.
UH, SOME OF US ARE LUCKY ENOUGH TO HAVE A, UH, HAVE A FAMILY MEMBER THAT'S A DOCTOR.
UM, BUT IF YOU'RE ANYTHING LIKE YOUR COMMUNITY HERE IN GARLAND, 70% OF YOU WILL START OUT IN THE EMERGENCY DEPARTMENT.
UH, OF THAT 70%, ABOUT ONE TO 2% WILL UTILIZE EMS FOR, UH, A RIDE TO THE HOSPITAL, NOT BECAUSE IT'S, IT'S NECESSARY, BECAUSE IT'S THEIR ONLY OPTION TO GET TO THE HOSPITAL.
UH, JUST LAST NIGHT IN AN ER SHIFT, UH, THAT, THAT I WAS WORKING, I SAW THREE, THREE PEOPLE FROM YOUR COMMUNITY.
AND IT'S, IT'S ONE OF THE REASONS WHY I'M HERE TO TALK TO YOU SPECIFICALLY IN GARLAND, BECAUSE THE LAST 20 YEARS WORKING AS AN ER DOCTOR IS ONE THING THAT BOTHERS ME MORE THAN ANYTHING.
AND IT'S WHAT I SEE WHEN THERE'S A LACK OF ACCESS TO HEALTHCARE AND OUR ER BECOMES THE EASY BUTTON.
AND IT IS, IT'S EASY TO GET CARE.
WE ACCEPT ANYBODY REGARDLESS OF HER INSURANCE, BUT IT'S AT THE CHECKOUT.
I, I, I SAW A, A, A WOMAN, SINGLE MOM, TWO CHILDREN, BOTH OF THEM HAD STREP THROAT.
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THEM SPEND ALL THREE OR FOUR MINUTES OF TIME, LOOKED IN THE BACK OF THEIR THROAT, WROTE A $5 PRESCRIPTION, AND SENT 'EM ON THEIR WAY.AND THEN HOSPITAL REGISTRATION WALKS IN, THEY SAY, MA'AM, WE SEE YOU DON'T, DON'T HAVE INSURANCE.
WE'RE A FAITH-BASED NONPROFIT HOSPITAL.
UH, NORMALLY THAT WOULD BE $2,000 PER CHILD OR $4,000 ALTOGETHER, BUT IF YOU PAY $1,200 ON YOUR CREDIT CARD PER CHILD TONIGHT, WE'LL CALL IT EVEN.
AND I, I PROMISE IF YOU TALK TO ANY ER DOCTOR, WE'RE EMBARRASSED.
IT SHOULDN'T BE $1,200 FOR FIVE MINUTES OF MY TIME.
UM, AND SO WHAT I'VE DONE IS I'VE SET THAT TO BE MY MISSION.
AND I STARTED ON MY MISSION ABOUT FOUR YEARS AGO TO SOLVE THAT CRISIS.
AND WHAT WE DID IS THROUGH MY WORK IN THE COMMUNITY AS HEALTH AUTHORITY, I SAW THIS OPPORTUNITY THAT EXISTS TO PROVIDE HEALTHCARE OUTSIDE OF THE DEFINED WALLS OF OUR HOSPITAL SYSTEM.
UM, AND WHAT WE DID IS WE MODELED A MECHANISM, A WAY TO ACCESS A DOCTOR THAT'S MODELED OFF OF THE, THE WAY I TREAT MY OWN FRIENDS AND FAMILY.
WHEN MY FRIENDS AND FAMILY GET SICK AND, AND, UH, COUNCILMAN BASS, YOU, YOU KNOW THIS BETTER THAN ANYONE.
WE GET A TEXT MESSAGE FROM OUR FRIENDS AND FAMILY AS A DOCTOR WHEN THEY, WHEN OUR FRIENDS AND FAMILY GET SICK, IT'S, IT'S MAYBE, HEY, I'M SICK.
AND 10 TO 15 TEXT MESSAGES, MAYBE A PICTURE OF BACK OF THE THROAT.
WE'RE ABLE TO HANDLE THESE, THESE SIMPLE MEDICAL COMPLAINTS.
AND WHAT'S A MINOR INCONVENIENCE FOR ME AS A DOCTOR IS A HUGE BENEFIT TO MY FRIENDS FAMILY THAT HAVE ACCESS TO THIS TO ME.
UM, AND WE DECIDED TO FORMALIZE THAT, UH, FOUR YEARS AGO.
AND WE LAUNCHED IN OUR FIRST CITY, UH, AS A SIMPLE TEXT MESSAGE MECHANISM TO A DOCTOR.
UM, AND WE PROVIDED A SINGLE PHONE NUMBER TO EVERY MEMBER IN A COMMUNITY TO HAVE, HAVE ACCESS TO US.
AND WE LAUNCHED, UH, UH, THREE YEARS AGO IN THE CITY OF FERRIS, SMALL CITY, UH, NOT NOT FAR OUTSIDE OF DALLAS.
AND THEY FUNDED THIS WITH ARPA FUNDS, AMERICAN RESCUE PROTECTION ACT FUNDS.
AND THEY FUNDED AN ENTIRE YEAR SERVICE.
AND THEY CAME BACK TO US AFTER A YEAR AND THEY SAY, DOC, WE GOT GOOD AND BAD NEWS.
I'M LIKE, OKAY, I, I'D LOVE THE GOOD NEWS.
THEY'RE LIKE, QUITE FRANKLY, YOU ARE OUR NUMBER ONE MOST UTILIZED CITY SERVICE.
MORE THAN POLICE, MORE THAN FIRE, MORE THAN PARKS AND REC, GREATER THAN 50% OF OUR COMMUNITY IN THE LAST YEAR HAS UTILIZED YOUR SERVICE AT LEAST ONE TIME.
I'M LIKE, ALL RIGHT, THAT SOUNDS GOOD.
AND HE GOES, BECAUSE OF THAT, OUR SURROUNDING COMMUNITIES THAT ARE SEEING INCREASED 9 1 1 AND EMS CALLS, UM, AND HAVING TO, TO HIRE IN ANOTHER AMBULANCE TO SERVICE THE COMMUNITY.
WE ACTUALLY HAD A DROP IN EMS CALLS BY 20%, AND WE ATTRIBUTE THAT TO YOUR SERVICE.
IT SAVED US, QUITE FRANKLY, HUNDREDS OF THOUSANDS, IF NOT MILLIONS OF DOLLARS, UH, TO OUR AMBULANCE SERVICE.
HE GOES, NUMBER TWO, OUR SCHOOLS, UH, THEY SAW A DECREASE IN ABSENCES.
AND, AND DOC, I DON'T KNOW IF YOU'RE AWARE, BUT OUR SCHOOLS GET PAID OFF OF ATTENDANCE AND AN ATTENDANCE IS WORTH ABOUT $35 A DAY.
AND ON AVERAGE, OUR KIDS ARE, ARE GETTING BACK TO SCHOOL TWO TO THREE DAYS SOONER WITH YOUR SERVICE, WHICH IS A DIRECT PAYMENT TO OUR SCHOOL SYSTEM, ABOUT 70 TO A HUNDRED DOLLARS EACH TIME YOU DO THAT.
WELL, GUYS, THAT'S GREAT NEWS.
WHAT'S THE BAD NEWS? HE GOES, THE BAD NEWS IS WE CAN'T AFFORD TO PAY FOR YOUR SERVICE ANY LONGER.
WE, WE RAN OUTTA THE ARPA FUNDS.
WE HAD, THERE'S NO WAY WE COULD WORK THIS INTO THE BUDGET.
UM, SO UNLESS YOU CAN COME UP WITH SOME OTHER MECHANISM, UH, TO PROVIDE THIS SERVICE, WE WON'T BE ABLE TO CONTINUE IT.
AND BECAUSE I'M A HEALTH AUTHORITY AND I'VE, UH, I'VE WORKED WITH, UH, LOCAL COUNTY JUDGES.
ONE LOCAL COUNTY JUDGE CAME TO ME AND GOES, DOC, I KNOW HOW YOU CONTINUE THE SERVICE.
YOU MODEL IT OFF OF A WAY THAT'S BEEN DONE FOR THE LAST 20 YEARS WITH CAREF FLIGHT.
THEY OFFER A SMALL, UH, OPT OUT FEE ON A WATER UTILITY BILL.
AND WHEN CAREF FLIGHT GOES AND PICKS UP SOMEBODY FROM OUR COMMUNITY, IT'S NORMALLY AN $80,000 BILL.
THAT'S WHAT IT COSTS TO FLY A PATIENT FROM, FROM OUR COMMUNITY TO, TO THE, THE METROPLEX.
BUT IF YOU HAVE THAT SMALL FEE ON YOUR WATER UTILITY BILL, UH, CAREF FLIGHT CALLS IT, EVEN THEY DON'T, THEY DON'T CHARGE OUR, OUR CLIENTS.
AND IT'S BEEN A VERY SUCCESSFUL PROGRAM.
HE GOES, I DON'T KNOW YOUR FINANCES, UM, AND YOUR NUMBERS, BUT, BUT YOU NEED TO FIGURE THAT OUT AND, AND OFFER THIS.
WE LAUNCHED, UH, IN FERRIS, UH, AND TRANSITIONED EVERYONE OVER TO A $9 FEE ON A WATER UTILITY BILL, UH, WHICH ALLOWED US TO EXPAND.
AND, AND NOW WE'RE IN, UH, UH, ALMOST 20 CITIES, UH, SUCCESSFULLY AND SEEING VERY SIMILAR RESULTS AS WE SAW, UH, IN THAT COMMUNITY.
AND SO THAT'S WHY I'M HERE TO TALK TO YOU ABOUT TODAY.
BUT, BUT OUT OF ALL COMMUNITIES, GARLAND IS ONE I'M MOST PASSIONATE ABOUT BECAUSE I SEE YOUR COMMUNITY EVERY DAY IN MY ER, I SEE WHAT HAPPENS WHEN THEY LEAVE THINGS TOO LONG, UH, UH, WHEN THEY WAIT TOO LONG, OR THEY COME IN AND THEY GET HIT WITH THESE EXORBITANT BILLS.
UM, NOW YOU CAN'T JUST LAUNCH THIS SERVICE AND NOT HAVE COMMUNITY INVOLVEMENT.
SO IT'S NOT LIKE WE JUST GO IN AND SAY, HEY, COMMUNITY, THIS SERVICE IS AVAILABLE.
IT, WE, WE HAVE A VERY WELL DEVELOPED MARKETING AND ENGAGEMENT STRATEGY BECAUSE IF PEOPLE DON'T USE THE SERVICE, UH, IT'S OF LITTLE TO NO VALUE.
AND THAT'S WHY I BROUGHT HERARDO HERE WITH ME TODAY.
[00:30:01]
IS MY NUMBER ONE EMPLOYEE WE MET IN THE ER.HE WAS APPLYING TO MEDICAL SCHOOL, QUITE FRANKLY, GOT ACCEPTED TO, TO A PRESTIGIOUS MDPHD PROGRAM.
AND THAT'S WHERE YOU BECOME A MEDICAL DOCTOR AND, AND ALSO A RESEARCHER.
AND WHEN HE HEARD ABOUT WHAT I'M DOING, GERALDO GAVE UP THE OPPORTUNITY TO GO TO MEDICAL SCHOOL BECAUSE HE SAW THE IMPACT THAT WE WERE HAVING WITH OUR SERVICE.
AND SO I'LL LET HIM TALK A LITTLE BIT ABOUT, UH, COMMUNITY ENGAGEMENT AND WHAT IT LOOKS LIKE TO, TO GET A COMMUNITY INVOLVED AND A LITTLE BIT ABOUT HIS STORY.
UH, FIRST OF ALL, I'D LIKE TO MAKE SURE THE RECORD REFLECTS.
I WAS CALLED THE NUMBER ONE EMPLOYEE.
IF I ASKED FOR A RACE NEXT YEAR, I MAY HAVE TO RELY ON ONE OF YOU, UH, TO BACK ME UP THERE.
UM, BUT YEAH, AS, AS DIRK SAID, I, I MET DIRK WORKING AT THE EMERGENCY DEPARTMENT.
MY GOAL WAS ALWAYS TO GO TO MEDICAL SCHOOL.
UM, AND I DID THAT BECAUSE BELIEVE IT OR NOT, I DIDN'T SEE MY, THE FIRST PHYSICIAN EVER IN, IN MY LIFE UNTIL I WAS IN COLLEGE WHERE I WAS MANDATED TO HAVE HEALTH INSURANCE.
THAT WAS THE FIRST PHYSICIAN I EVER SAW.
BUT, UM, YOU KNOW, I, DOUG AND I HAVE A RELATIONSHIP OUTSIDE OF WORK.
AND ONE TIME WHEN WE WERE HAVING JUST TACOS AND, AND MARGARITAS, UM, I TOLD THEM THAT WHEN I WAS YOUNG, MY MOM WOULD ALWAYS, NO MATTER WHAT THE SYMPTOM WAS, IT WAS ALWAYS THE SAME REMEDY AND IT WOULD BOTHER ME SO MUCH.
AND IF I CLOSE MY EYES, I CAN STILL ENVISION THAT IT WAS THE SAME TEA.
IT WAS GARLIC, ONION, LEMON AND HONEY.
AND SHE SAID, YOU HAVE TO DRINK THIS AS HOT AS POSSIBLE.
OH MY GOD, THAT BURNED SO BAD.
SO WE WOULD NEVER FAKE BEING SICK, FOR SURE.
AND I REMEMBER I WAS A, YOU KNOW, SMART, LIKE 10-YEAR-OLD.
I WAS LIKE, MOM, THERE'S MEDICINES FOR THIS.
LIKE SURELY THERE'S MEDICINES FOR THIS.
WHY DO WE HAVE TO DRINK THE STUPID TEA? AND SHE SAID, NO, THIS IS BETTER THAN MEDICINES.
AND IT WASN'T BETTER THAN MEDICINES.
WE DIDN'T HAVE ACCESS TO GETTING SIMPLY PRESCRIBED ANTIBIOTICS, UH, BECAUSE WE DIDN'T HAVE HEALTH INSURANCE AND WE COULDN'T AFFORD TO GO TO, TO A PHYSICIAN.
UM, AND SO I SAY THAT BECAUSE THE BIGGEST TRAGEDY THAT I THINK I I SAW IN THE EMERGENCY DEPARTMENT WAS SEEING A LOT OF INDIVIDUALS WHO COME TO EMERGENCY FOR SOMETHING THAT'S VERY MANAGEABLE, CHRONIC DISEASES, AND NOW IT'S A TRUE EMERGENCY.
UH, AND SO YOU HAVE A LOT OF THE INDIVIDUALS WHO ARE THERE BECAUSE THAT'S THE EASY BUTTON.
UNFORTUNATELY, YOU ALSO HAVE INDIVIDUALS THERE WHO SHOULDN'T HAVE BEEN THERE IN THE FIRST PLACE IF THEY HAD ACCESS TO PROPERLY MANAGED CHRONIC DISEASES.
THAT'S MY PARENTS, UH, TO THIS DAY.
UH, NOW THEY HAVE HEALTH INSURANCE.
THEY'RE HORRIBLE ABOUT SCHEDULING THEIR MEDICATION REFILLS.
THEY HAVE HYPERTENSION, DIABETES, AND I'M LIKE, MOM, SCHEDULE 'EM THREE WEEKS BEFORE AND SHE ONLY SCHEDULES IT ONCE SHE RUNS OUT.
AND SO BY THE TIME SHE'S CALLS, SHE'S LIKE, HEY, CAN I GET INTO THE DOCTOR'S OFFICE? YEAH.
AND SO SHE'S ABLE TO JUST TEXT INTO THE SERVICE WE PROVIDE, BRIDGE THAT GAP, AND THEN UNTIL SHE'S, YOU KNOW, SO SHE DOESN'T GO WITHOUT HER MEDICATIONS.
UM, BUT IT'S A TREMENDOUS IMPACT.
IT'S A LOT OF WORK OF WHEN, WHEN DIRK FIRST EXPLAINED IT, I WAS LIKE, THIS IS GONNA BE EASY, RIGHT? I'M GONNA GO OUT TO THE COMMUNITY.
I'M GONNA TELL PEOPLE WHAT THEY, WHAT THEY HAVE ACCESS TO AND HOW TO USE IT.
IT'S NOT, THERE'S A LOT OF SKEPTICISM WHEN YOU GO UP TO PEOPLE AND A HEALTHY LEVEL OF SKEPTICISM.
YOU HAVE TO KIND OF JUST MEET THEM WHERE THEY'RE AT, EXPLAIN WHAT, ONCE THEY REALIZE WHAT THEY'RE PAYING FOR, IT'S, UH, IT KIND OF CATCHES FIRE PER SE.
BUT THAT'S PROBABLY LIKE A THREE MONTH PERIOD OF US JUST BEING, WORKING IN THE COMMUNITY, UM, HOLDING PARTNER UP WITH THE RIGHT VESSELS IN THE COMMUNITY, THE RIGHT COMMUNITY HUBS.
BUT I THOUGHT, I WAS LIKE, I'M GONNA BE SO GOOD AT THIS.
AND I HAD SO MANY EMBARRASSING MOMENTS WHERE I WAS KIND OF SHOOED AWAY FROM OFFICES AND LIKE, NAH, THIS IS LITTLE TOO GOOD TO BE TRUE.
GRADUALLY THOUGH, UM, AS, AS YOU KIND OF GET OUT THERE AND MAKE THE RIGHT CONNECTIONS, THIS IS AN AMAZING PROGRAM THAT PEOPLE REALLY BENEFIT FROM.
SO, UM, LIKE DOUG SAID, IT WAS A TOUGH CONVERSATION HAVING WITH MY MOM, LETTING HER KNOW THAT I WASN'T GONNA MEDICAL SCHOOL.
BUT THAT'S HOW PASSIONATE I DO FEEL ABOUT THIS SERVICE.
AND I THINK IT CAN HAVE TREMENDOUS IMPACT ON THE CITY OF GARLAND AS WELL.
WELL, HER HERARDO IS NOT GONNA BRAG ABOUT HIMSELF TODAY.
LET ME GIVE YOU AN EXAMPLE OF A COMMUNITY.
WE, WE, UH, UH, HAVE COMMUNITIES BOTH IN TEXAS AND SOUTH CAROLINA.
AND A LITTLE LESS THAN A YEAR AGO, WE PARTNERED WITH A COUNTY OF 45,000 PEOPLE IN, IN A SMALL, UH, RURAL COMMUNITY IN SOUTH CAROLINA.
AND WE WENT OUT THOUGH, THEY SAID, THIS ISN'T GONNA WORK.
WE, WE OFFERED A FREE, UH, DOCTOR'S OFFICE ON WHEELS CLINIC THAT WE MOVED AROUND OUR COMMUNITY.
AND IN TWO YEARS WE ONLY SAW 130 PATIENTS.
UM, NO ONE IN OUR COMMUNITY IS GONNA USE YOUR SERVICE.
UH, WE TOOK THAT AS A CHALLENGE.
AND, AND THE FIRST MONTH WE LAUNCHED, IT WAS DIFFICULT.
WE, WE, WE SAW 130 PATIENTS OUR FIRST MONTH EQUIVALENT TO TWO YEARS OF WHAT THAT THE, THE MOBILE SERVICE SAW.
BUT THAT WAS A FAILURE FOR US.
130 PATIENTS IN A MONTH WAS NOT A, NOT A SUCCESS.
HOWEVER, SIX MONTHS LATER, AFTER GERARDO WENT INTO LOCAL CHURCHES AND FORMED THE PASTORS, TALKED TO CONGREGATIONS, UH, TALKED TO LOCAL BUSINESSES, GOT INTO THE SCHOOLS, TALKED TO THE SUPERINTENDENT AND THE SCHOOL NURSES.
AFTER SIX MONTHS, WE, WE WERE SEEING 2000 PATIENTS A MONTH.
UM, AND SO IT DOES TAKE SOME TIME AND SOME, UH, WORK.
[00:35:01]
BUT IT'S ON US.WE COME OUT AND WE INFORM THE COMMUNITY.
WE ENGAGE THE COMMUNITY BECAUSE WE REALIZE IF PEOPLE DON'T UTILIZE THIS SERVICE, IT'S, IT'S WORTH WORTHLESS.
UM, BUT WHEN THEY LEARN AND THAT SKEPTICAL MOM GOES, THERE'S NO WAY.
THERE'S GONNA BE A DOCTOR THAT TEXTS ME BACK WITH NO INSURANCE, NO COPAY, UH, AND NO, NO OFFICE STAFF SAYING THEY'LL SEE YOU IN THREE DAYS.
AND THEN THEY USE THE SERVICE.
THEY DON'T HAVE TO DRAG THEIR KIDS TO THE ER, UH, AND THEY GO PICK UP THEIR ANTIBIOTICS.
AND QUITE FRANKLY, THEY PICK UP THEIR ANTIBIOTICS WITH A CASH PAY PRICE THAT WE'VE NEGOTIATED WITH PHARMACIES THAT'S AFFORDABLE.
SHE GOES AND TELLS THREE OR FOUR OF HER FRIENDS AND THE SERVICE TAKES OFF BECAUSE OF WORD OF MOUTH.
SO, SO THAT'S ABOUT OUR SERVICE.
I'M VERY PASSIONATE ABOUT THIS.
I'M HAPPY TO, TO ANSWER QUESTIONS.
UM, UH, SO I'D LIKE TO KIND OF THROW IT OUT TO YOU GUYS.
GERARDO'S GOT SOME HANDOUTS HE'S GONNA GIVE YOU AS WELL.
DOCTOR, BEFORE WE OPEN FOR QUESTIONS, I THINK, IF IT'S OKAY, CAN I JUST SHARE ONE MINUTE STORY ABOUT HOW IT WORKS? LIKE JUST FROM THE FIRST ENGAGEMENT UNTIL YOU, YOU RECEIVE YOUR MEDICATION.
SO MY, MY SON WAS HOME FROM COLLEGE, UH, OVER THE CHRISTMAS BREAK.
AND WE WENT HIKING AND CONVINCED MY WIFE TO GO AND SHE DOESN'T LIKE TO GO HIKING 'CAUSE THERE'S TICKS WHEN YOU GO HIKING AND SHE'S AFRAID OF TICKS.
AND SO TWO DAYS LATER WE FOUND A TICK UNDER HER ARM.
SO I WAS IN TROUBLE AT THAT POINT.
UM, BUT I THOUGHT, YOU KNOW WHAT, I'M GONNA USE THE, THE SERVICE.
SO I, I TEXTED THE 10 DIGIT NUMBER.
I HAVE IT SAVED IN MY PHONE IS TAP TELEHEALTH.
I JUST TEXT, I ACTUALLY SPOKE AND I SAID, MY WIFE HAS A TICK.
WHAT SHOULD I DO? UM, THEY CAME BACK IMMEDIATELY, TOLD ME HOW TO EXTRACT THE TICK, UM, THEN TAKE A PICTURE.
SO I TOOK A PICTURE FROM THAT POINT AND THEY SAID, OKAY, THERE'S A LITTLE INFECTION SETTING IN, WE'RE GONNA CALL IN THIS ANTIBIOTIC.
UH, ARE YOU STILL AT THE CVS ON DENTON TAP? YES I AM.
IT SHOULD BE READY IN 15 MINUTES.
THAT'S HOW THE, THE PROGRAM WORKS.
UM, SHOULD WE HAVE NEEDED MORE, SHOULD WE HAVE NEEDED AN MRI OR A A CAT SCAN OR AN X-RAY, WE WILL REFER THEM TO AN ER.
UM, OR A, AN URGENT CARE CLINIC THAT HAPPENS ABOUT 3% OF THE TIME, 97%.
WE CAN HANDLE THE ISSUE OVER THE PHONE, THROUGH TEXT OR THROUGH A FACETIME INTERACTION.
UM, BUT IN, IN THAT SITUATION, IT WAS SIMPLY, HERE'S THE PRESCRIPTION, WOULD YOU LIKE IT FILLED? BECAUSE THIS IS CONSIDERED OUT OF THE INSURANCE NETWORK.
CONCIERGE MEDICINE WE CAN GET, AND CORRECT ME IF I'M WRONG ON THESE PRICES NOW, BUT IN NORTH TEXAS, UH, WITH IMAGING WE CAN GET $75 CASH PAY X-RAYS, $275, CAT SCANS, AND $450 MRIS.
AND, AND THAT'S, THAT'S THIRD PARTY, UH, ENTITIES THAT WE REFER TO AS, SO IT'S THAT THOSE AREN'T OUR COMPANIES, BUT WE HAVE FOUND THE LOWEST PRICES FOR PEOPLE THAT DON'T HAVE INSURANCE TO OBTAIN BLOOD WORK X-RAYS, UM, IF THEY DON'T HAVE ACCESS TO, TO A PHYSICIAN.
BUT OUR GOAL, NOTHING'S BETTER THAN SEEING A DOCTOR IN PERSON.
NOTHING'S WORSE THAN NOT SEEING A DOCTOR AT ALL.
AND SO WE'RE REALLY HERE TO HELP YOU NAVIGATE TO FIND WHERE, WHERE A TRUE MEDICAL HOME IS AFTER YOUR INTERACTION WITH US.
UM, AND SO WE REALLY WANNA REFER YOU BACK INTO THE COMMUNITY AFTER WE TAKE CARE OF YOUR ORIGINAL NEED.
AND IT'S FINDING WHERE THE BEST HOME MEDICAL HOME IS FOR YOU AND, AND WHAT YOU CAN AFFORD.
I KNOW THAT WAS A LOT OF TALKING ON OUR PART.
UM, COUNCIL MEMBER BEARD, SO OKAY.
FROM, YOU ARE NOT ON, THERE'S THE ONE NEXT TO YOU ON IS NO, WELL, THERE'S NOTHING.
UH, UM, I, THIS SOUNDS WONDERFUL.
SO I JUST WANNA BE CLEAR ON WHO IT SERVES.
SO I HAVE INSURANCE OF COURSE, BUT IF IT'S 2:00 AM AND I WAKE UP AND I'M HAVING AN ISSUE OF WHATEVER, I CAN USE THAT SERVICE.
SO MY HEART IS TO GET TO THE PEOPLE THAT DON'T HAVE ACCESS, BUT WE SEE PEOPLE THAT EVEN HAVE ACCESS THAT HAVE INSURANCE THAT QUITE FRANKLY EVEN HAVE TELEHEALTH USE OUR SERVICE BECAUSE IT'S SO EASY.
THAT WAS MY NEXT QUESTION IS ABOUT TELEHEALTH.
IT IS NOT AS EASY AS PEOPLE WANTED TO THINK.
UM, SO, UM, YOU KNOW, I I, I KNOW A LOT OF PEOPLE, ESPECIALLY ELDERLY PEOPLE IN MY NEIGHBORHOOD,
[00:40:01]
IN MY COMMUNITY THAT DO USE 9 1 1 AS THEY HAVE, THEY MAY HAVE INSURANCE, BUT THEY HAVE NO WAY OF GETTING TO THE DOCTOR OR GETTING TO THE HOSPITAL.AND SO THEY CALL 9 1 1, UM, THE AMBULANCE SHOWS UP.
YEAH, THEY DO NEED SOME SORT OF MEDICAL TREATMENT.
SO THEY TAKE 'EM TO PRESBYTERIAN OR TO METHODIST OR WHEREVER.
UM, SO IT WOULD BE NICE FOR THOSE PEOPLE TO HAVE ACCESS TO SOMETHING 24 7.
UM, I THINK THIS IS A WONDERFUL IDEA, WONDERFUL PROGRAM.
I'M GLAD Y'ALL HAD SOME SUCCESS WITH IT.
SO THAT GIVES ME SOME, SOME, UM, SUPPORT THERE.
UM, SO FAR YOU'VE ONLY TALKED ABOUT SMALL AREAS.
SO EVEN THE COUNTY IN SOUTH CAROLINA, IT'S 45,000 PEOPLE.
DISTRICT TWO, WHICH IS WHERE YOU'RE SITTING, HAS LIKE 35,000 PEOPLE.
SO IS IT, CAN IT HANDLE HALF A MILLION A QUARTER MILLION PEOPLE ALL AT ONCE COMING ONLINE? THAT'S MY BIG QUESTION.
'CAUSE WE'RE WE'RE, YOU KNOW, 10 TIMES BIGGER THAN FERRIS, YOU KNOW, AND, AND THAT'S A GREAT QUESTION.
UM, THERE'S A REASON WE DIDN'T COME TO YOU THREE YEARS AGO WHEN I LAUNCHED THE SERVICE.
UM, BECAUSE WE NEEDED TO, TO GET OUR FEET UNDER OURSELVES, PROVE THAT THIS WORKS AND BE ABLE TO SCALE IT TO SERVE A COMMUNITY LIKE GARLAND.
UM, AND SO WE INTENTIONALLY HAVE WAITED.
UM, BUT WE ARE READY AND WE ARE CAPABLE OF SCALING THIS EASILY TO SERVE A COMMUNITY THIS SIZE.
AND QUITE FRANKLY, YOU ARE AT AN ADVANTAGE OF MOST OF OUR COMMUNITIES.
'CAUSE NEARLY ALL OUR DOCTORS ARE LOCATED HERE IN THE METROPLEX.
AND SO WE'RE VERY FAMILIAR WITH THE RESOURCES, THE REFERRAL RESOURCES.
WE'RE FAMILIAR WITH YOUR POPULATION AND PROBABLY THE HEAVIEST LIFT OF THIS ENTIRE PROCESS IS NOT OUR DOCTORS SEEING PATIENTS ON THE PLATFORM.
IT'S GETTING PATIENTS AWARENESS TO ENGAGE WITH THE PLATFORM AND USE IT.
I'D LIKE THAT YOU SAID, CHRIS, THAT YOU HAVE EXPERIENCE WITH TELEHEALTH AND IT'S NOT EASY.
AND THAT'S WHY WE BUILT THIS IS BUILT BY A PHYSICIAN THAT KNOWS THAT TELEHEALTH IS NOT EASY.
AND WE MODELED IT OFF OF THE WAY I INTERACT WITH MY FRIENDS AND FAMILY, WHICH IT MEANS IT'S A TEXT MESSAGE.
YOU COULD LITERALLY TEXT IN OUR SERVICE RIGHT NOW.
UH, THEIR FIRST QUESTION IS, WHY ARE YOU HERE? HOW WE CAN HELP? AND YOU KNOW, WHO'S ASKING THAT QUESTION? THERE'S A MEDICAL PROVIDER, THERE'S NO OFFICE STAFF, THERE'S NO ONE TELLING YOU NEED TO DOWNLOAD AN APP FIRST.
NOW, QUITE FRANKLY, TEXT MESSAGING IS, IS NOT HIPAA COMPLIANT.
MEANING THAT WHEN YOU SEND OUT A TEXT MESSAGE, UH, UNTIL IT GETS TO OUR SERVERS, IT GOES ACROSS AT AND T VERIZON SERVERS, SERVERS.
AND THOSE AREN'T HIPAA COMPLIANT.
SO THE US GOVERNMENT SAYS IF WE INFORM A PATIENT AND AND THEY'RE OKAY WITH THAT, YOU CAN CONTINUE TEXTING THEM, UH, AND AND DO IT THROUGH A TEXT MESSAGE.
ABOUT 10% OF OUR OUR PATIENTS AREN'T COMFORTABLE WITH THAT.
SO WE SEND THEM A SECURE LINK TO CONTINUE THE MESSAGING THROUGH A SECURE LINK, WHICH IS FULLY HIPAA COMPLIANT.
UM, WE HAVE THE ABILITY TO DO VIDEO, BUT WE'VE ALL GOTTEN ON VIDEO AND KNOW, HEY, YOUR MICROPHONE'S OFF.
CAN'T HEAR YOU, YOUR CAMERA, HEY, GOTTA TURN THAT ON.
AND THAT'S WHY WE START OFF WITH THE TEXT MESSAGE BECAUSE IT'S THE LEAST TECHNOLOGICAL BARRIER WE CAN COMMUNICATE WITH OUR PATIENTS.
WE CAN EASILY PROGRESS TO A PHONE CALL AND THEN WE CAN PRO PROGRESS TO A VIDEO.
SO, SO THEY ANSWER THOSE QUESTIONS? YES.
WE'RE DIFFERENT THAN EVERY OTHER TELEHEALTH PROVIDER.
'CAUSE THEIR FIRST QUESTION IS, HOW ARE YOU GONNA PAY FOR THIS ANSWER, THIS 50 QUESTION SURVEY ON YOUR MEDICAL HISTORY AND THEN TURN ON THE VIDEO.
AND THOSE ARE ALL BARRIERS TO INTERACT.
WE INTERACT THAT TEXT FIRST, TEXT MESSAGE IS ANSWERED BY OUR MEDICAL TEAM.
AND THEN TWO, CAN WE SCALE TO SERVE A COMMUNITY THE SIZE OF GARLAND? ABSOLUTELY.
AND THAT'S WHY WE WAITED TO, TO COME TO YOU UNTIL NOW.
AND AND I THINK IT'S IMPORTANT TO UNDERSTAND WE HAVE, UH, 10 PEOPLE IN EACH HOME WILL HAVE ACCESS FOR THAT WILL BE $6 A MONTH.
UM, SO 10 PEOPLE PER HOME, 10 PEOPLE PER BUSINESS IN DALLAS OR IN DALLAS IN GARLAND.
UH, 10 PEOPLE PER BUSINESS IN GARLAND.
AND EVERY CITY EMPLOYEE WOULD HAVE IT FOR FREE IN THE CITY OF GARLAND,
AND, AND BRIAN, I, OUR, OUR NORMAL, JUST SO YOU'RE AWARE, OUR NORMAL PRICE IS $9 PER MONTH.
AND I TALKED TO, TO BRIAN AND MY TEAM AND
[00:45:01]
I SAID, I WANNA GIVE THIS TO GARLAND AT OUR COST BECAUSE IF THEY'RE WILLING TO TAKE A RISK ON US THAT, THAT THIS, THEY'RE GONNA BE OUR LARGEST COMMUNITY.I WANNA DO THIS AT OUR COST TO REWARD THEM FOR THAT.
BECAUSE OUR REWARD IS IF WE DO THIS IN GARLAND, GARLAND IS THE BIGGEST CITY IN THE UNITED STATES THAT DOES NOT HAVE A HOSPITAL.
AND IF I CAN GO TELL THE REST OF THE COUNTRY THAT GARLAND, TEXAS DID THIS, THEY'RE THE BIGGEST CITY THAT DOESN'T HAVE A HOSPITAL.
THERE'S NOT A CITY THAT I CAN'T GO TO.
AND SO, SO NOT ONLY DO I WANNA SERVE GARLAND BECAUSE I'M SEEING YOUR PATIENTS, I ALSO WANNA SERVE IT BECAUSE I KNOW IF THIS IS A SUCCESS IN GARLAND, THERE'S NOWHERE WE CAN'T DO THIS.
NO, YOU, I THINK THIS IS FANTASTIC.
I ALREADY, UM, I JUST WENT ONLINE AND DID THE REGISTRATION.
SO REGARDLESS OF WHAT EVERYONE ELSE DOES, MY HOUSE, WE'LL HAVE IT.
UM, BECAUSE I AM LIKE THE LARGER MAJORITY OF OUR CITY, AND I DON'T HAVE HEALTH INSURANCE, SO WE DO THE GOOD OLD, CUT AN ONION, STICK IT ON YOUR FOOT, PUT A SOCK ON AND CALL IT A DAY.
LIKE, YOU KNOW, SO, UM, I HAVE, I HAVE A, A SPECIAL NEEDS FOSTER AT HOME.
AND SHE DOES THE WEIRDEST STUFF AT THE WEIRDEST HOURS.
AND SO IT'S LIKE, YOU KNOW, IF YOU HAD THAT LITTLE, THAT LITTLE CUSHION WHERE YOU COULD JUST CALL SOMEONE AND BE LIKE, HEY.
SO THE OTHER DAY SHE DECIDED SHE WAS THE GIRL FROM ANNA MANIAC AND HELD A CAT BY THE NECK AND THE CAT, UH, QUITE LITERALLY BEAT HER UP.
UM, AND SO IT WAS ONE OF THOSE LIKE, OH, DO WE, DOES SHE NEED STITCHES? LIKE, UH, I DON'T REALLY KNOW.
I SUPER GLUE IT AND CALLED IT GOOD, BUT THEN THERE FOR THE NEXT WEEK, I WAS LIKE, SHE'S GONNA GET CAT SCRATCH FEVER.
AND SO HAVING THAT, THAT CUSHION OF BEING ABLE TO CALL A PROFESSIONAL AND BE LIKE, HEY, SO SHOULD WE GO TO GET STITCHES OR NO? AND SO I THINK THAT IT WOULD BE SUPER BENEFICIAL.
UM, I ALSO HAD A NEIGHBOR A COUPLE OF WEEKS AGO THAT PASSED AWAY.
UM, SHE HAS CHRONIC HEALTH ISSUES, UM, POTS AND E DS AND ALL OF THAT, ALL OF THE ALPHABET FUN STUFF.
UM, AND I, I THINK THAT SHE ENDED UP CATCHING C AND DIDN'T THINK THAT IT WAS THAT SERIOUS.
AND SO SHE WAS ALSO A FRIEND, BUT SHE PASSED AWAY BECAUSE SHE DIDN'T, SHE COULDN'T GO TO THE HOSPITAL.
BECAUSE THEY'RE BOTH DISABLED.
NO ONE HAS A CAR AND WHAT DO YOU DO? SO SHE PASSED AWAY IN HER SLEEP.
THIS, I THINK IS SOMETHING THAT COULD HAVE SAVED HER.
AND, AND WE, UM, YOU, YOU SAW A, A LADY IN THE FIRST VIDEO, UM, WHAT SHE DIDN'T GO INTO DETAIL WAS THAT, UH, SHE HAD, UH, A HISTORY OF SOME BREATHING AND RESPIRATORY ISSUES AND SHE HAD THE TYPE A FLU THAT TURNED INTO PNEUMONIA.
UM, BUT SHE THOUGHT SHE WAS OKAY.
SHE WAS JUST HAVING LABOR BREATHING.
SO SHE WAS OUR FIRST PATIENT IN DALLAS DIALYSIS DOING A PILOT.
SHE, SHE WAS OUR FIRST ONE THAT HIT THE SYSTEM.
AND UNLIKE MOST OF OUR CALLS THAT DID GO TO A FACETIME INTERACTION WHERE OUR PHYSICIAN SAID, NO, NO, YOU NEED TO GO TO THE HOSPITAL LIKE FIVE MINUTES AGO.
AND SHE SAID, WELL, I DON'T HAVE MY MAKEUP ON RIGHT NOW.
I NEED, WE SAID, LISTEN,
SHE'S LIKE, NO, MY SISTER'S HERE.
SO WE CALLED AHEAD TO PRESBY AND HAD THEM WAITING FOR HER WHEN HER SISTER PULLED UP, THEY TOOK HER IN.
AND HOW LONG BEFORE SHE WAS ON A RESPIRATOR? I MEAN, IT WAS VERY YEAH.
UM, BUT THAT'S, THAT'S THE IMPACT.
AND THANK YOU FOR SHARING THAT.
UM, AND I, I CAN'T WAIT TO, TO SEE YOU GUYS BLOOM AND SAVE SOME LIVES THAT, YOU KNOW, NOT ONLY DO WE NOT HAVE A HOSPITAL, BUT WE HAVE A VERY LARGE MAJORITY OF OUR CITY THAT IS NOT INSURED.
AND SO, UM, WE RECENTLY LOOKED AT HEAT MAPS ABOUT, ABOUT THAT SAME TOPIC OF WHAT AREAS, UM, OUR UNINSURED IN MY DISTRICT IS ONE OF THE HIGHEST UNINSURED.
SO I THINK IT'LL BE A GREAT THING FOR US.
ONE REALLY SENSITIVE THING THAT DOESN'T GET MENTIONED A LOT IS GARLAND IS I THINK PRIMARILY HISPANIC.
UM, AND AT THE HOSPITAL, IT'S REQUIRED BY STATE LAW NOW TO ASK IMMIGRATION STATUS.
[00:50:02]
THE, THAT COMMUNITY IN PARTICULAR IS SCARED TO DEATH TO SHOW UP TO THE HOSPITAL NOW.AND THEY'RE LEAVING MEDICAL CONDITIONS REALLY, REALLY LATE UNTIL THEY HAVE TO BE THERE.
A SERVICE LIKE THIS OFFERS THEM SOME DEGREE OF ANONYMITY AND AN OPTION TO RECEIVE TREATMENT, UM, UH, AND NOT LEAVE THINGS TOO LONG.
AND SO I'M, I'M CONCERNED WHAT THE REPERCUSSIONS OF THAT IS TO THE HEALTHCARE OF OUR COMMUNITIES IN PARTICULAR GARLAND WITH ITS HIGH HISPANIC POPULATION.
WELL, AND NOT TO MENTION OUR IT IS AS SIMPLE AS A 10 DIGIT NUMBER YOU TEXT, BUT IT'S SO MUCH MORE BEHIND THE SCENES.
SO WHEN I TEXT THAT NUMBER IN WHATEVER LANGUAGE I SPEAK, IT IMMEDIATELY GETS TRANSLATED TO OUR PHYSICIANS AND THEIR LANGUAGE AND VICE VERSA.
SO, UM, WE CAN HAVE THAT MULTILINGUAL COMMUNICATION WITH YOUR, WITH YOUR COMMUNITY EVEN BETTER.
REALLY APPRECIATE THE PRESENTATION, LADIES, APPRECIATE THE FEEDBACK AND COMMUNICATION.
ONE, WE WILL START OFF, WE WERE TALKING ABOUT LANGUAGE, UM, IS, UH, SO WE HAVE, WE HAVE A, UH, LARGE, UH, SOUTHEAST ASIAN POPULATION HERE.
UM, ESPECIALLY, UH, VIETNAMESE.
UH, IS VIETNAMESE ONE OF THE LANGUAGES OFFERED IN YOUR TRANSLATION SERVICE? IT IS, YES.
AND THEN, UM, SO ACTUALLY I'LL TELL YOU JUST SO EVERYBODY KNOWS WHERE I'M COMING FROM.
UM, SO, YOU KNOW, I, I HAVE HEALTH INSURANCE, UM, YOU KNOW, MY WIFE IS A PHYSICIAN.
UM, HOWEVER, THAT IS NOT THE SITUATION I GREW UP IN.
I DIDN'T SEE A DOCTOR UNTIL I WAS AN ADULT.
UM, I DID NOT GROW UP WITH HEALTH INSURANCE, DIDN'T GO TO THE DOCTOR, DIDN'T GO TO THE DENTIST, NONE OF THAT STUFF.
UM, SO, YOU KNOW, MY EXPERIENCE MOST OF MY LIFE IS, IS PRIMARILY, YOU KNOW, THE, THE, THE DEMOGRAPHIC YOU'RE TALKING ABOUT.
UM, THAT BEING SAID, UM, I HAVE HAD AS A, UM, MY EXPERIENCE WITH, WITH TELEHEALTH HAS BEEN, AND THIS IS WHAT I'M BRINGING THIS UP 'CAUSE I WANNA HAVE A CONVERSATION ABOUT THE DIFFERENCES BETWEEN YOUR SERVICE AND WHAT I HAVE EXPERIENCE WITH.
SO I HAD, UM, UM, I'VE OWNED BUSINESSES IN THE PAST.
AT ONE POINT I HAD, UH, 60 EMPLOYEES ACROSS EIGHT DIFFERENT LOCATIONS.
AND I, UM, COULDN'T AFFORD A COURSE TO, TO ENSURE PAY HEALTH INSURANCE FOR ALL MY EMPLOYEES.
SO WHAT I DID IS I HAD A, A TELEMEDICINE SERVICE CALLED MEMD FROM AFLAC.
UM, DID THAT FOR A YEAR AND A HALF AND HAD ALMOST ZERO PARTICIPATION FROM MY STAFF ON THAT SERVICE.
UM, IF YOU'RE FAMILIAR WITH THAT SERVICE, CAN YOU EXPLAIN TO ME DIFFERENCES BETWEEN WHAT YOU'RE OFFERING AND WHAT THAT IS? I, I'M ASSUMING EMD IS, UH, A VIDEO BASED, UH, SERVICE.
I, I THINK THE LACK OF ENGAGEMENT ON GENERAL TELEHEALTH BE, IT IS TWOFOLD.
ONE, PEOPLE JUST DON'T REMEMBER IT.
IF YOU'RE NOT IN FRONT OF THEM CONSTANTLY REMINDING THEM THAT THEY HAVE ACCESS, THEY'RE NOT GONNA U UTILIZE IT.
SO THAT, THAT'S THE FIRST BARRIER, UH, IS JUST MAKING EVERYONE REALIZE, HEY, WHEN YOU HAVE A MEDICAL PROBLEM, USE IT.
BUT ONCE THEY USE IT, IF IT'S NOT A GOOD EXPERIENCE, IT DESTROYS IT.
SO IF YOU'RE NOT GETTING AN EMPLOYEE GOES, OH MY GOODNESS, THIS, DID, YOU KNOW THIS, THIS NEW TELEHEALTH SERVICE THAT OUR COMPANY'S EMPLOYED IS GREAT.
UH, AND THEY TELL THREE OTHERS IT DOESN'T TAKE OFF.
AND THE REASON THAT THE EXPERIENCE ON GENERAL TELEHEALTH DOESN'T TAKE OFF IS, NUMBER ONE, YOU GOTTA DOWNLOAD AN APP, YOU GOTTA CREATE AN ACCOUNT.
UH, YOU THEN HAVE TO INPUT YOUR INSURANCE INFORMATION TO SHOW HOW YOU QUALIFY FOR THE SERVICE.
UH, AND THEN ONCE YOU DO THAT, YOU, YOU, YOU EMAIL, TEXT IN, I'LL BE EXAMPLE.
I USED, UH, EMD, UH, SERVICE IS WAS ACQUIRED BY WALMART.
WALMART LAUNCHED, I I, I TRIED MY COMPETITOR'S PRODUCTS.
SO I WENT ON, I REGISTERED, I, I DOWNLOADED THE APP AND SAID I HAD A SORE THROAT AND SENT IN A, A, IT WAS AN EMAIL THAT WAS REQUIRED.
AND THEY SAID, OH, A, A DOCTOR WILL BE REACHING OUT TO YOU BY VIDEO OR PHONE IN IN A FEW HOURS.
THEY DIDN'T GIMME A TIMEFRAME, THEY JUST SAID THEY'RE GONNA REACH OUT.
WELL, I, I GET A PHONE CALL FROM AN UNRECOGNIZED NUMBER, I ANSWER IT, AND IT'S A, A DOCTOR SPEAKING VERY QUICKLY.
AND THEY SAID, ARE I UNDERSTAND YOU'RE HERE FOR A SORE THROAT? I'M LIKE, UH, EXCUSE ME.
I'M, WHO, WHO IS THIS? THIS IS DR.
SO-AND-SO FROM, DO YOU NOT NEED MY SERVICE? I'M LIKE, OH, YEAH, YEAH, I DO.
SO I SAID, I HAVE A SORE THROAT.
AND I WAS HOPING TO, UH, TO GET EVALUATED FOR THAT.
HE'S LIKE, WELL, WHAT ANTIBIOTIC DO YOU WANT? AND I'M LIKE, OH, DO I NEED AN ANTIBIOTIC? HOW, HOW DO YOU KNOW I HAVE AN INFECTION? UM, AND THAT DOCTOR WAS GETTING PAID ON THROUGHOUT OUTPUT.
AND THE MORE PATIENTS HE SAW, THE, UH, THE MORE MONEY HE MADE.
AND, AND THE EXPERIENCE FOR A PATIENT LEVEL WAS HORRIBLE.
AND SO WE'VE TAKEN EVERYTHING WE THINK IS BAD ABOUT TELEHEALTH AND WE'VE RE-ENGINEERED IT TO MAKE IT A GREAT EXPERIENCE.
SO WHEN YOU TEXT IN, THE FIRST QUESTION
[00:55:01]
IS NOT, NOT FILL OUT THIS QUESTIONNAIRE LIKE YOU WOULD AT THE DOCTOR OFFICE OR WHO IS YOUR INSURANCE IS, WHY ARE YOU HERE? UH, OH, YOU HAVE A SORE THROAT.AND ABOUT HALFWAY INTO YOUR INTERACTION, UH, WE WE'RE GETTING YOUR DEMOGRAPHIC INFORMATION.
WHAT'S YOUR FULL NAME? WHAT'S YOUR FULL ADDRESS IF YOU HAVEN'T INTERACTED WITH US BEFORE, AS YOU'RE GIVING YOUR FULL NAME AND FULL ADDRESS, WE'RE PULLING FROM A NATIONAL PHARMACY DATABASE.
WELL, I CAN SEE ALL THE DRUGS THAT YOU'VE FILLED IN THE PAST.
SO WHEN I ASK YOU, DO YOU HAVE ANY MEDICAL PROBLEMS? SOME PEOPLE SAY NO.
AND THEN WE'LL SAY, WELL, MR. SMITH, WE SEE THAT YOU'RE ON LISINOPRIL AND METFORMIN.
THOSE ARE FOR HIGH BLOOD PRESSURE AND DIABETES.
OH YEAH, I TAKE THOSE MEDICINES.
BUT THEY'RE, THOSE AREN'T PROBLEMS ANYMORE BECAUSE THEY'RE, THEY'RE BEING ADDRESSED WITH THOSE MEDICINES.
WELL NOW WE KNOW YOUR MEDICAL HISTORY.
UM, AND SO IF YOU, IF YOU'RE NOT IN THE DATABASE, WE HAVE YOU TAKE A PICTURE OF YOUR MEDICINES.
SO NOW WE CAN FILL OUT THE, THE DATABASE.
WE GET YOUR ENCOUNTER TAKEN CARE OF.
WE TELL YOU ACTUALLY WHAT THE DRUGS ARE GONNA COST AT THE PHARMACY, AND WE GIVE YOU A DISCOUNT CARD, UH, UH, UH, TO, TO GET THE LOWEST PRICE POSSIBLE.
AND THEN AT THE, UH, VERY END, WE FOLLOW UP WITH YOU.
UM, TWO DAYS LATER, EVERY SINGLE ONE OF OUR PATIENTS GETS A FOLLOW UP TEXT MESSAGE, HOW ARE YOU DOING? ARE YOU IMPROVING? UM, WHO DOESN'T WANT THEIR DOCTOR TO CHECK IN ON THEM? AND SO WE TRY TO, TO CREATE A GREAT EXPERIENCE.
IT, IT'S BEEN SO, SUCH A GOOD EXPERIENCE.
I'LL GIVE YOU AN EXAMPLE OF A PATIENT WE, WE SAW THREE TIMES FOR, FOR STREP THROAT.
UH, TWO TIMES WE'LL TREAT THREE TIMES.
YOU NEED TO SEE A DOCTOR IN PERSON.
AND SO ON THE THIRD TIME, WE RECOMMENDED TO THE MOM, YOU, YOU NEED TO GO IN TO, TO SEE THE DOCTOR IN PERSON.
THIS IS YOUR DAUGHTER'S THIRD TIME WITH STREP THROAT.
SURE ENOUGH THAT ENDED UP SEEING AN ENT GOT, GOT THEIR TONSILS OUT, AND WE GET A TEXT MESSAGE FROM THE MOM SAYING, HEY, MY DAUGHTER'S HAD SOME VOMITING.
UM, CAN YOU HELP? WE'RE LIKE, SURE.
UH, AND SHE JUST HAD HER TONSILS OUT.
I, WE SEE IN THE NOTES THAT WE RECOMMENDED HER GET FOLLOW UP.
I'M GLAD TO HEAR THAT SHE'S GOTTEN, GOTTEN HER TONSILS OUT.
WHEN DID THAT HAPPEN? OH, 40 MINUTES AGO.
WHERE ARE YOU? WELL, I'M IN POST-OP RECOVERY.
WE COULDN'T GET AHOLD OF THE DOCTOR, BUT WE KNOW WE CAN ALWAYS GET AHOLD OF YOU.
UM, AND SO CAN YOU HELP US OUT? AND I'M TELLING YOU, THAT HAPPENS MORE FREQUENTLY THAN I'D LIKE TO ADMIT.
UM, EVEN THE LADY THAT WE SAW IN THIS VIDEO WHO WENT TO THE HOSPITAL, GOT ADMITTED TO THE HOSPITAL FOR FOUR DAYS FOR HER PNEUMONIA, WENT HOME, STARTED FEELING SICK AGAIN, HAD NO WAY OF GETTING A HOLD OF THE DOCTORS THAT SAW HER IN THE HOSPITAL.
IT'S EASY AS TEXTING A FRIEND AS EASY AS YOUR WIFE WHEN SHE GETS A, A, A MESSAGE FROM HER FRIENDS THAT THEY'RE FEELING SICK.
UM, AND THAT'S HOW WE'RE DIFFERENT IS IT IS REALLY THE EASY BUTTON.
AND JUST TO QUICKLY COMPLIMENT THAT, THE OTHER, THE OTHER THING IS WHEN I'VE TRIED, AND SOME OF 'EM MAY OPERATE A LITTLE BIT DIFFERENT, BUT TO BUILD TELEHEALTH INSURANCE, THEY SAY, HEY, BLOCK OUT A TIME PERIOD BETWEEN FOUR AND SIX AND WE'LL GIVE YOU A CALL DURING THAT TIME WITH US.
IT'S PRETTY IMMEDIATE, YOU KNOW, WITH OUR AVERAGE RESPONSE UNDER TWO MINUTES.
SO YOU LITERALLY TEXT IN AND WE'LL, WE'LL GET BACK TO YOU.
UM, AND, UH, DUR CAN, CAN'T SPEAK TO THIS, BUT ALL OF OUR, OUR MEDICAL STAFF IS ER TRAINED, UH, MEDICAL STAFF.
SO THAT'S UNLIKE EVERY, NOT, NOT, NOT ALL TELEHEALTH SERVICES DO THAT.
A LOT OF TIMES THE EASY REQUEST THAT THEY DO IS LIKE, JUST GO TO THE ER BECAUSE THEY'RE NOT, THEY'RE NOT AS TRAINED AS, AS DEALING WITH THIS, UH, UNDIFFERENTIATED CARE.
AND DR. PERRY, ONE THING YOU MENTIONED AT THE BEGINNING OF YOUR RESPONSE WAS, UM, THE SERVICE DOESN'T DO PE PEOPLE ANY GOOD IF THEY'RE NOT, IF THEY DON'T THINK ABOUT IT.
SO WHAT DO YOU GUYS DO TO KEEP PEOPLE AWARE OF THE SERVICE? SO WE HAVE A VERY EXTENSIVE MARKETING, UH, PROGRAM.
PART OF IT IS A PARTNERSHIP WITH THE CITY, USING YOUR CHANNELS OF INFLUENCE.
BUT WHAT WE HAVE FOUND HIGHLY SUCCESSFUL IS GETTING INTO THE CHURCHES.
UH, WHEN WE CAN GET INTO A CHURCH, TALK TO A PASTOR, GET BEFORE A CONGREGATION, UM, THEY'RE PROBABLY SOME OF THE MOST TRUSTED LEADERS IN OUR COMMUNITY.
AND THERE'S A LOT OF CHURCHES IN GARLAND.
AND SO THAT WOULD BE ONE WE START IN THE CHURCHES, TWO IS THE SCHOOLS.
AND SO EVERY TIME A KID GETS SICK, UH, WE, WE HAVE THE SCHOOL NURSE IN HOME, A LITTLE FORUM, HEY, DON'T FORGET YOU HAVE ACCESS TO THIS SERVICE TO TEXT IN TO THE PARENTS.
THAT'S A BIG, BIG, UH, UH, UTILIZER.
AND THEN IT'S SMALL BUSINESSES.
THE SMALL, LIKE YOU HAD MENTIONED, YOU COULDN'T AFFORD INSURANCE FOR YOUR EMPLOYEES, SO YOU WENT THE TELEHEALTH PRODUCT.
ANYONE THAT GETS PAYS A WATER UTILITY BILL CAN PUT UP TO 10 PEOPLE ON THIS SERVICE FOR THAT COST.
AND THAT'S INCLUDING YOUR SMALL BUSINESSES.
MAYBE IT'S LOCAL TAHE, UH, THAT, UH, CAN'T AFFORD TO, TO PAY THEIR, UH, FOR THEIR EMPLOYEES' HEALTH INSURANCE.
AND SO THIS WOULD GIVE THEM SOME ACCESS TO, TO A HEALTHCARE PRODUCT, BUT IT'S REALLY ABOUT GETTING OUT AND ENGAGING THAT COMMUNITY ON A REGULAR BASIS AND LETTING 'EM KNOW, UH, AWARENESS.
YOU GUYS ARE DOING A GREAT JOB OF ANSWERING A LOT OF THE QUESTIONS I'VE GOT WRITTEN DOWN HERE,
[01:00:01]
I'M GONNA TRY TO KEEP THESE FLOWING IN A ORDER THAT MAKES SENSE.AND Y'ALL TALKED A LITTLE BIT WITH, WITH CHRIS ABOUT THE, UM, LET'S SEE.
YOU'RE IN 20 CITIES, UM, YOU KNOW, THE COUNTY IN SOUTH CAROLINA WITH A POPULATION OF 45,000.
IS THAT THE LARGEST SERVICE AREA YOU HAVE IN ONE? THAT'S OUR LARGEST ONE, UH, SERVICE AREA.
WE, WE COVER, UH, IT'S NOW WE'RE UP TO ABOUT 120,000 LIVES THAT WE SERVE TODAY.
SO COMING TO GARLAND, YOU WOULD BE GROWING BY A FACTOR OF THREE.
YOU'D BE GOING FROM 120 TO THE, THE GREAT THING IS IT'S, UH, TO SCALE FOR US.
WE, WE, WE HAVE DEVELOPED OUR OWN SOFTWARE ON THE BACKEND, UH, THAT NOW ALL WE HAVE TO DO IS PLUG IN MORE PHYSICIANS, UH, TO THE SERVICE.
AND THAT'S ALL, ALL IT'S ABOUT.
WE HAVE THE, I THINK YOU NEED TO EXPLAIN THE PROGRAM, HOW THAT PHYSICIAN PLATFORM WORKS AND HOW MANY ARE IN THERE AND HOW, YEAH.
SOUNDS LIKE HOW, HOW YOU GONNA, SO WHEN, WHEN THAT MANY MORE, WHEN YOU TEXT IN, IT LOOKS LIKE A SIMPLE TEXT MESSAGE, IT LOOKS LIKE YOU'RE TEXTING A FRIEND.
ON OUR END, THERE'S A REALLY ROBUST TECHNICAL TOOL, UH, ELECTRONIC MEDICAL RECORD THAT WE HAVE.
AND SO WE IDENTIFY YOU BASED OFF YOUR PHONE NUMBER, UH, THAT'S KIND OF YOUR, YOUR ID.
AND THEN WE CAN CONFIRM, UH, WHO WE'RE TALKING TO FROM THAT PHONE NUMBER.
BECAUSE, YOU KNOW, MAYBE YOU'RE TALK TEXTING IT ABOUT YOUR CHILD, MAYBE YOU'RE TEXTING IT ABOUT YOURSELF.
UM, WE HAVE A LOT OF RESOURCES WE HAVE ACCESS TO.
SO THERE'S A NATIONAL DATABASE, PHARMACY DATABASE.
WHEN YOU GIVE, UH, WE NEED TO KNOW YOUR NAME, YOUR ADDRESS, YOUR GENDER, UH, AND YOUR PHONE NUMBER.
AND THAT GETS US EVERYTHING WE NEED OUT OF A PHARMACY DATABASE THAT ALLOWS US TO SEE ALL DRUGS YOU'VE HAD FILLED IN THE LAST 12 MONTHS.
AND THAT'S REALLY THE BEST WAY TO GET SOMEONE'S MEDICAL HISTORY.
WE ALSO ARE ON A, A MEDICAL DATA EXCHANGE.
SO THAT'S WHAT BAYLOR USES, WHAT, UH, UH, PRESBY USES TO LOOK AT YOUR PAST MEDICAL HISTORY IF YOU'RE AT ANOTHER HOSPITAL.
SO WE HAVE ACCESS TO, TO PULL THAT.
UM, AND THEN WE HAVE YOUR MEDICAL RECORD, IF YOU'VE TEXTED IN BEFORE, WE HAVE, WHAT I'M MOST PROUD OF THAT WE'VE DEVELOPED IS WE WE'RE UTILIZING AI TO ENSURE THAT, THAT WE ARE PROVIDING THE BEST CARE.
AND SO FROM A MEDICAL STANDPOINT, IF YOU HAVE A URINARY INFECTION, THERE'S, THERE'S PROBABLY EIGHT QUESTIONS WE NEED TO YOU TO ANSWER.
ONE, TO MAKE SURE IT'S NOT A, A KIDNEY INFECTION TO MAKE SURE THAT YOU DON'T HAVE SEPSIS.
UM, AND SO THERE'S THIS AI TOOL WORKING IN THE BACKGROUND, REMINDING OUR PHYSICIANS, HEY, YOU'RE, YOU'RE TWO QUESTIONS AWAY FROM CONFIRMING WITH A HIGH DEGREE OF CERTAINTY THAT THIS IS A SIMPLE URINARY INFECTION.
AND SO THE AI TOOL'S KIND OF MONITORING THAT.
AND THEN TWO, WHEN THE DOCTOR DOES MAKE A DIAGNOSIS, THEY SAY, YEP, THIS IS URINARY INFECTION.
THE AI TOOL IS, IS ALLOWING THE DOCTOR TO KNOW, DID YOU, UH, THERE'S WHAT'S CALLED AN ANTIBIOGRAM.
SO ESSENTIALLY THE ANTIBIOTICS THAT WORK IN GARLAND, TEXAS ARE DIFFERENT AND HAVE DIFFERENT RESISTANCE THAN THE ONES THAT WORK IN SOUTH CAROLINA.
AND IT'S REALLY HARD, ALMOST IMPOSSIBLE FOR A PHYSICIAN TO KNOW OFF THE TOP OF THEIR HEAD WHEN ANTIBIOTIC WORKS IN GARLAND WHEN, WHEN WORKS IN SOUTH CAROLINA.
SO WE HAVE AN AI TOOL THAT'S REMINDING A CLINICIAN WHAT THE MOST EFFECTIVE DRUGS ARE, UH, BASED OFF THAT ANTIBIOGRAM IN YOUR COMMUNITY.
SO, SO WE REALLY HAVE A LOT OF TOOLS THAT I WOULD LOVE TO HAVE ACCESS TO AS I WORK IN THE ER.
EVEN AT PRESBY DALLAS, THEY, THEY HAVEN'T EVEN IMPLEMENTED YET.
AND SO BECAUSE OF THAT, WE'VE ELIMINATED ALL THE CLERICAL WORK ON THE PHYSICIAN END.
AND SO OUR, UH, THE, THE, THESE TECHNOL TECHNOLOGY TOOLS ALLOW US TO BE VERY EFFICIENT, BUT BE VERY ACCURATE.
ONE, ONE MORE POINT OF CLARITY, IF, IF YOU COULD EXPLAIN HOW WE SCALE THE DOCTORS, I, IT'S ALMOST LIKE A, AN UBER POOL OF DRIVERS.
AND OUR PLATFORM CAN THEN GO IN AND SAY, IF WE'RE IN, IF WE COVER THIS MANY PATIENTS, THEN WE WILL HAVE ACCESS TO X AMOUNT OF PHYSICIANS.
SO WE KNOW BASED OFF POPULATION WHAT THE AVERAGE UTILIZATION RATES ARE, AND UH, TYPICALLY THE HIGH PEAK TIMES.
BUT WE DO HAVE A POOL OF PHYSICIANS JUST LIKE WE DO IN THE ER FOR HIGH VOLUME TIMES THAT WE CALL IN AND SAY, HEY, THE SYSTEM'S SEEING AN INCREASED DEMAND.
AND SO FROM DAY ONE, IF GARLAND WERE TO CONTRACT WITH US, UH, IMMEDIATELY WE WOULD HIRE AN ADDITIONAL 25 PHYSICIANS TO SERVICE THE, THE GARLAND AREA.
UM, AND THEN WE WOULD USE OUR RESOURCE POOL FOR HIGH SURGE IN DEMAND TIMES.
BUT IT'S, IT'S WELL CALCULATED, UH, UH, TOOLS THAT WE WOULD USE.
AND IT'S REALLY JUST ABOUT HIRING THE, THE PHYSICIANS, UH, UH, AND THEY'RE GONNA BE FOR GARLAND.
THEY'RE GONNA BE DOCTORS THAT WORK AT BAYLOR.
THEY'RE GONNA BE DOCTORS THAT WORK AT MEDICAL CITY, DOCTORS THAT WORK AT PRESBYTERIAN.
[01:05:01]
GONNA BE THE SAME DOCTORS THAT ARE SEEING YOU IN PERSON.UH, FOR GARLAND, AND I CAN'T SAY THAT ABOUT SOUTH CAROLINA, WE UTILIZE A LOT OF DOCTORS FROM OUR COMMUNITY.
WE, WE HAVE ABOUT 20% OF THE DOCTORS IN SOUTH CAROLINA ARE FROM SOUTH CAROLINA.
BUT FOR GARLAND, YOU GUYS WOULD HAVE A HUNDRED PERCENT OF THE DOCTORS BEING LOCAL, UH, TO YOU.
AND DIRK, DIRK WAS NOT KIDDING WHEN HE SAID HE PURPOSEFULLY SPENT THREE YEARS BUILDING THE PROGRAM SO THAT IT COULD NOW EXPAND.
BECAUSE I AM, EARLIER THIS WEEK I WAS IN AUSTIN MEETING WITH THEIR ASSISTANT CITY MANAGER OF PUBLIC HEALTH.
THEY WOULD LIKE TO DO THE PILOT.
DALLAS HAS OFFERED IT TO FOUR DIFFERENT COUNCIL DISTRICTS, UM, TO HAVE A THOUSAND PEOPLE PER DISTRICT, WHICH IT COULD BE 50,000 PEOPLE IF FIVE, FIVE PEOPLE ARE IN, I'M DOING MY MATH WRONG, BUT IT'D BE A LOT OF PEOPLE
AND THEN, UM, NEXT IN WEEK AFTER NEXT I'LL BE WITH CHICAGO WATERS COMMISSION, CHICAGO WATER COMMISSIONER, CITY OF MILWAUKEE.
UM, WE'RE TALKING OF LOS ANGELES.
I MEAN, DIRK HAS, LET ME GO WITH MY, MY NLC CONTACTS AND, AND WE'RE TRYING TO TAKE IT EVERYWHERE, BUT WE WOULD LOVE FOR GARLAND TO BE OUR FIRST, OUR FIRST BIG ONE.
AND THEN, UM, AND YOU TOUCHED A LITTLE BIT UPON AVERAGE USERS.
SO, UM, SPEAKING OF THE AVERAGE USERS, SO HOW MANY TIMES, OKAY, WAIT, SO I'D LIKE TO KNOW WHAT PERCENTAGE OF THOSE ENROLLED UTILIZE THE SERVICE AT LEAST ONCE PER YEAR AND AS WELL, UH, FOLLOW UP WITH THAT.
THE AVERAGE NUMBER OF TIMES THE USER UTILIZES THE SERVICE PER YEAR.
SO OUR HIGHEST COMMUNITY IS 65% OF THE COMMUNITY USES IT AT LEAST ONCE DURING A YEAR.
UM, AND OUR LOWEST COMMUNITY, UH, IS IN THE 25% RANGE.
UM, SO OUR LOWEST COMMUNITY OR USUALLY OUR NEWEST COMMUNITIES, IT TAKES TIME TO, TO BUILD IT UP.
LIKE I GAVE THE EXAMPLE IN SOUTH CAROLINA WHERE WE, UH, WENT FROM 130 PATIENTS A DAY TO 2000.
AND THEN, UM, OF, OF THOSE USERS, WHAT IS THE AVERAGE NUMBER OF TIMES THAT USER UTILIZES THE SERVICE PER YEAR? I DON'T KNOW THE ANSWER OFF THE TOP OF MY H UH, HAND WITH THE AVERAGE NUMBER I COULD PROBABLY GIVE YOU PER HOUSEHOLD.
UH, PER HOUSEHOLD, IT'S USUALLY THREE TO THREE TO FOUR TIMES PER YEAR.
A HOUSEHOLD WILL UTILIZE OUR, OUR SERVICE.
AND THEN, AND JUST TO ADD ONE QUICK, I THINK ACROSS OUR COMMUNITIES, REPEAT USERS ARE, USE IT MORE THAN ONCE, UH, WITHIN A YEAR OR IN THE HIGH EIGHTIES.
SO ONCE THEY, THEY HAVE A CHANCE TO USE IT ONCE, UM, IT IS MORE OFTEN THAN NOT THAT THEY'LL COME BACK FOR AT LEAST A SECOND TIME.
AND THEN, UH, FOLLOW UP ON THAT, GOING INTO, UH, CHRONIC CONDITIONS.
SO, UM, LET'S SAY, YOU KNOW, SOMEBODY'S GOT DIABETES, THEY NEED, YOU KNOW, IT'S A CHRONIC CONDITION, THEY NEED MAINTENANCE ON THAT.
UM, AND I'M NOT SURE, I DON'T HAVE DIABETES.
I DON'T KNOW ANYONE WITH DIABETES.
I DON'T KNOW HOW OFTEN THEY'RE, YOU KNOW, HAVE TO HAVE THAT MAINTENANCE.
BUT I DO KNOW IT IS SOMETHING THAT NEEDS TO BE MAINTAINED.
SO HOW DO YOU GUYS WORK WITH CHRONIC CONDITIONS? DO YOU KEEP PEOPLE ON YOUR PLATFORM FOR THAT? DO YOU REFER THEM AT SOME POINT TO A, A, A PHYSICIAN, UM, YOU KNOW, TO CONTINUE THAT MAINTENANCE? CAN YOU TELL ME A LITTLE BIT ABOUT THAT? LIKE I I SAID EARLIER, IT'S NOTHING BETTER THAN SEEING A DOCTOR IN PERSON.
SO WE DON'T WANNA REPLACE YOUR, YOUR IN-PERSON DOCTOR IF YOU HAVE ACCESS TO ONE.
SO IF YOUR DOCTOR IS MAINTAINING YOUR DIABETES AND YOUR HIGH BLOOD PRESSURE, BUT YOU RAN OUT OF YOUR MEDS, YOU CAN'T GET IN TO BE SEEN.
SO THOSE PATIENTS ARE DIFFERENT.
WE WANT YOU REALLY TO, TO BE SEEN AGAIN BY YOUR PHYSICIAN THAT'S BEEN MANAGING YOUR CONDITION.
HOWEVER, ABOUT 15 TO 20% OF OUR PATIENTS, UH, ON OUR PLATFORM, DON'T HAVE A PHYSICIAN, DON'T HAVE ACCESS TO ANY KIND OF FOLLOW UP.
UH, AND SOME OF THOSE PATIENTS CAN BE REALLY CHALLENGING TO MANAGE.
AND SO WE ACTUALLY HAVE FOR REALLY HIGH UTILIZERS, THOSE THAT HAVE POORLY CONTROLLED DIABETES OR POORLY CONTROLLED HIGH BLOOD PRESSURE, WE HAVE CELLULAR CONNECTED BLOOD PRESSURE CUFFS AND GLUCOMETERS THAT WE PROVIDE AT NO CHARGE TO THOSE PATIENTS BECAUSE IT BENEFITS US TO KNOW IN REAL TIME WHAT THEIR NUMBERS ARE.
AND THOSE NUMBERS, EVERY TIME YOU CHECK YOUR BLOOD SUGAR, BLOOD PRESSURE, YOU DON'T EVEN HAVE TO CLICK A BUTTON THAT THE DEVICE SENDS THOSE NUMBERS TO OUR PLATFORM.
SO WE CAN MONITOR THOSE AND HELP MANAGE THOSE, UH, VERY CLOSELY.
UM, WE USE THOSE REALLY JUDICIOUSLY 'CAUSE THEY'RE EXPENSIVE FOR US, BUT EVERY COMMUNITY HAS A NUMBER OF THOSE PATIENTS THAT DON'T HAVE A DOCTOR THAT ARE REALLY HARD TO MANAGE.
AND THEN WE TAKE THAT ONUS ON OURSELVES, UH, TO, TO MANAGE THAT, THAT POPULATION.
I JUST WANNA CONFIRM A COUPLE THINGS REAL QUICK.
SO YOU GUYS, YOU GUYS CAN, UH, WRITE PRESCRIPTIONS OVER THE TEXT SERVICE? YES.
AND THEN, AND JUST TO BE CLEAR, WE WRITE PRETTY MUCH YOUR BASIC, UH, UH, MEDICINES.
WE WILL NOT WRITE FOR SCHEDULED NARCOTICS.
[01:10:01]
UM, OKAY.AND YOU TALKED A LITTLE BIT ABOUT BENEFITING THOSE WITH INSURANCE.
UM, I'D LIKE TO KNOW A LITTLE BIT ABOUT THE, UM, TELL ME A LITTLE MORE, BIT MORE ABOUT THE PILOT PROGRAM WITH DALLAS.
HOW LONG HAS IT BEEN GOING ON? HAS IT STARTED YET? I WANT TO, I WANNA HEAR AGAIN.
HOW MANY PEOPLE ARE ENROLLED IN IT? WHAT, WHAT'S, TELL ME MORE ABOUT THAT, PLEASE.
YEAH, SO I'VE MET WITH SEVERAL DALLAS COUNCIL MEMBERS.
I'VE, I'VE WORKED WITH THEIR COUNCIL FOR YEARS AND YEARS THROUGH NLC, AND I TOLD THEM ABOUT THIS, AND THEY WERE LIKE, WELL, CAN WE JUST DO, 'CAUSE AGAIN, THEY'RE HUGE, RIGHT? YEAH.
AND SO, UH, WE SAID, OKAY, LET'S, UM, WE TARGETED, UH, COUNCIL MEMBER ZAN GRACIE, UM, FOR HIS DISTRICT.
HE'S GOT A NONPROFIT, TWO NON-PROFITS.
ONE IS FOR IMMIGRANTS AND ONE IS, UH, FOR, IT'S CALLED HARMONY.
AND HE'S, WE'RE TAKING 500 FROM EACH ONE OF THOSE AND ALLOWING THEM TO USE IT.
UM, OMAR NVAS, UH, HIS DISTRICT WILL HAVE A THOUSAND, UM, UH, PAULA BLACKMAN, WE'VE GIVEN HER ACCESS TO A THOUSAND.
AND THEN, UM, OH, I'M FORGETTING THE FOURTH DISTRICT, UH, OH, J JESSE MORENO.
AND SO WE'VE SAID, HERE IS A GOOGLE SHEET THAT WE CREATED.
NOW IT'S LITERALLY WAY MORE DIFFICULT TO GET PEOPLE TO PARTICIPATE IN THE PILOT THAN IT IS TO JUST LAUNCH IT, BECAUSE IF YOU LAUNCH IT, EVERYBODY'S IN, RIGHT? AND WE DO A PRESS CONFERENCE, PRESS RELEASES, GO TO THE CHURCHES.
IT'S, IT'S DONE FOR THE PILOT.
WE HAVE A GOOGLE SHEET THAT EACH DISTRICT, IT'S SPECIFIC, SO THEY WOULD HAVE TO PUT THAT LINK ON THEIR INSTAGRAM, FACEBOOK, UM, COUNCIL PAGE THAT SAYS, CLICK HERE.
IF YOU LIVE IN MY DISTRICT, FILL THIS OUT.
AND YOU'LL GET AN EMAIL WITH THE NUMBER AND AN EXPLANATION ON HOW TO USE THE SERVICE.
SO THAT'S WHAT WE'RE DOING WITH DALLAS.
WE'RE SETTING, WE'VE SET THAT SAME THING UP FOR AUSTIN.
UM, AND THEN, UH, BUT AGAIN, I, I WOULD SAY IF, IF I HAD MY MAGIC WAND, UM, AND THERE WAS, UH, A DESIRE TO MOVE THIS OUT OF A COMMITTEE TO A FULL COUNCIL MEETING, IF YOU WERE TO ASK ME WHAT I WOULD LIKE TO DO NEXT, IT WOULD BE TO EITHER, UM, ASK IF WE CAN LAUNCH THIS IN GARLAND, OR IF YOU THINK WE, WE NEED TO CRAWL BEFORE WE, WE WALK, WE'RE HAPPY TO DO A, A PILOT.
BUT, UM, I ALWAYS THINK THAT IF WE LAUNCH IT, AND DIRK WOULD AGREE AND HERARDO AGREE MORE PEOPLE ARE GONNA BE HELPED SOONER THAN, UM, THAN IF WE DID A, A PILOT.
BUT WE'RE HAPPY TO DO EITHER OR.
AND THE DIFFERENCE IS, WHEN WE DO A PILOT, WE, WE, A BIG EXPENSE OF OURS IS, IS THE COMMUNITY ENGAGEMENT ASPECT IS SENDING IN PEOPLE TO, TO ENGAGE THE COMMUNITY FOR A PILOT THAT'S LIMITED HOW MUCH, UH, MONEY WE CAN EXPEND TO, TO GO, UH, ENGAGE THE COMMUNITY, BUT WITH A PARTNERSHIP, UH, WE, WE, WE ROLL OUT THE FULL MARKETING PLAN, UH, WITH THAT.
AND SO THAT'S WHY IT'S EASIER, I THINK, TO SEE PEOPLE SIGN UP WHEN WE ROLL OUT THE FULL MARKETING PLAN ALONGSIDE OF IT.
I REALLY, REALLY APPRECIATE THE ANSWERS.
IT WAS WAGED A LOT OF MY FEARS.
I'M, I'M NOT FINISHED YET, THOUGH.
I'VE GOT ONE MORE THING I WANNA TALK ABOUT, AND THEN WE, I'LL GET BACK TO YOU.
SO, UM, FOR ME, THE BIG ELEPHANT IN THE ROOM IS THE LAST THING I WANNA TALK ABOUT.
AND THAT IS, UM, AND OF COURSE I UNDERSTAND THE, THE COST DOESN'T SEEM LIKE A LOT $6 A MONTH, BUT IT SAYS IN THE NOTES, RESIDENTS ARE AUTOMATICALLY ENROLLED, BUT CAN OPT OUT ANYTIME.
UM, SO FOR ME, THE, THE, THE BIGGEST CONCERN I HAVE IS AUTOMATICALLY ENROLLING PEOPLE INTO SOMETHING.
UM, I MEAN, NO MATTER HOW MUCH YOU MARKET IT, NO MATTER HOW MUCH WE TELL THEM, UM, THERE'S GOING TO, I FEEL THERE'S GOING TO BE, YOU KNOW, FEELINGS OF LACK OF TRANSPARENCY AUTOMATICALLY ENROLLING INTO SOMEBODY, INTO SOMETHING.
I'D, YOU KNOW, I, I UNDERSTAND YOUR REASON FOR AN OPTOUT MODEL, BUT OF COURSE I WOULD, I WOULD FEEL A LOT MORE COMFORTABLE WITH AN OPT-IN MODEL.
UM, I'D LIKE TO TALK A LITTLE BIT ABOUT, UM, IF YOU GUYS COULD SHARE A LITTLE BIT ABOUT WHAT KIND OF COMMUNITY FEEDBACK YOU'VE HAD WITH THE OPT-OUT MODEL.
I THINK WHAT YOU JUST MENTIONED IS PROBABLY THE BIGGEST HURDLE FOR EVERY COMMUNITY WE ENTER IN.
UM, I THINK RIGHTFULLY SO, LEADERS LIKE YOURSELF WANT TO MAKE CERTAIN THAT A FEE ISN'T GOING ON SOMEONE'S UTILITY BILL, AND THEY DON'T KNOW IT'S THERE.
UM, AND, AND THEY'RE NOT UTILIZING THE SERVICE.
AND, AND AS A PHYSICIAN, I, I, I CAN PROMISE YOU, I DON'T WANT ANYONE GETTING A BILL THAT DOESN'T KNOW THAT THIS IS AVAILABLE TO THEM.
AND SO WE'VE MADE A PROMISE TO EVERY CITY THAT WE WORK IN THAT WE WILL OFFER A 90 DAY REFUND FOR ANYBODY THAT COMES AND SAYS, HEY, UH, COUNCILMAN BASS, I HAD NO IDEA.
EVEN IF THEY'VE UTILIZED THE SERVICE THREE TIMES, WE WILL REFUND ANYONE'S MONEY UP TO, TO 90 DAYS, UH, UH, TO OFFSET THAT, TO MAKE IT NO RISK.
BUT LET ME TELL YOU WHY THAT'S NECESSARY TO
[01:15:01]
DO THIS, BECAUSE YOUR WIFE WILL TELL YOU, I WORK IN AN ER.NO ONE THINKS ABOUT THEIR HEALTHCARE UNTIL THE MOMENT THEY NEED IT.
AND SO IT'S NOT UNTIL YOUR KID'S SICK UNEXPECTEDLY OR YOU'RE SICK, UM, THAT YOU'RE LIKE, OH MY GOODNESS, I'M GONNA NEED TO GO SEE A DOCTOR.
AND IF YOU DON'T HAVE THIS AVAILABLE TO YOU, YOU CAN'T JUST SIGN UP FOR IT THAT DAY.
UM, AND SO YOU NEED SOMETHING THAT YOU HAVE ACCESS TO, UH, TO TAKE CARE OF THAT.
AND OUR GOAL IS NOT ONLY TO TREAT THE INDIVIDUAL, BUT IT'S TO HAVE AN IMPACT ON THE COMMUNITY.
SO THE NUMBERS WE TALKED ABOUT, REDUCING UNNECESSARY 9 1 1 CALLS, REDUCING THE NUMBER OF NEEDED AMBULANCES, UH, FOR GARLAND, UH, CAN'T BE DONE UNLESS WE DO IT ON A COMMUNITY LEVEL.
THE SCHOOL ABSENCES CAN'T BE DONE UNLESS WE OFFER IT TO EVERYONE.
UM, UH, SO, SO IT HAS THE COMMUNITY IMPACT ASPECT.
AT THE SAME TIME, WE DON'T WANT ANYONE NOT KNOWING THIS WASN'T THERE.
AND I'LL, I'LL GIVE YOU AN EXAMPLE.
WE WENT, UH, HE, CITY OF HENDERSON, JAY ABERCROMBIE, I THINK HE'S PRESIDENT OF THE CITY MANAGERS ASSOCIATION THIS YEAR, UH, IN TEXAS.
AND WE LAUNCHED IN THEIR COMMUNITY, UM, ALMOST A YEAR AGO.
AND WHEN WE LAUNCHED, THERE WAS A GROUP ON FACEBOOK, UH, THAT COMPLAINED THAT THEY FELT LIKE THIS WAS CITY OVERREACH BY PUTTING AN OPT OUT.
I THINK THERE'S FIVE PEOPLE ON FACEBOOK THAT, THAT WE'RE POSTING, UH, NEGATIVELY.
AND THEY'RE CITY ABOUT 20,000.
SO FIVE PEOPLE ON FACEBOOK FOR 20,000 TO JAY AND HIS COUNCIL, THAT FELT LIKE A THOUSAND PEOPLE COMPLAINING ON FACEBOOK.
SO JAY CALLED ME UP AND HE'S LIKE, DOC, YOU MIND COMING TO OUR NEXT CITY COUNCIL MEETING? WE HAVE, SOUNDS LIKE WE HAVE SOME PEOPLE THAT, THAT, UH, AREN'T HAPPY ABOUT THE OPT OUT.
SO I SHOW UP AND OUT OF THE NUMBER OF MESSAGES ON FACEBOOK, ONE PERSON SHOWED UP TO, TO CITY COUNCIL.
UM, THEY GOT UP AND SPOKE AND SAID, HEY, I DON'T KNOW ANYTHING ABOUT THE SERVICE.
IT MAY BE GREAT, BUT I THINK THIS IS CITY OVERREACH BY PUTTING AN OPT-OUT FEE AND, AND MADE THEIR ARGUMENT.
AND THEN THERE WAS, UH, A WOMAN THAT STOOD UP AND SAID, I'D LIKE TO SPEAK.
AND SHE SAID, LISTEN, MY HUSBAND WORKS FOR CHICK-FIL-A.
UH, HE DOESN'T PROVIDE MEDICAL INSURANCE TO US.
UH, MYSELF AND MY DAUGHTER HAVE USED, UTILIZED THE SERVICE ALREADY THREE TIMES.
MY DAUGHTER GOT TO THE FIRST DAY OF SCHOOL, UH, BECAUSE THE SERVICE WAS AVAILABLE, AND SHE LOOKED DIRECTLY AT THE PERSON THAT COMPLAINED.
IF YOU WOULDN'T MIND JUST CLICKING THAT BUTTON JUST TO OPT OUT.
'CAUSE THIS PROVIDES AN OPPORTUNITY FOR ME AND MY FAMILY TO HAVE HEALTHCARE.
AND IF THE CITY DECIDES TO TAKE IT AWAY, BECAUSE OF A FEW INDIVIDUALS, UH, THAT, THAT DON'T WANNA GO THROUGH AN OPTOUT, YOU'RE MAKING THE DECISION ON BEHALF OF EVERYBODY SAYING, EVERYONE, YOU CAN'T HAVE THIS.
BUT, BUT WHEN YOU GIVE US AN OPTION AND AN OPT OUT, UH, OPTION, YEAH, IT DOES TAKE A LITTLE EFFORT.
UH, BUT IT, IT, IT'S A CLICK OF A BUTTON.
BUT PEOPLE LIKE MYSELF, UH, NOW HAVE AN OPTION FOR HEALTHCARE.
AND SO I THINK THAT WAS REALLY MEANINGFUL.
UH, AND, AND YES, THAT IT IS, IT IS ALWAYS WHEN YOU IMPLEMENT SOMETHING, UH, LIKE THIS, A NEW PROGRAM, YOU'RE GONNA HAVE PEOPLE IN THE COMMUNITY THAT COME OUT, UH, AND COMPLAIN JUST LIKE YOU DO IF YOU'RE GONNA BUILD A NEW ROAD OR PUT IN A NEW, UH, UH, STOPLIGHT.
UM, BUT ONCE YOU GET THROUGH THAT AND YOU ANSWER THOSE QUESTIONS APPROPRIATELY, AND YOU OFFER AN OPTION OF, OF A 90 DAY REFUND, I, I THINK IT REALLY DE-RISKS EVERYTHING, UH, ON THOSE THAT AREN'T GONNA UTILIZE THE, THE SERVICE.
AND CHRISTIE, YOU HAD SOMETHING ELSE.
THIS IS ON HOW THOSE SYSTEMS PAID FOR.
YOU SAID THERE'S A $6 $9 ATTACHMENT TO YOUR UTILITY.
BILL GARLAND, ESPECIALLY DISTRICT TWO, HAS A LOT OF ALL BILLS PAID APARTMENTS.
HOW ARE THOSE APARTMENTS ADDRESSED? YEAH, SO THOSE ARE ALWAYS A CHALLENGE.
WE HAVE TO DIRECTLY BILL THOSE THAT ARE ON A SINGLE WATER UTILITY BILL.
SO IF THOSE LARGE APARTMENT COMPLEXES, UH, WE TALK TO THE APARTMENT, UH, MANAGERS AND LET THEM KNOW, HEY, IF YOUR COMMUNITY WITHIN YOUR, UH, UH, MULTIFAMILY HOUSING UNITS ARE INTERESTED, WE CAN BILL THEM DIRECTLY, UH, FOR THE SERVICE.
WE HAVEN'T COME UP WITH ANOTHER MECHANISM.
WE'RE OPEN TO IDEAS FOR THAT, BUT IT WOULD BE A DIRECT BILLING MECHANISM FOR THOSE THAT ARE IN THE MULTIFAMILY UNITS.
'CAUSE LIKE I SAID, THERE'S, THERE ARE MULTIPLE ALL BILLS PAID APARTMENTS.
SO IT'S, THERE'S NOT A UTILITY BILL TO ATTACH THE FEE.
LIKE A MASTER METER DEPARTMENT.
GUS, REALLY APPRECIATE THE PRESENTATION.
UM, WE'LL DISCUSS HOW WE WANT TO, HOW WE WANNA CONTINUE WITH THIS AND LET GET BACK TO MY AGENDA.
THAT WAS THE LAST ITEM ON OUR AGENDA.
[01:20:01]
IN THE ROOM HAVE ANYTHING THEY'D LIKE TO BRING UP? RECOMMEND WHAT, WHAT OUR NEXTUM, SO WE'VE GOT A AND B CITY FOLLOWING UP.
SO WHAT, WHAT IS, WHAT IS THE, UM, WHAT'S THE NEXT THING YOU GUYS WANNA DO WITH THIS? DO WE WANT TO, DO WE NEED ANY FURTHER DISCUSSION? I THINK WE NEED TO, OR JUST GO AHEAD AND BRING IT TO COUNSEL? CHRIS, GO AHEAD AND OKAY.
I GUESS WE'LL GO AHEAD AND, UM, LET YOU GUYS GET WITH STAFF AND PREPARE SOMETHING FOR COUNCIL.
SO WE'LL WANNA KICK THIS ITEM OUT TO THE FULL COUNCIL POTENTIALLY AT A APRIL MEETING AND APRIL WORK SESSION FOR A SIMILAR PRESENTATION TO WHAT YOU HEARD TODAY.
I THINK THIS ONE IS A BETTER, AND I THINK RIGHT NOW WE'RE DOING ALL OF THESE, UM, BOND, UH, BOND MEETINGS AND SO THAT MIGHT BE A GOOD FEELER.
UM, SO IF COUNCIL KIND OF KNOWS WHAT'S IN THE WORKS, THEY CAN, 'CAUSE I KNOW AT MY, AT MY TOWN HALL FOR THE BOND, THAT WAS ONE OF THE BIG THINGS WAS WE DON'T EVEN HAVE A HOSPITAL MM-HMM
UM, SO THAT MIGHT BE BENEFICIAL FOR BOND, FOR THOSE BOND MEETINGS IF KIND COUNCIL KIND OF KNOWS AND MAYBE GIVE RISE.
MAYBE GIVE US EVERYONE THE OPPORTUNITY TO KIND OF FEEL THE PROGRAM OUT AND SEE THE TEMPERATURE OF THE ROOM ON IT AND, OKAY.
ALSO, WHAT DO YOU THINK OF THE THOUGHTS OF A, OF A TRIAL? OR IS IT SOMETHING THAT Y'ALL ARE FEELING THAT IT'S SOMETHING I'D LIKE THE COUNSEL'S OPINION ON THAT.
YEAH, I THINK HONESTLY, I MEAN, FROM, FROM FROM WHERE I SIT AND ONLY FROM MY PERSPECTIVE, I WOULD PREFER A PILOT, BUT I CAN ALSO UNDERSTAND FROM WHERE THEY SIT, IT'S GOING TO BE A LOT MORE EFFECTIVE ON THEIR SIDE TO ROLL THE WHOLE THING OUT.
SO, I MEAN, I UNDERSTAND A PILOT'S, A PILOT'S, IT'S DIFFERENT BECAUSE YOU HAVE, YOU ARE ROLLING OUT A SMALLER PROGRAM, BUT A LOT OF ON THE BACK END IS STILL THE SAME AS ROLLING OUT THE WHOLE THING.
SO IT JUST REALLY ON FROM THEIR SIDE REALLY MESSES WITH THE NUMBERS, JUST DOING A PILOT.
BUT I CAN UNDERSTAND FROM OUR SIDE WHERE A PILOT WOULD, AND I DON'T, AND THAT'S THE THING, RIGHT? I MEAN, AND DALLAS, DALLAS IS SUCH A, SUCH A LARGER CITY.
I UNDERSTAND A PILOT THERE WITH GARLAND.
YEAH, IT'S A BIG CITY, BUT HOW MUCH MORE INFORMATION YOU, ARE YOU GOING TO GET FROM 20,000 PEOPLE THAN YOU'RE GONNA GET FROM 10 TIMES THAT? RIGHT? YEAH.
THE POTENTIAL OF GETTING TESTIMONIALS THOUGH, FROM PEOPLE IN OUR COMMUNITY.
WELL, THAT'S WHERE I THINK ONCE WE GET ON COUNCIL, AND THEN ALSO BEFORE, BEFORE WE DO ANYTHING ABOUT THIS, WE'RE GONNA HAVE SOME KIND OF A COMMUNITY FORUM TO GET FEEDBACK.
SO I THINK ONCE WE DO THAT, UM, THEN WE'LL HAVE INFORMATION TO, TO HELP US MAKE A DECISION TO ROLL THE ENTIRE THING OUT.
UM, BECAUSE YOU, I MEAN, I, I, I DON'T WANT THIS THING, I DON'T WANT THIS THING IMPLEMENTED UNLESS WE HAVE SOME COMMUNITY FEEDBACK.
YOU KNOW, IN ADDITION TO, YOU KNOW, IN ADDITION TO COUNCIL MEETINGS.
UM, SO, AND I'M SURE YOU GUYS HAVE EXPERIENCE WITH THAT TOO, RIGHT? YEAH.
SO, UM, YEAH, I DON'T, I DON'T WANNA JUMP INTO THIS, YOU KNOW, I, I FEEL A LOT MORE COMFORTABLE ABOUT IT NOW THAN I DID AN HOUR AGO.
UM, SO APPRECIATE ALL THE, ALL THE ANSWERS AND FEEDBACK.
UM, BUT DEFINITELY NOT SOMETHING I WANNA, I DON'T WANNA HURRY THROUGH IT, YOU KNOW? AND WHEN I SAY THAT, I MEAN, YES, I WANNA KEEP IT MOVING AND PROGRESSING FAST.
I HATE PUTTING STUFF OFF TILL ANOTHER MEETING.
UM, SO THE FASTER WE CAN GET MOVING ON THIS, THE BETTER, BUT I DON'T WANNA BE TOO FAST TO IMPLEMENT IT, YOU KNOW, IN ADDITION TO COUNCIL FEEDBACK HAVE, I DON'T KNOW, ONE OR TWO DIFFERENT MEETINGS WITH THE PUBLIC, WHATEVER THEY, THEY GOT THE PROTOCOLS ON THAT.
UM, YOU KNOW, BUT I, I'D PROBABLY BE BEFORE ROLLING THE WHOLE THING OUT JUST BECAUSE I DON'T THINK IT'S GONNA MAKE ANY DIFFERENCE JUST GETTING INFORMATION FROM A PILOT.
UM, I'M ALL IN FAVOR FOR JUST ROLLING IT OUT AS LONG AS WE DO OUR DUE DILIGENCE YEP.
SO THAT WE'RE NOT CONSENT ATTENDING SOME STUFF, SO OH, YEAH.
SO AS LONG AS WE'RE DOING OUR PART IN MAKING SURE THAT WE'RE INFORMING PEOPLE TRANSPARENCY, BEST OF OUR ABILITIES, I AM ALL FOR JUST ROLLING IT OUT.
TRANSPARENCY, TRANSPARENCY, TRANSPARENCY.
ANYTHING ELSE? THANK YOU SO MUCH.