[00:00:02] GOOD EVENING AND WELCOME TO THE FEBRUARY 2ND, 2026 WORK SESSION OF THE GARLAND CITY COUNCIL. WE'RE GOING TO SWITCH UP OUR AGENDA A LITTLE BIT HERE. WE HAVE BUMPED OUR INTRODUCTIONS TO STAFF LAST TIME AND I WANT TO BRING THOSE UP FIRST. SO WE'RE GOING TO FIRST ITEM WE'RE GOING TO TAKE CARE OF. [3. Introduction of Sarah Washburn, Police Legal Advisor] FIRST ITEM OF BUSINESS WILL BE ITEM NUMBER THREE UNDER VERBAL BRIEFINGS. INTRODUCTION OF SARAH WASHBURN POLICE LEGAL ADVISOR. GOOD EVENING MAYOR AND COUNCIL. IT'S MY PLEASURE TO INTRODUCE SARAH WASHBURN TO YOU ALL TODAY. SHE IS THE NEW POLICE LEGAL ADVISOR. AND I THINK I'VE TOLD MANY OF YOU ALL OR SEVERAL OF YOU ALL THAT I BELIEVE THAT THAT'S THE TOUGHEST POSITION IN MY OFFICE TO FILL. IT'S JUST A IT'S NOT A MATTER OF JUST BEING A GOOD ATTORNEY. YOU HAVE TO BE A GOOD ATTORNEY. YOU HAVE TO KNOW POLICE PROCEDURE, YOU HAVE TO KNOW THE CODE OF CRIMINAL PROCEDURE, AND YOU HAVE TO HAVE A CERTAIN PERSONALITY TO WORK AT THE POLICE DEPARTMENT, AND THAT'S DIFFICULT TO FIND. BUT WE'VE GOTTEN FORTUNATE WITH SARAH ALREADY. WE'VE SEEN IN THIS FIRST MONTH THAT SHE'S BEEN HERE SHE'S FIT IN GREAT OVER THERE. SHE HAS A GREAT PERSONALITY TO WORK WITH. ALL THE MEN AND WOMEN OVER THERE. A LITTLE BIT ABOUT HER BACKGROUND. SHE GRADUATED LAW SCHOOL IN 2010. SHE CAME TO US FROM DIRECTLY FROM KANSAS. SHE SPENT FIVE YEARS AFTER LAW SCHOOL WORKING AS A PROSECUTOR. SO SHE'S BEEN SHE PROSECUTED CRIMINAL CASES THE FIRST FIVE YEARS OUT OF LAW SCHOOL. SHE THEN WENT OVER TO THE KANSAS HIGHWAY PATROL AND SPENT SEVEN YEARS THERE AS THEIR LEGAL ADVISOR, AS ONE OF THEIR LEGAL ADVISORS. AND THEN HER LAST THREE YEARS IN KANSAS, SHE WORKED FOR THE KANSAS BUREAU OF INVESTIGATION. AND DID THAT FOR THREE YEARS. AND THEN WE WERE FORTUNATE ENOUGH TO GET HER TO CONVINCE HER TO COME AND WORK FOR US. HERE AT THIS LAST MONTH. SO THIS IS SARAH. IF YOU HAVE ANY QUESTIONS FOR SARAH. SARAH, WOULD YOU LIKE TO SAY ANYTHING TO THEM? I WAS PROMISED WARMER WEATHER, AND I'M A LITTLE DISAPPOINTED. YOU KNOW, I LEFT KANSAS BECAUSE OF THE ICE AND THE SNOW, AND THEN APPARENTLY IT'S MY FAULT. SO I APOLOGIZE TO EVERYONE FOR THAT. I HOPEFULLY IT WON'T STAY. I'M HAPPY TO ANSWER ANY QUESTIONS. I'M REALLY PLEASED TO BE HERE. I'M VERY EXCITED TO LEARN THE GARLAND POLICE DEPARTMENT, AND I'VE GOTTEN SOME OPPORTUNITIES TO DO JUST THAT. AND WORK WITH CHIEF BRIAN OVER THERE A BUNCH OF REALLY GREAT PEOPLE. SO I'VE BEEN MADE TO FEEL VERY WELCOME, AND I APPRECIATE THAT QUITE A BIT, BUT I'M HAPPY TO ANSWER ANY QUESTIONS YOU ALL MAY HAVE ABOUT YOUR BOSS. OH HE'S FANTASTIC. WE LOVE HIM DEARLY. IS THAT WHAT YOU WANTED? OKAY, NOW YOU GOT QUESTIONS? I WOULD HAVE QUESTIONS, TOO. WE DO HAVE QUESTIONS, COUNCILMEMBER WILLIAMS. TELL US. TELL US WHAT YOU REALLY THINK ABOUT CHIEF BRIAN. I YOU KNOW, HE'S HE'S BEEN OUT BECAUSE HE HAD THAT FIRST FOOT SURGERY. BUT FROM THE TIME I'VE SPENT WITH HIM, HE'S COME BACK TODAY. HE'S SCOOTING AROUND ON HIS LITTLE LITTLE WHEELED CART FOR HIS FOOT. BUT FOR THE TIME I SPENT WITH HIM, HE SEEMS TO HAVE A REALLY GOOD FINGER ON THE PULSE OF THE POLICE DEPARTMENT AND HAS THE RIGHT IDEAS AS FAR AS I'M CONCERNED, ABOUT POLICING AND THE WAY IT SHOULD BE DONE AND THE WAY IT SHOULD BE DONE, LAWFULLY AND PROPERLY SO. I THINK THE CITY IS IN GREAT HANDS, AND I HOPE TO BE ABLE TO CONTINUE SAYING THAT. I'M SURE I WILL. OKAY, OKAY. YOU PAID YOU WELL. THANK YOU. I WAS TOLD THAT THERE WOULD BE COOKIES, I DON'T KNOW. COUNCIL MEMBER THOMAS. YEAH. SO. HI, SARAH. WELCOME. GLAD TO HAVE YOU ON BOARD. TELL US ABOUT A TYPICAL DAY FOR THIS POSITION. HAVE YOU HAD ANY TYPICAL SO FAR OR. I THINK I'M STILL REALLY NEW AND I DON'T KNOW THAT I CAN TELL YOU WHAT A TYPICAL DAY IS LIKE. IT'S REALLY INTERESTING BECAUSE YOU GET A LOT OF SIMILAR QUESTIONS, BUT THE FACTS DIFFER, SO IT'S KIND OF UNIQUE EVERY DAY. I MAY ANSWER QUESTIONS ABOUT CAN WE, FOR EXAMPLE, CAN WE DO A PROTECTIVE SWEEP BEFORE WE GET A SEARCH WARRANT FOR A HOUSE? AND BY THE WAY, IF YOU'RE FOLLOWING ALONG AT HOME, THE ANSWER IS NO. ABSENT A COUPLE OF OTHER LEGAL THINGS. SO THERE'S AN ASTERISK THERE. I AM AN ATTORNEY. I, YOU KNOW, I'VE BEEN ASKED, YOU KNOW, HOW DO WE DEAL WITH THIS PROBLEM THAT WE'RE HAVING IN THE COMMUNITY? CAN WE WHAT OPTIONS DO WE HAVE IN THE CITY CODE THAT WOULD HELP US DEAL WITH THAT? SO WE'RE LOOKING AT THAT. WE'RE LOOKING AT WRITING SOME RESOLUTIONS TO UPDATE SCRAP METAL, SECONDARY METAL SELLERS AND SOME OF THE REQUIREMENTS ON THEM TO MAKE SURE THAT WE'RE NOT TRAFFICKING. WE'RE NOT TRAFFICKING IN STOLEN METALS. SO LAST WEEK I ATTENDED THE FORT WORTH SCRAP METAL WORKING GROUP THAT'S PUT ON BY AT&T. AND IT WAS VERY INTERESTING TO JUST REALIZE WHAT A BREADTH OF A PROBLEM THAT IS. SO I'VE GOTTEN KIND OF MY TOES WET IN A LOT OF DIFFERENT THINGS. AND IT'S I WOULD TELL YOU, ONE OF THE THINGS I LOVE ABOUT THE JOB IS IT'S NEVER THE SAME EVERY DAY. IT'S VERY GOOD. SO THANK YOU. THANK YOU FOR THE COOL OFF LAST WEEK. WE WE APPRECIATE THAT. ONE WEEK A YEAR. STILL FEEL REALLY BAD ABOUT THAT. HANG ON. AUGUST IS COMING. YEAH. YOU'RE GOING TO GET YOUR HOT WEATHER. DON'T WORRY. I KEEP TELLING PEOPLE, YOU KNOW, I MAY BE HAPPY NOW WHEN IT'S 50 OR 60 DEGREES. [00:05:02] I WILL NOT BE HAPPY IN JULY AND AUGUST. SO KIND OF SOAK UP THIS. COOL. BECAUSE YOU'RE GOING TO THINK BACK TO THIS AND BE REALLY HAPPY ABOUT IT IN ABOUT SIX MONTHS. THAT'S FAIR. VERY GOOD. THANK YOU MAYOR. THANK YOU SIR. I DON'T SEE ANY OTHER QUESTIONS, BUT WE'RE SO HAPPY TO HAVE YOU HERE. THANK YOU SO MUCH. WE'RE GOING TO MOVE ON TO OUR SECOND INTRODUCTION. [4. Introduction of Lilly Clarke, Managing Director] THIS IS THE INTRODUCTION OF LILY CLARK, OUR MANAGING DIRECTOR FOR HUMAN RESOURCES. I APOLOGIZE FOR LAST TIME. I KNOW WE KEPT YOU LATE AND YOU HAD TO GET BACK TO YOUR FAMILY, BUT WE'RE GLAD TO HAVE YOU BACK AGAIN THIS WEEK. GOOD EVENING, MAYOR AND COUNCIL. I'M EXTREMELY EXCITED TO INTRODUCE TO YOU ALL LILY CLARK, WHO IS OUR NEW MANAGING DIRECTOR OF HUMAN RESOURCES. WHILE SHE'S NEW TO THIS ROLE, SHE HAS BEEN WITH THE CITY OF GARLAND'S HR DEPARTMENT FOR 22 YEARS. TWO YEARS WELL BEFORE TAKING A SHORT BREAK AT THE CITY OF SUNNYVALE AND THEN COMING BACK. SO WE'RE EXCITED TO HAVE HER AND TIME TO ASK SOME QUESTIONS. WELL I'M SO HAPPY TO BE BACK. AS MATT SHARED OVERALL 23 YEARS OF MUNICIPAL HR EXPERIENCE. WHILE I WORKED HERE FOR THOSE 22 YEARS, I HAD THE OPPORTUNITY TO GET TWO BUSINESS TWO DEGREES IN BUSINESS ADMINISTRATION AND MAINTAINED THREE SENIOR LEVEL PROFESSIONAL HR CERTIFICATIONS. ASIDE FROM MY PROFESSIONAL EXPERIENCE, I ALSO HAD THE OPPORTUNITY TO WORK CLOSELY WITH SEVERAL COMMUNITY LEADERS THROUGHOUT MY TENURE HERE. IN 2017, I ACTUALLY WAS AWARDED THE BRIDGE BUILDER OF THE YEAR AWARD BY THE NAACP AND GRADUATED FROM LEADERSHIP GARLAND IN CLASS 42, THE BEST CLASS. AND I'M EXCITED TO BE HERE. HAPPY TO ANSWER ANY QUESTIONS AS COUNCIL MAYOR PRO TEM. I DON'T HAVE ANY QUESTIONS, BUT WELCOME BACK HOME. THANK YOU. ALSO GRADUATE OF SOUTH GARLAND HIGH SCHOOL. THAT'S RIGHT. THANK YOU MAYOR. THANK YOU MA'AM. I DON'T SEE ANYONE ELSE, BUT WE'RE GLAD TO HAVE YOU BACK. THANK YOU. LOOKING FORWARD TO SERVING. CONTINUING TO SERVE GARLAND. THANK YOU. ALL RIGHT, COUNCIL, WE'LL MOVE BACK NOW TO OUR STANDARD AGENDA HERE. WE'RE GOING TO LOOK FIRST ITEM IS PUBLIC COMMENTS ON WORK SESSION ITEMS. [ PUBLIC COMMENTS ON WORK SESSION ITEMS] MADAM SECRETARY I KNOW WE HAVE SOME SPEAKERS SIGNED UP. SO WOULD YOU PLEASE CALL US FIRST SPEAKER? YES, SIR. WE HAVE DOCTOR PARROTT, AND THEN ON DECK WE HAVE DAVID NAVARA. ALL RIGHT. WELL, SIR, I HAVE TO TELL YOU NAME AND ADDRESS FOR THE RECORD, AND YOU'LL HAVE THREE MINUTES. YEP. I'M DOCTOR DIRK PARROTT. I RESIDE AT TWO TERRIBLE LANE HEATH, TEXAS 75032 COUNCIL. I HOPE I CAN FIT THIS IN IN THREE MINUTES. IT MIGHT BE FOR BUT IF YOU COULD JUST BEAR WITH ME. THANK YOU FOR YOUR TIME TODAY, GUYS. YOU GUYS KNOW I'M NOT A POLITICIAN. I'M A DOCTOR. I SPENT ALMOST A DECADE ON THE THE HOSPITAL THAT IS NO LONGER HERE THAT THE CITY LOST RECENTLY. AND I'VE WATCHED FAMILIES COME INTO THE E.R. TWO IN THE MORNING FOR PROBLEMS I COULD HAVE SOLVED WITH A SIMPLE CONVERSATION. AND, YOU KNOW, THOSE FAMILIES OFTEN LEFT WITH A $1,500, ER, BILL. AND EVEN TO THIS DAY, THAT BOTHERS ME. AND THAT'S WHY I STARTED THIS, THIS ORGANIZATION. THAT'S WHY I'M HERE IN GARLAND. LAST AUGUST, THIS VERY COUNCIL VOTED 7 TO 2 TO GIVE GARLAND FAMILIES SOMETHING MOST PEOPLE DON'T HAVE. AND THAT'S A DOCTOR, A DOCTOR. THEY CAN TEXT WHEN SOMETHING'S WRONG, MUCH AKIN TO LIKE HAVING A DOCTOR IN THE FAMILY. SINCE THEN, WE'VE TREATED THIS AS A TRUE PARTNERSHIP. WE'VE BEEN OUT IN YOUR COMMUNITY. WE'VE BEEN TO MANY CHURCHES THE SCHOOLS. WE'VE BEEN TO GROCERY STORES. QUITE FRANKLY, WE TOOK IT VERY SERIOUS. AND WE'VE INVESTED OVER $1 MILLION IN IN HIRING THE RIGHT DOCTORS. WE'VE WE'VE HIRED EIGHT NEW MEDICAL PROVIDERS. WE'VE INVESTED IN OUR SOFTWARE. AND THEN WE'VE REALLY INVESTED IN THE COMMUNITY ENGAGEMENT. AND ALREADY TO THIS DAY, WE'VE GIVEN FREE HEALTH CARE TO THE 10,000 FAMILIES THAT WE'VE AGREED TO GIVE THEM TO. WE'RE SEEING THOSE FAMILIES COME IN. WE'RE CARING FOR THEM TODAY. BUT I WANT TO ACKNOWLEDGE SOMETHING. I KNOW THE HEAT AS COUNCIL THE SEVEN OF YOU THAT VOTED FOR THIS. I KNOW WHAT IT'S LIKE TO SIT HERE IN THE CHAMBER AND HEAR THE SAME VOICES. MEETING AFTER MEETING, QUESTIONING YOUR VERY JUDGMENT. I KNOW SOME OF YOU HAVE BEEN ATTACKED PERSONALLY FOR SUPPORTING THIS PROGRAM. I KNOW THAT'S NOT EASY. I FELT IT MYSELF. AND I WANT YOU TO KNOW, I SEE IT, AND I'M GRATEFUL FOR YOUR COURAGE. BUT HERE'S WHAT I. WHAT I REALLY NEED YOU TO SEE. THE NUMBERS TELL A DIFFERENT STORY THAN THE NOISE THAT YOU HEAR IN THE CHAMBERS. WE SENT A MAILER TO EVERY SINGLE ONE OF THE 82,000 HOUSEHOLDS JUST RECENTLY, AND WE MADE OPTING OUT SIMPLE. [00:10:05] AND DO YOU KNOW HOW MANY HAVE OPTED OUT? 5400 PEOPLE HAVE OPTED OUT. THAT'S 6% OF GARLAND DECIDED THIS IS NOT FOR THEM. THAT'S 94% OF GARLAND THAT'S DECIDED TO STAY IN AND KEEP THE SERVICE AND SEE THE VALUE IN IT. MEANWHILE, THE THOUSANDS THAT ARE ALREADY USING IT, WE'VE SERVED FAMILIES THAT HAD NO OTHER OPTION. AND I'VE GIVEN YOU SOME EXAMPLES OF SOME. LAST TIME YOU HEARD FROM A YOUNG SINGLE MOM WITH TWO SPECIAL NEEDS CHILDREN THAT AVOIDED THE E.R., GOT TREATMENT FOR AN UPPER RESPIRATORY INFECTION BEFORE IT TURNED INTO A PNEUMONIA, AND MAY HAVE ENDED UP AS A HOSPITAL ADMISSION. JUST BEAR WITH ME A COUPLE OF MINUTES. PATIENTS WITH MENTAL ILLNESS WHO MISSED A DOCTOR'S APPOINTMENT WERE ABLE TO GET BACK ON THEIR MEDS TO STABILIZE THEM. AND AND THESE ARE THE TYPES OF PATIENTS WE'RE CURRENTLY SERVING. WE'RE SERVING THE VIETNAMESE COMMUNITY IN THEIR OWN LANGUAGE. THE HISPANIC COMMUNITY WITH DOCTORS THEY CAN TRUST. OUR PATIENT SATISFACTION SCORE IS 9.8 OUT OF TEN. AND 22% OF THOSE PATIENTS WE'RE SEEING ARE SENIOR CITIZENS, THE VERY PEOPLE THE OPPONENTS CLAIM WERE HURTING. AND THE PEOPLE WHO SHOW UP TO THESE MEETINGS, THE PEOPLE WHO NEED THIS SERVICE ARE RARELY THE SAME PEOPLE, THE FAMILIES WE SERVE. THEY DON'T HAVE TIME TO ATTEND COUNCIL MEETINGS. THEY DON'T HAVE TIME TO OFTEN VOTE. MANY HAVE NEVER VOTED. THEY'RE WORKING TWO JOBS, CATERING FOR KIDS, CARING FOR AGING PARENTS. THEY DON'T WRITE THANK YOU LETTERS. WHEN YOU GUYS OPEN A NEW PARK OR THE ROAD GETS FIXED, THEY JUST QUIETLY APPRECIATE THAT THEIR CITY SHOWED UP FOR THEM. AND TODAY YOU'LL HEAR FROM SOME OF THEM. WE REACHED OUT AND ASKED ANYONE THAT'S USED OUR SERVICE, THEY'RE WILLING TO COME, COME SPEAK OUT TODAY. AND THEY'VE TAKEN TIME AWAY FROM WORK, AWAY FROM THEIR FAMILIES TO TELL YOU WHAT THIS SERVICE HAS MEANT. I'M ASKING YOU TO LISTEN TO THEM. THE WAY YOU'VE LISTENED TO THE OPPOSITION. AND THEN ASK YOURSELF, WHOSE VOICE HAS BEEN MISSING FROM THESE CONVERSATIONS? COUNCIL MEMBER WILLIAMS, I KNOW THIS IS YOUR FINAL TERM. YOU'VE SPENT YOUR CAREER STANDING UP FOR THOSE PEOPLE THAT DON'T HAVE A VOICE. YOU GREW UP IN A COMMUNITY THAT THE GOVERNMENT FORGOT AND YOU DEMANDED BETTER. THIS IS THAT MOMENT AGAIN. YOUR LEGACY ISN'T WITH THE LOUD, LOUD FEW, REMEMBER? THE QUIET WILL NEVER FORGET. COUNCIL MEMBER. I KNOW YOU'VE USED THIS SERVICE YOURSELF. YOU SHOW UP THE FOOD BANK OFTEN. YOU KNOW THE FACES OF THE PEOPLE THAT WILL NEVER COME TO A COUNCIL MEETING THAT YOU REPRESENT. THEY'LL NEVER SHOW UP TO A REFERENDUM TO VOTE. COUNCIL MEMBER LUCK. I KNOW YOU'RE A LEADER THAT STANDS ON PRINCIPLE. YOU DIDN'T VOTE FOR THIS BECAUSE IT'S EASY. YOU VOTED FOR IT BECAUSE IT WAS THE RIGHT THING TO DO FOR YOUR COMMUNITY. COUNCIL MEMBER BASS I KNOW YOU KNOW WHAT IT'S LIKE TO HAVE A DOCTOR IN THE FAMILY. YOU'VE GOT A DOCTOR IN THE FAMILY. YOU KNOW THE BENEFITS OF THIS. YOU KNOW WHAT THIS MEANS. AND THAT'S WHAT WE'RE GOING TO BE ABLE TO GIVE TO THE 82,000 FAMILIES, THE 250,000 PEOPLE IN GARLAND. AND TO ALL OF YOU, I UNDERSTAND THE PRESSURE TO PUT THIS TO A REFERENDUM. IT FEELS LIKE A RELEASE VALVE. IT FEELS LIKE YOU'RE HANDING THIS TO THE PEOPLE. BUT I NEED YOU TO CONSIDER WHAT WOULD ACTUALLY BE DOING. A REFERENDUM, I'M TOLD, WOULD COST THE CITY SEVERAL HUNDRED THOUSAND DOLLARS. EXCUSE ME, EXCUSE ME. I AM RUNNING THIS MEETING AND I WILL TELL THE SPEAKER WHEN HIS TIME IS UP. I WILL DO THE SAME THING FOR YOU AS WELL. THANK YOU. JUST GIVE ME ONE MORE MINUTE, PLEASE. BUT WHAT TYPICALLY AN OFF CYCLE ELECTION DOES IS IT SHOWS UP 4000 VOTERS, WHICH IS A TYPICAL TURNOUT. THAT'S $50 PER OPINION OF THE PUBLIC. AND THIS REFERENDUM IS NON-BINDING. YOU'VE ALREADY VOTED. YOU'VE ALREADY SIGNED A CONTRACT. WE'VE ALREADY BEEN OUT IN YOUR COMMUNITY AND INVESTED $1 MILLION TO MAKE THIS HAPPEN. AND ALL THIS REFERENDUM DOES IS TELL YOU WHAT 4000 PEOPLE THINK ABOUT A DECISION YOU'VE ALREADY MADE AND COMMITTED TO. AS CURRENTLY CONSTRUCTED, THE PROGRAM OFFERS EVERYONE A VOTE. YOU DON'T WANT THIS SERVICE. YOU SIMPLY OPT OUT. YOU DON'T KNOW ABOUT IT. LEARN. TWO MONTHS FROM NOW, YOU SIMPLY OPT OUT AND YOU GET A REFUND. IN A YEAR FROM NOW. YOU DON'T WANT THIS, OR YOU DECIDE YOU WANT BACK IN. YOU OPT BACK IN. YOU'RE GIVING 250,000 PEOPLE A VOTE INSTEAD OF 4000 AT A REFERENDUM. AND HERE'S WHAT CONCERNS ME MOST. IF YOU MOVE TO A REFERENDUM, I CAN'T PERSONALLY DIVERT HEALTH CARE FUNDS TO RUN A POLITICAL CAMPAIGN AT $6 PER HOUSEHOLD. THERE'S VERY LITTLE MARGIN FOR YARD SIGNS, MAILERS TO RUN THIS CAMPAIGN I'D BE FORCED TO SUSPEND THE SERVICE TO THE FAMILIES WE'RE ALREADY SERVING THAT ARE ALREADY COUNTING ON US, AND THE POLITICAL PRESSURE YOU'RE TRYING TO RELIEVE. TO BE HONEST, IT MIGHT ACTUALLY INTENSIFY. YOU'VE GOT THOUSANDS OF FAMILIES THAT ARE ALREADY USING THIS SERVICE. I'M GOING TO HAVE TO TURN IT OFF. AND THE $6. THE FOUNDING, LITERALLY. WE GAVE GARLAND A $6, WHICH IS A DISCOUNT AND MADE YOU A FOUNDING PARTNER. THAT $6 CAN NO LONGER BE SIX. IF I'VE GOT TO RUN POLITICAL CAMPAIGN, IT'S GOING TO BE A $9 FEE. SO I'M GOING TO HAVE TO ASK. AND I'M JUST I'M ASKING YOU NOT BECAUSE IT'S EASY, I KNOW, BUT BECAUSE THE HEAT YOU'VE TAKEN, [00:15:06] IT'S WORTH IT. IF YOU WERE ELECTED TO REPRESENT ALL OF GARLAND, INCLUDING THE VOICELESS, I'M JUST ASKING YOU ONE MORE TIME TO BE THE VOICE FOR THE VOICELESS. STAND BY YOUR VOTE. HONOR THE PARTNERSHIP. LET'S BUILD A HEALTHIER. THANK YOU. THANK YOU. AND I HAVE A FEW QUESTIONS HERE. COUNCIL MEMBER DUTTON, YOU SAID YOU SENT OUT MAILERS TO EVERY HOUSE. CAN YOU TELL ME WHEN? YEAH, THE UTILITY DEPARTMENT A LITTLE OVER A MONTH AGO, SENT OUT MAILERS TO EVERY SINGLE UTILITY PARTNER. THAT'S WHEN WE STARTED SEEING NOTIFICATION, AND THAT'S WHEN WE STARTED SEEING ADOPTION OF THE PRODUCT SYSTEM. THANK YOU. YEAH. MAYOR PRO TEM LUKE. I'M REALLY DISAPPOINTED THAT THIS HAS COME TO A REFERENDUM BECAUSE, AS YOU SAID, WE'VE ALREADY VOTED ON A CONTRACT. AND BY PUTTING IT TO A REFERENDUM, WILL YOU BE FORCED TO CANCEL THE CONTRACT? WE WON'T BE ABLE TO PROCEED. CONTINUING THE SERVICE. SO A REFERENDUM IS KIND OF A MOOT POINT THEN IT IS. AND LET ME BE HONEST, BECAUSE I'LL BE HONEST. WHEN YOU HEAR ME SAY NO, IT MAKES IT SOUND LIKE I'M AFRAID OF A VOTE. I'M NOT. I THINK THE CITY OF GARLAND SUPPORTS THIS, BUT. BUT A NON-BINDING REFERENDUM WHERE YOU CAN'T EVEN GUARANTEE ME THAT IF WE INVEST A QUARTER OF $1 MILLION IN A IN A POLITICAL CAMPAIGN, THAT YOU'LL EVEN FOLLOW THROUGH. AND LET'S BE HONEST, I HAVE A WEALTHY FAMILY THAT SUPPORTS US. THEY BELIEVE IN OUR MISSION. I REACHED OUT TO THEM. I SAID, WILL YOU BE WILLING TO SUPPORT US THROUGH THROUGH A POLITICAL CAMPAIGN? AND THEY SAID, ABSOLUTELY NOT. THEY SAID, WE'RE ON THIS FOR A MISSION TO KEEP HEALTH CARE AFFORDABLE. AND IF SUDDENLY YOU'VE GOT TO RUN A POLITICAL CAMPAIGN IN EVERY CITY BECAUSE THIS SETS PRECEDENTS, YOU'RE $6 BECOMES $25 AND WE'RE OFF MISSION. WE'RE NO LONGER SERVING THE PUBLIC THAT NEED THIS, ONLY THOSE THAT ARE WEALTHY ENOUGH TO AFFORD IT. AND SO THEY'RE LIKE, EVEN IF YOU WIN IN GARLAND, WE CAN NO LONGER SUPPORT THIS BECAUSE YOU'VE SET PRECEDENTS FOR OTHER COMMUNITIES, AND YOUR $6 PRICE POINT WILL NO LONGER BE THERE. I THINK THAT YOUR PROGRAM IS GOING TO REVOLUTIONIZE HEALTH CARE. I THINK IT'S A FANTASTIC PROGRAM, AND I THINK IT WILL HELP SO MANY PEOPLE. I REALLY WISH IT COULD HAVE HELPED THE PEOPLE OF GARLAND. THANK YOU, COUNCILMEMBER WILLIAMS. YES, SIR. SIR, YOU'RE RIGHT ABOUT SEVERAL THINGS. AND THAT'S WHERE I STOOD AND WHERE I AM STANDING AND WHERE I'VE ALWAYS STOOD. FOR THOSE WHO FEEL THAT THEY HAD NO VOICE, THE VOICELESS, THAT'S WHERE I STAND. BUT SOME OF YOU SAID THAT I WANT TO ASK YOU ABOUT. YOU SAID THAT THE MAILERS AND CONTACTS. YOU'VE GOT A TEAM, SOME MEMBERS OF YOUR TEAM THAT HAVE WORKED THE COMMUNITY. I HAD A I HOSTED A TOWN HALL LAST THURSDAY AT THE AUDUBON RECREATION CENTER, AND I POLLED THAT THOSE THAT WERE THERE AND IT WAS PACKED, PACKED HOUSE. YOU WEREN'T THERE, RIGHT? WHAT WOULD YOU. WHAT WOULD YOU LIKE TO GUESS WHEN I ASK? HOW MANY OF YOU HAVE BEEN CONTACTED BY MD HEALTH PATHWAYS? WAIT, WHAT? WHAT DO YOU THINK THE ANSWER WAS? NOT AS MANY AS I WOULD HAVE PROBABLY WANTED. I WOULD GUESS ABOUT HALF. AND LET ME JUST EXPLAIN BRIEFLY. WE'VE ASKED THE CITY. JUST PLEASE USE THE USE THE FUNDS WE'VE GIVEN YOU TO SEND OUT A MAILER. PLEASE SEND OUT A PHONE CALL TO EVERYONE. WE CAN'T DO THAT WITHOUT YOU. AND WE WERE TOLD NO BECAUSE OF COST. YET, MY UNDERSTANDING THIS REFERENDUM IS NOT FREE. IT WILL COST THE CITY UP TO $200,000. JUST TO PUT THIS FOR A REFERENDUM. THAT MONEY COULD HAVE BEEN USED TO NOTIFY THE PUBLIC. EVERY SINGLE PERSON IN A MAILER, IN A PHONE CALL, IN AN EMAIL. THIS IS THE PROGRAM. THIS IS HOW YOU OPT OUT. BUT WE WERE TOLD, NO, THE CITY WILL NOT DO THAT BECAUSE WE DON'T WANT TO WAIT TO BE REIMBURSED FOR THAT COST. YET THE CITY IS WILLING TO PUT UP NEARLY $200,000 TO DO A REFERENDUM. AND HOW MANY OF THOSE PERSONS THAT WERE AT THE MEETING KNEW ABOUT THE OPT OUT FEATURE OF THIS PROGRAM? I WOULD SAY IT'S PROBABLY A DISAPPOINTING NUMBER. YES. EXACTLY RIGHT. AND THOSE THOSE CONSTITUENTS THAT THAT. SHOULD HAVE KNOWN ABOUT THIS PROGRAM. THEY DIDN'T. AND I HAVE A RESPONSIBILITY. TO MAKE SURE THAT THEY KNOW ABOUT THE PROGRAM, WHATEVER WE ROLL OUT. [00:20:09] OKAY. BUT THEY DIDN'T. SO THAT WAS ONE OF THE DRIVERS. MY POSITION, AS FAR AS YOU CALLED IT, THE WHAT WHAT TERM YOU USED. A DISAPPOINTING NUMBER? NO, NO. USED ABOUT ELECTIONS, REFERENDUMS, REFERENDUM. YEAH, YEAH. SO I HAVE A I HAVE AN OBLIGATION TO ALL OF THE CONSTITUENTS OF MY DISTRICT. THOSE THAT KNOW ABOUT IT. THOSE THAT DIDN'T. RIGHT. RIGHT, RIGHT. AND I, AT THAT TOWN HALL MEETING, ONE OF THE PRIMARY REASONS WAS SO THAT YOUR PRESENTATION COULD HEAR YOU AND DECIDE FOR THEMSELVES. RIGHT. SO THAT'S WHERE I LANDED. RIGHT. I APPRECIATE YOU, AND WE'LL GO FROM THERE. ALL RIGHT. THANK YOU. THANK YOU. SIR. COUNCIL MEMBER BEARD. THIS HAS CAUSED ME A LOT OF HEARTACHE AND GRIEF. I WAS ELECTED TO REPRESENT DISTRICT TWO, NOT JUST THE FEW THAT ARE LOUD AND POST ON FACEBOOK, BUT ALL OF DISTRICT TWO, INCLUDING THOSE WHO DO NOT VOTE. I HAVE TO LOOK AT THOSE PEOPLE. I'VE RECEIVED NUMEROUS CALLS, NUMEROUS EMAILS AND TEXT MESSAGES SUPPORTING THIS PROGRAM, AND I WANT TO SUPPORT MY DISTRICT. THERE ARE PEOPLE THAT IN MY DISTRICT THAT ARE BEING VERY VOCAL AGAINST, AND OF COURSE, NONE OF THE ONES THAT LOVE IT ARE BEING VERY VOCAL FOR. THAT'S JUST HOW THINGS GO. US AS COUNCIL. I FEEL LIKE WE'RE IN A NO WIN SITUATION. IF WE SAY. LET'S NOT PUT THIS ON A REFERENDUM AND LET'S HONOR THE CONTRACT WE ALL AGREED UPON, OR SEVEN OF THE NINE OF US DID. LET'S HONOR THIS CONTRACT IN OUR CONSTITUENTS THAT ARE VERY VOCAL WILL SAY, YOU'RE NOT LISTENING TO YOUR CONSTITUENTS. YOU DON'T CARE WHAT WE SAY IF WE VOTE FOR THE CONTRACT, IF WE VOTE FOR THE REFERENDUM AND SAY YES, THAT'S WHAT WE WANT TO DO, THEN THOSE THAT VOTE, THOSE 3000, 500, 4000 PEOPLE THAT COME OUT IN MAY TO VOTE WILL MAKE A DECISION FOR EVERYBODY. AND THE ONES THAT ARE VERY VOCAL WILL GET THOSE FEW PEOPLE OUT TO VOTE. AND AGAIN, I REPRESENT PEOPLE WHO EVEN WHO DON'T VOTE. I HAVE NEIGHBORS IN MY NEIGHBORHOOD THAT I'VE TALKED TO THAT HAVE USED THE PROGRAM THAT LIKE THE PROGRAM THEY ARE THEY ARE NOT US CITIZENS. THEY ARE HERE LEGALLY. SO I DON'T WANT TO HEAR ANY THING ABOUT THAT FROM FROM CONSTITUENTS, BUT THEY CAN'T VOTE. THEY'RE NOT ELIGIBLE TO VOTE, BUT THEY'RE ELIGIBLE TO USE THIS PROGRAM. AND THEY'VE USED IT. AND THEY AND THAT'S WHAT'S IMPORTANT. SO I JUST FEEL SO. HEARTBROKEN RIGHT NOW BECAUSE. I THINK THIS PROGRAM I THINK WE NEED TO LAYER ON WHAT WE CAN DO TO HELP OUR EMS SERVICES. IF THAT MEANS I CAN GET A TELADOC ON A PHONE CALL, AND THEN WE'RE GOING TO TALK ABOUT ANOTHER PROGRAM HERE IN A LITTLE BIT THAT WILL ALSO HELP WITH NON-EMERGENCY EMS SERVICES. AND THEN THOSE WILL TAKE SOME BURDEN OFF OF OUR FIREFIGHTERS AND OUR EMS PROGRAM. AND IT ADDS LAYERS TO WHAT GARLAND IS OFFERING FOR THE RESIDENTS OF THEIR CITY. SO, DOCTOR DARK. I REALLY APPRECIATE ALL THAT YOU'VE PUT INTO THIS. AND I WISH THE CITY OF GARLAND THE BEST HEALTH POSSIBLE. AND I KNOW YOUR PROGRAM COULD PROVIDE THAT. THANK YOU, MR. MAYOR. THANK YOU, MA'AM. SEEING NO OTHER SPEAKERS. THANK YOU. THANK YOU. COUNCIL. MADAM SECRETARY, WOULD YOU PLEASE CALL OUR NEXT SPEAKER, DAVID NAVARA. AND ON DECK WE HAVE DANNY STAN'S. NAME AND ADDRESS. FOR THE RECORD, SIR, YOU HAVE THREE MINUTES. DAVID NAVARA 1025 TWILIGHT DRIVE 75040, DEFINITELY. GARLAND. I'M A LITTLE BIT MORE PREPARED THIS TIME, BUT I'M ALWAYS NERVOUS, SO BEAR WITH ME. [00:25:06] THIS IS ABOUT THE TELEHEALTH STUFF AGAIN. LAST TIME I WAS HERE, I USED IT PHENOMENAL. SO I REALLY, REALLY WANT THIS SYSTEM TO BE IMPLEMENTED IN GARLAND AS MUCH AS SOME PEOPLE MAY NOT. IT'S VERY, VERY BENEFICIAL FOR PEOPLE LIKE ME. BUT HOW DO WE RECOVER FROM THE WAY THAT IT WAS SET UP TO BE IMPLEMENTED? I DON'T KNOW, BECAUSE EVEN I CAN RECOGNIZE HOW IT WAS BEING IMPLEMENTED. IT KIND OF SUCKS. BUT HOW DO WE RECOVER FROM THE WAY THAT IT WAS SET UP? I DON'T BELIEVE GOING TO A VOTE SYSTEM IS REALLY GOING TO WORK. I THINK TOO MANY PEOPLE GOT BURNT AND THEY'RE GOING TO BE LIKE, NO, THIS IS A SCAM. HOWEVER THEY WANT TO PLACE IT. PLUS, WITH THE BAD ECONOMY RIGHT NOW, IF YOU HAVEN'T BEEN ABLE TO SELL THIS IN A WAY TO WHERE THEY CAN JUSTIFY $6, THEY'RE NOT GOING TO WANT TO SPEND $6. NOW, IF THERE WAS A WAY TO DO THIS OUTREACH TO EXPLAIN THIS IN A POSITIVE MANNER, THAT WOULD BE AMAZING. BUT AS I JUST HEARD, THIS CAN COST A LOT OF MONEY. I DON'T KNOW HOW YOU DO IT, I DON'T. HOPEFULLY THERE'S MORE PEOPLE LIKE ME THAT CAN SPEAK OUT AND SAY SOMETHING POSITIVE ABOUT IT. SO LAST TIME, AS I STATED THIS, THIS PROGRAM SAVED ME $150 AND A DOC FROM A DOCTOR VISIT. THE FACT THAT THIS PROGRAM ONLY COST ME $72 IS ASTONISHING FOR THE ENTIRE YEAR. SO THAT ONE VISIT SAVED ME TWO YEARS OF PAYING FOR THIS SYSTEM. JUST THAT ONE TALK ON THE WASN'T EVEN A TALK, IT WAS TEXT. IT SAVED ME DAYS. AND I DID, BY THE WAY, LEAVE WORK EARLY TODAY TO BE HERE TO TALK ABOUT THIS. SO IT WAS IMPORTANT. LUCKILY MY BOSS IS VERY LENIENT. SO GOING BACK TO THIS. SORRY, LET ME CATCH UP TO MY STUFF HERE. TO ME, THIS IS A POSITIVE QUALITY OF LIFE CHANGE FOR THE PEOPLE OF GARLAND, ESPECIALLY FOR BLUE COLLAR SINGLE FOLK LIKE MYSELF. I KNOW I REALIZE THAT SOME PEOPLE HAVE MEDICARE OR MEDICAID THAT GETS PAID FOR BY HARD WORKING TAX DOLLARS, AND I DON'T REALLY NEED AND DON'T REALLY NEED THIS PROGRAM. BUT TO ME, THE IDEA OF HELPING THE COMMUNITY OUTWEIGHS THE FACT THAT I MAY OR MAY NOT USE IT WITHIN THE NEXT YEAR OR TWO. IN THE END, IT'S $6 A MONTH. I DON'T KNOW ANYBODY IN MY LIFE THAT DOES NOT WASTE $6 A MONTH IN A CALENDAR, IN A CALENDAR MONTH FOR SOMETHING USELESS. I'M GOING TO LEAVE HERE TODAY AND I'M KIND OF NERVOUS. I'M PROBABLY GOING TO HAVE ONE BEER OVER AT INTRINSIC. THAT ONE BEER IS GOING TO COST ME HOW MUCH THIS SYSTEM COST ME AN ENTIRE MONTH. SO I DON'T KNOW WHAT YOU ALL CAN DO TO TRY AND SAVE THIS, BUT I MEAN, FOR FOR FOLKS LIKE ME THAT ARE LIKE, I DON'T HAVE HEALTH INSURANCE. IT'S ROUGH. LIKE, THIS IS REALLY, REALLY BENEFICIAL, ESPECIALLY FOR THE SMALLER PEOPLE TOO. I KNOW THAT'S ALL. THAT'S IT. I HOPE THAT MADE SENSE. THANK YOU SIR. OKAY. ONE QUESTION FOR YOU. WAIT A MINUTE. DEPUTY MAYOR PRO TEM ORT. MISTER NAVARRO, THANK YOU FOR COMING DOWN HERE AND GIVING US YOUR TESTIMONY. DO YOU HAVE YOU CONSIDERED ACTUALLY HAVING INSURANCE? WHAT WOULD BE AN IMPEDIMENT FOR YOU HAVING INSURANCE THESE DAYS? OH. THAT'S LOADED. THE FACT THAT I'M ACTUALLY ABLE TO GO DO A CUSTOMER PAY AND THEN GO AND DO CUSTOMER PAY TO GET MY PRESCRIPTION. THIS ONE WAS FUN. THEY THOUGHT I HAD INSURANCE. IT WAS GOING TO COST ME MORE FOR MY PRESCRIPTION THE LAST TIME. NOT WHEN I USE TELEHEALTH, BUT THE TIME PRIOR TO THAT THAN IT WAS WITHOUT PRESCRIPTION, WITHOUT INSURANCE. SO EVEN WITH INSURANCE, IT WAS GOING TO COST ME MORE FOR MY PRESCRIPTION. AND THEN YOU HAVE TO PAY IT. YOU HAVE TO PAY X AMOUNT UNTIL YOU REACH A DEDUCTIBLE. YOU DON'T REALLY GET ANY BENEFITS. I DON'T WANT INSURANCE IS SOMETHING THAT REALLY RATTLED MY CAGE BECAUSE I'VE HAD A ROUGH RUN WITH THEM. SO. SO WHEN YOU HAD INSURANCE, WOULD YOU CONSIDER YOURSELF UNDERINSURED? ABSOLUTELY, ABSOLUTELY. WHAT WOULD HAVE TO HAPPEN FOR YOU TO ACTUALLY MAKE USE OF YOUR INSURANCE? OKAY, I'LL GIVE YOU A REALLY BRIEF STORY. I WON'T MAKE IT LONG, GUYS. THE ONLY TIME INSURANCE EVER HAPPENED, LIKE, WAS USEFUL FOR ME WAS DURING A MOTORCYCLE ACCIDENT, WHEN I LOST 35% OF MY FLESH AND I HAD TO SPEND TIME IN A HYPERBARIC CHAMBER. THAT WAS THE ONLY TIME THAT MY $10,000 DEDUCTIBLE WAS WORTH IT. BEYOND THAT, IT NEVER HELPED ME. FOR EVERYDAY LIFE, FOR EVERYDAY LIFE, FOR MY WORLD. THE FACT THAT I GET SICK MAYBE ONCE A YEAR, SOMETIMES TWICE. I'D RATHER CALL THIS $6 SERVICE AND GET A PRESCRIPTION AND MOVE ON WITH MY LIFE, VERSUS TRYING TO GET AN APPOINTMENT LIKE I SPENT, LIKE EXPLAINED THE LAST TIME WHEN I HAD THE FLU. ASKED SOME FRIEND TO COME OVER IN A HAZMAT SUIT TO TAKE ME TO THE DOCTOR. IT JUST MAKES SENSE TO SOMEBODY LIKE ME. I KNOW IT DOESN'T MAKE SENSE TO EVERYBODY, BUT IT MAKES SENSE TO ME. [00:30:03] AND THE FACT THAT I MAY NOT USE IT FOR TWO YEARS AND I'M STILL SPENDING THE SIX BUCKS, I'LL SEND IT BECAUSE IT'S GOING TO HELP SOMEBODY ELSE. BUT I DON'T KNOW. MAYBE THAT'S THE HUMAN IN ME. THANK YOU, MR. MAYOR. THANK YOU SIR. MAYOR PRO TEM LUCK. DO YOU KNOW ANYBODY THAT HAS A GYM MEMBERSHIP? YES. DO THEY USE THAT GYM MEMBERSHIP? I KNOW A BUNCH THAT DON'T. I DO TOO. BUT I DO ACTUALLY KNOW SOMEONE WHO DOES. SO, YOU KNOW, A BUNCH OF PEOPLE THAT DON'T. AND, YOU KNOW, ONE PERSON THAT DOES, MAYBE TWO. BECAUSE THAT'S HOW GYMS WORK. RIGHT. OH YEAH. YOU PAY FOR YOUR MEMBERSHIP FOR THE ENTIRE YEAR WHETHER YOU GO OR YOU DON'T. EXACTLY. AND, AND YOU HAVE THE OPTION TO USE IT. BUT IF A GYM OPERATED SOLELY ON ACTIVE MEMBERS DO YOU THINK THAT THEY WOULD SURVIVE? NO, OF COURSE NOT. AND THAT'S KIND OF HOW MD HEALTH PATHWAYS SET UP WITH THE OPT OUT SYSTEM. YOU HAVE A BUNCH OF PEOPLE PUTTING IN MONEY, JUST LIKE IN A GYM SCENARIO, AND YOU'LL HAVE PEOPLE THAT USE IT OFTEN, BUT YOU'LL ALSO HAVE PEOPLE THAT DON'T USE IT. AND THOSE PEOPLE THAT DON'T USE IT KEEP IT BECAUSE THEY MAY NEED IT ONE DAY. YES, THEY MIGHT GO WORK OUT ON THE TREADMILL ONE DAY. AND THEY THEY KEEP RENEWING IT BECAUSE THEY HAVE HOPE THAT NEW YEAR'S RESOLUTION IS GOING TO COME IN AND THEY'RE GOING TO DO WHAT THEY THOUGHT THAT THEY WOULD HAVE DONE THE WHOLE LAST YEAR AND THE YEAR BEFORE THAT. I HAVE A GYM MEMBERSHIP TO PLANET FITNESS THAT MY HUSBAND HAS HAD FOR FIVE YEARS. DO YOU KNOW HOW MANY TIMES HE HAS BEEN TO PLANET FITNESS? I DON'T WANT TO GUESS ZERO. DO YOU KNOW HOW MANY TIMES I HAVE ASKED HIM IF I COULD CANCEL THAT? BECAUSE I'M TIRED OF PAYING FOR IT? PROBABLY ABOUT 15 OR 20. AND EVERY SINGLE TIME IT'S LIKE, NO, I THOUGHT MAYBE I'D GO NEXT MONTH. SO THAT'S THAT'S HOW THIS PROGRAM IS SET UP. AND THAT'S WHY IT'S AN OPT OUT PROGRAM BECAUSE THEY'RE BANKING ON PEOPLE WANTING TO USE THE PROGRAM, AND IF THEY DON'T, THEY STILL PAY FOR IT BECAUSE THEY MAY NEED IT SOMETIME. RIGHT. YEAH. I HOPE I HOPE IT CAN LAND. I REALLY DO. I WANT IT. ME TOO. THANK YOU. I SEE NO FURTHER QUESTIONS. THANK YOU SIR. THANK YOU. MADAM SECRETARY, WOULD YOU PLEASE CALL OUR NEXT SPEAKER, DANNY STARNES, AND ON DECK, RODOLFO LOPEZ. NAME AND ADDRESS. FOR THE RECORD, YOU'LL HAVE THREE MINUTES. DANNY STARNES, SIX FIVE, ZERO NINE FALLBROOK DRIVE, GARLAND, TEXAS, SEVEN FIVE, 043. AND I HAVE TO GO OFF SCRIPT A LITTLE BIT BECAUSE SOME OF THE THINGS THAT WERE SAID, HOPEFULLY I GET THE SAME COURTESY OF EXTRA TIME THAT DOCTOR PARROTT HAD. LET'S TALK ABOUT THAT MAILER THAT WAS SENT OUT TO ALL HOUSEHOLDS. I ACTUALLY HAVE A PICTURE OF IT, AND THE ONLY REASON I KNEW ABOUT IT IS BECAUSE I WAS LOOKING FOR IT. AFTER ALL OF THIS, I CHECK EVERYTHING NOW. BELIEVE ME. YOU KNOW WHAT THIS MILLER DOESN'T DO? IT TELLS YOU HOW TO JOIN IN BIG, BIG, BOLD LETTERS. IT TELLS YOU ALL ABOUT THE SERVICE AND HOW GREAT IT IS. WHAT IT DOESN'T DO IS IT DOESN'T TELL YOU THERE'S A FEE COMING. WHAT IT DOESN'T DO IS IT DOESN'T TELL YOU HOW TO OPT OUT. IF YOU SCAN THIS QR CODE, IT PULLS UP THE NUMBER TO JOIN. THAT IS THE MAILER SENT OUT TO NOTIFY EVERYONE HOW TO OPT OUT. TELL ME HOW THAT'S GOING TO WORK, FOLKS. ALSO, I HAVE A MEMBERSHIP TO PLANET FITNESS. YOU SHOULD HAVE SEEN ME BEFORE. I ACTUALLY USE IT. OKAY. I'VE LOST 70 POUNDS, SO DON'T SAY ANY COMMENTS. YOU KNOW WHAT I DIDN'T DO? WELL, LET ME TELL YOU WHAT I DID DO. FIRST OF ALL, I WENT OUT TO THE MARKET. I LOOKED AT MY OPTIONS. I LOOKED AT WHAT I WANTED TO PURCHASE. I LOOKED AT THE EQUIPMENT THAT WAS AVAILABLE. I MADE A DECISION. AS A CONSUMER, Y'ALL SITTING IN THIS COUNCIL CHAMBER DID NOT SIGN ME UP FOR PLANET FITNESS. I CHOSE IT, I SIGNED MYSELF UP. IF I DON'T WANT TO CANCEL IT, I WON'T CANCEL IT. I'LL KEEP PAYING FOR IT. BUT IT WAS MY DECISION. THAT IS A BIG DIFFERENCE. SO BACK TO MY SCRIPT. I WOULD LIKE TO THANK MAYOR HEDRICK AND COUNCILMAN MOORE, WHO HAVE BEEN STEADFAST IN THEIR OPPOSITION TO THE AUTOMATIC OPT IN BUSINESS MODEL REQUIRED BY MD HEALTH PATHWAYS. I HAVE ALWAYS VIEWED THIS TYPE OF AUTOMATIC FORCED CHARGE AS CONTRARY TO FREE MARKET PRINCIPLES, AND AS PLACING AN UNDUE BURDEN ON OUR ELDERLY CITIZENS, MANY OF WHOM ARE NOT AS CONNECTED AS THEY ONCE WERE AND WOULD BE LESS LIKELY TO NOTICE SUCH A CHARGE. MOST ARE ON FIXED INCOMES AND ARE ALREADY STRUGGLING TO MAKE ENDS MEET WITHOUT HAVING TO DEAL WITH SURPRISE FEES. THANK YOU COUNCILMAN BASE AND COUNCILWOMAN DUTTON FOR BRINGING THIS MATTER BACK TO COUNCIL SO THAT PEOPLE WILL HAVE AN OPPORTUNITY TO VOTE ON WHETHER THEY WANT A [00:35:02] $6 FEE ESCALATING TO $9 OVER TIME TO BE AUTOMATICALLY PLACED ON EVERY CITIZEN'S WATER BILL. THANK YOU AS WELL. COUNCILMAN THOMAS, FOR MAKING A PUBLIC COMMENT TO SUPPORT ADDING THIS ORDINANCE TO THE BALLOT. IN THE BUSINESS WORLD, WE HAVE A TERM FOR WHAT IS HAPPENING HERE. IT'S CALLED GOOD LEADERSHIP. LEADERS HAVE TO MAKE DECISIONS BASED ON FACTS THEY HAVE AVAILABLE AT THE TIME. AS NEW FACTS COME TO LIGHT, AS NEW FEEDBACK COMES TO LIGHT, YOU HAVE TO MAKE DIFFERENT DECISIONS. THE DECISION BEFORE YOU TODAY IS TO ALLOW EVERY CITIZEN TO VOTE. I CAN'T IMAGINE ANYONE THAT'S ANTI-VOTING WHO WOULD NOT WANT THE CITIZENS TO IS TO VOTE. SO I ASKED YOU HONESTLY, WHY NOT REMOVE ALL THE GUESSWORK? IT'S A CORNERSTONE OF OUR DEMOCRACY AND IT LEVELS THE PLAYING FIELD FOR EVERYONE. EACH PERSON, WHETHER A DOCTOR, A LAWYER, A TEACHER OR BUSINESS OWNER, YOUNG ADULT OR A SENIOR CITIZEN GETS ONE VOTE AND ONE VOTE ONLY. NO ONE ELSE DECIDES HOW THAT VOTE IS CAST. ONLY THE INDIVIDUAL VOTER DECIDES HOW THEY WANT TO VOTE. IT'S TRULY A BEAUTIFUL SYSTEM WHERE EVERY VOICE MATTERS AND NO ONE IS LEFT OUT. I RESPECTFULLY ASK ALL COUNCIL MEMBERS TO VOTE TO PLACE THIS ORDINANCE ON THE BALLOT, AND GIVE EVERY CITIZEN THE OPPORTUNITY TO HAVE THEIR VOICE HEARD. THANK YOU VERY MUCH. THANK YOU SIR. MADAM SECRETARY, WOULD YOU PLEASE CALL OUR NEXT SPEAKER, ADOLFO LOPEZ, AND ON DECK, INGRID GODOY. SIR, IF YOU GIVE YOUR NAME AND ADDRESS FOR THE RECORD, YOU HAVE THREE MINUTES. OKAY. A TODOS MI NOMBRE ES RODOLFO LOPEZ. LA NUEVA HITLER. GALAN YOU KNOW,. OKAY. ESTOY APOYANDO LO Q ES EL EL PROGRAMA DE HOSPITAL PARA NOSOTROS. AUN NO TENGO EL PROGRAMA. PERO COMO ES SE SIENTE MUY BIEN Y ME GUSTARIA GOZAR TAMBIÉN DE LOS BENEFICIOS DE LOS Q AQUI NOS Q IS. NO MUY ELEVADO. PODEMOS TENER LOS BENEFICIOS AL IGUAL OK TODOS LOS CIUDADANOS TAMBIÉN TIENE. MEDICAID O DINING CUALQUIER OTRO TIPO DE NOSOTROS. NO PODEMOS TENER EN ESTE PLAZO DE DOLARES. QUÉ ES PODEMOS USAR ESTE BENEFICIO PARA PODER TENER UN RECORD DE NUESTRA SALUD. YA SEA CONSTANTEMENTE O A LA DISTANCIA PUEDEN SER ATENDIDOS MAS FACILMENTE. SO HE JUST WANTED TO BASICALLY SAY THAT HE'S IN FAVOR OF THE HEALTH PATHWAYS. HE WANTED TO MAKE SURE THAT HE EMPHASIZED HE DOESN'T HAVE ACCESS TO A LOT OF THE SOCIAL PROGRAMS AVAILABLE TO A LOT OF THE CITIZENS. HE DOESN'T HAVE ACCESS TO MEDICARE OR MEDICAID, AS MANY OTHERS DO, BUT FOR $6 A MONTH, IT'S SOMETHING THAT HE CAN PROVIDE A LOT OF BENEFITS FOR HIM AND HIS FAMILY. HE DOESN'T THINK IT'S A VERY ELEVATED CHARGE FOR $6 A MONTH. AND JUST PLAYING THE MIGRANT COMMUNITY WHO WOULD OTHERWISE HAVE NO ACCESS TO AFFORDABLE HEALTH CARE. SO FOR $6 A MONTH, IT'S SOMETHING THAT CAN GIVE HIM A LOT OF BENEFITS FOR THE COST THAT'S BEING OFFERED AT MS. QUESTIONS FOR HIM? I SEE NONE, BUT YOU HAVE A FEW MORE SECONDS LEFT, BUT IT'S UP TO YOU IF YOU'RE DONE SPEAKING. D CASEY DE LA OPORTUNIDAD DE ESTE PROGRAMA VAMOS A HACER MUCHOS MIGRANTES BENEFICIOS DE LOS CUALES. TAL VEZ EN ESTE PROGRAMA Y SE PUEDE EXTENDER EN VAMOS A TENER FACILIDADES DE UN DOCTOR NOS ATIENDA O PODER TENER RECETAS A UN MENOR COSTO O UNA MEJOR FACILIDAD. AND LASTLY, HE JUST WANTED TO EMPHASIZE THAT IMPLEMENTING THIS PROGRAM WOULD PROVIDE WANT TO REEMPHASIZE THE MIGRANT COMMUNITY THAT WOULD OTHERWISE HAVE NOTHING OR NO ACCESS TO TO [00:40:08] THE HEALTHCARE SYSTEM. SO HE HOPES THAT IT'S AN OPPORTUNITY THAT'S OFFERED IN THE NEAR FUTURE. VERY GOOD. I DO HAVE ONE QUESTION. COUNCIL MEMBER DUTTON. HAS HE ACTUALLY USED THE SERVICE BECAUSE HE HAS HIS OWN AUN NO LO. PERO SI TENGO AMIGOS HAN COMENTADO ESTA MUY UTIL Y REALMENTE SI QUIERO UTILIZARLO. HE HAS NOT USED IT HIMSELF, BUT HE DID HEAR FROM FAMILY MEMBERS, FRIENDS AND FAMILY MEMBERS WHO HAVE USED THE SERVICE AND TALKED ABOUT THE BENEFITS OF USING IT. THANK YOU. THAT'S ALL THE QUESTIONS I HAVE. THANK YOU VERY MUCH. MADAM SECRETARY, PLEASE CALL OUR NEXT SPEAKER, INGRID GODOY. AND ON DECK, OLIVIA NARANJO. ELVIA NARANJO. SORRY. NAME AND ADDRESS. FOR THE RECORD, YOU HAVE THREE MINUTES. A LA VEZ Y YO, PERO SI PUEDE DAR ES UN NOMBRE PARA MUY BUENAS TARDES. MI NOMBRE ES INGRID GODOY O GALAN BRASIL PARA MI SO INTERESANTE EL PROGRAMA PORQUE ES PARA TODOS PARA TODOS LOS CIUDADANOS DE GARLAND. NO SOLO ES. I'LL BREAK IT UP INTO 1 OR 2 SENTENCES JUST SO WE CAN, YOU KNOW, HAVE A MORE DIRECT TRANSLATION. BUT YOU WANT TO SAY THAT IT'S A VERY INNOVATIVE PROGRAM BECAUSE IT'S A PROGRAM FOR ALL, FOR ALL THE RESIDENTS OF GARLAND. IT'S IMPORTANT I SOLTERAS LA CUAL NO, NO TIENEN UN CARRO. Y EL ACCESO A UN TELÉFONO. UNA LLAMADA ES MAS FACIL FACTIBLE. YES. IT'S A VERY IMPORTANT, ESPECIALLY FOR YOUNG MOTHERS WHO ARE SINGLE AND DON'T HAVE THE MEANS OF TRANSPORTATION, HAVING THE ABILITY TO USE THE PHONE AND ACCESS MEDICAL CARE, WHETHER THAT BE THROUGH THE TELEPHONE OR MAKING A PHONE CALL. IT'S SOMETHING THAT INCREASES HEALTHCARE ACCESS FOR THOSE WHO NEED IT THE MOST. PROGRAMA ES IMPORTANTE. EN ALGUNOS LUGARES YA LO OBTIENEN PORQUE NO GALAN OTROS LO TIENEN RIJINO GALAN. GUSTARIA ME LO USADO, PERO SI ME GUSTARIA USARLO. YEAH. SO SHE SAID IF OTHER COMMUNITIES HAVE HAD ACCESS TO THIS PROGRAM, WHY NOT GARLAND? IF OTHER COUNTRIES HAVE IMPLEMENTED SIMILAR PROGRAMS, WHY NOT GARLAND? SHE SAID IT'S A VERY INTRIGUING PROGRAM THAT SHE HOPES SHE CAN HAVE ACCESS TO IN THE VERY NEAR FUTURE. ANY QUESTIONS? YOU HAVE A COUPLE QUESTIONS. COUNCIL MEMBER DUTTON. HAS SHE ACTUALLY USED THE PROGRAM? NO. NO, NO. NOT YET. COUNCIL MEMBER WILLIAMS. WOULD YOU ASK HER, IS SHE A REGISTERED VOTER, OR DOES SHE HAVE MEMBERS OF HER FAMILY WHO ARE REGISTERED VOTERS? YES. REGISTRADA O SI PARTE DE SU FAMILIA ESTA REGISTRADA PARA VOTER. PARTE. NO. HER NO. PART OF HER FAMILY. SHE SAID PART OF HER FAMILY, NOT HER IS REGISTERED VOTER. OKAY. ALL RIGHT. THEY LIVE IN GARLAND. HAVE YOU BEEN IN GARLAND? SU FAMILIA. YES, SIR. FAMILY MEMBERS. PART OF HER FAMILY. SEVERAL OF HER FAMILY MEMBERS ARE REGISTERED VOTERS, BUT NOT HER. BUT THOSE FAMILY MEMBERS LIVE IN GARLAND, CORRECT? YES. YES. OKAY. ALL RIGHT. THANK YOU. THANK YOU MAYOR. THANK YOU SIR. I HAVE NO OTHER QUESTIONS. THANK YOU VERY MUCH. THANK YOU, MADAM SECRETARY. WOULD YOU PLEASE CALL OUR NEXT SPEAKER? SILVIA NAVARRO AND ON DECK, COURTNEY RAINS. [00:45:04] YOUR NAME AND ADDRESS FOR THE RECORD. YOU HAVE THREE MINUTES. PARA HACER UN HOMBRE PARA EL BUENOS TARDES A TODOS. MI NOMBRE ES EL HIJO. VIVO EN LA UNO. TYLER GARLAND, TEXAS 70. CINCO. OKAY. YEAH. IMPORTANTE PARA MUCHAS FAMILIAS PODER TENER EL PROGRAMA PRECISAMENTE FAMILIAS Q TENEMOS NINOS A SIX DOLARES. NO ES UNA GRAN CANTIDAD Y NO LO DIGO PORQUE AQUI HAY MUCHAS PERSONAS PUEDEN TENER MUCHO MAS Q YO LA POSIBILIDAD. TAL VEZ PUEDO TENER SOLAMENTE ESOS DOLARES. PERO LOS PAGO CON GUSTO PORQUE NO ES EL BENEFICIO SOLO PARA ME SINO PARA TODA MI FAMILIA. PRECISAMENTE ESTA MANANA. ENTONCES SORRY. SO SHE WAS SAYING THAT SHE HOPED THAT SHE THINKS A GREAT PROGRAM THAT FOR FAMILIES LIKE HER WHO HAVE KIDS AND HAVE USED THE PROGRAM $6 A MONTH FOR AN ENTIRE FAMILY IS NOT IS NOT A SIGNIFICANT MEANS ON A MONTHLY BASIS. THERE MAY BE INDIVIDUALS WHO HAVE MORE THAN I HAVE, AND THERE MAY BE INDIVIDUALS WHO HAVE MORE PRIVILEGE THAN I HAVE. BUT FOR SOMEONE LIKE ME WHO HAS A FAMILY AND MULTIPLE KIDS, $6 A MONTH IS A VERY REASONABLE PRICE. HOSPITALIZADA TODA LA NOCHE. POR LA MEDICINA CU ME PUSIERON VENIR UN GRANDE. ES SI ME VOY A SER MUY DIFICIL. SIX DOLARES CADA VEZ POR EL BENEFICIO. TODA MI FAMILIA. ESTOY DISPUESTO. YEAH. SO RECENTLY I WAS HOSPITALIZED. AND I KNOW THAT THAT EMERGENCY MEDICINE HOSPITALIZATION OR OVERNIGHT OBSERVATION IS GOING TO BE A COUPLE THOUSAND DOLLARS FOR SOMETHING THAT WAS NOT NECESSARY TO GO TO THE EMERGENCY DEPARTMENT. SO FOR SOMETHING TO HAVE A MEDICAL ACCESS AND ASK THE QUESTIONS TO, TO A MEDICAL PROVIDER FOR $6 A MONTH IS FAR MORE BENEFICIAL THAN THAN TO GO TO THE EMERGENCY DEPARTMENT, ALMOST ANYTHING ELSE? HOLD ON ONE SECOND, SIR. FIRST COUNCIL MEMBER DUTTON. YOU'RE FIRST IN THE QUEUE. I'M THE SAME QUESTION. HOW SHE USED THE SERVICE. SHE HASN'T USED IT HERSELF. SHE'S REGISTERED AS WELL AS ALL HER FAMILY HAVE BEEN REGISTERED FOR FOR THE SERVICE. BUT SHE HASN'T USED IT HERSELF. YEAH. SO IT WAS HER JULIUS. HER JULIUS, HER, HER SISTER. SHE WAS THE FIRST ONE THAT INFORMED HER ABOUT IT. BUT THEY'RE ALL REGISTERED. SHE HASN'T USED IT YET, BUT HASN'T HAD THE NEED TO USE IT YET. COUNCIL MEMBER WILLIAMS. HAVE ANY MEMBERS OF HER FAMILY BEEN USED THIS SERVICE AND BEEN TRANSPORTED? IF SO, HOW WERE THEY TRANSPORTED? HOW WERE THEY TRANSPORTED TO THE HOSPITAL OR YES, TO MEDICAL SERVICES WHEREVER THEY WENT, OR SERVICIOS MÉDICOS COMO UN TRANSPORTADORES? YEAH. SELF TRANSPORT. SELF TRANSPORT. THEY DROVE THEMSELVES TO THE TO THE HOSPITAL. SELF TRANSPORT. OKAY. ALL RIGHT. THANK YOU. THANK YOU. THANK YOU MAYOR. THANK YOU SIR. I HAVE NO OTHER QUESTIONS. THANK YOU VERY MUCH. MADAM SECRETARY, WOULD YOU PLEASE CALL OUR NEXT SPEAKER, COURTNEY RAINS, AND ON DECK, ELEAZAR MORALES. YOUR NAME AND ADDRESS. FOR THE RECORD, YOU HAVE THREE MINUTES. COURTNEY RAINS, 6518 LIMERICK LANE, GARLAND, TEXAS, 75044. GOOD EVENING COUNCIL. MY NAME IS COURTNEY. AS I SAID, I'VE BEEN A PARAMEDIC FOR 13 YEARS. I'VE WORKED IN BOTH THE PUBLIC AND PRIVATE SECTOR OF MS, AND I WANT TO SHARE THAT AND WHAT THAT LOOKS LIKE, BECAUSE I THINK IT'S DIRECTLY RELEVANT TO WHY THIS PROGRAM MATTERS. I'VE RESPONDED TO MULTIPLE 911 CALLS AND ONE SHIFT THAT WERE NOT EMERGENT. A COUPLE EXAMPLES A CHILD WITH A FEVER SOMEONE WITH BACK PAIN THAT THEY'D HAVE HAVE HAD FOR WEEKS SOMEONE LOOKING TO GET ANTIBIOTICS FOR A MINOR ILLNESS AND EVEN FOR A MEDICATION REFILL. EVERY ONE OF THOSE CALLS TIED UP IN AMBULANCE FOR PROBABLY ABOUT AN HOUR BY THE TIME WE GET BACK IN SERVICE. THAT'S AN AMBULANCE THAT WASN'T AVAILABLE. [00:50:03] IF SOMEONE WAS HAVING A HEART ATTACK. THAT'S A CREW THAT IS UNABLE TO GET TO OTHER CRITICAL CALLS. IT'S LESS COVERAGE FOR THE CITY AND CAUSES LONGER RESPONSE TIMES. I DON'T BLAME THOSE PEOPLE THAT CALLED 911. THEY DIDN'T KNOW WHAT ELSE TO DO WHEN YOU'RE WORRIED ABOUT YOURSELF OR YOUR LOVED ONES AND YOU DON'T HAVE OTHER OPTIONS, YOU CALL FOR HELP. THAT'S HUMAN NATURE. BUT HERE'S THE THING THOSE CALLS DON'T NEED AN AMBULANCE. THEY NEED ACCESS TO A DOCTOR WHO CAN TELL THEM WHAT'S GOING ON AND WHAT TO DO ABOUT IT. THAT'S WHAT THIS TELEHEALTH WILL PROVIDE A PHYSICIAN, AVAILABLE BY TEXT FROM 7 TO 10 EVERY DAY OF THE YEAR. I CAN'T EVEN SEE MY OWN PRIMARY CARE PHYSICIAN FOR $6. SO IF I USE THIS PROGRAM ONCE, IT'S BASICALLY A WASH FOR ME. AND THIS IS FOR FAMILIES. THEY ALSO GET QUICKER AND FASTER ANSWERS WITHOUT MASSIVE BILLS OR EMERGENCY RESOURCES STILL AVAILABLE FOR TRUE EMERGENCIES. RESPONSE TIMES IMPROVE FOR THOSE WHOSE LIVES ARE ACTUALLY ON THE LINE. THE DATA FROM CITIES IN TEXAS ARE ALREADY USING THE PROGRAM SPEAKS FOR ITSELF. EMS CALLS FOR NON-EMERGENT CALLS GO DOWN. THAT'S NOT A THEORY. THAT'S DOCUMENTED RESULTS. SO I ASK THAT YOU PLEASE LET THIS PROGRAM LAUNCH. AND I BELIEVE IT WOULD MAKE GARLAND HEALTHIER AND SAFER. THANK YOU. ALL RIGHT. THANK YOU. MA'AM. MADAM SECRETARY, WOULD YOU PLEASE CALL OUR NEXT SPEAKER? ELEAZAR MORALES AND ON DECK, CARL SMITH. GIVE YOUR NAME AND ADDRESS FOR THE RECORD. AND YOU HAVE THREE MINUTES. THREE MINUTES. BUENAS TARDES. MI NOMBRE ES ELIAS MORALES. UNO. UNO. CUATRO. GARLAND, TEXAS 70. CINCO. DE ESTE PROGRAMA. PERO SI SI ME PARECE INTERESANTE PORQUE CON UNA. CON UN SIMPLE TEXTO. UNA LLAMADA PUEDO TENER UNA CONSULTA SIN SALIR DE CASA. MI ESPOSA A NOCHE ESTUVIMOS EN EL HOSPITAL AHORITA. VENGO A TRABAJAR EN UN SEGUNDO. EN TODA LA NOCHE EN EL HOSPITAL. SOLO PARA MI TRABAJO. ENTONCES ESTE PROGRAMA HACE UNOS DOS DIAS NOCHE HUBIERA USADO Y NO NO TANTO Y LA ATENCION EN CASA Y EL MÉDICO. YEAH. SO I WANTED TO MAKE SURE THAT RETREAT. HE FINDS HIS PROGRAM VERY INTERESTING. AND WITH THE FACT THAT YOU CAN USE GET ACCESS TO MEDICAL HELP FROM FROM YOUR PHONE. THAT'S HIS WIFE OVER THERE. AND HE SAID THAT WHENEVER THEY WENT TO THE EMERGENCY DEPARTMENT, HE WASN'T ABLE TO SLEEP. GOT UP THIS MORNING. HAD TO GO STRAIGHT TO WORK. BUT IT WAS SOMETHING THAT HE BARELY KNEW ABOUT. AND IF IT WAS SOMETHING THAT HE KNEW ABOUT BEFORE HIS WIFE WAS GETTING SICK, IT WAS SOMETHING HE WOULD HAVE USED RIGHT OFF THE BAT. THEY JUST PRESCRIBED HER ANTIBIOTICS. AND SO IT WAS SOMETHING THAT COULD HAVE BEEN HANDLED JUST FROM HOME. BUT FEELS THAT THIS IS AN IMPORTANT PROGRAM THAT COULD SAVE HIM. COULD HAVE SAVED HIM YOU KNOW, A NIGHT OF SLEEP, BUT ALSO SOME TIME OFF OF OF SPENDING AN ENTIRE NIGHT AT THE EMERGENCY DEPARTMENT. TODOS SOMOS SERES HUMANOS Y TODOS TENEMOS. UNA ATENCION MÉDICA TANTO COMO CIUDADANOS DE ESTA DE LA CIUDAD DE TODOS CONTRIBUI CON LA CIUDAD Y POR $6 DEL VALLE DE THE DEL AGUA. ES PODEMOS TENER ACCESO UN MÉDICO PARA TODA NUESTRA FAMILIA Y TANTO, HAY MUCHAS PERSONAS NO PUEDEN NI NI ESOS DOLARES Y LES VAN A BENEFICIAL UN PROGRAMA. YEAH, HE WANTED TO MAKE SURE THAT THERE'S RHETORIC. HE'S HEARD RHETORIC ABOUT WHO THE PROGRAM IS MEANT FOR AND WHO IS SUPPOSED TO BENEFIT. HE WANTED TO REITERATE THAT WE'RE ALL HUMANS. AND WHETHER OR NOT YOU KNOW, YOU MAY AGREE WITH THAT OR NOT. WE ALL CONTRIBUTE TO GARLAND, AND WE ALL SHOULD HAVE ACCESS TO A DECENT HEALTH CARE ACCESS. AS YOU KNOW, CONTRIBUTORS OF GARLAND. SO FOR $6 A MONTH, IT'S SOMETHING THAT HE WOULD HIGHLY FIND BENEFICIAL FOR INDIVIDUALS WHO ARE THE MOST VULNERABLE IN THE COMMUNITY. SO THAT'S IT. I SEE, NO QUESTIONS. THANK YOU VERY MUCH. MADAM SECRETARY, PLEASE CALL OUR NEXT SPEAKER, CARL SMITH. [00:55:06] AND ON DECK, CHANCE MARCHIA. AVA. NAME AND ADDRESS. FOR THE RECORD, YOU HAVE THREE MINUTES. CARL SMITH, 2216 RICH OAK DRIVE. SO MANY THINGS TO ADDRESS. I'LL JUST START WITH MY ORIGINAL THOUGHTS. THANK YOU, MAYOR AND COUNCIL, FOR ALLOWING ME TO SPEAK TONIGHT. YOU'VE REGAINED SOME OF MY RESPECT DUE TO YOUR DECISION TO DISCUSS THE PLACING OF MD PATHWAYS AS A CITIZEN'S CHOICE ON THE UPCOMING ELECTION. PLEASE KEEP THAT RESPECT AND THAT OF MANY OF THE OTHER CITIZENS OF THIS CITY BY VOTING TO ALLOW THIS ELECTION TO GO FORWARD. AS FAR AS THE COMMENT THAT WAS MADE EARLIER ABOUT ABOUT THE COST OF AN ELECTION, WE'RE ALREADY HAVING AN ELECTION. IT'S THE RIGHT THING TO DO. NO AMOUNT OF GUILT TRIPPING AND THREATS SHOULD SWAY YOU FROM DOING WHAT IS RIGHT. AS WE GO FORWARD, PLEASE CONSIDER ALL OPTIONS THAT ARE AVAILABLE. PARKLAND. RIGHT SITE. ALL OF THEM WOULD CONTRIBUTE TO THIS WITHOUT FORCING CITIZENS INTO A PROGRAM THAT THEY DID NOT ASK FOR. AS TO THE CRITICISM THAT WE ARE TOO VOCAL. I'M SORRY THAT WE ARE ACTUALLY ENGAGED, WHICH IS WHAT THE CITY HAS BEEN CONCERNED ABOUT FOR FOREVER. THAT SEEMS COUNTERPRODUCTIVE AND A LITTLE HYPOCRITICAL BECAUSE YOU WANT US TO VOTE, BUT YOU DON'T WANT US TO BE ENGAGED. THAT KIND OF DOESN'T MAKE ANY SENSE TO ME. I DON'T KNOW ABOUT ANYBODY ELSE. AND IF THIS PROGRAM IS SO SPECTACULAR AND IT SHOULD SURVIVE AN ELECTION THE AMERICAN WAY. THANK YOU. THANK YOU SIR. ONE SECOND SIR. I DO HAVE A QUESTION FOR YOU. OKAY. MAYOR PRO TEM LUCK. MR. SMITH, I JUST WANT TO LET YOU KNOW THAT ADDING AN ITEM TO A BALLOT DOES COST MONEY OUT. IT'S LIKE ABOVE THE COST OF WHAT WE'VE ALREADY GOT GOING. SO I'VE BEEN TOLD ANYWHERE FROM 150 TO $200,000 TO GET THIS ONTO THE BALLOT. OKAY. STILL THE AMERICAN WAY. THANK YOU SIR. THANK YOU MA'AM. NO FURTHER QUESTIONS. THANK YOU SIR. THANK YOU. MADAM SECRETARY, WOULD YOU PLEASE CALL OUR NEXT SPEAKER, MARSHA. AND UP ON DECK, ETHAN, ADAM NEWMAN. IF YOU GIVE YOUR NAME AND ADDRESS FOR THE RECORD, YOU HAVE THREE MINUTES. IF Y'ALL CAN HEAR ME. OKAY. MY NAME IS CHANCE MARCHIAFAVA. 2006 WOODEN OAK LANE, GARLAND, TEXAS 75040. I'M GOING TO GO OFF MY NOTES THIS TIME. MAYOR AND COUNCIL MEMBERS. I'M A PARAMEDIC. I'VE SERVED THE NORTH TEXAS COMMUNITY FOR 13 YEARS. I'VE BEEN IN EMS SINCE 2004. I LIVE IN GARLAND. I PAY TAXES IN GARLAND AND I VOTE IN GARLAND. I'M NOT HERE REPRESENTING A COMPANY. I'M HERE AS A RESIDENT WHO'S WATCHED THIS DEBATE UNFOLD. AND I GOT SOME STUFF TO SAY. FIRST OF ALL, LET'S TALK ABOUT WHAT I SEE ON THE JOB. I SEE A LOT OF PATIENTS, AND A SIGNIFICANT NUMBER OF THEM ARE NOT EMERGENCIES. THERE ARE PEOPLE WHO HAD NOWHERE ELSE TO TURN AS THE OTHER SPEAKERS LISTED BE CHILDREN WITH FEVER. YOU KNOW, A PERSON WHO NEEDS ACCESS TO THEIR MENTAL HEALTH MEDICATION AND THEY DON'T HAVE IT. THEY COULDN'T MAKE THEIR DOCTOR'S APPOINTMENTS. SOMETHING HAPPENED. MAYBE THE ROADS FROZE. THEY COULDN'T MAKE IT. THESE AREN'T BAD PEOPLE. THEY'RE NOT MAKING BAD CHOICES. THESE ARE PEOPLE WITHOUT OPTIONS. AND WHEN YOU DON'T HAVE OPTIONS, YOU CALL 911. AND WHEN YOU CALL 911, THAT TAKES AN AMBULANCE OUT OF SERVICE. IT'S EXPENSIVE FOR THEM. IT'S EXPENSIVE FOR THE CITY. AND THAT AMBULANCE IS OUT OF SERVICE. IT CANNOT RESPOND TO ANY OTHER KIND OF EMERGENCY. ADDITIONALLY, THAT HOSPITAL IS GOING TO BE LONGER THAN I'D PREFER, OR THAT AMBULANCE IS GOING TO BE GONE LONGER THAN I'D PREFER BECAUSE WE DON'T REALLY HAVE A FUNCTIONAL HOSPITAL IN GARLAND. WE'VE GOT A GREAT 911 SYSTEM. OUR PARAMEDICS ARE SORRY. I KNOW I'M NOT SUPPOSED TO USE PROFANITY. THEY'RE DANG GOOD. THEY'RE REAL GOOD. YOU GUYS HAVE REALLY GOOD PARAMEDICS IN GARLAND, AND THAT IS A LUXURY NOT A LOT OF PEOPLE HAVE. I WAS PRETTY EXCITED WHEN I HEARD ABOUT THIS PROGRAM, AND WHEN I HEARD THE COUNCIL VOTED TO GIVE FAMILIES A DOCTOR THAT COULD TEXT A REAL DOCTOR OR ADVANCED PRACTICE OR ADVANCED PRACTICE PROVIDER. I THOUGHT, FINALLY, SOMEBODY DOING SOMETHING ABOUT THIS INSTEAD OF JUST TRYING TO MANAGE IT. WE'VE GOT A SOLUTION. IT'S NOT PERFECT. NOT A LOT IS PERFECT. BUT FOR THE PRICE FOR A MCDONALD'S MEAL PER MONTH TO HAVE ACCESS TO THIS FROM 7 A.M. [01:00:04] TO 10 P.M., SEVEN DAYS A WEEK. THAT'S AMAZING. IF I AND I WAS ON YOUR SUBSTACK EARLIER, THANK YOU FOR DOING THAT. I LIKE TO SEE WHAT'S GOING ON BEHIND THE CURTAIN, SO TO SPEAK. WE'RE HAVING TO OPEN UP VOTING SITES FOR THIS REFERENDUM. RIGHT. BECAUSE THE CITY COUNCIL, IT'S ONLY CERTAIN SPOTS THAT ARE OPENING. SO WE HAVE TO OPEN UP THOSE VOTING SITES. THAT'S WHERE A LOT OF THE COST IS COMING FROM. IS THAT CORRECT? OKAY. THANK YOU. SO WE'RE GOING TO DROP $200,000 AND ESSENTIALLY CONDUCT A SURVEY OF WHAT WE SAY 4000 PEOPLE. SO 50 BUCKS A POP PER RESPONSE FOR A NON-BINDING OPINION ON SOMETHING WE ALREADY VOTED ON. EXCUSE ME? SOMETHING YOU ALREADY VOTED ON. SOMETHING WE ALREADY HAVE A CONTRACT ON. SOMETHING THAT COULD ALREADY BE IN PROCESS. I DON'T THINK THAT'S GOOD STEWARDSHIP OF PUBLIC FUNDS. THE SAME PEOPLE, AND MYSELF INCLUDED, HAVE SHOWN UP TO SPEAK ABOUT THIS, AND WE ALL HAVE SOMETHING IN COMMON. WE GOT THE RESOURCES TO BE HERE. I WAS LUCKY TO BE OFF WORK TODAY. I ALSO HAD A WORK SESSION TODAY. THAT'S WHY I'M IN MY SHORT PANTS. BUT YOU KNOW WHO CAN'T SHOW UP? THE PEOPLE WHO NEED THIS PROGRAM THE MOST. THEY GOT KIDS TO LOOK AFTER BECAUSE THEY GOT TWO JOBS. OR BECAUSE THEY'RE AFRAID TO LEAVE THEIR HOUSE. THOSE ARE THE PEOPLE THIS PROGRAM SERVES. THESE PEOPLE WILL NEVER COME TO DEFEND IT. AND IT'S YOUR JOB, ALL OF YOU. COUNCIL CITY CITY COUNCIL MEMBERS TO STAND UP FOR THEM, EVEN IF THEY DON'T VOTE, EVEN IF THEY CAN'T SHOW UP TO A TOWN HALL. IT'S YOUR JOB TO TAKE CARE OF THEM. I NEED YOU GUYS TO TAKE CARE OF THEM. PEOPLE ARE GOING TO DIE. PEOPLE HAVE DIED. I'M NOT BEING DRAMATIC. A TEN MINUTE RIDE TO THE HOSPITAL VERSUS A 20 MINUTE RIDE TO THE HOSPITAL CAN MAKE A DIFFERENCE. OR GETTING IN CONTACT WITH A DOCTOR IMMEDIATELY AND KNOWING EXACTLY WHAT TO DO AND HOW TO PROCEED. THAT'S PRETTY INVALUABLE. HOW MUCH TIME I GOT LEFT THERE, BOSS? YOUR TIME HAS EXPIRED, SIR. OH. I SAID WHAT I NEEDED TO SAY. I'M HAPPY TO TAKE ANY QUESTIONS. I HAVE A QUESTION FOR YOU, SIR. PLEASE. MAYOR PRO TEM LUCK. YES, MA'AM. DID YOU HEAR? DID YOU HEAR THEM SAY THAT MD HEALTH PATHWAYS WOULD CANCEL THE CONTRACT IF WE GO TO A REFERENDUM? YES. SO ARE YOU IN FAVOR OF A REFERENDUM? NO. THIS HAS ALREADY BEEN. SORRY. I APOLOGIZE. I GET A LITTLE HIGH. I DON'T MEAN TO BE. THIS IS SOMETHING THAT WAS ALREADY. YEAH. THIS IS SOMETHING I KNOW. YOU ALL LOOK LIKE. SOMEBODY SHOT YOUR DOG OVER THIS. AND IT BREAKS MY HEART TO. IT REALLY DOES, MAN. I'M SORRY TO GET BACK TO YOUR QUESTION. YEAH, I KNOW THAT. I DON'T THINK THIS IS GOING TO WORK IF IT GOES TO REFERENDUM. AND IT'S FRUSTRATING TO ME PERSONALLY, BECAUSE WHETHER WE IMPLEMENTED THIS CORRECTLY OR NOT, WHETHER ALL THE PEOPLE IN THE ROOM THINK THIS WAS IMPLEMENTED CORRECTLY OR NOT, WE HAD A SOLUTION ON THE TABLE THAT WAS GOING TO HELP PEOPLE, AND THAT LOOKS LIKE IT'S GOING TO GO AWAY. AND I'M GLAD WE'VE GOT SOME STUFF IN THE CHAMBER WITH RIGHT SITE AND THE PARKLAND PROGRAM. WE'RE GOING TO HAVE TO GO THROUGH THOSE PROGRAMS AS WELL. THEY DON'T OFFER THE SAME THING. THEY DON'T OFFER AS GOOD A PRODUCT, IN MY OPINION, BECAUSE YOU'RE NOT TALKING TO A DOCTOR THAT YOU CAN CONTACT ANY TIME FOR THE RIGHT SITE PEOPLE TO BE OUT THERE. I BELIEVE THAT HAS TO BE A 911 CALL THAT WAS INITIATED AND THE PARAMEDICS ON SCENE INTERACT AND GET THE RIGHT SITE. PEOPLE CONTRACTED, RIGHT, IF I'M NOT MISTAKEN, AND I'M NOT READ UP ON THIS, SO PLEASE CORRECT ME. SO IF YOU HAVE THAT, IT SOUNDS GOOD, BUT YOU'VE GOT ACCESS TO A DOCTOR FOR MOST OF THE DAY AND MOST OF THE EVENING SEVEN DAYS A WEEK, AND WE DON'T HAVE TO GET AN AMBULANCE OUT TO YOU. AND IF WE DO NEED TO GET AN AMBULANCE OUT TO YOU, THEY'RE GOING TO TELL YOU THAT AND APPARENTLY STAY ON THE PHONE WITH YOU UNTIL THEY GET THERE. SO THAT'S I HOPE I APPROPRIATELY ANSWERED YOUR QUESTION, MA'AM. THANK YOU. YES, MA'AM. COUNCIL MEMBER MOORE. YES, SIR. THANK YOU, MR. MAYOR. I'VE JUST FINISHED GOOGLING. TELEHEALTH SERVICE COMPARISONS. IN THE REGION? THE CITY I'VE JUST COME UP WITH TELADOC HEALTH, AMWELL, MD LIVE DOCTOR ON DEMAND LEMONAID. I MEAN, IT JUST GOES ON AND ON. WOULD IT MAKE A DIFFERENCE IF WE WERE ABLE TO FIND A SERVICE THAT WERE COMPARABLE, THAT MAYBE EVEN GAVE THE SERVICE FOR LESS THAN MD PATHWAY, OR DOES IT HAVE TO BMD PATHWAY? IT DOESN'T HAVE TO BE MD PATHWAYS TO ME. BUT I TELL YOU THIS, I'VE HAD TELADOC ACTUALLY. ALL RIGHT. SO IT DOESN'T HAVE TO BE MD PATHWAY. NO, WE NEED SOMETHING. IT COULD BE ANY COMPANY THAT PROVIDES THOSE TYPES OF SERVICES. IS THAT WHAT YOU'RE SAYING? ABSOLUTELY. BUT IF YOU ALREADY HAVE A CONTRACT READY TO GO, WHY NOT EXECUTE THAT AND GET IT GOING IN? WE COULD HAVE THIS COULD HAVE BEEN SETTLED. I APOLOGIZE FOR INTERRUPTING. COUNCILMAN. OKAY, THAT'S ALL RIGHT. I CAN BE JUST AS AGGRESSIVE AS YOU. WE'RE WE'RE WE'RE ALL RIGHT. [01:05:07] SO IT DOESN'T NECESSARILY HAVE TO BE MD PATHWAY. I'M NOT MARRIED TO MD PATHWAYS. THE REASON I LIKE MD PATHWAYS HERE IS BECAUSE YOU GUYS ALREADY HAVE ALL THE PAPERWORK DONE. I MEAN, THIS IS THIS WAS READY TO GO. SUPPOSE IT WASN'T VETTED IN SUCH A MANNER THAT WE DO KNOW THAT THERE ARE OTHER SERVICES OUT THERE THAT MAY PROVIDE A BETTER SERVICE. THERE MAY BE SERVICES OUT THERE THAT PROVIDE A BETTER SERVICE. IF WE REALLY WANT TO SIT HERE AND GO THROUGH THE VETTING PROCESS FOR EVERY SINGLE SERVICE OUT THERE, I MEAN, I SUPPOSE THAT OPTION, I DON'T KNOW WHAT ALL THE PEOPLE ARE GOING TO DO. I GET SICK OR GET BIG BILLS FOR GOING TO THE EDITOR. DO YOU BELIEVE THAT WE SHOULD MAKE OUR DECISIONS BASED ON INFORMATION WE HAVE AVAILABLE? DO YOU FEEL THAT THAT INFORMATION WAS PROPERLY RESEARCHED? NO, SIR. OKAY. WELL, THEN. OKAY, NOW WE'RE GOING TO GO BACK AND FORTH. OKAY. ARE WE COOL? ALL RIGHT. OKAY, SO YOU DO FEEL THAT, IN FACT, WE MAKE OUR DECISIONS BASED ON INFORMATION WE HAVE AVAILABLE TO US. CORRECT? CORRECT. WHAT I WOULD WONDER IS WHY WE DON'T WANT TO PROCEED WITH THIS. IF YOU HAVE THE INFORMATION AVAILABLE TO YOU, ESPECIALLY IF IT'S ALREADY READY TO GO. YOU KNOW, BECAUSE AS THE INFORMATION HAS BEEN REVEALED TO US AT THIS POINT, WE DO FEEL THAT IF WE TAKE IT TO THE REFERENDUM, THAT DOES NOT MEAN THAT MD PATHWAY WOULD NOT BE ABLE TO COME BACK. BUT IT WILL GIVE US OPPORTUNITY AND OUR PUBLIC AND OUR CONSTITUENTS OPPORTUNITY TO, IF NOTHING ELSE. NOW, I'M NOT TALKING ABOUT ALL THE OTHER NUANCES THAT WE HAVE. I'M JUST GOING TO AND I HAVE SOME OTHER THINGS THAT I'LL DO AS OTHER PEOPLE COME. BUT RIGHT NOW I JUST WANT TO TALK ABOUT THIS VETTING PROCESS. YES, SIR. TO ME, IT DOES NOT HAVE TO BE MD PATHWAY. AND I'M SAYING TO YOU THAT I'VE JUST FOUND 15, 20 OTHERS ON HERE. I DON'T KNOW IF THEY ARE BETTER THAN OR WHATEVER. OKAY. BUT I WOULD LIKE TO KNOW THAT IF I'M GOING TO PUT SOMETHING FOR 80,000 HOMES AND 250,000 PEOPLE, THAT THEY'RE GETTING THE VERY BEST PRODUCT THAT THEY COULD POSSIBLY GET. DOES THAT MAKE SENSE TO YOU? THAT MAKES EXCELLENT SENSE TO ME. THANK YOU SIR. HAVING PREVIOUS EXPERIENCE WITH SOME OF THESE, INCLUDING TELADOC, WHICH WAS INSURANCE, COVERED THAT THROUGH MY COMPANY THAT I HAD, LIKE I SAID, I'M LUCKY ENOUGH TO HAVE INSURANCE AND GOOD WITH IT. THE PRODUCT WAS OKAY. THE WAIT TIMES WERE HORRENDOUS, AND I DIDN'T NECESSARILY HAVE A GOOD RESULT WITH THAT. NOW I KNOW ONE MAN'S EXPERIENCE IS NOT ANSWERED MY QUESTION. OKAY. THANK YOU VERY MUCH. COUNCIL MEMBER BEARD. I JUST WANT TO ADDRESS COUNCILMEMBER MOORE'S COMMENTS THERE. I'VE DONE RESEARCH ON TELEHEALTH. ALL OF THE ONES THAT I HAVE PULLED UP AND FOUND. YES, YOU CAN GET THEM. YOU CAN CALL. THERE'S THE NEW ONE, DOCTOR HOUSE. THERE'S SEVERAL OUT THERE. AMAZON HAS ONE. THEY ALL REQUIRE INSURANCE OR FOR YOU TO PAY FOR THAT SERVICE. SO THERE IS A COST FOR ALL THE ONES THAT I'VE RESEARCHED, WHICH HAS BEEN ABOUT SIX OF THEM, INCLUDING THE THE TELEHEALTH THAT COMES WITH MY PERSONAL INSURANCE. THERE IS A CO-PAY INVOLVED AND YOU MUST PROVIDE YOUR INSURANCE INFORMATION. THIS IS THE ONLY SERVICE THAT I HAVE FOUND THAT DOES NOT REQUIRE INSURANCE TO USE THE SERVICE. THANK YOU VERY MUCH. THANK YOU. I SEE NO OTHER QUESTIONS. THANK YOU. ALL RIGHT. THANK YOU ALL VERY MUCH. THANK YOU. COUNCIL. DID YOU. OKAY. COUNCIL MEMBER WILLIAMS, DO YOU HAVE A QUESTION FOR THE SPEAKER? YES. OKAY. YES, SIR. WHAT CITY ARE YOU? YOU MENTIONED SEVERAL TIMES THAT YOU'RE IN MS, RIGHT? YES, SIR. WHAT CITY? SO I'VE WORKED IN SEVERAL DIFFERENT CITIES. I'M CURRENTLY WORKING IN DALLAS. YOU WERE IN DALLAS? YES, SIR. AT A HOSPITAL. WHERE? I'M SORRY. AT A HOSPITAL IN DALLAS. SO YOU WERE THE EMERGENCY DEPARTMENT. YOU'RE WORKING AT A HOSPITAL? YES, SIR. IN DALLAS? YES, SIR. CURRENTLY. DO YOU MIND MENTIONING THE HOSPITAL? YES, SIR. TEXAS HEALTH ALERT. OKAY. ALL RIGHT. THANK YOU. THANK YOU, SIR. ALL RIGHT. NO OTHER QUESTIONS. THANK YOU. THANK YOU VERY MUCH. MADAM SECRETARY, WOULD YOU PLEASE CALL OUR NEXT SPEAKER? ETHAN. ADAM NEWMAN AND ON DECK, AMANDA MADDOX. GIVE YOUR NAME AND ADDRESS. FOR THE RECORD, YOU HAVE THREE MINUTES. MY NAME IS ETHAN ADAM NEWMAN. I RESIDE AT 217 SOUTH GARLAND AVENUE, APARTMENT ONE TWO, TWO ONE. GARLAND, TEXAS, 75040. GOOD EVENING AGAIN. COUNCIL. MY NAME IS ETHAN ADAM NEWMAN. I HAVE LIVED IN GARLAND FOR ONLY ONE YEAR, AS YOU MIGHT REMEMBER, BUT I HAVE SHOPPED HERE AND ENGAGED HERE WITH PEOPLE HERE FOR MANY YEARS, WHICH FUELED MY INTEREST IN LIVING HERE FULL TIME. AND I'M HAPPY TO BE PART OF THIS COMMUNITY. I WANT IT TO BE. I WANTED TO COME BY AGAIN HERE TO EXPRESS MY SUPPORT AS A RESIDENT HERE, AND JUST AS SOMEONE WHO BELIEVES IN SOMETHING LIKE THIS FOR TELEHEALTH AND ITS POTENTIAL BENEFITS FOR THE COMMUNITY. I BELIEVE IN SYSTEMS FREE AT THE POINT OF SERVICE. [01:10:06] I BELIEVE THESE SYSTEMS HELP PEOPLE IN MANY WAYS, LIKE GIVING PEOPLE THE PEACE OF MIND, OF KNOWING THEY DON'T NEED TO WORRY ABOUT BILLING FOR HELP. WE'VE OTHERWISE PUT BEHIND PAY WALLS QUESTIONS WHOSE ANSWERS CAN MEAN THE DIFFERENCE BETWEEN SOMEONE GETTING HELP FOR DANGEROUS SYMPTOMS, AND THAT SAME PERSON DYING FROM PREVENTABLE ILLNESS CAUSED BY IGNORING THOSE SYMPTOMS. WE HAVE THE POWER TO ASSIST IN PREVENTING ILLNESS IN OUR NEIGHBORS. TO ME, THAT'S WHAT COMMUNITY IS ALL ABOUT BANDING TOGETHER AND MAKING SURE EVERYONE IS LIVING THE BEST LIFE THAT THEY CAN. I BELIEVE THIS PROGRAM IS A VALUABLE POTENTIAL GOOD. AND THOUGH SOME MAY BE LUCKY ENOUGH NOT TO NEED IT, I AND MANY OTHERS BELIEVE IT IS WORTH THE SMALL PRICE TO MAKE SURE THAT OUR FELLOW ISLANDERS GET ACCESS TO FREE, POTENTIALLY LIFE SAVING HELP THROUGH TAP TELEHEALTH. PEOPLE WHO PUT OFF DOCTOR VISITS ARE MORE COMMON THAN EVER NOWADAYS. I MYSELF AM GUILTY OF THAT. I'M SURE I'M NOT THE ONLY ONE HERE. I KNOW PEOPLE WHO FREAK OUT OVER NEW FOUND PAIN IN THEIR ABDOMEN OR MAYBE UNDER THEIR CHIN, MAYBE THEIR LYMPH NODE OR SOMETHING. OR MAYBE IN THEIR HEAD. PEOPLE YOU KNOW, THEY MAKE MENTAL, MENTAL EFFORTS TO IGNORE THOSE SO THAT THEY CAN JUSTIFY NOT SPENDING MONEY ON IT TO GET IT CHECKED OUT BY AN ACTUAL BY A DOCTOR, LIKE, IN PHYSICAL FORM, ESPECIALLY IF THEY DON'T HAVE HEALTH INSURANCE, WHICH IN THIS COUNTRY IS AN UNFORTUNATE REALITY FOR MANY WITH TAP. TELEHEALTH. THOSE PEOPLE CAN GET REAL HELP FROM REAL PHYSICIANS. PEOPLE CAN GET EXPERT KNOWLEDGE TO HAVE A BETTER UNDERSTANDING OF WHERE TO GO NEXT, ALL WELL, THEIR HARD EARNED MONEY IS STILL IN THEIR POCKETS. I BELIEVE IN THIS PROGRAM AND OTHERS LIKE IT. I THINK THESE CAN DO MORE GOOD THAN SOME PEOPLE MIGHT THINK. I UNDERSTAND TIMES ARE TOUGH NOW, AND IT MAY SEEM LIKE EVERY CENT SAVED MATTERS MORE THAN EVER FOR THOSE PEOPLE. I MEAN, YOU'VE HEARD IT HERE MANY TIMES. THEY CAN JUST OPT OUT, YOU KNOW? AND YOU KNOW, WHETHER OR NOT IT COULD BE AN EASIER ADVERTISEMENT AS TO HOW TO OPT OUT. I BELIEVE IT SHOULD BE EASIER IF THEY COULD, IF THEY COULD FIX THAT. IF THAT IS A PROBLEM RIGHT NOW, PLEASE DO SO. BUT THE POINT THE POINT IS YOU COULD OPT OUT, YOU KNOW? BUT I BELIEVE IT'S A DUTY OF MINE AS A RESIDENT OF GARLAND TO HELP THE PEOPLE AROUND ME. AND BECAUSE OF THAT, I'LL PAY THE BILL GLADLY, KNOWING I'VE HELPED THE PEOPLE AROUND ME SO THAT THEY CAN CONTINUE MAKING THIS COMMUNITY GREAT. THANK YOU. EXCUSE ME. THANK YOU SIR. NO QUESTIONS. THANK YOU VERY MUCH. THANK YOU. MADAM SECRETARY, WOULD YOU PLEASE CALL OUR NEXT SPEAKER? AMANDA MADDOX AND ON DECK, DAVID NANCE DOERFER. MY APOLOGIES. I GOT THAT WRONG. YOUR NAME AND ADDRESS? FOR THE RECORD, YOU HAVE THREE MINUTES. AMANDA MADDOX, THREE FIVE, ZERO SIX CLOVER MEADOW DRIVE, GARLAND, TEXAS, 75043. I'VE LIVED IN GARLAND FOR 25 YEARS AND HAVE A COMPUTER SCIENCE DEGREE AND AN M.B.A., M.D. PATHWAYS IMPLEMENTATION VIA GARLAND UTILITY SOFTWARE ADDS UNNECESSARY TECHNICAL DEBT. AS LEADERS, YOU UNDERSTAND THAT SYSTEM INTEGRITY IS IMPORTANT. GARLAND UTILITY SOFTWARE IS CRITICAL AND IS LINKED TO MANY DOWNSTREAM SYSTEMS. THE SOFTWARE SHOULD REMAIN FOCUSED ON ESSENTIAL SERVICES LIKE ELECTRICITY AND WATER, RATHER THAN SERVING AS A BILLING CLEARINGHOUSE FOR A PRIVATE COMPANY. I DID SOME RESEARCH, AND THE MD PATHWAYS WEBSITE IS BUILT ON WORDPRESS. I FOUND A WORDPRESS MODULE CALLED SIMPLE PAY THAT MANAGES THE COLLECTION OF MONTHLY FEES FROM USERS. IT COSTS ABOUT $400 A YEAR. MY RESEARCH ALSO FOUND DOCTOR ADAM MURDOCK ON NAME AND SCHOOL ROAD IN GARLAND. HIS WEBSITE STATES, AND I QUOTE, WE WANT TO REMOVE THE BARRIERS TO ACCESS. SO ON HIS WEBSITE, THERE'S A LINK TO PAYPAL TO COLLECT A $60 MONTHLY RECURRING MEMBERSHIP FEE, WHICH INCLUDES, AND I QUOTE, NO PHYSICIAN VISIT CHARGES SIMILAR TO WHAT MD PATHWAYS IS OFFERING. EVEN HOPE CLINIC, A NONPROFIT IN GARLAND, MANAGES RECURRING DONATIONS VIA CREDIT CARD AND ACH ON ITS OWN WEBSITE. THESE TWO ORGANIZATIONS IN GARLAND CAN MANAGE THEIR OWN BILLING ONLINE. MD PATHWAYS CAN ALSO. COUNCIL MEMBERS HAVE BEEN VOCAL ABOUT SERVICE IMPROVEMENTS BEFORE, AND BECAUSE OF THIS, MD PATHWAYS EXPANDED THEIR SERVICE FROM TEXT ONLY TO INCLUDE PHONE CALLS. NOW IS THE TIME TO BE VOCAL ABOUT TECHNOLOGY INDEPENDENCE. [01:15:05] THERE IS NO TECHNICAL REASON FOR GARLAND TO ADD THIS SEVEN YEAR TECHNOLOGY BURDEN IN A $400 PER YEAR MODULE COULD SOLVE THIS PROBLEM IF MD PATHWAYS SERVICE IS VALUABLE, ADDING AN ENROLL NOW OPTION ON ITS WEBSITE WILL SUCCEED WITHOUT HAVING TO CHANGE THE GARLAND UTILITY SOFTWARE TECHNOLOGY MOVES VERY FAST, AND UPDATING THE GARLAND UTILITY SOFTWARE FOR MD PATHWAYS IS NOT ADVISABLE. I URGE YOU TO DIRECT MD PATHWAYS TO UPGRADE THEIR WEBSITE TO ACCEPT PAYMENTS, JUST AS OTHERS DO IN GARLAND. THANK YOU MA'AM. QUESTION FOR YOU MAYOR PRO TEM LUCK. SO AS THIS IS PRESENTED, YOU ARE NOT IN FAVOR OF THE PROGRAM BECAUSE OF THE TECHNOLOGICAL DEFICIENCIES THAT YOU SEE IN IT. YES. I THINK THAT MD PATHWAYS IS AN EXCELLENT SERVICE. IT JUST NEEDS TO PROVIDE ITS OWN BILLING AND WILL SOLVE ALL THESE PROBLEMS. SO IN THE WE'RE TALKING ABOUT THOUGH, GOING TO THE BALLOT TO ADD A UTILITY FEE TO THE WATER BILL, WHICH IS THE SOFTWARE THAT WE'RE TALKING ABOUT. CORRECT. SO YOU'RE NOT IN FAVOR OF IT? NO, I WOULD NOT TO REFERENDUM. I WOULD NOT GO TO REFERENDUM AT THIS POINT. I WOULD REQUEST THAT YOU WOULD ASK MD PATHWAYS TO UPGRADE THEIR WEBSITE, POSSIBLY USE THIS $400 PER YEAR TO DO THAT, AND ALLOW PEOPLE TO ENROLL THROUGH THAT. THANK YOU, COUNCILMEMBER WILLIAMS. YES, THANK YOU MAYOR. GOOD EVENING. GOOD EVENING. COULD YOU TELL ME A LITTLE BIT ABOUT YOUR YOUR FIRST YOUR YOUR TECH BACKGROUND, PLEASE? YES. I'VE BEEN WRITING CODE FOR 25 YEARS IN THE GARLAND AREA. I AM CURRENTLY WORKING FOR A CONSULTING FIRM THAT IMPLEMENTS SOFTWARE FOR MANY BUSINESSES. AND ARE YOU FAMILIAR WITH THE BILLING SYSTEM THAT'S USED BY WATER UTILITIES DIVISION? I DO NOT KNOW THE ACTUAL SOFTWARE THAT'S BEING USED, BUT I DO KNOW THAT IT IS A GREAT COST TO ADD THIS $6 FEE, WHEREAS WE COULD USE THIS OTHER WORDPRESS MODULE FOR $400 A YEAR. AND IF, IF, IF THAT AFFECTED ALL THE OTHER BUILDINGS, THAT CITY BUILDS EVERYTHING. I MEAN, ALL KIND OF STUFF. ALL RIGHT. IF IF, IF YOU MADE CHANGES TO THOSE PROGRAMS, WOULD THAT MAKE A DIFFERENCE? WELL, IF IF EMPTY PATHWAYS COULD COLLECT ITS OWN FEES, THEN YOU WOULD NOT HAVE TO CHANGE ANYTHING ON THE GARLAND UTILITY SOFTWARE. AND HAVE YOU HAD THIS CONVERSATION WITH OUR I.T. EXPERT? I HAVE NOT. WOULD IT BE BENEFICIAL FOR YOU TO HAVE THAT CONVERSATION WITH ME? PATHWAYS AND WITH OUR OUR TECHS? WELL, IDEALLY, WE WOULD HAVE THE CONVERSATION WITH MD PATHWAYS TO UPGRADE THEIR TECHNOLOGY SO THAT GARLAND IT DEPARTMENT WOULD NOT BE INVOLVED AT ALL. AND YOU HAVE NOT WANT TO BE CLEAR. YOU HAVE NOT HAD THAT CONVERSATION. I HAVE NOT HAD THAT CONVERSATION, NO. IS MY MEMORY SHORT? THIS IS THE FIRST TIME YOU'VE COME BEFORE THE COUNCIL. I, I CAME TO THE OPEN COMMENTS LAST MONTH. YOU OKAY? ALL RIGHT. SO YOU MEAN TWICE? YES. OKAY. ALL RIGHT. THANK YOU. MAYOR. OKAY. COUNCIL MEMBER. DUTTON. CAN SOMEONE JUST SO I DON'T SPEAK OUT OF POCKET? CAN WE VERIFY WHAT THE ADDING THE $6 CHARGE TO OUR SOFTWARE IS ACTUALLY COSTING? BECAUSE I KNOW THAT THERE'S BEEN A LOT OF CONFUSION OVER THE THE UPGRADES THAT WE NEEDED TO DO TO OUR BILLING SYSTEM THAT HAD TO. THEY WERE ALREADY IN PROCESS, AND WE WERE WE HAD TO COVER THAT EXPENSE ANYWAY. AND I KNOW THAT IT'S LIKE 80,000. IF YOU CAN HELP WITH THAT. YES, MA'AM. THE THE COST TO UPGRADE THE SOFTWARE TO ADD THE $8 CHARGE WAS ABOUT $80,000. AND IT'S BEING PAID FOR BY MD PATHWAYS PURSUANT TO THE CONTRACT. I JUST WANTED TO MAKE SURE THAT WE HAD THAT CLARIFIED, BECAUSE IF I MEAN, IF THAT'S THE ONLY REASON OR IF THAT'S THE MAIN REASON FOR BEING IN OPPOSITION, I JUST WANTED TO MAKE SURE THAT EVERYONE WAS AWARE THAT OUR SOFTWARE IS ALREADY AT THE UPDATE DID ALREADY START PRIOR TO THIS COMING TO COUNCIL, AND THAT MD PATHWAYS WAS COVERING THE ADDITIONAL EXPENSE. [01:20:06] SO THEN YOU HAD MENTIONED ABOUT DOCTOR MURDOCH AND THE HOPE CLINIC BOTH TAKING PAYMENTS ON THEIR SITE THE HOPE CLINIC, THEY ONLY ACCEPT DONATIONS ON THEIR WEBSITE. CORRECT? THAT IS CORRECT, BUT IT IS A RECURRING FEE THAT YOU CAN ADD. AND DOCTOR MURDOCH, YOU SAID IT'S $60 AND THAT'S LIKE LIKE IN HOUSE INSURANCE TYPE OF SITUATION IS THAT. YEAH. SO DOCTOR MURDOCH DOES NOT TAKE HEALTH INSURANCE AT ALL. HE HAS HIS PRICES LISTED ON HIS WEBSITE. AND YOU CAN SIGN UP FOR $60 PER MONTH FOR UNLIMITED VISITS. AND HE DOES TELEHEALTH. I DON'T KNOW HOW MANY PATIENTS DOCTOR MURDOCH SEES, BUT I WOULD ASSUME THAT HE DOESN'T HAVE A QUITE THE LOAD THAT THE CITY OF GARLAND WOULD HAVE IMPLEMENTING THIS PROGRAM. AND THEN ON THE HOPE CLINIC, THEY, THEY ALSO THEIR PROGRAM IS STRUCTURED VERY DIFFERENTLY THAN I. WE'VE ONLY LEARNED PART OF HOW THEIR, THEIR SOFTWARE AND ALL OF THEIR PROGRAMING IS FUNDED. AND THEY WERE GIFTED FROM BAYLOR. I MEAN, IT'S A WHOLE THING, SO THEY DON'T EVEN COVER THE COST OF THAT. SO THE THE POINT THOUGH, IS THAT THEIR OWN WEBSITES ARE THE CLEARINGHOUSE FOR THEIR DONATIONS OR FOR THEIR PATIENT FEES. SURE, SURE. AND SO THE POINT IS, IS THAT MD PATHWAYS FOR A SMALL FEE PER YEAR COULD DO THE SAME. AND I AND I UNDERSTAND THAT THE POINT I'M TRYING TO SAY IS WHEN DOCTOR MURDOCK IS TAKING PAYPAL, I DON'T I FEEL LIKE A LOT OF PEOPLE ARE GOING TO QUESTION PAYPAL. TO CLARIFY, IT IS A PAYPAL LINK THAT ALLOWS ANY CREDIT CARD OR ANY ACH TO BE USED. AND THAT'S I MEAN, THAT'S HOW PAYPAL IS SET UP. BUT I'M JUST SAYING, IF I WERE TO GO ON AND SOMEONE WANTED ME TO PAY PAYPAL, I WOULD I WOULD DEFINITELY QUESTION THE SKETCHINESS OF IT. BUT YEAH. THE POINT IS THAT I UNDERSTAND THAT THEY CAN PROCESS THEIR OWN PAYMENTS. THAT IS, IT IS A THING, RIGHT? SO WHAT WHERE I'M GOING WITH THIS IS WHAT WOULD THAT JUST BECAUSE IT COSTS SOMEONE ELSE $400 ON A SMALL SCALE. I DON'T KNOW WHAT IT WOULD COST THEM ON A CITY OF GARLAND SCALE. SO THAT'S THAT'S ALL I WAS GOING WITH. THAT IS IT'S IT'S VASTLY DIFFERENT FROM THE WHOLE CLINIC TAKING DONATIONS OUT OF SOFTWARE THAT I MEAN, YOU DON'T YOU'RE NOT TRACKING DONATIONS LIKE YOU'RE TRACKING A MONTHLY SUBSCRIPTION TYPE OF SERVICE. AND THEN WHAT IS THE THE ACTUAL LABOR THAT YOU HAVE TO HAVE TO HAVE SOMEONE TO TRACK ALL OF THAT. THERE'S MULTIPLE DIFFERENT THINGS. AND SO I DO APPRECIATE YOU BRINGING THOSE TWO THINGS UP BECAUSE, I MEAN, I'M NOT AN IT PERSON. I'M NOT LIKE I LOCK MYSELF OUT OF MY EMAIL ALL THE TIME, LIKE I'M RESETTING PASSWORDS LIKE A MAD WOMAN AT ALL TIMES. SO THOSE ARE VERY VALID THINGS THAT YOU BROUGHT UP. AND SO THAT WAS JUST KIND OF WHERE MY BRAIN WAS GOING WAS WHAT IS THE THE LOAD OF PEOPLE THAT THEY'RE PROCESSING WITH THAT? WHAT IS THE LABOR TO HAVE SOMEONE TRACK THAT. AND THOSE ARE ALL THINGS THAT I DON'T HAVE ANSWERS TO. I'M ASSUMING NO ONE ELSE HAS THEM OFF THE TOP OF THEIR HEAD. SO. SO THE WORDPRESS MODULE THAT I WAS TALKING ABOUT WOULD BE ABLE TO HANDLE THE LOAD OF THE CITY OF GARLAND BECAUSE IT IS WORDPRESS MODULE WHICH CAN HANDLE VERY LARGE SCALE TRANSACTIONS. AS FAR AS THE STAFFING AND CONCERN WHAT YOU'RE TALKING ABOUT IS THE CITY OF GARLAND UTILITY DEPARTMENT WOULD BE THE STAFF FOR MD PATHWAYS TO HANDLE ALL CREDITS AND ALL QUESTIONS ABOUT THE BILLING INSTEAD OF MD PATHWAYS, HIRING A BILLING INDIVIDUAL OR CUSTOMER SUPPORT INDIVIDUAL SO THOSE COSTS WOULD BE PUT BACK ONTO MD PATHWAYS? YES. SO ARE YOU AWARE OF THE EMPLOYEES THAT MD PATHWAYS IS FUNDING FOR THE CUSTOMER SERVICE DEPARTMENT? YES, I'VE HAD HEARD THAT THERE IS A SIX MONTH INTERNS THAT ARE GOING TO BE COMING IN OR PART TIME, I GUESS WORKERS. YES. BUT AFTER THAT SIX MONTHS, THE SEVEN YEAR CONTRACT. SO YOU'LL HAVE SIX AND A HALF YEARS OF BILLING QUESTIONS THAT THE CITY OF GARLAND WILL HAVE TO PAY FOR INSTEAD OF HAVING [01:25:04] MD PATHWAYS HAVE THEIR OWN STAFFING. ONE OTHER NOTE THAT I DID WANT TO TALK ABOUT. SINCE WE'RE TALKING ABOUT CONTRACTS WITH GARLAND, I. I REALLY DON'T SEE A REASON WHY THIS ORGANIZATION HAS TO LIMIT ITSELF TO THE CITY OF GARLAND. MY DOCTOR IS IN MESQUITE. I DO TELEHEALTH WITH HIM IN MESQUITE. THERE'S NO REASON WHY THERE HAS TO BE A CONTRACT AT ALL FOR THIS OFFERING. A TEXAS MEDICAL LICENSE CAN TREAT ANY PATIENT THAT'S LOCATED IN TEXAS. SO IF M.D. PATHWAYS REALLY WANTS TO BE A DISRUPTOR IN THE INDUSTRY, IT COULD OFFER ITS SERVICES ONLINE THROUGH ITS OWN PAYMENT PROCESSOR. ANYBODY IN THE STATE OF TEXAS WOULD BE ABLE TO PAY THE $9 PER MONTH, AND HE'D BE ABLE TO HELP ANYONE IN TEXAS, NOT JUST IN GARLAND. SURE. I, I LOVE THAT YOU SAID THAT BECAUSE I'VE HAD THAT SAME THOUGHT PROCESS MYSELF LIKE I WOULD LOVE. I MEAN, OBVIOUSLY THAT WOULD PUT IT AS AN OPT IN OPT IN, WHICH IS WHAT, YOU KNOW, EVERYONE HAS SAID FROM THE BEGINNING, I DON'T THINK ANY OF US HAVE EVER QUESTIONED OR DEBATED THAT. LIKE WE ALL HAVE SAID, LIKE WE WISH IT WAS AN OPT IN. I WOULD LOVE TO SEE THEM BE ABLE TO OFFER IT TO THE ENTIRE STATE. I WILL NOT PRETEND TO KNOW THAT THEIR WHAT THEIR BUSINESS MODEL IS AND WHAT THE COST OF THAT WOULD BE OR ANYTHING. BUT I, I COULD SEE THE BENEFIT OF THAT, YOU KNOW. SO I DO I DO APPRECIATE THAT. AND I, I'M GOING TO GOOGLE WORDPRESS MODULE BECAUSE YOU SAY THAT IT SOUNDS VERY SERIOUS, BUT IT, IT MEANS NOTHING TO SOMEONE THAT IS NOT EXACTLY SO IT'S CALLED SIMPLE PAY IT. YEAH. IT'S A LITTLE WIDGET. YES. AND YOU CLICK THE BUTTON, YOU CONFIGURE IT AND YOU'RE GOOD TO GO. WELL YEAH. YOU LOST ME WITH THE WIDGET TOO. SO I APPRECIATE YOU. THANK YOU. I SEE NO FURTHER QUESTIONS. THANK YOU VERY MUCH. THANK YOU. MADAM SECRETARY, WOULD YOU PLEASE CALL OUR NEXT SPEAKER? DAVID MANNES AND UP ON DECK, MARISSA HETTINGER. GIVE YOUR NAME AND ADDRESS FOR THE RECORD. YOU HAVE THREE MINUTES. THANK YOU SIR. THANK YOU, HONORABLE COUNCIL MEMBERS AND MAYOR. MY NAME IS DAVID ALL FOR. I LIVE ON LOMAX LANE IN FORT WORTH, TEXAS. I'VE HAD THE PLEASURE OF WORKING WITH MD HEALTH PATHWAYS FOR OVER A YEAR, THOUGH I WILL STATE THAT I HAVE NO ACTIVE RELATIONSHIP WITH THEM, AND I'M HERE ON MY OWN. RIGHT, BECAUSE I BELIEVE IN THE SERVICE AND I'VE USED THE SERVICE A NUMBER OF TIMES. SO I'VE BEEN I'VE HAD THE PLEASURE OF SERVING AS THE PRESIDENTIALLY APPOINTED DEPUTY ASSISTANT SECRETARY OF HEALTH AT THE US DEPARTMENT OF HEALTH AND HUMAN SERVICES. I'VE HELPED TO OVERSEE PUBLIC HEALTH PROGRAMS RANGING FROM MENTAL HEALTH TO OPIOIDS TO SUBSTANCE USE ISSUES. AND I HAVE YET TO COME ACROSS A PROGRAM THAT HAS THE INNOVATION THAT THIS TYPE OF PROGRAM IS. AND I WANT TO TALK ABOUT SOME VARIOUS PUBLIC HEALTH ASPECTS TO WHY I THINK THIS IS VALUABLE TO THE CITY AND ITS RESIDENTS. THE FIRST IS ON A CONSUMER SIDE. IT'S ESTIMATED THAT ROUGHLY 18 TO 20% OF RESIDENTS IN THIS AREA ARE UNINSURED. THAT ADDED TO THE UNDERINSURED, WHICH I VERY MUCH APPRECIATED THAT QUESTION EARLIER. WHAT SHOWS THAT YOU HAVE PROBABLY AROUND 25 TO 30% OF PEOPLE THAT ARE UNINSURED, UNDERINSURED WITHIN THIS AREA, THE AVERAGE COST OF A TELEHEALTH VISIT WITHOUT INSURANCE NATIONWIDE IS ROUGHLY $75 TO $89. SO IF YOU TAKE THE MATH, THEY'RE $6 A MONTH EQUALS 72. SO FOR THE AVERAGE COST OF ONE UNINSURED TELEHEALTH VISIT NATIONWIDE, YOU HAVE THE ABILITY TO GIVE THIS TO UP TO TEN MEMBERS. WE'RE NOT EVEN TALKING ABOUT THE ECONOMIES OF SCALE TO TEN MEMBERS WITHIN EACH HOUSEHOLD THAT HAS A WATER UTILITY BILL AS A SECOND PART. WE ALSO TALK ABOUT ACCESS TO CARE. SO WE'VE MENTIONED THE HOSPITAL ISSUE THAT YOU ALL HAVE HERE IN GARLAND. WELL TEXAS IS CLASSIFIED AS 47TH OUT OF 50TH WHEN IT COMES TO ACCESS TO PRIMARY CARE PHYSICIANS. 88% OF TEXAS COUNTIES ARE CLASSIFIED AS MEDICALLY UNDERSERVED, WHICH MEANS THAT IF EVERYONE WANTED TO GO TO AN APPOINTMENT AT ANY PARTICULAR TIME, YOU WOULD HAVE A SIGNIFICANT ISSUE IN A NUMBER OF AREAS HERE IN TEXAS. SO YOU HAVE BOTH A ACCESS ISSUE AND YOU HAVE A COST ISSUE. AND FINALLY, JUST TO KEEP THIS SHORT WHEN WE TALK ABOUT REPRESENTATION THE AVERAGE VOTING TURNOUT IN THE LAST TWO ELECTIONS HAS BEEN BETWEEN 5 AND 8%. SO THAT EQUATES TO ROUGHLY 8000 TO 9000 VOTES IN THE LAST TWO MAYORAL ELECTIONS. [01:30:06] NOW, I WOULD TOTALLY UNDERSTAND IF THIS WAS ON THE GENERAL BALLOT IN FOR THE PRIMARIES IN MARCH, BUT THE FACT THAT IT'S IN THE MAY BALLOT SHOWS THAT YOU'LL HAVE A SIGNIFICANTLY LESS REPRESENTATION THAT HAS THIS CONVERSATION. SO IF YOU TAKE THE MATH OF OF 150,000 TO $200,000 TO PLACE THIS BALLOT QUESTION ON THIS ELECTION, YOU COULD PAY FOR 2100 TO 2500 PEOPLE TO ACTUALLY HAVE THIS SERVICE HERE IN TEXAS. SO THAT'S THE VALUE PROPOSITION THAT YOU'RE PAYING FOR A NON-BINDING RESOLUTION THAT CARRIES THE LEGAL WEIGHT OF THE SAME QUESTIONS THAT POLITICAL PARTIES ASKED DURING PRIMARY ELECTIONS, WHICH IS NONE. AND IT DOESN'T PROVIDE ANY BENEFIT TO A, TO A CLIENT OR TO A VENDOR BECAUSE YOU ALL STILL HAVE THE BENEFIT OF A, I BELIEVE, A AT THE GOVERNMENT'S CONVENIENCE TERMINATION OF THIS CONTRACT EITHER WAY. AND SO I BELIEVE IN THE SERVICE I'VE USED, THIS SERVICE I DROVE DOWN BECAUSE I VEHEMENTLY THINK THAT GARLAND COULD BE ONE OF THE BEST AREAS OF THE COUNTRY TO IMPLEMENT SOMETHING LIKE THIS FROM A PUBLIC HEALTH PERSPECTIVE, AND I THANK YOU ALL FOR YOUR CONSIDERATION. DEPUTY MAYOR PRO TEM, THANK YOU FOR BEING HERE. WOULD IT SURPRISE YOU TO KNOW THAT GARLAND HAS YOU HAD MENTIONED UNINSURED WAS SOMEWHERE AROUND 20%. WOULD IT SURPRISE YOU TO KNOW THAT IT'S ACTUALLY ABOUT 25%, AND THAT THE UNDERINSURED IS ACTUALLY 18%. SO YOU ADD THOSE TOGETHER AND YOU HAVE 43%. THAT WOULD NOT SURPRISE ME. OKAY. THANK YOU. COUNCILMEMBER MOORE, THANK YOU. COULD YOU GIVE US YOUR PARTY AFFILIATION, YOUR NATIONAL AFFILIATION? SORRY. AGAIN, WHO YOU WORK FOR? I WAS A PRESIDENTIALLY APPOINTED MEMBER AS THE DEPUTY ASSISTANT SECRETARY OF HEALTH AT THE US DEPARTMENT OF HEALTH AND HUMAN SERVICES. PRESIDENTIAL APPOINTMENT TO GARLAND. ALL THOSE FACTS. THANK YOU SO VERY MUCH, SIR. WE GREATLY APPRECIATE THE INFORMATION. YES, SIR. ALL RIGHT. I SEE NO FURTHER QUESTIONS. THANK YOU. THANK YOU ALL FOR YOUR CONSIDERATION. MADAM SECRETARY, WOULD YOU PLEASE CALL THE NEXT SPEAKER, MARISSA HENNINGER. AND UP ON DECK. SUMMER WASSEF. GIVE YOUR NAME AND ADDRESS FOR THE RECORD, YOU HAVE THREE MINUTES. YES. MARISSA HETTINGER, 913 KINGSBRIDGE AVENUE IN GARLAND, TEXAS. ZIP CODE 75040. MAYOR AND COUNCIL MEMBERS, THANK YOU FOR LENDING US YOUR EARS THIS EVENING. I KNOW IT'S A LOT OF LISTENING TO DO, AND IT'S BEEN HAPPENING FOR WEEKS ON END. I LIVE AND WORK HERE IN GARLAND, AND I'M PROUD TO CALL THIS CITY HOME. I WANT TO START OUT BY THANKING THE COUNCIL FOR YOUR WILLINGNESS TO CONSIDER PLACING MD PATHWAYS HEALTH ISSUES BEFORE VOTERS. I APPRECIATE THE SHIFT TOWARDS TRANSPARENCY AND PUBLIC INPUT REGARDING THE MD PATHWAYS TELEHEALTH CONTRACT. GIVING RESIDENTS A VOICE IS AN IMPORTANT STEP TOWARDS RESTORING TRUST AROUND THIS PROPOSAL THAT HAS BEEN LOST. THAT SAID, I WANT TO ENCOURAGE THE COUNCIL TO BE VERY THOUGHTFUL ABOUT HOW THIS POTENTIAL BALLOT MEASURE IS STRUCTURED. WHILE I FULLY SUPPORT ACCESSIBLE HEALTHCARE OPTIONS AND MANY PEOPLE THAT I SPEAK TO DO. THE ISSUE THAT CONTINUES TO BE A CONCERN IS THAT OF THE AUTOMATIC ENROLLMENT MODEL TIED INTO OUR UTILITY BILLS. EARLIER TONIGHT, ANOTHER SPEAKER ASKED, HOW CAN WE GET PEOPLE BOUGHT IN? I PROPOSE TO YOU THAT THIS IS THE KEY. TONIGHT, PER THE AGENDA, COUNCIL WILL ALSO HEAR ABOUT RIGHT SITE AS WELL AS THE PARKLAND TELEHEALTH PILOT PROGRAM. AND OF COURSE, WE HAVE OTHER LONG STANDING COMMUNITY RESOURCES LIKE HEALTH HOPE CLINIC. MY QUESTION IS, HAVE YOU, AS COUNCIL, TAKEN A COMPREHENSIVE LOOK AT HOW ALL OF THESE OFFERINGS TOGETHER MIGHT MEET THE HEALTHCARE NEEDS OF OUR RESIDENTS WITHOUT REQUIRING MANDATORY ENROLLMENT IN A STARTUP TELEHEALTH PROGRAM THAT AUTOMATICALLY ENROLLS ALL HOUSEHOLDS IN BILLING. I REMAIN SKEPTICAL OF MD PATHWAYS FOR A FEW KEY REASONS. ONE, THE THE COMPANY HAS PROVIDED LITTLE TO NO DATA DEMONSTRATING THE EFFECTIVENESS OF THEIR MODEL. THERE'S A LOT OF TALK, THERE'S A LOT OF PERSONAL STORIES, BUT IT'S LIGHT ON DATA. THEIR MESSAGING FREQUENTLY EMPHASIZES THAT GARLAND DOES NOT HAVE A HOSPITAL, BUT THERE IS NO EVIDENCE THEIR PROGRAM WOULD CHANGE THAT REALITY, AND THEY HAVE NO TRACK RECORD OF BRINGING HOSPITALS TO ANY COMMUNITY THAT THEY OPERATE IN. THEY HAVE STATED THAT THEIR PROGRAM ONLY WORKS WITH FORCED ENROLLMENT OF ALL HOUSEHOLDS, WHILE ALSO CLAIMING THEY WOULD CONTINUE EVEN IF MOST RESIDENTS OPTED OUT. THESE STATEMENTS SEEM CONTRADICTORY, DON'T YOU THINK? [01:35:03] GIVEN THESE INCONSISTENCIES, I WOULD STRONGLY ENCOURAGE THE COUNCIL TO CONSIDER PLACING ON THE BALLOT AN OPT IN ALTERNATIVE, NOT AN AUTOMATIC ENROLLMENT WITH A FEE ADDED TO EVERY HOUSEHOLD. IF THIS PROGRAM IS TRULY VALUABLE, RESIDENTS WILL LINE UP TO SIGN UP FOR IT. I ALSO WANT TO ADDRESS WHAT MAY FEEL LIKE A LOOMING DEADLINE TO FINALIZE BALLOT LANGUAGE. IF THIS PROGRAM OR CONTRACT STILL NEEDS VETTING, IT IS OKAY TO SLOW DOWN. IT IS OKAY TO CANCEL THE CONTRACT AND GO BACK TO THE DRAWING BOARD, EVEN IF THAT MEANS THAT THE ITEM DOES NOT APPEAR ON THE BALLOT IN MAY. WHEN WE ARE TALKING ABOUT A PROGRAM THAT LITERALLY IMPACTS EVERY SINGLE HOUSEHOLD IN GARLAND. IT IS FAR MORE IMPORTANT TO DO IT RIGHT THAN IT IS TO DO IT FAST. MOST IMPORTANTLY, I HOPE THE COUNCIL WILL FULLY VET MD PATHWAYS NOW BEFORE SENDING THIS MEASURE TO VOTERS. THAT INCLUDES COMPARING THEIR SERVICES TO PROGRAMS WE ALREADY HAVE OR ARE CONSIDERING. GARLAND DESERVES A COMPLETE PICTURE OF ITS HEALTH CARE OPTIONS TO PROVIDE TO CITIZENS NOT A SINGLE, UNVERIFIED, UNPROVEN SOLUTION PRESENTED AS THE ONLY PATH FORWARD. AGAIN, THANK YOU FOR YOUR TIME, FOR YOUR SERVICE, FOR YOUR WILLINGNESS TO HEAR FROM RESIDENTS. I APPRECIATE THAT YOU'RE GIVING THE PUBLIC A CHANCE TO WEIGH IN, AND I HOPE THAT WHAT ULTIMATELY APPEARS ON THE BALLOT REFLECTS CAREFUL ANALYSIS, TRANSPARENCY, AND THE BEST INTEREST OF OUR COMMUNITY. I HAVE A QUESTION FOR YOU. MAYOR PRO TEM LOOKED HIGH. SO AS IT'S WRITTEN, YOU'RE NOT IN FAVOR OF THE LANGUAGE THAT WE'RE GOING TO BE TALKING ABOUT TONIGHT AND POSSIBLY VOTING ON TOMORROW. CORRECT? THANK YOU. COUNCILMEMBER WILLIAMS. GOOD EVENING. TELL ME A LITTLE BIT MORE ABOUT YOUR BACKGROUND. YOUR PROFESSIONAL BACKGROUND, PLEASE. OKAY. I'M AN EARLY CAREER RECRUITER CURRENTLY. I'VE ALSO SPENT PRIOR TO THAT EARLY IN MY CAREER, PROBABLY A DECADE WORKING IN NONPROFITS IN THE DALLAS, TEXAS AREA MANAGING VOLUNTEERS AND LEARNING AND EDUCATIONAL PROGRAMS. YOU MENTIONED YOU MENTIONED THAT YOU WERE IN ONE OF YOU MENTIONED THAT YOU WERE WORKING IN GHANA. YES. WHAT DO YOU DO IN GHANA? I RECRUIT EARLY CAREER PROFESSIONALS, INTERNS, APPRENTICES AND EARLY CAREER RECENT COLLEGE GRADUATES FOR JOBS. SO YOU RECRUITED, RIGHT? YES, SIR. RIGHT. HAVE YOU HAD ANY DISCUSSION WITH THE MD PATHWAYS REPRESENTATIVE? ANY OF THEM? I HAVE AT A BOOTH ONCE WHEN THEY WERE OUT AND I WAS UNIMPRESSED. I FELT LIKE I WAS NOT INFORMED OF THE OPT OUT WHICH I WAS WAITING TO HEAR ABOUT. I WAS OFFERED TO SIGN UP FOR THE PROGRAM, BUT NOT TO OPT OUT. WE PROVIDE ANY INFORMATION BY THE PERSON, PERSON OR PERSONS WHO APPROACHED YOU. YEAH, THEY I MEAN, THEY HAD INFORMATION AT THEIR BOOTH. I DIDN'T TAKE IT. OKAY. SO AND LOOKING AT THE LANGUAGE THAT'S IN HERE IN THE POST, AND YOU MENTIONED THAT WE SLOW DOWN AND MAYBE FINE TUNE THE LANGUAGE. GIVE ME SOME LANGUAGE THAT YOU WOULD LIKE TO SEE IN THAT. I THINK SPECIFICALLY, I WOULD LIKE TO SEE THIS BECOME A PROGRAM THAT RESIDENTS HAVE AVAILABLE TO THEM THAT THEY COULD SIGN UP FOR AND REGISTER FOR. I DO NOT BELIEVE ON ITS PREMISE THAT THIS WOULD NOT SUCCEED IF PEOPLE COULD SIGN UP FOR IT. THANK YOU SIR. I HAVE NO FURTHER QUESTIONS. THANK YOU. THANK YOU. MADAM SECRETARY, PLEASE CALL OUR NEXT SPEAKER. SUMMER WASSEF. AND ON DECK, NANCY, CLICK. YOUR NAME AND ADDRESS. FOR THE RECORD, YOU HAVE THREE MINUTES. OKAY. I DON'T GET A LITTLE EXTRA TIME. I, I, I HAVE BEEN I HAVE BEEN LENIENT ALL NIGHT. IF YOU'VE NOTICED, I YEAH, I WILL START CUTTING YOU OFF SO YOU HAVE TWO MINUTES AND 45 SECONDS NOW. NO, I KNOW I DON'T KNOW HOW THIS HAPPENS. THREE MINUTES BUT I SOMEHOW I BECOME LAST WHEN Y'ALL ARE TIRED OF LISTENING TO EVERYBODY BUT SUMMER WASSEF 2014 BROOKTREE DRIVE IN GARLAND. I CAME HERE TONIGHT BECAUSE I WANT TO ACKNOWLEDGE THOSE OF YOU WHO LISTEN TO THE COMMUNITY. THAT BROUGHT OPTIONS BACK TO THE TABLE AND ARE CONSIDERING ADDING THIS TO THE BALLOT FOR THE CITIZENS TO DECIDE. I HOPE THAT THIS IS THE FIRST STEP TOWARDS HEALING SOME OF THE DIVISIVENESS IN OUR CITY. JUST NEEDED. IT'S IMPORTANT TO EMPHASIZE AGAIN THAT THE FRUSTRATION MANY PEOPLE FELT CAME FROM BEING PLACED INTO A PROGRAM WITHOUT THEIR KNOWLEDGE AND [01:40:06] WITHOUT THEIR PERMISSION, AND WITH INCONSISTENT MESSAGING. THERE WAS ALSO DEEP CONCERN FOR OUR MOST VULNERABLE RESIDENTS, INCLUDING THE ELDERLY, THOSE WHO STRUGGLE WITH LITERACY, INDIVIDUALS LIVING WITH SEVERE MENTAL ILLNESS, AND IMMIGRANTS WHO ARE NOT FLUENT IN ENGLISH. AT THE SAME TIME THAT I HIGHLIGHT THESE VULNERABLE POPULATIONS, I WANT TO BE ABSOLUTELY CLEAR AGAIN. AND MAYOR I SAID THIS TO YOU BEFORE. I AM NOT OKAY WITH ANY OF THESE GROUPS BEING EXPLOITED BY OUR CITY OR BY THIS PROGRAM. I WILL SPEAK UP EVERY TIME I HEAR SOMEONE GETS EXPLOITED. IT IS NOT OKAY. I'LL BE THE PEOPLE'S ADVOCATE. LEADERSHIP SOMETIMES HAS TO CHANGE COURSE WHEN NEW INFORMATION COMES TO LIGHT. THAT IS NOT A WEAKNESS. THAT IS RESPONSIBLE GOVERNANCE. WHEN OUR LEADERS ARE WILLING TO REASSESS, TO LISTEN AND ADJUST, THEY DESERVE GRACE FOR DOING SO. GROWTH AND CORRECTION ARE SIGNS OF INTEGRITY, NOT INCONSISTENCY. I URGE YOU TO MAKE DECISIONS INDEPENDENTLY, NOT BASED ON FRIENDSHIPS OR ALLIANCES, BUT BASED ON WHAT IS ETHICAL, PROFESSIONAL, TRANSPARENT, AND IN THE BEST INTEREST OF THE MAJORITY OF THE CITIZENS. THAT WAS WHAT I CAME HERE TO SAY. BUT I NEED TO ADD I'M. I'M OVER AND OVER AND OVER. PEOPLE ARE LIKE, WELL, IT'S ONLY $6. IT'S $6. YOU KNOW, PEOPLE BUY A BEER FOR $6. THEY CHOOSE TO BUY A BEER FOR $6. I CAN GO OUT AND BUY A $15 DUBAI CHOCOLATE BAR, BUT I CHOOSE NOT TO. I DON'T WANT TO SPEND $15 ON A CHOCOLATE BAR. I DON'T I DON'T NEED THIS PROGRAM. BUT IF IT WAS AN OPT IN PROGRAM, I WOULD BE ONE OF THE FIRST PEOPLE TO STEP UP AND SAY, I'LL PAY FOR ANOTHER CITIZEN FOR ONE YEAR IF THEY NEED THIS. I BELIEVE IN HEALTHCARE. I BELIEVE IN OUR COMMUNITY GETTING HELP, AND I COULD PROBABLY ENCOURAGE MANY OTHER HOUSEHOLDS TO DO THE SAME. BUT THE FACT THAT IT'S FORCED UPON US THAT WITHOUT KNOWLEDGE IS WHAT PEOPLE ARE UPSET ABOUT. THEY'RE NOT UPSET THAT A HEALTH CARE PROGRAM IS AVAILABLE TO GARLAND RESIDENTS UPSET ABOUT THE WAY IT WAS IMPLEMENTED. QUESTION FOR YOU, MAYOR PRO TEM. SO IF THIS WERE TO GO TO A REFERENDUM, IT WOULDN'T CHANGE THE OPT OUT NATURE OF THE PROGRAM. IT WOULDN'T. SO MY UNDERSTAND. SO WHAT WOULD IT DO? IT WOULD GIVE US THE AUTHORITY TO PUT TELEHEALTH SERVICES BY A FEE ON A UTILITY BILL. SO WE CAN WE CAN VOTE AGAINST THAT AND THEN IT WOULDN'T BE PUT ON THERE. RIGHT. IF IF IT DIDN'T PASS. RIGHT. BUT IF IT DID PASS. BUT IF THE REFERENDUM DID PASS, THEN IT WOULD STILL BE AN OPT OUT PROGRAM AND IT WOULD STILL COST $6. CORRECT. BUT THAT WAY, TAKE IT TO YOUR VOTERS, WHICH ARE NOT 4000. I BELIEVE IN THE LAST ELECTION IT WAS BETWEEN 7 AND 8. THAT WAS A MAYORAL RACE. THAT WAS HIS POINT. IT WAS A MAYORAL RACE. EVERY OTHER YEAR WE HAVE A MAYORAL RACE AND THE THE PERCENTAGE OF REGISTERED VOTERS INCREASES SIGNIFICANTLY DURING A MAYORAL RACE. SO USUALLY IT'S BETWEEN 1.5 AND 3% OF THE REGISTERED VOTERS THAT GO OUT A LARGE A NON MAYORAL, A VERY LARGE GROUP IN THE COMMUNITY THAT'S WILLING TO GO DOOR TO DOOR TO EDUCATE PEOPLE ON THIS REFERENDUM. SO YOU WOULD WANT IT TO NOT PASS. CORRECT? CORRECT. OR YOU GUYS CAN GO BACK TO THE DRAWING BOARD. I DON'T WANT IT TO PASS BECAUSE I DON'T THINK IT'S RIGHT. I DON'T THINK IT'S RIGHT FOR OUR CITIZENS. I DON'T THINK IT'S RIGHT FOR A COMPANY TO MAKE A LOT OF MONEY OVER THE FACT THAT PEOPLE AREN'T AWARE THAT THIS IS HAPPENING. MY OWN, AS MUCH AS I'VE BEEN OUTSPOKEN ABOUT THIS, I DIDN'T REALIZE MY OWN NEXT DOOR NEIGHBOR HAD NO IDEA WHAT MD HEALTH WAS, THAT THIS WAS HAPPENING. I GUESS I GUESS MY CURIOSITY LIES IN THAT YOU'RE OKAY. IF IT PASSES, YOU'LL STILL BE UPSET ABOUT THE PROGRAM, BUT IT'S OKAY IF IT PASSES BECAUSE THEN WE'VE GONE TO THE VOTERS. BUT YOU HOPE THAT IT DOESN'T PASS, SO WHY EVEN GO TO THE VOTERS? WHY NOT JUST CANCEL THE CONTRACT? PLEASE DO. I'M FINE WITH THAT. I'M SORRY. IT'S A LOT OF MONEY TO TO BANK ON. MAYBE IT DOESN'T. PLUS, HE'S ALREADY SAID THAT HE'S PULLING OUT AND CANCELING THE CONTRACT IF WE GO TO REFERENDUM. SO IT JUST SEEMS LIKE A NONSTARTER TO ME TO EVEN GO TO BALLOT. SO I THINK IF YOU'RE ASKING MY OPINION AGAIN, LIKE I SAID, I'M NOT HERE. I'M HERE TO PRAISE YOU GUYS ALSO. OKAY. I'M HERE TO PRAISE YOU FOR THE DECISION. WELL, MAYBE NOT YOU IF YOU DON'T WANT TO BE PRAISED, BUT YOU ARE BRINGING IN OTHER OPTIONS TONIGHT, CORRECT? THESE AREN'T. THESE AREN'T THE SAME. [01:45:02] OKAY. BUT IT'S STILL ANOTHER OPTION THAT COULD HELP OUR COMMUNITY. CORRECT? YES, BUT THIS IS THIS IS ACCESS TO A DOCTOR. THE OTHER OPTIONS ARE ONE. YOU ALREADY HAVE PARKLAND HEALTHCARE. AND THE OTHER ONE IS YOU HAVE TO CALL 911 FIRST AND AN EMERGENCY VEHICLE HAS TO COME TO YOU. AND YOU'RE STILL UTILIZING EMS SERVICES, AND TEXTING IN AN EMERGENCY VEHICLE CAN COME TO MY HOUSE. SURE, IF YOU HAVE A FEVER AND YOU NEED TO GO TO THE ER FOR A FEVER AND MAYBE SOME ANTIBIOTICS AND USE AN AMBULANCE FOR THAT. GREAT. SO? SO, JUST SO YOU KNOW, NO MATTER WHAT, THE PEOPLE THAT ARE, ARE, ARE PARANOID AND WORRIED ABOUT THEIR HEALTH OR THEIR CHILD'S HEALTH, THEY'RE STILL GOING TO CALL 911 OVER THE LITTLE PETTY THAT YOU MIGHT THINK IS PETTY. THAT'S NOT GOING TO CHANGE. I DON'T THINK IT'S PETTY. THAT'S NOT MY POINT. OKAY. WELL, IT'S BEEN SAID OVER AND OVER. WELL, WE CAN REDUCE THE AMBULANCE CALLS. WE CAN REDUCE THE AMBULANCE CALLS. BUT. THERE'S PEOPLE TALKING OVER THERE. SO. SO I GUESS. YES, IF I HAVE, WE HAVE TO AGREE WITH WHAT THE MAJORITY MAJORITY OF VOTERS CHOOSE. CORRECT. I DIDN'T VOTE FOR DYLAN. HE KNOWS I DIDN'T VOTE FOR HIM, BUT I I'VE TOLD HIM THAT. BUT I ACCEPT HIM NOW BECAUSE THAT'S WHAT OUR CITY CHOSE. SO IF WE TAKE IT TO BALLOT AND PEOPLE VOTE THAT, YES, WE CAN PUT A FEE ON THE UTILITY BILL, WHETHER IT'S WITH MD HEALTH PATHWAYS OR NOT. WE SHOULD DO THAT. THEN I'M GOING TO SHUT UP AND I'LL TURN MY, MY, MY ADVOCACY INTO MAKING SURE THAT WE AS THE PEOPLE ARE EDUCATING OUR CITIZENS, NOT DEPENDING ON THE MAILERS, BECAUSE THERE'S ANOTHER ISSUE WITH THOSE MAILERS, HE SAID TONIGHT. 80,000 MAILERS WERE SENT OUT TWO WEEKS AGO. HE SAID 63,000 MAILERS WERE SENT OUT. SO WHAT'S TRUE HERE? THERE'S SO MUCH MISINFORMATION. I GOT ONE. BUT I, I UNDERSTAND TOTALLY WHERE YOU'RE COMING FROM. AND I MEAN, IF THEY'RE PULLING OUT, IF WE TAKE IT TO A BALLOT, I DON'T SEE WHY WE WOULD STAY IN THE CONTRACT IN THE FIRST PLACE. SO THERE'S THAT. TO ME, IT'S A I WOULD ENCOURAGE A MOOT POINT. LIKE I SAID EARLIER, I WOULD ENCOURAGE MD HEALTH TO FIND THEIR OWN BILLING SYSTEM AND LET PEOPLE OPT IN. AND THEY CAN ALSO START A CHARITY FUND. WE'LL DONATE. THANK YOU. ANOTHER QUESTION FOR YOU, MA'AM. COUNCIL MEMBER MORE. THANK YOU. SO YOU THINK, YOU KNOW, JUST. JUST. I THINK IT'S IMPORTANT RIGHT NOW. THIS IS A VERY GOOD TIME TO DO THIS, BECAUSE IT DOES APPEAR THAT THERE IS A CONFUSION AS IT RELATES TO WHY TAKING IT TO THE VOTERS IS SO IMPORTANT. AND SO, IN ANSWER TO THAT, I WOULD LIKE FOR OUR LEGAL TO HELP YOU AND HELP ME AND MAYBE HELP THE HELP ALL OF US TO UNDERSTAND WHAT DOES IT MEAN WHEN WE TALK ABOUT NON-BINDING. BECAUSE MY MY EXPLANATION, MY UNDERSTANDING OF THAT IS IT'S IMPORTANT THAT WE TAKE IT TO THE VOTERS, BECAUSE AT THAT POINT, THE VOTERS IN THIS REFERENDUM ARE GOING TO ALLOW US. WOULD YOU LIKE TO EXPLAIN? DO YOU WANT ME TO EXPLAIN IT FIRST? AND YOU COME BEHIND ME. OKAY. ALL RIGHT. AND I'M JUST EXPLAINING IT FROM MY PERSPECTIVE. AND WHAT I UNDERSTAND, TAKING IT TO THE VOTERS IS GOING TO GIVE THE VOTERS OPPORTUNITY TO ALLOW COUNCIL TO HEAR. WE'VE SAT HERE IN THIS ROOM SO OFTEN, THE SAME PEOPLE COME BEFORE US EACH TIME AS IT RELATES TO WHY THEY'RE AGAINST IT. AND THEN WHEN MD PATHWAY COMES, WE GET A LOT OF PEOPLE COMING IN THAT MAYBE NEW, BUT THEY'RE ALL FOR IT. PEOPLE THAT LIVE HERE, PEOPLE THAT DON'T LIVE HERE, PEOPLE WHO USE THE SERVICE, WHO HAVE NOT USED THE SERVICE. AND SO REALLY, WE REALLY JUST DON'T REALLY KNOW ABOUT OUR CONSTITUENCY AND WHAT THEY REALLY THINK ABOUT THIS PROGRAM BECAUSE WE HEAR THE SAME THING EACH WEEK. BUT WITH THIS REFERENDUM, IT WILL GIVE THE CONSTITUENCY OPPORTUNITY. AND REGARDLESS OF WHAT THAT CONSTITUENCY WOULD, WE KNOW THAT 5 TO 10% OF GALA NIGHTS MIGHT BE VOTING. WELL, THAT'S WHO YOU'RE GOING TO HEAR FROM THE ONES WHO PUT US HERE. YOU'RE GOING TO HEAR FROM THAT 5 TO 10%. IF IT'S 10%, THAT'S WHAT IT IS. BUT YOU'RE GOING TO HEAR IF, IN FACT, THIS COMMUNITY WANTS THIS SERVICE OR DON'T AT THAT POINT, NON-BINDING IS SOMETHING THAT I WANT OUR ATTORNEY TO MAKE US AWARE OF. AT THAT POINT, THIS COUNCIL WILL KNOW, LET'S SAY THAT THE VOTERS OVERWHELMINGLY SAY WE WANT THIS PROGRAM. [01:50:02] THIS COUNCIL WILL BE REMISS NOT TO APPROVE MD HEALTH PATHWAY. IF THE VOTERS OVERWHELMINGLY SAY NO, THEY DON'T WANT IT, THIS COUNCIL, THEN WHAT? THIS AGAIN, IS VOTE NOT VOTE IT DOWN. AND SO TO SAY THAT, WELL, YOU DO KNOW THAT EVEN IF IT PASSES THAT OPT OUT SERVICE IS STILL GOING TO BE THERE. OH, NO. THE ENTIRE PROGRAM, IT'LL BE JUST LIKE IT WAS. NOTHING WILL CHANGE THERE. WHAT HAS CHANGED IS THIS ONE PRIMARY THING YOU HAVE JUST TOLD COUNCIL THE BIDDING OF THIS CITY IS. AND IF THIS COUNCIL IS LISTENING, LOVES THIS COMMUNITY THE WAY THAT WE SAY IT DO. AND WE'RE GOING TO VOTE OVERWHELMINGLY TO GO IN THE DIRECTION OF WHAT? THE CITY STATE'S ATTORNEY, I THINK YOU DID A FINE JOB OF EXPLAINING IT. THE NON-BINDING ASPECT OF IT IS I WOULD PROBABLY TIE IT TO A COUPLE OF THINGS. THE FIRST BEING THE TARIFF AMENDMENT. IF THE VOTE, FOR EXAMPLE, WOULD COME BACK AS A NO, THE COUNCIL DOES NOT HAVE TO FOLLOW THAT VOTE. THEY CAN GO AHEAD AND VOTE TO AMEND THE TARIFF AND TO ALLOW FOR A SEPARATE ITEM LINE ITEM ON THE BILL, ON THE UTILITY BILL TO HAVE THE $6. IT WAS A YES. SAME THING. IF IT WAS A YES. THEY COULD ALSO VOTE NO. AND SO THAT'S WHAT IT'S MEANT BY NON NON BINDING. SO I PRIMARILY WOULD TIE THAT TO Y'ALL'S LEGISLATIVE DISCRETION IN HOW Y'ALL GOING TO AMEND OR NOT AMEND THE TARIFF LANGUAGE. I THINK IT'S IMPORTANT BECAUSE WHAT WE DO OFTENTIMES COME SIT DOWN THE WAY SUMMER IS DONE. WE ASK A QUESTION AND THEY DON'T ANSWER IT PROPERLY. THE NEXT THING THAT HAPPENS IS WE BIND THEM UP IN QUESTIONS, PUSH THEM IN DIRECTIONS THAT THEY DON'T SHOULDN'T EVEN BE GOING. I THINK THAT'S WRONG. AND I HEAR THAT. I'M GOING TO CALL IT OUT BECAUSE I LOVE THIS COMMUNITY. I LOVE THIS CITY. I TRULY BELIEVE THAT WE'RE PLAYING GAMES. DO PEOPLE LIKE THAT? DO YOU UNDERSTAND WHAT NON-BINDING MEANS? YES, SIR. SO I WOULD SAY TO THAT WHY, YOU KNOW, YOU'RE CONCERNED ABOUT SPENDING $200,000 ON IT. WHY EVEN SPEND THE $200,000? IF YOU CAN CHANGE? AND WE CAN. WE CAN CHANGE THAT TONIGHT. HOWEVER, BECAUSE THINK ABOUT WHAT HAS HAPPENED HERE. WE HAVE A 7 TO 2 VOTE. YOU HAVE SEVEN COUNCIL MEMBERS HERE WHO TRULY BELIEVE THAT THIS IS A GREAT PROGRAM AND UNDERSTAND SOMETHING. SOME OF THEM HAVE CHANGED. WELL, I'M JUST GOING WITH WHAT WE HAVE. I'M NOT DOING WHAT MAYBE AND UNDERSTAND SOMETHING I. I LOVE THIS COUNCIL. I RESPECT THIS COUNCIL. WHEN THEY COME WITH A 7 TO 2 VOTE, AS I STATED TO YOU AT THAT POINT. IT'S NOT I VOTED AGAINST IT AT THAT POINT, WE AS A COUNCIL, ME INCLUDED. I'M INVOLVED. I'M INVOLVED IN THAT VOTE. BUT I'M ALSO ONE WHO FEELS THAT WHEN WE HAVE A SITUATION OR WE HAVE NEW INFORMATION, OR WE MAKE OUR DECISIONS BASED ON THE INFORMATION WE HAVE AVAILABLE TO US, WHEN WE HAVE NEW INFORMATION THAT'S COMING FORWARD. AND THAT NEW INFORMATION RIGHT NOW IS SAYING THAT, HONESTLY, THERE IS SO MUCH CONFUSION IN OUR COMMUNITY. THAT'S WHERE THE PROBLEM IS. WE CANNOT CONTINUE TO GO FORWARD WITH OUR COMMUNITY DIVIDED MANNER BY WHICH IT IS. THAT'S WRONG. THAT'S NOT RIGHT. BUT FOR THIS COUNCIL AT THIS POINT TO SAY, WELL, NO, WE'RE JUST GOING TO VOTE, VOTE AGAINST IT. THAT IS TO SAY THAT MAYBE THEY THEMSELVES DIDN'T HAVE IT RIGHT TO BEGIN WITH. I DON'T WANT TO FEEL THAT WAY EITHER, BECAUSE I DO BELIEVE THAT THEY THEY DID. THEY LOOKED AT IT. THEY TOOK IT THROUGH DIFFERENT COMMITTEES AND SO ON AND SO FORTH. BUT I STILL BELIEVE IT WRONG TO OPT IN A 250,000 PEOPLE, 80,000 HOMES INTO A PROGRAM THAT THEY DIDN'T ASK FOR. THEY DON'T WANT IT NOW. DO THEY REALLY DON'T WANT IT? OR THAT'S JUST THE VOICES THAT WE HAVE COMING. WE HAVE THOSE VOICES COMING EVERY WEEK. ALRIGHT. BUT I SEE THE SAME FACES. NO, SIR, THEY REALLY DON'T WANT IT BECAUSE I DIDN'T START COMING HERE UNTIL TWO WEEKS AGO. AND THAT WAS AFTER I MADE AN EFFORT AND PUT A POLL ON FACEBOOK, ON THE FACEBOOK PAGE. AND BECAUSE I WANTED TO KNOW ALSO BECAUSE I KEPT HEARING Y'ALL SAY IT'S JUST A HANDFUL, IT'S JUST A HANDFUL OF PEOPLE ON SOCIAL MEDIA. SO I ASKED AND REMEMBER, IT WAS LIKE AROUND 377 PEOPLE THAT SAID THEY ARE NOT OKAY WITH THAT, AND 40 SAID THEY WERE OKAY. OKAY, I'M GOING TO BRING THIS TO A CONCLUSION. I'M GOING TO BRING THIS BECAUSE I THINK, YOU KNOW, I DON'T WANT TO HOLD THIS UP. [01:55:04] THE KEY RIGHT NOW IS YOU DO UNDERSTAND WHAT IT MEANS WHEN YOU SAY NONBINDING, AND YOU DO UNDERSTAND WHY IT ALMOST IMPOSSIBLE FOR US TO JUST STOP RIGHT NOW. AND FOR SEVEN COUNCIL MEMBERS TO SAY, WE'RE GOING TO VOTE AGAINST THIS. IT'S BEST AT THIS POINT. I DON'T SEE IT CAN'T BE A MATTER OF DOLLARS ANYMORE EITHER. THEY WON'T SPEND $250,000. WHAT ARE WE GOING TO DO? WE'RE GOING TO HEAL OUR COMMUNITY. WE'RE GOING TO BRING OUR COMMUNITY BACK TOGETHER, ESPECIALLY BECAUSE WE GOT TOO MANY OTHER ISSUES FACING US RIGHT NOW FOR THIS ISSUE TO HOLD US UP. YES. AND THAT'S WHAT I WANT TO SEE, IS THAT FOR OUR COMMUNITY TO HEAL. THANK YOU SO VERY MUCH, MR. MAYOR. THANK YOU SIR. COUNCILMEMBER WILLIAMS. CITY ATTORNEY, IS HE DONE WITH ME? I WON'T BE AS CAN BE, AS ELOQUENT AS IT IT EXPLAIN TO TO THE PEOPLE HERE, THIS COUNCIL AGAIN. THE NECESSITY OF THE VOTE BALLOT LINKED TO THE REQUIREMENT TO PASS AN ORDINANCE IN ORDER TO FOR THIS PROGRAM TO BE EFFECTIVE. YES, PLEASE. IT'S NOT A NECESSITY. I THINK COUNCILMAN MOORE DID A GREAT JOB OF EXPLAINING THE PURPOSE OR THE RATIONALE FOR WHY YOU MIGHT WANT TO TAKE IT TO A VOTE AND THAT BEING GETTING GETTING A BETTER IDEA OF WHAT VOICES THAT Y'ALL HAVEN'T HAD THE OPPORTUNITY TO HEAR YET, WHAT THEY'RE FEELING ON IT. BASICALLY WHAT YOU'RE DEALING WITH WHEN YOU'RE WHEN YOU'RE ASKING FOR THE COMMUNITY TO DO A NON-BINDING VOTE ON A MATTER LIKE THIS IS YOU'RE TAKING A STRAW POLL AND IT'S GIVING Y'ALL INFORMATION. IT'S INFORMING Y'ALL AS Y'ALL DECIDE AND AS Y'ALL DELIBERATE ON HOW YOU MIGHT WANT TO VOTE, TAKE LEGISLATIVE ACTION IN AMENDING THE UTILITY TARIFF OR THE UTILITY ORDINANCE, HOWEVER YOU MIGHT WANT TO CALL IT, TAKING IT FROM WHATEVER THE PEOPLE SAY, RIGHT? IN CASTING THAT VOTE. RIGHT. YOU COULD DO THAT, OR YOU COULD CHOOSE NOT TO GO? YEAH. EITHER WAY, I MEAN. BUT IT WOULD HAVE TO BE AFTER THE VOTES HAVE BEEN CAST, RIGHT? NO, Y'ALL WOULD. LEGISLATIVELY, Y'ALL STILL HAVE THE DISCRETION TO CHANGE THE ORDINANCE PRIOR TO THE RESULTS OF THE VOTE, IF THAT'S WHAT YOU WANTED TO DO. BUT IF THE VOTE COMES BACK, NAY OR YAY, IT INFLUENCES IT JUST DOESN'T INFLUENCE IT. IT DOES NOT INFLUENCE IT IN A LEGAL SENSE. IT MIGHT INFORM. IT SHOULD INFORM YOU AS TO WHAT YOUR CONSTITUENTS MAY WANT IN REGARD TO THAT. OKAY. THAT'S THAT'S THAT'S YOUR YOUR POINT. OKAY. ALL RIGHT. THANK YOU. THANK YOU, MR. CITY ATTORNEY. THANK YOU. THANK YOU. I JUST I'M SORRY. I HAVE A QUESTION FOR YOU. I JUST HAVE SOMETHING TO SAY FOR COUNCIL. SO, ARE WE IN PUBLIC COMMENTS OR ARE WE DISCUSSING AGENDA ITEM NUMBER SEVEN? BECAUSE THERE SEEMS TO BE QUITE A BIT OF TOPIC. I AGREE IT SHOULD BE DIRECTED AT THE SPEAKERS. YES. THANK YOU MAYOR. I WOULD APPRECIATE IT IF YOU WOULD KEEP THE COUNCIL'S QUESTIONS DIRECTED TO THE SPEAKERS. WE'VE BEEN HERE FOR TWO HOURS, AND I THINK THAT IT HASN'T BEEN A WASTE OF TIME. BUT WE HAVE SPENT TIME DISCUSSING AN AGENDA ITEM THAT WE HAVEN'T EVEN PROCEEDED TO GET TO, AS OPPOSED TO THE TASK AT HAND, WHICH IS OUR RESPONSIBILITY. RIGHT HERE IS TO ASK A QUESTION BASED UPON SPEAKER COMMENTS. I AGREE, SIR, THANK YOU FOR THAT. AND THANK YOU FOR YOUR COMMENTS. EVEN THOUGH YOU DIDN'T VOTE FOR ME, I'M HAPPY TO REPRESENT YOU. WELL I'M HAPPY. I'M STILL, I'M STILL. I WANT THE CITY TO HEAL TO MORE THAN ANYONE. AND I'M HAPPY TO REPRESENT YOU AND ANYONE IN THIS ROOM AS WELL. THANK YOU. THANK YOU. COUNCIL. WE'VE BEEN AT THIS TWO HOURS. WE STILL HAVE SEVERAL MORE SPEAKERS TO GO. I'M GOING TO GIVE US A TEN MINUTE BREAK. MAKE IT 12 MINUTES. SO I WOULD ASK YOU, BE BACK AT 810. WE'RE IN RECESS. ALL RIGHT. WELCOME BACK. WE ARE NOW CONTINUING OUR WORK SESSION. EXCUSE ME IF I COULD HAVE. QUIET IN THE ROOM, PLEASE. WE'RE CONTINUING WITH OUR WORK SESSION. AND, MADAM SECRETARY, IF YOU'D PLEASE CALL OUR NEXT SPEAKER. NANCY KLICK AND UP ON DECK, JOE VILLATORO. NANCY, I DIDN'T CATCH THAT LAST NAME, BUT. NANCY. YOUR NEXT SPEAKER, PLEASE. NANCY, CLICK. ALL RIGHT. IF YOU GIVE YOUR NAME AND ADDRESS FOR THE RECORD, YOU HAVE THREE MINUTES. NANCY, CLICK 2201 ROYAL CREST DRIVE, GARLAND, TEXAS, 75043. MINE'S NOT GOING TO BE THAT LONG TODAY. HOPEFULLY. I DO WANT TO SAY ONE THING TO ALL OF YOU. I'M GRATEFUL FOR THE THINGS THAT YOU ALL HAVE DONE TO GARLAND. YOU'VE IMPROVED THE DOWNTOWN, YOU'VE IMPROVED THE SCHOOLS, WHICH BRINGS PEOPLE INTO GARLAND. [02:00:08] AND BY BRINGING THESE TYPE OF PEOPLE INTO GARLAND, THEY CONTRIBUTE TO OUR TAX BASE. AND ISN'T THAT WHAT YOU WANT TO DO IS INCREASE OUR TAX BASE TAX BASE. I MEAN, I REMEMBER WHEN I, MY PARENTS MOVED TO RICHARDSON, I DIDN'T LIVE HERE AT THE TIME. AND WE'D SAY, OH, LET'S GO TO GARLAND. YOU KNOW, YOU JUST HIT IT. YOU DIDN'T WANT TO GO TO GARLAND. BUT I'M PROUD TO SAY I LIVE IN GARLAND NOW. I REALLY, REALLY LIKE GARLAND, AND I WANT TO STAY HERE. AND I THINK YOU ALL HAVE DONE SOME THINGS THAT MAKE ME WANT TO STAY HERE. I HAVE MANY QUESTIONS BECAUSE I LOOKED UP AND STARTED READING ABOUT THIS MD PATHWAY. I HAVE MORE QUESTIONS THAN ANYTHING NOW BECAUSE IT SOUNDS LIKE IT'S AI ANSWERING THESE QUESTIONS INSTEAD OF A REAL PERSON. AND THEN FROM WHAT I READ, ONE PLACE SAID YOU IMMEDIATELY GET A DOCTOR. OTHER TIMES IT SAYS IT COULD BE A COUPLE HOURS BEFORE YOU GET A CALL FROM A DOCTOR. AND THAT'S CONCERNING, YOU KNOW. AND THE TWO THINGS I WANT TO POINT OUT, WE HAD A LADY HERE A COUPLE WEEKS AGO. I WAS HERE A SECOND TIME. SHE WAS A MOTHER WITH THREE CHILDREN, THREE LITTLE GIRLS, CUTE KIDS. AND SHE FELT LIKE THIS WAS THE ANSWER TO, OH MY GOSH, THIS IS GOING TO HELP ME. I WON'T MISS WORK. YOU'VE GOT A KID THAT'S SICK. YOU'RE GOING TO MISS WORK. YOU'RE NOT GOING. THIS ISN'T THE ANSWER. THIS ISN'T A HOSPITAL THAT TAKES SIX SICK KIDS SO YOU CAN GO TO WORK ONCE THEY HAD THAT IN TEXAS. I DON'T KNOW IF Y'ALL KNEW ANYTHING ABOUT THAT. A HOSPITAL OPENED A PLACE. IF YOU HAD A SICK CHILD, YOU YOU PAID, BUT YOU WENT, DROPPED YOUR KID OFF AND YOU COULD GO TO WORK. THIS ISN'T TAKING CARE OF THAT. YOU HAVE A SICK KID. YOU STILL HAVE TO RELY ON ANOTHER RELATIVE, A CLOSE FRIEND, A SPOUSE. MAYBE AN OLDER CHILD WILL STAY THERE AND TAKE CARE OF THAT SICK KID, BUT IT'S NOT GOING TO SOLVE HER PROBLEM OF MISSING WORK. THE OTHER ONE THAT REALLY CONCERNED ME WAS THE MAN THAT HIS CHILD NEEDED AN MRI. I MEAN, HE WAS ALMOST IN TEARS. THIS ISN'T GOING TO HELP THAT. THIS DOES NOT GIVE THEM AN MRI TEST. THAT IS STILL GOING TO BE YOUR COST AS AN INDIVIDUAL TO HAVE THAT MRI DONE. WHY DIDN'T ANYONE TELL HIM. GO TO PARKLAND. PARKLAND IS THERE FOR YOU IF YOU DON'T HAVE INSURANCE. I MEAN, IT HELPS EVERYBODY. LEGAL, ILLEGAL CITIZEN. YOU KNOW, A VOTER, NON VOTER. IT HELPS EVERYONE. AND IF NO ONE, IF ANYONE IN HERE KNOWS WHO THAT PERSON WAS AND IT'S IN YOUR DISTRICT, SHAME ON YOU FOR NOT CALLING HIM AND SAYING, OH, PARKLAND, GET HELP FOR YOUR CHILD. THAT MAN NEEDED HELP FOR HIS CHILD. I MEAN, HE WAS IN TEARS BECAUSE HE COULD NOT GET HELP. AND IT SOUNDED PRETTY SERIOUS TO ME. THIS ISN'T GOING TO HELP THAT. AND THEN Y'ALL TALKED ABOUT PEOPLE, YOU KNOW. OH, THEY CALL 911 AT THE LAST MINUTE. THAT'S STILL GOING TO HAPPEN. THESE PEOPLE THAT ARE SICK, THEY DON'T CALL THEIR DOCTOR. THEY WAIT TILL THE LAST MINUTE, THEN IT'S A DIRE SITUATION. THEY THINK IT IS. SO THAT'S NOT GOING TO CHANGE THAT AT ALL. AND IF YOU THINK IT IS, MA'AM, I HAVE TO ASK YOU TO SUM UP. I'M SORRY YOUR TIME IS UP. IF YOU SUM UP, I STILL HAD A COUPLE MORE THINGS TO SAY. YOU CAN GET THEM IN THE NEXT FEW SECONDS. GO AHEAD. ANY QUESTIONS? I DO HAVE A QUESTION FOR YOU, MAYOR PRO TEM LUCK. HI. SO I GREW UP IN A DIFFERENT TIME. BUT I, I STAYED HOME SICK BY MYSELF WHILE MY MOM WENT TO WORK MANY, MANY TIMES. AND I CAN REMEMBER DOING SO. AND BEING I USED TO GET STREP THROAT EVERY SINGLE YEAR. AND I STAYED HOME BY MYSELF WHILE SHE WENT TO WORK. THAT'S JUST HOW IT WAS, BECAUSE SHE HAD TO GO TO WORK. AND IT IS WITH A LOT OF PEOPLE. IT IS. SO SO I JUST WANTED TO MENTION THAT BECAUSE YOU DID TALK ABOUT THE LADY WITH THE THREE KIDS. AND AND I THINK THAT THE POINT WAS THAT SHE WOULD BE ABLE TO CONTACT MD HEALTH PATHWAYS, GIVE HER GIVE HER [02:05:02] KIDS SYMPTOMS AND BE ABLE TO GET THEM MEDICATION. MAYBE WHEN SHE WAS GETTING OFF OF WORK AND GO HOME AND GIVE THEM THE MEDICATION. IBUPROFEN ANTIBIOTICS, PROBABLY. MAYBE ANTIVIRALS. YOU DON'T PUT ANTIBIOTICS DOWN AS THE FIRST THING YOU GIVE A KID IF YOU CAN AVOID IT. IT IS NOT THE BEST THING FOR YOUR BODY. EVEN AS AN ADULT, YOU TRY TO DO OTHER THINGS OTHER THAN ANTIBIOTICS. BUT IF SOMEONE HAS A BACTERIAL INFECTION, HOW DO YOU KNOW THAT WITHOUT A LAB TEST? WELL, THERE ARE SEVERAL DISEASES THAT CAN BE IDENTIFIED, LIKE STREP THROAT. YOU CAN SEE YOU HAVE A LAB TEST FOR THAT, BUT YOU CAN ALSO SEE PUSTULAR POCKETS ON THE TONSILS, WHICH IS A AN INDICATOR THAT THAT IS HARD TO SEE. PROBABLY A LAB TEST. IT'S A LAB TEST. YOU HAVE TO HAVE A LAB. I UNDERSTAND WHERE YOU'RE COMING FROM WITH WINDY PATHWAYS. YES. THEY DO HAVE PARTNERS WITH LABCORP, PARTNERSHIPS WITH LABCORP THAT ALLOW YOU TO GO GET TESTS DONE. THEY ALSO HAVE PARTNERSHIPS WITH ENVISION THAT ALLOW YOU TO GET LOW COST MRIS. SO SO AREN'T THEY ARE THEY NOT HELPING THAT POOR MAN? LOW COST. I'M NOT PRIVY TO THAT GENTLEMAN'S HEALTHCARE. THAT'S HIPAA STUFF. SO I DON'T HAVE INSIGHT INTO HIS MEDICAL RECORDS. BUT I JUST WANTED TO SAY YES, THEY DO HAVE PARTNERSHIPS THAT ALLOW PEOPLE WHO DO NOT HAVE A GENERAL PRACTITIONER, WHO DON'T HAVE INSURANCE, WHO MAYBE CAN'T GET TO PARKLAND TO GO GET LOW COST SERVICES THROUGH THEIR PARTNERSHIPS. SO I JUST WANTED TO ANSWER SOME OF THOSE QUESTIONS FOR YOU. I KNOW, I MEAN, IF I'M DON'T FEEL WELL AND I DON'T WANT TO GO TO THE DOCTOR, I'LL GO TO MY PHARMACIST. THEY HAVE A PLACE THAT YOU CAN CONSUME AND THEY SAY OVER-THE-COUNTER. TRY THIS. ISN'T THAT WHAT THIS IS PROVIDING? NO, MA'AM. THEY THEY PROVIDE ACTUAL PRESCRIPTIONS BECAUSE IT'S A MEDICAL PROFESSIONAL THAT ANSWERS THE. THEY WANT TO GIVE YOU AN ANTIBIOTIC. I DON'T I CAN'T SAY THAT THAT'S THE FIRST THING THEY GO TO OR NOT, BUT THEY'RE MEDICAL PROFESSIONALS. SO I WOULD TRUST THAT SOMEONE WITH A MEDICAL LICENSE WOULD FOLLOW THEIR HIPPOCRATIC OATH AND GIVE SOMEONE THE BEST POSSIBLE CARE, I WOULD HOPE. THANK YOU. ALL RIGHT. IS THAT IT? THAT'S IT, MA'AM. THANK YOU. THANK YOU. MADAM SECRETARY, PLEASE CALL OUR NEXT SPEAKER, JOE VILLATORO. AND UP ON DECK, SANDRA CARLTON. IF YOU GIVE YOUR NAME AND ADDRESS. FOR THE RECORD, YOU HAVE THREE MINUTES. GOOD EVENING, MAYOR AND COUNCIL MEMBERS. MY NAME IS JOE VILLATORO. I LIVE AT 802 CLARISSA PLACE 7540. I'VE BEEN THERE FOR EIGHT YEARS. DESPITE WORKING AT. DESPITE WORKING IN HEALTHCARE, MY COMPANY DOES NOT OFFER HEALTH INSURANCE. MY EMPLOYER STOPPED WHEN I WROTE IN THE AFFORDABLE CARE ACT. THIS YEAR, THE PREMIUMS BECAME UNAFFORDABLE AND I WAS UNABLE TO ENROLL. LIKE MANY FAMILIES, MANY WORKING FAMILIES THAT FALL BETWEEN THE GAPS. SORRY, I FALL INTO THAT GAP WHERE I EARNED TOO MUCH TO QUALIFY FOR ASSISTANCE, BUT NOT ENOUGH TO COMFORTABLY AFFORD PRIVATE INSURANCE. WHEN SOMEONE IN YOUR HOUSEHOLD GETS SICK, THAT LEAVES YOU WITH VERY LIMITED OPTIONS AND A LOT OF STRESS. I RECENTLY USED THE SERVICE FOR MY DAUGHTER'S MEDICAL ISSUES AND MADE A HUGE DIFFERENCE, AND SAVED TIME BY NOT HAVING TO SIT IN AN URGENT CARE OR EMERGENCY ROOM AND NOT RISK EXPOSING ANYONE ELSE. SIGN UP PROCESS WAS EASY AND I GOT CONNECTED TO A MEDICAL PROFESSIONAL. IT WAS IT WAS PRETTY QUICK, LIKE LESS THAN FIVE MINUTES. FOR THE PRICES PROGRAM PROVIDES REAL VALUE IN BOTH AFFORDABILITY AND PEACE OF MIND. I WOULD HAPPILY PAY THE FEE KNOWING IT CAN MAKE A REAL DIFFERENCE FOR PEOPLE IN OUR COMMUNITY DURING VULNERABLE MOMENTS. I STRONGLY SUPPORT MOVING FORWARD WITH THIS PROGRAM AND HOPE YOU WILL CONSIDER THE REAL, EVERYDAY IMPACT IT CAN HAVE ON FAMILIES. THANK YOU FOR YOUR TIME AND CONSIDERATION. RIGHT. THANK YOU SIR. MADAM SECRETARY, WOULD YOU PLEASE CALL OUR NEXT SPEAKER? SANDRA CARLETON HAS REQUESTED TO SPEAK FOR THREE DIFFERENT ITEMS. IF YOU GIVE YOUR NAME AND ADDRESS FOR THE RECORD AND MENTION THE ITEM YOU WISH TO SPEAK ON, AND WE'LL GIVE YOU THREE MINUTES ON EACH OF THOSE ITEMS. OKAY. [02:10:01] ALL RIGHT. MY NAME IS SANDRA CARLETON. HI, EVERYBODY. I LIVE AT 1410 MERRIMACK TRAIL 75043. AND I AM RETIRED. WHICH ITEM ARE YOU ADDRESSING FIRST? I'M SORRY. THE ONE THAT WE'VE BEEN TALKING ON THE MDH. LET'S START WITH THAT ONE. THERE YOU GO. YEAH. SO I'M ONE OF THOSE RETIREES WHO. I JUST LIKE PAPER STILL. SO I GET THOSE PAPER BILLS, AND I GOT THAT LITTLE FLIER IN THERE THAT SAID, YOU KNOW, I WAS GOING TO HAVE TO OPT OUT OF THIS SITUATION. SO I THOUGHT, OH, THAT'S FOR SURE, BECAUSE THERE'S THERE WAS NO REASON FOR THAT TO BE PUT IN MY BILL TO BEGIN WITH. WE WERE NEVER NOTIFIED THAT THAT WAS SOMETHING THAT WE WOULD BE GETTING. SO I DID OPT OUT RIGHT AWAY. BUT THIS HAS CONTINUED TO GO ON. I'M ALREADY PAYING FOR SOME MEDICARE. I'M A WIDOW. I AM NEW TO VISITING CITY COUNCIL HERE BECAUSE I'VE BEEN KIND OF BUSY THE LAST 30 YEARS. I'VE BEEN HOMESCHOOLING MY SEVEN DAUGHTERS, AND THEY'RE ALL THE LAST ONE. WILL GRADUATE FROM COLLEGE THIS YEAR. AND IN 2012, MY HUSBAND DIED OF A HEART ATTACK. AND I DID CALL THE AMBULANCE, AND THEY CAME AND WORKED ON HIM A LITTLE BIT AND TRANSPORTED HIM TO OUR GARLAND HOSPITAL. BUT HE DIED EN ROUTE. AND I WAS NOT ABLE TO CONTINUE HAVING HEALTH INSURANCE AT THAT TIME BECAUSE HE HAD WORKED FOR BANK OF AMERICA, AND I WAS A FULL TIME HOMESCHOOL MOM, AND I'VE BEEN HOME FULL TIME SINCE 1983. WE'VE LIVED IN GARLAND SINCE 1983, AND I'VE BEEN IN SOUTH CAROLINA SINCE 1999. WELL, I DECIDED AT THAT TIME I STILL PRAYED ABOUT THAT. I STILL WANTED TO BE ABLE TO FINISH HOMESCHOOLING MY CHILDREN. AND I HAD CHILDREN THAT WERE 16, 14, AND TEN WHEN DADDY DIED. AND GOD BLESSED US AND I WAS ABLE TO CONTINUE HOMESCHOOLING THEM. BUT FOR HEALTH REASONS I DID DECIDE TO BE UNINSURED, AND I USE SAMARITAN MINISTRY HEALTH CARE AND THAT THAT WORKED FOR OUR FAMILY. AND IN 2021 I NEEDED TO HAVE MY AORTIC VALVE REPLACED. THAT WAS FOR THE SECOND TIME. AND THE SAMARITAN MINISTRY HEALTH SHARE TO PAY FOR THAT THROUGH ALL THE CONTRIBUTIONS OF ALL THE MEMBERS. AND I PRAISE GOD BECAUSE AT WHEN I HAD THAT, BAYLOR WAS GOING TO ACCEPT THAT PAYMENT AND I WAS AN UNINSURED PERSON. OKAY. AND THEN THEY DECIDED TO TO WRITE THE WHOLE $85,000 BILL OFF AT THE END. BAYLOR DID. SO ALL OF THOSE CONTRIBUTIONS WERE ABLE TO GO BACK TO OTHER PEOPLE, AND THEY WERE BLESSED BY THAT. SO EVERYBODY THAT'S UNINSURED, SOME PEOPLE ARE UNINSURED BY CHOICE, AND THEY'RE DOING OTHER THINGS. I WANT TO LET YOU KNOW THAT I AM A VOTER. I'M A FORMER PRECINCT COMMITTEE CHAIRMAN, I'M A FORMER ELECTION JUDGE. AND ANYTHING LIKE THIS SHOULD DEFINITELY HAVE HAD A ELECTION PROCESS BEFORE THIS WAS EVER AGREED TO. THIS IS GOING TO RESULT IN OVER $5 MILLION A YEAR FOR THIS PROGRAM. AND SO A LOT OF PEOPLE, THEY DON'T THEY DON'T GET THEIR BILLS ANYMORE. THEY DON'T OPEN THEIR BILLS ANYMORE. THEY DO ELECTRONIC BILLING. THERE'S A LOT OF PEOPLE THAT DON'T KNOW ANYTHING ABOUT THIS, AND IT'S ALMOST LIKE IT WAS JUST SNUCK IN UNDERNEATH THE RUG BY THE CITY COUNCIL. I DON'T KNOW, I HAVEN'T KEPT UP WITH CITY COUNCIL, BUT I'LL BE SEEING YOU A WHOLE LOT MORE IN THE FUTURE. SO THIS THIS FEE IS, IS JUST IT'S RIDICULOUS THAT THAT WOULD BE PUT ON OUR BILL. I PAY FOR MY CITY SERVICES, I PAY MY BILLS, I PAY EVERYTHING ON TIME. BUT THIS THIS IS JUST WRONG. AND I APPRECIATE COUNCILMAN WILLIAMS SAYING EARLIER THAT HE WAS GOOGLING SOME STUFF ABOUT OTHER PROGRAMS AND OTHER THINGS THAT COULD BE DONE, AND I THOUGHT SOMEBODY NEEDED TO BE GOOGLING BEFORE THIS EVER PASSED. AND SOMEBODY NEEDED TO BE SAYING, LET'S PUT THINGS TOGETHER. MAYBE YOU CAN HAVE SEVERAL DIFFERENT OPTIONS TO PUT TOGETHER AND OFFER AS HEALTH CARE. BUT NO, MA'AM. YOUR THREE MINUTES IS EXPIRED. IF YOU SUM UP YOUR COMMENTS, PLEASE PARDON. IF YOU SUM UP YOUR COMMENTS, YOUR THREE MINUTES ON THIS TOPIC IS EXPIRED. SO IF IF THIS CONTRACT CAN JUST BE CANCELED, THAT WOULD BE GREAT. AND IF IT IF AND IF Y'ALL CAN'T VOTE TO CANCEL IT AS A LAST RESORT, WE NEED TO HAVE A VOTE ON THIS AS A REFERENDUM AND NOT, YOU KNOW, BEING ALL WORRIED ABOUT HOW MUCH IT'S GOING TO COST THE CITY. [02:15:03] Y'ALL NEED TO DO THE RIGHT THING. AND IF IT'S GOING TO COST THE CITY A BUNCH OF MONEY, DO IT. BUT AT LEAST YOU'VE TAKEN IT TO THE VOTERS. AND THE VOTERS VOTE ON IT. AND I DO HAVE A QUESTION FOR YOU, COUNCILMEMBER WILLIAMS. YOU'RE IN THE QUEUE, SIR. YES, I THINK YOU MAY HAVE. I'M SORRY, I MEANT MR. MOORE. DID I SAY WILLIAMS? NO. I'M SORRY. YOU MAY HAVE ALREADY YOU MAY HAVE ALREADY ANSWERED THIS. DID I HEAR YOU SAY THAT YOU WERE A VOTER AND SOME KIND OF PRECINCT CHAIR? IS THAT RIGHT? I'M A FORMER PRECINCT CHAIR. OKAY. HOW MANY YEARS? IT WAS BACK, LIKE, ABOUT 2016. IT WAS A LONG TIME AGO. SO IF WE PUT THIS REFERENDUM ON THE BALLOT, WOULD YOU VOTE FOR IT OR AGAINST IT? WOULD YOU, WOULD YOU WOULD YOU LIKE TO HAVE THE THE THE PRIVILEGE OF DECIDING FOR OR AGAINST AS A VOTER IF THIS CONTRACT CANNOT BE CANCELED? I WOULD LIKE TO BE ABLE TO HAVE IT ON A BALLOT ON THE REFERENDUM. OKAY. AND DO YOU HAVE ANY PREFERRED LANGUAGE? I HAVEN'T LOOKED INTO ANY SPECIFICS OF IT. OKAY. BUT YOU WOULD. YOU WOULD IF IT WERE PUT OUT THERE FOR VOTE, YOU WOULD PARTICIPATE, RIGHT? ALWAYS. THANK YOU. THANK YOU MAYOR. THANK YOU SIR. ALL RIGHT MA'AM. THREE MINUTES ON YOUR NEXT TOPIC. WHICH ITEM WOULD YOU LIKE TO ADDRESS NEXT? OKAY. THE PARTNERSHIP WITH WITH GARLAND. I JUST WITH THE PARKLAND TELEHEALTH. ALL RIGHT. SO THERE WAS A LOT OF INFORMATION ABOUT PEOPLE BEING NOT HAVING ACCESS TO INTERNET AND THAT THAT SOME OF THE LIBRARY ROOMS WERE GOING TO BE USED AND SOME OF THE PUBLIC COMPUTERS. SO MY CONCERN WITH THAT IS THAT YOU ARE USING A PUBLIC PLACE TO BRING IN PEOPLE WHO ARE POSSIBLY SICK AND WHO ARE GOING TO DO TELEHEALTH APPOINTMENTS. AND WE HAVE HOMESCHOOL FAMILIES, WE HAVE PEOPLE WITH LITTLE CHILDREN. WE HAVE JUST ALL KINDS OF PEOPLE WHO ARE IN THE LIBRARY NOT GOING IN THERE, OR ASSUMING THAT THERE'S NOT GOING TO BE SICKNESS IN THERE. IF YOUR KIDS ARE SICK, YOU KEEP THEM HOME FROM SCHOOL, BUT THEN YOU SAY, GO TO THE LIBRARY WITH THESE OTHER SICK PEOPLE SO THEY CAN HAVE ACCESS TO INTERNET. THAT DOESN'T MAKE SENSE TO ME. THERE OUGHT TO BE SOME OTHER KIND OF WAY. IF WE GO WITH THIS PARKLAND TELEHEALTH THING WHERE IT, YOU KNOW, IF I DON'T KNOW, LIKE A DOCTOR'S OFFICE OR SOME PLACE WHERE, WHERE THERE'S AN OFFICE SETTING THAT IS, IS NOT A PUBLIC SETTING, IF THEY'RE GOING TO GO HAVE THEIR INTERNET ACCESS FOR THESE TELEHEALTH MEETINGS. AND THAT WAS REALLY ALL I HAD TO SAY ON THAT. DOES ANYBODY HAVE ANY YOU HAVE A QUESTION FOR YOU, COUNCIL MEMBER DUTTON. I JUST HAD A QUICK COMMENT BECAUSE I DO AGREE ABOUT HAVING SICK PEOPLE GOING INTO THE LIBRARIES SO THAT WE CAN INFECT EVERYONE ELSE. SO I JUST WANT TO POINT OUT THE IRONY OF THAT IS THAT WITH THE EMPTY PATHWAYS, IT AVOIDS THAT FROM HAPPENING. SO IT'S THIS IS WHY WE ARE IN THIS POSITION AND WHY WE ARE. IT IS A DOUBLE EDGED SWORD BECAUSE THERE ARE OTHER OPTIONS. BUT ARE THEY THE BEST? ARE THEY THE END ALL, BE ALL? ARE THEY GOING TO SOLVE THE WORLD'S PROBLEMS. THEY'RE STILL GOING TO BE STARVING CHILDREN IN AFRICA. I MEAN IT'S IT'S IT IS SUCH A MULTIFACETED PROBLEM IN THAT'S WHY WE WE APPRECIATE YOU GIVING US GRACE. BECAUSE PODS SOUND GREAT, RIGHT? IT'S IT'S NO COST. YOU'RE NOT GETTING A $6 CHARGE ON YOUR UTILITY BILL. BUT GUESS WHAT? YOU HAVE LITTLE KIDS THAT ARE AT THE LIBRARY, AND YOU'VE GOT PEOPLE THAT HAVE COVID OR THE FLU OR WHATEVER THAT ARE GOING TO SHOW UP TO GO TO THAT POD. WHO'S DISINFECTING THE PODS, RIGHT. SO IT'S EVERYBODY IN TO GO TO THE LIBRARIES. SO, SO IT IT HAS ITS OWN. IT HAS ITS IT. EVERY PROGRAM THAT WE ARE GOING TO HEAR TONIGHT. RIGHT SITE THE PARKLAND PODS AND PATHWAYS THERE. NONE OF THEM ARE GOING TO BE PERFECT. SO I DO APPRECIATE YOU COMING UP HERE AND GIVING US YOUR OPINIONS AND DOING SO KINDLY AND GRACEFULLY. AND I JUST WANT EVERYONE TO KEEP THAT IN MIND THAT THAT'S THAT'S WHAT WE'RE, WE'RE TRYING TO ACCOMPLISH AND WE'RE TRYING TO DO IT WITH EVERYONE. SO JUST KEEP THAT IN MIND. THANK YOU. THANK YOU MA'AM. FINAL TOPIC. GO RIGHT AHEAD. [02:20:01] YES, SIR, I SUPPORT THAT. WE WE DO NEED SOMETHING DIFFERENT WHERE EVERYBODY IS JUST NOT TAKING AN AMBULANCE TO THE E.R.. THAT'S RIDICULOUS. IT'S IT'S JUST TOTALLY IRRESPONSIBLE. AND THAT HAS BEEN. THAT'S BEEN A THING FOR YEARS. BECAUSE THE AIR HAS BECOME WHERE PEOPLE GO FOR HEALTH CARE. BUT WE DON'T EVEN HAVE AN AIR HERE. SO THEN THEY'VE GOT TO TRANSPORT THEM TO SOME OTHER TOWN. AND THERE, I REALLY BELIEVE THAT WE NEED TO HAVE LIKE A COMBINATION OF SOME OF THESE THINGS, BECAUSE NOT EVERYTHING IS GOING TO WORK FOR EVERY PERSON, AND A LOT OF PEOPLE ARE NOT GOING TO DO SOMETHING THAT'S NOT IN PERSON FOR THEIR HEALTH CARE. THERE'S A WHOLE OLDER POPULATION THAT DOESN'T APPLY TO THEM AT ALL. EVEN AS FAR AS LIKE BEING ABLE TO OPT OUT OF SOMETHING. I HAVE A COLLEGE DEGREE. I KNOW WHAT OPT OUT MEANS. A LOT OF PEOPLE THAT ARE OLDER THAN ME, THEY READ THAT IN THEIR BILL. THEY DON'T EVEN KNOW WHAT THAT MEANS, PROBABLY. AND IF YOU DON'T HAVE A LITTLE BIT OF TECHNOLOGY GOING WITH YOU, YOU MAY NOT EVEN DO THAT. SO I KNOW, LIKE FOR THE, FOR THE RIGHT SIDE, THAT'S COMPLETELY DIFFERENT. BUT SO THERE'S, THERE'S A WHOLE COMBINATION OF THINGS THAT NEED TO COME TOGETHER BEFORE WE JUST MAKE SOME BIG PUSH THAT ALL OF OUR CITIZENS ARE GOING TO HAVE TO PAY FOR FOR $5 MILLION A YEAR. THAT'S ALL I HAVE. I SEE NO QUESTIONS. THANK YOU VERY MUCH. THANK YOU VERY MUCH FOR YOUR TIME. MADAM SECRETARY, WOULD YOU PLEASE CALL OUR NEXT SPEAKER? RACHEL HIRSH AND ON DECK PANDOO GREEN. YOU CAN CALL HER ONE MORE TIME, PLEASE. RACHEL. HIRSH. ALL RIGHT, LET'S MOVE ON, THEN, TO OUR NEXT SPEAKER, PLEASE. PANDOO GREEN. ALL RIGHT. DO WE HAVE ANOTHER SPEAKER AFTER THAT, PLEASE? KIKI BERTENS. OR TAI CHI QI. ALL RIGHT. AND IF WE HAVE A SPEAKER CARD AFTER THAT PERSON, PLEASE. WILLIAM DAVIS. OKAY, GOOD. GOOD. PLEASE. IF YOU GIVE YOUR NAME AND ADDRESS FOR THE RECORD, YOU HAVE THREE MINUTES. SURE. RACHEL HERSH 111. SANDRA. RIGHT AWAY. AUSTIN, TEXAS. FIRST OFF, THANK YOU ALL FOR HAVING US SPEAK HERE TONIGHT. I KNOW IT'S BEEN A LONG NIGHT, SO I'LL BE BRIEF. SO I'M RACHEL. I RECENTLY JOINED THE MD, MD HEALTH PATHWAYS TEAM TO HELP LEAD OUR OPERATIONS. SO FOR A BIT OF CONTEXT, I SPENT THE EARLY PART OF MY CAREER WORKING ON INVESTING IN MISSION DRIVEN COMPANIES. AND THESE COMPANIES WERE DEDICATED TO OFTEN SERVING SOME OF THE MOST UNDERREPRESENTED MEMBERS OF OUR COMMUNITIES. AND OH, SORRY, A LITTLE OUT OF BREATH FROM RUNNING OVER. WHEN I MET DOCTOR PARAGON, THE MD HEALTH PATHWAYS TEAM, LAST YEAR, I WAS PRETTY TAKEN ABACK BY THE MODEL AND THE MISSION AND THE PRODUCT THAT OUR TAP SERVICE PROVIDES. AND I WAS REALLY EXCITED WHEN I HEARD THAT GARLAND HAD CHOSEN TO BE A PIONEER IN THE DELIVERY OF THIS PLATFORM TO ITS RESIDENTS. AND SO I JOINED THE TEAM ABOUT TWO MONTHS AGO TO TO HELP THEM MAKE THAT VISION A REALITY. AND SO WE'VE DONE THE WORK IN HIRING CLINICIANS, LOCAL STAFF TO HELP ON BOARD, TO HELP WITH BILLING AND CUSTOMER SUPPORT. AND WE'VE BUILT THE THE INFRASTRUCTURE TO HELP REALLY ROLL THIS OUT PROPERLY. GOING FORWARD, LEADING UP TO LAUNCH I WANTED TO BE HERE TONIGHT TO HELP REITERATE WHY WE'RE NOT ABLE TO PARTICIPATE IN A PUBLIC REFERENDUM. I KNOW THAT IT MAY FEEL LIKE A PUBLIC REFERENDUM IS THE BEST WAY TO TAKE A PULSE ON WHAT THE COMMUNITY DESIRES. BUT I UNFORTUNATELY KNOW THAT WE ARE A SMALL, VERY PASSIONATE TEAM, AND ANY RESOURCES THAT WE HAVE TO DIVERT FROM OR TO A POLITICAL CAMPAIGN WILL, UNFORTUNATELY TAKE AWAY FROM SOME OF OUR CLINICIANS ABILITY TO SERVE OUR NOT ONLY OUR PATIENTS IN GARLAND, BUT ALSO IN TEXAS AND OUR OTHER STATES. AND SO WE WERE FOUNDED TO BE A SOLUTION FOR INDIVIDUALS AND HELP REALLY SOLVE THE PUBLIC HEALTH CRISIS IN, IN THE HEALTHCARE DESERTS THAT ARE SHOWING UP ACROSS OUR COUNTRY. AND I REALLY BELIEVE THAT AFFORDABLE HEALTHCARE IS A RIGHT THAT ALL OF OUR CITIZENS SHOULD HAVE. [02:25:01] AND THIS IS ONE OF THE FIRST SOLUTIONS THAT I'VE SEEN REALLY HELP TO SOLVE THAT. RIGHT. AND SO AGAIN, I WISH WE HAD A BETTER ANSWER, AND I WISH THAT WE HAD MORE RESOURCES, BUT UNFORTUNATELY, EVERY RESOURCE THAT WE HAVE TO DIVERT TO ANY SORT OF CAMPAIGNING ARE ONES THAT WE HAVE TO TAKE AWAY FROM SERVING OUR PATIENTS. AND THAT'S DOES NOT ALIGN WITH THE MISSION THAT WE SET OUT TO DO. AND WE, UNFORTUNATELY, YOU KNOW, WON'T BE ABLE TO DO BOTH OF THOSE MANDATES. SO I WANT TO THANK YOU AGAIN FOR THE TIME, AND I HOPE THAT WE'RE ABLE TO MOVE FORWARD IN SERVING OUR MISSION AND SERVING THE GARLAND COMMUNITY. THANK YOU. THANK YOU, COUNCILMEMBER WILLIAMS, A. GOOD SAFE TRIP FROM AUSTIN. THANKS. SINCE YOU SAID THAT MD HEALTH PATHWAYS WAS A TEXAS TEXAS WIDE SERVICE, WE'RE NOT TEXAS WIDE. WE'RE IN SEVERAL CITIES AROUND THE TEXAS AREA. GIVE ME SOME OF THOSE TEXAS CITIES. CRANDALL. MAYBANK. FERRIS. PARADISE. HENDERSON. I'M MISSING A COUPLE, BUT THOSE ARE OFF THE TOP OF MY HEAD. AND WHICH OF THOSE CITIES IS THE LARGEST POPULATION WISE? MAYBANK. I BELIEVE MAYBANK. MAYBANK. SO GARLAND IS QUITE A BIT LARGER, POPULATION WISE, DIVERSE, WISE, ECONOMICALLY WISE. YEAH. AND BUT I THINK YOU SAID THAT. THE HEALTHPATHWAYS DID NOT HAVE A STAFF OR TEAM TO TO ENGAGE IN ANY POLITICAL. I THINK THIS TERM YOU USED. SO I DON'T WANT TO INTERRUPT. OKAY. POLITICAL OUTREACH. CORRECT. RIGHT. EXPLAIN. SO WE HAVE TAKEN THE RESOURCES THAT WE HAVE IN THE TIME THAT THIS WAS APPROVED IN AUGUST. UNTIL NOW, IN ORDER TO HIRE THE NECESSARY CLINICIANS, SOME OF OUR COMMUNITY OUTREACH MEMBERS, AND REALLY TRY TO ENGAGE AS MANY MEMBERS OF THE COMMUNITY AS POSSIBLE. AND WE'VE KIND OF HIT A POINT WHERE WE ARE READY TO GO IN TERMS OF BEING ABLE TO SERVICE THE AMOUNT OF CAPACITY WE WOULD HAVE WHEN GARLAND OFFICIALLY LAUNCHES. BUT IN ORDER TO ADD IN THE INCREMENTAL COSTS OF A POLITICAL CAMPAIGN FROM STARTING NOW, YOU KNOW, WE'D BE SPENDING AN INCREMENTAL HUNDREDS OF THOUSANDS OF DOLLARS IN ADDITION TO THE HUNDREDS OF THOUSANDS OF DOLLARS WE'VE ALREADY SPENT STAFFING OUR CLINICIANS. AND SO WE HAD OUR TIMELINE AND OUR PLANNING SET TO LAUNCH, YOU KNOW, SOMETIME IN THE SPRING. AND AS THIS KEEPS GETTING PUSHED AND PUSHED AND PUSHED, IT'S, YOU KNOW, STRAINING OUR RESOURCES, AND WE WANT TO FOCUS AS MANY OF OUR RESOURCES ON TO PROVIDING HEALTH CARE RATHER THAN HAVING TO, YOU KNOW, KIND OF TAKE OUR EYE OFF THE BALL AND REALLY, YOU KNOW, DIVERT OUR ATTENTION TO LEARNING HOW TO RUN A POLITICAL CAMPAIGN, BEING, YOU KNOW, FOCUSING ALL OF OUR RESOURCES ON THAT. SO YOU YOU'RE YOU'RE OF THE OPINION THAT YOU WOULD NOT BE A SUCCESS IF YOU HAD TO, IN GALLEN, ENGAGE IN POLITICAL CAMPAIGNING. RIGHT? I THINK WE COULD, BUT WE WOULD BE JEOPARDIZING SOME OF THE SERVICES THAT WE CAN PROVIDE TO OUR PATIENTS, BECAUSE WE'D HAVE TO DIVERT A LOT OF OUR RESOURCES TO TO A POLITICAL CAMPAIGN. DO YOU THINK THAT I, I DON'T INTERRUPT I THINK THAT FUNDAMENTALLY THAT IS DIFFERENT THAN THE MISSION THAT WE SET OUT TO ACHIEVE, WHICH IS PROVIDING HEALTH CARE TO AS MANY PEOPLE AS POSSIBLE? WELL, ONE OF THE FIRST THINGS THAT WAS SAID BY YOUR REPRESENTATIVE WAY BACK WHEN WAS THAT THEY WANTED TO REACH THE GOLDEN COMMUNITY AT LARGE. RIGHT. SO HOW CAN YOU PENETRATE? WE'VE GOT I THINK 250,000 PEOPLE. OKAY. 81,000 HOUSEHOLDS. RIGHT. WITH THOSE NUMBERS. OKAY. HOW DO YOU INTEND TO REACH THAT POPULATION OR WOULD YOU RATHER SEE IT WITHOUT THAT. AND GOING FORWARD. SO I'D SAY A COUPLE POINTS TO THAT ONE. WE WE'VE BEEN IN THE PROCESS OR I'VE BEEN IN THE PROCESS OF TRYING TO SHIFT OUR MESSAGING CAMPAIGN. SO WE'RE TO TRY AND RAMP UP A SOCIAL MEDIA PRESENCE, BE MORE ACTIVE IN THE COMMUNITY, AND MAKE SURE WE'RE REACHING AS MANY PEOPLE AS POSSIBLE. THE ONLY THING THAT I, I STRUGGLE TO KEEP COMING BACK TO IS HOW DO WE REACH 250,000 PEOPLE? AND SO AS A REFERENDUM, THE RIGHT WAY TO REACH 250,000 PEOPLE. [02:30:03] I JUST I KEEP COMING BACK TO THE NUMBERS THAT WE'VE BEEN TALKING ABOUT OF, YOU KNOW, COUNCILMAN MOORE SAID, YOU KNOW, THE 5 TO 10% OF THE PEOPLE WHO VOTE ARE THE 5 TO 10% OF THE PEOPLE WHO VOTE. AND WE ARE COMMITTED TO WORKING WITH YOU GOING FORWARD OVER THE NEXT SEVERAL MONTHS TO TRY AND FIGURE OUT HOW TO GET 250,000 PEOPLE TO UNDERSTAND WHAT OUR PRODUCT DOES AND HOW IT CAN SERVE THEM, AND HOW IT CAN REALLY CHANGE THE HEALTHCARE ACCESS PROBLEM. AND I JUST I WANT TO REALLY INVEST IN THIS PARTNERSHIP GOING FORWARD. AND I THINK TAKING AWAY AN INVESTMENT IN THE PARTNERSHIP TO BECOME A, YOU KNOW, FOCUS ON CAMPAIGNING IS, IS JUST A HARD ALLOCATION OF RESOURCES FROM A BUSINESS STANDPOINT. SO HOW DO YOU THINK THEN WE WE GET THE PENETRATION. WE REACH OUR POPULATION OUR PUBLIC WITH TO BE SUCCESSFUL WITH THIS. HOW DO YOU HOW DO YOU TELL ME HOW HOW DO YOU PROPOSE WE REACH 250,000 PEOPLE OR 81,000 HOMES? SO A COUPLE THINGS. ONE, I WOULD BECAUSE LET ME I HAD A TOWN HALL LAST THURSDAY. OKAY. I DID A POLL. YOU SEE, I ASKED THAT VERY QUESTION AND HALF OF THE PEOPLE THAT WERE THERE AND YOUR REPRESENTATIVES WERE THERE HAD NEVER HEARD OF MD HEALTH PATHWAYS, HAD NEVER GOTTEN ANY FIRE. NOW SOME PEOPLE GOTTEN IT, BUT BUT I HAD A CROWD. PROBABLY 6,060% OF THE PEOPLE HAD NOT HEARD. SO IN MY DISTRICT WON'T BE SUCCESSFUL. HOW ARE YOU GOING TO REACH THOSE THOSE 60% OF THE POPULATION THAT I SERVICE TO MAKE THIS PROGRAM A SUCCESS. SO I WOULD A COUPLE OF THINGS. ONE, I THINK WE NEED TO TAKE OWNERSHIP. IF WE HAVEN'T DONE ENOUGH THUS FAR, WE WANT TO BE ABLE TO REACH ALL THE PEOPLE THAT THIS PRODUCT CAN REALLY HELP. AND SO OUR PLAN IS TO REALLY START TO RAMP UP, YOU KNOW, SOME OF OUR, YOU KNOW, KIND OF THE BASICS OF JUST GENERAL GRASSROOTS ADVERTISING, LIKE HOW DO WE GET, YOU KNOW, PEOPLE ON SOCIAL MEDIA, HOW DO WE GET LOCAL NEWS, LET'S REDO THE FLIERS SO THAT PEOPLE KNOW WHAT THE PRODUCT IS, HOW TO OPT OUT, AND THEN HOW TO ACTUALLY USE IT IF THEY NEED TO. AND SO JUST KIND OF GOING BACK TO THE BASICS OF LET'S DO ANOTHER ROUND OF FLIERS, LET'S PUT SIGNS UP AT EVERY PUBLIC SPACE. THAT'S LIBRARIES, THAT'S PARKS. AND LET'S RUN A COUPLE SOCIAL MEDIA ADVERTISEMENTS AND WORK WITH THE SCHOOLS AND SEE WHERE WE CAN GET AS A PARTNERSHIP TOGETHER. THAT SOUNDS A LOT LIKE POLITICAL ACTIVITY TO ME. RIGHT. OKAY. THANK YOU. ALL RIGHT. THANK YOU. SIR. COUNCIL MEMBER MOORE. THANK YOU, MR. MAYOR. YOUR NAME AGAIN? RACHEL. RACHEL, THANK YOU SO VERY MUCH FOR COMING AND SHARING WITH US THE THOUGHTS THAT YOU'VE JUST SHARED, BECAUSE I REALLY SENSE THAT. YOU'RE VERY PASSIONATE ABOUT THIS, AND YOU'RE REALLY WANTING TO PUT FORTH A MESSAGE THAT MD PATHWAY IS DOING THE VERY BEST THAT IT POSSIBLY CAN PRESENTLY IN ORDER TO PUT FORTH THIS MESSAGE. AS YOU WERE TALKING, I HEARD A COUPLE OF THINGS. I'M GOING TO START OUT TALKING ABOUT HOW WE DEAL WITH ZONING. FOR EXAMPLE, AS A CITY COUNCIL, WE COME A LOT OF PEOPLE COME BEFORE US IN THE WAY OF PROJECT DEVELOPMENTS AND WHAT THEY WANT TO DO IN THE WAY OF THOSE PROJECTS. AND AS THEY'RE TALKING, SOMETIMES THEY BEGIN TO TALK WITH US ABOUT THEIR PROFITABILITY. AND WHEN THEY DO THAT, OFTENTIMES OUR OUR ATTORNEY STOPS BECAUSE THERE ARE CERTAIN THINGS THAT WE JUST DON'T TAKE INTO CONSIDERATION. AND THAT IS IS THE COMPANY GOING TO LOSE BUSINESS, IS IT GOING TO AND SO ON AND SO FORTH. AND THERE'S A REASON, REASON FOR THAT. BECAUSE WHAT WE'RE LOOKING FOR MORE THAN ANYTHING IS LAND USE, THE USE OF THE PROPERTY, THE USE OF THE LAND. AND I THINK THAT AS YOU WERE TALKING, I HEARD IT THERE. THE DIFFERENCE TRULY BETWEEN GOVERNMENT AND HOW WE DO GOVERNMENT AND CORPORATE ENTERPRISE. AND AS YOU WERE TALKING, YOU SAID THAT YOUR PROFITABILITY, YOUR MARGINS, YOU'RE NOT GOING TO BE ABLE TO DO SOME OF THE THINGS THAT YOU WOULD LIKE TO DO, AND YOU'RE GOING TO PROBABLY HAVE TO BACK OFF FOR SOME OF THE THINGS THAT YOU WOULD DO FOR PATIENTS AND SO ON AND SO FORTH. WELL, FROM MY PERSPECTIVE AS A LEGISLATOR, AS ONE WHO GOVERNS, I THINK THAT THAT'S GOOD FOR [02:35:07] YOU TO CONSIDER. AND YOU SHOULD FOR ME, I'M I'M THINKING ABOUT IT FROM THE PERSPECTIVE OF BUT THAT'S WHAT BUSINESS DOES. BUSINESS MARKETS. IT, IT IT IT PROMOTES, IT GOES INTO THE COMMUNITY AND IT TALKS TO THE COMMUNITY ABOUT ITS PRODUCT. IT SELLS ITS PRODUCT, AND IT COSTS MILLIONS OF DOLLARS OFTENTIMES TO GO ABOUT DOING THAT. EVEN THEN, THOUGH, FROM MY PERSPECTIVE, THAT'S NOT SOMETHING THAT I'M GOING TO REALLY BE CONSIDERING. FROM MY PERSPECTIVE, MY MISSION IS TO ASSURE THAT MY CONSTITUENTS THAT THEIR BEST INTEREST. IS KEPT ABOVE ALL. AND AS THIS PROGRAM HAS COME TO US, YOU'LL NEVER HEAR ME SAY THAT THIS COMMUNITY DOES NOT NEED SERVICES LIKE HEALTH PATHWAY. I KNOW THAT THAT'S NOT TRUE, BECAUSE I'VE JUST GONE ON MY TELEPHONE HERE AND FOUND 15, 20, 35 OTHER COMPANIES THAT DO THE VERY SAME THING. AND THERE'S NO DOUBT THAT THERE ARE MANY PEOPLE OUT THERE WHO NEED THE SERVICE. BUT FROM THE PERSPECTIVE OF I DON'T FEEL THAT THIS COMPANY WAS VETTED. THAT IS, WE NEVER COMPARED YOUR COMPANY TO MY UNDERSTANDING, AGAINST 15, 20 OTHER COMPANIES IN ORDER TO COME FORWARD WITH WHAT IS IN THE BEST INTEREST IN THE WAY OF ONE, MAYBE OR TWO OF OUR COUNCIL PEOPLE GOING AND CHECKING THINGS OUT TO SEE WHAT'S THE BEST COMPANY OUT THERE? AND SO ON AND SO FORTH. OKAY. I APPRECIATE THAT, BUT I SURE WOULD LIKE TO HAVE MY STAFF DO IT. I LIKE TO HAVE MY PROFESSIONALS DO IT AND COME BACK TO ME WITH A REPORT, BECAUSE THERE MAY BE COMPANIES OUT THERE THAT IN FACT WE CAN GET A BETTER SERVICE, WE CAN GET A BETTER PROFIT MARGIN, WE CAN DO BETTER BY THEM. SO VETTING WAS SOMETHING CERTAINLY THAT I WOULD LIKE TO SEE. BUT MORE IMPORTANTLY, THE OPT OUT THAT IS A GOOD MODEL FOR YOU. FOR GOVERNMENT I DON'T THINK IS A GOOD MODEL, ESPECIALLY FOR SERVICES THAT ARE NOT NECESSARY, SOMETHING THAT IS NOT NECESSARILY REALLY NEEDED. SO WHEN YOU BEGIN TO TALK ABOUT THE PROFITABILITY, THAT'S NOT SOMETHING THAT I WANT YOU TO SPEND THE MONEY. I WANT YOU TO SHOW MY PEOPLE, SHOW THEM. AND THAT'S THE REASON THAT I THINK THAT THE VOTE TAKING IT TO THE VOTERS IS SO IMPORTANT. IT'S IMPORTANT BECAUSE YOU'RE GOING. NOT YOU. BUT WE. WE'RE NOT GOING TO BE GUESSING ANYMORE AS IT RELATES TO WHAT OUR COMMUNITY THINKS. WE'RE GOING TO REALLY KNOW BECAUSE THOSE PEOPLE WHO VOTE ARE GOING TO COME OUT AND DO THAT FOR US. DOES THAT MAKE SENSE TO YOU? I HEAR YOU. AND I THINK I, I UNDERSTAND THE RATIONALE TO TO WANT TO GO TO A VOTE. IT'S YOU KNOW, IT'S A LITMUS TEST OF A SUBSET OF THE POPULATION TO REALLY GET A BETTER PULSE ON. YOU KNOW, WHAT THOSE THE THOSE WHO TURN OUT BELIEVE OF THE PRODUCT. AND, YOU KNOW, I THINK AT SOME POINT IT'S YOU KNOW, I BELIEVE THAT WE HAVE A GREAT PRODUCT THAT WE CAN SERVE THE COMMUNITY. AND I'M NOT IN POLITICS. I'M IN BUSINESS. SO WE SPEAK A SLIGHTLY DIFFERENT LANGUAGE. AND I DON'T HAVE A TON TO, YOU KNOW, TO REBUT WHAT YOU'RE SAYING. I THINK, YOU KNOW, WE'VE CHOSEN THE OPT OUT MODEL BECAUSE AS WE'VE HEARD AND AS SOME OF YOUR RESEARCH SHOWS, THE TYPICAL OPT IN TELEHEALTH PROGRAM IS $75 PLUS A VISIT. AND SO WE BELIEVE THAT, YOU KNOW, WE CAN CREATE A MUCH BETTER ECOSYSTEM FOR HEALTHCARE THAT I THINK IS NECESSARY FOR THE COMMUNITY TO BE HEALTHY AT LARGE FOR A MUCH CHEAPER PRICE WITH THIS MODEL. AND SO, I THINK, YOU KNOW, THAT'S THAT'S MY VIEW. AND THEN, YOU KNOW, I SEE WHERE YOU'RE COMING FROM. AND SO IT'S, YOU KNOW, THAT'S ALL I'M SAYING. WE JUST WE SEE WHERE EACH OTHER'S COMING FROM. WE JUST ON A DIFFERENT SIDE FOR ME ANYWAY, I'M NOT SAYING FOR ANYONE ELSE. I'M JUST I'M NOT TRYING TO CONVINCE YOU. I'M TRYING TO ARTICULATE WHERE I AM, AND I HEAR YOU. THANK YOU, MR. MAYOR. THANK YOU SIR. COUNCILMEMBER BASS. THANK YOU. MAYOR. FIRST OF ALL, I'D LIKE TO REMIND THE COUNCIL AGAIN THAT WE'RE IN PUBLIC COMMENTS. WE'RE NOT TALKING ABOUT AGENDA ITEM NUMBER SEVEN YET. WE'VE BEEN HERE ALMOST THREE HOURS BECAUSE IT SEEMS THAT COUNCIL IS CONFUSED ON THAT POINT. THERE'S BEEN A LOT OF TALK. AND YOU SAID YOU SAID AS WELL ABOUT VOTER TURNOUT, VOTER APATHY. BY THE WAY, OUR VOTER TURNOUT IS NOT 10%. IT'S NOT 5%. IT'S ACTUALLY 2 TO 3% IF WE'RE LUCKY. IT'S ON A GOOD DAY. FOR THIS MAYORAL ELECTION, IT'LL BE CLOSER TO 1.5%. SO. BUT. VOTER TURNOUT IS NOT A JUSTIFICATION FOR TAKING DECISIONS OUT OF THE PUBLIC'S HANDS. OUR RESPONSIBILITY IS TO BE TRANSPARENT AND PUT ISSUES BEFORE VOTERS NOT TO DECIDE FOR THEM, [02:40:05] BECAUSE PARTICIPATION MIGHT BE INCONVENIENT. OKAY. AND POINT BJ WAS MAKING, WHICH IS I WANTED TO MAKE THE SAME POINT AS WELL. COUNCILMEMBER WILLIAMS TALKED ABOUT YOUR CURRENT MARKETING. YOU KNOW, YOU GUYS HAVE BEEN MARKETING IT FOR A WHILE. YOU GOT A COMMUNITY LIAISON, GOT ADS ON FACEBOOK, GOT SOME SIGNS OUT AT PUBLIC PLACES. YOU MENTIONED TO RUN A POLITICAL CAMPAIGN IS GOING TO EAT INTO OTHER SERVICES. HOWEVER, I WOULD DISPUTE THAT AND SAY THAT IT COSTS NO MORE TO PUT OUT THE SAME INFORMATION. AND YOU'RE ALREADY DOING IT FOR PUBLIC ENGAGEMENT. AND, YOU KNOW, I UNDERSTAND. IT BENEFITS YOU TO SAY IT'S A POLITICAL CAMPAIGN AND THEREFORE IT'S A DIFFERENT MESSAGE. BUT IT'S REALLY NOT. IT'S THE COMMUNITY ENGAGEMENT. THE WHOLE POINT IS COMMUNITY ENGAGEMENT. SO THAT'S ALL YOU WOULD NEED TO DO IS STILL CONTINUE THAT. YEAH. SO I DON'T WANT TO INTERRUPT, BUT I, I AGREE THAT A LOT OF IT IS COMMUNITY ENGAGEMENT. I THINK THE MECHANISMS THROUGH WHICH WE ENGAGE WITH THE COMMUNITY ARE SLIGHTLY DIFFERENT WHEN WE'RE TRYING TO MARKET TO THE ENTIRE COMMUNITY AND MAKE SURE EVERY POCKET, INCLUDING THOSE WHO CAN'T VOTE OR DON'T VOTE, HEAR ABOUT THE PRODUCT, WHEN INSTEAD, IF WE'RE GOING FOR A POLITICAL CAMPAIGN, WE'RE GOING TO LIKE POLITICAL CAMPAIGNS ARE HYPER TARGETED TOWARDS PEOPLE WHO VOTE A LOT OF TIMES, AND WE WANT TO MAKE SURE THAT IT'S NOT JUST THE PEOPLE WHO VOTE, HEAR ABOUT OUR SERVICE. WE WANT TO MAKE SURE EVERYONE HEARS ABOUT IT. AND SO WHILE I AGREE THAT IT IS LARGELY SOME OF THE SAME MECHANISMS, I MEAN, I'VE NEVER RUN A CAMPAIGN BEFORE. SO I CAN FIRMLY SAY THAT YOU KNOW, FROM THE RESEARCH THAT WE'VE DONE, IT'S IT'S JUST WHO YOU TRY TO TARGET AND WHO YOU TRY TO REACH IS SLIGHTLY DIFFERENT. YOU KNOW, WE WANT TO TRY AND MAKE SURE THAT WE'RE REACHING LARGE SWATHS OF THE COMMUNITY INSTEAD OF, YOU KNOW, FOCUSING ON JUST THE LIKELY TO TURN OUT RIGHT. BUT IN REACHING OUT TO THE ENTIRE COMMUNITY WITHIN THE A SUBSET OF THAT, BE THE VOTERS. SURE. OKAY. SO I MEAN, IT'S IT'S, YOU KNOW, YOU COULD YOU COULD SAY, YES, WE WANT TO BE HYPER FOCUSED AND, AND TARGET ONLY THE 8000 PEOPLE THAT ARE GOING TO SHOW UP TO VOTE. BUT, YOU KNOW, BEING MORE ALTRUISTIC, REACH OUT TO ALL 80,000 HOUSEHOLDS. AND IN DOING THAT, YOU WOULD ALSO CAPTURE THOSE VOTES. I CAN'T DISAGREE WITH THAT. AWESOME. THANK YOU. THANK YOU MAYOR. THANK YOU SIR. MAYOR PRO TEM LUCK. IF THE COUNCIL WERE TO MOVE FORWARD WITH A REFERENDUM, WOULD MD HEALTH PATHWAYS CONTINUE WITH THE CONTRACT THAT WE HAVE? I HAVE TO REITERATE WHAT DOCTOR PARROTT SAID. THANK YOU. ALL RIGHT. NO FURTHER QUESTIONS. THANK YOU. SECRETARY. HOW MANY MORE SPEAKERS DO WE HAVE? WE HAVE THREE, BUT I'VE BEEN TOLD THAT THEY ARE ALL NOT HERE. ALL RIGHT. VERY GOOD. WE'LL MOVE ON WITH OUR AGENDA. ALL RIGHT. LOOK. LOOKING. UP. HOLD ON A MINUTE, SIR. WHAT'S YOUR NAME? WILLIAM DAVIS. DID YOU CALL A WILLIAM DAVIS, MADAM SECRETARY? WELL, MY APOLOGIES, SIR WILLIAM DAVIS. OKAY. GIVE YOUR NAME AND ADDRESS. FOR THE RECORD, YOU HAVE THREE MINUTES. AND COUNCIL, I REMIND YOU THAT WE HAVE SOME OTHER ITEMS, AND THERE'S SOME PEOPLE WAITING FOR THE SOME OF OUR TOPICS. THEY MAY HAVE TO BE RESCHEDULED AS WELL. IF THIS. OKAY. I WANT TO THANK YOU ALL. MY NAME IS BILL DAVIS. I LIVE AT 414 TULANE STREET, GARLAND, TEXAS, 75043. AND I WANT TO THANK YOU FOR THE OPPORTUNITY TO SPEAK TO THIS. I DO SUPPORT PUTTING THIS TO A VOTE, SIMPLY BECAUSE I THINK THERE'S A CONCERN ON THE VETTING PROCESS AND THE COMMUNICATION PROCESS FROM THE CITY. ON THE ENGAGEMENT WITH MD PATHWAYS. I DO WANT TO ASK SOME QUESTIONS, AND I DON'T KNOW WHETHER THESE MAY BE ANSWERED IN THE CONTRACT OR WHAT HAVE YOU, BUT WHAT OUTCOME MEASUREMENTS DO YOU HAVE FOR THIS SERVICE? IS IT REDUCED EMS CALLS? BECAUSE I STILL SEE PEOPLE CALLING 911 EVEN FOR, YOU KNOW, SORE THROAT RATHER THAN GOING THROUGH THIS PROCESS BECAUSE IT HASN'T BEEN COMMUNICATED TO PEOPLE EFFECTIVELY. SO PEOPLE ARE GOING TO CONTINUE THE HABITS THEY'VE GOT UNTIL IT'S BROUGHT FORWARD TO THEM. WHAT OTHER, YOU KNOW, MEASUREMENTS WILL YOU HAVE FOR THE COMPANY? PERCENTAGE OF HAPPY CITIZENS SLASH PATIENTS. WHAT ARE THE PROFITABILITY GOALS OF THE CORPORATION? BECAUSE I COULD SEE VERY QUICKLY THAT, AS SOMEONE ALLUDED TO EARLIER, A COST SAVING MECHANISM OF UTILIZING AI OR SOMETHING AS A. PRECURSOR FOR THE USE OF CLINICAL STAFF. BECAUSE I CAN SEE [02:45:03] THAT BECAUSE HOSPITALS ARE MOVING THAT WAY AND THE DOCTORS ARE RELYING SOMEWHAT ON AI TO GIVE THEM OPTIONS ON WHAT THEY'RE HAVING. I'D WORKED IN HOSPITALS FOR 40 YEARS, SO I HAVE A CLUE ON HOW THEY WOULD TRY AND CUT BACK ON COSTS. WHAT IS THE LIABILITY FOR THE MD PATHWAYS CLINICIANS? BECAUSE THERE'S ALL KINDS OF LAWSUITS I COULD FORESEE HAVING. AND WHAT COVERAGE DO THEY HAVE? TO LIMIT THAT, BECAUSE IF THEY AREN'T BEING ABLE TO DO A TEST TO VALIDATE A DIAGNOSIS, THEN HOW ARE THEY GOING TO PROTECT THEMSELVES FROM SOME OF THESE SITUATIONS THAT MIGHT COME UP WHERE THEY MISDIAGNOSED WHAT THEY WERE TALKING ABOUT? BECAUSE YOU DO HAVE DIFFERENT LANGUAGES THAT PEOPLE USE. YOU HAVE THREE, AT LEAST THREE MAJOR ONES HERE VIETNAMESE, SPANISH AND ENGLISH. BUT THERE'S ALSO A BUNCH OF LINGO. I KNOW WE DID A STUDY IN CHICAGO ON PATIENTS THAT HAD HEART ATTACKS, AND BLACKS DESCRIBED IT DIFFERENTLY THAN WHITES, WHAT THEIR SYMPTOMS WERE. SO I'M CONCERNED ABOUT THAT. ANYWAY, I THINK THOSE ARE MY POINTS. IF THERE'S AND I'M. THAT'S WHAT I WANTED TO BRING FORWARD TO YOU. VERY GOOD. I SEE NO QUESTIONS. THANK YOU SIR. WELL. WITH THAT I THINK THAT'S ALL OUR SPEAKERS FOR THIS EVENING. MOVE ON THEN. NOW TO WRITTEN BRIEFINGS. FIRST WRITTEN BRIEFING IS GPL TRANSMISSION ENGINEERING OFFICE BUILDING LEASE. [1. GP&L Transmission Engineering Office Building Lease] [2. Calling the 2026 General Election for May 2, 2026] SECOND WRITTEN BRIEFING IS CALLING THE 2026 GENERAL ELECTION FOR MAY 2ND, 2026. ALL RIGHT. NOW ON THE VERBAL BRIEFINGS, WE'VE ALREADY DONE NUMBERS THREE AND FOUR. [6. Agreement with the City of Garland and Parkland ILA Update] I'D LIKE TO MOVE UP ITEM SIX. THIS ONE TO TAKE NOW IS THE AGREEMENT WITH THE CITY OF GARLAND AND PARKLAND I A UPDATE. ALL RIGHT. WHATEVER YOU'D LIKE. THANK YOU. GOOD EVENING, MAYOR, COUNCIL AND MR. BETTS. I'M KAREN ARCHIBALD, DIRECTOR OF LIBRARIES, HERE TO PRESENT AN UPDATE ON THE PARKLAND POD PILOT PROJECT. I LOVE AN ALLITERATION, SO IT WAS EXCITING FOR ME TO BE ABLE TO SAY THAT I'M JOINED TONIGHT BY BECKY AIR WITH BECKY KING, MANAGING DIRECTOR OF COMMUNITY AND NEIGHBORHOOD DEVELOPMENT, AND MICHAEL MOLATE, PARKLAND SENIOR VICE PRESIDENT OF COMMUNICATIONS AND EXTERNAL AFFAIRS. SO IT'S BEEN A WHILE SINCE WE BROUGHT THIS PROJECT TO COUNCIL. I'D LIKE TO PROVIDE A LITTLE BIT OF A REVIEW OF THE PROJECT AND STEPS WE'VE MADE SINCE THAT ORIGINAL PRESENTATION BACK IN AUGUST OF 2024. PARKLAND WAS AWARDED A FEDERAL GRANT AND BROUGHT AN OPPORTUNITY TO THE CITY SHORTLY AFTER. THE GRANT FUNDS THE PURCHASE AND INSTALLATION OF TELEHEALTH PODS IN THE DALLAS COUNTY IN DALLAS COUNTY TO INCREASE ACCESS TO HEALTH CARE FOR AT RISK PATIENTS. THE PODS PROVIDE FREE, PRIVATE, AND ACCESSIBLE TECHNOLOGY FOR VIRTUAL HEALTH CARE. AFTER REVIEWING MULTIPLE DATA SETS FROM BOTH CITY SOURCES AND PARKLAND, WHICH WE'LL TAKE A LOOK AT IN A MOMENT, WE BROUGHT FORWARD OPTIONS TO COUNCIL ON HOW AND WHERE TO MOVE FORWARD, INCLUDING THE SELECTION OF SOUTH GARLAND LIBRARY AS THE PILOT LOCATION. AS YOU CAN SEE FROM THIS SLIDE, THESE ARE IMAGES OF WHAT THE TELEHEALTH POD WILL LOOK LIKE. IT'S A LITTLE LARGER THAN THE SIZE OF AN OLD PHONE BOOTH. PHONE BOOTHS USED TO BE AVAILABLE. IT'S EQUIPPED WITH A COMPUTER, CAMERA, MICROPHONE, AND SPEAKERS. THE POD PROVIDES A LEVEL OF PRIVACY AND SOUNDPROOFING FOR TELEHEALTH VISITS TO TAKE PLACE. TELEHEALTH POD IS SIMPLY AN ACCESS POINT. IT PROVIDES THE TECHNOLOGY AND SETUP FOR VIRTUAL HEALTHCARE HEALTHCARE VISIT, BUT NOT THE ACTUAL HEALTH CARE ITSELF. SO A LITTLE MORE ABOUT THE SERVICES PROVIDED AT PARKLAND PROVIDES HEALTHCARE, [02:50:10] INCLUDING TELEHEALTH SERVICES FOR INSURED AND UNINSURED PARKLAND PATIENTS. IT INCLUDES PRIMARY CARE, SPECIALTY CARE, BEHAVIORAL HEALTH, AND MORE PATIENTS FROM OTHER MEDICAL INSTITUTIONS WITH MYCHART ACCESS COULD ALSO ACCESS TELEHEALTH SERVICES USING THE POD ON OUR END. THE CITY IS RESPONSIBLE FOR PROVIDING AN INDOOR SPACE, ELECTRICITY, INTERNET CONNECTIVITY AND ACCESSIBLE PLACEMENT. ALSO BE RESPONSIBLE FOR MAINTAINING THE COMPUTER AND TECH EQUIPMENT INSIDE THE POD. THE SERVICE IS AVAILABLE TO THE PUBLIC DURING NORMAL OPERATING HOURS. LIBRARY OPERATING HOURS AND THE SERVICES PROVIDED TO THE PUBLIC FOR FREE. I DO WANT TO CLARIFY THAT THERE'S NO CHARGE TO USE THE TELEHEALTH POD OR ACCESS HOWEVER. PATIENTS. A PATIENT MAY HAVE A COPAY OR CHARGES ON THAT TELEHEALTH VISIT WITH THEIR MEDICAL COVERAGE. THESE COSTS ARE NOT DETERMINED OR COLLECTED BY THE CITY. SO WHY IS GARLAND AND SPECIFICALLY SOUTH GARLAND LIBRARY. A GOOD FIT FOR THIS PILOT PROJECT. AS I MENTIONED EARLIER, OUR TEAMS LOOKED AT MULTIPLE DATA SETS FROM DIFFERENT SOURCES, AND HERE YOU CAN SEE A LIST OF THOSE SOURCES THAT WE LOOKED AT. SOME BIG TAKEAWAYS FROM THAT DATA ARE PROVIDED ON THIS SLIDE. BUT JUST TO REVIEW, 20% OF GARLAND HOUSEHOLDS LIVE BELOW THE POVERTY LINE. IT'S ESTIMATED THAT ABOUT 24% OF RESIDENTS ARE UNINSURED, AND ABOUT 15% OF HOUSEHOLDS LACK A COMPUTER OR INTERNET ACCESS AT HOME, EMPHASIZING THAT DIGITAL DIVIDE. THERE'S ALSO A HIGH RATE OF FROM RESIDENT TO PHYSICIAN RATIO, SO IT'S ABOUT 1 TO 2200 RESIDENTS OF PHYSICIANS IN GARLAND. THE NEXT TWO SLIDES JUST PROVIDE VISUAL MAPS TO HELP BACK UP THOSE BIG TAKEAWAYS. THE DARKER THE COLOR INDICATED ON THE MAP IS TRANSLATED TO A HIGHER RATIO OR PERCENTAGE OF AFFECTED HOUSEHOLDS. IF YOU CONSIDER THE PRIMARY CARE PHYSICIAN RATIO, HOUSEHOLDS WITHOUT INTERNET ACCESS PER HOUSEHOLD AND HOUSEHOLDS IN POVERTY. AND PEOPLE WITHOUT HEALTH INSURANCE AND FAIR OR POOR GENERAL HEALTH AMONG ADULTS. SO OUR TEAM REVIEWED SEVERAL OPTIONS WHEN TRYING TO DETERMINE THE BEST PLACE TO PILOT THE PROGRAM. FROM THIS MAP, YOU CAN SEE THAT MOST OF THE OF OUR NONPROFIT PARTNERS THAT PROVIDE SOME TYPE OF SERVICE IN THE COMMUNITY ARE KIND OF LOCATED CENTRALLY WITHIN GARLAND, AND THERE'S A GAP DOWN IN SOUTH GARLAND TO BE ABLE TO PROVIDE THOSE SERVICES. I SHOULD ALSO ADD THAT THIS MAP SHOWS PEOPLE IN POVERTY WITH FAIR OR POOR HEALTH. DARKER. THE THE THE COLOR ON THIS MAP REPRESENTS THE CORRELATION BETWEEN THOSE TWO THINGS. THIS MAP SHOWS PEOPLE WITH FAIR OR POOR HEALTH AND NO INTERNET ACCESS. AND THE DARKER DARKER POINTS SHOW A HIGHER RATE REVIEWED OPTIONS BASED ON THE DATA. IN EFFICIENCY. SOUTH GARLAND LIBRARY MAKES SENSE FOR THE PILOT. SOUTH SERVES IN A A HIGH NEED AREA AND HAS THE INFRASTRUCTURE TO. SUPPORT THE ROLLOUT OF THIS THIS PILOT. SO THAT'S THE HISTORY WHERE WE ARE NOW. THERE'S A LOT OF DIFFERENT STEPS THAT HAVE TAKEN PLACE SINCE WE BROUGHT THIS TO COUNCIL BACK IN AUGUST OF 24. EXCUSE ME. WE'VE BEEN MOVING FORWARD WITH THE PARKLAND TEAM, THE PILOT LAUNCH AT SOUTH GARLAND LIBRARY, OUR TEAM, INCLUDING OUR IT DEPARTMENT AND THE PARKLAND TEAM WITH SPECS, TECH, EQUIPMENT. THE INTERLOCAL AGREEMENT WAS REVIEWED BY BOTH PARTIES ATTORNEYS AND PARKLAND'S BOARD APPROVED THE INTERLOCAL AGREEMENT IN THE LAST QUARTER OF 25. THE INTERLOCAL AGREEMENT WILL BE PLACED ON THE NEXT REGULAR SESSION AGENDA FOR COUNCIL'S CONSIDERATION AND APPROVAL. EXCUSE ME, AND IF APPROVED, WE'LL MOVE FORWARD WITH THE INSTALLATION OF THE PILOT PROJECT PROGRAM AT SOUTH GARLAND LIBRARY. [02:55:06] ANY QUESTIONS? ALL RIGHT, MAYOR PRO TEM LUCK. WE GO OVER THE MY HEALTH CHART QUALIFICATION, BECAUSE YOU HAVE TO HAVE THAT IN ORDER TO PARTICIPATE IN AND USE THE PODS. IT SAID ON THE FIRST PAGE, YOU MEAN MY CHART, RIGHT? WELL, SO THERE'S TWO DIFFERENT GROUPS. DO YOU WANT ME TO ANSWER THIS? I SHOULD HAVE ASKED. SORRY, BUT GO AHEAD, INTRODUCE YOURSELF AND THEN. OH, I'M SORRY, I'M MIKE MELISSA WITH PARKLAND HOSPITAL. AND SO THERE'S TWO DIFFERENT THERE'S PARKLAND PATIENTS AND THERE'S EVERYBODY ELSE. THE POD IS NOT EXCLUSIVE TO PARKLAND. IF YOU COME IN AND YOU'RE PARKLAND PATIENT, THAT'S THAT'S WHEN WHAT YOU'RE TALKING ABOUT APPLIES. PARKLAND DOES NOT ALLOW A PATIENT TO ESTABLISH THEMSELVES AS A PATIENT THROUGH TELEHEALTH. SO IT WOULD REALLY BE A LOT OF THE FOLKS WHO ALREADY HAVE MEDICAL RECORD NUMBERS WITH PARKLAND CAN USE THIS. NOW, IF THEY'RE A PATIENT OR A METHODIST PATIENT, THEY CAN STILL USE THAT POD TO CONTACT THEIR PROVIDER. AND THEN WHATEVER CRITERIA THEIR PROVIDER REQUIRES WILL BE APPLICABLE. THEN, BECAUSE I JUST TRIED TO SIGN UP FOR THE MYCHART ACCESS THROUGH PARKLAND, AND IT SAID I EVEN PUT IN MY SOCIAL SECURITY NUMBER. WE WERE UNABLE TO VERIFY YOUR INFORMATION. SO YOUR YOUR REQUEST HAS BEEN SENT TO THE CLINIC. YOU WILL RECEIVE AN ACTIVATION CODE BY MAIL OR EMAIL WITHIN A WEEK. YEAH. SO ARE YOU A PARKLAND PATIENT? NO. AND THAT'S WHY YOU WOULD HAVE GOTTEN. THAT'S WHAT I WAS TALKING ABOUT. WE DON'T ALLOW YOU TO ESTABLISH YOURSELF AS A PATIENT. BECAUSE, I MEAN, PARKLAND JUST HAS A POLICY OF THE FIRST TIME YOU'RE SEEN AS A PATIENT. WE ESTABLISH YOU AS A PATIENT AND GIVE YOU MEDICAL RECORD NUMBER. YOU NEED TO SEE A PERSON. SO I'D HAVE TO GO TO PARKLAND HOSPITAL IF YOU'RE PARKLAND PATIENT, IF YOU CAME IN AND YOU'RE A METHODIST PATIENT OR YOU HAVE BAYLOR, LET'S SAY I DON'T HAVE INSURANCE BECAUSE THAT'S I MEAN, REALLY WHO WE'RE TRYING TO SERVE WITH ALL OF THESE PROGRAMS. SO. WELL, THAT'S ONE GROUP OF WHO YOU'RE TRYING TO SERVE. YOU'RE YOU KNOW, I WOULD THINK OF THIS AS THIS IS NOT JUST A THIS IS NOT REALLY A PROGRAM THAT'S GOING TO COVER ALL THE UNINSURED FOLKS PUT IN THERE. MOST OF THOSE FOLKS ARE STILL GOING TO HAVE TO GO TO THE CLINIC. THIS IS AN ACCESS POINT. SO IT'S AN ACCESS POINT FOR PEOPLE WHO HAVE TROUBLE WITH THEIR. SO MAYBE THEY DON'T HAVE INTERNET ACCESS AT HOME. A LOT OF THOSE FOLKS WILL USE THEIR PHONE FOR INTERNET. A LOT OF PEOPLE USE THE PHONE FOR INTERNET, HAVE DATA PLANS INSTEAD OF UNLIMITED DATA PLAN. YOU CAN EAT UP YOUR DATA PLAN PRETTY QUICKLY WITH A TELEHEALTH VISIT. SO YOU DON'T WANT THEM DOING THAT. YOU WANT TO PROVIDE A SPACE FOR THEM TO GO USE THIS. SO IT'S NOT REALLY AN ATTEMPT TO SCOOP UP EVERYBODY WHO'S UNCOVERED IN THE GARLAND AREA. NOW, WE DO WANT TO SEE THOSE FOLKS. THOSE ARE GOING TO END UP BEING OUR PATIENTS, WHETHER THEY'RE OUR PATIENT TODAY OR WHETHER THEY'RE OUR PATIENT. WHEN THEY COME TO THE EMERGENCY ROOM, THEY'RE GOING TO END UP OUR PATIENTS IF THEY'RE UNINSURED. SO WE WOULD LIKE TO ESTABLISH THEM. WELL, WE DO ESTABLISH THEM IN PERSON. NOW, I WOULD SAY THE OTHER BENEFIT IS I DON'T HAVE TO TELL ANYBODY SITTING ACROSS FROM ME THAT OUR GARLAND CLINIC IS FULL TO THE GILLS EVERY SINGLE DAY. THERE IS NOT A INCH OF SPACE IN THAT PLACE. SO IF A GARLAND PARKLAND PATIENT WHO USES THE GARLAND CLINIC CALLS OVER THERE AND THEY'RE SAYING WHATEVER I WANT FOR MY PARTICULAR THING, IT'S GOING TO BE FOUR MONTHS, FIVE MONTHS BEFORE I CAN GET IN. BECAUSE, YOU KNOW, THERE'S TWO WAYS TO PAY FOR HEALTH CARE WITH MONEY OR TIME. AND OUR, OUR, OUR PATIENT POPULATION TENDS TO PAY WITH TIME. AND SO IF THEY HEAR, WELL, IT'S 4 OR 5 MINUTES AND THEY'RE THINKING, WELL, I NEED A DERMATOLOGY APPOINTMENT, I CAN TAKE A PICTURE OR I CAN JUST GO UP TO THE CAMERA, SHOW THEM THIS GROWTH OF MY ARM, AND THEY CAN DIAGNOSE THAT OVER THE OVER THE VIDEO. THAT PERSON DOESN'T HAVE TO WAIT FIVE MINUTES CREATES A LITTLE BIT MORE OF AN EVEN PLAYING FIELD FOR THOSE WHO DON'T HAVE THE RESOURCES TO GO TO A HIGHER FALUTIN HEALTH SYSTEM, FOR LACK OF A MORE TECHNICAL TERM. DOES THAT DOES THAT MAKE SENSE? IT DOES. SO THEY WOULD BE PRESCRIBING MEDICATION WITHOUT SEEING THE PATIENT IN PERSON. CORRECT. THEY WOULD ALREADY BE AN ESTABLISHED PATIENT WITH AN MRN, AND THEY WOULD HAVE ALL OF THEIR HEALTH RECORDS AND THEY WOULD HAVE THE MEDICATION RECORDS. AND IF IT'S LIKE A RASH, LIKE A NEW THING. YEAH. THEY COULD. YEAH. IF IT WAS SOMETHING LIKE, LISTEN, IF YOU WANT AN OPIOID YOU'RE NOT GOING TO GET THAT. YOU CAN'T GET THAT FROM TELEHEALTH AT ALL. YOU'RE NOT GETTING THAT KIND OF STUFF. BUT IF IT'S A CREAM TO PUT ON A THING YOU CAN GET THAT. HOW ARE THE PODS DISINFECTED? THAT'S GOING TO BE HANDLED WITH THE LIBRARY. SO I'M GOING TO LET THAT THOSE ARE SOME OF THE THINGS THAT WE WOULD HAVE TO ESTABLISH. BUT MORE THAN LIKELY IT WOULD BE LIBRARY STAFF GOING IN AFTER WE ALREADY HAVE PROTOCOLS IN PLACE FOR CLEANING AND DISINFECTING COMPUTER EQUIPMENT ON A REGULAR BASIS. [03:00:01] SO IT WOULD BE SOMETHING SIMILAR TO TO DISINFECTING THE POD OR WIPING DOWN THE POD AFTER EACH USE. THAT MAKES ME VERY UNCOMFORTABLE. WILL YOU GO BACK TO THE THE PAGE THAT SHOWED THE PROPOSED SITES? HAD SOME BLACK BLOCKS ON IT RIGHT THERE. WHAT ARE THOSE BLACK BLOCKS REPRESENTATIVE OF? THAT'S THAT'S THE ONE. LET ME GO BACK. THESE ARE HIGHER. THE HIGHEST CONCENTRATION OF PEOPLE WITH FAIR OR POOR HEALTH AND NO INTERNET ACCESS. WHY IS THIS NOT GOING INTO CENTRAL LIBRARY? IT'S RIGHT IN THE MIDDLE, RIGHT BY ALL OF THOSE BLOCKS. AND SOUTH GARLAND IS ALL THE WAY DOWN THERE. I'M SORRY. PART OF THE REASON FOR SOUTH INSTEAD OF CENTRAL IS GOING BACK TO THIS SLIDE THAT SHOWS THE DIFFERENT COMMUNITY PARTNERS. THERE ARE OTHER RESOURCES CLOSER TO CENTRAL LIBRARY THAN THERE ARE IN SOUTH GARLAND LIBRARY. SO WE HAVE HOPE CLINIC WELL, PARKLAND, THE PARKLAND CLINIC AT CARVER. BUT HE JUST SAID THAT IT WAS 4 TO 5 MONTHS TO SEE SOMEONE. IN SOME CASES, SOMETIMES IT DEPENDS WHAT YOU'RE. I APOLOGIZE, I DIDN'T WANT I DON'T WANT TO MAKE THAT A BLANKET STATEMENT FOR EVERY SERVICE. BUT THERE ARE SOME SERVICES. LIKE. THERE ARE SOME SERVICES THAT IT IS THAT LONG, BUT I DON'T WANT TO MAKE IT SOUND LIKE EVERY SINGLE SERVICE YOU NEED IS IF YOU'LL GO TO THE NEXT SLIDE. ALSO, IF YOU'LL NOTICE ON HERE, IT'S HARD TO SEE, BUT THERE'S RED ICONS AND GREEN ICONS. SO SOUTH GARLAND WAS CHOSEN AS THE PILOT, BUT NOT NECESSARILY THE ONLY FUTURE OPTION. SO FOR CENTRAL GARLAND, THE LOCATION THAT WAS ACTUALLY CHOSEN FOR A POD WAS GALE FIELDS REC CENTER. AND PART OF THAT IS BECAUSE IF YOU'LL SEE, THERE'S A GREEN LITTLE LAPTOP ICON IN AT CENTRAL LIBRARY AND AT WEST LIBRARY, BOTH OF THOSE LIBRARIES JUST HAD ADDITIONAL STUDY ROOMS WHICH PROVIDE PRIVATE, YOU KNOW, EXISTING PRIVATE OPTIONS AND LAPTOP KIOSKS. SO THERE ARE SOME RESOURCES AT THOSE LIBRARIES NOW WHERE YOU CAN CHECK OUT A LAPTOP, GO INTO A PRIVATE STUDY ROOM. WE ALSO HAVE THAT AT SOUTH, BUT WE'VE EXPANDED THAT AT CENTRAL AND AT WEST. I COULD ADD ONE THING ON THAT TOO. YOU KNOW, WE'RE PAYING FOR THIS WITH GRANT MONEY BECAUSE WE GOT GRANT MONEY, BUT THESE THINGS ARE NOT COST PROHIBITIVE. IF YOU CAME TO US. WE DIDN'T HAVE A DIME OF GRANT MONEY AND SAID, WE WANT THREE MORE AND SOME OTHER LOCATIONS. WE WOULD NOT HAVE TO CONSIDER THE GRANT MONEY. WE WOULD JUST TAKE A LOOK AT YOUR REQUEST. THEY'RE NOT PARTICULARLY COST PROHIBITIVE FOR US TO SET UP AND UTILIZE. MY POINT BEING, YOU CAN PUT THEM WHERE YOU WANT TO PUT THEM. I HAVE A REALLY HARD TIME WITH LIBRARY STAFF OR EVEN REC CENTER STAFF HAVING TO DISINFECT A POD WHERE SOMEONE WHO WHO COULD BE QUITE SICK HAS BEEN. I. THAT'S MY BIGGEST PROBLEM WITH IT. THE SECOND PROBLEM IS THAT I JUST TRIED TO SIGN UP FOR IT. AND IF SOMEBODY HEARS, OH, THERE'S. YOU KNOW WHAT? THERE'S A PARKLAND POD THAT WE CAN GO TO, AND WE'LL JUST BE ABLE TO GO USE IT. AND THEY DON'T HAVE INSURANCE WITH BAYLOR OR OR METHODIST. THEY WILL STILL HAVE TO GO TO PARKLAND HOSPITAL IN ORDER TO GET CARE. OR THE GARLAND CLINIC WHICH YOU KNOW, THEY'RE EITHER WAITING IN A REALLY LONG LINE OR THEY'RE JUST WAITING A REALLY LONG TIME. SO THOSE ARE MY BIGGEST APPREHENSIONS ABOUT THIS. BUT SECONDLY, IT SEEMS LIKE THE PILOT PROGRAM SHOULD START SOMEWHERE WHERE THE BLACK BLOCKS ARE. SO THAT'S MY MY THIRD THING. THANK YOU. THANK YOU, MA'AM. MR. DUTTON, FIRST, I WANT TO APOLOGIZE THAT YOU ARE HERE ON SUCH A HEATED NIGHT. SO YOU'RE PROBABLY GETTING A LITTLE MORE HEATED. QUESTIONS? THIS IS A REPRIEVE FOR ME, I APPRECIATE IT. WE DO APPRECIATE YOU BEING HERE. JUST KNOW YOU'RE UNDER THE MICROSCOPE TONIGHT. SO I THINK THAT A LOT OF PEOPLE, WHEN THEY HEARD THE PARKLAND PODS, KIND OF ASSUMED THAT IT WAS A WAY TO REALLY BENEFIT OUR COMMUNITY THAT WAS LACKING ON INSURANCE AND MEDICAL ACCESS. [03:05:02] RIGHT. BUT IN ALL ACTUALITY, THIS IS REALLY JUST GOING TO ALLEVIATE SOME OF THE PEOPLE BEING AT THE GARLAND CLINIC BECAUSE YOU HAVE TO BE A PARKLAND PATIENT, AS YOU SAID. AND WHAT IS THE WHAT IS THE LENGTH OF TIME THAT IT REQUIRES TO BECOME PARKLAND PATIENT? YEAH. SO OKAY, SO JUST TO BE CLEAR, YOU DO NOT HAVE TO BE PARKLAND PATIENT TO USE THE POD. IF YOU ARE PARKLAND PATIENT. SO IF YOU'RE METHODIST, WHATEVER RULES THEY HAVE, BAYLOR, WHATEVER RULES THEY HAVE, THAT'S WHAT YOU'LL HAVE TO FOLLOW. BUT IF YOU'RE PARKLAND PATIENT TO ANSWER YOUR QUESTION AND YOU GO INTO THIS PLACE IF YOU ARE A FIRST TIME YOU'VE NEVER SEEN PARKLAND BEFORE, YOU'RE NOT AN ESTABLISHED PATIENT. YOU'RE CORRECT. THAT WILL THAT WILL TAKE A WHILE. YOU MAY TAKE SIX MONTHS FOR YOU TO GET A FIRST TIME APPOINTMENT. HOPEFULLY. I THINK WE HAVE THAT DOWN NOW, BUT GARLAND IS ONE OF OUR BUSIER CLINICS. I THINK LAST TIME MAYBE IT WAS 3 OR 4 MONTHS. BUT SO I GUESS THERE'S A, THERE'S A FEW RIPPLE EFFECT THINGS. ONE, YOU KNOW, OUR PATIENTS, WHEN YOU'RE TALKING ABOUT NOT JUST THE UNINSURED, BUT MEDICAID, BECAUSE THERE'S ONLY 23% OF DOCTORS AND PROVIDERS IN THIS STATE EVEN ACCEPT MEDICAID. SO EVEN IF YOU GOT MEDICAID, YOU STILL CAN'T GET INTO MOST PLACES. YOU KNOW, SOME OF OUR, OUR, OUR, OUR BRETHREN HEALTH SYSTEMS WON'T SCHEDULE MEDICAID PATIENTS INTO THEIR PRIMARY CARE CLINICS. SO WHAT THAT MEANS IS YOU'RE JAMMING ALL OF THESE PEOPLE INTO ONE CLINIC THERE IN GARLAND FOR THE GARLAND AREA. AND SO TO THE EXTENT THAT THERE ARE PEOPLE WHO DON'T NEED TO BE IN THAT CLINIC WHO COULD BE DOING THIS OVER THE, OVER THE TELEHEALTH, THAT REDUCES SOME THEM DECOMPRESSES SOME FOR ADDITIONAL PATIENTS. AND THEN TO THE EXTENT THAT PEOPLE HAVE TRANSPORTATION ISSUES. SO WE HAVE A LOT OF PATIENTS WHO DON'T HAVE CARS. THEY RELY ON BUSSES. THEY RELY ON RAIL. THEY RELY ON OTHER WAYS TO GET TO THE CLINIC. IN ADDITION TO THAT, WE HAVE A LOT OF PATIENTS WHO WORK HOURLY JOBS. IF THEY'RE NOT AT THEIR JOB, YOU KNOW, THEY'RE NOT LIKE ME. I TAKE A DAY OFF, I STILL GET PAID. THEY DON'T GET PAID IF THEY DON'T GO SERVE THAT HOUR. SO THEY GET THE. SO THEN THEY HAVE TO GET HELP. SO THEY GOT TO GET TRANSPORTATION. THEN IF THEY GOT THREE KIDS ON AN HOURLY JOB, THEY GOT TO FIND SOMEBODY TO TAKE CARE OF THE KIDS OR THEY GOT TO PAY FOR THAT. SO IT'S NOT JUST AS SIMPLE AS YOU KNOW, MAKING THINGS JUST A, YOU KNOW, JAMMING MORE PATIENTS THROUGH THE PARKLAND FUNNEL. I GUESS THERE'S LIKE, SOME RIPPLE EFFECTS ON THERE THAT HAVE A LOT OF IMPACT ON PEOPLE'S LIVES, THAT AN ACCESS POINT LIKE THIS CAN HELP ALLEVIATE. I'M NOT GOING TO BE POLLYANNAISH AND SIT HERE AND TELL YOU IT'S GOING TO SOLVE THEIR PROBLEMS. IT'S NOT. BUT IF IT CAN KEEP THEM FROM GETTING A BABYSITTER FOR THAT DAY, PAYING FOR THAT, THEN PAYING TO GET ON A BUS, THEN PAYING TO GET BACK ON A BUS, THEN TAKING AN HOUR, AND THEN ALL OF THAT TIME IT TAKES THEM TO GET SET UP CHILDCARE, GET TO THE PLACE THROUGH PUBLIC TRANSPORTATION. ALL OF THAT IS HOURS. THEY'RE NOT AT WORK. SO NOT ONLY ARE THEY PAYING FOR THE FOR THE KIDS, FOR THE TRANSPORTATION, THEY'RE ALSO HAVE THE OPPORTUNITY COST OF THE HOURLY WAGE THAT THEY'RE LOSING WHEN THEY'RE NOT GOING TO WORK. SO ANYTHING YOU CAN KIND OF IT'S KIND OF MY CEO DOCTOR SIRI'S PHILOSOPHY ON THIS, ANYTHING YOU CAN DO TO KEEP PEOPLE FROM HAVING TO GO TO THE CLINIC OR TO A BRICK AND MORTAR PLACE HAS A LOT OF IMPACT ON THEIR LIVES JUST BEYOND THAT ONE CLINIC VISIT, IF THAT MAKES SENSE. DID I ANSWER YOUR QUESTION? DID I JUST RAMBLE INCOHERENTLY? SO. WHY? WE SAY, YOU KNOW, YOU DON'T HAVE TO GET TRANSPORTATION AND BABYSITTER, BUT YOU'RE JUST BECAUSE YOU'RE NOT GOING TO A BRICK AND MORTAR, YOU'RE STILL GOING TO WHATEVER LOCATION THIS POD IS AT. SO THOSE THINGS ARE STILL GOING TO BE IN EFFECT, JUST IN A DIFFERENT LOCATION. SO MY. YOU GO BACK TO THE PARTNERSHIP MAPS. SO I HAVE LIKE 18,000,000 TRILLION QUESTIONS RIGHT NOW. SO SO WHEN MARGARET ASKED ABOUT WHY SOUTH GARLAND INSTEAD OF CENTRAL, YOU MENTIONED SOMETHING ABOUT THE PARTNERSHIP LOCATIONS. SO THE PARTNERSHIP LOCATIONS ARE JUST PLACES THAT HAVE AGREED TO LET US HOST A POD. CORRECT. OR WHAT IS IT? NOT NECESSARILY. THESE ARE. THESE ARE CITY PARTNERS OR NONPROFIT PARTNERS WITH PUBLIC ACCESS AREAS. SO I DID NOT SET THAT THIS SLIDE UP VERY WELL. THESE ARE PLACES THAT WE WERE IN CONSIDERATION, BUT WE MAY NOT HAVE HAD FORMAL DISCUSSIONS WITH THEM ABOUT HAVING A POD IN THESE LOCATIONS, BUT THERE ARE OUR NONPROFIT PARTNERS WITH PUBLIC ACCESS AREAS. [03:10:08] I JUST WANTED TO MAKE SURE THAT WE WERE CLEAR THAT THESE WERE NOT ACTUAL RESOURCES FOR FOR MEDICAL HELP. RIGHT. BECAUSE I WHEN WE'RE KIND OF, LIKE, FLYING THROUGH IT, IT'S, IT GETS A LITTLE EASY TO GET A LITTLE DISCOMBOBULATED WHAT WE'RE ACTUALLY TALKING ABOUT. SO. OKAY. THAT'S FINE. SORRY. SO WE GOT SIX MONTHS TO BECOME A PARKLAND PATIENT. YOU SAID THAT YOU COULD. YOU DON'T HAVE TO BE A PARKLAND PATIENT. THAT WAS A GUESS. AND IT KIND OF ALSO DEPENDS. SO WHAT IF YOU GO TO IF YOU GO TO GARLAND, THEY TELL YOU IT'S GOING TO BE 4 OR 4 AND A HALF MONTHS FOR YOU TO GET AN INITIAL SET UP PATIENT. THEY WILL ALSO OFFER YOU TO GO DOWN TO VICKERY TO GO TO THE NEW RICHLAND CLINIC WHEN IT'S BUILT. SO THEY DO TRY TO OFFER YOU OPTIONS. OF COURSE THEY'RE NOT. NOT CLOSE. I'M SURE. NO, I'VE I'VE ACTUALLY TAKEN A FRIEND TO GO GET ON THE PARKLAND HEALTH PLAN AND IT TOOK WELL OVER A YEAR. IT WAS A VERY LENGTHY PROCESS. I HAD A FRIEND THAT SAT IN PARKLAND FOR 14 HOURS THE OTHER NIGHT TRYING TO SEE A DOCTOR BECAUSE SHE WAS THROWING UP IN PAIN. YES. SO IT IS A VERY, VERY LENGTHY PROCESS. WHAT KIND OF WE'LL SAY WE DID JUST BECAUSE YOU'RE EVERYTHING THAT YOU SAID THERE. SOUNDS CORRECT. ON THE PFA APPLICATION, THE ASSISTANCE APPLICATION. WE HAVE STREAMLINED THAT NOW. SO WE GOT RID OF THE ASSET TESTS AND THINGS LIKE THAT TO SPEED THAT UP, BECAUSE YOU'RE RIGHT, IT USED TO TAKE WAY TOO LONG. WHAT KIND OF ISSUES COULD YOU GO TO A POD FOR? YOU CAN GO TO A POD FOR A VARIETY OF PRIMARY CARE AS WELL AS SPECIALTY CARE. I MEAN, NEUROLOGY YOU CAN GO THERE FOR DERMATOLOGY. YOU CAN GO THERE FOR ANYTHING THEY CAN DO OVER A ANYTHING, ANY SERVICE THAT YOU'RE ELIGIBLE FOR AT PARKLAND AND CAN RECEIVE AT PARKLAND THAT CAN SAFELY AND EFFECTIVELY BE DONE OVER THE OVER THE TELEHEALTH IS DONE. I CAN GET TO YOU AND WE CAN SEND THEM A LIST OF THE FULL THE FULL SUITE OF SERVICES, BUT IT'S LIKE A TELEHEALTH. WE DO TONS OF TELEHEALTH AT PARKLAND AND EVERYTHING THAT'S AVAILABLE TO EVERYBODY ELSE IS AVAILABLE IN THESE THESE IN THESE PODS. SO DID THE ARE THE PODS EQUIPPED WITH THE ABILITY TO DO BLOOD PRESSURE, TEMPERATURE PULSE OX, ALL OF THAT STUFF. THERE ARE WAYS TO DO THAT. I DON'T KNOW THAT THESE PODS IN PARTICULAR I'LL TELL YOU LONG TERM DOCTOR MORAN, BRETT MORAN, WHO RUNS THESE THINGS, WOULD LIKE TO SEE CUFFS AND STUFF TO PUT IN THERE SO THAT HE CAN DO MORE OF THAT. I DON'T THINK HE'S COMFORTABLE WITH THE OPTIONS THAT HE'S SEEN YET. TO PUT IN THERE. THERE ARE WAYS TO DO THAT. BUT SO I WILL SAY SOME OF THESE PLACES WHERE WE HAVE THEM NOW, LIKE IN WE HAVE ONE IN INSPIRED VISIONS IN PLEASANT GROVE. THERE ARE PARKLAND STAFF ON SITE BECAUSE IT'S, IT'S, IT'S SET UP IN ONE OF OUR HUBS. SO THEY HAVE THE ADVANTAGE OF HAVING NURSES THERE. ANYWAY, EVEN IF THERE WAS NO POD THERE, THERE WAS STILL GOING TO BE NURSES THERE. SO YOU KNOW, WE DON'T FOR THESE WE DON'T HAVE A CLINICIAN ON SITE. IN THE FUTURE, WE HOPE THAT THERE WILL BE SOME THINGS KIND OF SIMILAR TO WEARABLES FROM TELEMETRY THAT THEY CAN DO, BUT THEY DON'T HAVE THOSE IN THERE CURRENTLY. THAT IS A LITTLE CONCERNING. TO THINK THAT YOU MIGHT BE SEEING A SPECIALTY SPECIAL. WHAT AM I THAT, YOU KNOW, SPECIALTY DOCTOR? THAT CAN'T GET YOUR BLOOD PRESSURE, YOUR YOUR HEART RATE OR LISTEN TO YOUR LUNGS TYPE OF THING. I KNOW THAT'S BEEN A BIG POINTS OF CONTENTION WITH ALL OF OUR OTHER TELEHEALTH DISCUSSIONS. SO THAT'S GOING TO BE THAT'S GOING TO THAT'S NOT UNIQUE TO THIS. THAT'S GOING TO BE TO ANY TELEHEALTH. SURE, SURE. AND THAT WAS KIND OF THE POINT OF THAT WAS THAT TRYING TO WEIGH THE DIFFERENCES ON. YEAH, I'D SAY THE FLIP SIDE IS BECAUSE YOU'RE RIGHT. I MEAN, EVERYTHING YOU SAID IS CORRECT. THE FLIP SIDE IS WHAT HAPPENS TO THAT PERSON WHILE THEY'RE WAITING FOR MONTHS FOR AN FOR OR TWO MONTHS FOR FOR AN APPOINTMENT OR EVEN SIX WEEKS FOR AN APPOINTMENT. SO YOU'RE RIGHT. THERE'S A TRADE OFF. SO YOU SAID YOU DON'T HAVE TO BE A PARKLAND PATIENT. SO SAY, LIKE, I WALK IN RIGHT NOW, I'M. I AM SELF EMPLOYED. I HAVE NO INSURANCE. I DO NOT HAVE A PCP, I DON'T HAVE I LITERALLY HAVE NOTHING. [03:15:01] I GET PAID CASH ON. SO I NEED TO SEE A DOCTOR. WHAT WAS WHAT WOULD THAT LOOK LIKE FOR SOMEONE IN THAT POSITION? YEAH. THEORETICALLY, YOU COULD CALL ONE OF THE OTHER SYSTEMS, BUT PRACTICALLY THAT'S THEY'RE NOT GOING TO PUSH YOU THROUGH. SO YOU WOULD PROBABLY NEED TO AT THAT POINT, YOU WOULD BE TOLD TO ESTABLISH YOURSELF. LISTEN, IF YOU COME IN, YOU'RE LIKE, MY BLOOD PRESSURE'S OFF THE CHARTS AND YOU'RE SWEATING PROFUSELY AND YOU LOOK LIKE SOMETHING'S WRONG. THEY'RE GOING TO GET YOU TO THE EMERGENCY ROOM, BUT AT A POD, YOU CAN'T CHECK YOUR BLOOD PRESSURE. SO IT. BUT BUT THERE. BUT THERE ARE TIMES SOMEBODY WALKS INTO AN EMERGENCY ROOM AND SAYS, I'M HAVING CHEST PAIN. THEY DON'T. IT DOESN'T MATTER WHAT YOUR, YOUR, YOUR BLOOD PRESSURE IS, THEY'RE GOING TO THEY'RE GOING TO GIVE YOU THE FULL WORKUP FOR CHEST PAIN. SO I'M JUST SAYING IF THEY WALK IN THERE AND THEY'RE IN OBVIOUS DISTRESS, THEY'RE NOT GOING TO SIT THERE WITH THE WITH THE COMPUTER AND TRY TO FIGURE IT OUT. THEY'RE GOING TO SEND THEM TO THE EMERGENCY ROOM. SECOND OF ALL I'M SORRY, I FORGOT THE QUESTION. HELL, I DID TOO. I'M SURE THE ANSWER WAS BRILLIANT. I JUST GOT TO REMEMBER WHAT THE QUESTION WAS. IF YOU REMEMBER WHAT THE QUESTION WAS, IF YOU THAT'S IT. YES. THANK YOU, THANK YOU. SHE'S GOT US. YES. SO IF YOU'RE NOT ESTABLISHED PATIENTS AND WHAT THEY'RE GOING TO DO AT THAT POINT AND YOU'RE NOT LIKE SOMEBODY THAT THEY ARE GOING TO SEND AN AMBULANCE FOR THEY'RE GOING TO TELL YOU TO GO TO ANY OF THE PARKLAND LOCATIONS TO FILL OUT A PATIENT FINANCIAL ASSISTANCE APPLICATION. IN ADDITION PARKLAND IS NOT THE ONLY PLACE THAT YOU CAN DO THAT. I BELIEVE HOPE CLINIC CAN DO THAT NOW. THERE ARE OTHER CLINICS AROUND WHERE WE HAVE TRAINED THEIR STAFF TO GET THEM THROUGH THE, THE SYSTEM, BUT. AND LISTEN, I WOULD LOVE TO BE ABLE TO SIT HERE AND OUR STAFF WOULD LOVE TO TELL YOU, LIKE, WE CAN JUST TAKE NEW PATIENTS OVER THE TELEHEALTH, BUT THERE'S A LOT OF RISK TO THAT. AND THEY'RE JUST NOT COMFORTABLE. SOME PLACES DO IT. WE'RE JUST NOT THAT PARTICULARLY OUR PATIENT POPULATION IS SO SICK, MORE SO THAN OTHER HEALTH SYSTEMS. WE DO NOT LOOK LIKE BAYLOR'S PATIENT POPULATION. WE DON'T LOOK LIKE METHODIST'S. AND SO WE'RE JUST NOT COMFORTABLE DOING THAT SIGHT UNSEEN AT THIS POINT WITHOUT THEM COMING IN TO ESTABLISH AN MRN. SOMETIMES PEOPLE GIVE YOU, SOMETIMES THEY FORGET, AND SOMETIMES THEY WILLFULLY FORGET WHAT THEIR PRESCRIPTIONS ARE. WE WE JUST CAN'T TAKE THAT CHANCE AT THIS POINT. SO. THE OTHER THING, I MEAN, YOU KNOW, I'VE ANSWERED THIS. YOU'RE GOOD. WHAT IS DO YOU OFF THE TOP OF YOUR HEAD? NO. LIKE INCOME REQUIREMENTS TO BECOME A PARKLAND PATIENT. LIKE, WHAT IS WHAT DOES THAT LOOK LIKE? WHAT PERCENTAGE BELOW THE POVERTY LINE DO YOU HAVE? ANYBODY CAN BECOME A PARKLAND PATIENT, INSURED, UNINSURED. BUT THE CHARITY CARE THAT YOU'RE TALKING ABOUT, YOU NEED TO BE BELOW 400% OF POVERTY. BUT THEN IT ALSO WORKS IN LEVELS. SO LIKE THAT TOP LEVEL OF THE CHARITY CARE THAT MAY BE LIKE AN OUT OF COUNTY PERSON, AND THEY'RE EXPECT TO PAY A LOT MORE THAN AN UNINSURED PERSON. FOR THAT, THEN YOU GET DOWN TO LIKE WHAT WE WOULD CALL PFA ONE. THEY PAY NOTHING. THEY'RE GOING TO THEY'LL BE ASKED FOR A CO-PAY. BUT, YOU KNOW, AT THAT POINT THEY'RE LESS THAN 100% OF THE POVERTY LEVEL, WHICH MEANS FOR AN INDIVIDUAL, THEY MAKE LESS THAN $12,000 A YEAR. WE CAN JUST SEND IT BACK OUT ON THE ROAD SICK. OR WE CAN JUST SAY, TRY TO MAKE YOUR CO-PAY AND WE'RE GOING TO SEE YOU. AND THAT'S WHAT WE DO. WE SEE THEM AT THAT POINT. SO THERE'S FOUR LEVELS OF OUR FINANCIAL ASSISTANCE PROGRAM. AND IT GOES EVERYTHING FROM A ZERO PAY. WITH MAYBE YOU'RE ASKED TO PAY $30 A CO-PAY JUST SO PEOPLE DON'T COME IN AND HANG OUT IN THE E.D., WHICH SURPRISINGLY, WE HAVE. AND THEN IT GOES ALL THE WAY UP TO PAYING A SIGNIFICANT PERCENTAGE OF OF BILL. SO. SO THE LOWEST CO-PAY IS STILL ABOUT 30 BUCKS. YEAH. AND I, YOU KNOW, THAT'S THE YOU KNOW, THE OTHER THING IS IF SOMEBODY COMES IN, THEY REALLY DON'T HAVE CO-PAY. THEY'RE GOING TO GET SERVICE. AND THEN. WE'VE HAD YOU BROUGHT UP HOPE CLINIC. WE'VE HAD MULTIPLE OTHER PEOPLE BRING UP HAUTKLINIK. SO I ACTUALLY I DIDN'T MEAN TO PUT HIM IN. NO, NO NO, NO, IT'S FINE. YOU'RE FINE. ACTUALLY, I MEAN, I'M GLAD. I LOVE THAT OUR CURRENT HOT TOPICS HAVE BROUGHT SOME AWARENESS TO THE WHOLE PLANNING FOR PEOPLE THAT OTHERWISE MIGHT NOT HAVE KNOWN WHAT THEY DO OVER THERE. SO YOU GUYS ARE AT 400% BELOW THE POVERTY LINE. HOPE CLINIC IS 200% BELOW THE POVERTY LINE TO BECOME A CLIENT. THEY JUST STARTED TAKING NEW PATIENTS AS OF JANUARY 1ST. HEALTH CLINIC IS VERY, VERY SMALL. THEY RUN FULLY ON DONATIONS. [03:20:03] SO THE NUMBER OF NEW PATIENTS THAT THEY'RE ACTUALLY GOING TO BE ABLE TO TAKE, I'M GOING TO GO AHEAD AND SAY IT'S SAFE TO ASSUME IT'S GOING TO BE LESS THAN. NINE PEOPLE THAT WE HAVE IN THIS ROOM. SO AND THAT IS NOT TO DISCREDIT THE HOPE CLINIC AT ALL BY ANY STRETCH OF THE MEANS. THEY DO PHENOMENAL WORK OVER THERE. THEY'RE AMAZING. LOVE THEM. HOWEVER, THE AMOUNT OF SERVICES THAT THEY ARE ABLE TO PROVIDE TO ANYONE THAT IS NOT AN ESTABLISHED PATIENT IS VERY, VERY SMALL. DO YOU KNOW HOW MANY GARLAND RESIDENTS THAT ARE CURRENTLY ON OR ARE A PARKLAND PATIENT? YOU KNOW, I SHOULD HAVE THOUGHT TO ASK THAT. HOW MANY UNIQUE PATIENTS? WHAT'S THAT? WE'LL HAVE TO GET IT. I'LL HAVE TO GET THAT. AND WE CAN SEND IT TO THE WHOLE COUNCIL FOR YOU. BUT I SHOULD HAVE THOUGHT TO ASK THAT, BUT YOU KNOW, THERE'S UNIQUE PATIENTS AND PATIENT VISITS. I'LL GET YOU THE UNIQUE NUMBER. PERFECT, I APPRECIATE THAT. AND THEN, AS MARGARET STATED I, I AM CONCERNED ABOUT BRINGING SICK PEOPLE INTO OUR LIBRARIES OR OUR, REC CENTERS. WHEN THEY WHEN THEY TOOK ON THAT JOB, THEY DIDN'T NECESSARILY DECIDE THAT THEY WANTED TO EXPOSE THEMSELVES TO THAT. I THINK THAT COVID MADE A LOT OF PEOPLE MORE AWARE OF THE ENVIRONMENT THAT THEY'RE PUTTING THEMSELVES IN, FOR ONE REASON OR ANOTHER. I DO HOME HEALTH, AND SO I CAN'T RISK GOING INTO A CESSPOOL OF DWIS. RIGHT. SO BECAUSE WHAT I MIGHT BRING TO ONE OF MY PATIENTS COULD ACTUALLY BE FATAL TO THEM. SO I HAVE TO BE MINDFUL OF THAT. AND I THINK THAT COVID TAUGHT A LOT OF PEOPLE THAT AND SO I WANT TO MAKE SURE THAT WE'RE BEING VERY MINDFUL OF OUR STAFF, THAT THAT'S NOT WHAT THEY SIGNED UP FOR. DO WE HAVE ANY KIND OF LIKE REQUIREMENTS OF LIKE, AT WHAT POINT DO WE TELL OUR STAFF TO STAY AT HOME? LIKE, YOU'RE NOT IN THAT GRADE, LIKE YOU HAVE TO HAVE A TEMPERATURE OF 101.3. YOU KNOW, LIKE, WHAT ARE WE KIND OF HOW DO WE DO OUR HOW DO WE HANDLE OUR, OUR EMPLOYEES THAT ARE HOME SICK OR WHATEVER? SO I CAN SPEAK FOR THE LIBRARY OF HOW WE DO IT. WE ENCOURAGE OUR, OUR TEAM MEMBERS, OUR STAFF THAT IF THEY'RE NOT FEELING WELL. ESPECIALLY IF YOU HAVE A TEMPERATURE OR EXHIBITING EXHIBITING OTHER SYMPTOMS TO PLEASE STAY HOME, TAKE CARE OF YOURSELF AND THEN GIVE THEM THE DIFFERENT AVENUES THAT THEY CAN WHETHER IT'S THROUGH THE CITY CLINIC OR OTHER AVENUES FOR THEM TO BE ABLE TO TAKE CARE OF THEMSELVES AND GET THE HELP THAT THEY NEED. YEAH. I DON'T WANT TO SEE OUR, OUR FOLKS THAT THEY, YOU KNOW, BECAUSE YOU DON'T ALWAYS KNOW WHAT SOMEONE ELSE HAS. AND HECK, THEY MIGHT NOT KNOW WHAT THEY'VE GOT WHEN THEY'RE WALKING IN. AND SOME THINGS SIT AND HIBERNATE FOR A WHILE BEFORE THEY GET YOU IN. NOW YOU'VE AFFECTED EVERYBODY. AND THEN WOULD PARKLAND PROVIDE PPE FOR OUR STAFF THAT HAS TO GO AND CLEAN THOSE PODS, OR IS THAT SOMETHING THAT WE WOULD BE BEARING THAT COST? I HAVEN'T BEEN ASKED THAT, BUT I MEAN, I CAN ASK THAT. I MEAN, WE PARKLAND HASN'T BEEN ASKED THAT BEFORE. SO BECAUSE LIKE I SAID, IN THE OTHER LOCATIONS WE DO THIS, WE HAVE PEOPLE THERE. SO EDNA, CAN WE ASK ABOUT PPE? AND THAT ALSO IS NOT SOMETHING THAT'S COST PROHIBITIVE. SO IT'S IT'S A FAIR ASK. I CAN GET THAT ANSWER FOR YOU AND BRING IT BACK. AND THEN SO THIS WOULD BE THE FIRST UNMANNED LIKE POD STATIONS THAT YOU GUYS WOULD HAVE. EDNA. ARE ANY OF THE OTHER ONES OUTSIDE OF OUR HUBS WHERE WE HAVE THE STAFF RIGHT NOW. WHICH WHICH ONE? THAT ONE WE HAVE STAFF AT. ATHAT. WE HAVE. WELL, I THINK THE GASTON ONE WE MAY NOT HAVE A STAFF AT I MAY I I'LL HAVE THAT ONES NEWER. I'M MORE FAMILIAR WITH THE INSPIRED VISIONS AND THE VICKERY ONE. BUT CAN WE FIND OUT FOR SURE ON THAT GAS ONE AND ADD THAT TO THE LIST OF THINGS WE NEED TO SEND THE COUNCIL? DID YOU HAVE A QUESTION LIKE, RELATED TO. I WAS CURIOUS, I WAS JUST CURIOUS YOU KNOW I DIDN'T KNOW, LIKE, HOW THAT STRUCTURE LOOKED AND IF THIS WAS GOING TO BE LIKE A A VERY PILOT PROGRAM FOR AN UNMANNED POD. SO I WAS I WAS JUST CURIOUS. I IT PROBABLY WILL BE ON THE, I MEAN, EVEN THE ONE IF THAT THIRD ONE THAT I NOTED DOESN'T HAVE STAFF, [03:25:03] IT'S PRETTY NEW ONE. SO IT'LL I WOULD STILL CONSIDER IT A PILOT. PERFECT. THANK YOU SO MUCH I APPRECIATE IT. THANK YOU MA'AM. YOU MENTIONED CESSPOOL OF OOZE AND WE KEEP COMING BACK TO THIS COUNCIL WEEK AFTER WEEK. SO COUNCIL MEMBER WILLIAMS, I FORGOT WHAT I WAS GOING TO SAY. SORRY. OH, OH, JUST COME BACK TO ME. KAREN? YES, SIR. YOU DIDN'T. YOU MAY HAVE TALKED ABOUT IT WHILE I WAS OUT, BUT WHAT IS THE SECURITY, SAFETY AND SECURITY PROTOCOL FOR THIS? THESE NEW PARTS THAT YOU'RE PUTTING DOWN AT SOUTH DAKOTA LIBRARY IN THAT AREA, THAT WHOLE SOUTHERN SECTOR. AND I RAISED THAT BECAUSE OF THE ONGOING HOMELESSNESS THAT WE HAVE DOWN IN THAT AREA. SO NOW THAT WE HAVE A HUGE PROBLEM, BUT WE HAVE WE KNOW WE'VE GOT A PROBLEM. SO WHAT DOES IT SECURITY LOOK LIKE? AT THE LIBRARY. WHAT WILL IT LOOK LIKE WITH THESE PODS DOWN THERE? WELL, THE POVERTY FIRST COME, FIRST SERVED. IT WOULD BE LOCKED. AND TO BE ABLE TO USE THE POD, A PATIENT WOULD HAVE TO CHECK IN AT THE DESK. IN ORDER TO GAIN ACCESS TO THE POD, WOULD THERE BE SOMEONE IN INSIDE THE PARK OR INSIDE THE LIBRARY? SO ONE OF OUR STAFF MEMBERS WOULD HAVE A KEY TO BE ABLE TO UNLOCK THE THE DOOR TO THE POD FOR THE PATIENT TO BE ABLE TO HAVE ACCESS TO THE POD. IT WOULDN'T JUST BE OPEN. UNLOCKED. OKAY. WITHOUT OVERSIGHT, THE POD WOULD ACTUALLY BE PHYSICALLY INSIDE THE LIBRARY. YES, SIR. OKAY. ALL RIGHT. SO ARE YOU GOING TO MAKE SPACE INSIDE THE EXISTING LIBRARY FOR THESE PARTS? YES, SIR. OKAY. ALL RIGHT. THANK YOU. THANK YOU MAYOR. THANK YOU SIR. COUNCILMEMBER BASS. YES. THANK YOU MAYOR. THANK YOU. APPRECIATE YOU ALL BEING HERE. A COUPLE QUESTIONS FOR YOU, AND I APOLOGIZE IF ANY OF THESE WERE COVERED UNDER THE SLIDES. I WAS TRYING TO TAKE NOTES AS THE SLIDES WERE GOING AND SUCH. SO LET'S SEE, IT WAS COUNCIL MEMBER DUTTON BROUGHT UP, TALKED ABOUT CURRENT NUMBER OF PODS IN USE WITH AND WITHOUT MEDICAL PERSONNEL AVAILABLE. AVAILABLE. CAN YOU TELL ME THAT? THREE. THREE. RIGHT. THERE'S THREE CURRENT ONES. YES. AND THEN ONE OF THOSE AND THEN ONE OF THOSE YOU MENTIONED IS WITHOUT MEDICAL. BUT I NEED TO CONFIRM THAT THE OTHER TWO I'VE BEEN TO, THE THIRD ONE I HAVEN'T. SO I NEED TO CONFIRM. AND OF COURSE WHAT WE WANT TO FOCUS ON IS THE ONES THAT WOULD BE MOST SIMILAR TO OURS. RIGHT? SINCE OURS WON'T HAVE MEDICAL PERSONNEL AVAILABLE, THEN THE TALKING ABOUT THE ONES THAT HAVE THE MEDICAL PERSONNEL AVAILABLE WOULD BE MOOT. OKAY. AND SO THE ONE THAT DOES NOT HAVE MEDICAL PERSONNEL AVAILABLE ALONGSIDE IT, HOW LONG HAS THAT BEEN IN USE? THAT ONE I DON'T KNOW THE SPECIFIC TIME ON IT, BUT THAT ONE IS ONE THAT IS THE NEWEST OF THREE. AND AGAIN, I NEED TO CONFIRM THAT IT DOESN'T HAVE MEDICAL STAFF IN THERE. USUALLY I'LL TELL YOU THE MODEL, IT SOUNDS LIKE I'M BEING EVASIVE. BUT HERE'S WHAT I'M REALLY SAYING. THE MODEL THAT WE STARTED THESE THINGS UNDER WAS WE HAVE WHAT WE CALL LITTLE ACCESS POINTS THROUGHOUT THE THROUGHOUT THE COUNTY. ONE IS THAT INSPIRED VISIONS COMMUNITY CENTER IN PLEASANT GROVE. I'LL JUST USE THAT AS THE EXAMPLE. AND SO FOR THOSE THOSE ACCESS SITES PRE-DATE THESE THESE PODS. SO BASICALLY THERE'S NURSES THERE. THERE'S MOSTLY COMMUNITY HEALTH WORKERS WHO WILL TAKE BLOOD PRESSURE AND DO ALL OF THAT STUFF. THEN WE ADDED THAT, THAT POD IN. SO IT WASN'T A SITUATION WHERE LIKE WE WENT OUT AND PUT OUT A BUNCH OF PODS. WE ALREADY HAD THESE ACCESS CENTERS THERE, AND THEN WE ADDED A POD THERE. SO THE POINT BEING, THAT WASN'T REALLY A PILOT THAT WAS SIMILAR TO, TO THIS OR SIMILAR TO THE CREATION OF THIS OKAY. OKAY. SO THIS ONE PRETTY MUCH IS GOING TO BE FOR I WOULD CONSIDER THIS LIKE A TRUE PILOT EVEN IF THE OTHER ONE YOU KNOW, THAT OTHER COMMUNITY, THE ONE, THE THIRD ONE THAT I'M SAYING, I'M NOT 100% SURE ON WHETHER THE STAFF IS THERE, THAT THAT'S STILL MORE OF A COMMUNITY CENTER TYPE SITUATION. YEAH. SO THERE IS NO EXISTING DATA TO SHARE. THAT'S SIMILAR TO WHAT THIS ONE SPECIFICALLY. AND THEN SO WHAT IS INSIDE THE POD? BECAUSE WE KNOW IT DOESN'T HAVE A BLOOD PRESSURE MONITOR, DOESN'T HAVE O2. WHAT WHAT IS INSIDE THE POD? YEAH, THERE'S AN INSTRUCTION THERE'S AN INSTRUCTION BOOKLET, AND THEN THERE IS A SEAT AND THERE IS A COMPUTER. OKAY. AND AS FAR AS SO FOR LIBRARY STAFF WOULD ISSUE A KEY. OKAY. AND THEN I'M SURE THE, YOU KNOW, PLUG IN THE COMPUTER IN THE ELECTRICAL COST AND THAT'S VERY THAT'S MINIMAL. [03:30:01] I'M NOT CONCERNED ABOUT THAT. BUT AS FAR AS MAINTAINING THE POD, CLEANING THE POD ANY SUPPLIES THAT NEED TO BE IN THE POD, WHO'S RESPONSIBLE FOR THE THOSE FINANCIAL COSTS? THE CLEANING THE POD AND MAINTAINING THE POD WOULD BE THE CITY OF GARLAND. I DID SAY THAT I WOULD ASK ABOUT PPE BECAUSE THAT WAS ASKED. AND YOU KNOW, THE PPE YOU DON'T NEED, LIKE A HAZMAT SUIT FOR THAT. SO IT WOULD BE NOT SUPER EXPENSIVE. WHAT ARE THE WHAT ARE THE HOURS THAT THE POD IS AVAILABLE? THAT'S A LIBRARY QUESTION. IT WOULD BE AVAILABLE TO THE PUBLIC DURING NORMAL OPERATING HOURS OF THE LIBRARY. OKAY, SO THE HOURS WOULD COINCIDE WITH THE LIBRARY. OKAY. AND THEN KAREN, TAKING INTO ACCOUNT THAT THE LIBRARY STAFF IS NOW GOING TO HAVE AN ADDITIONAL RESPONSIBILITY HOW DOES THAT AFFECT STAFFING? WE CAN WORK INTO IT. IT'S PART OF THE PILOT FOR US TO SEE WHAT THE DEMAND IS OF THE POD, AND THEN US BE ABLE TO WORK WITH OUR EXISTING STAFFING STRUCTURE. OKAY. AND THEN AS FAR AS BECAUSE THIS WOULD OF COURSE WOULD REQUIRE SOME TRAINING, EVEN IF IT'S MINIMAL. AND WE UNDERSTAND THAT, YOU KNOW, EVEN AT THE LIBRARY AND EVEN WORKING FOR THE CITY OF GARLAND, SOME OF THOSE POSITIONS DO TEND TO BE TRANSIENT. AND SO YOU KNOW, SO THE TRAINING IS NOT A ONE TIME THING EITHER. IT WILL BE ONGOING. AND THEN ALSO, OF COURSE, THERE'S GOING TO BE, YOU KNOW, ANYTIME YOU GIVE SOMEBODY A RESPONSIBILITY, YOU HAVE TO HAVE ACCOUNTABILITY AS WELL. RIGHT? SO IT'S NOT JUST A ONE PERSON THING. RIGHT? IF YOU'VE GOT SOMEONE WHO'S AN HOURLY EMPLOYEE AND THEY'RE RESPONSIBLE FOR CLEANING, SOMEBODY ON A MANAGEMENT LEVEL, OF COURSE IS GOING TO HAVE TO CHECK IN PERIODICALLY AND MAKE SURE THAT'S TAKING PLACE. SO LABOR CAN I MEAN, IT'S NOT A MINIMAL THING. AND THEN ALSO ONE THING I'M THINKING ABOUT, WHICH WAS BROUGHT UP AS WELL, IF WE WERE ADDING ON A, A COMPLETELY DIFFERENT RESPONSIBILITY WHEN COMPARED TO THE LIBRARY, THAT COULD HAVE AN EFFECT ON, ON LABOR COSTS IN ADDITION TO JUST HIRING. LET'S SAY IF YOU HAD TO HAVE AN EXTRA TWO HOURS A WEEK, IT COULD HAVE AN ADDITIONAL EFFECT OF THE LIBRARY HAVING TO PAY MORE TO ATTRACT CANDIDATES WHO ARE WILLING TO TAKE ON THAT ADDITIONAL RESPONSIBILITY, NOT RELATED TO LIBRARY SERVICES AS WELL. SO I THINK THAT WOULD BE SOMETHING TO CONSIDER AS WELL. AND THEN IS THIS IS THIS POD AVAILABLE? WHO IS THIS POD AVAILABLE TO ONLY GARLAND RESIDENTS OR DALLAS COUNTY RESIDENTS? IT CAN BE AVAILABLE TO ANYBODY WHO GOES IN THERE NOW. IF SO, IF YOU'RE A DALLAS COUNTY RESIDENT AND YOU ARE A PARKLAND ESTABLISHED PARKLAND PATIENT, YOU CAN USE IT AND THEY'LL SEND YOU TO PARKLAND. DOCTOR, IF YOU'RE A METHODIST OR BAYLOR PATIENT, THEY'LL SEND YOU THERE. IF YOU COME FROM ACROSS THE COUNTY LINE OR ACROSS THE BRIDGE THERE FROM ROCKWALL AND YOU AND YOU GET IN THERE YOU KNOW, YOU'RE GOING TO BE TREATED AS AN OUT OF COUNTY PERSON AT PARKLAND. BUT IF YOU'RE A BAYLOR PATIENT WHO CROSSED THE COUNTY LINE. OKAY. I DON'T THINK THERE'S NOTHING ON OUR END THAT WOULD STOP THEM FROM ACCESSING THEIR DOCTOR. OKAY. SO FROM FROM THE FROM GARLAND'S STANDPOINT, THOUGH LOOKING AT IT FROM OUR PERSPECTIVE, WE'RE PUTTING THIS WITHIN LESS THAN TWO MILES FROM THE BORDER OF DALLAS AND WHICH IS DALLAS COUNTY. SO WE'LL BE ATTRACTING NON GARLAND RESIDENTS AS WELL. AND AGAIN, WE WILL HAVE SOME ANCILLARY COSTS INVOLVED IN THAT STAFFING. SO I'D WANT TO TAKE THAT INTO CONSIDERATION AS WELL. THERE'S, THERE'S A LOT OF, A LOT OF THOUGHT THAT NEEDS TO GO INTO THIS AND WHAT WE'RE GOING TO INCUR. AND ULTIMATELY THE CITY IS A BUSINESS. WE HAVE TO THINK ABOUT IT THAT WAY AS WELL. SO, YOU KNOW, THERE ARE GOING TO BE FINANCIAL COSTS ON DIRECT AND INDIRECT LEVELS ASSOCIATED WITH THIS. AND I JUST WANT TO MAKE SURE THAT WE'RE CONSIDERING THAT YOU LOVE THE IDEA OF SUPPORTING OUR UNDERSERVED. ABSOLUTELY. I THINK WE'RE JUST TRYING TO FIND THE BEST METHOD TO DO THAT. SOMEBODY HAD MENTIONED, AND I DON'T WANT TO HOLD THINGS UP, BUT SOMEBODY MENTIONED THE HOMELESS POPULATION AS WELL. AND I THINK YOU'D FIND A SURPRISING NUMBER OF THOSE ARE ALREADY ESTABLISHED PARKLAND PATIENTS BECAUSE, ONE, THEY EITHER COME THROUGH OUR EMERGENCY DEPARTMENT, THEY GET HELD ON A PSYCH THING OVER AT PARKLAND, WHICH MAKES THEM AN ESTABLISHED PATIENT, OR THEY'VE BEEN TO THE JAIL WHERE WE RUN THE HEALTH CARE THERE. SO IF THEY'VE BEEN TO ANY OF THESE, THEY END UP HAVE ALREADY HAVING MR IN NUMBERS. SO I THINK WHAT COUNCILMAN WILLIAMS WAS REFERRING TO WAS THEM USING IT AS A AS A HOME. OH, OKAY. WELL, YEAH. YES. YEAH. ALRIGHT. THANK YOU. MAYOR. DEPUTY MAYOR PRO TEM. THANK YOU, MISTER MAYOR. DOCTOR MOLATE, IT'S GOOD TO SEE YOU. GOOD TO SEE YOU AGAIN. WELL, THANK YOU FOR FOR Y'ALL COMING DOWN HERE AND SHOWING US THIS. ONE OF THE THINGS THAT I'M CURIOUS ABOUT, SINCE THIS IS A PILOT PROGRAM, WHAT DOES SUCCESS LOOK LIKE? WHAT WOULD THE NUMBERS BE IF SOMEBODY THAT'S HOW MANY VISITS PER DAY ARE WE TALKING ABOUT? ME? ARE YOU? I THINK IT WOULD BE A COMBINATION OF THINGS BETWEEN. BETWEEN THE LIBRARY AND BETWEEN PARKLAND. OF HOW OFTEN IS IT USED? [03:35:05] AND I DON'T KNOW. AND EDNA MAY HAVE TO CORRECT ME IF I'M WRONG ON THIS. SOME OF THE THE FIRST POD THAT WAS INSTALLED WASN'T BEING USED 20 TIMES A DAY. IT WAS SLOWER SMALLER NUMBER OF USAGE USAGES. BY THE PUBLIC. BUT I THINK IT'S WHAT IS PARKLAND SEEING. AND THEN WHAT ARE WE SEEING? IS IT I THINK SUCCESS IS IT'S BEING USED AT. A COUPLE OF TIMES A WEEK. BUT IT'S ALSO GOING TO BE DETERMINED BY HOW MUCH STAFF TIME IT'S TAKING AND SOME OF THOSE REQUIREMENTS. OKAY. SO A COUPLE OF TIMES YOU WOULD CONSIDER THE PILOT PROGRAM SUCCESSFUL IF IT WAS USED AT LEAST A COUPLE OF TIMES A WEEK, RIGHT. ESPECIALLY WHILE WORD OF MOUTH OR WHILE SOME OF THOSE THINGS WERE BEING WORKED OUT. WHAT WOULD YOU CONSIDER TO BE MAXIMUM CAPACITY THAT THE THAT THE LIBRARY WOULD FEEL COMFORTABLE SERVING? I DON'T KNOW THAT I CAN ANSWER THAT QUESTION AT THIS POINT. OKAY. AND WHAT WHAT IS YOUR COMFORT AND WHAT HAS BEEN THE STAFF'S COMFORT AT THE SOUTH GARLAND BRANCH? THEY HAVE TO KNOW THAT THIS IS A PROPOSED USE. ARE THEY EXCITED ABOUT IT? IS IT SOMETHING THAT THEY'RE INTERESTED IN? THEY'RE INTERESTED IN BEING ABLE TO SERVE THE COMMUNITY AND KNOW THAT ACCESS TO HEALTH CARE IS A BARRIER FOR A LOT OF RESIDENTS. OKAY. IF I COULD ADD ON TO THAT. ABSOLUTELY. THERE IS NEVER GOING TO BE A TIME WHEN YOU WALK IN AND IT LOOKS LIKE A CLINIC, WAITING ROOM OR AN EMERGENCY WAITING ROOM. THAT DOESN'T HAPPEN AT THESE THINGS. THERE'S NOT GOING TO BE 20 PEOPLE SITTING OUT THERE WAITING FOR SERVICE. IF I IF WE COULD GET TEN PEOPLE A WEEK INTO THIS, AND THAT'S TEN PEOPLE I DIDN'T HAVE TO SCHEDULE AT THE GARDEN GARLAND CLINIC. THAT MEANS THERE'S TEN OTHER PEOPLE WHO'VE BEEN WAITING FOR SERVICES TO GET INTO THAT CLINIC WHO NOW CAN TAKE THOSE SPOTS. THAT IS SUCCESS FOR US. LIKE, WE ARE SO JAM PACKED AT PARKLAND EVERY DAY, EVERYWHERE IN EVERY CLINIC THAT ANYTHING THAT DECOMPRESSES 1015 PATIENTS ALLOWS US TO GET 10 OR 15 MORE IN. IT DOESN'T SOUND LIKE A BIG NUMBER. BUT WE WE WORK EVERY SINGLE ANGLE THAT WE CAN TO GET ONE MORE PERSON INTO THAT SYSTEM. I DON'T KNOW. SO, YOU KNOW, LIKE I SAID, IF WE IF WE GOT TEN PATIENTS A WEEK AND THAT FREED UP TEN SPACES AT THE CLINIC I WOULD CONSIDER THAT A SUCCESS IF WE GET MORE. THAT'S GREAT TOO. AWESOME. WELL, I'M VERY COMFORTABLE WITH THE PROGRAM. I THINK THAT IT'S VERY INNOVATIVE. I KNOW THAT WE HAVE A AN UNDERSERVED POPULATION THAT ARE NOT VOCAL. AND IT'S SOMETHING THAT IS IMPORTANT TO THE COMMUNITY. SO I'M, I'M GLAD THAT THAT THIS IS COMING FORWARD. AND I, I. I DON'T KNOW WHETHER WHICH PLACE IT WOULD HAVE PLACED IT FIRST. I'M NOT GOING TO SECOND GUESS WHETHER THIS OR GAIL FIELDS WOULD HAVE BEEN A BETTER SPOT TO BE. THIS IS WHAT IS BEING PROPOSED. AND I HAVE I'M COMFORTABLE WITH IT. SO I THANK YOU FOR BEING HERE. THANK YOU, MR. MAYOR. SIR. COUNCILMEMBER BEARD. I AM ALL FOR HELPING PEOPLE WITH MEDICAL NEEDS IN ANY SHAPE, FORM OR FASHION THAT WE CAN DO IT. I'VE GOT ONE COMMENT AND ONE QUESTION. I HAD A DOCTOR'S APPOINTMENT TODAY, AND THEY HAD TO SANITIZE THE WAITING ROOM, THE EXAM ROOM BEFORE I WENT IN. SHE OPENED THE DOOR AND SHE WENT, OOPS, HOPE IT HASN'T BEEN SANITIZED. THAT REQUIRED ME TO WAIT ANOTHER 30 MINUTES FOR THAT SANITATION PROCESS TO HAPPEN. SO IF WE HAVE PEOPLE THAT LET'S JUST SAY THERE'S SOMEBODY WAITING FOR THAT POD AND THEY COULD POSSIBLY BE CONTAGIOUS, YOU CAN'T JUST WIPE IT DOWN AND THE NEXT PERSON GO IN, IT HAS TO BE CLEANED DOWN. AND THEN THAT HAS TO DRY BEFORE THE NEXT PERSON CAN GO IN. SO WOULD WE HAVE SOME WAY OF A PLACE NOT IN THE GENERAL PUBLIC, FOR THAT PERSON TO WAIT? WOULD THEY HAVE TO WAIT OUTSIDE? THAT'S ONE OF MY QUESTIONS, BECAUSE IN CASE THAT DID HAPPEN, IT'S IT'S NOT. ONE PERSON GOES IN, THEY COME OUT, ANOTHER PERSON GO WIPE DOWN REAL QUICK AND THE OTHER PERSON GOES IN FOR PROPER SANITATION. YOU'VE GOT TO CLEAN IT AND IT HAS TO AIR DRY. SO THAT'S A QUESTION A SECOND QUESTION. AND I'LL LET YOU ALL COME BACK TO THAT BECAUSE THAT'S THE SECOND QUESTION. OKAY. I'M NOT AN ESTABLISHED PARKLAND PATIENT, BUT I AM AN ESTABLISHED BAYLOR PATIENT. SO I GO IN TO USE THE POD FOR BAYLOR. THAT WOULD HOW DOES I JUST HOW DOES THAT WORK? [03:40:06] USUALLY YOU LOOK UP WHAT THE PROTOCOLS ARE FOR BAYLOR, AND USUALLY YOU CAN FIND THAT IN YOUR. WE HAVE MY CHART. I DON'T KNOW IF THEY CALL IT THAT AT BAYLOR. SO THEY'LL HAVE INSTRUCTIONS THAT YOU CAN ASK YOUR DOCTORS. THEY'LL TELL YOU. BAYLOR WILL TELL YOU HOW THEY WANT YOU TO ACCESS THEIR TELEHEALTH SERVICES. SO SOME HEALTH SYSTEMS DO THAT INTERNALLY. SOME HEALTH SYSTEMS CONTRACT THAT OUT. IT REALLY WOULD BE HEALTH SYSTEM, HEALTH SYSTEM. BUT THEY'LL TELL YOU WHAT THE PROCESS IS TO ACCESS THEM. AND ON, ON THE, ON THE HYGIENE THE CLEANING OF THE THING. THERE HAVE BEEN A FEW QUESTIONS ABOUT THAT. SO, EDNA, CAN WE GET THE WHATEVER TRAINING COMES WITH THIS? I APOLOGIZE, I'M NOT A I'M NOT A REAL DOCTOR. I'M ONE OF THE FAKE PHD DOCTORS, SO I NEED TO GET THE. I WANT TO MAKE SURE I SAY EVERYTHING CORRECTLY FROM A HOW A CLINICIAN WOULD SAY IT. SO, EDNA, CAN WE ADD THAT TO THE LIST OF WE CAN SEND THEM ALL THIS THE TRAINING THAT GOES WITH THAT FOR, FOR SPECIFICALLY FOR SANITATION SANITATION, HYGIENE. ALL RIGHT. SO YOU SAID THAT THERE'S AN INSTRUCTION BOOKLET, SO I WOULD ASSUME THAT WOULD ALSO NEED TO BE LAMINATED SO IT COULD BE WIPED DOWN. IT IS. I DON'T LOVE THE CONSTRUCTION. THE, THE BOOKLET. I'M TRYING TO GET THEM TO WORK ON A LITTLE BETTER, BETTER THING, BUT. OKAY, BECAUSE IF THE PERSON BEFORE ME MAYBE HAS A CONTAGIOUS SKIN DISEASE, I MEAN, LIKE, MAYBE THEY'VE GOT SOMETHING THAT'S CONTAGIOUS THAT'S ON THERE. YOU KNOW, A STAPH INFECTION OF SOME SORT. AND I'VE GOT A SINUS INFECTION. I WANT TO MAKE SURE ANYTHING THAT I WOULD TOUCH AFTER THEY TOUCH SOMETHING. I FEEL VERY UNCOMFORTABLE WITH OUR LIBRARY STAFF DOING THAT SANITATION. BUT THAT'S SOMETHING WE'LL HAVE TO DEAL WITH IN A DIFFERENT. YEAH, IT'S A FAIR QUESTION. AND, EDNA, IF WE CAN ALSO TO TO ANSWER THIS QUESTION, GET HOW HOW THAT'S WORKING AT THE OTHER ONE BECAUSE I DID CONFIRM ONE OF THOSE. THE GAS AT LEAST DOES NOT HAVE STAPH. SO CAN WE SEE HOW THEY'RE GETTING THE ANSWER THE QUESTION BY GETTING HOW THEY'RE DOING IT AS WELL AND INFORM THE COUNCIL. THOSE ARE JUST LIKE I SAID, I, I LOVE OUR LIBRARY STAFF AND I WANT THEM TO STAY SAFE AND HEALTHY. AND I WANT THE PERSON THAT USES THE POD AFTER THE PREVIOUS PERSON TO NOT CONTRACT ANYTHING ELSE. I LOVE THE IDEA THAT WE'VE GOT A PLACE THAT PEOPLE THAT DON'T HAVE INTERNET SERVICE CAN GO AND DO A TELADOC VISIT, YOU KNOW, ON A ON A SCREEN THAT ARE NOT SITTING IN A DOCTOR'S OFFICE OR CLINIC WITH 50 OTHER PEOPLE. BUT I WANT TO MAKE SURE THAT THEY'RE NOT CONTAMINATING OTHER PEOPLE, TOO. SO I JUST WANT A LITTLE MORE INFORMATION ON THAT. SO. OKAY. THANK YOU SO MUCH. GOOD QUESTION. WE WANT TO WE WANT TO SERVE PATIENTS NOT MAKE CREATE PATIENTS. AND TO FOLLOW UP ON YOUR FIRST QUESTION WE DON'T HAVE ALL OF OUR SPACE IS PUBLIC, SO THERE WOULD NOT BE WE CAN'T GUARANTEE A QUARANTINED SPACE SOMEWHERE IN CONTACT WITH OTHER PEOPLE. FOR THE RECORD, I LOVE OUR LIBRARY TEAM TO BE AS SAFE AS POSSIBLE, SO I APPRECIATE THE QUESTIONS. THANK YOU. COUNCIL MEMBER DUTTON, SECOND TIME. SORRY. IT'S GOING TO BE. AND AGAIN. ALL RIGHT. OKAY. SO JEFF HAD ASKED ABOUT HOURS OF OPERATIONS WHICH WOULD BE LIBRARY WHENEVER THE LIBRARY IS OPEN. SO ON TUESDAYS AND THURSDAYS, THE LIBRARY IS OPEN UNTIL 8 P.M.. DOES THAT MEAN THAT YOU HAVE DOCTORS THAT ARE DOING TELEHEALTH CALLS UNTIL 8 P.M.? I DON'T KNOW THAT WE'VE BEEN ASKED. I KNOW THAT I KNOW THAT WE CAN HAVE DOCTORS TO DO IT AT 8 P.M. BECAUSE WE DO DO SOME NIGHT AND WEEKEND CLINICS. I HAVEN'T ASKED ABOUT THIS SPECIFIC I DIDN'T KNOW ABOUT THE AFTER HOURS, SO I DIDN'T THINK TO ASK ABOUT IT, HONESTLY BEFORE THIS MEETING. BUT IT HAS BEEN DONE IN OTHER SETTINGS. SO WE CAN ASK ABOUT THAT AND GET IT BACK TO YOU. I KNOW, I BELIEVE, I THINK AT GARLAND, WE DO SOME GARLAND CLINIC, WE DO SOME NIGHTS AND WEEKENDS, AND THEN THERE WAS SOME TELEHEALTH ASSOCIATED AROUND THAT. BECAUSE WE HAVE A GOAL OF CONVERTING SO MANY OF OUR VISITS OR A CERTAIN NUMBER OF OUR VISITS TO TELEHEALTH WHEN THEY CAN IN ORDER TO FREE UP SPACE. SO LET ME ASK THAT IF THAT'S A POSSIBILITY AND AND GET THAT BACK TO YOU. DID YOU GET THAT ONE, TOO? THANK YOU. AND THEN YOU'VE MADE THE COMMENT ABOUT, LIKE, BEING A BAYLOR PATIENT OR METHODIST PATIENT. CAN YOU JUST CLARIFY WHAT ACTUALLY YOU MEAN WHEN YOU SAY IF YOU'RE A PATIENT? YEAH. I'M SORRY IF THEY HAVE A MEDICAL RECORD NUMBER ALREADY OVER AT ONE OF THOSE OTHER HEALTH SYSTEMS. [03:45:04] AND LIKE I SAID, I DON'T KNOW. I DON'T KNOW WHAT THEIR RULES ARE. THEY MAY SOMEBODY HERE MAY KNOW BETTER, BUT THEY MAY MAKE YOU GO ESTABLISH YOURSELF IN PERSON, TOO. THAT'S UP TO THEM. BUT THAT'S WHAT IT MEANS WHEN YOU HAVE A MEDICAL RECORD NUMBER, USUALLY HOW WE WOULD LOOK AT AN ACTIVE PATIENT. THEY HAVE A MEDICAL RECORD NUMBER. AND THEN THE LAST 18 MONTHS THEY'VE BEEN ACTIVE WITH THE HEALTH SYSTEM. SO BUT THAT WOULD BE LIKE WITH A PRIMARY THAT IS LINKED TO THAT WOULD BE ANY, ANY WAY THAT THEY GOT. SO THEY CAME INTO THE EMERGENCY DEPARTMENT AND NEVER SAW A PRIMARY CARE PERSON. THEY WOULD HAVE A MEDICAL RECORD NUMBER AND BE AN ESTABLISHED PATIENT. AND IT'S NOT INCONCEIVABLE. I'M SURE A LOT OF PEOPLE DO HAVE MEDICAL RECORD NUMBERS AT MULTIPLE HEALTH SYSTEMS, BUT THEY'RE ESTABLISHED AT THOSE HEALTH SYSTEMS AT THAT POINT. OKAY. I GUESS BECAUSE MY THING IS, I'M REALLY TRYING TO JUST FIGURE OUT WHAT PERCENTAGE OF PEOPLE THIS IS GOING TO BENEFIT. IS IT ONLY BECAUSE IT SOUNDS LIKE THE THE LARGE AMOUNT OF PEOPLE THAT IT'S GOING TO BENEFIT IS PEOPLE THAT ALREADY HAVE ACCESS TO MEDICAL CARE OF SOME KIND. SO WHEN I HEAR ACCESS TO HEALTH CARE, I, I THINK OF SOMEONE WHO DOESN'T HAVE MEDICAID, WHO DOESN'T HAVE THE PARKLAND PROGRAM, WHO THAT IS WHAT I THINK OF AS SOMEONE THAT JUST GENUINELY DOES NOT HAVE ACCESS FOR WHATEVER REASON, EITHER THEIR EMPLOYER DOES NOT OFFER IT OR THEY CAN'T AFFORD IT, OR WHATEVER THE CASE MAY BE, RIGHT? SO THIS SOUNDS MORE LIKE A MORE OF A LIABILITY TO HEALTHCARE VERSUS AN ACCESS TO HEALTHCARE. I WOULD I THINK THAT YOU'RE RIGHT. IT'S A WAY TO ONE HOPEFULLY REDUCE THEIR WAIT TIMES AND TO GET MORE PEOPLE TO THE SYSTEM THAN WE CAN GET IN TODAY. AND WITHIN THE CITY LIMITS. BUT YOU'RE RIGHT, IT'S NOT GOING TO SOLVE THE PROBLEM OF THEM HAVING TO ESTABLISH THEMSELVES AS PATIENTS. PERFECT. I JUST I WANTED TO MAKE SURE THAT I WAS NOT MAKING IT. YOU ARE CORRECT. MAKING IT UP IN MY HEAD. SO IT'S, YOU KNOW WE'RE NOT REALLY DOING A BENEFIT TO THE UNDERSERVED POPULATION PER SE, BECAUSE WE'RE NOT IT'S NOT OFFERING THEM SOMETHING NEW. UNTIL THEY DO THE OTHER LONG PROCESS OF GETTING ESTABLISHED. SO THE BENEFITS. YEAH. I MEAN, I THINK AGAIN, THE BENEFIT IS THE TIME THAT'S CUT DOWN. AND AGAIN, YOU KNOW, I KNOW THEY STILL I THINK I CAN'T REMEMBER IT MIGHT HAVE BEEN YOU WHO SAID, WELL THEY STILL HAVE TO GO TO THE THING. THEY'RE NOT DOING IT AT HOME. BUT YOU KNOW, IF THEY LIVE ON THIS LITTLE PART DOWN HERE AND THEY CAN TAKE ONE BUS INSTEAD OF THREE BUSSES WITH TRANSFERS TO GET TO THE PLACE. THAT KIND OF MATTERS FOR A PERSON WHO WORKS ON AN HOURLY THING. YOU KNOW, I HAVEN'T DONE IT TO GARLAND, BUT I TIMED THE, THE TIME THAT IT TAKES PUBLIC TRANSPORTATION TO GO FROM PARKLAND TO PLEASANT GROVE, AND IT WAS 2.5 HOURS. SO 2.5 HOURS THERE, 2.5 HOURS BACK. THAT'S YOUR ENTIRE WORKDAY? YEAH, BUT WE WON'T TALK ABOUT PUBLIC TRANSPORTATION. YEAH, RIGHT. I SHOULD I SHOULDN'T EVEN HAVE BROUGHT THAT UP. BUT IT MIGHT TAKE TWO HOURS TODAY. MIGHT TAKE A THAT'S WHY ALL THE EXPERIENCED ONES HERE. AND I'M ON THIS SIDE. AND SO YOU SAID THAT THESE WERE GRANT FUNDED. SO COUNCIL, WE'VE GOT EXPERIENCE WITH HEALTHCARE THAT WAS GRANT FUNDED, AND WE NO LONGER HAVE A PUBLIC. SO DO WE. IT'S A IT IS A BIG PET PEEVE OF MINE. YES. SO MY QUESTION IS WHAT HAPPENS WHEN, WHEN AND IF, IF AND WHEN GRANT FUNDS ARE NO LONGER AVAILABLE. YEAH. WHAT SPECIFICALLY? THESE ARE THE ARPA GRANTS THE AMERICAN REINVESTMENT GRANTS THAT WERE DONE UNDER THE BIDEN ADMINISTRATION BACK FROM THE FEDERAL GOVERNMENT. SO, YOU KNOW, WE ANTICIPATE SOME POINT THOSE ARE GOING TO BE GONE. BUT, YOU KNOW, AS I MENTIONED BEFORE, THESE ARE NOT COST PROHIBITIVE. THESE ARE THESE ARE NOT SUPER EXPENSIVE TO SET UP. SO, YOU KNOW, IF Y'ALL HAD ASKED US TO DO THIS AND WE DIDN'T HAVE GRANT MONEY, WE STILL WOULD HAVE PROBABLY DONE IT. SO ARPA. THE GRANT IS JUST PAYING FOR THE POD AND THE SHIPMENT AND NOT THE SERVICE ON THE OTHER END AS WELL. RIGHT. I MEAN, IN REALITY, THIS IS NOT SOMETHING THAT WE ARE BENEFITING FROM. IT IS A SERVICE THAT ALLOWS YOUR CLIENTELE TO HAVE MORE AVAILABILITY TO THEIR DOCTORS. AND YES, IF WE'RE BREAKING IT DOWN, THIS ISN'T LIKE, HEY, WE'RE WE WE HAVE A LOW INCOME NEIGHBORHOOD THAT REALLY COULD USE A HEALTH POD THAT THEY COULD JUST MINUTE CLINIC WALK IN AND I, I HAVE THIS PAPER, READ IT FOR ME. [03:50:05] LIKE, PLEASE, YOU KNOW, LIKE IT'S NOT A QUICK SOLUTION TO ANY ONE DEMOGRAPHIC OR WHATEVER. IT'S IT IS SIMPLY AN AN A WAY TO HAVE DIFFERENT, MORE AVAILABILITY IF YOU'VE ALREADY GONE THROUGH THE PROCESS TO GET TO THAT POINT. I DON'T KNOW IF THAT MADE A WHOLE LOT OF SENSE. DID IT MAKE SENSE? DO YOU WANT ME TO RESPOND TO THAT OR. I THINK IT'S FAIR, AND I'M NOT SAYING THAT THERE'S ANYTHING WRONG WITH THAT. I'M JUST. YEAH, I THINK YOU HAVE THE. I THINK YOU HAVE THE LONG AND SHORT OF IT, YOU KNOW. YOU KNOW, AGAIN, I GET BACK TO THAT THING, I MAYBE IT SOUNDS LIKE I'M BEATING A DEAD HORSE BECAUSE THIS IS WHAT WE ARE ABSOLUTELY OBSESSED WITH AT PARKLAND. WAY TOO MANY PATIENTS. NOT ENOUGH SPACE, NOT ENOUGH CAPACITY. SO ANYTHING THAT WE'RE DOING THAT BRINGS A LITTLE MORE CAPACITY. SO I AGREE WITH YOU. YOU CAN'T JUST IF YOU'VE NEVER BEEN TO A DOCTOR BEFORE AND YOU JUST GO, THIS IS NOT THE PLACE TO JUST GO WALK IN AND TRY TO FIGURE OUT HOW TO BE A PATIENT. BUT, YOU KNOW, IT GETS BACK INTO THE USUALLY YOU'D PUT THESE THINGS IN ZIP CODES WHERE A LOT OF PEOPLE INEVITABLY ARE GOING TO BE PARKLAND PATIENTS, A LOT OF THEM, IF THEY. MAYBE THEY NEVER WENT TO THE DOCTOR BEFORE, BUT THEY'VE BEEN TO OUR EMERGENCY DEPARTMENT. THEY'RE GOING TO HAVE AN MRN NUMBER. SO YOU WERE RIGHT. YOU CAN'T JUST GO 0 TO 60 IN THAT POD AND BECOME A PATIENT. BUT FOR PEOPLE WHO ARE PATIENTS OR PEOPLE WHO HAVE INTERACTED EITHER AT THE COUNTY JAIL OR WITH OUR HOLMES UNIT ALL OF THOSE PEOPLE WOULD HAVE MRS. NOW, ANYONE LISTENING, PLEASE DO NOT GO OUT AND DO STUPID THINGS TO GO GET YOUR INTO THE POD. YEAH. SOME PEOPLE YOU NEVER KNOW. SO IF FUNDS RUN OUT I WOULDN'T. WHAT WOULD IT. WHAT WOULD WE ACCRUE? A COST BY KEEPING THE PODS LIKE. SO FUNDS RUN OUT. BECAUSE THIS IS ACTUALLY HOW WE. WE DON'T HAVE OUR OWN PUBLIC HEALTH CARE CLINIC. NO, THIS IS BECAUSE OF OUR. THE FIRST TWO WE DID DIDN'T HAVE ARPA FUNDS. OKAY. WE JUST DID THEM. I JUST I IF THERE'S GOING TO BE A COST ASSOCIATED AT ANY POINT IN TIME TO THE CITY. FOR THAT, I WANT TO MAKE SURE THAT WE KNOW THAT COUNCILWOMAN BASS POINT, YOU KNOW, IT WOULD BE OPERATIONAL COSTS. SURE. YOU WOULD NEVER BE ASKED TO PAY FOR THE POD. OKAY, KAREN, CORRECT ME IF I'M WRONG, BUT I THINK THE ILA ALLOWS US TO OPT OUT AT ANY POINT. YES, YES. BOTH PARTIES. PERFECT. AWESOME. SO I, I THINK THAT WE'VE GOT A LOT OF GOOD INFORMATION. THERE'S INFORMATION THAT YOU GUYS ARE GOING TO LOOK INTO AND GET BACK TO US. I DO WANT TO BE MINDFUL THAT THIS IS KIND OF IF IT'S GOING TO GO TO A FORMAL VOTE. QUICKLY. I FEEL LIKE THAT'S KIND OF HOW WE'VE GOT OURSELVES INTO THE THE LAST FOUR HOURS OF SITUATIONS. SO. I, I WOULD, I, I WOULD LIKE TO MAKE SURE THAT WE'VE GOT ALL OF THE INFORMATION FROM ALL OF THE PUBLIC. I WOULD LOVE TO CHIME IN. OR WE ARE. ARE WE DONE? NO. YOU'VE ALREADY YOU. I WOULD LOVE TO SAY YES. WE HAVE PLENTY OF QUESTIONS WE ASKED, AND THEY'VE OFFERED TO COME BACK WITH ANSWERS FOR SEVERAL OF THE ITEMS. AND I PROPOSE THAT WE JUST BRING THIS BACK TO ANOTHER WORK SESSION WHERE WE COULD HAVE AND BRING BACK THE ANSWERS. AND I THINK, CITY MANAGER, YOU'RE IN AGREEMENT THERE. AND THAT'S WHERE I WAS GOING. I THINK THE DIFFERENCE IN THIS, THOUGH, IS THAT THERE IS NO CHARGE TO THE CITY OF GARLAND AT ALL, AND IT'S A GREAT WAY TO ADD ADDITIONAL ACCESS TO THE PEOPLE WHO WOULD BENEFIT FROM THIS PROGRAM. SO I WOULD LOVE TO INVITE YOU TO COME BACK. AND I'D LIKE TO NOTE FOR THE RECORD, I THINK THERE WAS SOME NOT FROM ANY OF YOU, BUT AROUND HERE THERE WAS SOME CONFUSION ABOUT US. AND THE OTHER THING. ALL OF THIS IS COST OF PARKLAND. LIKE THIS ISN'T LIKE MAKING MONEY BUSINESS. WE WILL LOSE MONEY ON THIS, WHICH IS OUR JOB. OUR JOB TO DO THAT. SO NO, NO COMPLAINT, BUT I JUST DIDN'T WANT IT TO. I DIDN'T WANT THE ANYBODY IN THE PUBLIC HERE TO THINK THAT THIS IS PARKLAND OUT THERE PITCHING BUSINESS. AND I THINK ANYTHING THAT CAN HELP, LIKE YOU SAID, GET PEOPLE MORE ACCESS THROUGH THE SYSTEM, REDUCE THOSE WAIT TIMES IS GREAT. SO COUNCIL, I PROPOSE THAT WE BRING THIS BACK IN ANOTHER SESSION. SO MR. CITY MANAGER, DO YOU HAVE SOMETHING? YES. ONCE WE HAVE ALL THE ADDITIONAL INFORMATION BACK FROM PARKLAND SCHEDULED FOR AGENDA ITEM. VERY GOOD. ALL RIGHT, WE'LL DO THAT THEN. I APPRECIATE YOU SO MUCH FOR BEING HERE. THANK YOU. THANK YOU. COUNCIL. WE'VE BEEN AT IT FOR A WHILE NOW. I'M GOING TO GIVE US A TEN MINUTE BREAK. IF YOU'LL BE BACK AT 1015, PLEASE. WE ARE IN RECESS. ALL RIGHT. WELCOME BACK TO OUR FEBRUARY 2ND, 2026 WORK SESSION. [5. Garland Fire Department and RightSite for Non-emergency Patients] WE'RE MOVING NOW TO ITEM NUMBER FIVE ON OUR VERBAL BRIEFINGS. GARLAND FIRE DEPARTMENT AND RIGHT SITE FOR NONEMERGENCY PATIENTS. [03:55:01] GOOD EVENING, MR. MAYOR. CITY COUNCIL MEMBERS, AND MR. BETTS, AND THANK YOU FOR THE OPPORTUNITY TO PRESENT IN FRONT OF YOU ALL TONIGHT. MY REASON FOR BEING HERE IS THREEFOLD. FIRST, TO INTRODUCE THE GENTLEMAN TO MY LEFT WITH THE RIGHT SIDE COMPANY. SECOND IS TO ANSWER ANY QUESTIONS YOU MAY HAVE REGARDING FROM THE FIRE DEPARTMENT'S POINT OF VIEW. AND THIRD, TO GET A DIRECTION TO PURSUE THIS, ONCE YOU'VE HAD THE OPPORTUNITY TO ASK THE QUESTIONS THAT YOU WOULD LIKE TO ASK. I'D LIKE TO ADD THAT I BELIEVE I HEARD COUNCILWOMAN BEARD SPEAK EARLIER ABOUT ADDING LAYERS OF SERVICE TO OUR CITIZENS, AND I THINK AFTER YOU HEAR THIS PRESENTATION, YOU'LL REALIZE THIS IS A VERY VALUABLE LAYER THAT WE CAN ADD TO THE CITIZENS OF GARLAND. FOR THOSE OF YOU THAT DON'T KNOW ME OR HAVEN'T BEEN EXPOSED TO ME BEFORE, MY NAME IS KEITH WEBB. I'M THE ASSISTANT CHIEF OF THE GARLAND FIRE DEPARTMENT, AND I HAVE HAD THE PLEASURE AND HONOR TO SERVE THE CITIZENS OF GARLAND FOR ALMOST 35 YEARS NOW. SO I THANK YOU FOR THAT, THAT PRIVILEGE AND THAT PLEASURE. WITH THAT BEING SAID, I'M GOING TO TURN IT OVER TO THE SUBJECT MATTER EXPERTS, AND I'M GOING TO DO MY BEST TO GET RID OF THE WORD SALAD AND GIVE YOU ALL THE MEAT AND POTATOES. VERY GOOD. THANK YOU. CHIEF. THANK YOU FOR HAVING US HERE. IS IT? AM I NOT CLOSE ENOUGH? IS THAT BETTER? YEAH. OKAY. THANK YOU. MEMBERS OF THE COUNCIL FOR HAVING US HERE TONIGHT. I'M CLAYTON WAHLBERG. I AM RIGHT SIDE'S CHIEF COMMERCIAL OFFICER. WHAT THAT MEANS TO YOU GUYS. AND SIMPLE IS I MANAGE ALL OF OUR MS 911 NETWORKS ACROSS THE MULTIPLE STATES THAT WE OPERATE IN. I ALSO HAVE RESPONSIBILITY FOR OUR HOSPITAL AND OUR HEALTH PLAN RELATIONSHIPS AS WELL. THE THREE OF THOSE TOGETHER WILL MAKE A LOT MORE SENSE WHEN WE GET INTO OUR PRESENTATION OF WHY ALL THOSE ROLL UP THROUGH ME. AND THEN. LARRY, I'LL LET YOU GO. HELLO. THANK YOU FOR HAVING US HERE AGAIN. MY NAME IS LARRY. I'M THE REGIONAL DIRECTOR OF PARTNERSHIPS. I OVERSEE ALL THE ALL THE GROWING AGENCIES IN TEXAS. AGAIN, SET IT TO BE HERE. THANK YOU. SO I'VE GOT A BRIEF PRESENTATION. INFORMAL. I THINK AT THIS POINT IN TIME, YOU GUYS SIMPLY WANT TO KNOW WHAT WE DO. I'VE GOT ABOUT THREE SLIDES. I WILL KEEP IT SHORT. AND THEN MOVING TO QUESTIONS. WHAT YOU GUYS ARE SEEING ON THE SCREEN RIGHT NOW IS A REAL LIVE INTERACTION OF HOW WE ACTUALLY OPERATE. SO RIGHT SIDE HAS A VERY SIMPLE MODEL. YOU'VE HEARD THIS TONIGHT FROM A COUPLE OF INDIVIDUALS THAT WERE MS MEDICS THAT OPERATED IN YOUR IN THE, EITHER IN YOUR CITY OR OTHER CITIES. VERY SIMPLY PUT, SOMEWHERE BETWEEN 50 AND SOMETIMES AS MUCH AS 60% OF MS OR 911 CALLS COME IN OR NON-EMERGENT. YOU SIMPLY DON'T NEED AN AMBULANCE AND THEY DON'T NEED THE ER. BUT THEY DO NEED CARE AND THEY DO NEED A SOLID EAR AND THEY DO NEED GUIDANCE. AND THAT'S EXACTLY WHAT WE PROVIDE. SO FOR THESE AGENCIES THAT ARE SEEKING THE EFFICIENCIES OF BEING ABLE TO HAVE THEIR ASSETS AVAILABLE FOR EMERGENCY VISITS VERSUS NON-EMERGENT LOW ACUITY TRANSPORTS, WE BECOME AN OFF RAMP FOR THOSE PATIENTS. SO WE ALREADY HIT THIS PIECE. THERE'S TOO MANY 911 CALLS. NOT ENOUGH EMERGENCIES ARE COMING IN. AND ONCE THAT OCCURS, YOU HAVE ASSETS AKA AMBULANCES AND MEDICS THAT ARE OUT OF THE FIELD THAT ARE RUNNING TO HOSPITALS WITH INDIVIDUALS THAT COULD HAVE BEEN CARED FOR IN A DIFFERENT CIRCUMSTANCE, OR AT A MORE APPROPRIATE SITE. RIGHT SIDE PROVIDES THE SERVICES TO GUIDE THEM TO THAT. OUR ENTIRE BUSINESS MODEL IS ON ONE SLIDE HERE. I'LL WALK THROUGH THIS QUICKLY AND I'LL STOP AND OPEN FOR QUESTIONS. FIRST AND FOREMOST, WE OPERATE OUT OF THE 911 CENTER. SO AS SOON AS A CALL COMES IN, A MEMBER OF YOUR COMMUNITY IS CALLED. THEY GET TRIAGED, WHETHER THEY'RE POLICE, FIRE OR MEDICAL. WHEN THEY'RE MEDICAL, THEY GO TO EMS. AT THAT POINT IN TIME, THERE IS A PROCESS WITHIN THE 911 CENTER WHERE THEY IDENTIFY THE ACUITY OF THAT INDIVIDUAL, THE LEVEL OF NEED THAT THEY HAVE IF THEY FALL INTO WHAT IS CONSIDERED A LOW ACUITY NON-EMERGENT STATUS, MEANING THERE IS NO MEDICAL NECESSITY FOR THEM TO GO TO THE E.R., THEY ARE OFFERED THE OPPORTUNITY AT THAT APPOINTMENT AT THAT POINT TO ACTUALLY SEE AND VISIT AN EMERGENCY PHYSICIAN ON DEMAND IN THAT MOMENT. SO GOES SOMETHING LIKE THIS. THE DISPATCHER SAYS YOU'VE BEEN ELEVATED TO SPEAK TO AN EMERGENCY MEDICINE PHYSICIAN RIGHT NOW. WOULD YOU LIKE TO DO THAT? 93% OF THE INDIVIDUALS THAT WE WORK WITH SAY YES IN THAT MOMENT. WHY DO THEY? BECAUSE THEY WANT TO GO SEE A DOCTOR. THAT'S WHY THEY CALLED 911. PRETTY SIMPLE. AND THEY CALLED 911. OFTENTIMES FOR SOCIAL CIRCUMSTANCES THAT ARE BEYOND THEIR CONTROL. I DON'T HAVE A CAR. I DON'T HAVE INSURANCE. I DON'T UNDERSTAND HOW TO USE MY HEALTH PLAN. MY CHILD HAS A 99 DEGREE TEMPERATURE, I THINK, BUT I DON'T HAVE A THERMOMETER. I THINK I'M PREGNANT. WE GET THEM ALL. SO IN THIS CASE, ONCE THAT PATIENT HAS BEEN HANDED OFF TO US. WE INTAKE THEM. A PHYSICIAN IS ON THE SCREEN APPROXIMATELY 11 SECONDS. WE PERFORM A TRIAGE ON THAT PATIENT, IDENTIFYING AND CONFIRMING THAT THEY ARE NOT EMERGENT. MAKING SURE THAT THEY'RE NOT THEY DON'T HAVE ANY LEVEL OF ACUITY THAT DOESN'T NECESSITATE AN E.R.. WE PROVIDE THEM A CARE PLAN. [04:00:02] THAT MAY BE SOMETHING THAT WE CAN TREAT RIGHT AT HOME VIA TELEHEALTH AND NEVER HAVE TO LEAVE THEIR HOUSE, OR THEY MAY NEED TO GO SOMEPLACE ELSE. NOT THE E.R., BUT THEY MAY NEED TO GO TO AN URGENT CARE CENTER. MAYBE THEY NEED A URINALYSIS. THEY NEED A LAB. THEY DON'T KNOW HOW TO GET THERE. THEY DON'T HAVE A CAR. SO NOW THAT THE PHYSICIAN HAS COMPLETED THEIR JOB, A VERY IMPORTANT JOB. THE MOST IMPORTANT PERSON IN OUR ENTIRE PROGRAM TAKES TAKES HOLD OF THE REINS. THE PHYSICIAN IS IDENTIFIED. OH, DYLAN, YOU'VE OR I SHOULD. THERE WE GO. SORRY ABOUT THAT. MAYOR. WE'VE IDENTIFIED THAT THE BEST CASE THAT THAT ANKLE LOOKS TWISTED PRETTY BADLY. I DON'T THINK YOU NEED THE E.R., BUT I DO THINK YOU NEED AN X RAY. WE'VE IDENTIFIED IN THIS CASE, I'M GOING TO ASSUME THAT YOU HAVE INSURANCE. WE'VE IDENTIFIED AN IN-NETWORK URGENT CARE FACILITY WITH X RAY CAPABILITIES. IT'S ABOUT FIVE MILES AWAY FROM YOUR HOUSE. WE'VE ALREADY BOOKED AN APPOINTMENT FOR YOU AT 230. CAN YOU MAKE THAT? IF YOU DON'T HAVE TRANSPORTATION, WE WILL ARRANGE ROUND TRIP TRANSPORTATION FOR THAT PATIENT TO GET TO THE CENTER, AND THEN GET BACK FROM THAT CENTER. CALL US AS SOON AS YOU'RE DONE WITH YOUR URGENT CARE VISIT. WE'LL ARRANGE THAT TRANSPORTATION TO PICK YOU UP. DID THEY GIVE YOU ANY MEDICATIONS? DID THEY PRESCRIBE YOU ANY MEDICATIONS? DID THEY RECOMMEND YOU HAVE ANY MEDICAL SUPPLIES? WHY YES THEY DID. LET'S MAKE SURE WE STOP AT THE PHARMACY. LET'S MAKE SURE WE ACTUALLY GET YOU THE COMPRESSION SOCK THAT THEY RECOMMENDED FOR YOUR ANKLE, OR THE ICE BATH THAT THEY RECOMMENDED FOR SWELLING AND GET YOU HOME. AND THEN THAT NAVIGATORS JOB IS TO DO ALL OF THOSE ITEMS, WHICH IS DERANGED LOGISTICS OF ANY VISITS. THEY NEED TO ARRANGE THE DELIVERY OF ANY SORT OF MEDICAL SUPPLIES, PRESCRIPTIONS OR PHARMACY THAT THEY REQUIRE, AND THEN WE FOLLOW UP WITH THEM FOR SEVEN DAYS. IN MANY CASES, THESE INDIVIDUALS NEED FINANCIAL ASSISTANCE AS WELL. THEY DON'T KNOW HOW TO DO IT. OUR NAVIGATORS GUIDE THEM THROUGH THE PROCESS OF OBTAINING FINANCIAL ASSISTANCE, OFTENTIMES HELPING FILL OUT DOCUMENTS. THEY MAY NOT UNDERSTAND THE BENEFITS THAT THEY HAVE. A LOT OF PEOPLE THAT DO HAVE A HEALTH INSURANCE, PROBABLY ARGUABLY ALMOST EVERYONE IN THIS ROOM, WE DON'T UNDERSTAND THAT BOOK THAT WE GET THAT'S THIS THICK. WE DON'T KNOW THAT I HAVE IF I'M ON MEDICAID, I HAVE FREE NON-EMERGENCY MEDICAL TRANSPORT. IF I BOOK IT A DAY IN ADVANCE, WHAT EXISTED? I DIDN'T KNOW THAT I HAD MAIL ORDER PHARMACY THAT WILL SHOW UP AT MY FRONT DOOR IF I JUST ENROLL. HOW DO I DO THAT? THAT'S WHAT OUR NAVIGATORS DO. SO AT THE HEART OF THIS, THE DOCTORS, THE PERSON THAT IS MAKING IT CLINICALLY SOUND, WE USE ONLY EMERGENCY MEDICINE PHYSICIANS, AND THE NAVIGATOR IS THE INDIVIDUAL THAT IS ACTUALLY ENSURING THAT PATIENT GETS EVERYTHING THEY NEED, WHICH IS TYPICALLY KNOCKING DOWN THE BARRIERS FOR WHY THEY CALL 911 IN THE FIRST PLACE. OUR OUTCOMES ARE SIMPLE. APPROXIMATELY 84% OF THE TIME THAT WE GET A CALL, WE'RE ABLE TO REDIRECT THEM TOWARDS MORE APPROPRIATE SITES OF CARE, WHICH COULD BE IN THE HOME, AN URGENT CARE FACILITY, OR AT A PCP OFFICE. THAT'S OUR SIMPLE STORY. ALL RIGHT, I HAVE A FEW QUESTIONS FOR YOU COMING IN HERE. WARD IS LIGHTING UP. ALL RIGHT. COUNCIL MEMBER DUTTON. HOW IS THIS FUNDED? C HOW IS IT FUNDED? IT IS FUNDED. SO FIRST AND FOREMOST, I'LL STATE THAT THERE'S NO CHARGE TO THE CITY OR MS. OUR FUNDING SOURCE COMES THROUGH TWO DISTINCT PLACES. ONE IS THROUGH HEALTH PLANS. SO FOR INDIVIDUALS THAT ARE INSURED, THE HEALTH PLANS ARE BILLED. THE HEALTH PLANS ARE HAPPY TO BUILD THIS BECAUSE GOING TO TAKING AN AMBULANCE RIDE OR GOING TO AN ER FOR A PRIMARY CARE EVENT IS A VERY COST COST IMPACTFUL IN A NEGATIVE FASHION WAY FOR A HEALTH PLAN. SO THEY WOULD PREFER TO HAVE AN OPTION WHERE A PATIENT TYPICALLY GETS BETTER OUTCOMES AND A BETTER PATIENT EXPERIENCE BY NOT SITTING IN PARKLAND FOR EIGHT HOURS FOR THE SNIFFLES. THE OTHER RESOURCE THAT WE GET FUNDED BY IS WE MAINTAIN A FOUNDATION, AND FOR EVERY COMMUNITY THAT WE'RE IN, WE ACTUALLY WORK COLLECTIVELY WITH CHARITABLE ORGANIZATIONS IN THAT COMMUNITY TO IDENTIFY RESOURCES THAT THEY MAY WANT TO ACTUALLY PROVIDE, SERVICES THAT ALLOW US TO EXTEND ADDITIONAL SERVICES TO THE UNINSURED. TO BE CLEAR, WE SEE ALL PATIENTS. WE OPERATE IN PARITY WITH MS, MEANING WE SEE THE EXACT SAME PATIENTS THAT ARE MS PARTNERS DO. IF YOU'RE UNINSURED, UNDERINSURED, OR FULLY INSURED, WE SEE YOU. WE TREAT YOU THE SAME. YOU JUST SIMPLY ARE GOING TO NEED DIFFERENT RESOURCES DEPENDING ON THAT. YOUR STATUS AS FAR AS YOUR INSURABILITY. SO AT ONE POINT WE HAD BAYLOR HOSPITAL HERE AND THEY HAD THE SAME TRAIN OF THOUGHT. RIGHT? WE TREAT EVERYBODY YOU WALK IN, THEY'RE NO LONGER HERE BECAUSE OUR POPULATION OF UNPOPULAR UNINSURED IS VERY HIGH. AND MAYBE IT'S NOT EVEN THAT. IT'S JUST SO HIGH BECAUSE THEY JUST USE THE HOSPITAL TOO MUCH. WHATEVER THE CASE MAY BE, IT'S NOT GOING TO BE MUCH DIFFERENT IN THIS SCENARIO. SO MY CONCERN IS. THAT WHAT IF WE DON'T HAVE THE PARTNERS TO HELP [04:05:06] FUND AND OFFSET THE COST OF THOSE FOLKS THAT SIMPLY CAN'T OR WON'T BE ABLE TO HAVE THE HEALTH PLANS TO COVER IT OR WHATEVER? WHAT HAPPENS AT THAT POINT WHERE THIS IS NO LONGER FEASIBLE FOR YOU GUYS, AND WHAT WOULD THAT LOOK LIKE? SO FOR ANY FOR ALL THE COMMUNITIES THAT WE'RE IN RIGHT NOW, ONLY A SMALL PERCENTAGE OF THOSE COMMUNITIES DO WE ACTUALLY RECEIVE CHARITABLE FOUNDATION DOLLARS FROM. THE MAJORITY OF OUR DOLLARS ARE FUNDED THROUGH OUR ACTUAL HEALTH PLAN CONTRACTS. SO THE SHORT ANSWER IS I DON'T NEED IT. BUT TYPICALLY WHAT WE FIND IS WE CREATE AN OPPORTUNITY FOR CHARITABLE ORGANIZATIONS WHEN THEY WRITE A CHECK TO ACTUALLY SEE HANDS ON PERFORMANCE DATA ON WHAT THEIR DOLLARS DID, WHO IT WAS DONE FOR, AND THE RESULTS THAT IT DROVE, WE DELIVERED THAT BACK TO THEM. BUT TO BE CLEAR, WE DON'T NEED IT AND WE DON'T HAVE IT IN EVERY COMMUNITY. IT'D BE FANTASTIC IF WE DID, BUT WE DON'T HAVE TO. I ALSO DON'T HAVE A BRICK AND MORTAR THAT I HAVE TO MAINTAIN THAT A HOSPITAL DOES. SORRY. SORRY. IT'S A IT'S IT'S LATE. SO HOW MANY CITIES ARE YOU CURRENTLY IN? WE OPERATE IN TEXAS, GEORGIA AND FLORIDA AND TEXAS. WE ARE IN SAN ANTONIO. SO SAN ANTONIO FIRE IS WAS OUR OUR FIRST CLIENT IN TEXAS. THEY ARE BEEN WITH US FOR ABOUT THREE YEARS NOW. WE ARE IN HOUSTON AND TWO DIFFERENT FIRE DEPARTMENTS. AUSTIN IS IN A VERBAL CONTRACTING. WE'VE RECEIVED VERBAL FROM THEIR LEADERSHIP THAT WE'RE MOVING FORWARD. WE ARE IN. HELP ME OUT HERE, LARRY. FORT WORTH IS ONE OF OUR CLIENTS AS WELL. MONTGOMERY COUNTY. CARROLLTON. CARROLLTON JUST SIGNED IN LANCASTER. JUST SIGNED. OKAY. SO YOU SAID SAN ANTONIO WAS YOUR FIRST. THAT'S CORRECT. THEY'VE BEEN WITH YOU GUYS FOR THREE YEARS. HOW OLD IS YOUR COMPANY? THE COMPANY IS ABOUT FIVE YEARS OLD. AND THEN. I DON'T I DON'T KNOW IF YOU WOULD KNOW THIS OFFHAND, BUT DO ANY OF THOSE CITIES COMPARE TO WHAT WE ARE LOOKING AT AS FAR AS UNINSURED OR UNDERINSURED? YEAH, THEY DO. I'D SAY LANCASTER PROBABLY FALLS PRETTY CLOSE TO YOU. SAN ANTONIO'S PAIR MIX BY AS FAR AS IN THE HEALTH PAIR MIX WOULD BE MEDICARE AND MEDICAID, COMMERCIAL AND THEN UNINSURED. SAN ANTONIO IS PROBABLY GOING TO BE NEAR YOU, IF NOT WORSE. BEAUMONT IS ANOTHER. EAST TEXAS IS ANOTHER AREA THAT FALLS VERY DIRECTLY IN LINE WITH GARLAND. UNLESS YOU'RE YOU'RE OPERATING IN ONE OF THE TONIER AREAS OF DALLAS OR HOUSTON, THERE'S A SIGNIFICANT NUMBER OF THE METROS THAT HAVE HIGH UNINSURED RATES. THAT'S GOOD TO KNOW. I'LL THINK ABOUT IT, BUT I APPRECIATE IT. THANK YOU. SURE. COUNCIL MEMBER MORE. THANK YOU, MR. MAYOR. I WANT TO DIRECT MY QUESTIONS TO CHIEF WHIP. YOU KNOW THAT PRESENTLY THERE IS A DISCUSSION GOING ON AS IT RELATES TO ALTERNATIVE MS SERVICES. IS THIS SERVICE PART OF THAT DISCUSSION? WE HAVE A HYBRID OR IN THE WAY OF ATTEMPTING TO REDUCE COSTS BY THEM BECOMING SOMEWHAT THE ALTERNATE THAT FROM MY UNDERSTANDING, THIS PROGRAM WOULD BE A COMPLEMENT TO WHATEVER MS SYSTEM, WHETHER IT'S AN ALTERNATIVE OR WE STAY WITH OUR FIRE BASED EMS SERVICE THAT WE HAVE NOW. IT'S GOING TO HELP WITH THE LOW ACUITY CALLS. I'VE HEARD SEVERAL PEOPLE SPEAK EARLIER TONIGHT TALKING ABOUT KEEPING OUR AMBULANCES IN SERVICE AND WHAT HAVE YOU. THIS WILL ASSIST IN KEEPING OUR AMBULANCE OR AN ALTERNATIVE AMBULANCE IN SERVICE PREPARED FOR THE MAJOR MEDICAL CALLS, WHETHER IT'S A CPR OR SOMETHING MORE IMPORTANT IN NATURE. SO I GUESS ANSWER TO YOUR QUESTION IS YES, BUT IT WOULD FACILITATE IT WOULD COMPLEMENT ANY EMS SYSTEM THAT THAT WE WENT WITH, WHETHER WE STAY FIRE BASED EMS OR AN ALTERNATIVE EMS SYSTEM. OKAY. WHEN WE TALK ABOUT RIGHT SITE IT SOUNDS LIKE YOU'VE DONE SOME VETTING ALREADY. BUT WHY? RIGHT SITE AS OPPOSED TO MAYBE THEIR COMPETITOR? TO BE HONEST, WE WERE WE MET WITH RIGHT SIDE APPROXIMATELY ABOUT TEN MONTHS AGO. THEY PRESENTED AT A DALLAS COUNTY FIRE CHIEFS LUNCH MEETING. [04:10:01] AND IT'S SOMETHING THAT WE'D BEEN DISCUSSING IN THE FIRE SERVICE FOR A COUPLE OF YEARS, SAYING, MAN, I WISH THERE WAS A PROGRAM OUT THERE LIKE THIS. AND WE JUST GOT TO THINKING THAT IT WAS LIKE A UNICORN AND IT WASN'T OUT THERE. THEY PRESENTED AT OUR MEETING WE GOT TO DISCUSSING WITH THEM AND THEN DOCTOR TYSON, I BELIEVE Y'ALL MET BEFORE IS OUR MEDICAL CONTROL DOCTOR. HE WAS FORTUNATELY IN THE BUILDING DELIVERING CE TO OUR MEDICS. WE GOT HIM INVOLVED IN THE CONVERSATION. IT PIQUED HIS INTEREST. AND FORTUNATELY FOR US, HE HAD A MEDICAL CONFERENCE DOWN IN SAN ANTONIO THE FOLLOWING WEEK OR TWO WEEKS, AND HE WAS ABLE TO CONVERSE WITH THE MEDICAL DIRECTOR FROM SAN ANTONIO. PICK HIS BRAIN, SEE HOW IT WORKS. AND WE GAINED BUY IN FROM DOCTOR TIES FROM HIS PERSPECTIVE. I ASKED THE QUESTIONS IN THE MANNER BY WHICH I ASK THEM, BECAUSE I LIKE TO KIND OF KEEP THINGS VERY TRANSPARENT, KEEP THEM STRAIGHT UP ABOVE BOARD, AND I'M CERTAIN THAT AS WE GO FORWARD WITH THIS, THAT WILL BE KIND OF CONSTITUENTS WILL KIND OF BEGIN TO TIE TOGETHER AT THE SAME TIME, THERE'S NO DOUBT IN MY HEART OR MIND THAT BASED ON WHAT I SEE HERE, IT'S SOMETHING THAT WE COULD CERTAINLY BE ADVANTAGEOUS TO THE CITY. VERY GOOD BENEFIT. I LIKE THE WAY THAT WE'RE BRINGING IT BEFORE THE PUBLIC BECAUSE THEY WILL UNDERSTAND WHY WE'RE DOING IT. AND IT HAS A LOT TO DO WITH THIS ALTERNATIVE OR WITH THIS METHODOLOGY. IT CERTAINLY HAS THE POTENTIAL OF DECREASING SOME OF THE COST AND CERTAINLY ALLEVIATING SOME OF THE 911 TRANSPORTS THAT WE HAVE WITH OUR AMBULANCES AND SO ON. SO WE'VE TRIED TO DO OUR BEST VETTING OUT EVERY ASPECT OF IT. RIGHT. SITE HAS PRESENTED TO OUR DISPATCH. WE DIDN'T WANT TO JUST PULL SAY, OH, YEAH, OUR DISPATCHERS CAN HANDLE THIS. THEY CAN HANDLE THAT. WE WANTED THEM TO BE ABLE TO SPEAK FOR THEMSELVES. THEY HAD A LENGTHY DISCUSSION. THEY ASKED FOR INFORMATION, AND THEY ACTUALLY ASKED FOR PEER CITIES THAT SHARED OUR DEMOGRAPHIC. MAYBE CALL VOLUME. AND IF I'M NOT MISTAKEN, I CAN'T REMEMBER THE NAME OF THE CITY, BUT IT WAS IN GEORGIA. OUR DISPATCH SUPERVISORS WERE ABLE TO FORMULATE QUESTIONS, REACH OUT TO THEM, AND PUT THEIR OWN MIND AT EASE. AND AFTER THEY DID THEIR VETTING OUT, THEY CAME BACK TO US, SAID, WE DON'T SEE A PROBLEM WITH IT. WE FEEL, AND I DON'T WANT TO SPEAK FOR THEM. YOU CAN, YOU KNOW, SPEAK TO THEM OR SPEAK TO THE POLICE REPRESENTATIVES AS WELL. BUT THEY WERE THEY WERE ON BOARD WITH THIS PROGRAM. ONCE THEY SPOKE WITH RIGHT SIDE AND VETTED OUT ALL THE INFORMATION THAT THEY WERE PRESENTED. OKAY. LOOKING AT PRESENTLY IN THE PROGRAM FOR WHAT IS YOUR PROCESS? THE WAY I UNDERSTAND IT NOW, WE'RE JUST IN A MATTER OF NEGOTIATING THE CONTRACT OR REDLINING THE CONTRACT. IF THE IF THE TERMINOLOGY IS PROPER, I BELIEVE IT'S BEEN TO THE CITY ATTORNEY'S OFFICE, IF I'M NOT MISTAKEN. AND I THINK YOU ALL HAVE THE REDLINE VERSION. SO IT'S JUST A MATTER OF, I GUESS, CROSSING A FEW MORE T'S AND DOTTING A FEW MORE I'S. AND I THINK IT COULD. AND FROM WHAT I UNDERSTAND, THEY HAVE THE INFRASTRUCTURE IN PLACE NOW TO HANDLE THE CALL VOLUME THAT THEY WOULD RECEIVE FROM US. SO THE, THE, THE REFLEX TIME TO PUT IT IN PLACE IS MINIMAL, NOT COSTING THE PUBLIC ANY MORE MONEY. NO, SIR. AND THEY EMBEDDED IN THE WAY OF THEY HAVE THE. THEY ARE THE COMPANY THAT CAN GIVE US THE SERVICES THAT WE NEED. THAT'S WHAT WE BELIEVE FROM WHAT WE'VE LOOKED INTO AND VETTED OUT. AND, YOU KNOW, ONCE WE HEARD THEM SPEAK, WE PROBABLY HAD THE SAME RATIONALE OR FEELING THAT A LOT OF PEOPLE, WHEN THEY FIRST HEAR IT, IF IT'S TOO GOOD TO BE TRUE, IT IS. WE HAVEN'T BEEN ABLE TO FIND PROOF THAT IT'S TOO GOOD TO BE TRUE. THANK YOU, MISTER MAYOR. THANK YOU SIR. COUNCILMEMBER BASS. THANK YOU, CHIEF. LARRY. APPRECIATE YOU GUYS BEING HERE. A COUPLE QUESTIONS. SO CHIEF WEBB, YOU HINTED ON THIS A LITTLE BIT, SO THE. WE FEEL THAT OUR DISPATCH CAN HANDLE THE CALLS AND HANDLE THE HANDOFF OF THE CALLS. QUESTION IS IN OTHER MARKETS, HAVE YOU SEEN AN INCREASE IN CALL VOLUME TO DISPATCH PEOPLE USING THIS SERVICE AS BASICALLY A TELEHEALTH SERVICE, AS OPPOSED TO CALLING 911 AND THEN FINDING OUT ABOUT IT, LIKE REPEAT CUSTOMERS AND STUFF? HOW MUCH INCREASE HAVE WE SEEN FROM THAT? YEAH, IT'S IT'S A COMMON QUESTION. AND THE PREVALENCE OF THAT HAS NOT BEEN THERE'S BEEN NO STATISTICAL VOLUME INCREASE THAT WE'VE SEEN FROM IT. SO TO DATE, NO. DO WE HAVE REPEAT VISITORS? YES. THEY'RE THE SAME REPEAT VISITORS THAT MS 911 HAVE HAD FOR THE LAST PROBABLY TEN, 20 YEARS. OKAY. THE OPPORTUNITY AT THAT POINT IN TIME, THEN BECOMES DEFLECTS. WHAT ARE THE CAPACITIES OF THE FIRE DEPARTMENT? THE EMS AGENCY IS OR MY CAPABILITIES? THE MOBILE INTEGRATED HEALTHCARE. THERE'S OTHER PLACES WHERE OFTENTIMES WE CAN CAPTURE THAT PERSON AND PUT THEM INTO RESOURCES THAT ARE AVAILABLE IN THE COMMUNITY. GENERALLY WHAT WE FOUND AND THIS WILL NOT HAPPEN TO EVERYBODY. BUT FOR THE MOST INDIVIDUALS, IF WE'VE COMPLETED THE SOCIAL NAVIGATION ASPECT OF OUR CARE EPISODE WITH THAT PATIENT CORRECTLY IDENTIFIED SOME OF THE CORE REASONS WHY THEY'RE [04:15:03] CALLING IN THE FIRST PLACE. IT HAS NOTHING TO DO WITH THEIR CONDITIONS, BUT EVERYTHING TO DO WITH THEIR LIVING SITUATION. WE'VE BEEN ABLE TO HAND THEM OFF TO RESOURCES OR EDUCATE THEM ON THINGS THAT ARE AVAILABLE. THE CALL VOLUME SLOWS. THERE WILL BE SOME FOLKS THAT STILL CALL MORE OFTEN. I MEAN, I'M NOT GOING TO WAVE A MAGIC WAND ON IT, BUT WE'VE NOT SEEN A PREVALENCE WHERE IT'S NOT A STATISTICAL INCREASE IN UNLIKE SOME OF THE OTHER. AND I'M NOT SPEAKING POORLY OF ANY OF THE OTHER INDIVIDUALS THAT WERE HERE TONIGHT. BUT WE'RE NOT MARKETING OURSELVES AS FAR AS AS FAR AS WE AS FAR AS WE'RE CONCERNED. THERE HAS TO YOUR COMMUNITY MEMBERS DON'T EVEN HAVE TO KNOW RIGHT SIDE EXIST UNLESS YOU WANT IT TO. WE ARE AN ADJUNCT TO THE FIRE DEPARTMENT. WE ARE A SERVICE THE FIRE DEPARTMENT UTILIZES. IT'S SIMPLY A RESOURCE THAT'S AVAILABLE. SO WE'RE NOT ADVOCATING OR HITTING SOCIAL MEDIA AIRWAVES WITH, YOU KNOW, START CALLING 911 IF YOU WANT PRIMARY CARE. THAT'S NOT PART OF OUR GAME. WE'RE SIMPLY TRYING TO CAPTURE INDIVIDUALS THAT OFTENTIMES ARE IN NEED, WHICH IS WHY THEY CALL 911. AND WE'RE GIVING THEM A MORE APPROPRIATE CLINICAL CARE IN THAT MOMENT, WHICH ARGUABLY IS A BETTER OUTCOME FOR THEM THAN GETTING AN AMBULANCE BILL AND RECEIVING A BILL FROM THE E.R.. OKAY. I'M ACTUALLY I'M GLAD YOU BROUGHT UP MARKETING, BECAUSE THAT WAS ACTUALLY WHAT I WANTED TO TALK ABOUT NEXT IS, YOU KNOW, ARE WE DOES FIRE DEPARTMENT HAVE ANY PLANS TO DO ANY MARKETING ON THIS? DOES THE CITY HAVE PLANS TO DO MARKETING ON IT? IS THAT A PART OF IT? IT'S NOT A PART OF YOUR MODEL. SO IT'S JUST SOMETHING, I GUESS, THAT PEOPLE DON'T FIND OUT ABOUT UNLESS THEY CALL 911 AND GET THAT DIRECTION. YEAH, IT'S A LITTLE BIT UP TO YOU GUYS AS A CITY AND HOW YOU WANT TO GO ABOUT DOING IT. EVERYONE'S DONE IT A LITTLE BIT DIFFERENT. WE DO HAVE CERTAIN CITIES THAT WANT WANT THEIR CONSTITUENTS TO UNDERSTAND THAT IT'S NOW AVAILABLE. AND THE REAL INTENT BEHIND THAT IS WANTING TO SHOW THAT THEY'RE PROGRESSIVE IN THE CITY AND WORKING WITH THE EMS AND THE FIRE DEPARTMENTS. THEY ALSO WANT CITIZENS TO KNOW THAT IT IS VETTED BY THE CITY, THAT WE'RE DOING THIS ON PURPOSE, SO THAT WHEN YOU GET YOU GET TOLD THAT YOU'VE BEEN ESCALATED TO SPEAK TO EMERGENCY MEDICINE PHYSICIAN RIGHT NOW ON 911 YOU YOU'RE COMFORTABLE THAT IT'S REAL. BECAUSE IT'S A LITTLE UNUSUAL. THIS IS NEW. IT'S NOT SOMETHING THAT'S UBIQUITOUS ACROSS THE NATION. SO WE I'D SAY IT'S PROBABLY ABOUT A 5050 SPLIT. A NUMBER OF OUR CITIES ACTUALLY DO WANT TO WORK WITH THEIR PUBLIC INFORMATION OFFICERS AND ACTUALLY START PUTTING OUT A PRESS RELEASE. THAT WAY COMMUNITY MEMBERS UNDERSTAND IT'S AVAILABLE. BUT WE DO IT. SEEK TO DO IT IN A WAY WHERE WE'RE NOT ACTUALLY TRYING TO DRIVE THE INAPPROPRIATE UTILIZATION OF 911. OKAY. AND THEN CAN YOU GO BACK TO THE SCREEN WHERE YOU SAID EVERYTHING'S ON ONE SCREEN RIGHT THERE? YES. OKAY. PERFECT. OKAY, GREAT. SO MY QUESTION IS ON THE PROCESS. SO SOMEONE CALLS 911 HOW THE DISPATCH SAYS OKAY THIS QUALIFIES FOR REFERRAL TO RIGHT SIDE. SO HOW IS THAT CALL HANDED OFF FROM DISPATCH TO RIGHT SIDE. YEAH. SO IN SO THERE'S TWO WAYS WE OPERATE IN DISPATCH. AND THE FIELD. AND THE FIELD IS KIND OF THE SECONDARY CATCHMENT FOR PATIENTS THAT NEED THIS IN DISPATCH. ONCE THE DISPATCHER THE PATIENT HAS SAID THAT SOUNDS FANTASTIC. THERE IS A WARM TRANSFER INTO OUR CALL CENTER. THE NAVIGATOR IS THE FIRST PERSON TO ANSWER THE PHONE WITH THE DISPATCHER ON. THE DISPATCHER MAKES THE INTRODUCTION. THE NAVIGATOR GAINS CONSENT IN SOME MINOR DEMOGRAPHIC INFORMATION BEHIND THE SCENES, WHICH IS IRRELEVANT. BUT IMPORTANT TO YOU GUYS IS THE PHYSICIANS ARE WATCHING THE BOARD AND SO THEY KNOW WHO'S ON THE BOARD. THEY CAN ACTUALLY SEE THE NAME GOING IN. THEY CAN SEE IF THERE'S A PRIMARY COMPLAINT THAT THE PATIENT HAS. SO THEY ARRIVE TO THAT CALL AWARE AS SOON AS CONSENTS RECEIVED. OUR NAVIGATORS PUSH A BUTTON AND THE DOCTORS ARE ON. SO A COUPLE OF IMPORTANT PIECES. OUR BRAND PROMISE TO ALL OF OUR 911 MS AGENTS AGENCIES ARE WHEN WE'RE ACTIVATED, WE RESPOND IN UNDER 15 SECONDS. LAST YEAR, I'M VERY PROUD TO ANNOUNCE THAT OUR ACTUAL AVERAGE TIME WAS 11 SECONDS. SO DISPATCHERS ARE NOT LOSING TIME WAITING FOR US TO ANSWER THE PHONE. AND THAT'S PROBABLY ONE OF THE SINGLE MOST IMPORTANT THINGS THAT DIFFERENTIATES US IN THE MARKET. AND THE PHYSICIAN IS ON GENERALLY SPEAKING, AT ABOUT A MINUTE TO MINUTE AND 20, BECAUSE WE HAVE TO GO THROUGH GATHERING CONSENT AND SOME EARLY DEMOGRAPHICS. OKAY. AND WHILE THAT CONSENT IS BEING GATHERED, THE DISPATCH IS STILL ON THE PHONE CALL. YES. SO DISPATCH TYPICALLY IS ON THE PHONE FOR ABOUT A MINUTE TO MINUTE AND 30S AND THEY'RE OFF. OKAY. SO WITH THAT WARM HANDOFF WHAT IS THERE A IS THAT A STATISTICAL INCREASE IN THE DURATION OF THE CALL? IF IT IS FROM WHAT THEY'RE DOING TODAY, YOU'RE TRADING A MINUTE AND A HALF OF A DISPATCHER'S TIME VERSUS 2 TO 3 HOURS OF A TRANSPORT TIME. OKAY, CORRECT. BUT THAT COULD BE I MEAN, AS FAR AS, YOU KNOW, STAFFING OR THAT COULD AFFECT DISPATCH. IT COULD. MOST OF OUR AGENCIES, THEIR THEIR GOAL IS TO KEEP ANY CALL THAT THEY HAVE UNDER TWO MINUTES. AND THAT'S THE GOAL THAT WE REPORT BACK ON. ARE WE STAYING UNDERNEATH THAT WINDOW OF TIME FOR DISPATCHERS. SO WE'RE NOT ADDING ADDITIONAL HOURS OR ADDITIONAL MAN HOURS NECESSARY. [04:20:01] AND IDEALLY IF WE LOOK AT IT AS A HOLISTICALLY, WE'RE SAVING BECAUSE WE'RE NOT SENDING A, SENDING A CREW OUT. OKAY. THAT'S CORRECT. OKAY. AND THEN NEXT QUESTION. CAN THE OKAY. SO THEY'RE CONNECTED. THEY'RE CONNECTED WITH THE PHYSICIAN. CAN THE PHYSICIAN VIA THE TELEHEALTH SERVICE PROVIDE PRESCRIBE A PRESCRIPTION, THEY CAN. SO THE ONE THING THAT I DIDN'T MENTION, AS SOON AS WE'RE ON WITH THE PATIENT, WHAT WE TYPICALLY DO IS WE SEND A LINK TO THAT PATIENT. SO FROM A TECHNOLOGY STANDPOINT, WE'RE AGNOSTIC. SO OUR EMS AGENCIES, OUR 911 CALL CENTERS, AND OUR PATIENTS DON'T NEED ANYTHING THAT THEY DON'T ALREADY HAVE. SO THERE'S NO SOFTWARE REQUIRED. THERE'S NO DOWNLOADS. THERE'S NO APPS. THERE'S NO INVESTMENT IN TECHNOLOGY BEYOND WHAT YOUR YOUR DEPARTMENTS AND YOUR CONSTITUENTS ALREADY HAVE. THAT LINK IS TYPICALLY GOES TO A PHONE. IF THEY HAVE VIDEO CAPABILITY ON THEIR PHONES, THEY'RE GOING TO BE ON A FACE TO FACE VISIT WITH OUR PHYSICIAN AND OUR NAVIGATOR. IF THEY DON'T, THEY'RE GOING TO BE AN AUDIO ON AUDIO. OUR CAPACITY TO DIVERT AND PROVIDE CLINICAL CARE IS REDUCED FOR OBVIOUS REASONS. WHEN WE'RE ON VIDEO, WE HAVE AN ENHANCED CAPACITY TO ACTUALLY TREAT A PATIENT BASED ON WHAT WE CAN SEE AND VISIT. OKAY. AWESOME. I APPRECIATE IT. YES. CIRCLE BACK TO YOUR ORIGINAL QUESTION ABOUT THE CALL VOLUME INCREASE FOR DISPATCH. I THINK ONE OF THE REASONS WHY IT MAY NOT BE TOO EXPONENTIAL IS BECAUSE A COMPONENT WE HAVEN'T SPOKE ABOUT, IF I'M NOT MISTAKEN, AFTER THEY MAKE CONTACT WITH THE PATIENT AND THEY, YOU KNOW, MITIGATE THE THE EMERGENCY, TWO WEEKS LATER OR 14 DAYS LATER, THEY CALL BACK AND CHECK ON THEM, MAKE SURE THEY HAVE EVERYTHING THEY NEED AND WANT AND EVERYTHING INVOLVED IN THAT. AND AS YOU ALL ARE WELL AWARE OF OUR SOCIAL WORKER PROGRAM, THAT'S PART OF WHAT THEY DO. AND THAT HAS DECREASED A LOT OF WHAT WE CONSIDER OUR FREQUENT FLIERS AND WHATNOT. SO I THINK THIS IS AN ADDED COMPONENT THAT WILL ASSIST IN THAT AND COMPLEMENT IT. SO WE'RE LOOKING AT IT NOT JUST AS IT BENEFITS THIS ONE AREA. WE'RE LOOKING AT IT THAT IT BENEFITS 3 TO 4 AREAS. SO THAT INCREASES OUR EFFICIENCY WITH DISPATCH, WITH OUR PERSONNEL, OUR FIREFIGHTERS AND MEDICS ON SCENE. AND THEN THE THE BIGGEST THING IS IT'S GIVING US MORE TREATMENT OPTIONS FOR THE CITIZENS. AWESOME. THANK YOU CHIEF. THANK YOU MAYOR. THANK YOU SIR. COUNCILMEMBER WILLIAMS. SIR CHIEF. QUESTION. TELL ME, HOW LONG DID IT TAKE FROM. THAT, ER, PHYSICIAN TRIAGING YOU? DESCRIBE THE PROCESS. HE, YOU KNOW, SCREENING AND GETTING TO THE PRESCRIPTION STAGE DIAGNOSIS. I DON'T KNOW IF HE'S RIGHT OR HE'S GOOD OR BAD. AND GET TO THE PHARMACIST. THE PHARMACIST DESK. HOW LONG DOES THAT PROCESS NORMALLY TAKES? ARE YOU TALKING LIKE IN A BRICK AND MORTAR ER. OR ARE YOU TALKING. NO, I'M TALKING ABOUT THAT. THAT WOULD BE A QUESTION FOR RIGHT SIDE TO ANSWER. I DON'T KNOW WHAT THE ACTUAL TIME FRAME IS. I'LL BE I'LL BE HONEST WITH YOU. SO JUST TO REPEAT BACK YOUR YOUR QUESTION, I THINK WHAT YOU'RE ASKING IS ONCE WE HAVE A PATIENT ON THE PHONE, HOW LONG IS THE ACTUAL CLINICAL INTERACTION TO RESOLUTION? ON AVERAGE, IT'S BETWEEN 9 TO 11 MINUTES. AND WHO'S THE LAST PERSON? WHO'S THE LAST PERSON ON THOSE CHARTS THAT THAT THAT THE PERSON THE PERSON CALLING HEARS. THE LAST PERSON. SO ONCE THEY'RE ON THE PHONE, THEY'RE GOING TO BE HANDED OFF FROM THE DISPATCHER TO OUR NAVIGATOR. OKAY. OUR NAVIGATOR IS GOING TO BE THE FIRST PERSON THEY INTERACT WITH IN THE LAST PERSON. OKAY. NAVIGATOR GAINS CONSENT, GATHERS THE PATIENT'S INFORMATION. THE PHYSICIAN IS NOW ON THE SCREEN. THE PHYSICIAN PERFORMS THEIR TRIAGE. KEEP IN MIND, WE DON'T GET PATIENTS THAT ARE HIGH ACUITY. THERE'S A PROCESS WE CAN SHARE ABOUT HOW WE DO THAT. WE'RE TYPICALLY DEALING WITH SNIFFLES AND SNEEZES. MY CHILD HAS A TEMPERATURE. I DON'T KNOW WHAT IT IS. THEY'RE SIMPLE THINGS. THE PHYSICIAN'S JOB IS TO DE-ESCALATE. FIRST AND FOREMOST. YOU CALL 911 REGARDLESS OF HOW LOW ACUITY IS. YOU CALLED IT FOR A REASON, AND YOU TRIAGE AND IDENTIFY AND CONFIRM THAT THE CONDITION IS NON-EMERGENT. IT'S REALLY IMPORTANT IF WE THERE IS WHAT WE CALL THE WHITE COAT SYNDROME. SOMETIMES YOU PUT A DOCTOR ON SCREEN AND STUFF STARTS COMING OUT AND EVERYBODY GETS EXCITED AND WE LEARN THINGS THAT WERE LIKE, WOW. ON SECOND THOUGHT, THE AMBULANCE DOES NEED TO GO. SO TO BE REALLY CLEAR, THERE ARE GROUPS OF PEOPLE THAT WE SEND BACK AFTER A TRIAGE THAT WE'RE LIKE, YOU KNOW WHAT, I DON'T THINK YOU THOUGHT YOU HAD AN EMERGENCY. BUT NOW THAT I'VE SPOKEN WITH YOU, I THINK YOU REALLY DO NEED TO GO TO THE E.R.. AND THAT'S PART OF OUR THE CONTINUITY THAT WE STAY IN TOUCH WITH, WITH EMS, TO ACTUALLY ALERT THEM THAT THIS PERSON DEFINITELY DOES NEED AN AMBULANCE. BUT TIME ON AVERAGE IS 9 TO 11 MINUTES. THE LAST PERSON THEY SEE IS THE NAVIGATOR. AND THE NAVIGATOR'S JOB IS TO ARRANGE THE LOGISTICS FOR THAT PATIENT. IF THE PHYSICIAN SAID, I THINK YOU NEED TO GO TO AN URGENT CARE CENTER, THE NAVIGATOR IS GOING TO SAY, [04:25:05] DO YOU HAVE TRANSPORTATION? NO. LET ME ARRANGE THAT. DO YOU UNDERSTAND HOW TO SCHEDULE FOR THIS URGENT CARE FACILITY? NO, LET ME GO AHEAD AND DO THAT FOR YOU. YOU MENTIONED. THANK YOU FOR THE CARE EPISODE PIECE. THE NAVIGATOR WILL BE THE PERSON THAT WORKS WITH THEM FOR THE NEXT SEVEN DAYS. SO WE STAY IN TOUCH AND CONSISTENT OUTREACHES 24 HOURS, 48 HOURS. AND OUR JOB IS TO ENSURE, HEY, DOES A PATIENT UNDERSTAND THE CARE PLAN THAT WAS PROVIDED, WHETHER IT WAS US OR FROM AN URGENT CARE FACILITY? DO THEY HAVE ALL THE TOOLS SUPPLIES IN PLACE TO BE ABLE TO MANAGE THAT CONDITION? AND WE STAY WITH THAT FOR SEVEN DAYS FOR THE NEXT 14 OR FOR THE FOLLOWING SEVEN DAYS. WE TAKE INBOUND FROM THAT PATIENT. SO THEY HAVE A 14 DAY WINDOW WHERE THEY HAVE ACCESS TO US TO HELP MANAGE THE CONDITIONS THAT THEY HAVE WIDELY. MOST OF THESE PATIENTS QUIT CALLING US BACK AFTER ABOUT 72 HOURS BECAUSE THEIR CONDITIONS ARE GONE. WHATEVER THEY HAD AT THAT POINT IN TIME. MY TUMMY HURT REALLY BADLY. I HAD A FEVER. IT'S. THEY HAD PAIN IN THEIR BACK. IT HAS GONE IN. THE RESIDUAL EFFECTS OF IT ARE NO LONGER IMPACTING THEM. SO IF THERE'S A PROBLEM, COMMUNICATIONS, MEDICAL, WHATEVER, WHO'S YOUR CONTACT IN A CITY LIKE SAN ANTONIO? WHO WHO IS YOUR CONTACT? IF THERE'S A PROBLEM, LIKE FOR EXAMPLE, WHO'S THE CITY? OF WHAT CITY OFFICIAL WOULD YOU CONTACT? IF THERE'S A ANY KIND OF PROBLEM, DISPATCH, MEDICAL ADVICE, ANYTHING? I MEAN, GENERALLY, IF WE HAVE ANY SORT OF ISSUE THAT'S GOING TO GO UP THROUGH FIRE LEADERSHIP, THROUGH FIRE, OKAY, FIRE AND EMS, WHOEVER, WHOEVER IS, BECAUSE EVERY CITY HAS DIFFERENT CONTROLS OVER EMS. IN THIS CASE, IT WOULD GENERALLY GO THROUGH THE FIRE DEPARTMENT. WHO OVERSEES EMS IF IT'S IN SAN ANTONIO'S FIRE BASE AS WELL. IF WE LOOK AT LIKE GRADY, WHICH IS AN ATLANTA BASED DEPARTMENT, EMS IS HOSPITAL BASED OUT OF THE GRADY SYSTEM THAT'S IN DOWNTOWN ATLANTA. ANY SORT OF ISSUES THAT WE HAD WOULD ESCALATE UP THROUGH THE GRADY HOSPITAL SYSTEM. OKAY. I SUSPECT IT DEPENDS ON WHAT THE PROBLEM IS. IS WHERE THE WHERE IT WOULD GO. I MEAN, IF IT'S A MEDICAL CONTROL PROBLEM, WOULD GO TO DOCTOR TICE BECAUSE HE IS OUR MEDICAL CONTROL, YOU KNOW, AUTHORITY. IF IT'S A COMMUNICATIONS PROBLEM, IT WOULD BE GOING THROUGH, YOU KNOW, THE SUPERVISORS AND WHOEVER'S OVER DISPATCH. SO I GUESS IT WOULD DEPEND ON THE NATURE OF THE PROBLEM AND WHO WOULD BE THE SUBJECT MATTER EXPERT TO HANDLE THAT. OKAY. THAT'S A BETTER ANSWER THAN MINE. YEAH. YEAH. AND A CITY LIKE LANCASTER. LANCASTER. LANCASTER. WHAT? WHO WOULD BE THAT? THAT LIAISON PERSON WHO'S WHO'S YOUR CONTACT PERSON? LANCASTER. IT WOULD BE THE CHIEF. IT WOULD BE THE CHIEF OKAY. ON ON ALL MATTERS. THIS. I MEAN THERE'LL BE THERE'LL BE DIFFERENT INDIVIDUALS THAT ARE RESPONSIBLE FOR DIFFERENT SECTIONS. SO THERE WILL BE SOMEONE THAT'S RESPONSIBLE FOR DISPATCH. THERE WILL BE SOMEONE THAT'S TYPICALLY A BATTALION CHIEF THAT'S OVER THE ACTUAL OPERATIONS OF ROLLING THE AMBULANCES THEMSELVES. THERE WILL BE MEDICAL DIRECTION AS WELL. SO MOST OF THE EMS AGENCIES OPERATE SIMILAR IN THAT FASHION. SO SIMILAR TO WHAT CHIEF INDICATED, DEPENDING ON WHAT THE PROBLEM IS WOULD, WOULD BE WE WOULD ACTUALLY GO TO. OKAY. ONE LAST QUESTION. ONCE LET'S SAY BACK TO SAN ANTONIO AGAIN WHEN YOU FIRST WHEN THEY FIRST GAVE YOU THE GREEN LIGHT. TO WELCOME YOU AND WELCOME YOU TO THE CITY, ANNOUNCED THIS PROGRAM. HOW'D YOU ROLL IT OUT? HOW'D YOU LET HOW DID YOU LET THE CITIZENS KNOW? HEY, WE'RE HERE. WE'RE ALIVE AND WELL. YEAH. OKAY. LANCASTER. ANY OF THOSE CITIES? HOW'D YOU DO THAT? SAN ANTONIO CHOSE TO NOT DO ANY PR RELEASES ON THIS. HOWEVER, SAN ANTONIO, FOR ANY OF YOU THAT HAVE EVER BEEN TO SAN ANTONIO'S EMS OPERATIONS, THEY OPERATE VERY DIFFERENTLY FROM ALMOST 99% OF THE OPERATIONS IN THE COUNTRY. THEY HAVE A CLINICAL DISPATCH. THEY HAVE PARAMEDICS THAT STAFF THE DISPATCH. THEY MAKE CLINICAL DECISIONS IN THE 911 CALL, AND THAT'S HOW THEY ACTIVATE RIGHT SITE. THEY'RE ALSO AT THE ADVANCED VANGUARD OF DENYING TRANSPORTS. THEY HAVE THE HIGHEST DENIAL RATE IN THE COUNTRY. SO THEY OPERATE A LITTLE BIT DIFFERENTLY. I WOULD SAY IN DON'T QUOTE ME. IT'S NOT A COWBOY WAY, BUT THEY OPERATE IN A VERY SPECIFIC MEANS THAT WORKS WELL FOR SAN ANTONIO. SO THEY CHOSE NOT TO PUBLICIZE THAT THEY WERE WORKING WITH US. OBVIOUSLY, THE CITY COUNCIL WAS WELL AWARE AND LEADERSHIP WAS WELL AWARE, BUT AS FAR AS THE COMMUNITY THEMSELVES, THEY DID NOT. IF WE TALK ABOUT HENRY COUNTY, WHICH I BELIEVE IS THE DISPATCH THAT YOUR, YOUR GROUP TALKED TO IN GEORGIA THEY DID A PR RELEASE FROM THE CITY THAT THEY WERE DOING THIS. THEY WERE DOING IT FOR THE BENEFIT OF THE COMMUNITY, TO PROVIDE MEMBERS OF THE COMMUNITY ALTERNATE CARE SOLUTIONS. [04:30:02] AND THEY MADE A PRETTY BIG DEAL OUT OF IT. BEAUMONT DID THE SAME THING. WE WERE ON THE NEWS. LARRY WAS ON THE NEWS WHEN HE DIDN'T KNOW HE WAS GOING TO BE ON THE NEWS. SO IT'S REALLY DEPENDENT ON THE COMMUNITY AND WHAT YOU GUYS WANT TO DO. SAN ANTONIO AT THAT POINT IN TIME DID DID NOT. NOW, MY LAST QUESTION IS, KNOWING WHAT YOU KNOW AT THIS POINT ABOUT GARLAND, WHAT WOULD YOU RECOMMEND? AS FAR AS HOW HOW TO TO WORK WITH US, THE ROLLOUT. YEAH. TYPICALLY WHAT WE DO AND I THINK CHIEF WEBB AND THE TEAM HAVE A GREAT IDEA THAT WE SUPPORT IS THERE'S TWO DIFFERENT WAYS THAT WE INTERACT WITH YOUR MEMBERS OF YOUR COMMUNITY IS ONE, IT CAN BE DIRECTLY IN THE 911 CALL. AND THEN SECOND, IT'S WHEN THE AMBULANCE ARRIVES. SO WE CALL THAT ON SCENE. SO IN THAT CASE YOU HAVE A PARAMEDIC ON SCENE THAT'S ACTUALLY SEEING THE PATIENT AND CAN RENDER ASSISTANCE TO OUR PHYSICIANS. THE MOST IMPACTFUL WAY TO START IS TO START WITH DISPATCH AND THEN TURN ON FIELD AGENCIES THAT ARE GARLAND SIZE. WE CAN ACTUALLY TURN ON BOTH AT THE SAME TIME, WHEREAS I COULDN'T DO THAT PER SE AT AGREE WHERE THEY HAVE FOUR TIMES THE VOLUME YOU GUYS DO, IF NOT TEN TIMES THE VOLUME. SO THANK YOU. THANK YOU SIR. THANK YOU, MAYOR PRO TEM. MISTER MAYOR, THANK YOU, GENTLEMEN, FOR BEING HERE. INTRIGUING PROGRAMS. VERY INTERESTING. ONE OF THE QUESTIONS THAT I HAVE IS LANGUAGE CAPABILITIES. HOW DO YOU DEAL WITH. WE HAVE A LARGE POPULATION OF PEOPLE THAT ARE SPANISH SPEAKERS AND VIETNAMESE. HOW DO WE WORK WITH THAT? YEAH. SO WE HAVE NATIVE SPANISH SPEAKERS. WE'RE IN SAN ANTONIO. IT PROBABLY DOESN'T SURPRISE YOU. FOR THE REMAINDER OF THE LANGUAGES, WE HAVE A REAL TIME LANGUAGE FACILITATOR THERE ON IN APPROXIMATELY 10S, AND THEY RESPOND A LITTLE. I THINK IT'S ABOUT 250 LANGUAGES AT THIS POINT IN TIME. SOME OF THEM THAT I'VE NEVER EVEN HEARD OF. DON'T QUOTE ME. IT'S 200 TO 250 SOMETHING. WE'VE USED IT QUITE FREQUENTLY. IT'S IT'S EFFECTIVE. IT TAKES A LITTLE LONGER BECAUSE WE HAVE TO ACTUALLY GET IT ONLINE, BUT IT ACTUALLY MOVES QUITE FAST. IT'S TYPICALLY ABOUT A TWO MINUTE DELAY IN THE CALL. OKAY. IT'S NOT AN INCREDIBLE AMOUNT OF DELAY. SO THEY GET THE SAME CARE. YES. I'M INTRIGUED BY THE LOGISTICS OF MOVING PEOPLE AROUND TO THEIR DESTINATIONS. LIKE, IF THEY NEED TO GO TO URGENT CARE, HOW ARE THEY MOVED? TYPICALLY, IT'S RIDE SHARE THAT'S THE MOST EFFECTIVE. IN SOME CASES, IF THEY HAVE BENEFITS LIKE NON-EMERGENCY, NON-EMERGENCY MEDICAL TRANSPORT, THAT'S PART OF THEIR HEALTH BENEFITS. WE CAN USE THAT. WE TYPICALLY RELY ON RIDE SHARE. AND THERE'S REALLY ONE REASON WHY. IT'S BECAUSE WE HAVE A PATIENT IN THE MOMENT THAT CALLED 911. WE DON'T WANT TO WAIT. THE ABILITY TO HAVE AN ON DEMAND TRANSPORT IS MORE IMPACTFUL FOR THAT PATIENT'S NEEDS IN THAT MOMENT. SO WE TYPICALLY RELY ON UBERS, LIFTS IN SOME CASES SOME OF THE CITIES HAVE TAXIS THAT CAN OPERATE IN MORE OF A ON DEMAND DISPATCH THAN OTHER PLACES CAN. BUT WE RIDESHARE BY AND FAR AND AWAY IS OUR IS OUR HIGHEST UTILIZATION. THAT'S SOMETHING THAT RIGHT RIGHT SITE WOULD DIRECT THAT YOU WOULD ARRANGE IT. THEY WOULD PICK THEM UP. AND THERE'S A LOT OF PEOPLE THAT HAVE MOBILITY MAY HAVE MOBILITY CHALLENGE FOR WHATEVER THEIR AILMENT MAY BE A SPRAIN OR SOMETHING LIKE THAT. HOW DO THEY DEAL WITH THAT. YEAH. FOR FOR SPRAINS AND ITEMS LIKE THAT WHERE THE PERSON CAN STILL MOVE AROUND. WE'RE CAPABLE OF DOING THAT. FOR INDIVIDUALS THAT HAVE LIKE LEGITIMATE MOBILITY ISSUES, IF YOU HAVE SOMEONE THAT'S FOR EXAMPLE SIGNIFICANTLY OVERWEIGHT, 600 POUNDS AND STRUGGLES TO MOVE, WE'RE NOT GOING TO BE ABLE TO DO THAT. THAT'S GOING TO HAVE TO WE'RE GOING TO HAVE TO PUSH THAT BACK TO MS. THERE ARE SOME MOBILITY RESOURCES WITHIN RIDESHARES, BUT IS QUITE LIMITED. SO IF WE DON'T HAVE THE ABILITY FOR SOMEONE TO ACTUALLY GO HELP AND ASSIST SOMEONE GET INTO A VEHICLE, WE'RE GOING TO MAKE SURE THAT THAT PERSON IS COVERED AND TAKEN CARE OF BY OUR EMS PARTNER. OKAY. APPROXIMATELY 43% OF OUR POPULATION IS EITHER UNINSURED OR UNDERINSURED. DO YOU HAVE ANY OTHER SIMILAR PAYER MIX THAT EL PASO, BEAUMONT OR ABOUT LIKE THAT ALSO? YEAH. OKAY. SOUTH GEORGIA OKAY. I GUESS MY LAST QUESTION THIS NOW I PUT ON MY OTHER HAT, WHICH IS I'M THE I'M THE CHAIRMAN OF THE FIRE AND EMS COMMITTEE. WE ARE EXPLORING IT'S A NINE MONTH COMMITTEE THAT'S LOOKING AT FINANCIAL SUSTAINABILITY FOR THE FIRE AND EMS SERVICES. AND ALSO ONE OF THE NUMBER ONE THINGS IS FIREFIGHTER FATIGUE AND THEIR HEALTH. HAVE YOU? SINCE THIS SOUNDS LIKE THIS HELPS REDUCE THAT BECAUSE OF CALL VOLUME, THAT WILL BE REDUCED. HAVE YOU BEEN ABLE TO QUANTIFY THE IMPROVEMENTS WE. [04:35:03] IT'S A GREAT QUESTION. IT'S SOMETHING THAT I WOULD SAY ALMOST ALL OF OUR FIRE LEADERSHIP TELLS US THAT THE BURNOUT FROM RUNNING FOR INDIVIDUALS THAT TRYING TO FIND THE GLASSES BETWEEN THE CUSHIONS OR TOTING SOMEONE FOR THE SNIFFLES IS IS REAL. MOST INDIVIDUALS THAT GET INTO THIS LINE OF BUSINESS ARE THERE TO ACTUALLY HELP SAVE LIVES. IT KIND OF SAPS THAT ENERGY OUT OF YOU WHEN YOU'RE GOING AROUND NONEMERGENCY. I DON'T HAVE LEGITIMATE NUMBERS AS FAR AS DECREASE IN TURNOVER. WE DO HAVE LEGITIMATE NUMBERS AS FAR AS CLIENT SATISFACTION THAT WE CAN SHARE. IT WOULD BE INTERESTING TO SEE SOME TESTIMONIALS FROM SOME OF THE DIFFERENT SOME OF THE DIFFERENT DEPARTMENTS ON WHAT THEY'VE SEEN AS FAR AS IN THAT SPECIFIC SPACE OF WHAT HOW THE FIREFIGHTERS HAVE BENEFITED THEMSELVES FROM THIS PROGRAM AS WELL. THANK YOU. WE'D BE HAPPY TO PUT YOU IN TOUCH WITH A NUMBER OF REFERENCES. OKAY. WE'RE ACTUALLY QUITE TRANSPARENT ABOUT THAT. AND FOR ANY OF YOU THAT ARE INTERESTED, WE'D ALSO BE HAPPY TO WALK YOU INTO OUR CALL CENTER IN SAN ANTONIO. WE HAVE A NUMBER OF CITIES THAT ACTUALLY COME. THEY WANT TO SEE HOW IT WORKS. THEY SIT IN THE CALL CENTER. YOU CAN ACTUALLY SEE OUR NAVIGATORS AND DOCTORS WORK. IT GIVES YOU A REAL APPRECIATION OF THE WORK, ESPECIALLY THE WORK THAT NAVIGATORS DO FROM A SOCIAL STANDPOINT. VERY GOOD. THANK YOU. SIR. MAYOR PRO TEM LUCK. HI. I'M HERE. SO ONCE YOU ONCE GARLAND FIRE STARTED TALKING TO RIGHT SIDE. WAS THERE A DID YOU LOOK AT ANY OTHER COMPANIES? WAS THERE LIKE A RFQ FOR OTHER COMPANIES? DID YOU INVESTIGATE ANYONE TO SEE IF THIS SERVICE WAS AVAILABLE THROUGH ANY OTHER COMPANIES TO GO BACK TO COUNCIL MEMBER. MOORE'S STATEMENT ABOUT TRANSPARENCY. I'LL MAKE THIS SHORT. NO, WE THERE WASN'T ANYBODY THAT REALLY OFFERED WHAT THEY DID. AND ONCE THEY PRESENTED THEIR PROGRAM, WE STARTED LOOKING INTO IT. AND I CAN'T TELL YOU OF ANYONE OFFHAND THAT IS THEIR COMPETITOR THAT OFFERS THE VARIOUS LEVELS OF WHAT THEY OFFER. SO I COULD SIT HERE AND SAY, YEAH, WE LOOKED HERE AND WE LOOKED THERE. WE'VE BEEN INVESTED. WE'VE BEEN INVESTING OUR TIME IN GETTING TO KNOW THEM, VETTING THEM OUT. AND EACH TIME WE, YOU KNOW, WE'RE TRYING TO BLOW HOLES IN IT TO MOVE ON FROM THEM. NO OFFENSE, BUT WE HAVEN'T FOUND A REASON TO MOVE ON FROM THEM. THANK YOU. I'M HAPPY TO SHARE A LITTLE. I MEAN, TAKE IT FROM THE SOURCE, BUT THIS SERVICE IS RELATIVELY NEW, SO THERE THERE AREN'T A LOT OF OPTIONS AS FAR AS ORGANIZATIONS THAT ARE DOING THIS. IT'S NOT LIKE WE HAVE 30 COMPETITORS TO GO LOOK AT. THERE'S REALLY ONLY ONE OTHER COMPETITOR IN THE MARKET, AND THEY'RE NOT IN TEXAS. SO WHAT MOST OF THESE ORGANIZATIONS HAVE DONE IS YOU HAVE AN ORGANIZATION LIKE US WHO'S PENETRATED TEXAS, ESSENTIALLY IN ALL FOUR METROS INCLUDING THE I-35 CORRIDOR. AND WE'RE NOW MOVING INTO SOUTH TEXAS. THEY'RE NOT COMING HERE. THEY'RE STAYING IN ARIZONA AND KENTUCKY, WHERE THEY GOT THEIR START, BECAUSE NO AGENCY IS GOING TO USE MORE THAN ONE OF THESE. SO ONCE YOU'VE ESTABLISHED A FOOTHOLD IN A STATE, YOU END UP KIND OF BEING THE ONLY PERSON THERE, WHICH IS WHY WE'RE THE ONLY PLAYERS IN GEORGIA AND TEXAS NOW. THAT OTHER ORGANIZATION OPERATES SIMILAR TO US. THEY'RE JUST THEY DON'T HAVE ANY LOCALE HERE, AND THEY'RE NOT A TEXAS BASED ORGANIZATION. AND TO MY KNOWLEDGE, THEY DON'T HAVE PHYSICIANS CREDENTIALED IN THE STATE. SO WHEN SOMEONE IS SPEAKING WITH ONE OF YOUR AFTER THEY SEE THE NAVIGATOR AND THEY GO INTO TELEHEALTH TRIAGE, THEY ARE SPEAKING TO A MEDICAL DOCTOR, NOT A PA. THEY'RE SPEAKING TO A BOARD CERTIFIED EMERGENCY MEDICINE PHYSICIAN. THAT'S ALL WE USE. WE DON'T USE FAMILY PRACTITIONERS. THEY ARE THE BEST PERSON SUITED IN THE PROFESSION TO ACTUALLY PERFORM TRIAGE AND DETERMINE THE LEVEL OF CRITICALITY THAT PATIENT HAS IN THE MOMENT. AND THEN THIS IS 24 SEVEN. I JUST I DIDN'T HEAR ANYBODY. IT IS NOT OKAY. WHAT ARE YOUR HOURS? WE OPERATE NOW FROM 6 A.M. TILL 10 P.M. CENTRAL TIME. OUR INTENT IS TO BE 24 OVER SEVEN BEFORE THE END OF THE YEAR. THE DECISION WE MADE ON THAT IS WE WERE GROWING. THE ORGANIZATION IS. AND I THINK, CHIEF, YOU CAN PROBABLY I THINK YOU CAN BACK ME. WE HAVE NOT COORDINATED THIS ANSWER IS IN OUR EARLY ITERATIONS WORKING WITH OUR OUR FIRST AGENCIES, WHICH WOULD BE SAN ANTONIO AND THEN GRADY AND ATLANTA, WHICH IS ATLANTA FIRE DEPARTMENT. THE AMOUNT OF NON-EMERGENT CALLS THAT COME IN BETWEEN 10 A.M. AND 6 A.M. DROPS PRECIPITOUSLY BECAUSE THEY'RE ASLEEP. I DON'T HAVE AN EMERGENCY CIRCUMSTANCE. I'M SLEEPING THROUGH IT. SO OVER TIME, AS FAR AS OUR ABILITY TO GENERATE THE MOST AMOUNT OF EFFICIENCIES FOR OUR AGENCIES, OUR TIMES ARE SET AT 6 TO 6 A.M. TO 10 P.M. CENTRAL. IF POSSIBLE, I WOULD LIKE TO GET SOME NUMBERS ON HOW LIKE OUR CALL VOLUME OF EMERGENCY CALL VOLUME DURING THOSE HOURS AND THEN OUTSIDE OF THOSE HOURS. [04:40:04] YES, MA'AM. WE CAN GET THAT FOR YOU, BECAUSE WE'VE LOOKED AT IT BECAUSE WE'VE TALKED ABOUT PUTTING PEAK AMBULANCES IN SERVICE. AND WHEN IS THE MOST OPPORTUNE TIMES TO PUT IT IN THE HOURS THAT CLAYTON JUST SPOKE OF ARE THE ONES THAT WE HAVE IDENTIFIED. ARE THERE OUR BUSIEST HOURS? YOU KNOW, SUNDAY THROUGH, YOU KNOW, SATURDAY. OKAY. SO WE'LL BE ABLE TO PROVIDE THAT FOR YOU. ONE OF THE OTHER THINGS THAT WE TYPICALLY DO AS WELL IS WE'LL DO A DATA REVIEW WITH, WITH THE CHIEF AND THE DEPARTMENT AS WELL. WE'LL LOOK AT THE DISPATCH RECORDS. THERE'S SPECIFIC DATA THAT IDENTIFIES THE THEY'RE CODED OUT BASED ON ACUITY LEVELS. AND WE'LL HAVE A VERY DISTINCT IDEA OF EXACTLY HOW MANY RIGHT SIDE ELIGIBLE PATIENTS SHOW UP AT ANY GIVEN HOUR DURING THE DAY. I SUSPECT IT WILL FALL OUT LIKE ALMOST EVERYBODY ELSE DOES, BUT IT MAY NOT. I MEAN, THAT'S THAT'S DATA THAT WE DO AS PART OF ACTUALLY SETTING UP THE PLATFORM EARLY ON. SO WE UNDERSTAND THE POTENTIAL VOLUME THAT COMES ON. THAT'S ALSO HOW WE UNDERSTAND HOW WE NEED TO STAFF. I'M GOING TO ANSWER IT. 11 SECONDS I COULD HAVE THE RIGHT PEOPLE, WHICH MEANS I NEED TO KNOW, HISTORICALLY SPEAKING, THE DATA, THE AMOUNT OF VOLUME THAT WE'RE GOING TO RECEIVE. AND THEN WE'LL CONFIRM IT TOGETHER AND SET SET THOSE GOALS APPROPRIATELY. THESE ARE THE THIS IS THE AMOUNT OF VOLUME THAT WE WOULD LIKE TO TAKE OUT OF THE SYSTEM TO OPTIMIZE MS READINESS. SO FOR A PATIENT THAT HAS LIMITED MOBILITY AND HAS FALLEN THEY DON'T THEY HAVEN'T BROKEN ANYTHING. THEY'RE, YOU KNOW, NOT IN PAIN, BUT THEY CAN'T GET UP. DOES YOUR DOES YOUR PROGRAM HELP IN ANY WAY WITH THAT? IT COULD IN THIS CIRCUMSTANCE, IF SOMEONE HAS FALLEN AND THEY HAVE A MOBILITY ISSUE, WE'RE NOT GOING TO BE ACTIVATED IN DISPATCH. YOU GUYS ARE LIKELY TO ROLL THAT AMBULANCE WHEN THE CREW IS THERE. ONCE THEY'VE RIGHTED THAT INDIVIDUAL, IF THEY FEEL LIKE THEY'RE STABLE AND THEY DON'T HAVE AN ACUTE CONDITION, BUT THEY STILL NEED TREATMENT, THEN WE CAN ABSOLUTELY PROVIDE SERVICES AT THAT POINT IN TIME. AND THAT'S DONE THROUGH AN IPAD THAT AN IPAD. FIREFIGHTERS WOULD HAVE IPHONE, ANDROID TABLET PATIENTS, ANDROID PHONE. WE'RE. YEAH. SO IN THE FIELD INITIATED CALLS. WE DON'T IT IF THE IF IT'S SENT TO YOUR NAVIGATOR AND GOES INTO TELEHEALTH TRIAGE, OUR FIREFIGHTERS CAN LEAVE THE SCENE AT THAT TIME. YES. THE TIME ON SCENE FOR THE EMS WHEN THEY ACTIVATE IN THE FIELD IS A LITTLE LONGER, BECAUSE GENERALLY WHAT OCCURS IS WE'RE OFTENTIMES ON THEIR DEVICE. AND I HAVE A FELLOW CLINICIAN WORKING ALONGSIDE MY PHYSICIAN AT THAT POINT IN TIME THAT CAN PROVIDE VITALS. THEY CAN PROVIDE DIFFERENT INFORMATION THAT I CAN'T GET PRIOR. TYPICALLY, THE ON SCENE TIME FOR MEDICS IS SOMEWHERE BETWEEN 7 TO 9 MINUTES. THEN THEY'RE RELEASED AS SOON AS THE PATIENT CONSENTS AND SAYS, HEY, THIS IS GREAT. I'M GOOD WITH THIS CARE PLAN. THEY GOT ME. THERE'S A DOCUMENT THAT THE PATIENT SIGNS AND THE EMS CREW IS RELEASED. AT THAT POINT IN TIME, THEY'RE BACK IN SERVICE. IS THERE ANY SO THEY SIGN THAT DOCUMENT. SO IF THERE WERE, YOU KNOW, IF IN OUR AMBULANCE LEFT AND THEN SOMETHING HAPPENED AND THEY DIDN'T GET BACK IN TIME, THAT DOCUMENT WOULD RELEASE OUR OUR FIREFIGHTERS FROM ANY, LIKE, LIABILITY. YEAH. AT THAT POINT IN TIME, THE PATIENT IS CONSENTED AND CARE HAS BEEN MOVED TO US. WE OPERATE AS A PROVIDER GROUP, SO WE'RE NOT A BUSINESS. WE'RE NOT A VENDOR. WE ARE A PHYSICIAN'S GROUP. SO THAT THAT INDIVIDUAL IS NOW UNDERNEATH OUR CARE. SO LIABILITY DOES FALL ON US. OKAY. SO IF A PATIENT IS SEEN VIA TELEHEALTH AND THEY HAVE INSURANCE, WHAT HOW DO YOU WHAT IS THEIR CO-PAY? DOES THAT DEPEND ON THEIR INSURANCE OR DOES THAT DEPEND ON YOU? LIKE IT'S COMPLETELY DEPENDENT ON THEIR INSURANCE. IN MEDICAID AND MEDICARE, IT'S GOING TO BE PRETTY SET. AT LEAST FEE FOR SERVICE, MEDICARE AND MEDICAID. MEANING IF I STAY WITH STANDARD MEDICARE FROM THE GOVERNMENT AND I DON'T GO GET IT FROM HUMANA OR UNITED THEY'RE GENERALLY GOING TO MOST MEDICARE AND MEDICAID CO-PAY IS ALMOST NOTHING. BECAUSE IF YOU'RE A HEALTH PLAN, YOU REALLY WANT THEM TO USE TELEHEALTH BECAUSE IT'S THE MOST LEAST IT'S THE LEAST EXPENSIVE AND THE LEAST INVASIVE FOR THE PATIENT. SO THE HEALTH PLAN WOULD PREFER THAT YOU USE THAT. HENCE THEY ACTUALLY OFTENTIMES MAKE CO-PAY FOR COMMERCIAL PLANS. LIKE WHAT PROBABLY EVERY SINGLE ONE OF US ARE ON. IT'S GOING TO DEPEND ARE THEY IN A HIGH DEDUCTIBLE PLAN OR IN A HIGH DEDUCTIBLE PLAN? THEY MAY GET A PORTION OF IT. TYPICALLY EVEN TELEHEALTH. AND THAT IS CARVED OUT. AND THERE'S NORMALLY A SMALL 10 TO $20 CO-PAY THAT'S TIED TO IT BECAUSE SIMILAR TO MEDICAID AND MEDICARE, COMMERCIAL HEALTH PLANS WOULD PREFER YOU USE TELEHEALTH AND GO TO BRICK AND MORTAR BECAUSE IT COSTS A LOT LESS, [04:45:03] ESPECIALLY IF IT'S JUST AS EFFECTIVE. I DON'T KNOW, MY MY INSURER CHARGES ME $75 EVERY TIME. EVERY TIME. THAT MAY BE THAT MAY DEPEND ON WHO THEY'RE ACTUALLY CONTRACTED THROUGH. BUT THAT'S A PAINFULLY BYZANTINE WORLD AND HOW THAT WORKS, I AGREE. OKAY. I THINK THAT'S ABOUT ALL I HAD. I THINK IT'S A REALLY GREAT PROGRAM AND. OH, WHAT PERCENTAGE OF REDUCTION HAVE YOU SEEN IN FIELD INITIATED CALLS? BECAUSE PEOPLE ARE ABLE TO USE THE TELEHEALTH SIDE OF YOUR SERVICE THROUGH DISPATCH AND THE NAVIGATOR? YEAH. IT'S GOING TO DEPEND ON THE AGENCY, BUT ANYWHERE BETWEEN 10 TO 30% OF TRANSPORTS HAVE BEEN REDUCED. THAT'S A GOOD NUMBER. OKAY. THANK YOU VERY MUCH. YOU'RE WELCOME. COUNCIL MEMBER DUTTON. I JUST WANT TO MAKE NOTE THAT YOU DID SAY THAT TELEHEALTH IS JUST AS EFFECTIVE FOR CERTAIN CONDITIONS. FOR THE RECORD CAVEAT THAT SO AND. SO, AS YOU SAID, YOU ARE NOT A BUSINESS. YOU ARE A MEDICAL PROVIDER. SO AND THAT IS FOR THE REASON OF BEING ABLE TO BUILD AN INSURED PERSONS INSURANCE TO GET PAID, RIGHT? WELL, IT'S YES AND NO. I MEAN, IN GENERAL, IN ORDER TO BE A IN ORDER TO PROVIDE CLINICAL CARE TO PHYSICIAN LEVEL, WE HAVE TO OPERATE AS A PHYSICIAN GROUP. AND WE HAVE DOCTORS. AND SO BY THAT REASON, WE ARE A PHYSICIAN GROUP. BUT YES, BEING A PHYSICIAN GROUP DOES PUT YOU IN THE POSITION POSITION WHERE YOU'RE CREDENTIALED WITH HEALTH PLANS. AND THEN WE WILL LIKE FILE A CLAIM FOR A TELEHEALTH VISIT FOR THAT HEALTH PLAN. SO THAT PORTION ALONE WOULD BOTHER ME. LIKE YOU WERE SAYING, SAN ANTONIO DOESN'T OR CHOSE NOT TO JUST BE TRANSPARENT ABOUT THE THE PARTNERSHIP WITH RATE SITE SIMPLY BECAUSE WHEN YOU HAVE CLAIMS ON YOUR MEDICAL INSURANCE THAT THAT IS EVENTUALLY GOING TO LEAD TO PREMIUMS GOING UP BECAUSE NOW YOU BECAUSE WE'RE OTHERWISE OUR OUR SERVICE IS STRUCTURED DIFFERENTLY AS IS RIGHT. SO MY CONCERN WOULD BE WHAT IS HOW IS THAT GOING TO AFFECT PEOPLE'S PREMIUMS IN THE LONG RUN? BECAUSE I WOULD HATE TO PUT US IN A, IN A NEW RISK POOL. RIGHT. YOU KNOW SO AS THE CITY, THOSE ARE THINGS THAT WE, WE HAVE TO LOOK AT, TOO BECAUSE WE DON'T WANT TO DO A DISSERVICE TO OUR CITIZENS THINKING THAT WE'RE DOING SOMETHING GOOD, BECAUSE THAT'S WHY WE'RE HERE AT 11:00. SO I WANT I JUST WANT TO MAKE SURE THAT WE'RE TAKING ALL OF THOSE THINGS INTO ACCOUNT. I, I DO AGREE THE SERVICE SOUNDS GREAT. BUT THERE'S, YOU KNOW, OTHER PEOPLE ARE GOING TO HAVE QUESTIONS THAT WE DIDN'T THINK OF TONIGHT. AND SO I WANT TO MAKE SURE THAT WE, WE ARE DEFINITELY LOOKING AT ALL OF, ALL OF THE SEVEN THINGS. CAN I CAN I ANSWER YOUR QUESTION? BECAUSE IT'S ACTUALLY THE EXACT OPPOSITE OF WHAT YOU'RE WORRIED ABOUT? SURE. SO IN IN IN THE CIRCUMSTANCE AS IT STANDS TODAY, LET'S JUST SAY IT'S NOT HERE TODAY. THAT PATIENT HAS A CLAIM FILED BY MS AGENCY FOR TRANSPORT. DEPENDING ON DEPENDING ON THE CLAIM, IT'S GOING TO BE ANYWHERE BETWEEN 250 TO $1500. THAT THEN THAT PATIENT IS GOING TO RECEIVE A CLAIM FROM THE ER, WHICH ON AVERAGE IS ABOUT $1,700 WITH US. A TELEHEALTH FEE. ABOUT $75. SO AS FAR AS EXPERIENCE, IF YOU THINK ABOUT HOW HEALTH PLANS, THEY DON'T OPERATE EXACTLY LIKE A CAR INSURANCE DOES, THE MORE YOU DO, THE MORE IT GOES. BUT GENERALLY SPEAKING, YOU'RE NOT WRONG. A GROUP WILL HAVE AN EXPERIENCE RATING THAT WILL ACTUALLY DRIVE THEIR PREMIUM. WE'D BE DRIVING IT DOWN. NOW. OKAY. I'M WITH YOU. WE TALKED ABOUT USE OF 10 P.M., YOUR 6 A.M. TO 10 P.M.. SO I BECAUSE I'M ALSO ON THE PUBLIC SAFETY COMMITTEE. AND DURING THE MS STAKEHOLDERS ONE THING I DID WAS GO AND WORK A 24 HOUR SHIFT WITH ONE OF OUR STATIONS. AND ONE OF THE MAIN TOPICS OF OUR MS STAKEHOLDER IS SLEEP. SO I WILL SAY THAT 100% OF THE CALLS THAT WE GOT FROM 10 P.M. [04:50:01] TO 6 A.M. WERE NON-EMERGENT THE CALL LOAD WAS DRASTICALLY SMALLER. HOWEVER, YOU'RE STILL WAKING UP IN THE MIDDLE OF THE NIGHT, WHICH IS WHAT WE'RE THAT'S WHAT WE'RE COMBATING, YOU KNOW, IN OUR STAKEHOLDER COMMITTEE MEETING IS, YOU KNOW, THE QUALITY OF SLEEP. AND SO WHEN YOU'RE GETTING WOKEN UP AT, YOU KNOW, 02:00 IN THE MORNING BECAUSE SOME KID FELL OFF HIS BIKE ON A CURB, THAT THAT WAS REAL LIFE. KID WAS FINE. I'M AWARE IT WAS FINE. DAD CAME AND WAS MAD, AND WE WENT ABOUT OUR BUSINESS. BUT YOU STILL GOT WOKEN UP FOR SOMETHING THAT COULD HAVE BEEN AVOIDABLE HAD IT HAVE HAPPENED BETWEEN 6 A.M. AND 10 P.M.. SO I'M VERY INTERESTED TO GET SOME MORE DATA ON THOSE HOURS AND WHAT OUR CALLS ARE AND MAYBE THROW THAT INTO A CONVERSATION WITH OUR STAKEHOLDER COMMITTEE. BECAUSE THOSE CALLS ARE ROUGH. THEY ARE ROUGH, MAN. LIKE, BECAUSE YOU'RE LIKE A ZOMBIE TRYING TO WALK TO THE AMBULANCE AND YOU KNOW IT TO ME, I THINK THAT WOULD BE THE MOST BENEFICIAL IS TO HAVE, YOU KNOW, IN THOSE SLEEPY HOURS THAT WE HAD SOMEWHERE TO NAVIGATE THOSE CALLS FOR OUR GUYS. SO I'M INTERESTED IN THOSE NUMBERS AND WHAT THAT LOOKS LIKE. AND THEN I DON'T SEE LET'S SEE. ARE YOU. SO YOU SAID IT IS AN ACTUAL ER, PHYSICIAN. CORRECT. AND THAT'S GUARANTEED EVERY CALL. NO. PA NO, NO. DOCTOR MOMS, WE MAY USE A PRN IN THE CARE EPISODE. TYPICALLY THAT'S SOMEONE FALLING OUT WITH THE PRESCRIPTIONS AS FAR AS THE TRIAGE AND THE INDIVIDUAL THAT ANSWERS THE PHONE AND PROVIDES AND RENDERS CARE, IT'S ALWAYS GOING TO BE AN ER PHYSICIAN, A BOARD CERTIFIED ER PHYSICIAN. OKAY. AND THEN AI HAS BEEN ANOTHER HOT TOPIC. RELATING AI. OKAY. NO, NO AI OF ANY SORTS DURING THE TRIAGE PROCESS. PERFECT. ALRIGHTY, I APPRECIATE YOU. THANK YOU. YOU'RE WELCOME. MA'AM. COUNCIL MEMBER BEARD. YEAH. HI. HELLO. I'M ALL FOR LAYERING, AND IT DOESN'T. IT DOESN'T MAKE SENSE TO ME THAT THERE IS. WE'RE DOWN HERE, AND THEN YOU GO. THE NEXT STEP IS, ER, IS 911 INTO THE AMBULANCE? THERE'S GOT TO BE STUFF IN BETWEEN BECAUSE OUR POOR EMS GUYS, OUR POOR AMBULANCE GUYS ARE JUST RUNNING RAGGED, ESPECIALLY OUT OF 2 OR 3 OF OUR 11 STATIONS. AND I LIVE CLOSE ENOUGH TO HEAR THE AMBULANCE WHEN IT GOES. MY BIG QUESTION IS, WHERE ARE YOUR NAVIGATOR AND YOUR PHYSICIAN'S? WHERE ARE THEY? ARE THEY WORKING FROM HOME OR ARE THEY STATIONED? IS IT A CERTAIN HOSPITAL? WHERE ARE THOSE PEOPLE WHEN THEY'RE. WHEN THEY GET PUT ON THE LINE? YEAH. SO OUR CALL CENTER RESIDES IN SAN ANTONIO. SO OUR CARE TEAM IS IN SAN ANTONIO. OUR NAVIGATORS ARE ALL CENTRALLY LOCATED IN THAT CARE CENTER. OUR PHYSICIANS WORK REMOTELY WHEN THEY WORK. WELL, NOT ALL OF THEM WORK REMOTELY, BUT SOME OF THEM DO. THEY ARE OWNED AND EMPLOYED BY RIGHT SITE. WE'RE NOT OUTSOURCING A GROUP. WE'RE NOT EXPECTING SOMEONE TO BE ON CALL WHEN THAT PHYSICIAN IS ON. THEY ARE ON SCHEDULE WITH US IN THAT MOMENT. ALL OF OUR PHYSICIANS, THEY GENERALLY LIVE IN TEXAS OR GEORGIA, WHERE WE'RE LOCATED. WE DO HAVE SOME THAT LIVE OUT OF STATE, BUT THEY'RE CREDENTIALED IN THE STATES. AND HAVE THEIR MEDICAL LICENSES TO PRACTICE IN THE STATE. OTHERWISE WE WOULDN'T BE ABLE TO OFFER SERVICES IN THE STATES. THERE'S PART OF THE EXPERIENCE THAT THE PATIENT RECEIVES IS IMPORTANT TO US. IF YOU'RE YOU'VE CALLED 911, YOU'VE HAVE COME TO EXPECT A CERTAIN EXPERIENCE WITH THE PROFESSIONALISM OF THE EMS AGENCIES YOU WORK WITH. AND WE HAVE WHAT WE CALL A CURTAIN REVEAL WHEN WE'RE UP ON THE SCREEN. THE BACKGROUND IS THERE'S A RIGHT SIDE LOGOED BACKGROUND. SO THEY WILL KNOW IT'S US. THE NAVIGATORS ARE GOING TO BE IN SOMETHING SIMILAR TO WHAT WE'RE WEARING. AND OUR PHYSICIANS, WHEN THEY COME ON, THEY'RE IN A WHITE COAT WITH THEIR NAME EVERY SINGLE TIME. AND IT SOUNDS SILLY, BUT IT'S IT'S IMPORTANT IN THAT MOMENT FOR THAT PERSON TO FEEL A COMFORT. I SEE A DOCTOR. I SEE SOMEONE IN A PROFESSIONAL ENVIRONMENT. THAT'S PART OF THE PRACTICE OF HOW WE OPERATE IN EVERY ONE OF THE CALLS. [04:55:04] WHEREAS FOR OTHER FOLKS THAT MAY HAVE HAD TELEHEALTH THAT IN THE PAST, SOMETIMES YOU'RE NOT QUITE SURE WHAT YOU MIGHT GET SOMEONE AT THE POOL WITH A SET OF HEADPHONES ON. WELL, TELEHEALTH WITH MY PROVIDER IS I CALL, I MAKE AN APPOINTMENT, I PAY MY CO-PAY, AND THEN AT SOME POINT IN TIME ON OR ABOUT THE TIME OR TWO HOURS LATER, THEY CALL ME BACK FROM, YOU KNOW. YEAH. SO YOU JUST DON'T GO TO THE RESTROOM WHILE YOU'RE ON, WHILE YOU'RE WAITING FOR THE CALL. OKAY. NOW, CHIEFLY MENTIONED THIS AT SOME MEETING I WAS AT 2 OR 3 YEARS AGO, NOT LONG AFTER SAN ANTONIO IMPLEMENTED THIS. AND IT CAUGHT MY INTRIGUE. NOW, I NEVER CAN REMEMBER THE NAME OF YOUR COMPANY. I DO APOLOGIZE FOR THAT. I ALWAYS GET IT. IT'S RIGHT SOMETHING. AND I CAN'T EVER REMEMBER WHAT GOES AFTER THE RIGHT RIGHT SITE. SO BUT I DID RESEARCH, Y'ALL, WHAT, A COUPLE OF YEARS AGO BECAUSE I'VE BEEN INVOLVED WITH THE FIRE DEPARTMENT, AND I LOVE THE IDEA. IF WE CAN FREE UP OUR AMBULANCES, EVEN IF THE AMBULANCE GETS CALLED OUT, AND THEN THEY TURN THE PATIENT OVER TO YOU AND IT TAKES THEM 20 MINUTES AT SITE, THAT'S STILL AN HOUR LESS THAN IF THEY HAVE TO TRANSPORT THEM TO THE HOSPITAL AND GET THEM BACK, BECAUSE WE HAVE SO MUCH WALL TIME AT THE HOSPITAL, IT'S RIDICULOUS. AND WE DON'T HAVE A HOSPITAL HERE, SO THEY ALWAYS HAVE TO LEAVE THE TOWN, TO LEAVE THE CITY LIMITS, TO GO TO THE HOSPITAL. SO I'M ALL FOR THAT. SO I LOVE YOU GUYS. I THINK IT'S A GREAT PLAN. I LOVE THAT WE'RE GOING THIS WAY. I'VE BEEN ASKED FOR ABOUT THE LAST YEAR. WHY AREN'T WE DOING THIS? WHY AREN'T WE DOING THIS? AND IT'S LIKE, WELL, IT'S AN OPTION. AND THAT'S WHAT WE'RE DOING WITH OUR PUBLIC SAFETY COMMITTEE. AND MS STAKEHOLDER'S COMMITTEE IS WE'RE LOOKING FOR WAYS TO PROVIDE ADDITIONAL SERVICES AND FREE UP OUR MS AND YOU KNOW, DEPARTMENT SO THAT THEY CAN HANDLE THOSE MORE URGENT CALLS. AND IF IT DOESN'T INCREASE OUR DISPATCH TIME ON A CALL, THEN GREAT. AND THAT'S THAT'S ANOTHER QUESTION I HAD. AND YOU'VE ANSWERED THAT ON THAT. THE DISPATCHER IS NOT INVOLVED ON THE CALL ANY LONGER THAN THEY WOULD HAVE BEEN DISPATCHING AN AMBULANCE TO THAT SITE. ALL RIGHT. WELL, SO THANK YOU SO MUCH. I'VE ENJOYED YOUR PRESENTATION. AND YES, I THINK WE NEED LAYERS HERE IN GARLAND. AND I THINK Y'ALL WOULD BE A GREAT LAYER TO ADD IN SO THAT WE CAN GET SOME ADDITIONAL SERVICES FOR OUR, OUR CONSTITUENTS. AND TONIGHT SEEMS TO BE ALL MEDICAL SO. ALL RIGHT. THANK YOU. THANK YOU. THANK YOU, MADAM MAYOR. PRO TEM LUCK. THANK YOU VERY MUCH, MAYOR. I HAD ONE OTHER QUESTION. IT WAS ABOUT THE CONTRACT. SO IF WE DISCOVER THAT WE DON'T LIKE YOU FOR SOME REASON. CAN WE GET OUT OF THE CONTRACT? YOU CAN, BUT NO, YOU CAN. I MEAN, THERE'S THERE'S A COUPLE OF SIMPLE WAYS TO LOOK AT THIS. ONE, THERE ARE OUTS IN THE CONTRACT BASED ON PERFORMANCE. THE OTHER WAY IS, IF YOU GUYS DON'T LIKE US, THEY JUST QUIT CALLING US, OKAY? THERE IS NO DEFINED VOLUMES THAT WE REQUIRE IN OUR CONTRACTS. SO THE REALITY IS, IF IF CHIEF DECIDES I DON'T LIKE THESE GUYS ANYMORE, YOU JUST GO IN AND INSTRUCT DISPATCH TO QUIT ACTIVATING RIGHT SITE, AND IT'S KIND OF OVER. SO WHAT IS THE CONTRACT FOR, THEN? THERE NEEDS TO BE LEGALESE THAT THERE'S A HANDOFF BETWEEN US AND THE AGENCY. IT'S FOR THE PROTECTION OF THE CITY. IT'S FOR THE PROTECTION OF OUR ORGANIZATION. IT'S ONLY ABOUT A TWO PAGE DOCUMENT. IT'S PRETTY SHORT. IT'S PRETTY BRIEF. IT'S NOT OVERLY COMPLEX. BUT THERE DOES NEED TO BE SOME SORT OF FORMAL AGREEMENT BECAUSE WE ARE PROVIDING PATIENT CARE. AND IT'S FOR IS FOR BOTH OF US IN THAT CIRCUMSTANCE. THANK YOU VERY MUCH. THANK YOU, MAYOR. I APPRECIATE YOU CHIMING BACK IN. DEPUTY MAYOR PRO TEM TWO QUICK FOLLOW UP QUESTIONS. SORRY. HOW LONG DOES IT TAKE TO INTEGRATE THE PROGRAM IF WE SAY YES? GENERALLY SPEAKING, IT IS. I'M THINKING ABOUT HOW BEST TO ANSWER THIS BECAUSE THERE'S A COUPLE OF DIFFERENT VARIABLES. ONE, IT WILL DEPEND IT DEPENDS ON OUR IMPLEMENTATION SCHEDULE. SO WE DO HAVE A NUMBER OF AGENCIES THAT ARE SIGNING UP. WE'VE SLOWLY BECOME AS WORD HAS COME OUT. GENERALLY WE'VE GROWN BY WORD OF MOUTH. YOU KNOW, AS CHIEF INDICATED, WE WE WE MET THE GARLAND FIRE DEPARTMENT AT A CHIEFS GROUP AS SAN ANTONIO CAME ONLINE AS MONTGOMERY COUNTY CAME ONLINE. [05:00:03] AS BEAUMONT CAME ONLINE, EVERYBODY TALKS. AND SO WE DO HAVE A BIT OF A BACKLOG. BUT ASSUMING YOU GUYS SAID YOU WANTED TO GO TOMORROW, I WOULD SAY THAT BASED ON THE VOLUME AND THE SIZE OF YOUR ORGANIZATION, WE COULD BE LIVE IN LESS THAN 90 DAYS. THAT'S VERY REASONABLE. NEXT QUESTION IS EVERYTHING DISPATCH EVERYTHING ORIGINATES FROM DISPATCH. CORRECT? DOESN'T HAVE TO. WE DO HAVE SOME AGENCIES THAT USE THIS PURELY OUT OF THE FIELD. WE DON'T. I WAS CURIOUS ABOUT LIKE POLICE THAT HAVE SOMETHING FROM THE FIELD. WE WE'VE ACTUALLY HAD WE DON'T DO IT NOW. WE'VE ACTUALLY HAD SOME DISCUSSIONS WITH POLICE WHETHER WE COULD ACTUALLY HELP WITH MENTAL HEALTH CRISES. IN SOME CASES, WE'VE NOT ACTUALLY ENGAGED WITH POLICE AT THIS POINT IN TIME. BUT IT'S SOMETHING I THINK WE'RE WILLING TO TALK ABOUT. OKAY. AND THEORETICALLY, IF THEY'RE IN CUSTODY, WE GENERALLY THAT'S SOMETHING THAT WE WE CAN'T GET INVOLVED IN FOR A VARIETY OF DIFFERENT LEGAL REASONS, LIKE IF THEY WERE IN IN HOLDING OR SOMETHING LIKE THAT. OKAY. AND THEN IF THERE'S SOMEONE LIKE ANOTHER ORGANIZATION, LIKE A, LIKE A TELEHEALTH ORGANIZATION OR SOMETHING LIKE THAT, CAN THEY WORK WITH YOU ALSO? FOR SURE. THERE'S BEEN SOME MARKETS WHERE OR EVEN SOME OF OUR HEALTH PLANS, LET'S SAY, FOR EXAMPLE, UNITED UNITEDHEALTHCARE HAS INVESTED HEAVILY IN TELEHEALTH. AND I THINK MR. MOORE, YOU ACTUALLY MENTIONED TELADOC. YOU WENT THROUGH A NUMBER OF THOSE DIFFERENT GROUPS. FOR ANY ANY MEMBER OR PATIENT THAT WE'VE ENGAGED WITH THAT WE UNDERSTAND THEIR HEALTH INSURANCE. WE GENERALLY IF I'M CONTRACTED WITH UNITED, WHICH WE ARE, IF I'M CONTRACTED WITH HUMANA, WHICH WE ARE, I UNDERSTAND THE BENEFITS PACKAGE THAT THAT PATIENT HAS. I'M GOING TO RECOMMEND. HEY, NEXT TIME, INSTEAD OF CALLING 911 FOR YOUR CHILD'S 99 DEGREE TEMPERATURE. DID YOU REALIZE YOU HAVE A TELEHEALTH BENEFIT? NO I DIDN'T. WELL, HERE. WOULD YOU LIKE ME TO SEND INFORMATION ON IT? WOULD YOU LIKE ME TO HELP YOU GET TO THE WEBSITE AND REGISTER SO IT'S IN YOUR FAVORITES? SO. ABSOLUTELY. I MEAN, THERE'S, THERE'S, THERE WOULD BE IF THE CITY HAD AN INVESTMENT IN OTHER TELEHEALTH PROGRAMS, WHICH OBVIOUSLY WE HEARD ABOUT THAT EARLIER. THERE'S A STRONG HANDOFF POSSIBILITY AS WELL OF US EDUCATING YOUR CITIZENS THAT THAT IS AN AVAILABLE RESOURCE TO HELP SLOW DOWN THE ACTUAL 911 UTILIZATION AS WELL. AWESOME. THANK YOU. DOES THAT ANSWER YOUR QUESTION? OKAY. THANK YOU SIR. ALL RIGHT. I THINK I DON'T HAVE ANYONE ELSE IN QUEUE, BUT I THINK IT'S A WONDERFUL PROGRAM AT NO COST TO OUR CITIZENS. I THINK THE CHOICE IS SIMPLE. AND REGARDING THE SENDING IT OUT FOR RFQ, ALL THIS DISCUSSION HAS BEEN GOING ON. I LOOKED AT SAN ANTONIO AND THEY DID THAT EXACT THING, AND THEY RECEIVED THREE RESPONSES. AND RIGHT SITE WAS BY FAR AND AWAY THE TOP CHOICE. THERE WERE TWO OTHER RESPONDENTS. RIGHT SIDE GOT A 90 OUT OF 100. THE OTHER TWO GOT A 56 AND A 43 OUT OF 100. AND RIGHT SIDE WAS DOCKED FIVE POINTS BECAUSE THEY'RE NOT VETERAN OWNED. SO I THINK THAT'S QUITE A HIGH SCORE THERE. AND I THINK WHAT THEY SAID ALSO, I WOULD AGREE, IF NOT MANY OTHER PEOPLE OFFER THIS KIND OF SERVICES THAT THEY DO AS WELL. SO I WOULD LOVE TO SEE A CONSENSUS FOR US MOVING FORWARD. SO COUNCIL. THAT IS A MAJORITY SEVEN WITH A OKAY, SO THAT COUNCIL MEMBER DUTTON IS THE ONLY ONE IN OPPOSITION. COUNCIL MEMBER. WELL, IT'S EITHER A CONSENSUS OR NOT. SO IT'S A THERE WAS OTHER REASONS. THAT'S JUST JUST TO MOVE FORWARD. I AGREE. IT'S JUST TO MOVE FORWARD. THEY WILL HAVE A CONTRACT THAT WILL COME BACK BEFORE ON A FORMAL SESSION TO DISCUSS, AND WE CAN BRING AN UPDATE AT THAT TIME, MR. CITY MANAGER. I'VE GOT A CURRENTLY SCHEDULED TO COME BACK ON THE 17TH OF FEBRUARY. IF YOU THINK YOU NEED MORE TIME TO GET THE INFORMATION THAT YOU NEED, I CAN MOVE IT TO THE FOLLOWING THE FIRST SESSION IN MARCH, IF THAT WOULD BE BETTER. IT'S JUST WHATEVER THE PLEASURE OF THE COUNCIL IS. IF I THINK THAT IF WE IF WE HAD IT AS A WORK SESSION ITEM ON THE 16TH, I'LL DO THAT. I'LL POST IT ON THE 16TH SO WE CAN GET THE REST OF THE QUESTIONS ANSWERED, THAT THE ADDITIONAL DATA THAT YOU'RE GOING TO PROVIDE. AND THEN I'LL PUT IT ON THE 17TH FOR CONSIDERATION BY COUNCIL IF THAT WOULD WORK. ALL RIGHT. OKAY. PERFECT. THANK YOU MAYOR. VERY GOOD. THANK YOU. APPRECIATE YOU. ALL RIGHT. ABSOLUTELY. THANK YOU ALL VERY MUCH. WE GREATLY APPRECIATE IT. THANK YOU CHIEF. ALL RIGHT. WE'LL MOVE ON. NOW TO THE NEXT ITEM ON OUR AGENDA IS CONSIDER AN ORDINANCE ORDERING A SPECIAL HOME RULE ELECTION. [7. Consider an Ordinance Ordering a Special Home-Rule Election] MR. CITY ATTORNEY. [05:05:20] GOOD EVENING AGAIN, MAYOR AND COUNCIL. I WANT TO START MY PRESENTATION WITH KIND OF A BRIEF SUMMARY OF HOW WE GOT HERE AND SOME OF THE CONSIDERATIONS MY OFFICE HAD WHEN THIS WAS BROUGHT TO US LAST WEEK ABOUT THE POSSIBILITY OF CALLING A POTENTIAL OF CALLING A SPECIAL ELECTION. THE FIRST CONSIDERATION WE HAD WAS THE TIMELINE AND ALL OF THIS. AND THAT'S AN IMPORTANT CONSIDERATION FOR FOR YOU ALL AS COUNCIL. THE LAST DAY THAT WE CAN CALL AN ELECTION FOR MAY IS FEBRUARY THE 13TH. AND SO IF IT'S NOT CALLED TOMORROW, YOU WOULD HAVE TO HAVE A SPECIAL MEETING BEFORE YOU ALL MEET AGAIN IN A REGULAR MEETING IN ORDER TO CALL THE ELECTION. SO TOMORROW IS THE LAST REGULAR MEETING THAT YOU COULD ACTUALLY CALL THE ELECTION. ALONG WITH THAT TIMELINE. IF IN THE EVENT THAT TOMORROW NIGHT, THIS COUNCIL CALLS, TOMORROW NIGHT, THIS COUNCIL VOTES FOR A SPECIAL ELECTION. AND OUR VENDOR, MD HEALTH PATHWAY ELECTS TO TERMINATE THE CONTRACT. AS YOU ALL KNOW, ONCE WE CALL A SPECIAL ELECTION, AS YOU ALL MAY KNOW, IT'S WE HAVE TO HAVE STATUTORY, STATUTORY AUTHORITY, SPECIFIC STATUTORY AUTHORITY TO CANCEL THAT ELECTION. SO ONCE THE COUNCIL VOTES AND IT'S BEEN CALLED, WE HAVE TO HAVE SPECIFIC STATUTORY AUTHORITY. AND IN CANCELING THAT ELECTION, IF YOU HAVE STATUTORY AUTHORITY, YOU HAVE UNTIL IN COLLIN COUNTY, YOU HAVE UNTIL THE 20TH OF FEBRUARY TO CANCEL THAT ELECTION AND THE 27TH OF FEBRUARY IN DALLAS COUNTY. SO YOU'RE LOOKING AT TWO WEEKS IF Y'ALL WERE TO CALL THE SPECIAL ELECTION TOMORROW AND IF MD HEALTH PATHWAY ELECTED TO TERMINATE THE CONTRACT NOW, IN TERMS OF THE ELECTION CODE, GIVES US SOME GUIDANCE ON WHEN A CANCELING OF A CALLED ELECTION SPECIAL ELECTION MAY OCCUR. AND ONE THING, ONE, ONE CONSIDERATION THAT IT ALLOWS IS CANCELLATION OF A MOOT MEASURE. AND SO IF THE ACTION AUTHORIZED BY THE ELECTION MAY NOT BE IMPLEMENTED REGARDLESS OF THE OUTCOME OF THE ELECTION, THEN YOU CAN, UNDER THE ELECTION CODE 2.0 81A SUBSECTION A, CALL IT BECAUSE IT'S CANCEL IT BECAUSE IT'S A MOOT MEASURE. SO IN THIS PARTICULAR INSTANCE, IF THE CONTRACT WERE TO BE CANCELED. IT WOULD BECOME MOOT AT THAT POINT, AND WE'D HAVE THAT TWO WEEKS TO CANCEL IN COLLIN COUNTY AND AND THREE WEEKS TO CANCEL IN DALLAS COUNTY. SO THAT'S THE TIMELINE CONSIDERATIONS MY OFFICE WAS WORKING WITH THIS PAST WEEK. THE SECOND CONSIDERATION WAS THE LANGUAGE ITSELF. THE PROPOSITION LANGUAGE AND AND DRAFTING PROPOSITION LANGUAGE FOR ANY ELECTION IS IS CHALLENGING AND I AND UNTIL YOU'RE INVOLVED IN THE PROCESS OF DOING IT, IT DOESN'T SEEM LIKE IT WOULD BE THAT CHALLENGING BECAUSE IT'S REALLY, AT ITS BEST, A SINGLE SENTENCE. AND IN FACT, IT HAS TO BE A SINGLE CONCISE STATEMENT IN A PROPOSITION. AND FOR ATTORNEY'S SINGLE, CONCISE STATEMENTS ARE VERY DIFFICULT TO DRAW DRAFT. BUT THE ELECTION CODE ALSO GIVES US SOME GUIDANCE AND SOME CONSIDERATIONS IN HOW WE DRAFT THOSE. AND IT USES LANGUAGE ON A VERY BROAD AND VERY HIGH LEVEL OF DEFINITE, CERTAIN AND FACIALLY NEUTRAL. SO YOU HAVE TO BE CAREFUL IN ORDER TO PASS ANY TYPE OF LEGAL CHALLENGE THAT IT MEETS THOSE HIGH LEVEL CRITERIA, AND IN THAT IT NEEDS TO BE, AS I SAID EARLIER, A SINGLE CONCISE STATEMENT. AND ALSO IT NEEDS TO INFORM WITHOUT PERSUADING. AND SO OFTENTIMES WHEN WE SIT DOWN IT TAKES A TEAM AND MULTIPLE DRAFTS. AND SO I THINK YOU'VE ALL SEEN THE PROPOSITION LANGUAGE, THE PROPOSED PROPOSITION LANGUAGE THAT WENT THROUGH ABOUT 7 OR 8 DRAFTS IN MY OFFICE. AND THIS IS THE LANGUAGE WE CAME UP WITH PROPOSING TO ENGAGE MEDICAL PROFESSIONALS TO PROVIDE TELEHEALTH SERVICES BY INCLUDING A SEPARATE FEE WITHIN THE CITY UTILITY BILL OF $6 A MONTH IN THE FIRST TWO YEARS, AND THEREAFTER ESCALATING UP TO $9 A MONTH IN YEAR FIVE, AND PROVIDING ANY UTILITY CUSTOMER THE RIGHT TO AVOID THE FEE BY OPTING OUT OF THE PROGRAM. SO THAT'S THE SINGLE CONCISE STATEMENT. IT WAS MEANT TO INFORM WITHOUT PERSUADING, BUT MADE SURE THE VOTER UNDERSTOOD WHAT THEY WERE VOTING ON OR WHAT THEY WERE VOTING AGAINST. ANY QUESTIONS ABOUT THE PROPOSITION? LANGUAGE COUNCIL MEMBER ESSER IN THE Q DO YOU HAVE A QUESTION ON THE LANGUAGE? OKAY. OKAY. SO WHAT IS THE PURPOSE OF THIS PARTICULAR SPECIAL ELECTION? [05:10:05] THIS QUESTION HAS COME UP QUITE A BIT, ACTUALLY, IN THE LAST WEEK. I KNOW YOU ALL HAVE BEEN ASKED THIS, AND I JUST WANTED TO MAKE SURE WE'RE ALL ON THE SAME PAGE WHEN ANSWERING THIS QUESTION. WHEN ASKED BY THE PUBLIC WHAT THE PURPOSE IS. THE PURPOSE IS TO INFORM COUNSEL AS TO WHETHER THE PUBLIC SUPPORTS AN AMENDMENT TO THE UTILITY TARIFF TO INCLUDE A MONTHLY CHARGE FOR THE TELEHEALTH SERVICE DESCRIBED IN THE PROPOSITION. AND THAT PURPOSE IS DISTINCT FROM WHAT THE PROPOSITION IS NOT AS A LEGAL, TECHNICAL MATTER, THIS DOESN'T REALLY MATTER, NUMBER ONE. BUT AS AN ATTORNEY, IT KIND OF, YOU KNOW, STICKS WITH ME A LITTLE BIT. IT'S NOT A REFERENDUM BECAUSE THIS IS COUNCIL INITIATED. THIS IS NOT INITIATED BY THE VOTERS. THAT DOESN'T REALLY MATTER. IT IS NOT BINDING. AND WE TALKED ABOUT THIS EARLIER. Y'ALL STILL WILL MAINTAIN YOUR LEGISLATIVE DISCRETION ON WHETHER OR NOT YOU WANT TO AMEND THAT UTILITY TARIFF, REGARDLESS OF WHAT THE PUBLIC SAYS IN THE VOTE. AND IT'S ALSO AND THIS IS IMPORTANT DISTINCTION BETWEEN WHAT IT IS AND WHAT IT'S NOT. IT IS NOT A VOTE ON THE CONTRACT. CONTRACT THAT BOTH PARTIES ASSIGNED IS STILL A VALID CONTRACT BETWEEN THE PARTIES. FULLY EXECUTED. AND EACH PARTY HAS ONGOING OBLIGATIONS UNDER THAT CONTRACT. TERMS AND CONDITIONS OF THE CONTRACT CANNOT BE AMENDED THROUGH A VOTE. AND SO THIS PROPOSITION IS NOT INTENDED TO AMEND ANY OF THE LANGUAGE IN THE CONTRACT. IT'S BEEN SIGNED. IT'S BEEN IT'S BEEN FULLY EXECUTED. AND IT'S IT'S A VALID AGREEMENT BETWEEN THE TWO PARTIES. SO WHAT EFFECT WILL APPROVING THE PROPOSED ORDINANCE HAVE ON PUBLIC CONVERSATION ABOUT THE TELEHEALTH PROGRAM? SO IF TOMORROW NIGHT COUNCIL ELECTS TO APPROVE THIS ORDINANCE AND MOVE FORWARD WITH THE SPECIAL ELECTION, THERE ARE SOME THINGS WE HAVE TO CONSIDER IN OUR PUBLIC CONVERSATION AND HOW WE TALK ABOUT THIS PROGRAM MOVING FORWARD. FIRST IS WE NEED TO BE AWARE OF TEXAS ELECTION CODE 25 255 .003. THAT'S THE UNLAWFUL USE OF PUBLIC FUNDS FOR POLITICAL ADVERTISING. SEEMS PRETTY STRAIGHTFORWARD. AN EMPLOYEE OF THE CITY, AN OFFICER OF THE CITY, SUCH AS Y'ALL MAY NOT KNOWINGLY SPEND PUBLIC FUNDS FOR POLITICAL ADVERTISING. POLITICAL ADVERTISING INCLUDES COMMUNICATION THAT SUPPORT OR OPPOSE A MEASURE LIKE THIS BALLOT PROPOSITION WHEN PUBLISHED IN MEDIA, AND THAT MEDIA COULD BE PRINT. IT CAN BE ONLINE. IT CAN BE FLIERS, BILLBOARDS, TV COMMERCIALS. IT CAN BE ALMOST ANYTHING YOU CAN THINK OF PRETTY MUCH ANYTHING IN PRINT. AND WE CANNOT FUND PROMOTIONAL CAMPAIGNS, SO WE CAN'T FUND THEM TO THROUGH ADS, MAILERS, SOCIAL MEDIA POSTS DESIGNED TO PERSUADE VOTERS TO APPROVE OR REJECT A BALLOT MEASURE. SO WHAT CAN WE DO? WHAT CAN YOU ALL DO SPECIFICALLY, WHAT Y'ALL HAVEN'T WAIVED AND WHAT THE ELECTION CODE RECOGNIZES. Y'ALL STILL MAINTAIN YOUR FIRST AMENDMENT RIGHTS AS INDIVIDUALS TO SUPPORT OR OPPOSE THE BALLOT MEASURE. AND SO, AS A COUNCIL PERSON, YOU MAY SPEAK IN YOUR PERSONAL CAPACITY ON WHETHER YOU LIKE THE PROGRAM OR YOU DON'T LIKE THE PROGRAM. YOU CAN WRITE OP EDS, YOU CAN DO INTERVIEWS, YOU CAN POST ON SOCIAL MEDIA WITH SOME LIMITATIONS THAT WE'RE GOING TO TALK ABOUT. YOU CAN CONTRIBUTE TO OR ENDORSE A PAC RELATED TO THE MEASURE. YOU CAN EVEN HOLD PUBLIC MEETINGS IN LOCATIONS OPEN TO ANY MEMBER OF THE PUBLIC. NOW, THAT'S AN IMPORTANT DISTINCTION. YOU CAN'T HOLD PUBLIC MEETINGS IN LOCATIONS THAT ARE PUBLICLY OWNED, WHERE OTHER MEMBERS OF THE PUBLIC DON'T HAVE THE SAME ACCESS TO. SO IT HAS TO BE ACTING AS A MEMBER OF THE PUBLIC YOURSELF. YOU CAN HOST MEETINGS TO DO THAT. BUT YOU MAY NOT USE IS PUBLIC RESOURCES TO ENGAGE IN ADVOCACY OR OPPOSITION. SO YOU CANNOT USE ANY STAFF TIME. SO IF YOU HAVE A PUBLIC MEETING, STAFF CANNOT HELP YOU COORDINATE THAT. THAT HAS TO BE SOMETHING THAT YOU DO ON YOUR OWN. YOU CAN'T USE ANY STAFF, EQUIPMENT, EMAIL SYSTEMS OR NETWORKS. NOW I WANT TO TALK ABOUT NETWORKS A LITTLE BIT. SO IF YOU MAKE IF YOU DECIDE IN THE MIDDLE OF A COUNCIL MEETING OR IF YOU'RE UP HERE AT CITY HALL AND YOUR PHONE CONNECTS TO THE CITY NETWORK YOU MAY NOT USE YOU SHOULD NOT BE POSTING ON SOCIAL MEDIA WHILE YOU'RE ON THE CITY NETWORK, SO YOU'RE GOING TO NEED TO PAY ATTENTION ABOUT WHERE YOU ARE POSTING ON SOCIAL MEDIA. AND YOU SHOULD NOT BE SENDING CITY EMAIL ADVOCATING OR OPPOSING THE PROPOSITION. YOU CAN HOLD MEETINGS ON CITY PROPERTY. SO LIBRARY CONFERENCE ROOMS TO WHICH THE SAME PROPERTY TO WHICH THE GENERAL PUBLIC WOULD NOT OTHERWISE HAVE ACCESS. YOU MAY NOT, I'M SORRY, HOLD MEETINGS ON CITY PROPERTY TO WHICH THE GENERAL PUBLIC WOULD NOT OTHERWISE HAVE ACCESS. [05:15:03] AND WHAT THE TEXAS AT THE COMMISSIONS. WHEN THEY LOOK AT THESE ISSUES AS THEY POP UP FROM TIME TO TIME THROUGHOUT DIFFERENT CITIES, COUNTIES AND STATE LEVEL CAMPAIGNS, THEY FOCUS ON YOUR CAPACITY. ARE YOU ACTING AS A CITY COUNCIL MEMBER OR IN YOUR INDIVIDUAL CAPACITY AND RESOURCES? IT'S NOT JUST THAT YOU'RE A SPEAKER, THAT YOU ARE AN ELECTED OFFICIAL. AND SO HE THERE IS. IF YOU'RE GOING TO POST ON SOCIAL MEDIA, MAKE SURE THAT YOU'RE DOING IT ON YOUR PERSONAL WEBSITE YOU CAN AND NOT USING CITY EQUIPMENT, CITY NETWORKS, EMAIL SYSTEMS OR ANYTHING LIKE THAT. SO IF Y'ALL DO PASS THIS TOMORROW, CALL A SPECIAL ELECTION. WHAT WE WILL DO WE'LL TREAT THIS MUCH LIKE WE DO OUR BOND ELECTIONS. I WILL WORK WITH TIFFANY AND HER TEAM TO BEGIN PUBLISHING INFORMATIONAL MATERIAL RELATED TO THE ELECTION AND THE TELEHEALTH SERVICES PROGRAM. INFORMATION WILL BE NEUTRAL AND INFORMATIVE. IT CAN. IT CANNOT ADVOCATE, AND IT WILL NOT ADVOCATE ON BEHALF OF OR OPPOSE THE BALLOT MEASURE. AND SO ON THAT NOTE, WE WILL PROVIDE EACH OF YOU WITH VETTED AND APPROVED TALKING POINTS THAT CAN BE USED IN PUBLIC MEETINGS OR CONVERSATIONS THAT UTILIZE PUBLIC RESOURCES. SO WE'LL GIVE YOU SOME LANGUAGE IF YOU WANT TO POST SOMETHING OR HAVE A MEETING, SAY SOMETHING. IN A PUBLIC MEETING LIKE THIS, YOU'LL BE ABLE TO AS LONG AS YOU STICK WITH THE TALKING POINTS, BECAUSE THOSE TALKING POINTS HAVE BEEN VETTED AND THEY'VE BEEN APPROVED AS ONLY INFORMATIONAL AND NOT ADVOCACY OR OPPOSING THE BALLOT MEASURE. ALL I HAVE ANY QUESTIONS? COUNCIL MEMBER BASS THANK YOU. THANK YOU. BRIAN. YEAH. SO ON THIS BALLOT MEASURE, WHEN MD HEALTH PATHWAYS FIRST CAME BEFORE COMMUNITY SERVICES COMMITTEE LAST MARCH, WHICH I CHAIRED AT THE TIME, I RAISED CONCERNS THAT HAD NOTHING TO DO WITH TELEHEALTH ITSELF AND EVERYTHING TO DO WITH PROCESS, SPECIFICALLY THE AUTOMATIC ENROLLMENT AND TRANSPARENCY. I SAID THEN, AND I'LL SAY AGAIN NOW, THAT ENROLLING RESIDENTS BY DEFAULT INTO A PAID PROGRAM, EVEN ONE THEY CAN OPT OUT OF, DESERVES FAR MORE PUBLIC DISCUSSION THAN RECEIVED. SINCE THAT TIME, THIS ISSUE HAS HAS EVOLVED. TONIGHT WE'VE HEARD PRESENTATIONS ON ADDITIONAL HEALTH RELATED SERVICES THAT COULD POTENTIALLY BE SPONSORED BY THE CITY. THIS CHANGES THE CONVERSATION IN AN IMPORTANT WAY. THIS IS NO LONGER ABOUT A SINGLE PROVIDER OR A SINGLE CONTRACT. IT'S ABOUT WHETHER THE CITY OF GARLAND SHOULD SPONSOR A MEDICAL SERVICE AT ALL, AND IF SO, WHAT THAT SERVICE SHOULD LOOK LIKE. GIVEN THAT BROADER CONTEXT, I BELIEVE THE RESPONSIBLE COURSE OF ACTION IS TO SLOW THIS DOWN RATHER THAN MOVING FORWARD TONIGHT WITH ANY WITH RATHER THAN MOVING FORWARD TONIGHT BY PLACING A SINGLE PROGRAM BEFORE THE VOTERS IN ISOLATION, I THINK WE OWE IT TO THE COMMUNITY TO STEP BACK, EVALUATE THE FULL LANDSCAPE OF OPTIONS, AND DETERMINE WHAT, IF ANY, ROLE THE CITY SHOULD PLAY IN THIS SPACE. WE PROVIDE ESSENTIAL SERVICES EVERY DAY ELECTRICITY, WATER, SANITATION, CODE ENFORCEMENT, HEALTH INSPECTIONS. WE TAKE THESE RESPONSIBILITIES SERIOUSLY. EXPANDING INTO HEALTH CARE RELATED SERVICES IS A SIGNIFICANT POLICY DECISION AND IT DESERVES DELIBERATE CONSIDERATION, CLEAR PUBLIC ENGAGEMENT AND A TRANSPARENT FRAMEWORK BEFORE ANY COMMITMENTS ARE MADE. I DON'T FEEL THAT THIS IS A REJECTION OF TELEHEALTH, AND IT IS NOT AN ENDORSEMENT OF ANY ONE PROVIDER OVER ANOTHER. IT'S A RECOGNITION THAT THERE ARE MULTIPLE OPTIONS ON THE TABLE AND WE SHOULD NOT BE. THE RIGHT ANSWER IS ISN'T TO RUSH INTO A DECISION, IT'S TO MAKE THE BEST ONE. FOR THOSE REASONS, I BELIEVE WE SHOULD REMOVE THE CITIZEN VOTE ITEM FROM TOMORROW'S AGENDA AND DELAY A DECISION ON SELECTING OR SPONSORING A MEDICAL SERVICE UNTIL WE'VE HAD THE OPPORTUNITY TO FULLY EVALUATE ALL OPTIONS PRESENTED AND ENGAGE THE COMMUNITY IN A MEANINGFUL WAY. MR. CITY ATTORNEY, CAN YOU TALK ABOUT REMOVING THE ITEM FROM THE AGENDA TOMORROW? YOU CAN, OF COURSE, REMOVE AN ITEM FROM THE AGENDA. IT DOESN'T TAKE A FORMAL VOTE IN THE PUBLIC MEETING. THE REASON IT'S ON THE AGENDA IS BECAUSE STATE LAW REQUIRES THAT FOR IT TO BE THERE, IF YOU'RE GOING TO DISCUSS IT. BUT YOU CAN CERTAINLY THE COUNCIL COULD REMOVE IT BY CONSENSUS IF THEY WOULD LIKE TO. VERY GOOD SIR. YES, SIR. THANK YOU. COUNCIL MEMBER THOMAS. SO I'M LOOKING AT YOUR LANGUAGE HERE, AND I KNOW WE HAD SOME EMAILS BACK AND FORTH WITH FORMER COUNCIL MEMBER ROBERT SMITH. KIND OF TRYING TO ADDRESS A BROADER QUESTION THAN JUST THE SPECIFIC DETAILS OF THIS CONTRACT. AND CAN YOU KIND OF RECAP THAT FOR THE WHOLE COUNCIL, THAT DISCUSSION I, I REACHED OUT TO HIM TO SEE, ARE YOU GOING TO REACTIVATE YOUR GARLAND ELECTIONS.ORG WEBSITE? [05:20:03] AND HE SAID YES AFTER THE FILING DEADLINE. AND THEN THAT CONVERSATION MORPHED INTO TELEHEALTH. RIGHT. I BELIEVE YOU CAN TELL ME IF MY MEMORY IS CORRECT. HIS HIS QUESTION, ONE OF HIS ONE PART OF HIS QUESTION WAS RELATED TO COULD WE ADD A ANOTHER ALTERNATIVE BESIDES FOR OR AGAINST THE PROPOSITION. AND THE ANSWER TO THAT QUESTION IS NO. YOU CAN'T HAVE A THIRD ALTERNATIVE UNDER STATE LAW, UNDER THE ELECTION CODE, IT NEEDS TO BE A FOR OR AGAINST PROPOSITION. SO THE IDEA THAT YOU COULD ADD MAYBE A THIRD OPTION IN THERE IS NOT A POSSIBILITY WHEN YOU'RE DRAFTING THE PROPOSITION LANGUAGE. THAT WAS THE MAIN QUESTION THAT HE ASKED. AND HE MAY HAVE ASKED A SECONDARY QUESTION THAT I'M TRYING TO. YEAH, I THINK THE SECONDARY QUESTION WAS HE WAS ASKING, SHOULD WE BE IN THE TELEHEALTH BUSINESS OR NOT? WAS REALLY HIS OVERARCHING QUESTIONS. THIS THIS DEAL WE HAVE ASIDE AND I THINK YOUR ANSWER WAS THAT WE'VE KIND OF ALREADY WE'RE ALREADY IN WE'VE ALREADY SIGNED A CONTRACT. WE'RE WE'RE IN THE BUSINESS. RIGHT. I'M. YEAH, YOU'RE RIGHT, I REMEMBER THAT. I MADE THE POINT TO HIM THAT JUST LIKE I MADE THE POINT EARLIER TO COUNCIL IS WE HAVE AN EXECUTED CONTRACT. WE'RE IN PRIVITY WITH THE TELEHEALTH COMPANY AT THIS POINT, AND WE HAVE OBLIGATIONS UNDER THAT CONTRACT SUBJECT TO THE TERMS AND CONDITIONS OF THE CONTRACT, AND THEY HAVE OBLIGATIONS TO THE CITY SUBJECT TO THOSE SAME TERMS AND CONDITIONS. AND SO THE CONTRACTS ALREADY IN PLACE. NOW THE CONTRACT, OF COURSE, AS WE'VE DISCUSSED NUMEROUS TIMES HAS A OPT OUT PERIOD 30 DAYS BEFORE IMPLEMENTATION AND ANOTHER OPT OUT PERIOD, I BELIEVE, SIX MONTHS AFTER IMPLEMENTATION. BUT PRIOR TO IMPLEMENTATION, THIS COUNCIL, AS I'VE, AS I'VE TOLD YOU ALL MANY TIMES, IS Y'ALL STILL HAVE TO AMEND THE TARIFF LANGUAGE IN ORDER TO EVEN ADD THE, THE FEE TO THE UTILITY BILL. AND SO THAT'S THE THIRD LAYER TO THIS. BUT IN TERMS OF THE CONTRACT, YES, WE ARE IN PRIVITY OF CONTRACT WITH THE TELEHEALTH COMPANY. AND THAT CONTRACT IS A VALID CONTRACT. OKAY. AND JUST READING THIS LANGUAGE, IT'S NOT APPARENT TO ME THAT THAT ALL UTILITY CUSTOMERS ARE OPTED IN AUTOMATICALLY. COULD WE ADD SOMETHING THERE? MAYBE AFTER THE $9 A MONTH IN YEAR FIVE, WHICH AUTOMATICALLY OPTS IN ALL UTILITY CUSTOMERS AND PROVIDING ANY SO THAT SO THAT IT'S CLEAR THAT YOU'RE VOTING TO OPT IN ALL UTILITY CUSTOMERS. BECAUSE THAT'S WHAT WE'RE DOING, IS OPTING IN. WE'RE THAT'S WHAT THIS PROPOSITION IS SAYING IS WE'RE WE ARE VOTING TO ACCEPT THE CONTRACT AS IT IS. AND THAT EXPLAINS THE I MEAN, THE WHOLE CONTRACT, PUT THAT WHOLE CONTRACT IN ONE SENTENCE IS A IS A TASK, I'M SURE. BUT CAN WE PUT SOME LANGUAGE IN THERE THAT LETS THEM KNOW THAT YOU'RE OPTING IN ALL UTILITY CUSTOMERS FOR THIS SERVICE. SO IT'S VERY CLEAR WHAT YOU'RE WHAT YOU'RE VOTING FOR. SHOULD WE PUT THIS TO A VOTE? WE HAD THAT IN THERE IN ONE OF THE DRAFTS. I DON'T REMEMBER WHICH DRAFT IT WAS. AND TRYING TO BE CONCISE, WE TOOK THAT BACK OUT AND JUST LEFT IT IN THE LANGUAGE, OF COURSE, BECAUSE WE NEEDED TO KNOW THAT THERE WAS AN OPT OUT PROGRAM. BUT I CAN LOOK AT THAT OVER IN THE MORNING, AND THEN IF I COME UP WITH SOMETHING, I CAN PRESENT IT TO COUNCIL TOMORROW NIGHT. IF WE IF THE COUNCIL ELECTS TO GO AHEAD AND MOVE FORWARD WITH THIS. OKAY, I DON'T KNOW. DOES THAT SEEMS TO MAKE SENSE TO ME THAT THAT ADDS SOME CLARITY TO THIS AS TO WHAT YOU'RE REALLY VOTING FOR BECAUSE OF THE PEOPLE THAT HAVEN'T HEARD OF IT, MAY NOT KNOW THAT YOU'RE VOTING TO OPT IN THE ALL UTILITY CUSTOMERS, BECAUSE WE HAVEN'T SPECIFICALLY SAID THAT IN THIS SENTENCE. THAT'S MY THAT'S MY POINT THERE. SO I'D LIKE TO SEE SOME MORE CLARITY IN THE LANGUAGE BEFORE WE PUT THE FINAL LANGUAGE TO A VOTE. OKAY. THANK YOU SIR. THANK YOU MAYOR. THANK YOU SIR. DEPUTY MAYOR PRO TEM. CAN YOU DEFINE DEFINE WHAT STATUTORY AUTHORITY IS? SURE. SO FOR THE MOST PART AS A HOME RULE MUNICIPALITY, WHAT DISTINGUISHES US FROM GENERAL LAW MUNICIPALITIES IS WE CAN DO ANYTHING THAT WE'RE NOT PROHIBITED DOING FROM STATE LAW OR THAT STATE LAW HASN'T OCCUPIED THE FIELD. WE CAN DO WHATEVER. THERE ARE SOME INSTANCES IN STATE LAW, THOUGH, WHERE IT'S STATUTE SAYS THAT IN ORDER TO DO THIS, YOU MUST HAVE THE AUTHORITY TO DO THIS. AND ONE OF THOSE INSTANCES AND THE ELECTION CODE HAPPENS TO BE SPECIAL ELECTIONS. [05:25:03] AND IT'S A DIFFERENT STANDARD FOR GENERAL ELECTIONS. SPECIAL ELECTIONS. YOU HAVE TO THERE'S ONLY A HANDFUL, NOT EVEN A HANDFUL. I THINK THERE'S THREE REASONS I DON'T REMEMBER THE OTHER TWO. I JUST PULLED OUT THE ONE THAT WOULD APPLY IN THIS SITUATION FOR US. AND THAT'S THE GOODNESS OF THE MEASURE. THE MEASURE BECOMES MOOT. AND IN THIS PARTICULAR CASE, IF MD HEALTH PATHWAY ELECTED TO TERMINATE THE CONTRACT, THEN THE MEASURE WOULD BECOME MOOT. IF THEY FAILED TO NOTIFY US OF TERMINATION OF THE CONTRACT BEFORE THE DEADLINE FOR CANCELING ELECTION, THAT'S BEEN CALLED SO THE 20TH FOR COLLIN COUNTY, THE 27TH FOR DALLAS COUNTY. THEY NOTIFIED US AFTER THOSE DATES. THEN IT WOULD GO IT WILL GO TO THE BALLOT AND THE VOTERS WILL TURN OUT AND THEY WILL VOTE ON THE MEASURE, EVEN THOUGH IT'S NON-BINDING AND IT'S MOOT AT THAT POINT, THERE'LL STILL BE A RECORD OF THE VOTE ON THAT PARTICULAR MEASURE. THAT'S LIKE SOMEONE WHO PASSES AWAY BEFORE THEY GET TO, YOU KNOW, IT'S AFTER THE TIME WHEN WE COULD ACTUALLY TAKE THEM OFF THE BALLOT. A DEAD PERSON COULD GET ELECTED. THAT'S RIGHT. THAT'S HAPPENED BEFORE? YES. OKAY. AND THERE'S BEEN DISCUSSION. THERE'S BEEN A SIGNIFICANT FINANCIAL BURDEN FOR THE CITY. IF WE HAVE THIS GO TO A IF WE DO HAVE THIS ELECTION, IS THERE A WAY TO QUANTIFY THAT AMOUNT? I BELIEVE I DON'T HAVE THAT NUMBER. THE CITY SECRETARY MIGHT HAVE AN ESTIMATE ON THAT AMOUNT. STAFF PUT TOGETHER AN ESTIMATE, AND WE'RE ESTIMATING AT THIS TIME AROUND 150,000. OKAY. AND SO IF WE DO DECIDE TO CALL OFF THE ELECTION, IT'S WITHIN TIME. ARE WE STILL HAVE THAT BURDEN. OKAY. AND LET'S SEE. ELECTIONEERING. WILL STAFF BE ABLE TO CONTINUE WORKING WITH MD HEALTH PATHWAYS AND INTEGRATING THE PROGRAM LIKE AT CUSTOMER SERVICE? I THINK I KNOW WHAT YOU'RE ASKING. STAFF WILL NOT BE ABLE TO MAKE ANY PUBLIC STATEMENTS ADVOCATING FOR THE PROGRAM. NOW. STAFF WILL BE ABLE TO EDUCATE THE PUBLIC ON WHAT THE PROGRAM IS, AS LONG AS THERE'S A BALANCE THERE WITH ALSO MY MY RECOMMENDATION IS THAT IT BECOMES CLEAR IN ALL COMMUNICATIONS THAT NUMBER ONE, THIS IS GOING TO BE OPTED IN AND THERE IS AN OPT OUT OPTION FOR YOU. BUT TO ANSWER YOUR QUESTION IS STAFF CAN EDUCATE THE PUBLIC ON BOTH THE OPPOSITION AND THE ELECTION AS WELL AS THE UNDERLYING PROGRAM STATING WHAT THE PROGRAM IS, BUT IT CANNOT ADVOCATE OR USE ANY LANGUAGE THAT WOULD APPEAR TO ADVOCATE FOR THE PROGRAM. I WOULD ASSUME THAT THAT WOULD ALSO BE FOR US AND OUR COUNCIL CAPACITY, THAT WE WOULD BE ABLE TO EDUCATE PEOPLE ON WHAT THE PROGRAM IS AND DISCUSS IT IN GENERIC TERMS, BUT WE CANNOT ADVOCATE FOR OR AGAINST IT. WE WILL PROVIDE YOU WORKING WITH TIFFANY'S GROUP. I WILL MAKE SURE THAT EACH OF YOU ALL HAVE TALKING POINTS AS THE LANGUAGE IS EMBEDDED, SO THAT IT'S NOT CANNOT BE PERCEIVED AS ADVOCACY OR OPPOSITION PROPOSITION LANGUAGE. OKAY. THANK YOU. THAT'S GOING TO REQUIRE SOME. THE DANGER HERE IS UNDERSTAND THERE'S THERE'S CRIMINAL LIABILITY ATTACHED TO YOU ALL AS CITY OFFICIALS, IF YOU ALL GO OFF THE TALKING POINTS, OKAY, IN YOUR CAPACITY AS CITY COUNCIL MEMBERS IN A PUBLIC MEETING. SO THAT'S THE THAT'S THE THING. IT'S GOING TO REQUIRE SOME DISCIPLINE ON THE PART OF COUNCIL TO MAKE SURE THAT Y'ALL DON'T GO OFF THOSE TALKING POINTS. AND IF Y'ALL GO OFF THOSE TALKING POINTS, I WON'T BE YOUR LAWYER THAT YOU GET YOUR OWN LAWYER. WOW. WELL I PUT TOGETHER A SMALL STATEMENT, AS FAR AS IT FEELS LIKE THIS MIGHT BE THE TIME FOR THAT. I JUST WANT TO STATE I JUST WANT TO START. CLEARLY, I SUPPORT TELEHEALTH. THE NEED IS REAL, THE VALUE IS WELL DOCUMENTED. AND AS WE'VE SEEN TONIGHT, WE WERE TALKING ABOUT TELEHEALTH ALL NIGHT. AND I UNDERSTAND WHY THE OPT OUT BILLING STRUCTURE GENERATED STRONG PUBLIC REACTION. THE ISSUE BEFORE US IS NOT WHETHER TELEHEALTH IS BENEFICIAL. IT IS. THE ISSUE IS HOW WE GOVERN RESPONSIBLY ONCE A PROGRAM IS IN PLACE. CITIES ROUTINELY MAKE COLLECTIVE DECISIONS ABOUT SERVICES WITHOUT WITHOUT CITYWIDE VOTES. THAT'S NOT A FLAW. IT'S HOW REPRESENTATIVE GOVERNMENT FUNCTIONS. IF EVERY PROGRAM REQUIRED A PUBLIC VOTE ONCE DISCOMFORT SURFACED, LONG TERM PLANNING AND OPERATIONAL STABILITY WOULD BE DIFFICULT TO MAINTAIN. AT THE NOVEMBER 3RD, 2025 CITY COUNCIL REGULAR MEETING, COUNCIL APPROVED APPROXIMATELY [05:30:07] $382,000 FOR LIBRARY, EBOOKS AND AUDIOBOOKS. IT WAS A CONSENT AGENDA ITEM. THE AGENDA DESCRIPTION WAS NON-DESCRIPTIVE. THERE WAS NO CITYWIDE VOTE AND I FULLY SUPPORTED IT. NOT EVERY RESIDENT USES EBOOKS AND THAT DOES NOT MAKE IT AN UNFAIR INVESTMENT. IT MAKES IT A SHARED CIVIC SERVICE. ANOTHER EXAMPLE IN 2019, VOTERS AUTHORIZED $4 MILLION FOR THE SENIOR ACTIVITY CENTER REFRESH AS THE PROJECT. AS THE PROJECT PROGRESSED, IT BECAME CLEAR THE EXISTING STRUCTURE REQUIRED A FULL REPLACEMENT RATHER THAN RENOVATION. THROUGH SUBSEQUENT CAPITAL IMPROVEMENT PROGRAM DECISIONS, THE PROJECT SCOPE AND BUDGET WERE ADJUSTED ACCORDINGLY. THE ORIGINAL AUTHORIZATION FOR THE BOND WAS $4 MILLION TOTAL, ALL IN PROJECT COSTS. TODAY IS $17 MILLION. THERE WAS NO ADDITIONAL CITYWIDE VOTE ON THAT CHANGE. THAT DOES NOT MAKE THAT PROJECT ILLEGITIMATE. IT REFLECTS HOW COUNCILS ARE EXPECTED TO EXECUTE VOTER APPROVED GOALS BY RESPONDING TO REAL CONDITIONS AND MAKING RESPONSIBLE ADJUSTMENTS OVER TIME. AND NOW TO TELEHEALTH. IT'S IMPORTANT TO REMEMBER THAT THIS PROGRAM COULD HAVE BEEN STRUCTURED DIFFERENTLY. TELEHEALTH COULD HAVE BEEN FUNDED AS A STANDARD DEPARTMENTAL SERVICE, PAID CENTRALLY WITH NO INDIVIDUAL OPT OUT MECHANISM, SIMILAR TO MANY OTHER CITY SERVICES. INSTEAD, THE CHOSEN STRUCTURE INTRODUCED AN ADDITIONAL LAYER OF INDIVIDUAL DECISION MAKING THAT WE DO NOT TYPICALLY ATTACH TO MUNICIPAL SERVICES. THAT DESIGN WELL INTENTIONED ALSO INTRODUCED FRICTION. WE CURRENTLY HAVE A CONTRACT IN PLACE, REOPENING AN ACTIVE AGREEMENT THROUGH A NON BINDING ELECTION, THROUGH UNCERTAINTY FOR RESIDENTS, FOR SERVICE PARTNERS, FOR THE CITY'S CREDIBILITY AS A RELIABLE PARTNER. IT ALSO SENDS A BROADER SIGNAL THAT PROGRAMS APPROVED THROUGH NORMAL GOVERNANCE MAY BE REVISITED THROUGH A PUBLIC VOTE ONCE CONTROVERSY ARISES. THAT IS A PRECEDENT WE SHOULD CONSIDER CAREFULLY. I REMAIN OPEN MINDED TO PUBLIC INPUT, INCLUDING THE POSSIBILITY OF A PUBLIC VOTE. AT THE SAME TIME, I BELIEVE WE MUST BE HONEST ABOUT WHAT THE VOTE REPRESENTS AND WHAT MESSAGE IT SENDS ABOUT HOW WE GOVERN, HOW WE HONOR CONTRACTS, AND HOW STABLE OUR DECISIONS ARE ONCE THEY'RE MADE. LISTENING MATTERS. PUBLIC TRUST MATTERS. SO DO. SO DOES CONSISTENCY, PREDICTABILITY, AND RESPONSIBLE GOVERNANCE. THIS IS NOT ABOUT WHETHER TELEHEALTH IS GOOD. IT IS. IT IS ABOUT BALANCING PUBLIC SENTIMENT WITH STEADY, DISCIPLINED DECISION MAKING. ONCE COMMITMENTS ARE MADE. THANK YOU. THANK YOU SIR. COUNCIL MEMBER. DUTTON. HI. SO I JUST WANT TO ECHO. I AGREE WITH JEFF. I THINK THAT EVERY ONE OF US IN THIS ROOM CAN AGREE THAT THE LAST YEAR IN THIS ROOM HAS BEEN ABSOLUTELY THE BIGGEST NIGHTMARE AND DIFFICULT PART OF LIFE THAT WE'VE GONE THROUGH. IT'S EASY TO POINT FINGERS AT. JEFF AND I BOTH HAVE BEEN LIKE, WELL, WHY DIDN'T WE DO THAT? WHY DIDN'T WE THINK OF THAT? LIKE, AND WE ALSO KNOW THAT THINGS TRANSPIRED IN WAYS THAT WE WOULD HAVE WISHED THEY DIDN'T, BUT THEY DID. AND THAT'S WHY WE'RE HERE NOW. BUT I THINK THAT WE CAN ALL ALSO AGREE THAT WE SEE THE NEED FOR HELPING OUR RESIDENTS. AND IF WE DID NOT CARE, WE WE WOULDN'T BE HERE RIGHT NOW AT MIDNIGHT. STILL TALKING ABOUT TELEHEALTH. YOU HEARD THE RIGHT SIDE, DOCTOR. SAY LITERALLY TELEHEALTH. IT'S JUST AS EFFECTIVE. LIKE, I DON'T THINK ANY OF US QUESTION THAT. I THINK THAT WE'RE AT THIS POINT WHERE WE'VE GONE THROUGH SUCH AN EXTENDED PERIOD OF TIME, OF JUMPING TO DECISIONS AND JUMPING TO VOTES WITHOUT HAVING ALL OF THE INFORMATION, WITHOUT ASKING THE RIGHT QUESTIONS. AND IT REALLY IS TIME FOR US TO SLOW DOWN AND REALLY THINK ABOUT WHAT WE'RE DOING. WE'RE IN A WHOLE FINANCIAL SITUATION WITH SB 2 OR 8 OR WHATEVER NUMBER IT IS. [05:35:01] AND SO WE WE HAVE TO BE VERY INTENTIONAL WITH EVERYTHING THAT WE'RE DOING. AND THE LAST YEAR, AFTER A SERIES OF UNFORTUNATE EVENTS IT'S ROCKED OUR RESIDENTS. AND IT'S IT'S NOT FAIR TO THEM. IT'S NOT FAIR TO US FOR US TO KEEP PUSHING THROUGH THINGS WITHOUT REALLY DOING OUR DUE DILIGENCE. SO I AGREE 100% WITH JEFF. WE NEED TO SLOW DOWN. I 100% AGREE I SUPPORT MD PATHWAYS IN THE OVERALL CONCEPT. DO I WANT IT TO BE OPT IN? I WOULD, I WOULD LOVE THAT TO BE AN OPTION. SO IT'S NOT AN ANTI M.D. PATHWAYS. IT IS A SIMPLY LET'S SLOW DOWN. LET'S LOOK AT OUR OPTIONS. ASK THE QUESTIONS. IF YOU HAVEN'T TALKED TO YOUR CONSTITUENTS. THIS IS A GREAT TIME TO DO SO. I STOP PEOPLE IN CITY HALL AND SAY HEY HAVE YOU HEARD ABOUT TELEHEALTH? I ASKED PEOPLE AT THE GAS STATION. I ASK LITERALLY ANYWHERE I GO JUST TO DO IT, JUST SO THAT I KNOW I'M DOING MY PART. I'VE COMMITTED TO PUTTING FLIERS ON EVERY SINGLE DOOR IN MY DISTRICT BETWEEN NOW AND WHENEVER. WELL, IT WAS APRIL WHEN WE WERE TALKING ABOUT GETTING ON A BILL. I'M FINE WITH DOING THAT BECAUSE YOU KNOW WHAT? AT THE END OF THE DAY, I KNOW THAT I DID MY PART TO MAKE SURE THAT EVERYONE HAS THE INFORMATION THAT THEY NEED. SO AT THAT POINT, OUR RESIDENTS, WITHOUT A DOUBT IN MY DISTRICT, THEY WILL KNOW WHAT? WHAT'S HAPPENING? BUT AS WE SAW TONIGHT, I LITERALLY SAT HERE AND JUST THOUGHT, THIS IS THIS IS EXACTLY HOW IT PLAYED OUT IN THE BEGINNING WITH MD PATHWAYS AND HOW WE GOT OURSELVES IN THIS PREDICAMENT. THERE'S QUESTIONS THAT IF WE HAVE QUESTIONS ABOUT SOMETHING AND SOMEONE IS GOING TO GET INFORMATION BACK TO US, THEN IT'S OKAY TO PAUSE. IT'S OKAY TO SAY, OKAY, WE MIGHT HAVE IT SLATED FOR A MEETING ALREADY. WE CAN CHANGE THAT. THERE'S THERE'S ZERO REASON WHY WE HAVE TO. OH, NOPE. IT SAYS 17TH ON THIS PAPER. NO, I HAVE QUESTIONS. THAT'S WHAT GOT US INTO THIS SITUATION. WE HAVE TO SLOW DOWN AND DO WHAT WE WERE ELECTED TO DO. SO I 100% SUPPORT SLOWING IT DOWN, DOING OUR DUE DILIGENCE, MAKING SURE THAT WE ANSWER THE QUESTIONS THAT WE'RE BEING ASKED. AND THAT'S NOT EVEN I MEAN, THAT IT'S ALSO DOING OUR PART TO MD PATHWAYS BECAUSE THEY GOT STRUNG ALONG IN THIS DEAL ALSO. SO IT TO DO EVERYONE A JUSTICE WOULD BE TO SLOW DOWN AND DO DO OUR PART RESEARCH ASK THE QUESTIONS IF WE WANT. IF WE WANT STAFF TO HAVE 90 OTHER PEOPLE COME IN HERE AND PITCH US THEIR THEIR SERVICE, LET'S DO IT. THERE'S WE'RE NOT ON A, WE'RE NOT ON A BOMB. LIKE WE'RE NOT GOING TO EXPLODE IF WE DON'T DO IT RIGHT NOW. RIGHT NOW. SO I, I WOULD LIKE I FEEL LIKE AFTER JEFF SPOKE, WE PROBABLY SHOULD HAVE TAKEN A CONSENSUS VOTE ABOUT SLOWING DOWN AND TAKING, WELL, TAKING IT OFF OF TOMORROW'S AGENDA. SO I WOULD I WOULD LIKE US TO CONSIDER THAT. THANK YOU. MA'AM. THERE'S NO ONE ELSE IN THE QUEUE. AND COUNCIL. I HAVEN'T SAID MUCH TONIGHT. I'VE BEEN DOING A LOT OF LISTENING TO EVERYBODY HERE, BUT I ALSO HAVE SOMETHING I PREPARED I'D LIKE TO READ. AND FOR YOUR CONSIDERATION, WHILE I DID NOT VOTE TO SUPPORT THE ORDINANCE IMPLEMENTING INDY HEALTH PATHWAYS PROGRAM LAST AUGUST, I ALSO HAVE NEVER ARGUED THAT A PROGRAM SUCH AS THIS SHOULD WOULD NOT HAVE POSSIBLE BENEFITS FOR THE CITY OF GARLAND. ALONGSIDE THE PARTNERSHIPS THAT WE EXPLORED TONIGHT WITH THE PARKLAND HOSPITAL PODS OR RIGHT SIDE TELEHEALTH PROGRAM COULD MEAN EXPANDED HEALTH CARE OPTIONS FOR RESIDENTS LIVING IN OUR CITY WITHOUT HEALTH INSURANCE AND IN A CITY WITHOUT A PUBLIC HOSPITAL. BUT AS YOU KNOW AND AS YOU'VE HEARD MANY TIMES, MANY CITIZENS HAVE EXPRESSED CONCERNS AND FELT LIKE THIS WAS AN OVERREACH, FORCING A FEE ON UPON THEM WITHOUT ENOUGH DIRECT INPUT. ONE SPEAKER TODAY, WHO WORKS FOR HEALTH SAID SHE WAS TAKEN ABACK BY THE MODEL, AND THAT'S WHY SHE DECIDED TO TAKE A JOB BY MD HEALTH PATHWAYS. BUT I THINK A LOT OF CITIZENS WERE TAKEN BACK BY THE MODEL AS WELL, BUT NOT IN THE WAY SHE DESCRIBED. IT IS THE OPT IN NATURE OF THE PROGRAM THAT HAS BECOME THE STICKING POINT ON ALL OF THIS SINCE THE VOTE LAST AUGUST. I'VE HEARD THE OPINIONS OF THE CITIZENS LOUD AND CLEAR, AND I'VE SHARED MANY OF THOSE SIMILAR CONCERNS, PARTICULARLY ABOUT THE OPT IN NATURE OF THE PROGRAM. AND AS YOU KNOW, THAT'S WHY THAT'S THE MAIN REASON I VOTED AGAINST THE PROGRAM. [05:40:02] I BELIEVE GOVERNMENT SHOULD SERVE THE PEOPLE, NOT NECESSARILY IMPOSE UPON THEM WITHOUT CONSENSUS. AND ON THIS ITEM, WE DEFINITELY DID NOT DO OUR DUE DILIGENCE, DIDN'T VET OTHER OPTIONS. WE DIDN'T HOLD REALLY ANY PUBLIC INFORMATION SESSIONS BEFORE THE VOTE. WE DIDN'T EVEN KNOW IF OUR BILLING SYSTEM COULD HANDLE THIS LINE ITEM BEFORE IT WAS VOTED UPON. AND THAT QUESTION IS STILL UNANSWERED TODAY. MD PATHWAYS HAS ARGUED THAT ANY FUNDS FOR A CAMPAIGN WOULD TAKE AWAY FROM THEIR MISSION TO SERVE THE COMMUNITY. DOCTOR MENTIONED THAT HE HAS SPENT THOUSANDS OF DOLLARS ALREADY ON AN AWARENESS CAMPAIGN PROGRAM, AND WOULD HAVE TO SPEND THOUSANDS MORE DURING AN ELECTION. NOW I MORE THAN ANYONE, KNOW WHAT IT TAKES TO SPEND ON A CITYWIDE ELECTION. AND WHETHER YOU SPEND $30,000 OR $130,000 OR A QUARTER MILLION DOLLARS, THAT ONE TIME EXPENSE SHOULD BE A SMALL PRICE TO PAY, GIVEN THE MILLIONS OF DOLLARS THAT IS AT STAKE FOR THIS CONTRACT OVER THE LIFE OF THE CONTRACT. AND IF M.D. HEALTH HAS ALREADY DONE SO MUCH TO RAISE AWARENESS, IT SHOULD BE AN EASY VICTORY AT THE POLLS. AS MENTIONED, THAT RIGHT SIDE AND PARKLAND HEALTH BOARDS DON'T OFFER THE SAME LEVEL OF SERVICE THAT THIS PROGRAM WOULD, WHICH SHOULD MAKE THIS PROGRAM EVEN EASIER SELL TO THE VOTERS. SINCE OUR VOTE IN AUGUST, YOU HAVE SEEN OUR CITIZENS COME TIME AND TIME AGAIN ASKING QUESTIONS ABOUT THE PROGRAM, HOW WAS IMPLEMENTED, WHETHER OR NOT WE HAVE A SECOND TIME, DO WE HAVE TO VOTE A SECOND TIME TO PLACE ON THE UTILITY BILLS, DETAILS OF THE SERVICE, HOW TO OPT OUT, AND THE LIST GOES ON AND ON. COUNCIL MEMBER YOU JUST SAID YOURSELF THERE'S A LOT OF QUESTIONS ABOUT WHY DIDN'T WE DO THIS? WHY DIDN'T WE DO THAT FROM THE BEGINNING? IT IS TIME TO STOP ARGUING WITH OUR SPEAKERS ABOUT EVERY POINT THEY MAKE. STOP DEBATING WITH OUR SPEAKERS OVER MEDICAL ADVICE, STOP THE SNIDE REMARKS, AND START GIVING OUR CITIZENS THE CHOICE THEY DESERVE, ONE THAT WE HAD GRANTED THEM FROM THE BEGINNING. IT'S TIME TO START LETTING OUR CITY HEAL. AS FAR AS THE NINE NON-BINDING RESOLUTION, I REALLY DON'T SEE ANYONE ON COUNCIL VOTING AGAINST THE RESULTS OF THAT ELECTION. THE PEOPLE HAVE SPOKEN. WE SHOULD LISTEN TO THEM. VOTING AGAINST THEM WOULD BE POLITICAL SUICIDE. BY PLACING THIS ITEM ON THE BALLOT, WE PRIORITIZE TRANSPARENCY AND CHOICE. WHETHER IT'S 4000 CITIZENS THAT DECIDE TO SHOW UP OR 40,000 CITIZENS, THAT'S THEIR OPTION. WE HAVE GIVEN THEM THAT CHOICE. A DELIBERATE STEP TO GIVE THEM A DIRECT VOICE AT THE BALLOT BOX. THIS IS A STEP THAT I SHOULD BELIEVE HAS BEEN TAKEN BEFORE APPROVING SUCH A CITYWIDE PROGRAM. BUT THAT'S THE KEY. BY PLACING THIS ITEM UP FOR VOTE, WE'RE NOT ASSUMING IT'S RIGHT FOR EVERYONE. TURNING IT OVER TO OUR VOTERS AND LETTING THEM DECIDE. I THINK THAT'S WHAT WE SHOULD DO TOMORROW WHEN WE MOVE FORWARD ON THIS RESOLUTION. I WOULD LIKE TO SEE IT REMAIN ON THE AGENDA. MR. MR. MAYOR, BEFORE Y'ALL TAKE A CONSENSUS VOTE ON THAT, I THINK IT'S IMPORTANT THAT WE TAKE FIVE MINUTES, MAYBE TEN, TO GOING TO DROP INTO EXECUTIVE SESSION ON THIS ITEM REAL QUICK JUST SO I CAN GIVE YOU ALL A LITTLE BIT OF LEGAL ADVICE AND EXPLAIN SOME LEGAL RISK. SURE. WITH THE DELAY OF IF COUNCIL WERE TO ELECT TO REMOVE IT FROM THE AGENDA, WOULD YOU LIKE TO DO THAT NOW? YES. OKAY, THEN WE ARE IN RECESS. GUYS, WE COME TO AN AGREEMENT. WELL. WELCOME BACK. WE'RE BACK IN OUR IN OUR WE'RE RECONVENING OUT OF EXECUTIVE SESSION INTO OUR WORK SESSION. AND WE ARE STILL DISCUSSING ITEM NUMBER SEVEN, CONSIDERING AN ORDINANCE ORDERING A SPECIAL HOME RULE ELECTION. AND I HAVE A SPEAKER IN THE QUEUE. DEPUTY MAYOR PRO TEM ORT. WELL, THANK YOU, MR. MAYOR. YES. ONE OF THE THINGS THAT I WAS CURIOUS ABOUT IS IF WE HAVE IF WE HAVE THIS ELECTION, WE DECIDE THAT WE'RE GOING TO WE'RE GOING TO HAVE IT AND WE HAVE THE NEXT DAY, WHENEVER IS THIS GOING TO HAVE AN EFFECT ON OTHER THINGS THAT WE'RE THAT WE ARE CONSIDERING, LIKE RIGHT SITE. THAT'S A THAT'S ANOTHER PRODUCT THAT'S OUT THERE THAT'S THAT'S IN THAT SAME SPACE. NOT DIRECTLY THE SAME, BUT IT'S MEDICAL, IT'S PUBLIC. IS THERE ANY GUIDANCE THAT WE SHOULD BE THINKING ABOUT WITH THAT? IF YOUR QUESTION IS RELATED TO THE CONTRACT WITH EMED HEALTH PATHWAY. THERE IS NO EXCLUSIVITY PROVISION IN THE CONTRACT RELATED TO SERVICES. I THINK THAT'S WHAT YOU'RE ASKING. YES IT IS. IN TERMS OF HOW IT FUNCTIONS WITHIN THE CITY'S OVERALL PLAN TO PROVIDE MEDICAL SERVICES TO THE EXTENT IT DOES TO THE CITIZENS OF GARLAND. I THINK I THINK SEVERAL COUNCIL MEMBERS HAVE MENTIONED TONIGHT THAT IT'S ONE LAYER. IT MIGHT BE A MULTI-LAYERED APPROACH. I WOULD AGREE THAT THIS IS SOMETHING THAT'S THAT'S ONE ELEMENT OF IT. [05:45:04] THAT'S REALLY MY ONLY THOUGHT THAT I HAVE FOR RIGHT NOW. THANK YOU. THANK YOU SIR. MAYOR PRO TEM LUCK. I THINK THAT WE SHOULD NOT GO TO A REFERENDUM AND CANCEL THE CONTRACT WITH EMED HEALTH PATHWAYS. THANK YOU. VERY GOOD. I HAVE NO OTHER SPEAKERS IN THE QUEUE ON THIS ITEM. AND WE'LL MOVE ON TO OUR NEXT AGENDA ITEM. WE HAVE TO TAKE CONSENSUS. I THINK IT'S ON THE AGENDA. IT'S JUST A DISCUSSION. YEAH, IT'S ON THE AGENDA FOR TOMORROW. SO IT'S JUST A WE'LL SEE IT ON THE AGENDA TOMORROW DURING TOMORROW'S REGULAR SESSION. VERY GOOD. MOVE ON NOW TO ITEM NUMBER EIGHT DISCUSSION AND FINAL DIRECTION OF THE 2026 PROPOSED CAPITAL IMPROVEMENT PROGRAM. [8. Discussion & Final Direction on the 2026 Proposed Capital Improvement Program (CIP)] ALISON, THIS IS THE MOMENT YOU'VE BEEN WAITING FOR. YOU THINK? YOU THINK AT 1230, SHE IS ALL FIRED UP ON CAFFEINE AND READY TO GO. YEAH. OKAY. GOOD EVENING, MAYOR. CITY COUNCIL. I'LL JUST WALK THROUGH AN OVERVIEW OF THE CHANGES PROPOSED TO DATE AND THEN OPEN UP FOR ANY FINAL DISCUSSION AND DELIBERATION. EARLIER TODAY AND POSTED ON THE CITY WEBSITE IS WE CIRCULATED AN UPDATED APPENDIX F FOR THE STREETS PROGRAM FOR THE YEAR ONE IMPROVEMENTS. THE FOLLOWING REFLECTS THE IMPACTS TO THE OVERALL BUDGET. BASED ON THAT UPDATED LIST, YOU'LL SEE THE ADJUSTMENT ACROSS THE VARIOUS PROGRAMS SHOWN UP HERE. BUT NO OVERALL CHANGE TO THE APPROPRIATION. WE ARE HOLDING THAT IN CONTINGENCY. AND THEN THAT WILL BE REALLOCATED AS WE MOVE INTO FUTURE YEARS OF THE PROGRAM. SO LOOKING AT OUR FINAL BUDGET FOR OUR TAX SUPPORTED AREA, WE'RE PROPOSING NO CHANGE TO THE OVERALL TAX SUPPORTED FINAL BUDGET OF $302.8 MILLION AND THEN NO PROPOSED CHANGE FOR OVERALL UTILITY INTERNAL SERVICE PROGRAM AREAS A TOTAL OF 341.7 MILLION TOMORROW NIGHT. WE HAVE. WE ARE SCHEDULED FOR A FINAL PUBLIC HEARING ON THE 2026 PROPOSED CIP. AND THEN, BASED ON THE DIRECTION WE RECEIVED FROM CITY COUNCIL TONIGHT, WE'LL BE SCHEDULED FOR ADOPTION. SO WITH THAT, I'LL OPEN IT UP FOR ANY FINAL DISCUSSION OR DIRECTION TO STAFF. THANK YOU. COUNCIL, ANY FINAL DISCUSSION? SEEING NONE. THEN WE'LL LOOK FORWARD TO THE ADOPTION TOMORROW. THANK YOU ALL. THANK YOU. MOVE ON NOW TO ITEM NUMBER NINE. IS TRAVEL EXPENSES RELATED TO MAYOR PRO TEM LUX ATTENDANCE AT THE 2026 TEXAS POLICE CHIEFS [9. Travel Expenses Related to Mayor Pro Tem Lucht’s Attendance at the 2026 Texas Police Chiefs Association Summit] ASSOCIATION SUMMIT. MA'AM. THANK YOU. MAYOR. THE TEXAS POLICE CHIEFS ASSOCIATION WAS FOUNDED IN 1958 TO PROMOTE AND ADVANCE THE PROFESSIONAL DEVELOPMENT OF CHIEFS OF POLICE AND SENIOR LAW ENFORCEMENT LEADERS ACROSS TEXAS. CURRENTLY HAS MORE THAN 1500 MEMBERS. I AM HONORED TO HAVE BEEN INVITED TO SERVE AS A PANELIST AT THE 67TH TPCA ANNUAL CONFERENCE, WHICH WILL BE HELD AT THE HILLIARD CENTER IN CORPUS CHRISTI. THE PANEL, TITLED THE TRIANGLE THAT WORKS, WILL FOCUS ON THE RELATIONSHIP AND COMMUNICATION BETWEEN POLICE CHIEFS, CITY MANAGERS AND CITY COUNCIL MEMBERS. IT IS SCHEDULED FOR TUESDAY, MARCH 31ST, FROM 4 P.M. TO 5 P.M. PARTICIPATION IN THIS PANEL ALLOWS ME TO PROUDLY REPRESENT THE CITY OF GARLAND, AND TO BRING BACK INSIGHTS THAT WILL DEEPEN OUR UNDERSTANDING AND APPRECIATION FOR THE IMPORTANT WORK OUR LAW, OUR LAW ENFORCEMENT PROFESSIONALS DO EVERY DAY. I PLAN TO TRAVEL TO CORPUS CHRISTI ON MARCH 31ST AND RETURN ON APRIL 1ST. TPCA WILL COVER MY LODGING AND I RESPECTFULLY REQUEST COUNCIL APPROVE. I RESPECTFULLY REQUEST COUNCIL APPROVAL FOR THE COST OF ROUND TRIP AIRFARE ON AMERICAN AIRLINES IN THE AMOUNT OF $29. THANK YOU MAYOR. THANK YOU MADAM. ANY DISCUSSION, COUNCILMEMBER DUTTON? I HAVE SOME QUESTIONS. SURE. THIS IS NOT INCLUDING, LIKE, ALCOHOLIC BEVERAGES ON THE PLANE. ABSOLUTELY. EXTRA PEANUTS. WILL YOU BE BRINGING YOUR OWN BLANKET AND PILLOW? I HAVE FAITH IN YOU. DON'T. DON'T SCREW IT UP. THANK YOU. ALL RIGHT THEN, COUNCIL AND I DON'T SEE ANYONE ELSE IN THE QUEUE. LOOKING FOR CONSENSUS ON THIS EXPENSE. THAT IS UNANIMOUS. [05:50:06] VERY GOOD. THANK YOU. ALL RIGHT, COUNCIL, NOW IT'S TIME FOR TO ANNOUNCE A FUTURE AGENDA ITEMS. [ ANNOUNCE FUTURE AGENDA ITEMS] IS THERE ANYONE WHO WISHES TO HAVE A FUTURE AGENDA ITEM? COUNCILMEMBER DUTTON. HOLD ON. I'M SORRY. I WOULD LIKE TO HAVE SOMEBODY, I DON'T KNOW, LOOK AT CODE COMPLIANCE ENFORCING POLITICAL SIGNS PLACED CORRECTLY. HISTORICALLY SPEAKING, OUR CODE COMPLIANCE DEPARTMENT HAS NOT ENFORCED OUR ORDINANCE. WHAT? WE HAVE AN ORDINANCE THAT SAYS YOU CAN'T PUT SIGNS IN CERTAIN PLACES. CAN WE ENFORCE IT OR NOT? IF WE CAN'T ENFORCE IT, LET'S DISCUSS TAKING IT OFF OF THE ORDINANCE. THANK YOU. APPRECIATE IT. ANYBODY SECOND? ME? NO. AND SECOND, FROM COUNCIL MEMBER BEARD. AND THEN I WOULD ALSO LIKE A STAFF PRESENTATION ON OUR DALLAS WINTER WEATHER SITUATION. JUST A BRIEF OVERVIEW OF WHAT THAT LOOKED LIKE FOR OUR OTHER DEPARTMENTS, WHAT OUR RESPONSE WAS, WHAT WE DID TO BE PROACTIVE. ALL OF THOSE FUN THINGS. AND A QUICK LITTLE LESSON ON WHY WE DID NOT PLOW OUR SNOW, OUR, OUR ROADS. AND HOW MUCH THE CITY BUTTONS COST. $40, IN CASE YOU'RE WONDERING. ALL RIGHT. IN A SECOND, BY MAYOR PRO TEM. THANK YOU. ANYTHING ELSE? MA'AM? NO. THAT'S IT. THANK YOU. ANY OTHER ITEMS? COUNCIL. ALL RIGHT. SEEING NONE TO OUR VIEWERS STILL WATCHING. OUR EXECUTIVE SESSION WILL BE PUSHED TO ANOTHER WORK SESSION. AND AT 1244, WE ARE ADJOURNED. GOOD MORNING. GARLAND. * This transcript was compiled from uncorrected Closed Captioning.