[Public Safety Committee on October 8, 2024.]
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I'M IN FACT CHAIR OF THE PUBLIC SAFETY COMMITTEE.
AND BEFORE WE START, UM, I'D LIKE TO WELCOME, UM, OUR VICE CHAIR COUNCIL MEMBER JACKSON IN CHAMBERS.
WE ALSO HAVE, UM, COUNCIL MEMBER FLICKINGER, UM, COUNCIL MEMBER RAMIREZ, AND COUNCIL MEMBER CARTER AND COUNCIL MEMBER ALCORN.
UM, AND WE HAVE STAFF FROM COUNCIL MEMBER CAYMAN'S OFFICE, UM, COUNCIL MEMBER CASTILLO'S, OFFICE MAYOR, PRO TEM CASTEX STADIUM'S OFFICE, AND VIRTUALLY, UM, FROM COUNCIL MEMBER PLUMMER'S OFFICE.
UM, TODAY WE HAVE ONE PRESENTATION, UM, THAT WILL BE ABOUT THE ETHAN PROJECT FROM DR.
PER, DR PER, IF YOU'D LIKE TO COME UP.
AND CHIEF MUNOZ, THANKS FOR BEING HERE AS WELL.
THANK, AND FOR ANYONE IN THE AUDIENCE, IF YOU, UM, WOULD LIKE TO SPEAK AFTER THE PRESENTATION, PLEASE, UM, IF YOU HAVEN'T SIGNED UP ALREADY, YOU CAN SIGN UP OVER, UM, AT THIS FRONT TABLE WITH JOSIE.
ALL RIGHT, GOOD MORNING, AND, UH, GOOD MORNING.
THANK YOU, COUNCIL MEMBER MIRANDA AND ALL THE COUNCIL MEMBERS FOR, UH, LETTING US COME AND SPEAK TO YOU TODAY ABOUT THE ETHAN PROGRAM.
OF COURSE, EVERYONE KNOWS WHO MY LEFT IS, UH, FIRE CHIEF MUNOZ, UM, AND SO ON.
WE'VE GOT A SERIES OF SLIDES WE'RE GONNA GO THROUGH.
I'M NOT GONNA READ THE SLIDES TO YOU, YOU SHOULD ALREADY HAVE THEM IN YOUR PACKET, BUT I'LL TRY TO MAKE THE HIGHLIGHTS ON, UH, ON EACH OF THE, UH, THE SLIDES.
SO IF WE GO TO THE NEXT SLIDE, PLEASE, AND SORT OF SET THE STAGE FOR, UH, WHAT WE'RE LOOKING AT IS, SO EMERGENCY MEDICAL SERVICES.
YOU KNOW, I THINK THAT HERE IN HOUSTON, WHEN WE TALK ABOUT EMS, WE OFTEN, AND, AND OF COURSE, MAKES TOTAL SENSE.
WE THINK ABOUT THE HOUSTON FIRE DEPARTMENT, WE THINK ABOUT OUR AMBULANCES.
BUT FOR A MOMENT, I WANNA TAKE YOU TO A HIGHER LEVEL OF THE ATMOSPHERE.
AND I WANT YOU TO THINK ABOUT EMS AS A, AS A $50 BILLION INDUSTRY ACROSS THE UNITED STATES.
UH, ONE OF THE THINGS WHICH IS COMMON AMONGST EMS ACROSS THE UNITED STATES, AND I WILL TELL YOU PERSONALLY, I STARTED OFF AS AN EMT IN BUFFALO, NEW YORK.
AND I'VE WORKED IN NEW YORK, I'VE WORKED IN NEW YORK CITY, I'VE WORKED IN LOS ANGELES, I'VE WORKED IN OHIO, AND I'VE, OF COURSE WORKED HERE IN TEXAS.
AND ONE OF THE THINGS WHICH IS COMMON ABOUT, UH, EMS IS WE HAVE A LOT OF PEOPLE WHO DON'T KNOW HOW TO NAVIGATE THE HEALTHCARE SYSTEM.
AND AS A DEFAULT, THEY WILL DO WHAT WE'VE BEEN ADVERTISING FOR 40 YEARS, AND THAT'S CALL 9 1 1.
AND THEY WILL DO THAT, BUT THEY WILL DO IT FOR NON-EMERGENT REASONS, NOT BECAUSE THEY'RE TRYING TO ABUSE THE SYSTEM, BECAUSE SIMPLY THEY JUST DON'T KNOW WHAT ELSE TO DO, OR THEY DON'T, THEY KNOW HOW TO USE THE SYSTEM, BUT THEY DON'T HAVE THE RESOURCES TO DO IT.
SO THAT'S A HUGE, UM, EXPENSE.
WE KNOW THAT LOCALLY, UH, HERE WITHIN HOUSTON, WE BELIEVE THAT, UM, UH, OUR NUMBERS ARE SIMILAR TO THE REST OF THE NATION.
WE'RE PROBABLY 40% OF OUR CALLS, AND THAT IS A LOW ESTIMATE, BUT AT LEAST 44% OF OUR CALLS WOULD FALL INTO THAT CATEGORY OF PEOPLE USING THE NINE ONE SYSTEM FOR NON-EMERGENCIES.
AND I WANNA REMIND YOU THIS, IT'S NOT ONLY THE AMBULANCES, BUT IT'S ALSO THE EMERGENCY DEPARTMENT.
AND SO THE EMERGENCY CARE SYSTEM IS BEING, UH, A BURDEN.
AND WE ALSO KNOW THAT OF OTHERS, OF THE PATIENTS THAT WE TRANSPORT TO THE HOSPITAL, ONLY ABOUT 39% WIND UP BEING ADMITTED TO THE HOSPITAL.
AGAIN, JUST, YOU KNOW, FURTHER SHOWING THE, UM, UH, THE, UH, INEFFICIENCY.
SO WHEN WE TRY TO PUT NUMBERS TO THAT, WE BELIEVE IT'S ABOUT A $10 BILLION WASTE TO THE HEALTHCARE SYSTEM NATIONALLY.
AND HERE IN HOUSTON, WE HAVE FOR A LONG TIME THOUGHT THAT WE COULD DO A BETTER JOB WITH THAT.
SO IF WE GO TO THE NEXT SLIDE, UH, WE'LL QUICKLY GO THROUGH A, A LONG HISTORY GOES, BRINGS US BACK IN, UH, 2008 WHERE WE RECOGNIZE THAT USING EMS FOR NON-EMERGENCY PROBLEMS WAS, UH, THIS PHRASE I'VE REPEATED PROBABLY A HUNDRED TIMES NOW, IS IT'S THE MOST EXPENSIVE FORM OF TRANSPORTATION TO THE MOST EXPENSIVE FORM OF UNSCHEDULED HEALTHCARE.
YET THAT'S WHAT WE'VE BEEN DOING.
U CALL WE HALL HAS BEEN THE SORT OF THE IDEA, AND WE, AND WE FELT WE COULD DO BETTER THAN THAT.
SO BACK IN 2008, WE THOUGHT, WELL, WHAT IF WE REDIRECTED CALLS FROM NINE ONE ONE CALL TAKERS TO A NURSE HELP LINE AND HAD THEM TO TRIAGE THE CALL.
AND WE GAVE THE NURSES THE OPPORTUNITY TO GET A CAB AND SEND PEOPLE TO, TO CLINICS.
AND WHAT WE FOUND WAS, UH, WHEN WE, WE DID THIS A COUPLE OF DIFFERENT WAYS, I WON'T GET INTO DETAIL, BUT BOTTOM LINE IS WHAT WE FOUND WAS, IS THAT THE NURSES WERE EXTREMELY CONSERVATIVE IN WHAT THEY WOULD NOT PUT INTO AN AMBULANCE.
AND ABOUT 80% OF THE TIME, THEY SENT THE CALL BACK TO, UH, TO NINE ONE AND TO, AND TO BE FAIR TO THE NURSES, UH, WE TRIED A COUPLE OF DIFFERENT ITERATIONS OF THIS WITH A COUPLE OF DIFFERENT ALGORITHMS, BUT IN THE END, IT, THE MAJORITY OF THOSE CALLS STARTED, UH, WOUND UP COMING BACK.
SO IT TOOK US SEVERAL YEARS OF TRYING TO TWEAK THAT, ABOUT SIX YEARS OF TRYING TO TWEAK THAT NURSE MODEL DIDN'T WORK.
IN 2014, WE STARTED, UH, WITH THE EMERGENCY TELEHEALTH AND NAVIGATION, UH, ETHAN, AND, UH, AND NOW WE HAVE ETHAN AND SYNAPSE, AND I'LL TALK ABOUT WHAT SYNAPSE IS IN A, IN A MOMENT.
BUT THIS IS WHERE WE USED PHYSICIANS INSTEAD
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OF NURSES.AND WE USED EMERGENCY PHYSICIANS INSTEAD OF NURSES.
ONE OF THE THINGS WE LEARNED WITH THE NURSES, THAT A NURSE THAT HAS SPENT THEIR CAREER WORKING IN A FAMILY PRACTICE OFFICE OR A PCP OR EVEN DERMATOLOGY, THEY DID NOT HAVE THE TOLERANCE TO SEND SOMEBODY WHO SAID THEY HAD CHEST PAIN IS SOME OTHER WAY THAN AN AMBULANCE.
BUT AN EMERGENCY PHYSICIAN IS PART OF THEIR DAILY DUTY TO QUICKLY ASSESS A PATIENT AND DETERMINE WHETHER THEY'RE SICK WITH A CAPITAL S OR SIX WITH A LOWERCASE S AND WHAT WOULD BE SAFE TO DO IT.
AND WHAT WE FOUND WAS THAT THERE WAS A HUGE INCREASE.
AND SO I'LL GIVE YOU THE NUMBER.
I'M GONNA, I'M GONNA HOLD, I'M GONNA HOLD MY THUNDER FOR A MINUTE AND GIVE YOU THE NUMBER IN JUST A MOMENT.
BUT WE FOUND THAT WORKED, UH, MUCH BETTER.
AND THE NURSE DOCTORS ARE GONNA BE ABLE TO USE AN ALTERNATIVE FORM OF TRANSPORTATION, A CAB, TO AN ALTERNATIVE CARE SITE.
SO NOT ONLY WERE WE NOT USING AMS AS MUCH, BUT WE WERE ALSO HAD THE ABILITY TO REDIRECT PATIENTS FROM THE EMERGENCY DEPARTMENT, WHICH IS THE SECOND HALF OF MY PHRASE, THE MOST EXPENSIVE FORM OF UN SCHEDULED HEALTHCARE, UH, TO A CLINIC.
SO CURRENTLY TODAY, AND FOR THE LAST SEVERAL YEARS, 200 OF THE FIRE DEPARTMENT'S, EMERGENCY VEHICLES ARE EQUIPPED WITH AN APP ON THEIR TABLET THAT THEY USE FOR THEIR RECORDS AND DISPATCH AND EVERYTHING ELSE.
IT'S JUST AN APP THAT'S ON THERE THAT ALLOWS THEM TO, UM, TO, UH, UH, TO CONNECT WITH A DOCTOR FOR THIS.
NOW A VERY IMPORTANT POINT FOR YOU TO UNDERSTAND, WE HAVE BEEN DOING THIS ALL THESE YEARS BASED ON GRANT FUNDS.
UH, STARTED OFF WITH 1115 WAIVER FUNDS, WHICH HAVE EXPIRED A LONG TIME AGO.
AND THEN SINCE THEN WE HAVE BEEN DOING A BUNCH OF OTHER PHILANTHROPIC FUNDING AND SO ON AND SO FORTH.
SO WE'VE NOT SPENT GENERAL FUND DOLLARS SHOULD BE CORRECT.
I THINK WE SPENT A LITTLE BIT OF GENERAL FUND DOLLARS DURING MAYOR TURNER'S, UH, TERM, BUT A, A, A TINY AMOUNT.
UM, AND THAT THE FUNDING THAT WE HAVE NOW, UH, IS GOING TO EXPIRE BY THE END OF FEBRUARY, 2025.
SO THAT'S JUST A FEW MONTHS FROM NOW.
IF WE DON'T COME UP WITH AN ALTERNATIVE, UH, PLAN, THEN UH, IT WILL, IT WILL, UH, WE'LL LOSE THE FUNDING.
SO, AGAIN, STICKING WITH A LITTLE BIT OF OUR, OUR, WHAT WE'VE ACHIEVED SO FAR.
SO, SO TO DATE, SINCE 2014, SINCE WE WENT TO THE ETHAN MODEL WITH THE PHYSICIANS, UH, 37,000 PATIENTS HAVE BEEN SERVED WITH THIS.
OVER 90% OF THE TIME, THE PHYSICIAN DOES NOT USE AN AMBULANCE.
QUITE ABOUT 10% OF THE TIME, THE PATIENT IS ACTUALLY SICKER THAN THE EMS CREW THOUGHT THAT THEY WERE.
AND THEY ACTUALLY ARE A TRUE EMERGENCY.
AND I, I'M ONE OF THE PHYSICIANS WHO DOES THIS, AND IT'S AN ILLNESS THAT I WOULD NOT EXPECT AN EMT OR PARAMEDIC TO UNDERSTAND, BECAUSE IT'S NOT WITHIN THEIR, WITHIN THEIR TRAINING.
SO THIS IS THINGS, THE EXAMPLE I ALWAYS USE, WE HAD A LADY WITH A HEADACHE, IT WAS A BAD HEADACHE.
AND WHEN I EV, WHEN I WAS ABLE TO EVALUATE HER, 'CAUSE I CAN SEE AND TALK TO THE CLIENT, I REALIZE SHE'S ACTUALLY HAVING A SUBARACHNOID HEMORRHAGE.
SHE'S HAVING A, A BLEED INTO HER BRAIN.
AND THE EMT AND PARAMEDIC TRAINING DOESN'T TEACH THAT.
SO I WOULDN'T EXPECT THEM TO KNOW IT.
BUT IT TURNS OUT ABOUT 10% OF THE CASES, THE DOCTOR ACTUALLY THINKS THAT THE, UH, THE PATIENT NEEDS TO GO BY AMBULANCE, WHICH, BUT GOING BACK TO THE, TO THE 90% FULL PART OF THAT CLASS, WE ARE SENDING PATIENTS TO HOSPITALS OTHER THAN AN AMBULANCE THE VAST MAJORITY OF THE TIME, UH, SINCE WE STARTED DOING IT.
AND SO THE CITY OF HOUSTON, UM, AND CHIEF'S GONNA TALK HERE IN JUST A MORE ABOUT SOME OF THE OPERATIONAL IMPACTS.
WE'VE ENJOYED AT LEAST A $22 MILLION BENEFIT.
NOW, UNFORTUNATELY, AN UNSPENT FUND OR A BENEFIT DOESN'T SHOW UP ON OUR SPREADSHEETS, RIGHT? A COST AVOIDANCE IS NOT ON THE CITY'S SPREADSHEETS, BUT WE ESTIMATE IT'S BEEN ABOUT A $22 MILLION BENEFIT TO THE CITY AND IN CHIEF, YOU WANT TO TALK A LITTLE BIT ABOUT THAT? ONE OF THE GREAT THINGS ABOUT THE PROGRAM IS THAT APOLOGIES, ONE OF THE GREAT THINGS ABOUT THE PROGRAM IS, AGAIN, AN AVERAGE OF 44 MINUTES IS SAVED PER, UH, EMS ENCOUNTER, WHICH IS A LOT IN OUR WORLD, RIGHT? UH, IF YOU LOOK AT, FOR EXAMPLE, THE LAST HURRICANE THAT WE HAD, UH, STAYING THERE, YOU KNOW, WAS REALLY AN IMPACT TO US.
THIS PROGRAM WILL ALLOW US TO DO THAT QUOTE UNQUOTE FIL ASSESSMENT OF SOMEONE AND DETERMINE WHAT WE CAN DO.
AND THAT'S A HUGE SAVINGS FOR US, ESPECIALLY WHEN WE'RE TRYING TO RESPOND TO APPROXIMATELY 700 SQUARE MILES THROUGHOUT THE CITY DURING NORMAL TIMES VERSUS, YOU KNOW, THEN WE HAVE THOSE HURRICANE MOMENTS AND ALL THOSE, UH, THOSE DICHO MOMENTS THAT WE HAVE TO UTILIZE AND WORK SMARTER WITH THE CAPABILITIES THAT WE HAVE.
BUT THIS PROGRAM WOULD DEFINITELY BE A HUGE ASSET TO BE A FORCE MULTIPLIER TO US.
ONE OF THE OTHER THINGS THAT WE ARE, UH, DEVELOPED ALONG THE WAY IS REMEMBER, YOU KNOW, I TALKED ABOUT THE, SOME OF THE FINANCES OF THIS.
AND ONE THING TO KEEP IN MIND IS THAT WHEN WE PUT SOMEBODY IN AN AMBULANCE AND WE SEND 'EM TO THE EMERGENCY DEPARTMENT, SOMEBODY'S PAYING FOR THAT.
WELL, WHO'S PAYING FOR THAT? WELL, IT'S YOUR BLUE CROSS BLUE SHIELD, AETNA, UNITEDHEALTHCARE, ET CETERA, ET CETERA.
THOSE ARE THE ONES WHO ACTUALLY SAVE.
'CAUSE WHEN WE PUT SOMEBODY IN A CAB, THEY DON'T GET AN AMBULANCE BILL.
WHEN WE SEND SOMEBODY TO A CLINIC, THEY DON'T GET THE EMERGENCY DEPARTMENT BILL.
SO WE'VE ENGAGED THE THIRD PARTY PAYERS, IF YOU WILL, AND THEY'RE EXTREMELY INTERESTED IN SUPPORTING THIS EFFORT.
AND WE THINK THAT THAT, AND WE'LL TALK IN A SLIDE IN A MINUTE HERE, BUT, UH, ABOUT, UH, BEING ABLE TO, A, SAVE THEM MONEY AND B, HELP THEM KEEP THEIR PATIENTS WITHIN THEIR NETWORKS, WHICH SAVES THEM EVEN MORE MONEY.
SO THEY'RE VERY INTERESTED IN, IN, UH, PAYING FOR US.
BUT THE FIRE CHIEF'S GOT ANOTHER GOOD POINT TO BRING UP ABOUT.
SO, YOU KNOW, IT IS, IT IS NO SECRET THAT
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THE DEPARTMENT IS DEFINITELY SUFFERING OR HAS A 600, UH, WE'RE NEEDING 600 MORE FIREFIGHTERS, AND WE'RE WORKING HARD TO THAT.AND THE CONCERN IS THAT IF WE LOOK DOWN A YEAR OR TWO DOWN THE ROAD, WE ALSO HAVE MAJOR WORLD CLASS EVENTS COMING HERE.
THE WORLD CUP IS ONE THAT WE ARE ALL LOOKING AT, WHICH IS GONNA BE APPROXIMATELY 31 STRAIGHT DAYS, RIGHT? WE'RE ALSO LOOKING AT THE RNC, WE'RE LOOKING AT WORLD BASEBALL CLASSICS, AND NOT TO MENTION ALL THE SPECIAL EVENTS THAT HAPPEN DURING THE DAY.
AND THE NORMAL DAY OPERATION THAT'S REQUIRED.
THIS ETHAN IS GONNA BE A CRITICAL RESOURCE FOR US.
UH, AS I SAID BEFORE, A FORCE MULTIPLIER THAT'LL ALLOW US TO UTILIZE THE RESOURCES THAT WE HAVE NOW TO, UH, RESPOND TO THOSE QUOTE UNQUOTE TRUE EMERGENCIES AS DR AS DR PER HAS, HAS ALLOCATED TO.
SO THIS IS WHY IT'S GONNA BE HUGE.
THIS IS A HUGE PROGRAM FOR US, A NEED FOR US, A MUST NEED FOR US TO BE THAT FORCE MULTIPLIER AND UTILIZE, YOU KNOW, THE CAPABILITIES THAT WE HAVE OUT THERE TO, UH, FORCE MULTIPLY WITH US AND AS WE MOVE FORWARD.
BUT THAT IT'S GONNA DEFINITELY, UH, HELP WITH THE, UH, SHORTFALL THAT WE HAVE WITH FIREFIGHTERS RIGHT NOW.
UH, IT ALLOWS US TO PUT THE UNITS, UTILIZE 'EM WISELY, AND COORDINATE WITH THE, WITH DOCTORS AS DR.
AND SO, JUST FOR THOSE OF YOU WHO MAY NOT BE AS FAMILIAR WITH ETHAN, A A QUICK, UH, ANATOMY OF A CALL.
SO SOMEBODY CALLS 9 1 1 FOR WHATEVER THEIR ISSUE MAY BE.
WE HAVE A VERY COMPLEX SORT OF DISPATCH ALGORITHM TO DECIDE WHAT SHOULD GET A, A, A BASIC LIFE SUPPORT RESPONSE VERSUS AN ADVANCED LIFE REPORT RESPONSE.
DO THEY NEED A FIRETRUCK, YES OR NO? DO THEY NEED MORE MANPOWER? WHATEVER THE FIRST ARRIVING UNITS, OF COURSE, THEN WILL REDEFINE THAT IS SO WE START, YOU KNOW, GETTING EXACTLY WHAT NEEDS TO BE THERE.
SO LET'S ASSUME, AND SINCE ETHAN'S REALLY DESIGNED FOR A LOW ACUITY CALL, THE EMTS GET UNSEEN, THEY ASSESS THE, THE PATIENT, THEY THEN WILL GET A VIDEO CALL USING TEAMS JUST LIKE WE USE IN THE CITY OF HOUSTON.
IT'S A, IT'S A SPECIAL VERSION OF TEAMS, BUT IT IS TEAMS WHERE THEY CAN HAVE A VIDEO CONFERENCE WITH, AND, AND USUALLY IT STARTS OFF WITH THE EMT TALKING TO THE PHYSICIAN SAYING, THIS IS WHAT WE'VE GOT.
WE'VE GOT A PERSON THIS AGE, THEY'VE GOT THIS PROBLEM, HERE'S THEIR VITAL SIGNS, HERE'S WHAT'S GOING ON.
AND THEN AS A PHYSICIAN, WE CAN THEN TURN IN, WE CAN TALK TO THE PATIENT A LITTLE BIT, ASK A COUPLE MORE QUESTIONS, VERIFY THAT THIS IS A, A GOOD CALL TO, FOR BE SAFE TO PUT SOMEBODY INTO A CAB, SAFE FOR THEM TO GO TO A CLINIC.
AND WE TALK WITH THE PATIENT AND WE UNDERSTAND AND WE COME TO UNDERSTAND WHAT THEIR ISSUE IS.
'CAUSE, YOU KNOW, SOMETIMES PEOPLE ARE THRILLED TO NOT GET AN AMBULANCE BILL.
THEY'RE THRILLED TO, I MEAN, I CAN GO TO A CLINIC INSTEAD THAT WILL COST ME SO MUCH LESS.
I DIDN'T KNOW THAT WAS POSSIBLE.
SO NOT ONLY IS IT OPERATIONALLY BENEFICIAL TO THE FIRE DEPARTMENT, I WANT YOU TO UNDERSTAND THAT IT'S ALSO BENEFICIAL TO YOUR CONSTITUENTS WHO VERY OFTEN WHEN THEY CALL, THEY KNOW THAT THEY'RE ABOUT TO INCUR THIS HUGE EXPENSE.
SO WE CAN AVOID THAT FOR THEM.
AND WE'RE DOING IT AT THE SAME TIME, MAKE SURE IT'S MEDICALLY APPROPRIATE, WHICH THEN HELPS TO PROTECT THE, THE, THE CITY AND I WE MENTIONED SYNAPSE.
SO SYNAPSE IS ANOTHER COMPUTER PROGRAM THAT HAS BEEN DEVELOPED HERE LOCALLY, AND THE CITY OWNS THE INTELLECTUAL PROPERTY TO THAT PROGRAMMING.
BUT THAT ALLOWS US, I WON'T GO INTO GREAT DETAIL, BUT THAT ALLOWS THE PHYSICIAN TO IDENTIFY WHAT ARE THE CLOSEST CLINICS, WHAT ARE THE CAPABILITIES OF THOSE CLINICS, ACTUALLY SCHEDULE AN APPOINTMENT FOR THAT PERSON.
SO THE CLINIC KNOWS THE PERSON'S COMING AND SIMULTANEOUSLY ARRANGE FOR THE CAB TO COME AND PICK THEM UP AND TAKE THEM THERE.
AND WITH THE CLINICS, WE ACTUALLY HAVE A DEAL WITH THE CLINICS THAT THEY, THAT THE CAB, WE HAVE THE, SO THE CAB COMPANY WILL ACTUALLY GIVE THAT PERSON A RIDE BACK HOME AS WELL.
SO IT'S REALLY VERY CONVENIENT FOR THE, FOR THE CITIZENS, FOR YOUR CONSTITUENTS.
IF THEY GO TO THE EMERGENCY DEPARTMENT, WE DON'T GIVE 'EM A FREE RIDE HOME BECAUSE IF THEY'D GONE BY AMBULANCE, THEY WOULD'VE HAD TO FIGURE OUT A WAY HOME ANYWAYS.
AND SO WHY SHOULD THE CITY HAVE TO PAY FOR THAT ONE? BUT IF WE CAN GET 'EM TO GO TO THE CLINIC, UH, WE WILL, WE WILL, SO THAT IT DOESN'T BECOME A PROBLEM FOR THAT CLINIC AND THEY CONTINUE TO WORK WITH US.
WE GUARANTEE THEM THE RIDE HOME.
SO AGAIN, A COUPLE OF THINGS THAT ARE OF, OF BENEFIT TO NOT ONLY THE, THE CITY, BUT ALSO, UH, TO THE PUBLIC.
ALRIGHT, SO COMING BACK TO SORT OF THE BIG PICTURE, WE THINK ONE OF THE REASONS THAT WE'RE GONNA BE MOVING, AND I'LL TELL YOU WHAT THE ASK IS IN A MINUTE.
WE'RE LOOKING TO MOVE ETHAN OUT OF THE CITY OF HOUSTON.
AND PART OF THE REASON FOR THAT IS THAT IT'S, IT'S JUST DIFFICULT TO DO WITHIN THE CITY TO HAVE OUTSIDE CLIENTS, FOR EXAMPLE, UM, I WON'T NAME SPECIFIC NAMES, BUT YOU KNOW, THERE ARE, THERE ARE COUNTIES AROUND US THAT OPERATE EMS SYSTEMS FOR THE ENTIRE COUNTY.
THEY COULD BENEFIT FROM THIS AS WELL.
AND THEY, IN FACT, HAVE REACHED OUT TO US, SAY, HEY, WE KNOW ABOUT YOUR ETHAN PROGRAM, WE'D LOVE TO HAVE THAT.
UM, HOW DO WE, HOW DO WE DO IT? AND JUST WORKING WITHIN THE CITY.
THOSE BUSINESS DEALS WITH VERONICA.
IT'S, IT'S VERY, VERY CUMBERSOME, AS YOU CAN IMAGINE.
SO WE WANNA MOVE IT TO AN LGC THAT WILL THEN HAVE THE ABILITY TO MAKE THOSE, THOSE, UM, UH, THOSE ARRANGEMENTS AND THOSE, UM, COORDINATE, YOU KNOW, THAT COORDINATED BUSINESS DEALS, IF YOU WILL.
UM, AND SO, YOU KNOW, OF COURSE WE'RE GONNA CRAWL BEFORE WE WALK BEFORE WE RUN, BUT IF YOU START LOOKING OUT SEVERAL YEARS FROM NOW, YOU KNOW, YOU CAN SEE ON THE NUMBERS HERE, IF 30 TO 35% OF THE NI OF THE EMS CALLS ACROSS THE NATION FALL INTO THIS CATEGORY, THERE'S LITERALLY, YOU KNOW, MILLIONS AND MILLIONS OF POTENTIAL VISITS THAT COULD COME TO AN ETHAN LAKE PROGRAM.
AND LET ME GO OFF, I'M GONNA GO OFF SCRIPT JUST A LITTLE BIT.
UM, THIS HAS BEEN TRIED BY OTHERS, UM, YET THEY DON'T HAVE OUR SECRET SAUCE.
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AND SO THEY HAVE UNIFORMLY FAILED.AND, UH, YES, THERE IS A LITTLE BIT OF SECRET SAUCE TO THIS THAT I WON'T DIVULGE, BUT, UH, IT IS OWNED BY THE CITY.
AND SO, UM, UH, OTHERS THAT HAVE TRIED THIS HAVE NOT, HAVE NOT SUCCEEDED AS WELL AS WE HAVE.
BUT YOU CAN SEE THAT FOR THE SURROUNDING MUNICIPALITIES, THEY WOULD, YOU KNOW, GET THE SAME BENEFITS AND OPERATIONALLY AND FINANCIALLY.
AND, UM, WE THINK THERE'S A TREMENDOUS GROWTH POTENTIAL HERE.
SO IF WE GO TO THE NEXT SLIDE, UM, AGAIN, REINFORCE THAT THE CITY HAS BEEN, YOU KNOW, BENEFITING FROM THIS FOR, FOR SOME TIME.
THIS IS A BIT OF A BUSY SLIDE, WHICH I'M NOT GONNA GONNA READ TO YOU.
BUT THE, THE BOTTOM LINE IS, IS THAT WE WILL BE ABLE TO, UH, HAVE BUSINESS RELATIONSHIPS WITH OTHER EMS PROVIDER, MUNICIPAL, EMS PROVIDER AGENCIES FOR WHICH THEY WILL PAY US.
THEY'RE GONNA, THEY'RE GONNA GET VALUE FOR THIS.
WE WILL ALSO HAVE A BUSINESS RELATIONSHIP WITH THE THIRD PARTY PAYERS WHO SEE BENEFIT AND LOWER COST FOR 'EM.
AND SO WE'RE GONNA BE ABLE TO TAKE THOSE SOURCES OF MONEY.
AND THEN THERE AND THERE, THERE'S, AND AS AN LGC THAT THEN OPENS THE DOORS FOR WHAT OTHER WAYS CAN WE MAKE MONEY ON THIS AND PROVIDE IMPROVED SERVICES.
SO, UM, UH, I WANT YOU TO THINK ABOUT THE RELATIONSHIPS THAT WE'RE GONNA HAVE WITH THE CLINICS WHO WE'LL BE LOOKING TO GET BUSINESS.
I WANT YOU TO THINK ABOUT, UM, UH, SO THERE ARE SOME, UH, UH, SO ONE EXAMPLE, AND I DON'T KNOW THAT WE'LL DO THIS.
THIS WILL BE UP TO THE BOARD, BUT FOR EXAMPLE, UH, A HOSPICE PATIENT, UH, THEY, THERE IS ALL KINDS OF REASONS FOR THEM TO REMAIN ON HOSPICE.
UH, IF THEY WIND UP GOING TO THE EMERGENCY DEPARTMENT, IF A HOSPICE PATIENT GOES TO THE EMERGENCY DEPARTMENT, ALL OF A SUDDEN, YOU KNOW, UH, AND FAMILIES WILL OFTEN PANIC AND DO THAT.
UH, THE HOSPICE WHO COULD HAVE HANDLED THAT SITUATION HAD THEY BEEN NOTIFIED, UH, NOW INCURS A LOSS.
AND SO WE'VE HEARD FROM THEM SAY, LISTEN, IF YOU WOULD SEND US TO THOSE SCENES INSTEAD, WE CAN, YOU KNOW, WE'VE ALREADY GOT A RELATIONSHIP, WE'VE GOT A HOSPICE NURSE, THEY KNOW THE FAMILY.
IF YOU NOTIFY US, WE CAN TALK TO THEM.
WE WILL THEN AVOID THAT EXP THAT UNNECESSARY EXPENSE TO THE FAMILY AND THAT UNNECESSARY TURMOIL TO THAT PATIENT.
THEY'RE WILLING TO PAY FOR THAT.
THERE ARE, IT'S JUST ONE, THERE ARE A VARIETY OF OTHER THINGS THAT WE COULD DO TO, TO, UH, TO BRING IN, UH, MONIES THROUGH, UH, ETHAN EL AND LGC.
AND AGAIN, THIS, THIS SLIDE BASICALLY REPEATS WHAT, WHAT I, KIND OF, WHAT I JUST SAID.
THERE WILL BE LICENSING FEES TO USE THE SOFTWARE TO THE MUNICIPAL EMS AGENCIES THAT WE WILL WORK WITH.
SO WE'LL CHARGE THEM A LICENSING FEE FOR THE SOFTWARE.
AGAIN, THAT SOFTWARE IS NOT OWNED BY ETHAN, LGC.
THAT SOFTWARE REMAINS THE PROPERTY OF THE CITY OF HOUSTON.
OKAY? SO WE NEVER GIVE UP THAT INTELLECTUAL PROPERTY FROM THE CITY OF HOUSTON.
THE CITY WILL LICENSE IT TO ETHAN, LGC, WHO WILL THEN SUB-LICENSE IT TO THE OTHER MUNICIPALITIES.
THE THIRD PARTY PAYERS SEE TREMENDOUS SAVINGS, UM, AND EFFICIENCIES ON THEIR SIDE.
THEY'RE WILLING TO PAY US TO DO THAT, TO EXECUTE THESE, UM, EFFICIENCIES.
AND THEN FINALLY, YOU KNOW, OUR IMAGINATION CAN START GOING ABOUT OTHER WAYS AS AN LGC THAT ETHAN MAY BE ABLE TO, TO BRING IN, UH, MORE FUNDS.
ETHAN, LGC WILL BE ABLE TO BRING IN MORE FUNDS.
SO IN ORDER TO DO THAT, THERE'S, UM, NEXT SLIDE PLEASE.
WE WILL BE ESTABLISHING A BOARD OF DIRECTORS.
UH, AT THIS POINT WE'RE LOOKING AT FIVE, UM, UH, BOARDS WITH TWO EX-OFFICIO BOARD MEMBERS.
SO A TOTAL OF SEVEN WILL BE ON THE BOARD.
THEY REPRESENT LEADERS FROM, UH, LOCAL HOSPITAL GROUPS, LOCAL CLINICS, UM, UH, TELEMEDICINE, UH, UH, AND, UH, THE HEALTHCARE, UH, INDUSTRY OVERALL.
UM, AND, UH, SO WE THINK THAT AS WE GET STARTED HERE, WE NEED THAT EXPERTISE TO HELP US NAVIGATE THIS AS ETHAN GETS UP AND GOING.
AND THEN OF COURSE, THE BOARD, ALONG WITH THE CITY'S PERMISSION, HAS THE EXP HAS THE ABILITY TO EXPAND THAT BOARD, SHOULD WE NEED TO BRING ON MORE EXPERTISE.
BUT AS WE START, WE THINK THAT WE'VE GOT THE FIVE PEOPLE THAT WILL BE MOST BENEFICIAL TO, UM, TO GETTING US UP AND GOING.
UM, SO THE ASK IS, AND WE BELIEVE THAT ON OCTOBER 23RD, IT WILL COME TO COUNCIL.
THAT'S OUR TENTATIVE DATE RIGHT NOW FOR TO COME TO COUNCIL WILL BE, UM, A COUPLE OF RCAS.
UH, ONE WILL BE THE LGC FORMATION DOCUMENT THAT WE WILL, HOPEFULLY YOU WILL, UH, BE PLEASED WITH AND, AND VOTE POSITIVELY ON.
AND ALSO THE INTERLOCAL AGREEMENT BETWEEN THIS, ONCE THE LGC IS FORMED, ONCE YOU VOTE TO FORM IT, THEN THE SECOND, UH, RCA WILL BE THE, UH, INTERLOCAL AGREEMENT BETWEEN THE CITY AND THE LGC THAT YOU HAD JUST FORMED.
AND THAT LAYS OUT, YOU KNOW, THE, UH, THE RELATIONSHIP AND THE SPECIFICS.
AGAIN, PROBABLY THE MOST IMPORTANT THING IS THE RETAINMENT OF THE INTELLECTUAL PROPERTY ON THE PART OF THE CITY.
UM, AND SPECIFIC TO THAT, YOU WON'T NEED TO VOTE ON IT, BUT IS THE SPECIFIC LICENSING AGREEMENT THAT RETAINS, AND THAT'S THE THIRD DOCUMENT THAT WE HAVE LISTED.
AND YOU DON'T NEED TO VOTE ON THAT ONE, BUT I WANT TO REINFORCE THAT THERE'S NO LOSS OF INTELLECTUAL PROPERTY, UH, IN THIS ARRANGEMENT.
AND SO IF WE CAN GO TO THE NEXT SLIDE.
UM, SO WE START TALKING ABOUT, ABOUT THIS, WE THINK IT'S GONNA TAKE, AND I, WE'VE GOT A SLIDE, A MOMENT TO LAY IT OUT IN A LITTLE BIT MORE DETAIL.
BUT THIS, THE LGC WILL AT SOME POINT NEED TO PAY THE CITY OF HOUSTON FOR THE LICENSE, JUST LIKE WE'RE GONNA BE EXPECTING OTHERS TO PAY FOR THE LICENSE.
BUT THE LG C'S GOTTA GET ITSELF FINANCIALLY UP AND GOING.
THAT'S GONNA TAKE A LITTLE BIT.
SO WE THINK IT'S GONNA, THE CITY WILL GET, JUST THE LICENSE FEE ALONE WILL BE FOUR
[00:20:01]
$50,000 PER YEAR.UM, AND THEN ONCE THE LGC IS FINANCIALLY ON ITS OWN, ALL OF THE, UM, UH, NET REVENUES THAT ARE BROUGHT IN, WE WILL GO TO THE CITY AND I WILL SHOW THAT, DEMONSTRATE THAT TO YOU IN A SLIDE IN JUST A MOMENT HERE.
AND IF WE GO OVER THE NEXT SLIDE, THE VERY BUSY SLIDE, LOTS OF NUMBERS, YOU'VE GOT IT.
SO YOU CAN GO BACK AND STUDY IT WITH A, EITHER YOUR BIFOCALS OR A MAGNIFYING GLASS.
'CAUSE THE NUMBERS ARE ADMITTEDLY SMALL.
BUT IT'S A LOT OF INFORMATION ON HERE.
WHAT I WANNA DRAW YOUR ATTENTION TO IS UP NEAR THE TOP, WE'VE GOT A COUPLE OF LINES, AND IT'S ONE IS NUMBER OF INSURANCE PROVIDERS, NUMBER OF NON-CITY OF HOUSTON MUNICIPALITIES SERVED AND NUMBER OF SPONSORS.
AND YOU'LL SEE AS YOU GO FROM THE ST.
STU YEAR, WHICH WILL BE FROM WHENEVER YOU VOTE TO APPROVE THE LGC UNTIL THE END OF THIS CURRENT FISCAL YEAR, WE'RE CALLING THAT A STUB YEAR.
UM, AND THEN THE FISCAL YEARS, THE CITY FUTURE OF FISCAL YEARS IS YEAR 1, 2, 3, 4, AND FIVE.
AFTER THAT, YOU CAN SEE THAT WE ANTICIPATE A GROWTH OF, OF A VARIETY OF CUSTOMERS, BOTH MUNICIPALITIES AND THIRD PARTY PAYERS.
UM, AND IF YOU GO DOWN TO THE BOTTOM, SO THIS IS THE REVENUES, YOU CAN SEE HOW THE REVENUES, WE EXPECT THE OUTSIDE DOLLARS COMING IN.
IT'S GONNA START OFF FAIRLY SMALL IN THIS FIRST YEAR, BUT THEN IT'S GONNA GROW QUITE A BIT OVER THE NEXT, UH, UH, FIVE AND A HALF YEARS TO A, A FAIRLY LARGE SUM THERE.
NOW, OFFSETTING THAT, OF COURSE, IS GONNA BE THE EXPENSES, WHICH IS THE NEXT SLIDE.
AND ON THE NEXT SLIDE, YOU KNOW, THIS ISN'T, THIS IS, THERE'S A LOT OF IT INFRASTRUCTURE HERE.
THERE'S A LOT OF COORDINATION.
WE GOTTA PAY FOR THE PHYSICIANS, WE GOTTA PAY FOR THE CABS, WE GOTTA PAY FOR A BUNCH OF THINGS, WHICH, SO THAT'S GONNA, WE HAVE TO HAVE THIS PRODUCT UP AND GOING AND RUNNING TO MAKE IT ATTRACTIVE FOR SOMEBODY.
SO WE HAVE TO BUILD THE CAR BEFORE WE CAN SELL IT, RIGHT? AND SO THERE'S, YOU CAN SEE ON THE BOTTOM LINE THERE, WE EXPECT TO BE IN THE RED FOR THE STU YEAR AND PROBABLY TWO YEARS AFTER THAT.
BUT THEN WE SHOULD BREAK EVEN.
WE HOPE, UH, BY YEAR THREE, AND YOU CAN SEE HOW THE, UH, THE PROFITS WILL GO UP AND REMEMBER, THESE ARE THE NET PROFITS WILL COME BACK TO THE CITY.
SO IT MAY TAKE US A FEW YEARS, BUT WE THINK THAT IN THE END, THIS WILL BE A REVENUE GENERATING OPERATION FOR THE CITY.
AND REMEMBER, WHILE YOU'RE LOOKING AT THOSE NUMBERS AS DOLLARS THAT WILL BE COMING IN, DON'T FORGET, THE HOUSTON FIRE DEPARTMENT WILL BE CONTINUING TO BE A, A, A, UH, A, A CUSTOMER WITHOUT HAVING TO PAY FOR IT.
SO ALL THE OPERATIONAL ADVANTAGES THAT THE FIRE CHIEF JUST TALKED ABOUT IN TERMS OF GETTING UNITS BACK IN SERVICE AND SO ON AND SO FORTH, UH, THOSE WILL CONTINUE TO BE REALIZED, BUT NOT ON A SPREADSHEET ANYWHERE.
AND THAT LADIES AND GENTLEMEN BRINGS ME TO THE END.
UM, WE HAVE ANY, ANY QUESTIONS.
PER, UM, AND WE WERE ALSO JOINED BY COUNCIL MEMBER HUFFMAN AND STAFF FROM COUNCIL MEMBER MARTINEZ'S OFFICE AS WELL.
UM, THIS IS SUCH AN IMMENSELY CRITICAL, UM, PROGRAM IN OUR CITY, AND I KNOW FOR YEARS YOU'VE KIND OF BEEN PRESENTING THIS PROGRAM AND SAYING THAT FUNDING WAS GOING TO RUN OUT.
AND SO THIS IS SUCH A GREAT WAY TO KEEP THIS PROGRAM GOING.
SO I'M REALLY EXCITED ABOUT THIS.
UM, COUNCIL MEMBER ALCORN, THANK YOU CHAIR, AND THANKS FOR THE PRESENTATION.
I LOVE SEEING ANYTHING THAT'S GONNA POSSIBLY BRING IN $27 MILLION IN FIVE YEARS.
SO ONE, IT DOESN'T EXIST YET, UM, BUT RIGHT WHEN IT, WHEN IT'S ISS FORMED, I MEAN, WHEN IT, WHEN IT'S FORMED.
SO THERE'LL BE, UH, THERE'LL BE, YOU KNOW, A, A, A PRESIDENT IF YOU WILL.
THERE'S GONNA NEED TO BE SOME IT PEOPLE AND SOME PEOPLE TO DO ADMIN.
AND THEN OF COURSE, THE PHYSICIANS THAT STAFF THE, THAT ARE ON CALL, IF YOU WILL, UM, THEY'LL, THEY'LL BE EMPLOYEES OF THE LGC.
AND THAT WILL LARGELY BE THE EMPLOYEES OF THE LGC.
DO YOU HAVE ANY KIND OF ESTIMATES ON HOW MANY PEOPLE THAT'LL BE, OR, SO YEAH, SO RIGHT NOW WE'RE RUNNING WITH, I THINK WE, WE'VE GOT, UH, 15 PHYSICIANS THAT ARE ON STAFF.
NOW, REMEMBER, THIS IS A SIDE JOB FOR THEM.
SO THEY WORK, THEY WORK FULL-TIME IN EMERGENCY DEPARTMENTS.
AND THEN OUR SCHEDULE IS THEIR, THEIR FOUR HOUR BLOCKS THAT THEY WORK.
AND SO, UM, YOU KNOW, TODAY WE RUN 10:00 AM TO 10:00 PM SEVEN DAYS A WEEK, ACTUALLY 365 DAYS A YEAR, EVEN ON HOLIDAYS.
AND SO WE'RE DOING THAT WITH ABOUT 15 PHYSICIANS WORKING FOUR HOUR SHIFTS AT A TIME.
AND IT MIGHT'VE BEEN EARLIER IN YOUR PRESENTATION, BUT REMIND ME, UM, THE CITY'S COST OF AN AMBULANCE, UM, AVERAGE COST OF AN AMBULANCE COME GET YOU AND TAKE YOU TO THE HOSPITAL.
SO IT'S ABOUT, YEAH, SO THE, THE, UH, OUR ORDINANCE SAYS THAT THE COST, THE TRANSPORT COST BEGINS AT, I BELIEVE IT'S $2,100, UH, ADD MILEAGE.
AND THEN THERE, THERE ARE CERTAIN THINGS THAT WE USE.
THERE'S AN, AN ADDED FEE FOR CERTAIN EQUIPMENT THAT WE USE.
AND THE PERCENTAGE OF NON PAYS IS, UH, SIGNIFICANT.
DO YOU KNOW WHAT IT IS OFF THE TOP OF YOUR HEAD? NO, IT IS SIGNIFICANT THOUGH.
COUNCIL MEMBER, UM, THAT IS ONE THING WE'LL GET FOR YOU, BUT IT IS VERY SIGNIFICANT.
'CAUSE YOU GOTTA KEEP IN MIND THAT DURING THOSE TRANSPORTS, WHETHER IT BE MEDICAID, MEDICARE, THERE ARE CERTAIN CRITERIA THAT HAS TO BE MET.
AND IF IT'S, IF IT'S A QUOTE NON-EMERGENCY, THEN IT'S A BIG STRUGGLE TO GET PAYMENT.
SO YOU ACTUALLY REMIND ME TWO THINGS.
SO WHAT, DON'T HOLD ME TO THIS.
I, I WANNA SAY, I WANNA SAY IT'S LIKE 37 TO 40% IS OUR RIGHT.
WE GET PERCENT, YOU KNOW, WE GET REIMBURSED BY MEDICARE, MEDICAID, I GUESS UNDER CERTAIN CIRCUMSTANCES.
[00:25:01]
DON'T.AND THEN BY THE THIRD PARTY PAYERS, RIGHT? UM, BUT, BUT WE HAVE A, I REMEMBER THERE BEING A CONSIDERABLE NUMBER OF, OF ACCOUNTS THAT WE, AND WE DON'T REALLY GO AFTER THEM.
I MEAN, WE DON'T, WE BASICALLY JUST WRITE THAT OFF, RIGHT? BUT TO THE MEDICAID AND MEDICARE, UH, THERE IS A, UH, THE, THE PATIENT, THE MEDICARE, MEDICARE CLIENT THAT'S TRANSPORTING AMBULANCE, THEY NEED TO MEET WHAT THEY CALL MEDICAL NECESSITY, RIGHT? AND SO FOR THE PATIENTS THAT TODAY, WELL, FOR THE PATIENTS THAT BEFORE ETHAN EXISTED, THAT THE FIRE T WE WOULDN'T GET PAID ON THOSE.
SO WE DIDN'T NEED MEDICAL NECESSITY.
WELL, IF YOU DON'T NEED MEDICAL NECESSITY, YOU DON'T NEED THE AMBULANCE, WHICH MEANS WE CAN, SO WE CAN STILL MEET THE NEEDS OF THE CLIENT OF THE PUBLIC BY PUTTING THEM IN A CAB.
IT'S NOW, NOW WE'RE NOT SENDING A BILL THAT'S NOT GONNA BE PAID FOR.
AND WE GET OUR AMBULANCE BACK IN SERVICE.
SO PARTICULAR FOR CASES WHERE UNDER MEDICAID AND MEDICARE, WHERE THEY'RE NOT GONNA MEET MEDICAL NECESSITY, THE PERFECT THING FOR THE CITY TO DO WOULD BE TO PUT 'EM IN A CAB.
RIGHT NOW WE CAN PUT 'EM IN A CAB AND ACTUALLY, YOU KNOW, GET SOME PAYMENT FOR IT.
AND, AND THE LGC WOULD ALLOW OTHER JURISDICTIONS THAT DON'T HAVE THE BENEFIT OF ETHAN TO ALSO PASS THAT ALONG TO THEIR, YOU KNOW, E EXACTLY.
AND THEN THE OTHER THING IS, KEEP IN MIND THAT THE WAY WE'VE GOT THIS SET UP, BECAUSE WE WILL CHARGE THE OTHER MUNICIPALITIES SOME SUM OF MONEY TO DO THIS, BUT BECAUSE WE'RE ALWAYS GETTING MONEY FROM THE THIRD PARTY PAYERS, WE'LL BE CHARGING THEM FAR LESS THAN IT WOULD EVER COST THEM TO BUILD THIS ON THEIR OWN.
THERE'S A BARGAIN FOR THEM TOO.
UH, THANK YOU MADAM CHAIR AND THANK YOU DOCTOR FOR LAYING OUT THIS, UH, INTERESTING, UH, PROPOSAL.
SO, IF I UNDERSTAND CORRECTLY, UH, ETHAN STARTED OUT AS A, A SORT OF A, A SOFTWARE PLATFORM TO SORT OF DIVERT, UM, CERTAIN CALLERS PATIENTS FROM AMBULANCE TRANSPORT TO A DIFFERENT WAY OF HANDLING, UH, THEIR, THEIR NEED.
AND, BUT, BUT THE WAY, UH, YOU PROPOSED TO, UH, USE ETHAN NOW IS TO TURN IT INTO, UH, ESSENTIALLY A BUSINESS, UH, IN THE FORM OF LOCAL GOVERNMENT CORPORATION.
AND, UM, RIGHT NOW, DOES ETHAN EXIST AS, AS IT, UH, SORT OF STARTED OUT AS A WAY TO DIVERT FOLKS FROM, UH, AN AMBULANCE RIDE TO THE HOSPITAL? SO IT CURRENTLY EXISTS, UH, WITHIN THE HOUSTON FIRE DEPARTMENT, AND IT IS A WAY THAT, UH, YEAH, PEOPLE WHO, YOU KNOW, DON'T NEED AN AMBULANCE AND PERHAPS DON'T EVEN NEED THE EMERGENCY DEPARTMENT, WELL, WE CAN STILL MEET THEIR NEEDS.
WE JUST DO IT IN A WAY THAT COSTS BOTH THE CITIZEN AND THE DEPARTMENT A WHOLE LOT LESS MONEY.
AND SO, UH, WHAT DOES IT CONSIST OF NOW, SOFTWARE PLATFORM IN TERMS OF PERSONNEL? UH, WHAT DOES IT CONSIST OF RIGHT NOW? SO THERE'S THE SOFTWARE PLATFORM THAT WE'VE GOT AND THERE'S, THERE'S, UH, THERE'S ACTUALLY TWO, THERE'S TEAMS AND THEN THERE'S SYNAPSE, AND THEY, YOU KNOW, WE'VE GOT 'EM SURE.
AND WE'VE GOT A, WE HAVE ONE PHYSICIAN ON MY STAFF WHO'S BASICALLY THE PROJECT MANAGER, DR. MICHAEL GONZALEZ.
HE'S BEEN WITH US SINCE WE STARTED THIS.
UH, HE HAS ONE ADMIN ASSISTANT, AND THEN WE'VE GOT, UH, AT THIS POINT WE HAVE ONE FTE IT PERSON THAT KEEPS THE SYSTEM RUNNING.
UH, ANY NURSES INVOLVED IN THE PROCESS? NO, NO.
WERE THERE NURSES INVOLVED, UH, AS CALL TAKERS? YES, WE DID.
WE TRIED, WE TRIED NURSES AND WE ACTUALLY TRIED SEVERAL DIFFERENT ITERATIONS OF, UH, USING NURSING FOR THIS, UM, WITH SEVERAL DIFFERENT NURSING ORGANIZATIONS.
THE PROBLEM WAS THAT THEY, THEY WERE SENDING BACK FOR AMBULANCE DISPATCH ABOUT 80% OF THE CASES.
AND SO NOW IT GOES DIRECTLY TO A DOCTOR.
SO NOW IT GOES TO A, WELL, NOT JUST A DOCTOR, THEY HAVE TO BE A, CURRENTLY WORKING IN THE EMERGENCY DEPARTMENT, EMERGENCY PHYSICIAN OR AN EMS PHYSICIAN LIKE MYSELF.
UH, MOST OF THEM ARE, THEIR FULL-TIME JOB IS WORKING IN LOCAL EMERGENCY DEPARTMENTS.
AND THEN THIS IS A PART-TIME HOURLY JOB FOR THEM.
AND SO IF CITY COUNCIL APPROVES THE LGC, UH, FOR WHAT IS TO BE CALLED ETHAN HEALTH, IS THAT RIGHT? THAT'S CORRECT.
IT WILL CONSIST OF WHAT IT'LL CONSIST OF.
THERE'LL BE, UM, A MANAGEMENT STRUCTURE, WHICH WILL BE PRETTY LEAN.
THERE'LL BE A PRESIDENT, THERE'LL BE SOME ADMINISTRATIVE FOLKS, AND THEN, UM, UH, THERE'LL BE A, UH, A CHIEF MEDICAL OFFICER AND THEN THE PHYSICIAN STAFFING MM-HMM
AND THERE'S GONNA BE SOME IT PEOPLE IN THERE TOO.
HAS THIS BEEN DONE BEFORE? ANYWHERE THAT YOU KNOW OF? UH, NOT LIKE THIS, NO.
SO THERE ARE OTHER MUNICIPALITIES WHO HAVE TRIED TO DO SOMETHING LIKE ETHAN.
UM, THEY, UH, THERE, UM, THEY HAVE LARGELY FAILED.
THERE HAVE BEEN A COUPLE OF PRIVATE, THERE'S BEEN NOT BEEN, IT HAS NOT BEEN DONE WHERE A MUNICIPALITY LIKE HOUSTON HAS CREATED AN LGC.
THERE HAVE BEEN SOME PRIVATE GROUPS THAT HAVE, HAVE TRIED DOING THIS.
I DON'T WANNA GET THIS TOO COMMON, BUT THERE IS A, THERE WAS A PROGRAM THAT CMS PUT OUT CALLED ET THREE, UH, WHICH MADE IT LOOK LIKE, UM, SOMETHING LIKE THIS WOULD, WOULD WORK.
AND, UM, SO A NUMBER OF PRIVATE, UH, GROUPS TRIED TO DO SOMETHING, BUT ET THREE THEN LOST ITS FUNDING.
AND SO THOSE COMPANIES ALL WENT AWAY.
[00:30:01]
BY, UM, STAFF FROM COUNCIL MEMBER THOMAS' OFFICE, VIRTUALLY.UM, COUNCIL MEMBER FLICKINGER CHIEF, FIRST OF ALL, THE GREAT EVENT SATURDAY EVENING.
UH, IT LOOKS LIKE YOU GUYS RAISED A TON OF MONEY, SO IT WAS A GOOD THING.
UH, I REMEMBER READING ABOUT THE ETHAN WHEN IT WAS FIRST COMING OUT.
AND, AND EVEN THOUGH YOU SAY 80% OF THE CALLS WHEN IT WAS GOING WITH THE NURSES WERE GOING BACK, YOU STILL ENDED UP SAVING 4% OF THE TOTAL.
SO I, I THOUGHT THAT WAS, YOU KNOW, A NICE REDUCTION.
UM, WE'VE GOT A COUPLE OF QUESTIONS.
ARE WE ABLE TO PARTNER WITH METRO ON ANY OF THESE RIDES? OR DO THEY, YEAH, SO, UM, METRO WOULD BE REALLY HELPFUL, PARTICULARLY WITH PEOPLE WHO NEED WHEELCHAIRS.
'CAUSE THEY'VE GOT THE METRO LIFT PROGRAM.
UH, THEY, I WOULD LOVE TO TALK TO THEM AGAIN.
LAST TIME WE TALKED TO THEM, THE ISSUE WAS THAT THEY WANTED 24 HOURS NOTICE FOR SCHEDULING.
AND OF COURSE IN OUR ENVIRONMENT THAT WOULDN'T WORK.
SO, I MEAN, I WOULD THINK THAT WOULD BE SOMETHING THAT AT A MINIMUM, IF THEY HAD THE AVAILABILITY AT THAT TIME, WE'D BE ABLE TO USE IT REGARDLESS OF THE 24 HOURS NOTICE ON THE AMBULANCE CALLS.
I ASSUME WE HAVE PRETTY GOOD TRACK OF WHEN THE CALLS COME IN DURING THE DAY, EACH DAY IS, IS THAT CORRECT? YEAH.
DOES OUR STAFFING MATCH THAT? THE ETHAN STAFFING? NO, THAT ACTUALLY JUST THE AMBULANCES COUNCIL MEMBER THAT, THAT'S A VERY HARD QUESTION.
THE ANSWER RIGHT NOW, AS I MENTIONED, WE HAD 600 SHORT, RIGHT? THAT WE'RE CONTINUOUSLY HAVING TO HOLD OVER PARAMEDICS, EMTS TO STAFF THOSE UNITS.
SO THIS WOULD BE A, IT WOULD BE A HUGE FORCE MULTIPLIER FOR US, SO WE CAN UTILIZE THAT.
BUT THE ANSWER TO THAT RIGHT NOW IS, AS I MENTIONED PRIOR, WE'RE 600 SHORT, NOW WE ARE HAVING FIVE CLASSES THAT WE'RE TRYING TO GET, YOU KNOW, THOSE NUMBERS UP TO MAKE IT EASIER FOR US.
BUT RIGHT NOW, YOU KNOW, WITH THE COVERAGE THAT WE HAVE OVER THE YEARS, THE NUMBER OF CALLS HAVE DOUBLED ON, YOU KNOW, WHAT THE NEEDS ARE FOR PEOPLE.
AND THOSE LOW ACUITY CALLS IF WE STARTED TO SEE AN INCREASE ON THAT.
SO THIS WOULD DEFINITELY BE A BIG, UH, FORCE MULTIPLIER FOR US.
BUT YEAH, THE STAFFING IS A, IS IS A CRITICAL PART ON WHY THIS WOULD BE A SUCCESS FOR THIS CITY AS WE GO ON TO.
AND THE, THE, UH, THE OTHER AREAS IS THE CONCERN TOO, AS I MENTIONED, YOU KNOW, US BEING A WORLD CLASS CITY, YOU KNOW, NEEDS A WORLD CLASS FIRE DEPARTMENT, ONE OF THE BIG THINGS THAT WE'RE LOOKING AT IS, AGAIN, WE'RE SEEING IN THE HORIZON WHAT'S ABOUT TO HAPPEN, RIGHT? WHICH WE DO HAVE MAJOR EVENTS COMING.
PEOPLE ARE WANTING TO COME TO HOUSTON NOW.
UH, THE WORLD CUP, THAT'S A BIG ONE THAT I KEEP ON TALKING ABOUT.
'CAUSE WE'RE LOOKING AT APPROXIMATELY 31 STRAIGHT DAYS OF SUPER BOWL TYPE CROWDS, RIGHT? UM, NOT TO MENTION THOSE THAT ARE OUT THERE.
SO WE'RE LOOKING AHEAD AS STRATEGIC PLAN ON WHAT THAT'S GONNA LOOK LIKE.
BUT STAFFING IS AN ISSUE THAT DOES HAVE AN IMPACT.
AND THIS WOULD BE, UH, ONE OF THE SOLUTIONS THAT COULD HELP.
WELL, OBVIOUSLY ETHAN, REDUCING NECESSARY RIDES, YOU KNOW, YOUR VOLUME GOES DOWN, HELPS YOU.
UM, IF WE LOOKED AT BRINGING ON ANY OUTSIDE RESOURCES DURING, I GUESS THE PEAK AMBULANCE CALL HOURS, THOSE ARE SOME DISCUSSIONS THAT WE'VE HAD.
AND WE'RE LOOKING AT WHAT THAT MODEL WOULD LOOK LIKE, BECAUSE I KNOW A LOT OF TIMES THEY'RE RESPONDING WITH A FIRETRUCK 'CAUSE THAT'S THE ONLY THING THERE.
BUT THAT'S AN EXPENSIVE PIECE OF EQUIPMENT.
THAT'S A VERY EXPENSIVE PIECE.
AND OF COURSE, THE TRANSPORT IS NOT THERE, RIGHT? YES.
COUNCIL MEMBER CARTER, THANK YOU.
WHAT A WONDERFUL PRESENTATION AND WHAT A WONDERFUL PROJECT.
I, YOU KNOW, I'M LOOKING AT 22 MILLION IN AMBULANCE SAVINGS SINCE 2014 AND, UH, 37,000 PATIENTS AS YOU'VE REPORTED.
ONE, UH, I THINK COUNCIL MEMBER FLICKINGER TOUCHED UPON THIS, UM, ON THE TAXI, THE LINE ITEM FOR TAXI.
WOULD THERE BE ANY CONSIDERATION FOR CONTRACT WITH RIDESHARE TYPE PROGRAM METRO, OR A DEDICATED FLEET EVEN? UM, BECAUSE I THINK LIKE, THIS IS A NO BRAINER.
I, I, YOU KNOW, I THINK ABOUT METRO'S BIG BUCKET OF MONEY OVER THERE, AND I THINK WE SHOULD TRY TO FIGURE THAT ONE OUT BECAUSE IT'S, IT'S A RELATIVELY, I SAY LOW COST FOR THE, FOR THE GAIN.
AND I, I MEAN, I THINK THERE'S SO MANY, SO MANY POSITIVES, BUT, YOU KNOW, I, UM, ARE THERE ANY RESOURCES OUT THERE, LIKE ANY GRANT TYPE FUNDING THAT YOU GUYS HAVE LOOKED AT OR CONSIDERED? UM, WELL, FROM A GRANT FUNDING STANDPOINT, I, I, I'VE BEAT EVERY GRANT FUND THAT I KNOW OF.
UM, AND THAT'S WHAT'S KEPT IT ALIVE FOR THE LAST, UH, 10 YEARS OR WHATEVER.
UH, BUT TO YOUR OTHER QUESTION ABOUT, UH, RIDE SHARE, SO YEAH, THAT'S, UH, YOU KNOW, THE LG DOESN'T, BUT I FULLY ANTICIPATE THAT THE LGC WILL TAKE ADVANTAGE OF, UH, OF RIDE SHARES AS A, AS AN ALTERNATIVE.
'CAUSE RIGHT NOW WE'RE USING ZTRIP, WHICH USED TO BE YELLOW CAB.
UM, AND THAT'S THROUGH A CONTRACT THROUGH HARRIS COUNTY RIDES.
UM, UH, BUT YEAH, AND AGAIN, THIS IS JUST ANOTHER EXAMPLE OF THE FLEXIBILITY THAT THE LGC WOULD HAVE, THAT WE AS A CITY OF HOUSTON HAVE TO GO THROUGH A LOT MORE.
[00:35:01]
UM, YOU KNOW, REGULATORY, I DON'T WANT, YOU KNOW, BUREAUCRACY NOT, I DON'T MEAN AS A BAD WORD, BUT, UH, YOU KNOW, WE MOVE A LOT SLOWER THAN THE LGC WILL BE ABLE TO.WELL, AGAIN, THANK YOU FOR YOUR GREAT PRESENTATION.
I THINK IT'S A, A GREAT OPTION AND SOLVES A, A SIGNIFICANT PROBLEM THAT WE HAVE.
AND I LOOK FORWARD TO EXPANDING.
AND YOU KNOW, AND I WANT TO, IF I CAN, I JUST WANT TO TALK ABOUT, TOUCH ON SOMETHING THAT, UH, COUNCILOR RAM MAYOR'S POINT TO SOME DEGREE.
YOU KNOW, WE, NOBODY'S EVER DONE IT LIKE THIS BEFORE, SO, YOU KNOW, WE THINK WE'VE REALLY THOUGHT THIS THROUGH.
UM, AND THE, THE SPREADSHEETS YOU HAVE ARE VERY CONSERVATIVE.
WE'VE HIGH BALLED THE EXPENSES AND WE'VE LOW BALLED THE REVENUES, UM, ON PURPOSE.
SO HOPEFULLY THE, YOU KNOW, YOU KNOW, FIVE YEARS FROM NOW WE LOOK BACK, THE PICTURE WILL ACTUALLY BE BETTER.
BUT, BUT YOU KNOW, TO YOUR POINT, UH, THE, THE, TO YOUR QUESTION, THE OTHER PRIVATE ENTITY ENTITIES THAT TRIED TO DO THIS, THEY DID IT BASED ON THAT C-M-S-E-T THREE PROGRAM, WHICH, IF YOU WANT, WE CAN TALK ABOUT IT, TAKE A LONG TIME TO EXPLAIN, BUT THAT FAILED.
AND THEN MEDICAID AND MEDICARE STOPPED FUNDING THAT.
AND SO THOSE ALL BASICALLY WENT AWAY.
UM, AND SO, YOU KNOW, SO AT THIS POINT WE DON'T, YOU KNOW, UH, BECAUSE BECAUSE OF OUR SUCCESS, AND I DON'T WANNA GIVE AWAY TOO MUCH SECRET SAUCE 'CAUSE THAT WOULD BE A DUMB THING TO DO.
UM, WE THINK WE'VE GOT A REAL PATH TO SUCCESS HERE THAT OTHERS DON'T.
AND IF I MAY, COUNCIL MEMBER CARTER, UM, LOOKING AT THE MODEL THAT, YOU KNOW, WE'VE HAD A GREAT WORKING RELATIONSHIP AND A GREAT DIRECTOR PAEZ, UM, WE LOOK AT THE MODEL THAT'S BEEN USED, YOU KNOW, DURING THE STORMS, YOU KNOW, WHERE WE HAD THE RIDE SHARE AND WE HAD THE ZTRIP MODEL.
I, YOU KNOW, I HAVEN'T TALKED TO DOCK AT LENGTH.
THIS IS WHEN YOU BROUGHT UP THAT QUESTION THAT GOT ME TO THINKING THAT HE WAS UTILIZING THAT MODEL AND GETTING THOSE CONTRACTS TOGETHER IS DEFINITELY ONE THAT, UM, THAT WE, WE WOULD DEFINITELY TALK ABOUT.
DIRECTOR PAEZ HAS BEEN VERY HELPFUL WITH THAT PROCESS DURING THE, YOU KNOW, DURING OUR STORMS TIMES.
AND SO I THINK THAT'S SOMETHING THAT WOULD DEFINITELY BE DISCUSSED AND HOW TO DO THAT.
AND I CAN TELL YOU THAT, UM, IT'LL DEFINITELY, UH, IS A MODEL THAT WOULD WORK.
SAID, DR PER, THIS IS SOMETHING THAT'LL DEFINITELY, UM, PUT US AT THE NEXT LEVEL FOR, FOR THE, FOR THE CARE THAT THE RESIDENTS DESERVE.
UM, AND THANK YOU FOR THE PRESENTATION.
UM, GREAT PROGRAM, UM, BENEFICIAL GENERATES RESOURCES.
AND SO, UM, MY QUESTION IS CURRENTLY THE ETHAN PROGRAM, YOU SAID THAT THE FUNDING ENDS IN 20 FEBRUARY, 2025.
SO HOW ARE YOU PLANNING ON ROLLING OUT THIS PROGRAM? IS IT ALREADY, UM, 'CAUSE IT'S COMING TO COUNCIL THIS MONTH, RIGHT? AND SO WHAT, AND WITH ANY BUSINESS YOU, YOU KNOW, IT TAKES TIME TO GET THINGS KICK STARTED OFF.
SO HOW DO YOU PLAN ON FUNDING THE, UM, ROLLOUT OF IT? YEAH, A GREAT QUESTION.
UM, AND I'M NOT A GREAT FINANCE PERSON, SO I'M GONNA GIVE YOU THE BEST ANSWER I KNOW.
SO WE, WE NEED TO HAVE IT CREATED.
THE BOARD NEEDS TO, TO MEET, THEY NEED TO, UH, DECIDE WHAT POSITIONS THAT THEY'RE GONNA HAVE.
YOU KNOW, IN TERMS OF THE EMPLOYEES THAT ARE GONNA NEED TO POST US POSITIONS, HIRE PEOPLE.
WE BELIEVE NOW, BECAUSE WE'RE NOT THE LGC, I CAN'T SPEAK FOR THEM, BUT AS WE WILL ADVISE THE LGC, WE HAVE A, WE HAVE A PLAN SO THAT THERE WILL BE NO INTERRUPTION IN, IN, IN CARE PROBABLY AT THE END OF A CITY OF HOUSTON PAY PERIOD.
ETHAN, AS WE KNOW IT TODAY, WILL END AT, YOU KNOW, MIDNIGHT THAT NIGHT AND AT, YOU KNOW, 10:00 AM THE NEXT MORNING THAT ETHAN LGC WILL PICK UP.
WE DON'T, WE WANT THERE TO BE NO INTERRUPTION IN SERVICE TO THE HOUSTON FIRE DEPARTMENT.
UM, SO YEAH, SO WE NEED TO HAVE THE LGC CREATED, YOU KNOW, FIRST AND FUNDED AND THEN, YOU KNOW, START MOVING DOWN THE ROAD.
AND SO WHAT'S THE TURN TIME ON CREATING THE LGC? SO WE BELIEVE IT'S GONNA GO TO COUNCIL FOR YOU GUYS ON THE 23RD, AND IF YOU VOTE ON IT, THEN AS SOON AS YOU VOTE YES, IT EXISTS.
THE, THE NEXT UM, THING IS GONNA BE THE DOCUMENT FOR THE, UH, THE AGREEMENT, THE INTER LOCAL AGREEMENT THAT WILL DEFINE THE RELATIONSHIP BETWEEN THE CITY AND, AND THERE'S ALREADY GONE THROUGH CITY LEGAL AND, AND THE LGC.
AND THOSE WILL SORT OF SET THE, THE GUIDE RAILS AND THEN THE LGC HAS TO GET TO WORK ON.
AND ALSO IT HAS TO GO TO THE STATE ATTORNEY GENERAL'S OFFICE AND THEY HAVE TO APPROVE IT.
THEY'VE GOT 30 DAYS TO DO THAT DURING WHICH TIME THE LGC CAN START, YOU KNOW, HAVING MEETINGS, THE BOARD CAN START HAVING MEETINGS AND SETTING UP THEIR BUSINESS PLAN.
WE'VE GOT SORT OF A STRAW MAN BUSINESS PLAN FOR 'EM, BUT AT THE END OF THE DAY THAT IT WILL BE UP TO THEM.
UH, THANK YOU MADAM CHAIR AND DR.
UH, FEW MORE QUESTIONS WITH REGARD TO THE INSURANCE PROVIDERS.
CAN YOU EXPLAIN TO US HOW THEY'LL, UH, HOW THEY'LL FIGURE INTO THIS PROCESS? INSURANCE PROVIDERS? SURE.
SO THE INSURANCE PROVIDERS, UM, UH, WE HAVE A WAY, AGAIN, THIS IS PART OF THE SECRET SAUCE, BUT WE HAVE A WAY TO WORK WITH THEM SO THAT WHEN SOMEBODY CALLS AND, UM, THEY GIVE US THEIR NAME AND ADDRESS AND SO ON AND SO FORTH, WE'LL BE ABLE TO KNOW WHAT THEIR INSURANCE PROVIDER IS.
IF THAT INSURANCE PROVIDER HAS ENTERED INTO AN AGREEMENT WITH US, WE'LL THEN KNOW, UM, WHERE THAT INSURANCE PROVIDER WOULD PREFER THE PERSON WENT.
NOW THE PERSON GETS TO MAKE THE FINAL CALL, PROVIDED
[00:40:01]
THAT WHAT THEY WANNA DO IS MEDICALLY APPROPRIATE, BUT WE WILL ADVISE THEM THAT, YOU KNOW, WITH YOUR INSURANCE, IT WOULD PROBABLY BE BETTER OFF IF YOU WENT HERE THAN THERE.WE'VE HAD AN AGREEMENT WITH ONE, UH, PROVIDER ALREADY.
AND SO I'VE, I'VE WORKED THIS, YOU KNOW, ETHAN, MYSELF, AND I FIND THAT ABOUT, UH, AT LEAST 80% OF THE TIME THEY SAY, OH, REALLY? OKAY, GREAT.
UM, ABOUT 15, 20% OF THE TIME THEY SAY, I DON'T CARE.
I'VE BEEN GOING TO THIS HOSPITAL MY WHOLE LIFE.
I DON'T CARE THAT IT'S IN NETWORK OR NOT, I WANNA GO BACK THERE.
THAT'S, THAT'S WHERE YOU'RE GOING.
SO IF IT'S MEDICALLY APPROPRIATE, THE PATIENT STILL MAKES THE FINAL CALL.
WE JUST ADVISE THEM THAT IT MAY, YOU KNOW, BE FINANCIALLY BENEFICIAL FOR THEM AND THEY'LL GET LESS OF A COPAY AND THEY'RE THRILLED TO FIND OUT ABOUT THAT 'CAUSE THEY DIDN'T KNOW THAT.
SO, UM, ETHAN WILL WORK WITH THE INSURER TO DETERMINE WHERE THE PATIENT WILL BE TAKEN, ESSENTIALLY.
WELL, WHERE WE CAN OFFER THE PATIENT.
WE'RE NOT GONNA OFFER THE PATIENT OFFER.
THE PATIENT INSURE DOES NOT TELL THE PATIENT WHERE TO GO.
WE JUST, YOU KNOW, WE JUST EDUCATE THEM AS THEIR OPTIONS.
AND YOU ALREADY HAVE AN AGREEMENT WITH ONE INSURER, IS THAT, IS THAT WHAT YOU SAID? WE'VE ALREADY DONE THIS WITH ONE AND IT WAS ON PURPOSE.
WE PICKED ONE AND WE DID IT AS A PILOT TEST TO SEE IF WE COULD WORK IT OUT.
NOW ALSO ON, UH, ONE OF YOUR SLIDES, I SEE AD FEES, UH, PAID FOR BY CLINICS FEATURED ON ETHAN.
CAN YOU TELL US ABOUT THAT? I'M SORRY, WHERE WERE YOU LOOKING AGAIN? UM, I, I DON'T HAVE, OH YEAH, I DON'T THINK IT'S SLIDE EIGHT.
SLIDE EIGHT AD FEES FOR CLINICS FEATURED ON ETHAN REVENUE STREAMS IN REVENUE SHARES.
I'M SORRY, COUNCIL, I GUESS I DON'T UNDERSTAND.
I GUESS ACTUALLY I'M NOT HEARING THE QUESTION, BUT IT'S CLEARLY BECAUSE THE, OH, I'M SORRY.
THIS DEALS WITH, UH, REVENUE STREAMS, REVENUE STREAM, FAR RIGHT SIDE OF THE, THERE WE GO.
SLIDE IT SAID, OH, THERE YEAH, YEAH, YEAH, YEAH.
AD FEES FOR CLINICS FEATURED ON ETHAN.
CAN YOU TELL US ABOUT THAT? YEAH, YEAH.
SO, SO THIS IS, UM, THIS IS WHERE WE GET TO USE OUR, WE DON'T HAVE ANYTHING SPECIFIC LINED OUT HERE, BUT THIS IS WHERE, AS AN LGC, THERE MAY BE OTHER WAYS THAT THEY CAN BRING IN MONEY.
AND SO I USE THE ONE EXAMPLE, UH, SO THE, THE CLINICS, THERE'S TWO EXAMPLES I GIVE.
ONE IS THAT THE CLINICS, THERE MAY BE A WAY THAT WE CAN HELP THEM ADVERTISE THEIR SERVICES, PERHAPS, UH, THROUGH ETHAN.
SO THAT WOULD BE A, A POSSIBLE REVENUE STREAM FOR THEM.
BUT, YOU KNOW, OTHERS, THERE ARE OTHER CREATIVE WAYS THAT WE CAN USE THIS PHYSICIAN INTERACTION.
UM, AND THE OTHER EXAMPLE I GAVE WAS WITH, IN THE SITUATION WITH HOSPICE.
SO THAT'S KIND OF AN ODD ONE, BUT, UM, IT WAS TRIED IN ANOTHER CITY.
IT, IT ACTUALLY WORKED OUT PRETTY WELL WHERE, UH, WHEN WE GOT ON SCENE FOR A HOSPICE CASE, NORMALLY YOU JUST TAKE THAT PATIENT AND TAKE 'EM TO THE HOSPITAL BECAUSE THE, THE, YOU KNOW, THE FAMILY IS PANICKING OR, OR WHAT HAVE YOU.
THAT'S THE MOST COMMON THING IS THE PATIENT.
YOU KNOW, THEY'RE IN HOSPICE FOR A REASON, RIGHT? AND THE FAMILY GETS SCARED AND WHEN THAT HAPPENS, THEY GO TO THE HOSPITAL.
THEN THE, THE, THE CONTRACT WITH THE HOSPICE ORGANIZATION TERMINATES.
SO THE HOSPICE ORGANIZATION, UM, AND WHAT OUR COLLEAGUES IN THE OTHER CITY THAT TRIED THIS FOUND OUT WAS THAT AFTER THE FACT, THE FAMILIES WERE VERY UPSET 'CAUSE THEY DIDN'T KNOW THAT THE HOSPICE RELATIONSHIP TERMINATED.
THE FAMILY MEMBERS BACK IN THE HOSPITAL, THEY CAN'T BRING 'EM HOME AGAIN 'CAUSE THEY DON'T HAVE HOSPICE ANYMORE.
AND SO, UH, WHAT THEY TRIED DOING WAS WORK WITH THE HOSPICE, AND THE HOSPICE WAS ABLE TO GET INVOLVED REAL TIME WITH THE NINE ONE CREW ON SCENE AND, YOU KNOW, HELP THE FAMILY THROUGH IT.
SOMETIMES THEY STILL WENT TO THE HOSPITAL, SOMETIMES THEY STAYED BEHIND.
BUT UNIFORMLY THE FAMILY SOMEHOW SAID, OH, THAT WAS A, THAT WAS A BENEFIT TO US.
WE'RE REALLY GLAD THAT THAT HAPPENED.
UM, AND THE HOSPICE COMPANIES ARE, OF COURSE, THEY'VE GOT IN A FINANCIAL, FINANCIAL INCENTIVE TO, TO CONTINUE HAVING THAT CLIENT.
SO THEY MADE THEMSELVES AVAILABLE 24 7 FOR THAT INTERACTION, SHOULD THEY NEED IT.
BUT I DON'T, I'M NOT SAYING THAT'S WHAT THE LG C'S GONNA CHOOSE.
THAT THERE ARE, THERE WE CAN USE OUR, OUR IMAGINATION HERE AND GET CREATIVE WITH OTHER WAYS THAT WE CAN SIMULTANEOUSLY SERVE THE PUBLIC IN THESE UNIQUE DIFFICULT, YOU KNOW, SITUATIONS THAT THEY'RE IN.
BECAUSE WE NOW, WE, WELL, FOR ONE THING, WE'VE GOT A PHYSICIAN WHO'S INVOLVED, WHO UNDERSTANDS EMERGENCY CARE NETWORK AND, UM, AND WE'VE GOT OTHER RESOURCES COME TO BEAR IN TERMS OF TRANSPORTATION AND CLINICS AND SO ON AND SO FORTH THAT NORMALLY WOULDN'T BE THERE FOR MOST EMS AGENCIES.
SO REALLY ALL THAT, THAT THING ON THE FAR RIGHT IS JUST, IT IS A, YOU KNOW, POINT OUT THAT, UH, THAT THERE ARE OTHER EVEN YET UNIMAGINED POTENTIAL, UH, REVENUE STREAMS TO HELP OUT.
AND I, I, I'LL BE HONEST WITH YOU, I DON'T THINK ANY OF THOSE IS GONNA BE A BIG MONEY MAKER.
BUT WHAT I REALLY SEE IS, AGAIN, YOU KNOW, AND I USE THE EXAMPLE OF THE HOSPITAL BEING LIKE, THAT'S A HORRIBLE SITUATION FOR PEOPLE TO BE IN.
AND IF WE CAN HELP THEM MAKE IT THROUGH THAT A LITTLE BIT MORE EASILY, YOU KNOW, EVEN IF WE ONLY BREAK EVEN ON IT SORT OF THING TO DO.
I, I JUST HOPE IF, IF, UH, CERTAIN CLINICS ARE FEATURED IN ADS AND OFFERED TO, UH, CUSTOMERS THAT THERE BE SOME VETTING, UH, PRIOR, PRIOR TO THAT HAPPENING.
IN ADDITION, ONE OF THE, ONE OF
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THE MEMBERS OF THE BOARD OF DIRECTORS COMES FROM THE CLINIC INDUSTRY, THE HEALTHCARE CLINIC INDUSTRY LOCALLY.SO WE'LL HAVE EXPERTISE THERE ON THE BOARD TO HELP NAVIGATE THAT SHOULD WE DECIDE TO GO THAT WAY.
OR SHOULD THEY DECIDE TO GO THAT WAY? I KEEP, I KEEP TALKING LIKE, THANK YOU.
COUNCIL MEMBER FLICKINGER, EARLIER WE TALKED ABOUT THE, UH, COST OF THE AMBULANCE.
I THINK $2,100 IS THE FIGURE AND THEN THERE'S INCREMENTALS POSSIBLY BEYOND THAT.
I, IS THAT THE COST TO THE FIRE DEPARTMENT WHEN YOU BREAK DOWN THE NUMBER OF RIDES VERSUS THE MONEY SPENT? OR IS THAT ACTUALLY WHAT WE'RE CHARGING THE USER FOR THAT RIDE OR BOTH USE FOR THAT RIDE FOR REST THE CITY ORDINANCE? THAT'S NOT, IT'S THE USE FOR THE RIDE, SIR.
IT'S THE USE FOR THE RIDE THE TRANSPORTATION.
THE FIRE DEPARTMENT IS, IS 2100 BUCKS.
WELL IT'S, IT'S THE COST THAT, YOU KNOW, FOR THE TRANSPORTATION THAT WE DO, BUT OBVIOUSLY THERE'S A LOT MORE INVOLVED IN THAT.
TO INTEGRATE THAT, THAT VALUE $2,100, IT'S IN CITY ORDINANCE.
AND THAT WAS WHENEVER THAT ORDINANCE WAS PASSED AT THAT LEVEL, THAT WAS BASED ON A STUDY OF WHAT IT COST THE FIRE DEPARTMENT TO, TO TRANSPORT.
I DON'T KNOW, THAT MAY BE 2, 3, 4 YEARS OLD.
BUT AT THE TIME, THAT WAS THE CALCULATED COST TO THE FIRE DEPARTMENT.
THAT'S WHERE THAT NUMBER CAME FROM.
IS THAT WHAT WE CHARGED THE END USER? YES.
UM, IF THIS WAS DONE THREE OR FOUR YEARS AGO, I ASSUME OUR COSTS HAVE ESCALATED.
UM, BUT I ALSO UNDERSTAND THAT THE MEDICARE AND MEDICAID REIMBURSEMENTS ARE BASED UPON, UH, WHAT IS IT NORMAL AND CUSTOMARY OR WHATEVER THE TERM THERE IS THAT THERE IS THAT PERIMETER, SIR, THAT, UH, COUNCIL MEMBER THAT IF IT'S NOT MET YOU KNOW THAT THAT'S THE CHALLENGE SOMETIMES THAT, YOU KNOW, OBVIOUSLY WHEN THEY CALL AND THEY NEED THAT TRANSPORT OR THEY NEED THAT SERVICE AND WE HAVE NO OTHER OPTION, ETHAN WOULD GIVE US THAT OPTION TO TALK TO, TO TALK TO THE, UH, THE RESIDENT WHO, WHO CALLED US.
UH, AND IF WE DO TRANSPORT, AND IF THAT CRITERIA IS NOT MET, THEN OBVIOUSLY WE DON'T GET PAID FOR THAT.
AND, AND I ASSUME THAT THE CITY OF HOUSTON IS THE DRIVER OF THAT NORMAL AND CUSTOMARY FOR THIS AREA BECAUSE WE ARE DOING THE MOST RIDES.
SO IF OUR COST HAVE GONE UP AND WE ACTUALLY CHARGE THE END USER MORE, THE REIMBURSEMENTS FROM MEDICARE, MEDICAID WOULD ALSO INCREASE BECAUSE THAT COST HAS BEEN DRIVEN UP AS THEORETICAL THE CUSTOMER.
BUT, BUT THEY DO HAVE THEIR, THEY DO HAVE THEIR, THEIR PERIMETERS TOO, RIGHT.
YOU CAN CAP UP AND IF WE RECOUP, IF WE'RE FORTUNATE TO RECOUP, AND A LOT OF TIMES YOU'LL SEE IT'S ONLY 40% OF, OF THE TOTAL COST.
IS, HAS ANYBODY GIVEN ANY CONSIDERATION TO ON WHAT WE ARE CHARGING THE END USER USING CPI EVERY YEAR? THAT'S SOME AREAS THAT WE'RE GONNA START LOOKING AT TOO, SIR.
TRYING TO MAKE SURE THAT WE'RE CAPTURING EVERYTHING THAT WE CAN GET, YOU KNOW, AS, AS A COST SAVINGS FOR US OR COST BENEFIT.
AND I MEAN, ONE OTHER THING, WHEN IT WENT TO 2100, THAT WAS, AT THAT POINT, THAT WAS A BIG JUMP BECAUSE, UH, THAT DELEGATION HADN'T BEEN DONE IN A LONG TIME.
SO GOING BACK IN THE HISTORY OF IT, AND I DON'T HAVE THIS, I'M, I'M THE DOCTOR, I DON'T KNOW ALL THE FINANCIAL STUFF THAT WELL.
UH, BUT I KNOW THAT WHEN WE WENT TO 2100, THAT WAS A BIG INCREASE FROM WHAT IT HAD BEEN BEFORE BECAUSE IT HADN'T BEEN CALCULATED IN A LONG TIME.
I, I, IF I RECALL CORRECTLY, AND SALLY PROBABLY KNOWS BETTER THAN ANYBODY ELSE HERE, I THINK IT ABOUT DOUBLED THE PRICE.
I WOULD THINK THAT THE PUBLIC WOULD PROBABLY BE CONSIDERABLY MORE RECEPTIVE TO KIND OF A CPI BUILT INTO IT, RATHER THAN HAVING THESE HUGE INCREASES EVERY DECADE.
UM, AND IT WAS MY IMPRESSION THAT THE ACTUAL COST TO THE CITY WAS, WAS MORE THAN THAT.
UM, WHAT WE COULD CHARGE, BUT MAYBE I'M NOT REMEMBERING THAT CORRECTLY.
WE BY, DO WE HAVE TO CHARGE EXACTLY WHAT IT, WHAT IT COSTS US? I MEAN, I THOUGHT OUR COSTS WERE MORE AND WE WERE CHARGING LESS.
SO ONE OF THE THINGS THAT WE LOOK AT COUNCIL MEMBER IS, YOU KNOW, WHAT'S ALLOWED.
AND THAT WAS THE NUMBER ALLOWED FOR US, YOU KNOW, AND OF COURSE WE CAN ALWAYS ADD MORE AND, YOU KNOW, AND THAT, AND THAT HONESTLY, WHEN YOU LOOK AT THE TRANSPORTATION AND THEN YOU LOOK AT EVERYTHING ELSE, ALL OUR COSTS OF FIREFIGHTERS AND WHEN KIND OF THE ALL IN COST OF WHAT IT TAKES TO SEND AN YES.
COUNCIL MEMBER, UH, JACKSON ASKED SOME QUESTIONS, WHICH PIQUED MY INTEREST ABOUT THE FUNDING FOR THIS.
I AM, I DID SAY 28 MILLION BRINGING IN, BUT I SEE THE NET IS 9 MILLION IN FIVE YEARS.
NOT, DON'T WANNA CONFUSE ANYBODY OUT THERE THINKING WE'RE GONNA GET 27 MILLION, BUT, UH, IS THE, IN THE SUB YEAR, THE $2.4 MILLION, IS THAT ALREADY INCLUDED IN THE FIREFIGHTER BUDGET? UH, FOR THIS YEAR? I MEAN, UH, SOME OF THAT'S CAPITAL EXPENSE.
IT LOOKS LIKE A LOT OF OPERATING EXPENSE.
I MEAN, DO WE HAVE THAT BUDGET AT ALREADY OR IS THAT ADDITIONAL FUNDS? I DON'T BELIEVE SO.
AND I KNOW WE GOT ROCHELLE MCHENRY HERE, BUT THAT I HAVEN'T SEEN THAT BUDGET.
SO THAT LINE ITEM, ADDITIONAL, ADDITIONAL $2.4 MILLION
[00:50:02]
THAT WE WILL NEED IN FISCAL YEAR 2025 TO SET THIS UP AND NEXT YEAR THAT NUMBER IS 3.6 MILLION, WHICH WILL BE FACTORED INTO OUR FY 26 BUDGET, CORRECT? CORRECT.I JUST WANNA MAKE SURE WE'RE, WE'RE, WE'RE CLEAR ON THAT'S ADDITIONAL FUNDING THAT WILL BE NEEDED THIS FISCAL YEAR.
YEAH, AND AND TO YOUR POINT, YOU KNOW, WITH THE, THE EXPECTED EXPECTED EXPENDITURES, WE, YOU KNOW, WE PUT IN THE BUDGET MM-HMM.
WE MAKE THE REQUEST FOR THE FULL AMOUNT AND THEN WHEN REVENUES COME IN TO OFFSET THAT.
BUT YOU, WE, WE ALWAYS REQUEST THE FULL AMOUNT ASSUMING THERE'S ZERO REVENUES.
IT'S, IT'S JUST THE WAY THE CITY ALWAYS DOES THINGS AND IT DOESN'T, IT, IT, IT LOOKS LIKE, UM, NO NET PROFIT IN THE FIRST, THE SUB YEAR PLUS THE FIRST TWO YEARS.
AND THEN YOU START GETTING INTO PROFIT IN THE, IN THE NEXT YEARS.
AND, AND AGAIN, SOME OF THAT IS, YOU KNOW, THERE'S A, SOME CAPITAL PURCHASES, SO NOT ALL OF THAT IS, WOULD HAVE TO BE ADDED TO THE OPERATING BUDGET, BUT, BUT I'D LIKE TO GET, UM, IF I COULD, A FINAL FIGURE ON WHAT WILL NEED TO BE ADDED TO THE FISCAL YEAR 2025 BUDGET IF WE, UM, ADOPT THIS.
UH, DOCTOR, JUST FOLLOWING UP HERE, THE, UH, LGC BOARD WILL BE SELECTED.
SO THE MAYOR HAS APPROVED THE NAMES ON THAT LIST.
MAYOR WILL NOMINATE, CITY COUNCIL WILL APPROVE OR NOT APPROVE.
I BELIEVE THAT'S WHEN YOU VOTE ON, UH, YOU'LL BE APPROVING THAT BOARD.
UM, LET ME ASK YOU ABOUT, UM, SLIDE NUMBER 11.
UH, SO THE CITY GETS, DO YOU HAVE THAT IN FRONT OF YOU? SLIDE 11, I'M SORRY, SLIDE 11.
UH, FIRST BULLET POINT, HOUSTON, UH, RECEIVED THE CITY RECEIVES $450,000 LICENSE FEE, UH, AND SO FORTH.
SECOND BULLET POINT AFTER THE MILESTONE OF THE FIRST BULLET IS REACHED, SO I GUESS THAT'S THE FOUR 50 LICENSE FEE.
UH, ETHAN HEALTH, LGC WILL PAY 100% OF ITS NET REVENUES TO THE CITY.
AND THEN THIRD BULLET POINT SAYS, ETHAN HEALTH, LGC AND CITY OF FUSION WILL BEGIN TO SHARE NET REVENUES ONCE THE MILESTONE IN THE SECOND BULLET POINT IS MET.
WHAT, WHAT IS THE MILESTONE IN THE SECOND BULLET POINT? WHAT'S THAT REFERRING TO? SO THE, THE MILESTONE, THE FIR FIRST BULLET POINT THEY REFER TO IS ONCE THE LGC HAS ACCUMULATED 12 MONTHS OF OPERATING BUDGET, UM, OR THE FIFTH YEAR.
SO THAT'S THE BULLET IN THE, THAT'S THE M IN THE FIRST BULLET.
THE, THE SECOND BULLET IS, UM, YOU KNOW, WELL ONCE WE HIT THE, THE FIRST MILESTONE, THEN IT'LL BE 100% OF THE REVENUE AFTER THAT.
SO AFTERWARDS, AS IF, UM, MORE REVENUES COME IN, UM, THEY WILL JUST CONTINUE TO BE SHARED WITH THE, WITH THE CITY.
UNLESS THE CITY WANTS TO HAVE SOME OTHER SORT OF ARRANGEMENT.
IS THERE A MILESTONE IN THE SECOND BULLET POINT? UH, NOT REALLY.
IT'S REALLY, IT'S THE, THE FIRST BULLET, MAYBE THAT'S A, MAYBE WE DIDN'T TYPE THAT PROPERLY, BUT REALLY IT'S THAT, THAT'S THAT MILESTONE AND IT'S IN THE FIRST BULLET.
WHICH IS 12 MONTHS OF OPERATING BUDGET OR THE FIFTH YEAR.
AND I GUESS THAT'S IF WE GET TO THE FIFTH YEAR AND WE DON'T HAVE THE 12 MONTHS OF OPERATING BUDGET.
IF WE'RE AT THAT POINT, THAT'S WHEN I THINK, WE'LL THE, IT'S THE CITY AND THE LGCL NEED TO TALK ABOUT HOW MUCH REVENUE COMES OVER TO THE CITY.
IF WE COULD GO TO SLIDE 12, THAT'D BE THE NEXT ONE.
UM, OKAY, NEXT TO LAST CATEGORY, IT SAYS, NUMBER OF ETHAN SPONSOR DIRECTED VISITS.
WOULD, WOULD THESE BE, UH, VISITS TO CLINICS, UM, SUGGESTED BY THE INSURANCE COMPANY AND APPROVED BY THE CUSTOMERS? YOU SEE THAT? SORRY, I'M TRYING, I'M SEEING IF I CAN FIND THE ANSWER FOR YOU HERE.
SEC, SECOND TO LAST LINE, NUMBER OF ETHAN SPONSOR DIRECTED VISITS.
YEAH, YOU KNOW, I'M GONNA HAVE TO GET BACK TO YOU ON THAT ONE.
AND JUST, UH, I, FINISHING UP HERE, UH, WHO, WHO DID Y'ALL WORK WITH IN LEGAL ON, UM, SETTING THIS UP? UH, SO RACHEL GREER WAS THE PRIMARY ATTORNEY THAT WE WORKED WITH GREER, BUT THERE WERE OTHERS AS WELL.
THANK YOU FOR YOUR WORK ON THIS.
COUNCIL MEMBER FLICKINGER, I'VE GOT A QUESTION ON THE STARTUP COST.
ETHAN'S CURRENTLY RUNNING TODAY, CORRECT? THAT'S RIGHT.
THE WAY I SEE THIS, THIS IS A BRANDING AND A CHANGE OF ENTITY, BUT ESSENTIALLY I'VE GOT THIS PRODUCT THAT'S IN EXISTENCE TODAY AND RUNNING TODAY GONNA HAVE THE SAME PRODUCT TOMORROW
[00:55:01]
THAT'S GONNA BE RUNNING, BUT I'VE CHANGED THE NAME AND CHANGED THE ENTITY AS TO, YOU KNOW, HOW IT'S DESCRIBED MM-HMMBUT WHY ALL THE STARTUP COSTS? UH, SO WELL THE STARTUP COSTS, 'CAUSE CURRENTLY WE'RE RUNNING OFF OF GRANT FUNDS, SO THEY'RE NOT GENERAL FUND DOLLARS.
SO WE MOVE FORWARD, WE NEED GENERAL FUND DOLLARS TO SO THE STARTUP COSTS ARE REPLACING THE GRANT FUNDS? EXACTLY.
UM, AND WE'RE ALREADY SAVING MONEY WITH ETHAN EXISTING.
SO IF WE DIDN'T BACKFILL THE LOSS OF THE GRANT FUNDS, WE WOULD NO LONGER AND ETHAN WASN'T RUNNING, WE'D NO LONGER HAVE THOSE SAVINGS EITHER.
AND REMEMBER THOSE ARE PREDOMINANT, THOSE AREN'T, YOU KNOW, IT'S NOT ON SPREADSHEET THOSE SA THOSE SAVINGS IT'S OPERATIONS.
I MEAN, IF, IF THE FIRE DEPARTMENT RUNS FEWER CALLS YEAH.
THE FIRE DEPARTMENT HAS FEWER, FEWER EXPENSES ASSOCIATED WITH EXACTLY REDUCED CALLS, SO, OKAY.
THERE IS NO ONE ELSE IN THE QUEUE, SO WE WILL MOVE ON TO OUR PUBLIC SPEAKERS.
THANK YOU AGAIN SO MUCH FOR THE PRESENTATION.
UM, EACH SPEAKER WILL HAVE THREE MINUTES AND OUR SPEAKER, TAY, OLIVIA, VERDI.
UM, SO I CAME HERE TODAY TO ACTUALLY SPEAK ABOUT THE PLIGHT OF THE HOMELESS, BUT UM, IN LISTENING TO THE LAST SPEAKERS, I HAVE A LOT OF QUESTIONS REGARDING FISCALLY, HOW THIS IS GONNA HAVE AN IMPACT ON THE TAXES, IF YOU WILL.
UM, BECAUSE THERE ARE A LOT OF OTHER COUNTRIES THAT HAVE PROGRAMS THAT ARE EFFICIENT SUCH AS THIS, A LOT OF SCANDINAVIAN COUNTRIES.
I ACTUALLY TOOK A LOOK AT A VIDEO LITERALLY EARLIER THIS WEEK REGARDING THIS SPECIFIC ISSUE.
UM, AND, AND ALSO LIKE WHEN IT COMES TO THE ABILITY TO SPEAK DIRECTLY WITH THE PROVIDER, IT ALSO TAKES AWAY THE AUTONOMY THAT AN INDIVIDUAL HAS WHEN IT COMES TO DETERMINING WHAT PROVIDER THEY SPEAK TO, WHAT PROVIDER THEY GO TO.
DOES THE BURDEN OF THEN, UM, TAKING CARE OF THE PAYMENT LAY ON THAT INDIVIDUAL ALSO THROUGH THE LENS OF HIPAA? I'M WONDERING HOW THEY'RE GOING TO DO THIS IN A WAY THAT'S HIPAA COMPLIANT AS FAR AS TRANSPORTATION GOES, UBER, LYFT, UM, TRANS GO, THERE ARE LIKE A MYRIAD OF APPLICATIONS THAT ARE OUT THERE THAT ARE ALREADY DOING THE NON-EMERGENCIES.
SO WHEN IT COMES TO THE WAY THAT THIS APPLICATION WORKS AND THIS BOASTING OF SOME SORT OF PURPORTED PROFIT THAT WE'RE GONNA RUN, I QUESTION THE LOGISTICS BEHIND IT.
I REALLY WOULD LIKE TO SEE TRANSPARENTLY HOW WE EXPECT TO SEE PROFITS RUN WHILE KEEPING HIPAA COMPLIANCE, WHILE MAINTAINING THE, WHILE, WHILE UNDERSTANDING THAT WE HAVE PATIENTS THAT ARE ALL OVER THE SOCIOECONOMIC SPECTRUM.
SO I COME FROM PRIVILEGE, I KNOW WHAT THAT SIDE IS LIKE NOW I'M ON THE OTHER SIDE HAVING NO PRIVILEGE.
I CAN'T EVEN IMAGINE LIKE BEING IN LIKE, YOU KNOW, I, I CAN'T IMAGINE HOW THAT LOGISTICALLY IS GONNA WORK, BUT I'LL TALK ABOUT THE TOPIC THAT I CAME HERE TO TALK ABOUT BECAUSE NONE OF THAT APPLICATION WILL RENDER THE KIND OF PROFIT THAT THEY'RE STATING.
PLUS IT WOULD BE IN COMPETITION WITH A LOT OF THE OTHER SERVICES THAT ARE AVAILABLE.
SO IT WOULD BE, I WOULD BE REMISS NOT TO SHARE THAT THROUGH A LOGISTICS STANDPOINT, THROUGH A FISCAL STANDPOINT AND THROUGH A, HEY, AS A CONSTITUENT OF THIS CITY, HOW MUCH OF THE BURDEN LAY ON THE TAXPAYERS? UM, AS FAR AS LIKE WHAT I CAME HERE TO TALK ABOUT WAS AN APPLICATION, ODDLY ENOUGH.
AND I THINK THAT AN INTEGRATION OF SOMETHING LIKE THIS INTO AN AGGREGATE APPLICATION MAY MAKE SENSE FOR CIVILIANS IN THE CONTEXT OF THE CITY.
I PROPOSE THAT WE LAUNCH AN APPLICATION THAT INCORPORATES THE FOLLOWING FOR HOMELESS.
ONE IS A DOCUMENTATION PROCESS WHERE CIVILIANS CAN ACTUALLY DOCUMENT ANY CONCERNS THAT THEY HAVE FOR THE HOMELESS.
IN ADDITION TO THAT, THAT UM, INDIVIDUALS THAT ARE WORKING WITHIN THE INDUSTRY CAN ALSO DOCUMENT A PLACE WHERE PEOPLE CAN DONATE ITEMS AND INDIVIDUALS CAN SEEK SPECIFIC AMENITIES.
THESE ARE NOT JUST GENERALIZED CONCEPTS.
I CAN PROVIDE YOU GUYS WITH A FULL LIST OF APPLICATIONS THAT HAVE HAVE WORKED IN OTHER AREAS.
UM, A LOCATION BASED SYSTEM WHERE PEOPLE CAN BE DIRECTED, WHERE TO GO ON ANY GIVEN DAY.
SO WE HAVE A BUNCH OF DISPARATE FACILITIES WITHIN THE CITY.
A BIG PART OF SAFETY FOR HOMELESS IS BEING ABLE TO FIND SAFE SPACE.
SO WHEN IT COMES TO BEING ABLE TO FIND A SAFE SPACE, IF ONE SPACE IS SATURATED, IT WOULD MAKE SENSE THAT THERE WAS AN APPLICATION WHERE IF ONE SPACE IS SATURATED, INDIVIDUALS CAN BE DIRECTED TO ANOTHER SPACE.
AND I WAS TOLD TO ONLY KEEP IT TO FOUR POINTS.
SO THOSE ARE FOUR POINTS, UM, ASSOCIATED WITH THE APPLICATION.
BUT THERE ARE A MYRIAD OF USES FOR THIS APPLICATION WHEN IT COMES TO THE SAFETY OF THE
[01:00:01]
CITY AS A WHOLE BECAUSE IT DOESN'T HAVE TO BE RESTRICTED TO JUST THE HOMELESS.IT CAN BE A PLACE WHERE WE CAN GO AND FILE REPORTS, NOT JUST ABOUT SAFETY WHEN IT COMES TO PERSONAL SAFETY, BUT THE SIDEWALK IS MESSED UP OR A TREE HAS FALLEN, ET CETERA.
AND OF COURSE, ONE COULD POSE THE ARGUMENT THAT THERE ARE COMPETITOR APPLICATIONS THAT DO SOMETHING COMPARABLE.
IS THAT MY THREE MINUTES? OKAY.
UM, IF YOU HAVE ANYTHING ELSE PREPARED THAT YOU'D LIKE TO SEND HER OFFICE, UM, WITH THE REST OF YOUR STATEMENT AND WE CAN DEFINITELY SEND IT OUT TO THE REST OF THE COMMITTEE MEMBERS.
THANK YOU FOR BEING HERE AND THANK YOU FOR YOUR PROPOSAL.
IS THERE ANYONE ELSE WHO WANTS TO SPEAK? I DON'T.
UM, HI, I'M LANCE CALLOWAY AND CRYSTAL HODGE.
AND WE JUST WANTED TO INTRODUCE OURSELVES.
WE'LL BE DOING A PRESENTATION ONCE IT GETS APPROVED BY THE CHIEF POLICE NEXT MONTH OR MONTH AFTER.
THANK YOU SO MUCH FOR BEING HERE.
I DON'T SEE ANYONE ELSE IN THE QUEUE.
SO OUR NEXT COMMITTEE MEETING WILL BE ON TUESDAY, NOVEMBER 12TH AT 10:00 AM WE STAND ADJOURNED.