1 1 2 3 KERR COUNTY COMMISSIONERS' COURT 4 Special Session 5 Friday, April 28, 2017 6 9:00 a.m. 7 Commissioners' Courtroom 8 Kerr County Courthouse 9 Kerrville, Texas 78028 10 11 12 13 14 15 16 17 18 19 20 21 22 23 PRESENT: TOM POLLARD, Kerr County Judge HARLEY BELEW, Commissioner Pct. 1 24 TOM MOSER, Commissioner Pct. 2 JONATHAN LETZ, Commissioner Pct. 3 25 BOB REEVES, Commissioner Pct. 4 2 1 I-N-D-E-X 2 NO. PAGE 3 1.1 Consider, discuss and take appropriate 3 action on designation of the Health 4 Service Authority for the Juvenile Detention Facility. This may include 5 the approval of a contract for provision of Medical Services for the Juvenile 6 Detention Facility. Authorize the County Judge to sign the same as needed. 7 *** Adjourned. 10 8 *** REPORTER'S CERTIFICATE. 11 9 * * * * * * 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 3 1 JUDGE POLLARD: All right, it's April 28th, 2 2017. It's -- call it 9 a.m. Kerr County 3 Commissioners' Court is in session, and to consider just 4 one item. This is a special called session to consider 5 one item. 6 1.1 consider, discuss and take appropriate 7 action on designation of the Health Service Authority 8 for the Juvenile Detention Facility. This may include 9 the approval of a contract for provision of Medical 10 Services for the Juvenile Detention Facility. Authorize 11 the County Judge to sign the same as needed. You want 12 to do it in executive session or all in open? 13 MR. DAVIS: All in open, Your Honor, if 14 that's okay. 15 JUDGE POLLARD: Okay. Mr. Davis, you have 16 the floor. 17 MR. DAVIS: Thank you, Your Honor. 18 Commissioners, thank you, and I apologize for having to 19 have this meeting this morning. In 3 years at the 20 facility and 11 years at the probation as chief I have 21 not had to do this, and so I do apologize for dragging 22 y'all in. 23 With that being said, I will be brief and 24 concise. Reached out to many entities. Obviously, I 25 wanted to try to make a connection with Corrections 4 1 Care. That is the entity that you contract with for the 2 Sheriff's Department. They at this point in time are 3 not interested. They do not have the staff available 4 per their standards, not per the State law, to provide 5 someone. They said after the jail expansion is open 6 they would be interested. Obviously we're looking at 7 about November before that would occur. Ballpark figure 8 number that they gave me, and this is a very general 9 number was about 20 thousand dollars a year. They are 10 out. 11 I'm still -- I reached out to the 12 Neighbors -- or Neighborhood Health Clinic. I never got 13 a response -- I got one initial phone call back, no 14 response from them. I reached out to a couple of our 15 RN's, Registered Nurses, to provide the services, 16 although the services would be limited. They could at 17 least keep the doors open in the meantime. One of those 18 nurses, an RN, is willing and able and available and 19 would like the position. 20 With that being said she wanted -- the 21 current rate we're paying the nurse we have now is about 22 725 a month. This nurse wants about a thousand dollars 23 a month, that is what she requested. And that's what 24 she requested, and it would allow us to continue to 25 operate, but we still have a problem of all physicals, 5 1 TB tests, any other medical needs are going to have to 2 be -- we'll have to find a doctor to provide those 3 services. Reached out to a couple of other facilities, 4 or entities, and within the City, and I have yet to 5 actually receive a firm response. 6 With all of that being said, the end of the 7 story is Peterson Medical Associates is absolutely 8 willing and able and excited to be named the Health 9 Service Authority if this Court should so decide. I 10 will tell you that they are looking -- I've been 11 speaking with a number of individuals with Peterson, 12 specifically a Sheila Mays is the RN with Peterson that 13 is over the Urgent Care Center. She would be, if this 14 Court so designates, she would be the designee or the 15 point of contact for -- we would name Peterson Medical 16 Associates as the Health Service Authority, she would be 17 the point of contact. The way that this would operate 18 is she would be the main nurse, the main on call. She 19 would have two other, one RN, and I believe one LVN that 20 would be available also when she's not available. So 21 we'd always have a twenty-four seven individual. All of 22 our youth any time we have to a child to the doctor, we 23 would take that child to the Urgent Care Center, which 24 is a huge benefit to us, because currently we're Monday 25 thru Friday with the doctor we've had for years. This 6 1 is seven days a week. Their hours are expanding, they 2 have great hours, I think they're 7 to 7 -- actually I'm 3 going to look. Yes, 7 to 7 on weekdays. Saturday and 4 Sunday 8 to 4 p.m., which we don't don't have anything 5 available right now other than ER. 6 The rates, I know that's going to be the big 7 question, they are absolutely would keep the 725 rate 8 monthly for contracting with the nurse, and they're 9 going to provide us doctors. Every time we take a child 10 into urgent care it would be $85.00, which is a very 11 good deal, and I really am excited about that. 12 JUDGE POLLARD: The doctors, if necessary, 13 would be $85.00, too? 14 MR. DAVIS: That's correct. Any time we 15 take a child -- if there's a doctor local -- 16 JUDGE POLLARD: Wow. 17 MR. DAVIS: What they do is you normally see 18 a nurse practitioner -- 19 COMMISSIONER MOSER: A PA. 20 MR. DAVIS: A PA, exactly. But yes to 21 answer your question. 22 COMMISSIONER MOSER: But you take it there 23 it's $85.00 whether you see the PA or the doctor or 24 whatever, right? 25 MR. DAVIS: Yes. 7 1 COMMISSIONER REEVES: Now, is that 85 plus 2 725 monthly retained? 3 MR. DAVIS: Yes. 4 COMMISSIONER REEVES: And now it's seven 5 twenty-five, but we could be paying additional -- 6 MR. DAVIS: We are. We're paying, depending 7 on what is done, with the current doctor, which that 8 expires as of today, but depending on what is done, you 9 know, there's some services that might be $60.00 but up 10 to $120.00 for basic services. So -- 11 JUDGE POLLARD: Everything's budgeted for 12 this? 13 MR. DAVIS: This actually is budgeted. 14 JUDGE POLLARD: And what do you have 15 budgeted kind of guessing on what the doctor's cost and 16 all of that? 17 MR. DAVIS: I think that we will still be 18 within budget. Well, we've got problems with the budget 19 otherwise as far as medically, so I don't want to 20 misrepresent that. We'll be back before the Court at 21 some point in time on that. 22 JUDGE POLLARD: I understand. 23 COMMISSIONER MOSER: So this is potentially 24 less than what you currently have. 25 MR. DAVIS: Potentially, yes. And again, 8 1 this is all pass thru because we pay that bill directly 2 to Peterson, and then we bill the County that places the 3 child. So if Bandera's child has medical needs we bill 4 them. You know once we pay the bill and then we turn 5 around and bill Bandera County and they pay us to 6 reimburse us for that bill. 7 COMMISSIONER MOSER: Okay. 8 COMMISSIONER LETZ: It sounds like you were 9 able to -- 10 COMMISSIONER MOSER: Got a winner. 11 COMMISSIONER LETZ: -- come up with a good 12 plan. So we need a motion to approve Peterson Medical 13 Associates? 14 MRS. STEBBINS: We prepared some language 15 yesterday for an order. There's some specific language 16 that we need to have that designates Peterson Medical 17 Associates as the health service. 18 JUDGE POLLARD: Hand it to us. 19 MR. DAVIS: Well, it's got typos, I'm going 20 to have to correct it. 21 COMMISSIONER LETZ: Can you read it the way 22 it's supposed to read? 23 MR. DAVIS: I can. Let me give you copies 24 of it so that you can read, but -- 25 COMMISSIONER LETZ: You read it into the 9 1 record the way it needs to be said and then we can move 2 on that. 3 MR. DAVIS: The way that this order reads 4 is -- and the County Attorney wrote it and then I put 5 the typos in it. 6 On this the 28th day of April, 2017, the 7 Kerr County Commissioner Court hereby designates 8 Peterson Medical Associates as the Health Service 9 Authority responsible for the development and 10 implementation of a health care system within the Kerr 11 County Juvenile Facility. Shelia Mays will be the 12 primary point of contact for Peterson Medical 13 Associates. 14 COMMISSIONER LETZ: Move for approval. 15 COMMISSIONER MOSER: Second. 16 COMMISSIONER REEVES: Second. 17 JUDGE POLLARD: Been moved my Commissioner 18 Letz, seconded by -- who was first? 19 COMMISSIONER MOSER: Him. 20 JUDGE POLLARD: Commissioner Reeves. That 21 the Kerr County Commissioners' Court designates Peterson 22 Medical Associates as the Health Care Service Authority 23 responsible for the development and implementation of a 24 health care system within the Kerr County Juvenile 25 Facility. Shelia, S-H-E-L-I-A? Usually it's 10 1 S-H-E-I-L-A. 2 MR. DAVIS: It was a different spelling, 3 Your Honor. 4 JUDGE POLLARD: First name whatever. All 5 right, Shelia Mays will be the primary point on contact 6 for Peterson Medical Associates. Any further 7 discussion, question or comment about the motion? 8 COMMISSIONER LETZ: The motion includes 9 authorization for the County Judge to sign. 10 JUDGE POLLARD: All right. Add to that, 11 that that authorizes the County Judge to sign the 12 contract. 13 COMMISSIONER REEVES: As does the second. 14 JUDGE POLLARD: Both parties, the movant and 15 second of the motion approve that, so those in favor of 16 the motion signify by raising your right hands. It's 17 four zero, unanimous. Thank you very much. 18 JUDGE POLLARD: Get it typed up for me and 19 I'll sign it. 20 MR. DAVIS: I will have it this morning, a 21 corrected copy. Thank y'all very much. 22 JUDGE POLLARD: Good work. 23 * * * * * * 24 25 11 1 STATE OF TEXAS * 2 COUNTY OF KERR * 3 I, DEBRA ELLEN GIFFORD, Certified Shorthand 4 Reporter in and for the State of Texas, and Official 5 Reporter in and for Kerr County Commissioners' Court, do 6 hereby certify that the above and foregoing pages 7 contain and comprise a true and correct transcription of 8 the proceedings had in the above-entitled Commissioners' 9 Court. 10 Dated this the 28th day of April, A.D. 2017. 11 12 /s/DEBRA ELLEN GIFFORD Certified Shorthand Reporter 13 No. 953 Expiration Date 12/31/2018 14 * * * * * * 15 16 17 18 19 20 21 22 23 24 25