[00:01:22]
          >> MAYOR: GOOD MORNING, IT IS NOVEMBER 5, 2026, AT 9:06 A.M. WE ARE STARTING THIS SESSION. 
          MADAM CLERK PLEASE CALL ROLL. (ROLL CALL) >> CLERK: WE HAVE A QUORUM. 
          >> MAYOR: I INVITE COUNCIL MEMBER TO INVITE THE INVO CATOR. 
          >> SHE'S A GUIDED BY A DEEP SENSE OF PERSON AND THE BELIEF THAT EVERY PERSON HAS AN OPPORTUNITY TO THRIVE, SHE'S DEDICATED TO BUILDING OPPORTUNITIES, STRENGTHEN FAMILIES AND BUILDING PATHWAYINGS TO RIGHTER FUTURES. 
          SHE WAS MY ELEMENTARY SCHOOL PRINCIPAL BACK IN 19-BLAH, BLAH, BLAH. 
          (CHUCKLING) ONE OF MY FAVORITE PICTURES WITH HER IS MY SISTER AND I ARE WALKING THE MARATHON. THAT IS HOW WE RAISED MONEY. AND SHE HAS BEEN A GUIDING LIGHT IN MY LIFE AND MY DAD'S LIFE AND IN MY MOM'S LIFE. I AM GLAD SHE'S HERE TODAY. 
          THRU BLESSED SACRAMENT CATHOLIC CHURCH SISTER ODILIA KORENCK IS WORKING TO CREATE OPPORTUNITIES FOR CHILDREN, FAMILIES AND YOUNG ADULTS FACING CHALLENGES. 
          UNDER HER LEADERSHIP BLESSED SACRAMENT CATHOLIC CHURCH HAS CONTINUED TO SERVE CHILDREN, FAMILY AND YOUNG ADULTS, PARTICULARLY THOSE FACING LIFE'S GREATEST CHALLENGES. 
          IT TAKES MANY FORMS, BELIEVING THAT EVERY PERSON DESERVES TO BE SEEN, SUPPORTED AND GIVEN THE OPPORTUNITY TO SUCCEED. THE CHILD DEVELOPMENT CENTER PROVIDES FOR INFANTS, TODDLERS, PRESCHOOLS. THE SENSORY CHILDREN'S GARDEN OFFERS CHILDREN AN INVITING OUTDOOR ENVIRONMENT. THE FAMILY SUCCESS ACADEMY BRINGS FAMILIES TOGETHER THROUGH INTERACTIVE PLAY, PLAY-BASED EXPERIENCE AND HELPING OTHERS. 
          BLESSED SACRAMENT CATHOLIC CHURCH HAS CELEBRATED 100 YEARS, WE HAVE BEEN DOING THAT THIS PAST MONTH OF BEING COMMITTED TO THE EDUCATION TO YOUNG PEOPLE AND GROWTH OF THE SOUTH SIDE. AS PRESIDENT OF THE BOARD OF THE SA ALTERNATIVE HIGH SCHOOL DIPLOMA PROGRAM SHE CHAMPIONS OPPORTUNITIES FOR TEENS AND YOUNG ADULTS TO OVERCOME OBSTACLES, EARN DIPLOMAS AND EMBRACE NEW POSSIBILITIES. CYST SISTER ODILIA KORENCK, IT IS NOT JUST WHAT WE ACCOMPLISH BUT WHOSE LIVES ARE BETTER BECAUSE WE CHOOSE TO SERVE. 
          I AM A TESTAMENT OF THAT I WOULD LIKE TO INVITE SISTER ODILIA KORENCK TO LEAD US IN 
          PRAYER. >> SISTER ODILIA KORENCK: THANK YOU FOR INVITING ME. 
          I CAN'T GO MORE THAN FIVE MINUTES, RIGHT? I PUT IT TO FOUR AND A HALF. 
          (CHUCKLING) MINDFUL OF THE GIFTS WE CONTINUE TO RECEIVE DAILY, WE THANK GOD ALWAYS. WITH ST. PAUL WHO WROTE TO HIS COMMUNITY IN PHILIPPI, I PRAY, I THANK GOD FOR EACH OF YOU IN LEADERSHIP HERE IN SAN ANTONIO. 
          I PRAY YOUR LEADERSHIP IS A BLESSING TO THE COMMUNITY WHOM YOU SERVE. 
          [00:05:03]
MAY YOU HAVE THE STRENGTH AND ENCOURAGE AND COMPASSION YOU NEED TO BE PRESENT TO THOSE YOU HAVE BEEN ELECTED TO LEAD. GOD BLESS OUR CITY. GOD BLESS OUR COUNTRY, GOD BLESS OUR STATE, GOD BLESS OUR WORLD. GOD HAS GIVEN US AN AMAZING VARIETY OF GIFTS FOR WHICH TO GIVE THANKS. HE CREATED THE WORLD WITH ALL THE MYSTERIOUS CYCLES, CHANGES, NATURAL WONDERS LIKE WATERFALLS, RAINBOWS, FLOWERS IN SPRING, THE SUMMER SUN, GLORIOUS COLORS IN THE FALL. THE CALM, COLD, QUIET OF WINTER. NOT SO MUCH IN SAN ANTONIO. GOD HAS GIVEN US OUR BODIES, OUR MINDS, OUR HANDS, OUR FEET TO DO OUR BIDDING. OUR LIPS TO SMILE AND OUR EARS TO HEAR. OUR MOUTHS WITH WHICH TO COMMUNICATE AND TO ENJOY FOOD AND DRINK. GOD HAS GIVEN US A HUMAN SPIRIT THAT NEITHER THE CREATED WORLD NOR OUR BODIES CAN CONTAIN. A SPIRIT THAT COMPOSES MUSIC AND POETRY. A COURAGEOUS SPIRIT THAT SERVES THOSE IN NEED. 
          A SPIRIT THAT ULTIMATELY OVERCOMES EVIL WITH GOOD. A SPIRIT THAT NEVER GIVES UP THE SEARCH FOR MEANING AND TRUTH. GOD HAS GIVEN US OTHER PEOPLE. 
          SPOUSES, CHILDREN, FAMILY AND FRIENDS, CO-WORKERS AND THOSE WITH WHOM WE MINISTER. 
          UNIQUE PERSONS. NONE OF THEM EXACTLY THE SAME. PEOPLE SOMETIMES GIVE US JOY, SOMETIMES BURDEN US. PEOPLE WHO LOVE AND CARE FOR US UNCONDITIONALLY. 
          PEOPLE WHO NEED US AND DEPEND ON US. GOD OUR FATHER, YOU ARE GRACIOUS AND GENEROUS BEYOND OUR WILDEST IMAGINGS. YOU HAVE VISITED US AND LEFT US THE GIFT OF YOUR PRESENCE. TEACH US TO RESPOND TO THIS PRECIOUS GIFT WITH DEEP FAITH NOW AND ALWAYS. NO, I DECIDED I CAN'T SING. SO I WILL JUST SAY GOD GRANT YOU A BENEFICIAL MEETING AND CONTINUED GROWTH IN LEADERSHIP SKILLS AND ENJOYMENT OF YOUR 
          WORK. AMEN. >> ALL:  AMEN. 
          >> MAYOR: THANK YOU, SISTER. JOIN ME IN THE PLEDGE OF ALLEGIANCE. 
          (PLEDGE OF ALLEGIANCE) ITEM THREE IS APPROVAL OF THE MINUTES FOR THE CITY COUNCIL MEETING OF OCTOBER 21, 2026. ARE THERE ANY CORRECTIONS OR EDITS TO THE MINUTES? OKAY. HEARING NONE, IS THERE A MOTION FOR APPROVAL OF THE 
          MINUTES? >> I MAKE A MOTION TO APPROVE. >> SECOND. 
          >> MAYOR: THERE IS A MOTION AND SECOND. PLEASE VOTE. 
          OKAY. THE MOTION CARRIES, THANK YOU. WE HAVE TWO PROCLAMATIONS THAT I WILL READ THIS MORNING. THE FIRST ONE HAS TO DO WITH DIADEL SAB DEL AND EXTERIOR. 
          I DO WANT TO ACKNOWLEDGE, THOUGH, FOR SOME THAT MAY FRANKLY HAVE SOME CONCERNS ABOUT WHAT WE'RE DOING TODAY. I THINK WE ALL UNFORTUNATELY RECOGNIZE THE HUMAN RIGHTS ABUSES THAT HAVE TAKEN PLACE IN EL SALVADOR, HOWEVER, THAT IS NOT WHAT THIS IS ABOUT. 
          THIS IS ABOUT RECOGNIZING THE CONTRIBUTIONS OF THE SALVADORAN PEOPLE IN OUR COMMUNITY, FOR WHICH WE ARE THANKFUL, THE WAYS IN WHICH YOU CONTRIBUTE AND ENRICH OUR ECONOMY, OUR SOCIETY, OUR CULTURE. I THINK WE CAN AND WE SHOULD DIFFERENTIATE BETWEEN THE PEOPLE AND THE POLICIES OF THEIR FEDERAL ADMINISTRATION AS THERE MAY NOT BE AS MUCH (AUDIO SKIPPING) AS ONE THINKS. 
          WE SAW THAT IN OUR OWN COUNTRY ON TUESDAY. WITH THAT, I AM PROUD TO PROVIDE THIS PROCLAMATION. WHEREAS THE CITY OF SAN ANTONIO RECOGNIZES DIADEL SALVADORAN AS A DAY TO ACKNOWLEDGE THE CONTRIBUTION OF SALVADORANS AND SALVADORAN AMERICANS WHO STRENTH OUR COMMUNITY. THOSE LIVING OUTSIDE OF EL SALVADOR CONTINUE TO INFLUENCE THE SOCIAL AND ECONOMIC AND REFLECTS THE DIASPORA AND THEIR HOMELAND. WHEREAS THIS DAY HONORS THE DEDICATION AND RESILIENCE OF 
          [00:10:05]
SALVADORANS THAT CONTRIBUTE TO THEIR COMMUNITIES THROUGH WORK, FAMILY LIFE, ENTREPRENEURSHIP AND CIVIC ELEMENT. (AUDIO SKIPPING) BROAD AN INTEGRAL PART OF SALVADORAN NATION REGARD LITTLE OF WHERE THEY RESIDE. 
          SAN ANTONIO JOINS AND OBSERVES THE TRADITIONS, VALUES, PRESENCE OF THE CITY, HONORING THE CULTURE AND NEW OPPORTUNITIES AND RECOGNIZING SHARED COMMITMENT TO FOSTERING UNDERSTANDING, AND CONNECTION AMONG ALL RESIDENTS. NOW THEREFORE, I GINA ORTIZ JONES, MAYOR OF THE CITY OF SAN ANTONIO AND RECOGNITION THEREOF DECLAIM THIS DAY TO BE THE DAY OF AL-SALVADOR IN SAN ANTONIO, TEXAS. COUNCIL GENERAL. 
          (APPLAUSE) >> GOOD MORNING TO EVERYONE. IT IS AN HONOR TO BE HERE AND SPEAK IN THIS SPECIAL OCCASION. IN THE NAME OF THE DIASPORA EL SALVADOR. I WOULD LIKE TO EXPRESS MY GREATEST SINCERE GRATITUDE FOR THE PROCLAMATION ON THIS DAY OF THE SALVADORANS OUT OF THE COUNTRY. 
          THE RECOGNITION THAT THE CITY OF SAN ANTONIO HAS GIVEN US REPRESENTS MORE THAN JUST A DATE ON A CALENDAR. IT REPRESENTS OUR ROOTS, OUR IDENTITY, OUR CULTURE, AND THE DEEP LOVE WE FEEL FOR OUR LAND. TODAY, WE ALSO RECOGNIZE AND HONOR ALL THOSE FELLOW CITIZENS THAT WITH THEIR SACRIFICE, PERSEVERANCE AND COURAGE HAVE OPENED WAYS AWAY FROM THEIR HOMELAND. WITHOUT FORGETTING WHERE THEY CAME FROM. WE DEEPLY APPRECIATE AND THANK AUTHORITIES TO INSTITUTIONS AND PERSONS WHO MADE THIS PROCLAMATION POSSIBLE. THANK YOU FOR RECOGNIZING THE IMPORTANCE OF OUR COMMUNITY AND FOR MAKING THE SALV SALVADORANS' VOICE VISIBLE FOR THOSE OF US WHO LIVE OUT OF OUR BORDERS. I ESPECIALLY THANK THE MAYOR FOR THIS RECOGNIZE. MAY THIS DAY BE AN OPPORTUNITY FOR ALL OF US TO UNITE. 
          TO CELEBRATE OUR IDENTITY, AND TRANSMIT TO NEW GENERATIONS THE PRIDE WE HAVE FOR OUR ROOTS. BECAUSE WE MIGHT BE LIVING AWAY AND FAR FROM EL SALVADOR, SALVADOR WILL NEVER LEAVE OUR HEARTS. LONG LIVE EL SALVADOR AND LONG LIVE OUR COMMUNITY OF EL SALVADOR AWAY FROM HOME. THANK YOU VERY MUCH. 
          (APPLAUSE) >> MAYOR: WOULD ANY OF MY COLLEAGUES LIKE TO SAY 
          SOMETHING. COUNCIL MEMBER. >> VIAGRAN: THAT WAS SOMETHING WE TALKED ABOUT IN OUR CATHOLIC SCHOOL. I KNOW IT IS HARD TO BE AWAY FROM HOME YOU ARE HERE AND WE RECOGNIZE YOU AND YOUR CONTRIBUTIONS. 
          (AUDIO SKIPPING) JUST LIKE SAN ANTONIANS. I WANT TO THANK Y'ALL FOR BEING HERE TODAY. THANK YOU FOR CONTRIBUTING. AND UNDERSTANDING WE CONTINUE TO MOVE FORWARD TO MAKE SURE THAT ALL CULTURES AND COMMUNITIES ARE RECOGNIZED AND 
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CELEBRATED FOR EVERYTHING THEY HAVE DONE TO CONTRIBUTE AND MAKE OUR FAITH STRONGER AND COMMUNITY STRONGER. THANK YOU FOR BEING HERE TODAY. 
          IT WAS GOOD TO RECOGNIZE JUST THE CONTRIBUTIONS THAT THE PEOPLE OF EL SALVADOR HAS 
          PROVIDED TO THE UNITED STATES. THANK YOU. >> MAYOR: THANK YOU. 
          I WILL READ A PROCLAMATION FOR PANCREATIC CANCER MONTH. I UNDERSTAND WE HAVE REPRESENTATIVES HERE FOR THIS ISSUE. OKAY. 
          GREAT. OKAY. WHEREAS THE CITY OF SAN ANTONIO RECOGNIZES THAT PANCREATIC CANCER IS THE THIRD LEADING CAUSE OF CANCER-RELATED DEATH IN THE UNITED STATES AND THE ONLY MAJOR CANCER WITH A FIVE-YEAR RELATIVE SURVIVAL RATE BELOW 20%. AND WHEREAS THE RELATIONSHIP WITH THE CANCER NETWORK PROTECTS RESEARCH AND OFFERING CRITICAL PATIENT RESOURCES AND EDUCATION TO PATIENTS AND FAMILIES IN SAN ANTONIO. WHEREAS NOVEMBER IS OBSERVED AS PANCREATIC CANCER AWARENESS MONTH IN COMMUNITIES AROUND THE WORLD RECOGNIZE NOVEMBER 19 AS WORLD PANCREATIC CANCER DAY TO SHINE THE LIGHT ON THE IMPACT OF THE DISEASE AND HONOR THOSE WHO PASSED AND WHEREAS THE INCREASING WARNING SIGNS, BACK PAIN, JAUNDICE AND DIABETES CAN SEEK EARLIER INTERVENTION AND STRENGTHEN AWARENESS. 
          I THE MAYOR OF SAN ANTONIO IN RECOGNITION THEREOF DO HEREBY PROCLAIM THE MONTH OF NOVEMBER TO BE PANCREATIC CANCER AWARENESS MONTH IN SAN ANTONIO, TEXAS AND URGE ALL RESIDENTS TO WEAR PURPLE, LEARN RISK FACTORS AND JOIN IN SUPPORT OF FAMILIES AND CAREGIVERS IMPACTED BY PANCREATIC CARN. CHARLOTTE, OVER TO YOU, 
          PLEASE. >> GOOD MORNING, MY NAME IS SHEILA SEXUALLY. 
          MY EXPERIENCE WITH PANCREATIC CANCER HAS BEEN ALMOST LIFELONG. 
          I WAS A NURSE FOR 45 YEARS. I WAS RETIRED AND WAS DIAGNOSED WITH PANCREATIC CANCER DECEMBER 14, 2023. I HAD HA VERY SHORT, NOT VERY EXCITING JOURNEY TO THAT DIAGNOSIS. I HAD SOME ABDOMINAL PAIN AND MY NURSE SPIDEY SENSE SAID THIS IS NOT RIGHT. IN THREE WEEKS I WAS DIAGNOSED. 
          THE EARLY DETECTION AND THE AWARENESS IS A BIG FACTOR THAT HELPED ME. 
          AND IT IS ONE OF THE SADDEST PARTS OF THE DIAGNOSIS IS THAT MOST PEOPLE ARE VERY -- AT A VERY ADVANCED STAGE WHEN YOU ARE SEEN BY A PHYSICIAN. IT IS REALLY IMPORTANT THAT WE RECOGNIZE PANCREATIC CANCER AWARENESS MONTH DAY ON THE 19TH. 
          I REALLY APPRECIATE YOUR GRACIOUSNESS IN AWARDING THIS PROCLAMATION. 
          BECAUSE THE OUTCOME FROM PANCREATIC CANCER IS VERY LOW. IT HAS NOT CHANGED IN FIVE YEARS. THE SURVIVAL RATE IS 13%. I HAVE BEEN VERY FORTUNATE AND VERY BLESSED TO HAVE A VERY GOOD OUTCOME. I CURRENTLY AM TWO AND A HALF YEARS WITH NO EVIDENT DISEASE AND PLAN ON DOING EVERYTHING I CAN TO HELP PEOPLE BE AWARE THAT GOING TO YOUR PHYSICIAN, ADVOCATING FOR YOURSELF CAN MAKE A HUGE DIFFERENCE. 
          AND THE AWARENESS WILL ALSO HELP WITH THE AMOUNT OF MONEY AND THE RESEARCH. 
          THERE IS SOME VERY EXCITING THINGS THAT ARE GOING ON. AND HOPEFULLY IF WE ALL WORK TOGETHER, WE CAN MAKE THE OUTCOME FOR PEOPLE WHO GET DIAGNOSED WITH THIS REALLY TERRIBLE DISEASE IMPROVE IN THE NEXT DECADE. THANK YOU. 
          >> MAYOR: THANK YOU. SEE IF ANY OF MY COLLEAGUES WOULD LIKE TO SAY SOMETHING. 
          COUNCIL VIAGRAN. >> VIAGRAN: THANK YOU FOR BEING HERE. 
          WHEN WE TALK ABOUT CANCER AND EARLY DECLARTECTION IT IS KEY, D GETTING THE SECOND OPINION. 
          GETTING THE FAMILY AND FRIEND SUPPORT. THANK YOU FOR SHARING YOUR STORY. IT IS NOT ALWAYS EASY TO SHARE YOUR STORY. 
          THAT IS WHAT WE NEED TO DO TO MAKE SURE PEOPLE ARE AWARE OF THE DIFFERENT TYPES OF CANCERS OUT THERE. AND THAT IT IS NOT ALL GOING TO BE ONE-SIZE-FITS-ALL. 
          [00:20:03]
WE NEED TO TALK ABOUT THIS. THANK YOU FOR YOUR WORK. I LOOK FORWARD TO WEARING PURPLE THIS MONTH. I LIKE PURPLE THOUGH. SO THANK YOU SO MUCH. 
          JUST I APPRECIATE YOU SHARING. BECAUSE IT IS NOT ALWAYS EASY BECAUSE IT IS YOUR STORY. 
          THANK YOU. >> MAYOR: ANYONE ELSE? THANK YOU. 
          COUNCIL MEMBER IS RECOGNIZED FOR A POINT OF PERSONAL PRIVILEGE. 
          >> I'M HONORED TO RECOGNIZE A LONG-TIME MEMBER OF THE PARKS DEPARTMENT FOR OVER THREE DECADES. RAYMOND COME UP TO THE PODIUM. HE'S PROUDLY SERVED FOR CITY OF SAN ANTONIO PARKS AND MAINTENANCE DEPARTMENT FOR 33 YEARS, INTERACTED WITH MANY OVER THE YEARS ENSURING THE JOB IS COMPLETED IN A PROFESSIONAL MANNER. 
          MR. CERVANTES HAS MADE HIMSELF A FIXTURE IT THE DEPARTMENT AND THE NEIGHBORHOOD AND THE COMMUNITIES HE SERVED. I MET RAYMOND BECAUSE I WOULD SEE HIM AT WOODLAWN LAKE PARK. 
          HE'S ONE OF THE GUYS THAT YOU MEET HIM AND IT IS LIKE SUNSHINE. 
          YOU KNOW? HE KNOWS EVERYBODY AT THE PARK. 
          HE INTERACTS WITH EVERYBODY. HE'S JUST ALWAYS SUCH A JOY TO INTERACT WITH. 
          THROUGHOUT HIS CAREER, HE'S SHOWN A COLLABORATIVE SPIRIT, SUPPORTED COLLEAGUES AND ELEVATED (AUDIO SKIPPING) AND ROLL MEMBER AND LEADER. MR. CERVANTES AND HIS TEAM ARE RESPONSIBLE FOR A NUMBER OF PARKS IN DISTRICT 7 INCLUDING WOODLAWN LAKE, MONTELA PARK, SUNSET HILLS AND OTHERS. HE CREDITS HIS ROLE AS A MAINTENANCE WORKER FOR MEETING HIS WIFE OF 30 YEARS. THEY HAVE A BEAUTIFUL FAMILY OF SEVEN CHILDREN AND 10 GRANDCHILDREN. IN HIS RETIREMENT, HE LOOKS FORWARD TO MORE FAMILY TIME, FISHING, CONTINUING TO ENJOY TIME ON THE GOLF COURSE. WE WISH HIM THE BEST OF LUCK ON HIS NEXT JOURNEY. WE WILL GREATLY MISS HIS CONTRIBUTIONS TO OUR BEAUTIFUL CITY. BUT WE LOOK FORWARD TO SEEING HIM OUT RELAXING, ENJOYING THE PARKS, I BETTER SEE YOU AT WOODLAWN LAKES, I WILL MISS YOU. 
          THANK YOU FOR THE DEDICATED SERVICE TO THE CITY OF SAN ANTONIO. 
          I WANT TO GIVE CREDIT TO GEORGE, RAYMOND'S SUPERVISOR FOR ALLOWING US TO HAVE THIS SURPRISE TODAY. WE HAVE A CERTIFICATE OF RECOGNITION AND THANK YOU SO MUCH FOR ALL YOUR WORK, RAYMOND. (GAVITO) 
          >> MAYOR: THANK YOU, COUNCIL MEMBER WHYTE IS RECOGNIZED. >> WHYTE: 16 YEARS AGO A MAN CREATED A THEME PARK, THAT IS NOW CALLED MORGANS WONDERLAND. IT IS THE MOST ACCESSIBLE PARK IN THE WORLD WITH CHILDREN FROM DISABILITIES ALL OVER THE COUNTRY COMING TO USE IT, I'M PROUD TO SAY IT IS IN THE HEART OF DISTRICT 10. TODAY GORDON IS AT IT AGAIN. 
          IN THE SPRING OF 2027, THE BRAND-NEW MORGAN'S HOTEL WILL WORK. 
          THIS ULTRA ACCOMMODATING HOTEL WILL HAVE MORE THAN 90 ROOMS WITH WIDER DOORS. 
          PRIVATE ENTRANCES SO GUESTS CAN SKIP THE LOBBY AND AN AI CONCIERGE THAT ARRANGES WHAT 50E67 GUEST NEEDS BEFORE THAT ARRIVE. GORDON DESIGNED THIS BY ASKING THE PEOPLE WHO WOULD USE IT WHAT THEY WANTED TO SEE. THE CAREGIVERS, GUESTS WITH DISABILITIES, THE FAMILIES. MORGAN HAS HELD TOWN HALL MEETINGS AND USED SOCIAL MEDIA TO HEAR DIRECTLY FROM THE PEOPLE AND THROUGH THAT PROCESS, OVER 600 IDEAS EMERGED AND MORGAN HAS ADOPTED 119 OF THEM. THEY DIDN'T STOP THERE. 
          ONCE THE FRAMING WAS UP. THEY BUILT TWO SAMPLE ROOMS SO PEOPLE WITH DISABILITIES COULD TEST THE ROOMS AND OFFER ADDITIONAL SUGGESTIONS AND TWEAKS. 
          CONSTRUCTION WAS THEN PAUSED FOR TWO MONTHS WHILE 52 CHANGES WERE INCORPORATED INTO THE PLANS. LET ME SAY THIS NOW, LOUD AND CLEAR, THERE WILL BE NO OTHER HOTEL LIKE THIS IN THE WORLD. BUT THAT'S NOT ALL. ONCE THE HOTEL IS UP, WHAT WOULD BE THE BEST WAY TO MOVE THE CHILDREN WITH DISABILITIES AND THEIR FAMILIES FROM THE HOTEL TO THE OTHER MORGAN'S PROPERTIES? WELL, THAT IS WHERE THE BORING COMPANY COMES IN. AND THANKS TO THEM AND THEIR PARTNERSHIP WITH GORDON AND 
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MORGANS, THE MORGAN'S INCLUSION TUNNEL WAS BORN. THIS TUNNEL WILL BE THE FIRST OF ITS KIND HERE IN SAN ANTONIO AND WILL CONNECT ALL FOUR ENTITIES OF THE MORGAN'S INCLUSION CAMPUS. AT ONE END OF THE TUNNEL WILL BE THE NEW MORGAN'S HOTEL THAT WE JUST TALKED ABOUT. THEN THERE WILL BE A SPECIALLY DESIGNED TRAM THAT WILL CARRY PEOPLE FROM THE HOTEL TO THE NEXT STOP WHICH IS MORGAN'S WONDER CARE. 
          AS MANY OF YOU KNOW, THIS COMPLEX HELPS CHILDREN AND YOUNG ADULTS WHO REQUIRE CONSTANT CARE AND THEY PROVIDE SKILLED DAYTIME NURSING SUPPORT WHILE HELPING THESE CHILDREN BUILD CONFIDENCE, CONNECTION AND COMMUNITY. FROM THERE (AUDIO SKIPPING) THIRD STOP WILL BE THE MAC, THE MORGAN'S MULTIASSISTANCE CENTER, WHICH SERVES MORE THAN 10,000 PEOPLE, MOST OF WHOM LIVE BELOW THE POVERTY LINE. THE MAC CONNECTS PEOPLE WITH DISABILITIES AND THEIR FAMILIES TO THE CARE AND SERVICES THEY NEED. 
          AT THE MAC THEY CONNECT EACH MEMBER TO A DEDICATED PERSON, A NAVIGATOR TO GUIDE THEM THROUGH EVERY STEP OF THEIR JOURNEY. AND THEY DO THIS FOR THEIR MEMBERS FOR THE REST OF THEIR LIVES AND DO IT COMPLETELY FOR FREE. 
          THE FINAL STOP ON THE TUNNEL WILL BE OF COURSE, MORGAN'S WONDERLAND, THE MOST ULTRA ACCESSIBLE FULLY INCLUSIVE THEME PARK IN THE WORLD. WE KNOW ALL ABOUT THE AMAZING EXPERIENCES THEY CREATE FOR PEOPLE OF ALL ABILITIES. I WANT TO THANK GORDON HARTMAN AND MORGAN'S AND I WANT TO THANK THE BORING COMPANY FOR PARTNERING WITH MORGANS. 
          YOUR COMMITMENT TO THIS PROJECT, CHILDREN WITH SPECIAL NEEDS AND THE CITY OF SAN ANTONIO IS APPRECIATED. CONGRATULATIONS TO MORGANS FOR THE COMMITMENT YOU MADE. 
          TO THE SEGMENT OF THE POPULATIONS THAT INVOLVES PEOPLE OF ALL RACES, CREED, COLOR, FINANCIAL STATUS, GEOGRAPHY TO EVERYONE. YOUR WORK MATTERS TO ALL OF US. MR. HARTMAN, IF YOU WOULD, THE FLOOR IS ALL YOURS. 
          >> MAYOR, COUNCIL, THANK Y'ALL VERY MUCH FOR THE OPPORTUNITY TO BE BEFORE YOU THIS MORNING. 
          APPRECIATE IT VERY MUCH. FIRST OF ALL, COUNCIL MEMBER WHYTE YOU TOOK ALL MY TALKING POINTS THANK YOU VERY MUCH. IT IS HARD TO BELIEVE THAT IN SIX MONTHS, MORNING GANS WILL B7 YEARS OLD. IT IS HARD TO BELIEVE IT HAS GONE BY SO FAST. 
          THERE IS MORGAN'S WONDERLAND, THE INSPIRATIONAL ISLAND, MORGAN'S CAMP, MORGAN'S FITNESS, HE MENTIONED THE MULTIASSISTANCE CENTER, THE MORGAN'S INCLUSION INSTITUTE, THE MORGAN'S SALON, SURGICAL CENTER, TV STUDIO, MORGAN'S SPORTS AND MORGAN'S WONDER CARE THAT WAS ALSO MENTIONED BY THE COUNCIL MEMBER. AND SOON WE WILL BE OPENING MORGAN'S HOTEL. IT WILL BE AN ULTRA ACCOMMODATING HOTEL. 
          WHAT DOES THAT MEAN? IT WILL BE LIKE ANY OTHER HOTEL BUT AS WAS MENTIONED WE LOOK AT HOW LODGING FOR INDIVIDUALS WITH SPECIAL NEEDS CAN BE ACCOMMODATED. 
          IF SOMEONE NEEDS AN ACCOMMODATION THEY WILL HAVE A DROP DOWN OF EVERYTHING THEY MIGHT NEED AND IT WILL BE IN THE ROOM. NO MATTER HOW ACUTE THE SPECIAL NEED MAY BE, THEY CAN TRAVEL WITHOUT THE STRESS OF WHAT HAPPENS IN A HOTEL. 
          THIS WILL BE THE NEW WAY IN WHICH LODGING WILL OCCUR. IT WILL START HERE AT MORGAN'S HOTEL. MORGAN'S INCLUSION TUNNEL WILL ADD TO THIS LIST TO BRING ABOUT A MORE INCLUSIVE WORLD. THAT IS WHAT MORGAN'S IS ALL ABOUT. 
          WE WOULD NOT BE BUILDING THIS TUNNEL IF IT WAS JUST ANOTHER TUNNEL. 
          THIS IS AN ULTRA ACCESSIBLE TUNNEL. WE'LL BE THE FIRST PRIVATELY OWNED, ULTRA ACCESSIBLE TUNNEL EVER BUILT IN THE WORLD. IT WILL TAKE INDIVIDUALS AS MENTIONED OF ALL ABILITIES FROM ONE SIDE OF MORGAN'S INCLUSION CAMPUS, WHICH CONSISTS OF ABOUT 175 ACRES NOW, TO THE OTHER SIDE, TOTALLY UNDERGROUND. 
          TWO TERMINALS, ONE AT THE HOTEL, AT MORGAN'S WONDERLAND AND TWO STATIONS THE MAC AND MORGAN'S WONDER CARE. I'M PROUD TO SAY THIS IS BEING DONE HERE IN SAN ANTONIO. 
          YOU KNOW, SAN ANTONIO AS YOU KNOW IS A CITY OF TRUE COMPASSION, A CITY OF COOPERATION, CITY OF COLLABORATION. AND THE DESIRE TO DO WHAT IS RIGHT TO BRING ABOUT A MORE INCLUSIVE WORLD. WE ALL KNOW WHAT MAKES SAN ANTONIO SO SPECIAL. THE CULTURE OF CARING AND DOING WHAT IS RIGHT. 
          [00:30:02]
OVER THE PAST JUST SIXING MONT -- SIX MONTHS I HAVE HAD THE OPPORTUNITY TO WORK WITH THE BORING COMPANY. THOSE FOLKS HAVE WORKED HARD TO BRING ABOUT THIS UNIQUE TUNNEL. THEY HAVE NEVER DONE A TUNNEL LIKE THIS BEFORE. THEY ARE WILLING TO DO IT AND WORK ALONGSIDE WHAT MORGAN STANDS FOR. JIM FITZGERALD WHO HAS BEEN A BIG PART OF BRINGING THIS ABOUT WHO IS WITH THE BORING COMPANY IS HERE WITH ME TODAY. I WANT TO THANK HIM AND ALL THE PEOPLE AT THE BORING COMPANY. BECAUSE NEXT WEEK THIS TIME WE WILL START DRILLING. I ALSO WANT TO THANK THE MANY CITY DEPARTMENTS THAT PLAYED A ROLE FOR US TO PUT THIS ALL TOGETHER. THE LEADERSHIP OF THE CITY MANAGER, WHO DID AN INCREDIBLE JOB ALONG WITH HIS ENTIRE STAFF TO MAKE THIS DAY POSSIBLE. I WANT TO THANK ALL THE PEOPLE AT CPS MANAGER, BECAUSE TO RUN A 900,000 POUND DRILL YOU CAN'T PLUG IT INTO AN OUTLET. YOU NEED SOMETHING AS BIG TO RUN A HOSPITAL. WORKING WITH CPS ENERGY WE WORKED WITH AN OUTLET BIG ENOUGH TO RUN IT WITH THE HELP OF CPS ENERGY. MANY MORGAN'S EMPLOYEES THAT PLAYED AN INCREDIBLE ROLE IN MAKING THIS POSSIBLE AND NUMEROUS MORGAN'S CONSULTANTS THAT MADE IT POSSIBLE AS WELL. THIS IS A SHORT BRIEFING OF WHAT IS COMING. 
          I WANT TO MENTION TO ALL OF Y'ALL, WE HAVE REACHED OUT TO EACH OF YOU, INVITED YOU TO OUR GROUNDBREAKING NEXT TUESDAY AT 2:00 P.M. WE WOULD LOVE FOR YOU TO BE THERE. THIS WILL NOT BE LIKE ANY OTHER GROUNDBREAKING. 
          YOU WILL ACTUALLY SEE THE BEGINNING OF THE START OF THE TUNNEL CONSTRUCTION. 
          WE HOPE THAT YOU WILL BE THERE. THERE WILL BE MANY MORE DETAILS AT THAT TIME OF OTHER SPECIFIC THINGS WE'RE DOING TO MAKE SURE THIS TUNNEL IS ULTRA ACCESSIBLE AND IS CHANGING THE WORLD. THINK ABOUT IT. 
          BEFORE PEOPLE WHO WERE IN WHEELCHAIRS NEVER THOUGHT THEY COULD MOVE ABOUT IN A TUNNEL. 
          THEY WILL BE ABLE TO DO THAT IN MORGAN'S INCLUSION TUNNEL. I THANK YOU VERY MUCH MAYOR AND COUNCIL MEMBERS FOR ALLOWING ME TO BE HERE TODAY. THANK YOU. 
          (APPLAUSE) >> MAYOR: THANK YOU. THE NEXT ITEM IS THE CITY 
          MANAGER'S REPORT. ERIK, DO YOU HAVE A REPORT. >> YES, MA'AM, ONE ITEM. 
          I THINK SHE'S HIDING AROUND THE CORNER HERE. SO MOST OF YOU KNOW THAT TOMORROW WILL BE JUSTINA TATE'S LAST DAY WITH THE CITY. SHE'S MOVING CLOSER TO HOME AND FAMILY AND WILL BECOME AN ASSISTANT CITY MANAGER WITH THE CITY OF OLAVE KANSAS WHICH IS A MUNICIPALITY RIGHT OUTSIDE KANSAS CITY. JUSTINA HAS WORKED FOR THE CITY FOR ALMOST 17 YEARS. SPENT THE MAJORITY OF THE TIME IN THE BUDGET OFFICE. 
          SHE HAD -- SHE THOUGHT SHE WANTED TO GET OUT OF BUDGET, WENT TO ECONOMIC DEVELOPMENT FOR ABOUT NINE MONTHS AND ASKED TO GO BACK TO BUDGET. SO WE HAD AN OPPORTUNITY TO CELEBRATE HER AS AN EXECUTIVE TEAM MEMBER EARLIER IN THE WEEK. 
          I THOUGHT IT WAS REALLY -- YOU ALL WILL APPRECIATE THIS. WE WERE MAKING FUN OF HER, BECAUSE WHENEVER YOU ASK QUESTIONS, SHE MADE IT A POINT TO BRING THE HUGE BINDER UP TO THE PODIUM. SHE ALREADY KNEW THE ANSWERS, BUT SHE CARRIES AROUND THAT HUGE BINDER OF STUFF. I DON'T KNOW WHAT IS EVEN IN IT. 
          BUT WE WANTED TO RECOGNIZE AND THANK JUSTINA FOR HER SERVICE TO THE ORGANIZATION, THE COMMUNITY, AND TIME AWAY FROM FAMILY AS MANY OF YOU KNOW THAT A LOT OF THE WORK THAT IS DONE IN THE LATE SPRING AND EARLY SUMMER, FALL ARE LONG HOURS. 
          AND I WANT TO THANK JUSTINA AND HER FAMILY FOR SHARING HER WITH US. 
          SHE'S DONE AN OUTSTANDING JOB AS ASSISTANT CITY MANAGER, BUT WISH HER THE BEST OF LUCK AS SHE CONTINUES HER CAREER. SHE WILL HAVE TO BUY A COAT. SHE PROBABLY DOESN'T HAVE A GOOD COAT FOR THE KANSAS WIND. BUT JUST WANT TO THANK HER FOR HER COMMITMENT AND FRIENDSHIP. 
          I THINK SHE'S DONE AN O OUTSTANDING JOB FOR THIS ORGANIZATION. 
          THANKS, MAYOR. (APPLAUSE) ARE YOU GOING TO SAY ANYTHING? 
          (APPLAUSE) >> I'LL KEEP IT BRIEF. I DON'T HAVE MY BINDER TODAY. 
          IT HAS BEEN RETIRED. GOOD MORNING MAYOR, CITY COUNCIL. 
          IT'S BEEN AN HONOR AND A PLEASURE TO WORK FOR YOU AND THE CITY OF SAN ANTONIO FOR OVER 16 YEARS. I AM GRATEFUL FOR THE MANY OPPORTUNITIES I HAVE RECEIVED THROUGHOUT MY CAREER WITH THE CITY. WHICH HAVE CONTRIBUTED TO MY 
          [00:35:02]
PERSONAL GROWTH AND DEVELOPMENT. ABOVE ALL, I VALUE THE OPPORTUNITY TO WORK ALONGSIDE DEDICATED, HARD WORKING, COMPASSIONATE, AND SUPPORTIVE COLLEAGUES WHO HAVE MADE MY TIME WITH THE CITY SO MEANINGFUL. 
          I WANT TO THANK EVERY MEMBER OF THE SAN ANTONIO STAFF. I WOULDN'T BE WHERE I AM TODAY WITHOUT YOUR HELP AND SUPPORT. BUT I ESPECIALLY WANT TO THANK ERIK AND MARIA. 
          THEY HAVE SUPPORTED ME AND TRUSTED ME THROUGHOUT MY CAREER. 
          I HAVE LEARNED SO MUCH FROM THEM. AND I AM BLESSED TO HAVE HAD THE OPPORTUNITY TO WORK ALONGSIDE THEM FOR SO LONG. I WILL CARRY SAN ANTONIO AND ALL I HAVE LEARNED AS I MOVE INTO MY NEXT CHAPTER OF MY CAREER. 
          THANK YOU SO MUCH. (APPLAUSE) >> MAYOR: I KNOW THERE WILL BE 
          LOTS OF COMMENTS, COMB KAUR. >> KAUR: I THOUGHT WE WERE JUST GETTING ON A ROLL. 
          I WILL BE SAD TO SEE YOU GO. OBVIOUSLY AS BUDGET DIRECTOR WHEN YOU STARTED ANSWERING ALL OF THE MILLION AND ONE QUESTIONS, JUDICIOUS NOTES AND FOLLOWED UP ON ALL THE QUESTIONS WE WERE ASKING. MORE SO IN THE PROMOTION YOU RECEIVED THIS LAST YEAR. 
          I THOUGHT IT WAS A GREAT PROMOTION YOU RECEIVED. I THINK YOU HAVE DONE AN AMAZING JOB, WORKING WITH ALL THE DEPARTMENTS THAT YOU ARE THE LEADER OF. 
          YOU ALWAYS RESPOND TO ME WITH SUCH KINDNESS, EVEN WHEN I AM COMING IN WITH A LOT OF FEELINGS ABOUT SOMETHING AND YOU ARE ALWAYS WILLING TO LISTEN AND COME TO A BETTER SOLUTION FOR OUR RESIDENTS. IT WAS AN AMAZING PLEASURE TO WORK WITH YOU. 
          I KNOW YOU WILL HAVE SO MUCH MORE SUCCESS IN YOUR NEXT ROLE, TOO. 
          THANKS, MAYOR. >> MAYOR: COUNCIL MEMBER MCKEE-RODRIGUEZ. 
          >> THANK YOU, I WAS AT THE GYM AT 2:00 ON NOVEMBER 16. AT 2:01 I CALLED CHRISTINA AND SAID I HAVE A QUESTION ABOUT THE BUDGET. AT 3:00 THERE WAS THE ANNOUNCEMENT OF THE RESIGNATION. I WAS LIKE MY GOODNESS, I'M SO EMBARRASSED. THE TIMING WAS HORRIBLE. WHAT I WANT TO CONVEY IS THAT THIS IS A TREMENDOUS LOSS FOR OUR CITY. WE WILL MISS YOU TREMENDOUSLY. 
          I REMEMBER MY FIRST BUDGET WITH YOU AS DIRECTOR AND FEELING SO IMPRESSED THAT EVERY TIME I ASKED A QUESTION OR ANYBODY ASKED A QUESTION THE DEPARTMENT DIRECTOR WOULD BE AT THE PODIUM AND YOU WOULD BE READY TO GET UP AND GO ANSWER. 
          IT WAS NOT A THING GOING ON IN THIS CITY THAT I FEEL YOU DON'T KNOW, ESPECIALLY THE FINANCIAL IMPLICATIONS OF. THAT IS SO IMPRESSIVE. I THINK YOUR FUTURE IS CERTAINLY BRIGHT ANY CITY WOULD BE LUCKY TO HAVE YOU. WE'LL TRY TO FIND A WAY TO GET YOU BACK AT SOME POINT, BUT I KNOW BEING WITH FAMILY IS REALLY IMPORTANT. 
          I'M GLAD THAT YOU WILL HAVE THAT OPPORTUNITY. I THINK IT WILL BE A BEAUTIFUL THING. WE'LL MISS YOU. MAYOR THANK YOU. 
          COUNCIL MEMBER VIAGRAN, PLEASE. >> VIAGRAN: CHRISTINA, I WILL MISS OUR CONVERSATIONS OF I'VE GOT THAT DRESS, I'VE GOT THAT DRESS. 
          YOU HAVE ALWAYS BEEN PROFESSIONAL. YOU ARE A WOMAN LEADER THAT HAS HELPED RUN AND SHAPE THIS CITY, THAT HAS NOT NEARLY GOTTEN ENOUGH ATTENTION OR RECOGNITION. SO I WANT TO RECOGNIZE YOU FOR WHAT YOU HAVE DONE THESE PAST YEARS TO MAKE SURE THE CITY CONTINUES TO GROW IN THE WAY IT HAS. 
          KANSAS IS LUCKY TO HAVE YOU. I UNDERSTAND IT IS IMPORTANT TO BE CLOSE TO FAMILY. 
          SO I HOPE YOU ENJOY THAT TIME. BUT I WANT YOU TO REMEMBER WHO YOU WERE HERE. 
          AND HOW WE APPRECIATED YOU HERE AND THAT THE EXPECTATION FOR ME AND THE WOMEN LEADERS SITTING AROUND YOU AND THE WOMEN LEADERS THAT YOU GUIDED, WE'RE EXPECTING GREAT THINGS. 
          SO YOU SEND US A CARD AS SOON AS YOU GET APPOINTED CITY MANAGER. 
          BECAUSE THAT IS WHERE YOUR FUTURE IS. THANK YOU. 
          >> MAYOR: THANK YOU, COUNCIL MEMBER, MUNGIA, PLEASE. >> MUNGIA: I JOKED I SAID I WAS YOUR FAVORITE COUNCIL MEMBER. I GUESS THERE IS DISAGREEMENT UP HERE. EVERYTHING I ASK YOU, YOU MAKE IT HAPPEN. 
          THERE ARE TIMES WHEN I HAD -- THERE IS YOUR THEME SONG RIGHT THERE. 
          THERE IS TIMES WHERE THERE IS MR EMERGENCIES, I'M FRANTIC ABOUT SOMETHING, I CALL YOU HANDLE IT WITH EASE AND GET IT DONE. I APPRECIATE ALL YOUR WORK SO MUCH. THE BUDGET. THANK YOU FOR GETTING US THROUGH THE WORST BUDGET YEAR OF THE CITY. AND SO I JUST THANK YOU FOR ALL YOUR WORK. YOU ARE LEAVING A LONG-LASTING IMPACT AND A LEGACY HERE WITH 
          [00:40:02]
ALL THE WORK THAT YOU HAVE DONE. SO I RESPECTED YOU SO MUCH FOR ALL YOUR PROFESSIONALISM, ALL THE WORK YOU DO HERE. TO KNOW YOU ARE MAKING YOUR DECISIONS FOR FAMILY FIRST, YOU ARE DOING IT FOR THE RIGHT REASONS. 
          THERE IS NOTHING BAD THAT CAN COME FROM THAT. I KNOW YOU WILL WORK YOUR WAY UP IN KANSAS. THERE IS WHAT I WOULD CONSIDER GOOD NEWS THERE THE OTHER NIGHT. HOPEFULLY THERE WILL BE EVEN BETTER THINGS IN KANSAS FOR YOU. JUST KNOW WE ARE ALWAYS WELCOMING YOU BACK HERE 
          WHENEVER YOU CAN. THANK YOU SO MUCH. >> MAYOR: COUNCIL MEMBER 
          CASTILLO. >> CASTILLO: THANK YOU FOR YOUR ROLE HERE, AND CONGRATULATIONS ON THE ROLE IN KANSAS. (AUDIO SKIPPING) I KNOW THAT IS IN YOUR FUTURE TO HELP RUN A CITY. BUT WITH THAT, I WANT TO COMMEND YOU FOR YOUR PROFESSIONALISM AND YOUR EXPERTISE. 
          NOT JUST FOR YOUR SERVICE TO SAN ANTONIO AS AN ORGANIZATION BUT TO OUR SHARED CONSTITUENCY, RIGHT, THE PEOPLE WE SERVE. WE CAN'T DO OUR JOB WITHOUT THE LEADERSHIP OF THE EMPLOYEES OF THE CITY OF SAN ANTONIO, THANK YOU FOR THE EXPERTISE, PARTICULARLY WITH THE BUDGET. BUT OF COURSE, JUST ALWAYS LEADING WITH PROFESSIONALISM, REALLY EXCITED FOR WHAT IS TO COME AND REALLY WANT TO THANK YOU FOR HELPING ALL 10 OF US, ALL 11 OF US DELIVER ON BEHALF OF OUR RESIDENTS. 
          I ALWAYS THINK ABOUT MY FIRST TERM IN COUNCIL. I WAS SURPRISED BUT NOT SURPRISED THAT AT 11:00 P.M., YOU ALL, RIGHT, ARE HERE AT CITY HALL WORKING. 
          SO AGAIN, AS MENTIONED, THIS IS TIME AWAY FROM YOUR FAMILY AND YOU'RE HERE FROM 8:00 A.M., TO PREPARE FOR THE SESSION WE HAVE TODAY AND NOT LEAVING UNTIL 11:00 P.M. 
          RIGHT? SO THANK YOU ALL FOR YOU AND YOUR BUDGET TEAM FOR YOUR DEDICATION IN ENSURING THAT WE CAN DELIVER FOR OUR CONSTITUENCY. 
          THANK YOU AND GOOD LUCK. >> MAYOR: COUNCIL MEMBER GALVAN. 
          >> GALVAN: THANK YOU FOR THE INCREDIBLE SERVICE YOU PROVIDED TO OUR CITY HERE. 
          THE BUDGET, IT IS THE LARGEST THINGS TO DO HERE. ONE OF THE LARGEST INSTITUTIONS IN THE ENTIRE REGION. THE FACT YOU MANAGE THROUGH THAT, DO IT IN AN INCREDIBLE WAY AND PROVIDE US INFORMATION. 
          WE NEED TO GO TO OUR COMMUNITIES AND GO THROUGH THE DETAILS. 
          I MEAN, AFTER THE BUDGET WAS PASSED, ONE OF THE LARGEST NEIGHBORHOODS IN MY DISTRICT ASKED ME TO GO TO THE BOARD MEETING, ASKED WHAT TOOK PLACE. 
          THEY HAD AN INTERESTING SET UP, INTERESTING TO THIS. I FELT LIKE I WAS JUSTINA TODAY. MY OWN BINDER, I AM LOOKING UP TO HER. 
          I DIDN'T DO IT QUITE AS WELL AS YOU, UNFORTUNATELY. BUT KNOW YOU ARE AN INSPIRATION FOR FOLKS DOING INCREDIBLE WORK IN PUBLIC SERVICE. 
          TO DELIVER IN SUCH A POSITIVE, PRODUCTIVE WAY FOR ALL OF US, ALL OF YOUR QUESTIONS, I ONLY HAD A COUPLE COMMITTEE MEETINGS WITH YOU AT COMMUNITY HEALTH AND EDUCATION, BOTH TIMES YOU WERE INCREDIBLE. NO SHADE TO ANYONE ELSE. EVERYONE IS DOING GREAT. 
          IT WAS INTERESTING TO NAVIGATE THE QUESTIONS WITH YOU, TO HEAR THE WAY THAT YOU ARTICULATE ABOUT WHAT YOU HEARD FROM THE CONVERSATION WE HAVE. 
          TO MAKE SURE WE COULD MOVE ALONG WITH WHAT WE WERE LOOKING FOR THERE. 
          I KNOW I TALK QUICK I HAVE AN UNDERSTAND THAT OPINIONS AND THOUGHTS AND FEELINGS, BLAH, BLAH, BLAH. AND ESPECIALLY FOR EDUCATION, ALEX KNOWS WE WENT BACK AND FORTH FOR A WHILE. I APPRECIATE IT. I SAW UP CLOSE HOW YOU WORK. 
          I AM JEALOUS YOU WILL GO TO KANSAS TAKING THE EXPERTISE WITH YOU, ESPECIALLY AFTER THIS INCREDIBLE BUDGET SEASON, I HOPE WE DIDN'T SCARE YOU OFF. 
          (CHUCKLING) NONETHELESS I'M EXCITED FOR YOU AND YOUR FAMILY AND WHAT IS HAPPENING NEXT AND HOPEFUL TO LOOK WHAT IS HAPPENING THERE AND WHAT HAPPENS WHEN THE SPURS WIN ON THAT SIDE OF THE WORLD. THANK YOU. 
          >> MAYOR: COUNCIL MEMBER GAVITO. >> GAVITO: THE BUDGET IS THE MOST IMPORTANT THING MY COLLEAGUES AND I DO. THANK YOU FOR ALL THAT MY COLLEAGUES HAVE MENTIONED. THE FOLLOW-UP, PROFESSIONALISM, IT IS PHENOMENAL TO WATCH YOU IN ACTION. THIS IS A LOSS FOR THE CITY. 
          IT IS A HUGE LOSS FOR THE CITY. WE'LL BE PLOTTING WAYS TO GET YOU BACK. I'M SURE OF IT. THANK YOU FOR (OFF MIC) ALL YOUR SERVICE TO SAN ANTONIO. I'M HAPPY YOU WILL BE WITH 
          YOUR FAMILY. >> MAYOR: COUNCIL MEMBER SPEARS. 
          >> SPEARS: CATHANK YOU JUSTINA FOR ALL THE CALLS AND EMAILS THAT I SENT DUPLICATIVE EMAILS BECAUSE I FORGOT I ASKED YOU ALREADY. I LOVE THE BINDER. 
          I LOVE TO CARRY MY BINDER. I JUST -- YOU ALWAYS SHOW UP. YOU WERE ALWAYS RESPONSIVE, CAME TO ALL THE MEETINGS I ASKED YOU TO DO FOR ALL MY CONSTITUENTS, I APPRECIATE 
          [00:45:02]
THAT. DISTRICT 9 WILL MISS YOU. YES, I CLAIM YOU. 
          SO WHEN YOU WANT TO COME BACK, WE'RE READY FOR YOU. CONGRATULATIONS. 
          I'M HAPPY FOR YOU, BUT WE'LL MISS YOU. THANK YOU, JUSTINA. 
          >> MAYOR: THANK YOU, COUNCIL MEMBER WHYTE. >> WHYTE: CONGRATULATIONS ON WHAT'S AHEAD FOR YOU. THERE IS NOBODY MORE DILIGENT, HARD WORKING OR PREPARED ON A DAILY BASIS HERE IN THE CITY. YOUR WORK HAS BEEN MUCH APPRECIATED. 
          AS YOU HAVE HEARD BY EVERYONE, AND LOOKING FORWARD TO SEEING WHAT YOU DO NEXT. 
          >> MAYOR: JUSTINA, THANK YOU. FOR ME, WHEN I THINK OF YOU I THINK OF A FEW THINGS, UNFLAP BELIEVE, DUE DILIGENCE AND A PERSON THAT GETS TO YES. WE SAW THAT THROUGH THE BUDGET IN A NUMBER OF WAYS, WHETHER YOU TALK ABOUT FRANKLY EVEN CAN WE USE MEDICAID 1115 WAIVER MONEY ON REPRODUCTIVE HEALTHCARE? HOW DO WE GET TO YES FOR OUR COMMUNITY? THIS IS A RESOUNDING APPRECIATION FOR YOUR COMMITMENT TO SERVE OUR COMMUNITY AND PROFESSIONAL WAY THAT IS TO BE CELEBRATED. 
          THANK YOU, CONGRATULATIONS AND ROCK CHOCK. (APPLAUSE) IS THERE ANY OBJECTION TO TAKING THE CONSENT AGENDA BEFORE THE INDIVIDUAL ITEMS SO WE CAN CLEAR MOST OF THE BUSINESS FOR THE DAY? OKAY. 
          HEARING NONE ITEMS 8-32 ARE ON THE CONSENT AGENDA. THEY WILL BE CONSIDERED AS A GROUP AND WON'T HAVE A STAFF PRESENTATION UNLESS PULLED. NOTE ITEMS 13, 21, 22, 23 HAVE BEEN WITHDRAWN BY STAFF AND WILL NOT BE CONSIDERED. THAT IS 13, 21, 22, AND 23. 
          OKAY. ANYTHING TO BE PULLED? OKAY. 
          ANYTHING ELSE TO BE HEARD INDIVIDUALLY? HEARING NONE. 
          OKAY. JUST ONE PERSON FOR PUBLIC COMMENT? OKAY. WE HAVE ONE MEMBER OF THE PUBLIC THAT SIGNED UP TO SPEAK AS PART OF PUBLIC COMMENT. CARMEN SMITH. CARMEN SMITH? OKAY. IS THERE A MOTION TO APPROVE THE CONSENT AGENDA ABSENT 
          ITEMS 13, 21, 22, AND 23 THAT HAVE BEEN WITHDRAWN? >> I MAKE A MOTION TO APPROVE. 
          >> MAYOR: OKAY. A MOTION AND SECOND TO APPROVE THE CONSENT AGENDA ABSENT ITEMS 13, 21, 22, AND 23. ARE THERE ANY HIGHLIGHTS OR QUESTIONS ABOUT THE AGENDA? OKAY. START ON THIS SIDE. COUNCIL MEMBER CASTILLO. 
          >> CASTILLO: I'M EAGER TO HIGHLIGHT THE ITEM 9, CONSTRUCTION FOR FIRE STATION 33. DURING MY FIRST FEW WEEKS ON COUNCIL, THE FIREFIGHTER ASSOCIATION HAD A TOUR. WE CONVENED NEARBY NEIGHBORS AND JOINED THE FIRE STATION 33 AND WE OBSERVED A NEED FOR A FULLY RECONSTRUCTED FIRE STATION, PARTICULARLY OVER AT 33. (AUDIO SKIPPING) BEFORE THE LEADERSHIP OF OUR FIRE CHIEF, OUR CITY MANAGER AND THE 2022 BOND COMMITTEES FOR IDENTIFYING AND SUPPORTING THIS AS A PROJECT. OF COURSE, FOR VOTER APPROVAL. I HAVE REALLY VALUED BEYOND THE PASSAGE OF THE BOND, SITTING DOWN AT FIRE STATION 33 AND HEARING FROM E.M.S. AND OUR FIREFIGHTERS ON WHAT THEIR EXPECTATION IS WITH THE CONSTRUCTION OF THAT NEW SITE. 
          AND AGAIN, WHEN I MEET WITH MIKE SHANNON TO TALK ABOUT BOND PRIORITIES, FIRE STATION 33 IS A PRIORITY TO CONTINUE TO MOVE ALONG. AS YOU ALL -- FOR MANY OF YOU IT IS YOUR LIVELIHOOD AND HOME AWAY FROM HOME. AGAIN, GRATEFUL FOR THE VOTERS FOR APPROVING THE 2022 BOND AND EAGER TO SEE THIS CONTRACT APPROVED FOR THE FIRE STATION 
          33. >> MAYOR: THANK YOU COUNCIL MEMBER GAVITO. 
          ANY OTHER HIGHLIGHTS. >> I WANT TO HIGHLIGHT THE REAPPOINTING TO DR. FRANCINE TO THE NORTHWEST QUADRANT. THERE SHE IS. THIS IS HER SEC TOND TERM ON THE CRIT CPS BOARD. DR. ROMERO HAS SERVED AS BOARD CHAIR SINCE JANUARY 2025 DEMONSTRATING LEADERSHIP AND DEDICATION TO THE BOARD. 
          [00:50:05]
A LONG CAREER AS A PROFESSOR AND DEPARTMENT CHAIR IN THE PUBLIC ADMINISTRATION DEPARTMENT AT UT SAN ANTONIO EDUCATING MANY PROFESSIONALS THAT NOW SERVE OUR CITY. 
          IN ADDITION SHE'S SERVED ON VARIOUS CITY BOARDS COMMISSIONS DEMONSTRATING UNWAVERING COMMITMENT TO SERVING SAN ANTONIO. I COULDN'T BE HAPPIER TO SUPPORT DR. ROMERO'S REAPPOINTMENT TO THE CPS MANAGER BOARD OF TRUSTEES, I THANK YOU FOR HER SERVICE AND ABILITY AND FULL FAITH IN THE ABILITY TO REPRESENT DISTRICT SEVEN AND REST OF THE NORTHWEST QUADRANT. I WILL SAY SINCE THE FIRST MEETING AT JIMENEZ, I HAVE BEEN IMPRESSED WITH DR. ROMERO AND LOOK FORWARD TO SEEING HER 
          CONTINUE TO LEAD THIS CHARGE. THANK YOU. >> MAYOR: OKAY. 
          NO FURTHER DISCUSSION THERE IS A MOTION AND SECOND TO APPROVE THE CONSENT AGENDA ABSENT ITEMS 13, 21, 22, AND 23. PLEASE VOTE. (V (VOTE) OKAY. THE MOTION CARRIES. 
          THANK YOU. MADAM CLERK, READ THE CAPTION FOR JUDITEM 5. 
          >> CLERK: ORDINANCE APPROVING THE CITY COUNCIL AD-HOC SUBCOMMITTEE TRI-CHAIR RECOMMENDATIONS TO THE CITY OF SAN ANTONIO 2027-2032 
          BOND PROGRAM. >> MAYOR: OKAY. GO AHEAD. 
          THANKS. >> GOOD MORNING MAYOR AND COUNCIL. 
          AS MENTIONED WE WILL TALK ABOUT THE TRI-CHAIR APPOINTMENTS FOR THE 2027 BOND PROGRAM. I WILL GO QUICKLY THROUGH IT. YOU REMEMBER A FEW WEEKS AGO, YOU ALL APPROVED AN ORDINANCE THAT SAID HEY, WE WANT TO ESTABLISH A SUB-COMMITTEE OF DISTRICTS 1 AND 3 TO LOOK AT AND POTENTIALLY RECOMMEND TRICHAIRS FOR THE PROCESS IN 2027 BOND. IN OCTOBER 29 WE RECEIVED THE RECOMMENDATIONS FROM DR. KAUR AND COUNCIL MEMBER VIAGRAN. THAT IS WHY WE ARE HERE TODAY. THE THREE TRICHAIRS WE ARE CONSIDERING TODAY ARE ANITA FER NANNEZ, KEVIN DIDDON AND SANDY WOLF. 
          THOSE ARE THE FOUR COMMITTEES THEY WILL HELP OVERSEE. AND REMEMBER THE PURPOSE OF THE TRICHAIRS IS REALLY TO SERVE THE ROLE AS OVERSEERS OF THE COMMITTEE PROCESS. 
          CERTAINLY STAFF WILL BE THERE HELPING FACILITATE. BUT MANAGING AND COORDINATING THE COMMITTEES IS KIND OF THEIR ROLE. THEY SERVE AS THE PUBLIC-FACING REPRESENTATIVES OF THE BOND. NOT ONLY DURING THE COMMITTEE PROCESS AND CERTAINLY AFTER. REMEMBER THE TIMELINE WHERE WE TALKED ABOUT COMING BACK TO YOU IN JANUARY WITH THE RECOMMENDATIONS. AND FEBRUARY, CALLING A VOTE AND THE PUBLIC PROCESS AND CAMPAIGN AFTER THAT. WE DID (AUDIO SKIPPING) RIDIC RECOMMENDATIONS TO YOU IN JANUARY. 
          WE HAVE A CALENDAR. WE HAD A CHANCE TO MEET WITH ALL THREE OF THEM YESTERDAY. 
          CITY MANAGER, CITY ATTORNEY, MYSELF, MARIA, WE HAD A CHANCE TO TALK ABOUT THE PROCESS. 
          THIS WOULD BE THE FIRST TIME DOING IT. GOING OVER THE TIMELINE, THE PROCEDURES, CITY'S ETHICS CODE, ET CETERA. THAT WAS IMPORTANT. 
          GOOD CONVERSATION TO GET THEM UP TO SPEED AS TO WHAT THEY WILL BE DOING WITH THIS PROCESS. THAT IS REALLY THE END OF IT. ALTHOUGH, THIS IS A NEW PROCESS. SO DON'T KNOW IF COUNCIL MEMBER KAUR OR VIAGRAN WANT TO SAY ANYTHING ABOUT THE PROCESS THAT GOT US HERE BEFORE WE FINISH IT. 
          >> MAYOR: COUNCIL MEMBER VIAGRAN YOU ARE RECOGNIZED, GO AHEAD. 
          >> VIAGRAN: THANK YOU, MAYOR AND MIKE FOR THAT PRESENTATION. 
          AS YOU KNOW, AS FAR AS MY FATHER BEING CITY EMPLOYEE MY SISTER SERVING ON COUNCIL AND MY NAME IS AS A CITY KEMPLOYEE THIS IS SOMETHING WE HAVEN'T SEEN BEFORE. 
          WE LOOK BEYOND THE BOND CYCLE AND CONSIDER THE FUTURE WE'RE BUILDING BUT TO GET TRICHAIRS THAT HAD THAT HISTORY, UNDERSTOOD SAN ANTONIO, AND OUR HABITS, IF WE WILL, AND ACTUALLY GET TRICHAIRS TO SERVE AS STRATEGIC LEADERS AND RESPONSIBLE STEWARDS OF PUBLIC INVESTMENT, BRIDGING PRIORITIES AND FISCAL ACCOUNTABILITY, I WANT TO THANK THOSE THAT PROVIDED NAMES OF INDIVIDUALS TO HELP. WE LOOKED AT INDIVIDUALS. 
          THIS WAS A TIME COMMITMENT. IT IS GOING TO BE QUICK AND BUSY AND THOSE THAT WE HAVE SELECTED SAID THEY ARE IN IT FOR THE LOCK NG HAUL, LONG NIGHTS, WORKING WITH THE NUMBER OF COMMITTEES, I HOPE YOU WILL FINALIZE TODAY. THOSE SELECTED DEMONSTRATE SOUND JUDGMENT, STRATEGIC VISION, COMMUNITY AWARENESS WITH A GENUINE COMMITMENT TO REPRESENT THE INTERESTS OF OUR ENTIRE DIVERSE COMMUNITY. THEY ENENSURE OUR INVESTMENTS ARE STRATEGIC, EQUITABLE AND RESPONSIBLE. AND EVERY PROJECT SHOULD BE 
          [00:55:03]
EVALUATED BASED ON READINESS, THAT INCLUDES SHOVEL READY COSTS, ANTICIPATED PUBLIC BENEFIT, GEOGRAPHIC DISTRIBUTION AND LONG-TERM MAINTENANCE REQUIREMENTS. 
          LASTLY, WE LOOKED FOR THOSE THAT NEED TO ESTABLISH CLEAR EXPECTATIONS FOR ACCOUNTABILITY AND RESULTS OF THE CITY STAFF RUNNING THE BOND COMMITTEE MEETINGS AND THE BOND COMMITTEE MEMBERS. THIS IS HOW WE MOVE SAN ANTONIO FORWARD THROUGH STRATEGIC LEADERSHIP, RESPONSIBLE INVESTMENT, MEANINGFUL COMMUNITY ENGAGEMENT AND A SHARED COMMITMENT TO BUILDING A CITY THAT IS COMPETITIVE, FISCALLY RESPONSIBLE AND RESPONSIBLE TO THE PEOPLE WHO CALL SAN ANTONIO HOME. 
          BECAUSE AT THE END OF THE DAY, THIS IS A VOTER APPROVED BOND. THANK YOU. 
          >> MAYOR: COUNCIL MEMBER KAUR WOULD YOU LIKE TO SAY SOMETHING? 
          >> KAUR: I WANT TO SAY THANK YOU TO THOSE THAT SUBMITTED NAMES, MADE PHONE CALLS AND DOING THIS WORK. IT IS REALLY IMPORTANT. THANKS, MAYOR. 
          >> MAYOR: OKAY. IS THERE A MOTION TO APPROVE THE ORDINANCE. 
          >> MAKE A MOTION TO APPROVE. >> SECOND MAYOR THERE IS A MOTION TO APPROVE AND SECOND. 
          WE MAY BEGIN DISCUSSION. ANYONE ELSE LIKE TO SPEAK ON THIS ITEM? 
          COUNCIL MEMBER WHYTE. >> WHYTE: I WANT TO THANK COUNCIL MEMBER KAUR AND VIAGRAN FOR THE WORK ON THIS. THANK YOU FOR ALL THE WORK THAT HAS BEEN DONE. 
          WE ARRIVED AT THREE GREAT PEOPLE TO MAKE SURE THE BOND GETS ALL THE ATTENTION IT DESERVES FROM THE COMMUNITY. WE HAVE SO MANY GREAT PEOPLE TO CHOOSE FROM IN THE NI COMMUNITY. THE WORK WAS DONE TO SELECT THESE THREE, AGAIN, WHICH I THINK ARE GOING TO LEAD THE EFFORT IN A WAY THAT IS GOING TO BE NICE TO SEE AND SOMETHING THE COMMUNITY CAN RALLY AROUND AND BE PROUD OF WHEN WE GET TO NEXT MAY. 
          AGAIN, THANK Y'ALL FOR THE WORK AND THANK YOU THREE FOR BEING WILLING TO TAKE ON THE 
          RESPONSIBILITY. >> MAYOR: COUNCIL MEMBER ALDERETE GAVITO. 
          >> GAVITO: THANK YOU TO KAUR AND VIAGRAN, I KNOW IT WAS DIFFICULT. 
          THERE HAS BEEN SO MUCH DONE FUR OUR COMMUNITY IN DIFFERENT WAYS. 
          THERE IS NO DOUBT FOR THE CITY WE WILL HAVE A SUCCESSFUL BOND WITH YOU LEADING THE CHARGE. 
          THANK YOU FOR THE TIME COMMITMENT. IT WILL BE FAST AND FURIOUS. 
          REALLY APPRECIATE YOU STEPPING UP TO HELP US WITH THIS. >> MAYOR: COUNCIL MEMBER 
          MUNGIA, PLEASE. >> MUNGIA: THANK YOU. I WANT TO SAY THANK YOU TO ANITA, SANDY, KEVIN FOR THE COMMITMENT TO STEP UP. IT WILL BE A LONG PROCESS. 
          A TIGHT WINDOW. I KNOW YOU ARE READY TO DO IT, BE OUT THERE IN ALL OF THE COMMUNITIES TALKING ABOUT THIS BOND. I ALSO DO WANT TO THANK, YOU KNOW, JIM, JILLIAN AND MARIO BEING WILLING TO PUT YOUR NAME OUT THERE. 
          IT IS NOT EASY TO PUT YOUR NAME OUT TO SERVE. IT IS A TEAM EFFORT. 
          WE WILL GET BEHIND THIS BOND. I THINK ALL OF US WILL AS WELL. 
          I AM LOOKING FORWARD TO GETTING THE PROJECTS OUT AND DONE FOR OUR COMMUNITY. 
          THANK YOU SO MUCH. >> MAYOR: COUNCIL MEMBER CASTILLO. 
          >> CASTILLO: I WANT TO THANK COUNCIL MEMBERS KAUR AND VIAGRAN AND THE RESPONSIBILITIES AND WITH THE SHARING OF WHAT IS GOING ON. THE APPOINTMENTS AND THE COMMITMENTS, AS FOLKS HIGHLIGHTED. YOU ARE WELL-SEASONED IN THIS PROCESS AND SO MUCH MANUFACTURE SO. I WANT TO -- MUCH MORE SO. 
          I WANT TO WISH YOU LUCK. THIS WILL MOVE FAST. I KNOW YOU ARE EXCITED TO MOVE FORWARD WITH THE DESIGNATE YOU'D FORWARD. MOVE FORWARD AT THE POLL. 
          >> MAYOR: COUNCIL MEMBER MCKEE-RODRIGUEZ. THANK YOU. 
          >> RODRIGUEZ: THANK YOU FOR ALL MAKING SURE OUR FEEDBACK WAS HEARD. 
          ONE OF MY MECHRECOMMENDATIONS ENDED UP MAKING THE CUT. THAT IS EXCITING. 
          THIS IS A VERY CHALLENGING BOND. YOU HAVE SEEN IT THE PAST FEW MONTHS AS WE DISCUSSED IT. BUTTIL T BUT I THINK IT IS ONE ULTIMATELY THAT THE COMMUNITY CAN SUPPORT. I THANK YOU FOR ACCBEING THE PUBLIC FACE, REPRESENTING US AND ALL THE EFFORTS TO ENSURE THE COMMUNITY ENGAGEMENT IS STRONG, THOUGHTFUL AND THAT THE COMMUNITY BUYS INTO NOT JUST THE PROCESS AND WHAT ULTIMATELY ENDS UP GOING TO VOTERS. I WOULD LOVE IF THE THREE OF Y'ALL WOULD COME AND INTRODUCE YOURSELF. JUST SO THAT -- I THINK IT 
          [01:00:04]
WOULD BE THE FIRST TIME MANY PEOPLE GET TO SEE AND HEAR FROM YOU. 
          I WOULD LOVE IF Y'ALL WANT TO STEP UP TO THE PODIUM? >> HI, GOOD MORNING, I'M DR. SANDY WOLF. I SERVE AS VICE PRESIDENT OF COMMUNITY ENGAGEMENT AND 
          ADVANCEMENT AT HALLMARK UNIVERSITY. >> GOOD MORNING, EVERYONE. 
          ANITA FERNANDEZ, BORN AND RAISED IN SAN ANTONIO. I'M A PARTNER AND FOUNDER OF OCI CONSULTING AND DEVELOPMENT AND PRIVILEGED AND HONORED TO SERVE IN THIS CAPACITY. 
          THANK YOU SO MUCH. >> GOOD MORNING, MAYOR, MEMBERS OF COUNCIL. 
          KEVIN DENNIN, I HAVE BEEN IN SAN ANTONIO A LONG TIME. I KNOW MANY OF YOU. 
          ANYTIME I'M HERE BEFORE YOU I THANK YOU FOR SERVING THIS COMMUNITY WE ALL LOVE. 
          ON MY DAY JOB I'M PRESIDENT OF THE FIRST AID FOUNDATION. WE PROVIDE PHILANTHROPIC SUPPORT ACROSS THIS COMMUNITY. THIS JOB IS -- ERIK I WON'T SAY ANYTHING I'M NOT SUPPOSED TO, MAYOR. THIS IS NOT A JOB THAT I REALLY SOUGHT OUT. 
          BUT WHEN MANY OF YOU -- SOME OF YOU REACHED OUT TO ME, I HAVE ALWAYS HAD TROUBLE IN MY LIFE SAYING NO WHEN I AM ASKED TO HELP SOMEBODY. IT IS KINDS OF WHAT I DO FOR A LIVING. ONE OF THE THINGS I THINK WE HAVE A GREAT OPPORTUNITY TO DO, IF I CAN TAKE A MINUTE TO SAY THIS, I THINK IT IS A WONDERFUL OPPORTUNITY TO TOUCH EVERY SEGMENT OF THIS CITY. WHEN I HAVE BEEN BEFORE YOU BEFORE, THAT IS SOMETHING THAT IS REALLY, REALLY IMPORTANT TO ME, THAT WE TOUCH EVERY QUADRANT OF THIS CITY. 
          EVERYONE DESERVES OPPORTUNITY. THE BOND PROGRAM IS SOMETHING THAT I THINK HAS THE OPPORTUNITY TO DO THAT. SO THANK YOU FOR YOUR WILLINGNESS TO PUT THE BOND FORWARD. THANK YOU FOR NOT PASSING ALONG A TAX RATE INCREASE. 
          I THINK IT WOULD BE THE WRONG TIME TO DO THAT. IT MAY BE NOT WHAT YOU WANT TO HEAR. THANK YOU FOR GIVING ME A COUPLE OF EXTRA MINUTES. 
          >> RODRIGUEZ: THANK YOU FOR ALREADY GETTING STARTED ON THE PITCH. 
          THANK YOU, MAYOR. >> MAYOR: THANK YOU. A COUPLE OF QUESTIONS ABOUT THE PROCESS. AS THESE ARE PUBLIC DOLLARS AND -- BECAUSE THE BOND AMOUNT IS SO SMALL WE DO WANT TO MAKE SURE WE HAVE A SUCCESSFUL BOND. 
          I THINK THAT REQUIRES FOLKS HAVING TRUST IN THE PROCESS AND AS MUCH TRANSPARENCY AROUND PROJECTS THAT ARE PROPOSED, REVIEWED, SELECTED AND ET CETERA. 
          SO THIS IS NOT SPECIFIC TO THE INDIVIDUALS, IT IS A QUESTION, THOUGH, ABOUT THE CIRCUMSTANCE THAT WE FIND OURSELVES IN, BASED ON SOME OF THE POSITIONS THAT THE PROPOSAL TRICHAIRS HOLD IN OUR COMMUNITY. BECAUSE WHAT WE WANT TO AVOID FOR EXAMPLE, IS A CIRCUMSTANCE WHERE AN ENTITY IN THE COMMUNITY SAYS, WELL, MY PROJECT MAY NOT HAVE BEEN SELECTED OR IS NOT GOING TO BE SELECTED BECAUSE I'M NOT A MEMBER OF THE RIGHT CHAMBER. 
          RIGHT? OR BECAUSE I DON'T HAVE THE RIGHT CONTRACT WITH THE RIGHT LOBBYIST. SO THOSE ARE CONCERNS THAT I THINK WE WANT TO LAY FLAT FOR THE COMMUNITY. ANDY, I WOULD WELCOME -- I KNOW WE TRADITIONALLY IN THE FINAL SELECTION OF THE PROJECTS, FOLKS HAVE TO RECUSE THEMSELVES. 
          IT IS IMPORTANT TO UNDERSTAND IF THERE ARE ANY KIND OF -- IF THERE ARE ANY CURRENT CLIENTS OF THE THREE, FOR EXAMPLE, THAT HAVE PROJECTS ON THE BOND? IT WOULD BE HELPFUL IF WE COULD UNDERSTAND THAT IN THE INTEREST EVER TRAOF TRANSPARENC. 
          I THINK MY UNDERSTANDING IS OCI, ONE OF THEIR CLIENTS IS THE SPURS' OWNERS, THE SPURS SAID HAVE YOU PASSED THE BOND. THE STATE WILL COME IN WITH 80%. 
          THAT IS NOT CLEAR AT THIS POINT. I WOULD WELCOME SOME UNDERSTANDING OF HOW WE WILL REVIEW OR AT LEAST BE PROACTIVE IN DISCLOSING YOU KNOW, SOME POTENTIAL CONCERNS IN THE COMMUNITY. GO AHEAD. 
          ANDY, DID YOU WANT TO SAY SOMETHING? >> I CERTAINLY DO, MAYOR. 
          THE TRICHAIRS WERE GIVEN AN ORIENTATION ON THE CITY'S ETHICS RULES. 
          LIKE EVERY OTHER SITUATION, WITH COUNCIL MEMBERS THOSE COME UP ON A CASE-BY-CASE BASIS. WE INSTRUCTED THEM IF THEY FEEL OR WE SEE THAT THERE IS POTENTIAL CONFLICTS, OBVIOUSLY WE'LL HELP THEM NAVIGATE THROUGH THAT AS WE HAVE THROUGH EVERY OTHER TRI-CHAIR SELECTION, MEMBERS SERVING ON THE TRI-CHAIR. 
          THERE IS NOTHING THAT WE'RE AWARE OF THAT WOULD DISQUALIFY THEM FROM SERVING IN THIS ROLE. AGAIN, WE WOULD APPLY THE ETHICS RULES ON A CASE-BY-CASE 
          BASIS AS SITUATIONS COME UP. >> MAYOR: WOULD IT BE POSSIBLE, ACTUALLY FOR FOLKS TO DISCLOSE NOW IF ANY OF THEIR CLIENTS HAVE PROJECTS ON THE PROPOSED LIST OF PROJECTS? 
          [01:05:04]
DO YOU HAVE THAT? I THINK IT WOULD BE HELPFUL TO UNDERSTAND -- AGAIN, WE WANT THIS TO BE AS TRANSPARENT AS POSSIBLE. EVEN IF THERE IS A RECOGNITION THAT SOMEBODY GETS A NEW CONTRACT AS A RESULT OF HAVING BEEN CONFIRMED BY THE COUNCIL TODAY TO SERVE AS A TRI-CHAIR, I MEAN, THESE ARE KIND OF REAL-WORLD EXAMPLES. 
          I THINK THINGS THAT WE WANT TO MAKE SURE WE HAVE GOOD ANSWERS FOR MOVING FORWARD. 
          SO, YOU KNOW, WOULD IT BE POSSIBLE FOR THE TRICHAIRS TO DISCLOSE TODAY -- ONE SECOND, THEN I'LL RECOGNIZE YOU. TO DISCLOSE TODAY IF ANY OF THEIR CLIENTS HAVE PROJECTS ON THE PROPOSED BOND LIST AND IF THERE ARE -- IF YOU GAIN NEW CONTRACTS WHILE SERVING AS THE BOND CHAIR THAT COULD BE PERCEIVED AS ASSOCIATED WITH YOUR POSITION AS A TRI-CHAIR IT WOULD BE HELPFUL FOR THAT TO BE DISCLOSED. AGAIN, NOT CLEAR WHAT WILL SHAKE OUT FROM THE LIST WE GET, BUT GIVEN THE PROCESS AND IF YOU BRING UP THE SLIDES, SLIDE 4 THESE ARE THE PUBLIC-FACING ENTITIES FOR THE BOND. 
          >> CALL TO QUESTION. >> SECOND. >> MAYOR: WE WANT THE FOLKS TO HAVE TRUST IN THE PROCESS. ANDY, DO YOU HAVE ANYTHING ELSE YOU WOULD LIKE TO ADD TO 
          THAT. >> NO, OTHER THAN THERE IS A MOTION TO CALL THE QUESTION, 
          MAYOR. >> MAYOR: ALL RIGHT. THIS NEEDS EIGHT, CORRECT, 
          ANDY, TO STOP DISCUSSION? 2/3? >> THAT'S CORRECT, MAYOR. 
          >> MAYOR: SO EIGHT TO STOP DISCUSSION ON UNDERSTANDING TRANSPARENCY AROUND THE TRICHAIRS. OKAY. WE'LL DO A ROLL CALL VOTE, 
          PLEASE. >> CLERK: AYE WILL BE TO CLOSE DISCUSSION, NAY TO CONTINUE 
          DISCUSSION. (ROLL CALL) >> MAYOR: OKAY. 
          THE MOTION PASSES. OKAY. SO TO THE MAIN MOTION OF ANYONE ELSE WANT TO SPEAK ON THIS ITEM? WE'LL GO TO THE MAIN MOTION 
          NOW, CORRECT? >> CITY MANAGER: THAT'S CORRECT, THERE IS NO 
          DISCUSSION. >> MAYOR: A MOTION AND A SECOND. 
          PLEASE VOTE. MOTION PASSES. >> CLERK: ITEM 6 IS STAFF BRIEFING ON THE REVISED 2027 - 2032 BOND PROGRAM PROPOSED PROJECTS. 
          >> GOOD MORNING AGAIN, MAYOR AND COUNCIL. GETTING BACK TO A LITTLE BIT OF THE CONVERSATION WE HAD LAST WEEK, LAST WEEK, YOU ALL DID THE HEAVY LIFTING IN APPROVING REALLY THE STRUCTURE AROUND THE BOND, THE RESOLUTION SINCE THEN WE HAD A CHANCE TO MEET WITH MANY OF YOU. TALKING ABOUT ANY POTENTIAL CHANGES TO WHAT WE DESCRIBED AND PROPOSED LAST WEEK. SO I WILL GO QUICKLY THROUGH 
          THAT. >> MAYOR: HOLD ON. WE DON'T HAVE A QUORUM. 
          FOLKS, WE'RE STILL MEETING. GO AHEAD, MIKE. THANKS. 
          WAIT, NOW WE DON'T. HOLD ON. ONE SECOND. 
          THANK YOU, THANK YOU. GO AHEAD. THANKS, MIKE. 
          >> THANK YOU, MAYOR. WE'LL TALK THROUGH THIS, BUT TODAY IS TO TALK ABOUT MOVING PAST THIS STEP IN THE PROCESS AND INTO THE BOND COMMITTEES WITH A REVISED PROJECT LIST. 
          LAST WEEK, REMEMBER, WE APPROVED A $442 MILLION BOND PROGRAM TO MOVE TOWARDS COMMITTEES, WHICH WOULD HAVE THE FOUR PROPOSITIONS OR CATEGORIES, STREETS, PARKS, FACILITIES, HOUSING, THE $208 MILLION STORMWATER REVENUE, FEE INCREASE. 
          THAT BOND PASSED TO MOVE TO THE COMMITTEES. LAST WEEK'S MEETINGS WE WENT THROUGH STAFF-PROPOSED PROJECTS TO FIT INTO THIS. SINCE THEN, WE HAD A CHANCE, WHETHER IT BE THE CITY MANAGER, JOHN PETEREK OR I TO TALK WITH OR SEE IF YOU HAD 
          [01:10:03]
PROPOSED CHANGES ON THE LIST BEFORE WE MOVE INTO COMMITTEE WORK TO START TO WORK AND PRIORITIZE AND BRING BACK A RECOMMENDED LIST. SO WE ARE STILL LOOKING AT $650 MILLION IN INVESTMENT. I'M SUMMARIZING WHAT WE LOOKED AT LAST WEEK. 
          YOU WILL SEE A CHANGE IN THE STREET NUMBER, 235, IT WAS 259 LAST TIME. 
          AND THE MUNICIPAL FACILITIES WENT FROM 35 TO 59. EVERYTHING ELSE IS THE SAME. 
          I WILL SHOW YOU SOME REVISED RECOMMENDATION BASED ON RECENT CONVERSATIONS THIS WEEK. 
          SO HERE'S OUR LIST OR REVISED LIST OF STREETS, BRIDGES, SIDEWALKS, PUTTING IT UP THERE. YOU CAN SEE THOSE IN YOUR DISTRICT, SOME OF THEM HAVE BEEN TWEAKED, MODIFIED BASED ON CONVERSATIONS. AGAIN, THIS ISN'T THE FINAL LIST. THIS HAS TO GO INTO THE COMMITTEE PROCESS AND WE WANT THEM TO CONTINUE TO WORK THROUGH THESE OVER THE NEXT COUPLE OF MONTHS. 
          SO THAT IS STREETS, BRIDGES, SIDEWALKS. DRAINAGE AND FLOOD CONTROL. 
          SAME THING. A REVISED LIST. A FEW TWEAKS THERE. 
          FEW CHANGES BASED ON INDIVIDUAL CONVERSATIONS WITH YOU ALL. 
          WE WANT TO WORK THROUGH THE COMMITTEE PROCESS TO FURTHER REFINE THIS AND BRING IT BACK TO YOU. PARKS AND REC, SAME THING. A LOT OF PROJECTS THERE. 
          WE DID MOVE THINGS AROUND, BASED ON CONVERSATIONS, DIFFERENT PRIORITIES, DIFFERENT OPPORTUNITY IIES FOR PARKS IN YOUR COMMUNITY AREAS. AGAIN, FLESHED OUT BY THE COMMITTEE PROCESS OVER THE NEXT COUPLE MONTHS. FINALLY, MUNICIPAL FACILITIES, WE HAD A FEW ADDS TO THIS LIST, BASED ON CONVERSATIONS. THIS IS WHAT WE ARE BRINGING TO THE PARKS AND FACILITIES COMMITTEE TO TALK ABOUT, DEBATE, BRING BACK A RECOMMENDATION TO YOU. THEN THE CITYWIDE PROJECT, REMEMBER THIS PART OF THE SLIDE, DISTRICT RELATED, NOTHING CHANGED HERE IN THE PROPOSED CITYWIDE PROJECTS THAT WE WILL BRING TO THE INDIVIDUAL COMMITTEES. THAT IS JUST A REPEAT OF LAST WEEK'S SLIDE. THEN I PUT THIS SLIDE UP HERE, AGAIN, JUST TO REITERATE, NOTHING HAS CHANGED IN TERMS OF THE PROPOSED BOND PROGRAM IN TERMS OF 442. 
          THIS IS THE BREAKDOWN THAT YOU ALL TALKED ABOUT APPROVED, A MOTION AND SOME CHANGES MADE ON THE DAIS LAST WEEK. THIS HAS ALL STAYED THE SAME. EVEN IF A PROJECT OR TWO HAS MOVED FROM YOUR RECOMMENDATIONS, WE STAYED WITHIN THESE. 
          THESE ARE ALL THE SAME NUMBERS AND ALLOCATIONS OF LAST WEEK. SO WE JUST LISTED THEM OUT THERE TO SAY, EVERYTHING IN TERMS OF THE NUMBER OF DOLLARS IN THE BUCKS, THE COUNCIL DISTRICT HAS STAYED THE SAME FROM LAST WEEK TO NOW. JUST HIGHLIGHT AGAIN, OUR CALENDAR. WE HOPE TODAY TO GET TO MOVE FORWARD. 
          AND START WORKING WITH THE TRICHAIRS AND THE COMMITTEE IT IS STARTING ON THE WEEK OF 16TH OF NOVEMBER. ONE CHANGE YOU WILL SEE, I THINK WE HIGHLIGHTED LAST TIME, JANUARY 20TH, WHERE THE TRICHAIRS WILL BE BACK WITH RECOMMENDATIONS FROM THE COMMITTEE PROCESS. WE MOVED THAT TO PROBABLY THE EIGHTH SESSION ON THE 21ST. 
          THAT IS THE CHANGE YOU WILL SEE THERE. WE HAVE MANY OF THE COMMITTEE APPOINTMENTS. SOME ARE OUTSTANDING. YOU ARE WORKING LAST CHANGES OR FINALIZATION. HOPING TO GET THOSE BACK IF NOT TODAY, TOMORROW. 
          AND AGAIN, THAT IS THE PROGRAM TIMELINE. THE SAME AS LAST WEEK. 
          SO ... I WILL BE HAPPY TO ANSWER ANY QUESTIONS, BUT THEY, MAYOR. 
          >> MAYOR: GREAT. THANK YOU. THANKS. 
          NO MEMBERS OF THE PUBLIC SIGNED UP TO SPEAK ON THIS ITEM. 
          A MOTION TO APPROVE TO BEGIN DISCUSSION. >> MOTION. 
          >> SECOND. >> MAYOR: MOTION AND SECOND. COUNCIL MEMBER ALDERETE 
          GAVITO. >> GAVITO: THANK YOU, MEET FOR ALL OF YOUR DILIGENT WORK AND TO TAKE OUR FEEDBACK TO GET SOMETHING THAT MEETS ALL OF THE DISTRICTS. 
          THIS IS A TRICKY CHALLENGE GIVEN THE LIMITED SCOPE OF THE BOND. 
          I AM SURE WE WILL DELIVER AND EXECUTE FOR RESIDENTS. I'M HAPPY WITH THE PROJECTS FOR DISTRICT 7. WE TALKED ABOUT SHIFTS TO WOODLAWN LAKE OF 6 MILLION TO BE PUSHED TOWARD SUNSHINE RANCH AND RECONSTRUCTION OF WILSON BOULEVARD. 
          I LOOK FORWARD TO THE DISTRICT AND DRAINAGE AND PARKS AND STREETS IN DISTRICT 7. 
          SOME OF THE HIGHEST PROJECTS ARE ON THE LIST. I'M GRATEFUL WE COULD GET THERE. WE HAVE A FANTASTIC SLATE OF DISTRICT 7 APPOINTEES FOR THE BOND COMMITTEES. I LOOK FORWARD TO HEARING THEIR RECOMMENDATIONS IN JANUARY. THANK YOU FORE THIS. GLAD TO SEE IT MOVING ALONG. 
          >> MAYOR: COUNCIL MEMBER VIAGRAN. >> VIAGRAN: THANK YOU CITY 
          [01:15:04]
MANAGER AND TEAM FOR WORKING WITH ME. YOU KNOW WHAT I HAVE FOR INFRASTRUCTURE. THIS WILL BE A TRUE COMMITTEE PROCESS. 
          THANK YOU TO PUBLIC WORKS AND WHAT WE HAVE GOING SO FAR. TO LOOK LIKE IF WE BEGIN A PROJECT, WE WILL BEGIN THE ISSUES. THANK YOU FOR WORKING WITH ME. 
          I HAVE MY LIST TOGETHER. I WANT TO ENCOURAGE, I AM SENDING THREE ALTERNATES THAT WILL BE (AUDIO SKIPPING) THERE IN CASE, BECAUSE I RAN INTO THIS LAST TIME. 
          I WANT TO GIVE ME COUNCIL MEMBERS THE IDEA. IF YOU HAVE OLDER PARTICIPANTS OR PEOPLE WITH HEALTH ISSUES, AND THEN THEY CAN'T MAKE IT, YOU REALLY WANT TO HAVE SOMEBODY THERE TO SPEAK AND USE THE VOICE. SO I WILL BE HAVING ALTERNATES AND COMMUNITY MEMBERS, WE HAVE A GREAT COMMUNITY MEMBER THERE WORKING BUT WE WANT TO SEE THIS GO THROUGH COMMUNITY SO AS WE TAKE IT TO THE VOTERS, THEY UNDERSTAND THAT THE VOICE OF THE COMMUNITY HAS BEEN HEARD AS WE GO THROUGH THIS PROCESS. 
          I WANT TO -- I LOOK FORWARD TO THIS PROCESS. I KNOW IT IS GOING TO BE TIGHT, FAST, AND FURIOUS, AND I KNOW THAT ... WE'RE GOING TO RUN INTO ISSUES BECAUSE OUR INFRASTRUCTURE IS SO OLD IN DISTRICT 3. I WANT TO BE MINDFUL OF THAT AS WE LOOK AT THAT. I DO BELIEVE THAT I HAVE SO MANY EXCITED ABOUT WHAT IS HAPPENING ON THE SOUTH SIDE THAT WE CAN SEE PRIVATE DO DOLLARS THAT WANT TO HELP WITH CITY PROJECTS. IF THEY GET TO PUT THEIR NAMES ON IT. 
          AGAIN, I'M LIKE I DON'T KNOW THAT I WANT YOU TO PURT YOUR NAME ON EVERYTHING. 
          SO I AM THINKING SIDEWALKS. I WANT TO THANK Y'ALL FOR THIS EFFORT. 
          I LOOK FORWARD TO MOVING THIS FORWARD. IF YOU CAN JUST GET US THE CALENDAR INFORMATION AS SOON AS POSSIBLE SO WE CAN SEND THAT OUT TO MY MEMBERS WHO ARE 
          READY TO GO. THANK YOU. >> MAYOR: THANK YOU, COUNCIL 
          MEMBER CASTILLO, PLEASE. >> CASTILLO: THANK YOU, MIKE FOR THE PRESENTATION AND TO YOUR TEAM. I APPRECIATED THE PREBRIEFINGS. 
          WE HAVE HAD FOLKS COME TO PUBLIC COMMENT DURING THE LAST BOND PRESENTATION AND CONVERSATIONS WITH BILL FITZ GIVENS A DISTRICT 5 ARTISTS AROUND THE PUBLIC ARTS FUNDING. I WAS UNDER THE IMPRESSION WITH THE STORMWATER FEE THAT THE DRAINAGE COMPONENT MIGHT NOT QUALIFY. I HAVE REVIEWED THE ORDINANCE. 
          I ASK THAT THE 1.5 OF THE ARTS CAN WITHIN THE DRAINAGE PROPOSITION. 
          IF THIS ISN'T SOMETHING THE COUNCIL BUILDS CONSENSUS ON TODAY, I ASK THAT THE BOND COMMITTEE HAVE THE OPPORTUNITY TO HAVE THE DEBATE IF THEY WANT TO THE 1.5%. 
          I THINK ABOUT THE DISTRICT 4 ARTS PROJECT THAT SERVES AS A DRAINAGE PROJECT THAT HAS ART WEAVED INTO IT. I THINK THIS IS SOMETHING OF VALUE FOR US TO WORK BACK IN THE PROPOSITION. I AM HOPEFUL THAT MY COLLEAGUES WILL BE SUPPORTIVE OF THE 1.5% OF ELIGIBLE CAPITAL IMPROVEMENT PROJECTS TO ALSO BE INCLUDED WITHIN THE 
          DRAINAGE PROPOSITION. THANK YOU. >> MAYOR: ANYONE ELSE LIKE TO SPEAK ON THIS ITEM? COUNCIL MEMBER KAUR. PLEASE SIGN IN. 
          >> KAUR: WE HAVE PLAYHOUSE FOLKS IN THE HOUSE AND THEY'RE SUPPORTING. 
          WE'RE HAPPY TO GET RECOMMENDED F FUNDED. 
          THE PLAYHOUSE AND MAGIC THEATER ARE TWO FACILITIES THAT PROVIDE LOW-COSTS ARTS PROGRAMMING TO ALL OF OUR RESIDENTS. THEY ONLY CAN DO THAT BECAUSE THEY'RE CITY FACILITIES AND WE HELP SUPPORT THEM. I KNOW THERE IS A BIG VISION THERE FOR BOTH FACILITIES. THEY WILL USE THIS AS A F FUNDRAISING TOOL TO DO A FULL CAPITAL CAMPAIGN. I'M GLAD WE COULD ALLOCATE DOLLARS. 
          IF YOU HAVEN'T HAD A CHANCE TO GO TO THE PLAYHOUSE. ASIA WILL GET YOU IN. 
          IT IS MY FAVORITE SPACE. ANNIE IS NEXT UP. THAT IS A GREAT MUSICAL I HOPE TO SEE ALL OF Y'ALL AT IF YOU HAVEN'T HAD A CHANCE TO VISIT. ALSO, BECAUSE I HAVE THE MIC, I WANT TO ANNOUNCE THAT JOHN PETEREK AND CAT HERNANDEZ GAVE ME THE BEST NEWS, THAT THE DISTRICT 1 SOUTH ZONES ARE BACK ON, THE FRAC JORDAN GALLERY IS IN THE HOUSE. 
          THE FRA TOLD THE UP TO TURN OFF THE HORNS. MIGHT TAKE A COUPLE OF DAYS. 
          SLEEP IS COMING SOON. THANKS, MAYOR. >> MAYOR: COUNCIL MEMBER 
          MUNGIA. >> MUNGIA: CONGRATULATIONS, THAT WAVE HAS GOOD RIPPLES. 
          THANK YOU TO MIKE AND THE TEAM. IT IS UNDERWAY. 
          WE TALKED ABOUT THE BRIEFINGS. WHAT COUNCIL MEMBER CASTILLO ASKED FOR THE COMMITTEE TO WEIGH-IN FOR THE DRAINAGE PIECE TO MAKE SURE THEY HAVE THE OPPORTUNITY TO ADD ART 
          [01:20:02]
INTO THAT TOO. I APPRECIATE IT. THAT'S ALL. 
          >> MAYOR: ON THE SECOND ROUND COUNCIL MEMBER KAUR. >> KAUR: I WANT TO ECHO THE 
          REQUEST ON ARTS AND DRAINAGE. >> MAYOR: ANY OTHER COMMENTS ON THE FIRST ROUND? GOT IT. A MOTION AND A SECOND. DO YOU HAVE -- 
          >> MAYOR, THIS IS JUST A BRIEFING. >> MAYOR: SOUNDS GOOD. 
          OKAY. THANK YOU FOR THE BRIEFING. >> MAYOR, ONE THING ON THE DRAINAGE ART. WE'LL APPRECIATE THE FEEDBACK ON THAT. 
          WE WILL MAKE SURE THAT THE COMMITTEES SEE THE 1.5% ON THE DRAINAGE AMOUNT. 
          IT IS $208 MILLION. A PERCENT AND A HALF IS 3 PEN3.1 MILLION. 
          T WE WILL LAY THOSE NUMBERS OUT TO THE DRAINAGE COMMITTEE FOR THE CONSIDERATION AND FEEDBACK. BACK TO YOU GUYS. 
          >> MAYOR: GREAT. ON THE PROJECTS IN LOOKING AT THE TRICHAIRS, I WOULD LIKE TO UNDERSTAND IF ANY OF THEIR CLIENTS ARE ON THIS LIST. THANK YOU. 
          ITEM 7, PLEASE. >> CLERK: BRIEFING AND POSSIBLE ACTION ON A RESOLUTION IN SUPPORT OF BROOKE ARMY MEDICAL CENTER'S 
          LEVEL I TRAUMA CENTER AND MILITARY MEDICAL MISSION. >> MAYOR: GREAT. 
          THANK YOU. I KNOW WE HAVE A PRESENTATION. >> MAYOR, COUNCIL, GOOD MORNING. JEFF COYLE ASSISTANT CITY MANAGER. 
          I WANTED TO SET THE STAGE INITIALLY WITH WHAT THIS RESOLUTION IS AND MORE IMPORTANTLY WHAT IT ISN'T. FIRST AND FOREMOST, THIS RESOLUTION IS IN SUBMIT OF BROOKE ARMY MEDICAL CENTER, WHICH IS THE DEPARTMENT OF DEFENSE'S LARGEST MEDICAL FACILITY AND ONLY LEVEL 1 TRAUMA CENTER. I WILL SAY THAT AGAIN. 
          IT IS THE ONLY LEVEL 1 TRAUMA CENTER IN THE DEPARTMENT OF DEFENSE. 
          IT IS THE DOD FLAGSHIP MEDICAL INSTITUTION. IT IS WHERE THOUSANDS OF MILITARY DOCTORS ARE TRAINED IN TRAUMA EVERY YEAR. AND IT IS WHERE TENS OF THOUSANDS OF OUR NEIGHBORS AND REGIONAL RESIDENTS ARE TAKEN CARE OF WHEN THEY HAVE SEVERE LIFE-THREATENING EMERGENCIES. A LITTLE HISTORY LESSON. SAN ANTONIO LANDED THIS UNIQUE ASSET THROUGH THE 2005 BASE REALIGNMENT CLOSER PROCESS. BRAC. 
          PEOPLE NORMALLY SEE IT AS A NEGATIVE BECAUSE IN '05 SAN ANTONIO WAS THE BIG WINNER OF THE '05 BRAC. IT LED TO $2 BILLION IN MILITARY CONSTRUCTION TO CREATE THE FACILITY WE HAVE AT BAMC TODAY. IT BROUGHT ABOUT 11,000 PERSONNEL AND FAMILIES HERE. AND AT THE TIME IT WAS GENERATING AN ADDITIONAL $650 MILLION A YEAR IN ECONOMIC IMPACT. THAT NUMBER HAS MOST CERTAINLY GROWN IN THE 20 YEARS SINCE THEN. FIRST AND FOREMOST THE RESOLUTION IS A STATEMENT OF SUPPORT FOR BAMC AND A RECOGNITION THAT IT IS A UNIQUE AND A VERY IMPORTANT ASSET. SECOND, THE RESOLUTION ACKNOWLEDGES A POTENTIAL NEW ENTRANT INTO THE TRAUMA SYSTEM FOR OUR REGION, SPECIFICALLY METHODIST HOSPITAL. THIS -- THE RECOGNITION INCLUDES THE AWARENESS THAT IMPACTS TO THE REGIONAL TRAUMA SYSTEM, WHICH CURRENTLY ARE SERVED PRIMARILY BY BAMC AND UNIVERSITY HOSPITAL, THAT A CHANGE TO THAT SYSTEM COULD HAVE AN IMPACT IF NOT MANAGED CORRECTLY. 
          WHAT THIS RESOLUTION DOES NOT DO IS TELL ANY PRIVATE HOSPITAL SYSTEM WHAT SERVICES THEY CAN ADD FOR THEIR PATIENTS. THE CITY HAS NO AUTHORITY TO DO THAT. METHODIST DOESN'T NEED OUR PERMISSION. 
          IT IS THE STATE'S RESPONSIBILITY TO APPROVE A NEW LEVEL 1 OR 2 TRAUMA CENTER. SO I WANT TO MAKE THAT VERY CLEAR. 
          AND METHODIST IS A CRITICALLY-IMPORTANT PARTNER TO THE CITY AND PIECE OF THE REGIONAL HEALTHCARE SYSTEM. THIRD, WHAT THIS RESOLUTION DOES IS CALL ON ALL OF US TO COME TOGETHER AND MANAGE THIS. ALL OF US MEANING THE CITY, WHOSE EMS UNITS TRANSPORT CRITICALLY-INJURED PEOPLE OR SEVERELY-INJURED PEOPLE TO TRAUMA CENTERS. IT CALLS ON STRAC, THE SOUTHWEST TEXAS REGIONAL ADVISORY COUNCIL, TO TRACK THE DATA AND MANAGE THIS. THEY ARE RESPONSIBLE FOR THE 
          [01:25:04]
INTERHOSPITAL TRANSFERS TO TRAUMA CENTERS. AND IT CALLS ON METHODIST AND ANY OTHER HOSPITAL SYSTEMS THAT MAY BE LOOKING AT EXPANDING IN THE TRAUMA SPACE, FOR ALL OF US TO HAVE EYES WIDE OPEN, TRACKING THE DATA, AND MAKING SURE WE TAKE THE STEPS NECESSARY AND PUT THE POLICIES IN PLACE TO PROTECT THIS UNIQUE ASSET IN BAMC. THAT'S WHAT THE RESOLUTION SAYS. 
          I THINK BY NOW ALL OF YOU HAVE HAD A CHANCE TO MEET OUR MILITARY AND VETERAN AFFAIRS DIRECTOR, MAJOR GENERAL SCOTT JACKSON . I WILL SAY PERSONALLY THAT IT'S TIMES LIKE THIS THAT WE ARE REALLY GRATEFUL TO HAVE SOMEBODY WITH HIS MILITARY EXPERIENCE, INSIGHT, AND IMPORTANTLY RELATIONSHIPS TO BE ABLE TO DIG INTO AN ISSUE AND HELP US AS MILITARY CITY, USA MANAGE IT TO THE BEST OF OUR ABILITIES. 
          I'LL TURN IT OVER TO SCOTT. >> JACKSON: MAYOR, MEMBERS OF COUNCIL. 
          GOOD MORNING. AS MR. COYLE JUST LAID OUT, HE SET THE STRATEGIC CONTEXT. MY TASK TODAY IS TO LAY OUT THE FACTS. 
          HOW TRAUMA CARE WORKS, WHAT THE REGION HAS TODAY, WHAT HAS HAPPENED THIS YEAR, AND WHAT THE DATA SHOW. AND AS HE CLOSED OUT, WHAT THE RESOLUTION ACTUALLY DOES. KEVIN KELLY IS NEXT TO ME BACK THERE. 
          BAMC'S COMMANDER WILL FOLLOW ME UPON COMPLETION OF MY REMARKS. 
          LET'S FIRST TALK ABOUT TRAUMA CARE. TRAUMA CARE IS A REGIONAL SYSTEM. IT'S NOT JUST A SINGLE EMERGENCY ROOM. 
          WHEN SOMEONE SUSTAINS A LIFE-THREATENING INJURY, PARAMEDICS ASSESS THE PATIENT IN THE FIELD USING CRITERIA SET BY STRAC. THEY MAKE A DECISION WHERE THE PATIENT IS GOING TO GO. SEVERE LIFE-THREATENING CASES WILL GO IMMEDIATELY TO A LEVEL 1 OR LEVEL 2 CENTERS WHILE OTHERS WILL GO TO THE NEAREST LEVEL 3 OR LEVEL 4 FACILITY. A LEVEL 1 PROVIDES COMPREHENSIVE CARE WITH A FULL RANGE OF SPECIALISTS IMMEDIATELY AVAILABLE. AND IT MUST ALSO RUN A RESIDENCY AND FELLOWSHIP PROGRAM TO CONDUCT RESEARCH. I WOULD ALSO NOTE A LEVEL 1 FACILITY, UNLIKE ALL THE OTHER FACILITIES, DOES HAVE A MINIMUM PATIENT REQUIREMENT. IT MUST SEE AT LEAST 1200 TRAUMA PATIENTS A YEAR, INCLUDING OR -- CORRECTION. OR 240 SEVERELY-INJURED PATIENTS. 
          THAT DISTINCTION DOES NOT APPLY TO THE OTHER LEVELS OF TRAUMA. 
          A LEVEL 2 TRAUMA CENTER PROVIDES THE SAME LEVEL OF CLINICAL CARE. 
          MEDICALLY CLINICALLY IS THE SAME AS A LEVEL 1 BUT IT DOES NOT HAVE THE TRAINING, TEACHING, AND RESEARCH REQUIREMENTS NOR THE MINIMUM PATIENT REQUIREMENTS. 
          LEVEL 3 AND LEVEL 4 EVALUATE AND RESUSCITATE THE PATIENTS. 
          FOCUSING MORE ON THE REGION , DURING OUR INITIAL PRESENTATION TO THE IGR COMMITTEE, THEY REQUESTED A LAYOUT OF THE CURRENT TRAUMA FACILITIES IN OUR REGION. 
          AS PREVIOUSLY MENTIONED, STRAC COORDINATORS TRAUMA ACROSS 22 COUNTIES IN OUR AREA. AND 2.8 MILLION PEOPLE. INSIDE THAT CATCHMENT AREA, THERE ARE 30 DESIGNATED FACILITIES. BOTH OF THE REGIONS' LEVEL 1 FACILITIES RESIDE HERE IN SAN ANTONIO ABOUT 54 MILES AWAY, THE NEAREST LEVEL 1 CENTER IS IN AUSTIN, ABOUT 74 MILES AWAY. 
          FOR THE FOLKS WHO LIVE IN DEL RIO, EAGLE PASS, AND THE BORDER COUNTIES, THEIR ONLY ACCESS TO A LEVEL 1 OR 2 IS HERE IN SAN ANTONIO. ZOOMING IN CLOSER TO OUR METROPOLITAN REGION. 15 OF THE REGION'S TRAUMA CENTERS RESIDE HERE IN BEXAR COUNTY. UNIVERSITY HOSPITAL IS THE REGION'S ONLY LEVEL 1 ADULT AND PEDIATRIC TRAUMA CENTER. BAMC AS WELL IS THE ONLY HOME TO A VERIFIED BURN CENTER IN SOUTH AND WEST TEXAS. THOSE TWO FACILITIES ARE SUPPORTED BY 13 OTHER OVER LEVEL 3S AND 4S. OF NOTE FOR THIS DISCUSSION, METHODIST HOSPITAL IS CURRENTLY A LEVEL 3 TODAY AND IS LOCATED ACROSS THE STREET FROM THE UNIVERSITY HOSPITAL. AS STRAC AND HOSPITAL DATA CONFIRMS, FOR SEVERAL YEARS NOW NEITHER BAMC NOR UNIVERSITY HAS HAD TO DIVERSITY A PATIENT BECAUSE OF SUFFICIENT CAPABILITY OR CAPACITY. 
          OVER THE LAST FEW YEARS THERE'S NOT BEEN A SINGLE PATIENT DIVERTED OUT OF SAN ANTONIO AWAY FROM UNIVERSITY OR BAMC BECAUSE THEY HAD NOT HAD THE CAPACITY. 
          BOTH ARE MEETING THE DEMAND AND BOTH REPORT CAPACITY FOR MORE VOLUME IF IT WAS PRESENT. THE BOTTOM LINE IS THERE IS NO SHORTAGE OF TRAUMA CAPACITY IN THIS REGION. RELEVANT FACTS AS RELATES TO TIME IN THIS CASE, DATE ALL THE WAY BACK TO 2011. AS YOU SEE ON THE TOP LINE, IN 2011, WILFORD HALL'S 
          [01:30:04]
LEVEL 1 FACILITY WAS STOOD DOWN BY THE DEPARTMENT OF DEFENSE IN ORDER TO CONSOLIDATE CAPACITY AT BAMC AND GAIN BETTER PATIENT OUTCOMES. 
          WE'LL TALK MORE ABOUT WHY VOLUME IS IMPORTANT BUT THE REGION WENT FROM THREE LEVEL 1S TO TWO LEVEL 1S. IN 2017, METHODIST SOUGHT TO OPEN A LEVEL 2 TRAUMA CAPACITY. SIMILAR TODAY, THE ARMY OBJECTED. 
          THE SAN ANTONIO CITY COUNCIL ALSO PASSED A RESOLUTION IN SUPPORT OF BAMC FOLLOWING THAT METHODIST DECIDED NOT TO PURSUE IT. THIS YEAR, IN MID-AUGUST, METHODIST AGAIN SOUGHT LEVEL 2 AND WITHIN DAYS, SENIOR MILITARY LEADERS FROM THE SERVICES AS WELL AS THE DEPARTMENT OF WAR WERE REACHING OUT TO LEADERS IN THIS COMMUNITY EXPRESSING THEIR CONCERN. ON SEPTEMBER 21 THE CITY CONVENED ALL THE REGION'S HEALTHCARE SYSTEM TO DISCUSS THE POTENTIAL IMPACTS AND POTENTIAL WAYS AROUND THIS. REGARDLESS, ON OCTOBER 1ST, METHODIST LAUNCHED THEIR TRAUMA SERVICE. ON THE 14TH STRAC, IN ACCORDANCE WITH ITS ROLE, BEGAN DISCUSSING MITIGATION MEASURES DUE TO METHODIST INTENTION. ON 15 OCTOBER, METHODIST FILED WITH THE STATE IN PURSUIT OF LEVEL 2 CARE STARTING THE PROCESS FOR ACCREDITATION. 
          STATE APPROVAL AND CERTIFICATION ARE PENDING, EXPECTED IN THE FALL OF 2027. TODAY, AS MENTIONED, WE ARE SEEKING YOUR SUPPORT IN SUPPORT OF BAMC. JUST TO STEP BACK FOR A SECOND. 
          AS MENTIONED, BAMC IS THE DEPARTMENT OF WAR'S ONLY LEVEL 1 TRAUMA FACILITY. 
          IT IS ALSO THE ONLY BURN CENTER AND IT IS THE LARGEST HOSPITAL. 
          BAMC EMPLOYS 4700 CIVILIAN EMPLOYEES. OF NOTE, THOSE 4700 EMPLOYEES CONTRIBUTE OVER $650 MILLION IN DIRECT FINANCIAL WAGE INPUT TO THE ECONOMY. THE CIVILIAN TRAUMA PATIENTS BAMC TREATS KEEP 3200 MILITARY MEDICAL PERSONNEL READY TO DEPLOY. SO HERE ARE THE CRITICAL NUMBERS. THESE ARE REFLECTING BAMC'S ADMISSIONS AND EVALUATIONS. 
          AN EVALUATION IS EFFECTIVELY FIRST CONTACT AND ASSESSMENT. 
          IF THE STAFF DETERMINED THE PATIENT NEEDS TO STAY IN THE HOSPITAL, THAT TURNS INTO AN ADMISSION. THAT'S THE TWO DIFFERENT NUMBERS THERE. 
          FROM '24 TO '25, EVALUATIONS FELL 11% FOR BAMC AND ADMISSIONS FELL 14%. 
          OVER THE LAST THREE YEARS THERE'S BEEN A DECLINING INPUT OR VOLUME. 
          OVER A LONGER PERIOD, FROM 2016 TO 2025, BURN CENTER ADMISSIONS FELL 39%. 
          MOST IMPORTANTLY, IN CONJUNCTION WITH THIS DROP IN VOLUME, 85% OF THE PATIENT VOLUME THAT BAMC SERVES COMES FROM OUR RESIDENTS HERE IN SAN ANTONIO. NOT MILITARY. ILLUSTRATING THE CRITICAL LINKAGE OF ACCESS IN ORDER TO MAINTAIN MILITARY READINESS. 
          LET ME ADDRESS HOW SAN ANTONIO COMPARES TO OTHER TEXAS CITIES. 
          THIS DATA HAS BEEN SHARED WITH SOME OF YOUR OFFICES. THIS IS FROM THE STATE'S TRAUMA CENTER DESIGNATION LIST AND WE HAVE ADDED CON CENSUS. 
          SAN ANTONIO HAS TWO , ABOUT ONE FOR EVERY 1.4 MILLION RESIDENTS. 
          HOUSTON AS 10. DALLAS-FORT WORTH, 15. AUSTIN, 6. 
          SAN ANTONIO IS THE ONLY REGION IN TEXAS WITH A LEVEL 1 MILITARY TRAUMA CENTER. 
          IT IS IMPORTANT TO UNDERSTAND THAT MORE ISN'T BETTER WITH RESPECT TO TRAUMA CARE. A MULTI-CENTER STUDY LED BY THE U.T. SOUTHWESTERN TRAUMA PROGRAM PUBLISHED IN THE ANNALS OF SURGERY FOUND THAT FOR EVERY 500 TRAUMA ADMISSIONS THE ODDS OF DEATH FELL 7%. MORE PATIENTS EQUATES TO BETTER OUTCOMES. MEANING MORE VOLUME, MORE REPETITIONS FOR TRAUMA DOCTORS EQUALS GREATER PROFICIENCY IN OUTCOMES. THEY CONCLUDED IT SHOULD AVOID UNNECESSARY DUPLICATION OF EFFORTS OR SERVICES. 
          ADDING TRAUMA CENTERS SPREADS THE NUMBER OF PATIENTS ACROSS MORE CENTERS. A STUDY CONCLUDED NEARLY 300 TRAUMA CENTERS FOUND THE REVERSE IS ALSO TRUE. CENTERS THAT LOSE VOLUME ARE MORE LIKELY TO SEE THEIR OUTCOMES WORSEN. TO SUMMARIZE THE FACTS. 85% OF THE BAMC'S TRAUMA PATIENTS ARE CIVILIANS. BAMC'S TRAUMA ADMISSIONS FELL 14% LAST YEAR. 
          A NEW LEVEL 2 WOULD DISTRIBUTE EXISTING VOLUME ACROSS THREE HIGH-LEVEL TRAUMA CENTERS INSTEAD OF TWO. THE FINAL IMPACT ON BAMC ISN'T KNOWN YET. WHILE THE NUMBERS PLAY OUT IN REALITY. 
          [01:35:01]
BUT THE EXPOSURE CAN BE MEASURED. BASED ON THE CURRENT TRANSFER AND ADMISSION SOURCE DATA, IN 2025 ONLY 37% OF TRAUMA EVALUATIONS AT BAMC WERE FROM DIRECT DELIVERY. MEANING OUR EMS OUR AIR DELIVERY OR WALK-IN ACTUALLY WALKED IN THE DOOR TO BAMC. 63% OF BAMC'S TRAUMA PATIENTS ARRIVE AS TRANSFERS FROM OTHER HOSPITALS. METHODIST, BAPTIST, AND CHRISTUS. METHODIST-OWNED HOSPITALS AND EMERGENCY ROOMS SENT BAMC 427 OF THOSE PATIENTS EQUATING TO 11% OF BAMC'S TOTAL VOLUME. 
          WHEN YOU COUNT THE HOSPITALS THAT METHODIST ALSO MANAGES OR PARTNERS WITH, THAT INCREASES TO 579 OR 15% OF BAMC'S TOTAL VOLUME. ONCE METHODIST TREATS TRAUMA ITSELF, IT IS A CORRECT AND LOGICAL ASSUMPTION TO ASSUME THOSE PATIENTS WILL AND CAN STAY INSIDE THE METHODIST SYSTEM AND WILL NOT GO TO BAMC, ENSURING 15%. 
          METHODIST'S PURSUIT OF LEVEL 2 MAY LEAD OTHER HOSPITAL SYSTEMS TO DO THE SAME. 
          LAST YEAR BAPTIST FACILITY SENT BAMC 450 TRAUMA TRANSFERS, SIMILAR TO METHODIST. ANOTHER 11%. CHRISTUS SENT 174. 
          BETWEEN METHODIST AND BAPTIST ALONE, THAT EQUATES TO A QUARTER, 25% OF BAMC'S ANNUAL VOLUME. BRINGING US TO THE RESOLUTION, AS JEFF DISCUSSED. WE'RE ASKING FOR FOUR THINGS. 
          IT REAFFIRMS SUPPORT OF THE RESOLUTION IN 2017. IT SUPPORTS BAMC'S TRAUMA AND READINESS MISSION AND ASKS FOR A COORDINATED DATA-DRIVEN REVIEW. 
          THAT REVIEW REFLECTS THE NATIONAL STANDARD. THE AMERICAN COLLEGE OF SURGEONS SAYS TRAUMA CENTERS SHOULD BE DESIGNATED BASED ON THE NEEDS OF THE POPULATIONS SERVED. THE RESOLUTION DOES NOT BLOCK OR OPPOSE ANY HOSPITAL OR LIMIT TRAUMA CARE FOR ANY RESIDENT . SOME OF YOU HAVE ASKED ME IN PREVIOUS COORDINATION, WHAT DOES THIS RESOLUTION ACTUALLY DO? WHAT IS THE EFFECT? I'LL SHARE WITH YOU TWO THINGS. 
          FIRST, FROM THE DEPARTMENT OF WAR'S PERSPECTIVE, IT IS A CLEAR SIGNAL OF SUPPORT. 
          I'LL JUST SHARE WITH YOU THE MESSAGE COMING OUT OF THE DEPARTMENT NOW IS WE NEED PARTNERS, NOT NEIGHBORS. THEY WANT PEOPLE WHO CONTRIBUTE AND PUT SKIN IN THE GAME. THIS WOULD BE A VISIBLE SYMBOL OF THAT COMMITMENT. 
          SECONDLY, IT SETS THE CITY'S POSITION BEFORE ANY OTHER HOSPITAL SYSTEM IN THE FUTURE CONSIDERS THE SAME PATH. I'LL CLOSE WITH THIS. 
          I FEEL THAT PART OF MY JOB AND REASON WHY YOU HIRED ME IS TO PROVIDE BEST MILITARY ADVICE, WHICH IS A REFLECTION OF MY EXPERIENCE, MY JUDGMENT, AND UNDERSTANDING OF THE LARGER ENVIRONMENT. SO THAT'S WHAT I'M GOING TO OFFER, MY BEST MILITARY ADVICE. IF BAMC'S VOLUME DECLINED TO THE POINT THAT THEY NO LONGER SUSTAINED THE READINESS OF SURGEONS, NURSES, AND MEDICS TO THE POINT WHERE THEY CAN'T GUARANTEE THEIR WARTIME MISSION, THE DEPARTMENT WILL BEGIN SHIFTING ITS MISSION, RESOURCES, ITS PEOPLE TO SOMEPLACE ELSE THAT CAN SUPPORT IT. IT WON'T HAPPEN IN A SINGLE ANNOUNCEMENT. IT WILL HAPPEN DEATH BY 1,000 CUTS. 
          YOU'LL START SEEING MORE SURGICAL TEAMS BEING SENT TO MIAMI, ATLANTA, SAN DIEGO, CALIFORNIA TO USE THEIR CIVILIAN TRAUMA CENTERS TO MAINTAIN THEIR READINESS. 
          MY FEAR IS THAT AS THAT BECOMES MORE OF THE NORM, THE FORMAL FUNCTIONS OF BAMC CAN GET RELOCATED TO OTHER LARGE DOW FACILITIES. THIS IS A NO-FAIL MISSION FOR THE DEPARTMENT OF WAR AND IT'S ONE THAT THEY WILL NOT RISK. 
          I APPRECIATE YOUR ATTENTION TODAY AND THANK YOU FOR THE OPPORTUNITY TO DISCUSS THIS. 
          I'LL BE FOLLOWED BY COLONEL KELLY TO OFFER HIS PERSPECTIVES. 
          >> GOOD MORNING, MAYOR, COUNCIL MEMBERS. THANK YOU FOR YOUR TIME. 
          AS GENERAL JACKSON MENTIONED, I AM COLONEL KELLY AND I HAVE THE PRIVILEGE TO BE THE COMMANDER AND DIRECTOR AT BROOKE ARMY MEDICAL CENTER. 
          SERVING TODAY AS THE DEFENSE AGENCY'S LIAISON TO THE CITY OF SAN ANTONIO AND ALSO TO BEXAR COUNTY IN AN ADVISORY CAPACITY ON MATTERS AFFECTING BROOKE ARMY MEDICAL CENTER. WE RECOGNIZE THE ONGOING DISCUSSION AND IN MY OFFICIAL ADVISORY CAPACITY I'M AVAILABLE TO PROVIDE SUBJECT MATTER EXPERTISE AND ANSWER QUESTIONS ABOUT POTENTIAL EFFECTS AND RISKS TO BAMC AND ITS MILITARY MEDICAL READINESS MISSION. I AGAIN APPRECIATE THE OPPORTUNITY TO BE HERE. 
          I'M JOINED BY DOCTORS VAN ZANT. THEY ARE MY SMES ON TRAUMA 
          [01:40:03]
I AM NOT A TRAUMA SURGEON. AS GENERAL JACKSON NOTED, BAMC IS THE DEPARTMENT OF WAR'S ONLY LEVEL 1 TRAUMA AND BURN CENTER MAKING US A CRITICAL NATIONAL READINESS ASSET. HE ACCURATELY DESCRIBED OUR CURRENT VOLUME AND SHOWS WHY WE ARE CONCERNED ABOUT THE RISK MOVING FORWARD. OUR ABILITY TO CARE FOR A HIGH VOLUME AND RANGE OF TRAUMA PATIENTS ENABLES MILITARY PHYSICIANS, NURSES, MEDICS, AND OTHER CLINICIANS TO DEVELOP AND SUSTAIN THE LIFE-SAVING SKILLS REQUIRED TO CARE FOR COMBAT CASUALTIES AND TO DEPLOY WORLDWIDE. 
          THIS READINESS MISSION SUPPORTS THE NATION'S MOST VALUABLE ASSET, OUR SERVICE MEMBERS, SONS, DAUGHTERS, MOTHERS, FATHERS, FAMILY MEMBERS, AND FELLOW AMERICANS AND SAN ANTONIANS WHO DEFEND OUR NATION AND OUR CONSTITUTION. 
          EARLY IN MY CAREER AS AN ARMY FAMILY PHYSICIAN, I TRAINED AT A LEVEL 1 TRAUMA CENTER IN ANOTHER COMMUNITY. IT WAS THE MOST IMPORTANT THING THAT I DID TO PREPARE TO PROVIDE COMBAT CARE FOR SOLDIERS DURING MY DEPLOYMENTS. 
          I REMEMBER TAKING CARE OF A CIVILIAN WHO HAD A LARGE TREE FALL ON HIM, CRUSHING HIS CHEST AND LEGS. AFTER STABILIZATION, MULTIPLE SURGERIES, AND WEEKS OF REHABILITATION, HE WALKED OUT OF THE HOSPITAL TO RETURN TO HIS FAMILY. 
          AS I TOOK CARE OF SOLDIERS INJURED BY IED BLASTS WITH SIMILAR INJURIES, I AND THE TEAM I COUNTED ON HAD THE EXPERIENCE TO ENSURE WOUNDED SOLDIERS RETURNED HOME AS WELL. FOR DECADES BAMC HAS WORKED CLOSELY WITH THE SOUTHWEST TEXAS REGIONAL ADVISORY COUNCIL AND HOSPITAL PARTNERS TO SUPPORT A COORDINATED TRAUMA SYSTEM . WE VALUE OUR ENDURING PARTNERSHIP WITH UNIVERSITY HEALTH, THE REGION'S OVER LEVEL 1 TRAUMA CENTER. TOGETHER OUR INSTITUTIONS PROVIDE LIFE-SAVING CARE WHILE PROVIDING MILITARY EDUCATION, TRAINING, AND READINESS. WE SUPPORT DATA-INFORMED EVALUATION OF PROPOSED CHANGES TO REGIONAL TRAUMA CAPACITY. ANY EVALUATION SHOULD CONSIDER PATIENT ACCESS, TRANSPORT TIMES, CLINICAL OUTCOMES, REGIONAL SYSTEM RESILIENCE AND THE ABILITY OF BOTH LEVEL 1 TRAUMA CENTERS TO SUSTAIN THE CLINICAL VOLUME, ACUITY, COMPLEXITY, AND DIVERSITY REQUIRED TO MEET THEIR ESSENTIAL MISSIONS. OUR MILITARY DOCTORS SERVE THE COMMUNITY EVERY DAY. 
          AND IN RETURN THE COMMUNITY GIVES OUR MEDICS THE REAL-WORLD EXPERIENCE NEEDED TO SAVE LIVES IN COMBAT. IT IS A MUTUALLY VITAL PARTNERSHIP. 
          WE ARE AT THE TABLE AS TECHNICAL ADVISORS. OUR PRIORITY IS SIMPLE. 
          PROTECT TOP-TIER TRAUMA CARE FOR SAN ANTONIO WHILE SAFEGUARDING MILITARY MEDICAL READINESS. WE REMAIN COMMITTED TO WORKING WITH REGIONAL PARTNERS TO PRESERVE TIMELY ACCESS TO THE TRAUMA CARE WHILE PROTECTING THE NATION'S MILITARY READINESS. I WAS THINKING I WOULD GET A LOT OF QUESTIONS ABOUT WHAT'S YOUR MINIMUM THAT YOU NEED. AND WHAT I WOULD SAY IS THAT IN TRAINING FOR COMBAT, WE DON'T THINK ABOUT MINIMUMS. AN ANALOGY I CAN GIVE YOU WOULD BE AN ATHLETE. SO LAST NIGHT 24 REBOUNDS. I WAS ONLY ABLE TO WATCH THE FIRST HALF BEFORE I HAD TO GO TO BED BUT I SAW IN THE FIRST HALF HE WAS 15 FOR 15 IN FOUL SHOTS. 
          PERFECT. 100%. I GUARANTEE YOU THAT WEMBE IS GOING TO SHOOT FOUL SHOTS. THEY ARE HIGH VOLUME NOW BUT THEY NEED TO DO THAT EVERY DAY SO WHEN THEY GET IN THE GAME THEY ARE JUST AS READY AS AN ATHLETE. WE OBVIOUSLY HAVE A HIGH STAKES THING THAT WE GO DO. 
          I APPRECIATE YOUR SUPPORT. I WILL STAND BY FOR QUESTIONS WHEN GENERAL 
          JACKSON TAKES QUESTIONS. THANK YOU. >> MAYOR JONES: THANK YOU, SCOTT. THANK YOU, COLONEL. I DO WANT TO MAKE SURE -- I SEE AVANA IS HERE FROM UNIVERSITY. IF YOU WOULD LIKE TO SPEAK 
          ABOUT THE IMPACT OF THIS, YOU'RE MORE THAN WELCOME TO. >> 
          >> MAYOR JONES: OKAY. I'LL GIVE YOU A LITTLE BIT MORE TIME THAN THREE 
          MINUTES, AS AN EXPERT AND STAKEHOLDER HERE. >> I CERTAINLY -- EVERYTHING THAT WAS SAID TODAY IS -- I'M NOT GOING TO SHARE ALL OF -- REHASH WHAT WAS SAID. 
          BUT I WOULD LIKE TO SHARE A LITTLE BIT ABOUT HOW WE WORK WITH THE PARTNERSHIP WITH THE MILITARY AND WHY AND HOW WE'RE DOING THIS. WHEN YOU LOOK AT UNIVERSITY HEALTH, THE COMMITMENT YEARS AGO WITH U.T. HEALTH WAS TO MAINTAIN THE HIGHEST RESIDENCY TRAINING IN MEDICAL SCHOOL TO TRAIN THE NEXT GENERATION OF PHYSICIAN ES. AS A LEVEL 1 TRAUMA CENTER WE HAVE OVER 600 RESIDENTS AND FELLOWS TRAINING IN SOME OF THE MOST ADVANCED CLINICAL CARE. 
          [01:45:02]
THAT'S NEUROSURGEONS, ORTHOPEDIC SURGEONS, GENERAL SURGEONS ALL THE WAY DOWN TO THE SMALL, MICROVASCULAR PLASTICS AND OTHERS. UNIVERSITY HEALTH HAS A DEDICATED TRAUMA EMERGENCY ROOM THAT IS NOT THE MEDICAL EMERGENCY ROOM STAFFED BY DR. STEWART AND HIS STAFF, WHO IS HERE TODAY. AROUND THE CLOCK 24 HOURS A DAY WITH FACULTY PHYSICIANS AND THOSE 600 RESIDENT TRAINING PHYSICIANS AVAILABLE TO BE THERE TO LEARN. IN PARTNERSHIP WITH BAMC, THAT LEARNING GOES ACROSS BOTH INSTITUTIONS. OUR INSTITUTION MADE SURE THAT THERE IS ADEQUATE TRAINING AND VOLUME. SO WHEN A TRAUMA COMES IN, WHILE THOSE LEVEL 1 TRAUMAS ARE COMING IN, WE HAVE ORTHOPEDIC SURGEONS, NEUROSURGEONS, GENERAL SURGEONS THAT HAVE TO TAKE CARE OF THOSE PATIENTS BUT THEY'RE ALSO LEARNING. THAT VOLUME OF LEARNING IS ON THE TRAUMA PATIENTS. 
          THEY'RE ALSO LEARNING WHEN THE PATIENT COMES THROUGH THE REGULAR EMERGENCY ROOM BECAUSE THEY MIGHT HAVE A CASE THERE. THOSE VOLUMES ARE NEEDED FOR COMPETENCY AND TRAINING. AS WE SEE ONE OF THE THINGS THAT AMERICAN COLLEGE OF SURGEONS, WHEN THEY CERTIFY A LEVEL 1 TRAUMA CENTER SHOWS THAT YOU HAVE TO USE OUTREACH AND PREVENTION AND RESEARCH TO BE A LEVEL 1. OUR OUTREACH AND PREVENTION DEPARTMENT IS ALSO WITH BAMC'S IS ONE OF THE REASON TRAUMA ISN'T GROWING. 
          WE ARE OUT THERE EDUCATING PEOPLE ABOUT GUN SAFETY, ABOUT WEARING A HELMET. 
          DOING THE SIMPLE THINGS THAT SOMETIMES WE TAKE FOR GRANTED. 
          BUT THAT'S WHERE, IN SAN ANTONIO ESPECIALLY, TRAUMAS HAVE BEEN LEVELED OFF. 
          WE ALSO, WITH THE MILITARY -- AND CREDIT TO DR. STEWART AND DR. DON JENKINS, WE WERE ONE OF THE INNOVATORS OF WHOLE BLOOD BECAUSE OF WHAT THE MILITARY LEARNED. NOW SAN ANTONIO AMBULANCES HAVE WHOLE BLOOD ON THEIR AMBULANCES TO GET BLOOD TO THE PATIENT BEFORE THEY EVEN COME TO THE HOSPITAL BECAUSE THAT COULD BE A LIFE-SAVING THING. THAT WAS ALL LED BY THE U.T. 
          HEALTH DOCTORS, BAMC AND OTHERS, BECAUSE OF WHAT OUR LEVEL 1 TRAUMA CENTERS DO. 
          WHEN WE LOOK AT THE VOLUME AND THE REDUCED VOLUME THAT COULD COME FROM THIS, THIS COULD SIGNIFICANTLY IMPACT BAMC. IT COULD SIGNIFICANTLY IMPACT OUR RESIDENT TRAINING PROGRAMS HERE WHERE IF THEY AREN'T GETTING ENOUGH CASES, PEOPLE HAVE TO GO AND LEAVE TOWN. THAT HAPPENS IN MAJOR CITIES. IN MAJOR CITIES ACROSS THE COUNTRY, IF YOU CAN NOT GET YOUR TRAUMA NUMBERS, YOU TRANSFER OR TAKE THAT RESIDENT FOR A PERIOD OF TIME AND HAVE TO SEND THEM TO ANOTHER CITY. WE DON'T EVER WANT TO HAVE TO SEND A TRAINING DOCTOR TO ANOTHER CITY BECAUSE WE DO NOT HAVE ENOUGH VOLUME FOR THE PATIENTS. THE OTHER THING I WOULD ALSO LIKE TO POINT OUT. 
          WHEN YOU SPREAD OUT TRAUMA OVER THREE HOSPITALS, BECAUSE OF THE COST OF MAINTAINING TRAUMA. DOCTORS AND NURSES AVAILABLE ALL THE TIME, WHEN THE VOLUME GOES DOWN, THE COST WILL GO UP. YOU'RE STILL PAYING FOR THE DOCTORS TO BE SITTING IN THAT TRAUMA UNIT WHEN THERE'S A TRAUMA OR NOT BECAUSE THAT'S OUR EXPECTATION. WHEN WE HAD SUTHERLAND SPRINGS AND UVALDE, THERE WAS 25 U.T. DOCTORS STANDING AT THE DOOR, FROM ANESTHESIA, SURGEONS, OTHERS, WAITING FOR THOSE PATIENTS TO COME IN THAT NEEDED TO BE DONE. THAT COST MONEY AND THAT TAKES PREPARATION. 
          WHEN YOU START SPREADING THAT OUT OVER OTHER INSTITUTIONS, THAT'S GOING TO RAISE THE COST OF TRAUMA CARE BECAUSE THERE'S TWO. NOW THERE'S THREE THAT HAVE TO BE READY AND AVAILABLE AT ALL TIMES WHEN THE VOLUME ISN'T GROWING. 
          THE OTHER THING THAT ALSO IS LOOKED AT IS THAT THAT'S ALSO GOING TO DRIVE UP THE COST FOR HEALTH INSURANCE. NOW WHEN THOSE COSTS ARE COMING ON, WHERE ARE WE GOING TO PAY FOR THAT? IT COULD BE PUT ON MORE UNINSURED OR PEOPLE THAT HAVE TO PAY OR THROUGH THE INSURANCES. SO WHAT I WOULD END WITH TODAY IS THAT IT'S IMPORTANT NO INSTITUTION, AS WAS MENTIONED EARLIER, IS GOING TO BE TOLD WHAT TO DO. BUT STANDING TOGETHER WITH BAMC AND OUR PARTNERS, WE'RE HERE TO BUILD WITH BAMC. WE ARE HERE TO MAKE SURE THAT WE CAN GET ADDITIONAL PROGRAMS. WE'VE TALKED IN THE FUTURE ABOUT HOW WE CAN CONTINUE TO DO MORE AND ACTUALLY BRING MORE TRAINEES FROM OTHER MILITARY HOSPITALS HERE SO THEY CAN DO THEIR ROTATIONS TOGETHER SO THAT THEY ARE BATTLEFIELD READY. 
          NURSES, CORPSMAN, PHYSICIANS. THEN THE OTHER THING I WOULD ADD IS THE LOSS OF ANY MILITARY MEDICINE HERE IS A LOSS TO SAN ANTONIO BECAUSE MANY OF THOSE PHYSICIANS, WHEN THEY RETIRE OUT OF THE MILITARY, THEY LOVE SAN ANTONIO AND THEY RETIRE HERE. AND THEY WOULDN'T BE IN SAN ANTONIO IF THEY WOULDN'T BE WORKING AT BAMC FIRST. SO WE HAVE A LOT OF RETIRED 
          [01:50:08]
PHYSICIANS OUT OF THE MILITARY NOW GIVING BACK IN THEIR SECOND CAREER AS A PHYSICIAN IN THE PRIVATE SECTOR, WHICH HELPS ALL OF SAN ANTONIO AND ALL OF SOUTH TEXAS. I WOULD LIKE TO THANK YOU FOR THE OPPORTUNITY TO SPEAK 
          TODAY AND I APPRECIATE IT. THANK YOU. >> MAYOR JONES: I KNOW ERIK IS ALSO HERE WITH STRAC. GIVEN THE LEADERSHIP ROLE THAT HE PLAYS IN THIS PROCESS, WELCOME TO MAKE A FEW COMMENTS, IF YOU WOULD 
          LIKE TO. >> HOWDY, MAYOR. I'M ERIC EPLEY, THE CEO AT STRAC. THE SOUTHWEST TEXAS REGIONAL ADVISORY COUNCIL'S JOB IS TO DEVELOP, IMPLEMENT, AND MAINTAIN THE REGIONAL TRAUMA AND EMERGENCY HEALTHCARE SYSTEM HERE. THAT'S DESIGNATED FROM THE STATE. 
          IT'S PART OF THE TEXAS TRAUMA SYSTEM CREATED IN LEGISLATION IN 1989 WITH THE HEALTHCARE RESCUE ACT . I HAVE BEEN AT STRAC FOR 27 YEARS. 
          CLINICAL BACKGROUND WAS A FLIGHT PARAMEDIC. I KNOW THIS REGION INTIMATELY. MY ROLE REALLY IS A NEUTRAL THIRD-PARTY CONVENER. 
          I DON'T HAVE AN OPINION ON THIS BECAUSE I SHOULDN'T HAVE AN OPINION ABOUT THAT. 
          I DO HAVE AN OPINION THAT WE ALL NEED TO WORK TOGETHER. THAT'S MY MAIN FOCUS RIGHT NOW IS THAT METHODIST'S DECISION TO MOVE FORWARD WITH THIS -- THERE'S SOMETHING CALLED CONSEQUENCE MANAGEMENT. IN PUBLIC SAFETY WE HAVE CRISIS MANAGEMENT, WHICH IS PREBOOM LEFT OF BOOM AND THERE'S CONSEQUENCE MANAGEMENT, RIGHT OF BOOM. I'M LIVING IN THE CONSEQUENCE MANAGEMENT. 
          THERE ARE PEOPLE WHO THINK THAT NEEDS TO BE DISCUSSED. I'M WORRIED ABOUT THE DECISION HAS BEEN MADE, THEY FILED WITH THE CITY AND WE NEED TO FIND A WAY TO WORK TOGETHER TO MAKE SURE THAT BAMC MAINTAINS THE HIGH VOLUME THEY NEED. 
          THE FINAL THING I'LL SAY. THE CHART THAT GENERAL JACKSON HAD ABOUT THE VOLUME. I LOVE THAT CHART. I THINK THAT CHART -- PEOPLE THINK THAT THAT CHART MAKES US LOOK LIKE WE'RE SOMEHOW BEHIND. 
          I WOULD SAY THAT THAT DEMONSTRATES OUR TRAUMA CENTERS ARE GETTING LOTS OF SETS AND REPS. THE TWO EXAMPLES I'LL GIVE THAT MAKE A WHOLE LOT MORE 
          SENSE -- >> MAYOR JONES: I THINK THAT'S SLIDE 4. 
          THANK YOU. >> THE THING I WOULD SAY MAKES A LOT OF SENSE -- EVERYBODY WATCHES FOOTBALL. SEVEN TIMES OUR TEN A BACKUP QUARTERBACK WILL THROW AN INTERCEPTION IN THE FIRST SERIES HE'S PUT IN THE GAME. WHY IS THAT? BECAUSE QB ONE GETS ALL THE REPS AND PREPARATION FOR THE GAME. 
          QB TWO GETS A QUARTER OF THE REPS. HENCE, HE DOESN'T DO AS WELL. AN F 1 CREW, IF THEY DID THAT PRACTICE THREE TIMES A YEAR VERSUS THREE TIMES A DAY EVERY DAY , WHO'S GOING TO BE FASTER? WHO'S GOING TO BE BETTER? WHO'S GOING TO BE MORE PROFICIENT? MORE SETS AND REPS MAKES YOU BETTER. THE FINAL THING I WOULD SAY, TO BRING IT BACK TO MEDICINE, ONE OF YOU IS GOING TO HAVE TO HAVE SOME KNEE SURGERY SOON. DO YOU WANT TO GO TO THE GUY WHO DID 20 LAST WEEK OR 20 
          LAST YEAR? THANKS, MAYOR. >> MAYOR JONES: JUST FOR EVERYONE'S TRANSPARENCY, I DID ASK ALSO SOMEBODY FROM METHODIST TO JOIN US THIS MORNING AND UNFORTUNATELY NO ONE WAS AVAILABLE. I DID WANT TO CLARIFY A POINT THAT JEFF MADE. JEFF SAID IT'S THE STATE THAT APPROVES IT. 
          WHAT THEY DON'T NECESSARILY SAY YOU NEED IT. WHAT THEY DO IS THEY SAY YOU HAVE MET ALL THE CRITERIA THAT YOU CAN OPERATE AS A LEVEL 2. 
          CORRECT? >> COYLE: CORRECT. I THINK OTHERS COULD ANSWER THIS BETTER THAN ME BUT MY UNDERSTANDING IS MANY STATES HAVE A NEED ASSESSMENT REQUIREMENT BEFORE A NEW TRAUMA CENTER CAN OPEN. TEXAS DOES NOT SO IN MANY CASES, ESPECIALLY AS WE LOOK AT THE HOUSTON, DALLAS DATA, THOSE ARE BUSINESS DECISIONS MADE BY HOSPITAL SYSTEMS TO OPEN. NOT NECESSARILY DRIVEN BY A DEMAND NEED ON THE FRONT END. DID I SUMMARIZE THAT RIGHT? 
          >> MAYOR JONES: IN CASE IT INFORMS ANYONE ELSE -- OR EVEN THE PUBLIC COMMENT. 
          WHEN WAS THE LAST TIME PATIENTS WERE DIVERTED FROM BAMC OR UNIVERSITY FOR 
          [01:55:09]
          TRAUMA? >> SORT OF NEVER. WE LOOKED AT THE LAST THREE YEARS OF DATA, SPECIFICALLY. THERE WERE THREE TIMES IN '24, '25, '26 DUE TO CAPACITY AT UNIVERSITY AND BAMC TOTAL. THREE PATIENTS, OUT OF MORE THAN 7,000. NONE OF THOSE WERE TRAUMA PATIENTS. 
          THEY WERE SKIN DISORDER PATIENTS LIKE STEVENS JOHNSON SYNDROME, ET CETERA THOSE THREE PATIENTS CAN BE MANAGED BY A GENERAL SURGEON AT A LEVEL 3 OR LEVEL 4 HOSPITAL. IF WE HAVE CAPACITY AT TRAUMA, WE'RE GOING TO SHUT THE SKIN DISORDER. BUT NO TRAUMA PATIENTS HAVE BEEN DENIED BASED ON CAPACITY. THERE ARE TIMES WHEN PATIENTS ARE CALLED IN BUT THEY'RE NOT APPROPRIATE FOR A LEVEL 1 TRAUMA CENTER. A BROKEN ANKLE. 
          WE PROCESS OVER 700 CRITICAL TRAUMA TRANSFERS EVERY MONTH. 
          ABOUT 100 OF THOSE, 80 TO 100 ARE DENIED BECAUSE THEY DON'T MEET CRITERIA. 
          THEY WERE MEDICAL PATIENTS. THEY HAD A STROKE. WELL, THIS IS TRAUMA MED, WE DON'T PROCESS MEDICAL PATIENTS. PERFORMANCE IMPROVEMENT REVIEW WITH THE SURGEONS EVERY MONTH FOR A PAINFUL 90 MINUTES WE GO THROUGH EVERY 
          SINGLE ONE OF THOSE PATIENTS THAT WAS NOT ACCEPTED. >> MAYOR JONES: HELPFUL. 
          GREAT. IS THERE A MOTION TO APPROVE THE RESOLUTION? 
          >> VIAGRAN: I MAKE A MOTION TO APPROVE. >> MAYOR JONES: OKAY. 
          ACTUALLY, ERIK, I'M SORRY TO MAKE YOU WALK ALL THE WAY BACK THERE. 
          COME ON BACK. THANK YOU FOR THE DISCUSSION THAT WE HAD. 
          THANKS AS WELL FOR PROVIDING MOST OF THAT LITERATURE. SOME OF THESE THINGS IS NOT CONJECTURE. THERE'S ACADEMIC LITERATURE THAT MAKES MANY OF THE POINTS YOU JUST MADE, WHICH IS AN INCREASE IN ACCESS TO TRAUMA -- OR AN INCREASE IN TRAUMA FACILITIES DOES NOT MEAN AN EQUIVALENT INCREASE IN TRAUMA ACCESS FOR THE PATIENTS. WE HAVE ALSO SEEN THE PROLIFERATION OF THESE THINGS IN OTHER PLACES HAS BEEN ROOTED IN REASONS OTHER THAN PATIENT CARE. 
          AT THE END OF THE DAY, ABSENT A NEEDS ASSESSMENT, WHICH WOULD BE HELPFUL IN THIS ENVIRONMENT, WELCOME YOUR KIND OF YOUR ASSESSMENT OF WHY NOW. 
          IS THERE SOMETHING DRIVING THE CIRCUMSTANCE? >> YES, MA'AM. 
          SO STRAC HAS DONE A REGIONAL TRAUMA ASSESSMENT IN 2017. WE DO EVERY FIVE YEARS. 
          2017, DID ONE IN 2022. WE WERE UP TO DO ONE IN 2027, THE SPRING. 
          WE'RE STARTING THAT PROCESS NOW BECAUSE OF THE ISSUE HERE. 
          THE REASON I DON'T HAVE AN OPINION IS WE HAVEN'T LOOKED AT THE DATA YET. 
          WE MAY VERY WELL SAY THAT THE DATA SHOWS THAT WE NEED A THIRD TRAUMA CENTER RIGHT NOW. THAT'S ACTUALLY POSSIBLE. WE HAVEN'T DONE THE DATA STUDIES. I DO KNOW THAT TRAUMA VOLUME IN BOTH DALLAS AND AUSTIN -- THE RISK FOR BAMC, I THINK THE EXISTENTIAL RISK THEY FEEL IS CLEAR EXAMPLES IN OUR OWN STATE. THESE ARE INFORMAL NUMBERS. I WOULD NOT LIKE TO BE QUOTED IN THE MEDIA WITH THESE EXACT NUMBERS BUT AT OUR TRAUMA MEETINGS I WAS TALKING TO SOME OF THE PEOPLE FROM DALLAS AND AUSTIN. 
          THIS IS WHAT I LEARNED. IN OUR TRAUMA SYSTEM ASSESSMENT, WE WOULD GET DIRECTLY THESE EXACT NUMBERS. I WILL HAVE THEM THAT I COULD TRUST. BUT GENERALLY PARKLAND MEMORIAL WHERE JFK WAS TREATED, LONGSTANDING LEVEL 1 TRAUMA CENTER. THEIR ADMISSIONS WERE OVER 7,000. NOW THAT THEY HAVE HAD A PROLIFERATION OF LEVEL 1 AND 2 TRAUMA CENTERS AROUND THEM, UNDER 3,000. IN AUSTIN, BRACRIDGE DELL SEATON HAD TRAUMA ADMISSIONS OVER 7,000 AND WITH THE EXPANSION OF NORTH AND SOUTH AUSTIN, FIVE ADDITIONAL LEVEL 2S IN A PERIOD OF 10 YEARS, DROPPED FROM 7,000 TO UNDER 3. THERE IS A REAL RISK. I'M NOT SAYING THAT'S GOING TO HAPPEN HERE BUT I HAVE HAD DISCUSSIONS WITH KEY LEADERS AT BAPTIST AND CHRISTUS. BAPTIST SAID IF METHODIST DOES THAT WE'RE GOING TO BE FORCED TO EVALUATE. THE TRAUMA EQUATION HAS SHIFTED AND WE'RE MAKING THESE DECISIONS BASED ON THE EQUATION THAT WE LOOK AT WHEN WE LOOK AT IT. 
          IF METHODIST IS DOING THIS, BAPTIST DOES IT, WHAT'S CHRISTUS -- WHAT DO YOU 
          [02:00:06]
THINK CHRISTUS IS GOING TO DO? NOW WE'RE TALKING ABOUT THREE ADDITIONAL TRAUMA CENTERS, NOT ONE. I DON'T KNOW THAT THAT'S GOING TO HAPPEN. I'M NOT PREDICTING THAT'S GOING TO HAPPEN BUT IF I LOOK AT THE OTHER TWO LARGER URBAN AREAS IN DALLAS AND AUSTIN, I WOULD SAY IT'S A 
          BETTER THAN EVEN ODDS IT COULD HAPPEN. >> MAYOR JONES: THANK YOU. 
          I MEAN, IT'S HELPFUL AS WE UNDERSTAND THE OVERALL SITUATION. 
          PROFIT IS THE MOTIVATION FACTOR FOR THE ENTITIES THAT YOU JUST DESCRIBED. 
          AS WE SEE THE IMPLEMENTATION OF THE ONE BIG BEAUTIFUL BILL OBVIOUSLY AS A RESULT OF TUESDAY. HOWEVER, IT'S NOT -- IT WOULDN'T BE UNEXPECTED THAT SOME OF THESE INSTITUTIONS WOULD BE TRYING TO SHORE THEMSELVES UP CHIEF, WOULD YOU LIKE TO PROVIDE ANYTHING TO THE CONVERSATION? 
          >> GOOD MORNING. VALERIE FRAUSTO, FIRE CHIEF. FROM OUR PERSPECTIVE, OUR PRIORITY IS TO TRANSPORT A PATIENT TO THE RIGHT HOSPITAL THAT WILL GIVE THE BEST CARE AND THAT IS FULLY CAPABLE. SO, I AM A BIT CONCERNED WITH THE CHANGE. HOWEVER, WE RECOGNIZE THAT ANOTHER LEVEL 2 TRAUMA, IT COULD PROVIDE BENEFITS. HOWEVER, IT MAY IMPACT IN A NEGATIVE WAY. 
          AT THE SAME TIME WE NEED TO UNDERSTAND WHAT THAT MEANS FOR THE TRAUMA SYSTEM THAT WE ALREADY HAVE. THAT IS WHERE MY CONCERN IS WITH BROOKE ARMY MEDICAL CENTER. THEY HAVE A ROLE THAT GOES BEYOND CARING FOR THE MILITARY. THEY DO PROVIDE EXCELLENT SERVICES, IN MY EXPERIENCE, AND EMS. BOTH OF OUR LEVEL 1 TRAUMA CENTERS ARE VERY -- I MEAN, WE WALK IN AND THEY TAKE VERY, VERY GOOD CARE OF OUR CIVILIANS THAT ARE TRANSPORTED THERE. SO OUR PARAMEDICS, WE CURRENTLY BASE OUR TRANSPORT DECISION ON NOT ONLY THE PATIENT CONDITION BUT ALSO JUST GEOGRAPHY. 
          SO CURRENTLY OUR ONLY TWO CHOICES ARE UH AND BAMC. THIS IS GOING TO BE A DISCUSSION THAT WILL INVOLVE PARTNERS, NOT ONLY OTHER HOSPITAL SYSTEMS BUT STRAC, OUR MEDICAL DIRECTOR. BECAUSE AGAIN OUR TRANSPORT DECISIONS ARE BASED ON THE 
          BEST OUTCOME FOR THE PATIENT. >> MAYOR JONES: CHIEF, MY UNDERSTANDING IS AS OF 1 OCTOBER METHODIST IS ALREADY FUNCTIONING AS A LEVEL 2. 
          THEY'RE ALREADY ACCEPTING THOSE TRAUMA FOLKS. AND IT'S ABOUT 60, 70 FOLKS THEY HAVE RECEIVED. FROM YOUR VIEWPOINT, WHAT ARE THE IMPACTS OF THAT, IF 
          ANY? >> CHIEF: WELL, CURRENTLY WE GO BY THE RED-BLUE CRITERIA. THE LEVEL 1 PATIENTS THAT MEET ONE RED OR TWO BLUE WILL GO TO EITHER UNIVERSITY OR BAMC AS A LEVEL 1 TRAUMA ALERT. 
          HOWEVER, THERE ARE INSTANCES WHERE TWO OR MORE BLUE WILL BE TRANSPORTED TO OTHER HOSPITAL SYSTEMS, WHICH IS THE CASE RIGHT NOW. BUT IT IS A VERY SMALL PERCENTAGE. I DON'T SEE THAT HAVING A VERY BIG IMPACT ON THE 
          NUMBERS, HONESTLY. >> MAYOR JONES: OKAY. ERIK, A NEEDS ASSESSMENT. 
          HOW LONG WOULD THAT NORMALLY TAKE TO ACCOMPLISH, YOU THINK? IF THAT WAS SOMETHING THAT METHODIST MAY BE INTERESTED IN DOING OR INTERESTED IN 
          BEING INFORMED BY. >> METHODIST HAS INDICATED TRAUMA SYSTEM ASSESSMENT. WE THINK THAT CAN TAKE FOUR TO SIX MONTHS. 
          IT TOOK US ABOUT TEN MONTHS WHEN WE DIDN'T KNOW WHAT WE WERE DOING. 
          WE HAVE DONE IT TWICE NOW. I THINK WE CAN DO IT A LITTLE BIT FASTER. 
          A LOT OF THE CHARTS AND GIS DATA WE KNOW HOW TO DO IT THIS TIME. 
          FOUR TO SIX MONTHS WOULD BE MY ESTIMATE. >> MAYOR JONES: THAT WOULD BE A VERY HELPFUL SOURCE OF INFORMATION FOR THE COMMUNITY EVEN BEYOND THIS CONVERSATION. OKAY. SOME OF YOU MAY HAVE ALREADY SPOKEN BUT WE'LL CALL YOU UP HERE. MR. DAVID COHEN. 
          YOU HAVE THREE MINUTES. FOLLOWED BY DR. RONALD STEWART AND ANDREW SMITH. 
          >> I'M DR. DAVID COHEN AND THE REASON I WANT TO SPEAK -- 
          [02:05:03]
          >> MAYOR, I'M ANDREW SMITH. I WOULD LIKE TO YIELD MY TIME TO DR. COHEN. 
          >> MAYOR JONES: YOU HAVE SIX MINUTES, SIR. >> THE REASON I WANT TO SPEAK IS THAT I HAVE A LOT OF EXPERIENCE IN THIS ENVIRONMENT. 
          I WAS TRAINED AS A GENERAL SURGEON AND TRAUMA SURGEON AND SUBSEQUENTLY AS A CARDIOTHORACIC SURGERY. I WAS HEAD OF THE RESIDENCY PROGRAM. 
          THE CONSULTANT TO THE SURGEON GENERAL ON THORACIC SURGERY. 
          AND MORE IMPORTANTLY I HAD THREE COMBAT MEDICAL TOURS, ONE IN OPERATION DESERT STORM AND TWO IN OPERATION IRAQI FREEDOM. I THINK I'M VERY EXPERIENCED WITH THE TRAUMA TRAINING PROGRAMS THAT THE MILITARY HAS. 
          OUR PROGRAM AT BAMC IS UNIQUE WITHIN THE MILITARY. IT'S TRI-SERVICE. 
          ALL OF THE SERVICES ARE REPRESENTED. IT IS THE ONLY PLACE WHERE WE TRAIN NOT ONLY THE SURGEONS AND A FEW MEMBERS, MEMBERS OF SMALL TEAMS, WHICH DOES HAPPEN IN SOME OTHER PLACES LIKE IN MIAMI AND IN CALIFORNIA AND DIFFERENT PLACES. IT'S THE ONLY PLACE WHERE THE ENTIRE HOSPITAL SYSTEM IS ORGANIZED TO TAKE CARE OF TRAUMA IN THE MILITARY. WHEN WE ARE IN THE FIELD, WE HAVE HOSPITALS, NOT TEAMS. WE HAVE COMBAT SUPPORT HOSPITALS. 
          I SERVED ON ONE AND I SERVED ON SURGICAL TEAMS. HOSPITALS HAD TO HAVE ALL TYPES OF PEOPLE. LAB, X-RAY, WHATEVER THAT ARE DESIGNATED FOR TAKING CARE OF TRAUMA SPECIFICALLY. IT IS UNIQUE. THIS IS THE ONLY PLACE IN THE UNITED STATES WHERE THE MILITARY DOES THAT. WHERE YOU HAVE BIG MILITARY HOSPITALS ON MILITARY BASES WHERE THE SPEED LIMIT IS 20 MILES PER HOUR. 
          YOU DON'T SEE A LOT OF TRAUMA. WE ARE UNIQUE, NOT ONLY BECAUSE WE HAVE THE TRAINING AND THE RESEARCH THERE, BUT BECAUSE OF OUR PARTNERSHIP WITH STRAC WHERE WE TAKE TO THE MILITARY HOSPITAL CIVILIAN TRAUMA CASES. 
          THAT'S G GOOD IN TERMS OF SAVING MONEY FOR SOME OF OUR COMMUNITIES BUT IT'S PARTICULARLY GOOD BECAUSE IT ALLOWS TRAUMA TRAINING THAT IS AVAILABLE NOWHERE ELSE IN THE MILITARY. PEOPLE HAVE ALREADY PRESENTED THE GREAT STATISTICS. THIS RESOLUTION I THINK IS A NICE THING BUT WHAT I WOULD ASK IS THAT YOU CONSIDER -- YOU CAN'T TELL -- WE CAN'T TELL METHODIST NOT TO DO THIS BUT IT IS CLEAR BUILDING A LEVEL 2 TRAUMA CENTER ACROSS THE STREET FROM OUR MAJOR LEVEL 1 TRAUMA CENTER, WHICH TRAINS RESIDENTS THAT METHODIST DOESN'T DO, AT LEAST NOT AT THAT LEVEL, AND DOES TRAUMA RESEARCH, IS NOT A GOOD IDEA AND DOES NOT AID THE COMMUNITY. USING THE MORAL AUTHORITY OF THE CITY COUNCIL, I WOULD HOPE THAT YOU MIGHT MEET WITH THE LEADERSHIP OF METHODIST HOSPITAL AND MAYBE BE ABLE TO INFLUENCE THEM THAT THIS IS NOT A GREAT IDEA FOR THE COMMUNITY. IF THEY WANT TO DEVELOP A LEVEL 2 TRAUMA CENTER, IT SHOULDN'T BE RIGHT ACROSS THE STREET FROM A LEVEL 1 TRAUMA CENTER. 
          IT OUGHT TO BE OUT NEAR SEA WORLD OR IN ONE OF THE SURROUNDING TOWNS THAT DOES NOT HAVE A GOOD TRAUMA PROGRAM. I THINK THAT'S WHERE YOU COULD BE PARTICULARLY HELPFUL AND IMPORTANT BY DOING SOMETHING LIKE THAT AND GETTING THEM TO SEE WHAT THEY'RE DOING AT THE METHODIST HOSPITAL IN THE MEDICAL CENTER IS NOT A GREAT IDEA FOR OUR COMMUNITY. 
          THANK YOU FOR THIS CONSIDERATION. >> MAYOR JONES: THANK YOU. 
          DR. RONALD STEWART FOLLOWED BY GREG ANDERS AND KEVIN KELLY. 
          >> GOOD MORNING. I'M DR. RONNIE STEWART. I'M THE CHAIR OF THE DEPARTMENT OF SURGERY AT UNIVERSITY HEALTH SAN ANTONIO. 
          I HAVE BEEN IN THAT ROLE FOR 18 YEARS AND HAVE BEEN HERE AS A FACULTY MEMBER FOR 33 YEARS. I WAS AT THE FIRST MEETING OF STRAC IN 1993. 
          I WAS IN THE MEETING WITH A COUPLE OF MAJORS. I WAS A VERY JUNIOR TRAUMA SURGEON. WHEN WE TALKED ABOUT THE MILITARY-CIVILIAN 
          [02:10:05]
PARTNERSHIP AND HOW WE COULD TOGETHER AND HOW THAT WOULD BE OF BENEFIT TO OUR PATIENTS. I'M REALLY GRATEFUL TO BE ABLE TO BE ABLE TO SPEAK TODAY AND I'M REALLY GRATEFUL FOR ALL YOU DO. JUST LIKE OUR TEAMS, THE THINGS YOU DO REALLY MAKE A DIFFERENCE. IT MAKES A DIFFERENCE IN PEOPLE'S LIVES. SO I'M GRATEFUL TO HAVE THE OPPORTUNITY TO SPEAK TODAY. 
          IT'S AN HONOR TO GIVE MY STRONGEST RECOMMENDATION TO THE RESOLUTION. 
          IT'S VERY WELL DONE. IT IS VERY STRAIGHTFORWARD AND IT SHOULD NOT BE CONTROVERSIAL TO ANYONE. I GIVE MY STRONGEST SUPPORT TO THAT. 
          AND IT'S SUPPORT FOR BAMC AND THE MILITARY HEALTH SYSTEM FOR INTEGRATION INTO OUR CIVILIAN TRAUMA SYSTEM. AND I VERY RESPECTFULLY REQUEST THAT YOU ALL UNANIMOUSLY SUPPORT THIS. I RESPECTFULLY REQUEST THAT YOU DO THAT. 
          YOU'VE HEARD THAT WE HAVE A UNIQUE TRAUMA SYSTEM AND EMERGENCY HEALTHCARE SYSTEM. 
          THAT IS VERY TRUE. IT IS THE MODEL FOR THE NATION. 
          AND WE ARE THE ONLY ONE THAT HAS TWO LEVEL 1 TRAUMA CENTERS, ONE CIVILIAN AND ONE MILITARY. AND THAT IS A GIANT WIN-WIN FOR OUR COMMUNITY. 
          IT IS A GIANT WIN-WIN FOR OUR COMMUNITY. A WIN-WIN ON SO MANY LEVELS. 
          A WIN FOR OUR PATIENTS. A WIN FOR THE TWO TRAUMA CENTERS. 
          IT'S BEEN BENEFICIAL IN SO MANY DIFFERENT WAYS. ONE OF THE THINGS THAT STRAC, THAT WE'RE PROUD OF IS THAT WE MAKE COOPERATION COMMUNICATION VALUES. 
          SO I'LL WRAP UP. I KNOW MY TIME IS UP. BUT IT IS VITAL TODAY. 
          IT'S VITAL THAT WE ALL RENEW OUR COMMITMENT TO OUR MILITARY-CIVILIAN TRAUMA SYSTEM AND PARTNERSHIP. AND IT'S CRITICAL THAT WE DO THAT. 
          THAT'S IN THE BEST INTEREST OF OUR PATIENTS AND OUR COMMUNITY. 
          THANK YOU. >> MAYOR JONES: GREG ANDERS, PLEASE. 
          FOLLOWED BY KEVIN KELLY. >> MAYOR, COUNCIL MEMBERS. I'M DR. GREG ANDERS. 
          I'M A PHYSICIAN PRACTICING IN SAN ANTONIO. BEEN HERE FOR ABOUT 45 YEARS. I RETIRED AS THE CHAIRMAN OF THE DEPARTMENT OF MEDICINE AT BROOKE ARMY MEDICAL CENTER. I PRACTICE NOW AT THE BAPTIST HOSPITAL AND ALSO PRACTICE AT BAMC. I'M HUMBLED TO BE IN THE PRESENCE OF THESE EXPERTS. SOME OF US LOOKING A LITTLE BIT LONGER FOR WEAR. 
          I WAS A YOUNG MAN IN SAN ANTONIO AT ONE POINT. I'M GOING TO NOT SPEAK TO THE DATA. MANY PEOPLE ALREADY HAVE ACCESS TO THE DATA AND THEY'RE EXPERTS AND CONSULTANTS WHO CAN ADDRESS THAT. 
          I SHOULD ADD THAT I'M AN OUT OF TOWN GUY. I LIVE IN OLMOS PARK. 
          I WANT TO TALK TO YOU ABOUT YOUR CONSTITUENTS JUST A MOMENT BECAUSE I'M CERTAIN IN THIS BODY, CONSTITUENTS REMAIN VERY IMPORTANT. TO CONSTITUENTS WHO ASK YOU DO WE NEED MORE TRAUMA ACCESS IN BEXAR COUNTY AND SAN ANTONIO? I THINK THAT THE DATA WILL CLEARLY SHOW THAT IS NO. THAT ADDITIONAL TRAUMA ACCESS AND CAPACITY IS NOT NEEDED BASED ON THE NUMBERS YOU WILL LIKELY SEE. 
          THE SECOND THING I WANT TO ADDRESS -- AND I WORK AT THE DOWNTOWN -- I'M INVOLVED IN TRANSFERRING PATIENTS FROM THAT SETTING TO ONE OF THE TWO LEVEL 1 TRAUMA CENTERS THERE. STRAC DOES AN EXCELLENT JOB WITH THE POLICY AND THE PROCEDURE ABOUT HOW THIS IS DONE. IT HAS NOT BEEN MY EXPERIENCE AS ONE OF THOSE PHYSICIANS CALLING TO MOVE THOSE PATIENTS THAT I HAVE ENCOUNTERED MUCH RESISTANCE. CERTAINLY THE STRAC REPRESENTATIVE INDICATED THERE HAVE BEEN LIMITED CASES WHERE TRAUMA CANNOT BE RECEIVED AT THOSE TWO LEVEL 1 CENTERS HERE IN BEXAR COUNTY. I WOULD SAY THAT WHEN YOU'RE TALKING TO YOUR CONSTITUENTS, THESE ARE THE THINGS THAT PEOPLE NOT INTIMATELY FAMILIAR WITH THE MEDICAL CARE SYSTEM MIGHT ASK. 
          [02:15:01]
          I THANK YOU FOR YOUR TIME TODAY. >> MAYOR JONES: THANK YOU. 
          KEVIN KELLY, PLEASE. OKAY. LET ME GO TO THE COMMENTS OF MY COLLEAGUES. LET ME ALSO SAY THANK YOU. BAMC, WHEN WE UNFORTUNATELY HAD THAT CPS EXPLOSION, THOSE FOLKS, OUR NEIGHBORS WERE TREATED AT BAMC AND THEY RECEIVED EXCELLENT CARE. I THANK COLONEL KELLY FOR YOU AND THE TEAM THAT DID THAT AND FOR THE WORK YOU DO EVERY DAY. 
          WE RECOGNIZE THAT THE TRAUMA LEVEL, THE NUMBER OF PATIENTS THAT ARE DECREASING FOR A NUMBER OF FACTORS. IT SOUNDS LIKE THE DECREASED OPERATIONS AT THE BORDER ARE CONTRIBUTING TO FEWER PATIENTS THAT YOU'RE SEEING AS WELL AS SOME OF THE OTHER DISPERSEMENT THAT MAY BE HAPPENING THAT MAY BE LESS REFLECTED. 
          WE RECOGNIZE THE IMPORTANCE OF THIS MISSION. IT'S A BADGE OF HONOR WHEN WE SAY MILITARY CITY, USA THAT WE'RE ABLE TO INCLUDE BAMC IN THAT. 
          OKAY. COUNCILWOMAN ALDERETE GAVITO. 
          >> GAVITO: THANK YOU. I WANT TO START OFF BY SAYING I FULLY SUPPORT OUR MILITARY MISSIONS HERE IN SAN ANTONIO AND I'M EXTREMELY PROUD TO LIVE IN MILITARY CITY, USA. I HEAR CONCERNS AND I DO BELIEVE IT'S CRUCIAL THAT WE ENSURE OUR MILITARY MEDICAL STAFF ARE FULLY TRAINED AND THAT BAMC IS PROTECTED. 
          THAT BEING SAID, HOW THIS WAS PRESENTED TO COUNCIL, YOU KNOW, IT WAS PRESENTED AS AN EITHER/OR AND THAT COUNCIL COULD INTERFERE WITH THE GROWTH IN THE PRIVATE SECTOR. WE HAVE A DUTY TO SUPPORT ADDITIONAL HEALTHCARE INVESTMENTS THAT PROMOTE THE SAFETY AND WELL-BEING OF OUR RESIDENTS. 
          ADDITIONALLY, I THINK IT'S WISE OF US TO MAKE SURE THAT WE'RE ADEQUATELY PREPARING FOR THE ONGOING GROWTH OF OUR CITY. AGAIN, TO ME AND ALL OF -- I'M SURE MY COLLEAGUES WOULD AGREE, IT'S ESSENTIAL OUR RESIDENTS HAVE QUICK ACCESS TO THE CARE THAT THEY NEED. WE KNOW THAT METHODIST IS THE SECOND LARGEST PRIVATE SECTOR EMPLOYER IN SAN ANTONIO. I THINK IT WAS MENTIONED EARLIER BY THE HEAD OF STRAC. THERE YOU ARE. 
          THAT WE NEED TO FIND A WIN-WIN SOLUTION. TO ME IS NOT AN EITHER/OR. 
          THERE IS A WIN-WIN HERE. WE CAN AFFIRM BAMC WHILE ALSO AFFIRMING METHODIST HEALTH CARE MISSION TO THEIR COMMITMENT TO THEIR PATIENTS. 
          I'LL BE SUPPORTING THIS RESOLUTION TODAY. I'M ALSO SUPPORTIVE OF METHODIST'S EFFORTS TO BEST CARE FOR THEIR PATIENTS. I LOOK FORWARD TO STRAC'S ASSESSMENT AND I GENUINELY BELIEVE WE CAN FIND A PATH FORWARD THAT IS BEST FOR BOTH OUR MILITARY MISSIONS AND THE RESIDENTS OF SAN ANTONIO. 
          THANK YOU. >> MAYOR JONES: THANK YOU. COUNCILMEMBER WHYTE, PLEASE. 
          >> WHYTE: FIRST, I WANT TO THANK COUNCILWOMAN SPEARS FOR SORT OF LEADING THIS EFFORT TO GET THIS HERE TODAY. I AGREE WITH THE COUNCILWOMAN ALDERETE GAVITO'S STATEMENTS AS WELL. I DON'T THINK WE NEED TO LIMIT ANYTHING THAT'S GOING ON, YOU KNOW, IN THE PRIVATE SECTOR BY THIS RESOLUTION AND I DON'T THINK THAT IT DOES THAT. TO ME, THIS IS REAFFIRMING OUR COMMITMENT TO BAMC AND THE WORLD-CLASS MEDICAL CARE THAT IT PROVIDES TO FOLKS, NOT JUST HERE IN SAN ANTONIO BUT OF COURSE FROM ALL OVER THE COUNTRY THAT COME HERE TO GET THE CARE. I'LL BE SUPPORTING THE RESOLUTION. 
          THANK YOU TO EVERYONE WHO CAME TODAY TO SPEAK ON BEHALF OF IT. 
          THANKS, MAYOR. >> MAYOR JONES: THANK YOU. COUNCILMEMBER SPEARS, 
          PLEASE. >> SPEARS: THANK YOU, MAYOR. 
          I JUST WANT TO SAY THANK YOU TO JEFF AND TO SCOTT FOR YOUR PRESENTATIONS. 
          AND COLONEL KELLY, THANK YOU SO MUCH FOR COMING. AND DR. COHEN. 
          IT'S ALWAYS A PLEASURE TO SEE YOU. THANK YOU. 
          I HAVE A COUPLE OF QUESTIONS AND COMMENTS. SCOTT, I WANTED TO ASK YOU MENTIONED YOUR ASSESSMENT IS THE DEPARTMENT MIGHT PULL OR REDUCE BAMC'S ROLE HERE IN SAN ANTONIO IF READINESS IS AT RISK. CAN YOU EXPLAIN MORE ABOUT HOW THAT WOULD HAPPEN AND WHAT WE SHOULD BE LOOKING FOR? 
          >> CURRENTLY EVEN RIGHT NOW THE DEPARTMENT OF WAR IS NOT REALLY MEETING ALL OF ITS MISSION REQUIREMENTS. IN MY LAST JOB IN MIAMI AT JACKSON MEMORIAL IN MIAMI, WE HAD ONE OF THE LARGEST COLLABORATIVE PARTNERSHIPS WITH THE DEPARTMENT OF WAR WHERE THEY WOULD COME TO MIAMI TO GET THEIR RESPECTFULLY REQUEST. 
          AS COLONEL KELLY WOULD FIGHT TO KEEP HIS READINESS UP, IF YOU CAN'T MEET MISSION, THEY WILL EXPAND THE PROGRAM IN JACKSON . THEY HAVE WORKED IN ATLANTA, TAKING ADVANTAGE OF WHAT GOES DOWN IN DOWNTOWN ATLANTA. 
          THAT WILL BLOW BACK UP AGAIN. I THINK THAT'S THE EASY BUTTON OF INITIAL ADJUSTMENTS THE DEPARTMENT CAN MAKE REALLY TO MEET THE 
          [02:20:02]
MINIMUM MISSION REQUIREMENTS OF FOLKS DEPLOYING OUT AS THEY HAVE TEAMS GET READY ON A MISSION CYCLE. THEY'LL SEND THEM THERE AND SEND THEM TO THE THEATER. 
          THAT'S THE EASY BUTTON. THE HARD ONE IS LONG-TERM ENTERPRISE LEVEL CHANGES. 
          IF THIS CONTINUES, THEY WOULD SAY, LOOK, MIAMI IS SUPER EXPENSIVE SO A CHEAPER OPTION WOULD BE AT A MILITARY TREATMENT FACILITY SOMEWHERE ELSE IN THE 
          SYSTEM. >> SPEARS: COLONEL KELLY, I HAD A FEW QUESTIONS FOR YOU TOO. COULD YOU EXPAND OR EXPLAIN -- I KIND OF HAVE SOME UNDERSTANDING HERE -- BUT THE IMPORTANCE OF TEAM TRAINING AT BAMC AND WHAT THAT MEANS FOR CIVILIANS AND ALSO WHAT THAT MEANS FOR MILITARY READINESS IN 
          COMBAT. >> THANKS, MA'AM. HEALTHCARE IS A TEAM SUPPORT ALWAYS. NO DIFFERENT IN COMBAT. WHEN WE GO TO COMBAT, OUR TEAMS LOOK A LITTLE DIFFERENT THAN THEY MIGHT IN A HOSPITAL HERE IN THE STATES. BY BEING A MILITARY TREATMENT FACILITY WE HAVE THOSE SAME PEOPLE TRAINING TOGETHER, WORKING TOGETHER, STILL PROVIDING THE SAME HIGH-QUALITY CARE. JUST RECENTLY THE NAVY ASKED US -- AND WE HAVE BEEN ABLE TO SUPPORT WHERE THEY BRING IN A SURGICAL TEAM THAT WILL TRAIN TOGETHER, TAKE CALLS TOGETHER. AND THEN DEPLOY TOGETHER. IT DOESN'T TYPICALLY GET TO WORK LIKE THAT. JUST THE NATURE OF HEALTHCARE. 
          SO AND WE CAN'T DO THAT -- THE PARTNERS THAT GENERAL JACKSON WAS DISCUSSING, OFTEN WE CAN'T RECREATE THAT. WE CAN GET INDIVIDUAL SKILL TRAINING BUT TO BRING THE TEAM TOGETHER, IT'S UNIQUE WE CAN DO IT AT A MILITARY 
          TRAINING FACILITY. >> SPEARS: AND THEN I'M GOING TO ASK YOU ABOUT THIS. 
          THERE'S BEEN SOME DISCUSSION IN THE NEWS ABOUT PAYMENT ISSUES WITH CIVILIAN PATIENTS TREATED 
          [02:35:03]
WE LOOK FORWARD TO THE NEEDS ASSESSMENT, ERIK, THAT HELPS INFORM THIS 
          [02:35:06]
CONVERSATION. I THINK THE NEXT TIME WE HAVE THIS CONVERSATION IT 
          [02:35:09]
WILL ALSO BE HELPFUL TO MAKE SURE WE HEAR FROM A BROADER PUBLIC HEALTH PERSPECTIVE, DR. JACOB'S PERSPECTIVE ON WHAT THAT NEEDS ASSESSMENT HELPS US UNDERSTAND. 
          WITH THAT, THERE'S A MOTION AND A SECOND. GO AHEAD. 
          >> KAUR: I JUST WANTED TO THANK EVERYONE FOR COMING OUT AND SPEAKING TODAY. 
          I HAVE LEARNED A LOT THROUGH THIS. RECENTLY I WAS WITH A FRIEND WHO BROKE HIS ANKLE WHEN WE WERE PLAYING FOOTBALL. HIS PH BONE CAME OUT. 
          STRAC CAME AND WE HAD TO TRANSPORT HIM TO BAMC. HE HAS PINS IN HIS FOOT BUT I SAW FIRSTHAND HOW QUICKLY Y'ALL WERE ABLE TO HELP. I REALLY APPRECIATE THAT. 
          AT THE SAME TIME, METHODIST IS IN MY DISTRICT AND I DO THINK THEY OFFER REALLY GOOD CARE. AS WAS SHARED. THEY OFFER REALLY GOOD CARE FOR OUR MOST UNDERSERVED POPULATIONS AS WELL, WHICH I KNOW YOU ALL DO TOO. 
          IT IS AN IMPORTANT INSTITUTION. I'M SENSITIVE TO WHAT THEY'RE DOING BUT I ALSO UNDERSTAND THAT THIS IS NOT, YOU KNOW, IT'S A BUSINESS DECISION AND I'M HOPING THAT PEOPLE CAN SEE THAT WE CAN MAKE DIFFERENT BUSINESS DECISIONS TO GET TO BETTER SOLUTIONS FOR OUR RESIDENTS AND THIS DOESN'T HAVE TO BE THE ONLY WAY. I'M HOPING WE CAN FIND A DIFFERENT WAY TO MOVE FORWARD AND LOOKING FORWARD TO SUPPORTING. I ALSO WANTED TO QUICKLY ADD THANKS TO CHIEF FRAUSTO AND EVERYTHING THEY ARE DOING WITH EMS BECAUSE I KNOW THAT CAN ALSO BE AN AVENUE WE CAN USE TO MITIGATE FUTURE CONSEQUENCES. 
          THANKS, MAYOR. >> MAYOR JONES: THERE'S A MOTION AND A SECOND TO APPROVE THE RESOLUTION. PLEASE VOTE. THE MOTION CARRIES. 
          THANK YOU. ANYTHING ELSE? THAT'S THE BUSINESS OF THE DAY. THE TIME IS 11:42 THE MEETING IS ADJOURNED.
* This transcript was compiled from uncorrected Closed Captioning.