City Council Meeting Workshop and Regular Session

1. City Council Meeting Workshop and Regular Session April 19, 2011

2. City Council Meeting – April 19, 2011 WORKSHOP SESSION 1. 5-5:15pm – Viewing of water line section (in parking area) 2. 5:15-5:45 – Council briefing on the changing face of health care in light of budget issues and federal intervention, presented by Sally Nelson, Huntsville Memorial Hospital (in Council Chamber).

3. Huntsville Memorial Hospital Some Cuts Don’t Heal

4. Some Cut’s Don’t Heal • The State of Texas is facing an unprecedented budget shortfall, and the magnitude of health care cuts being considered will have far-reaching consequences for all Texans. • If funding for local hospitals, doctors and nurses is not maintained, the health care system will be hurt beyond repair, and we will suffer the consequences. • Some cuts don’t heal, including those being proposed now in Austin. It’s time for hospitals, such as Huntsville Memorial, to get involved and • tell our state legislators to protect funding for local hospitals!

5. Summary of Proposed State Cuts • Health and Human Services, Article II – Cuts that Impact Hospitals • The Committee Substitute for House Bill 1, the 2012-13 budget, makes deep cuts in funding to local hospitals, doctors and nurses. Among the proposed cuts to health care – and those that impact hospitals especially – are the following: • 10 percent cut in rates paid to hospitals, nursing homes and physicians; • Expansion of Medicaid managed care which could jeopardize access to federal supplemental Upper Payment Limit funds; • Lack of funding to replace the $4.3 billion in federal stimulus funds set to expire later this year; • Medicaid bundling of payments for high cost/high volume services; and

6. Summary of Proposed State Cuts-Medicaid • A $225 million reduction in general revenue funds for each year of the biennium in the Medicaid program, of which many provisions are directed primarily to hospitals in the form of reductions for: • Implementation of Medicaid payment reform (pay-for-performance) and quality-based payments (reductions for health care-associated conditions and certain readmissions) in Medicaid fee-for-service and managed care, • Increasing neonatal intensive care managements, • Reducing hospital rates paid by Medicaid managed care organizations, • Implementing a prospective payment system for Medicaid out-patient services, • Reducing hospital payments for non-emergency Medicaid ER visits, • Maximizing co-payments in all Medicaid and non-Medicaid programs, • Maximizing federal matching funds through a statewide transportation broker or a Medicaid waiver, • Reducing costs for durable medical equipment and laboratory services through rate reductions, utilization management and consolidation, • Increasing nursing home utilization management and increasing reviews for appropriate RUGS levels, and • Expanding billing coordination to all non-Medicaid programs

7. Forced Response By HMH To Medicaid Cuts • With proposed cuts of 35 percent or more in state reimbursement for care, some hospitals will be forced to limit services. • Some clinics will close. • Wait times will grow longer for everyone. • Jobs will be cut, and unemployment will increase. • Hospital layoffs will have a ripple effect throughout Texas communities, and • The state’s ability to attract new businesses will be harmed. • Texas also will lose critical federal matching funds. State cuts will shift costs to local taxpayers and those with health insurance • What Will Huntsville Memorial Hospital Have To Do To Compensate For A Loss Of 20-30% Of Our Total Medicaid Reimbursement? • ($1.3 Million)

8. Some Cut’s Don’t Heal • Labor & Delivery/NICU/Nursery • 960 mothers/babies will no longer be able to access this service • 18 dedicated employees will experience job loss • 550 years of specialty nursing experience lost • Rural Health Clinic • 10,000 patients will no longer be able to access this service • 300 children will not receive required immunizations • No clinic available for Tuberculosis patients • 13 dedicated employees experience job loss • Licensed Vocational Nursing School • No longer graduate 50 nurses per year • Compound the nursing shortage by 500 over the next 10 years Where Will These Patients Go?

9. Summary of Proposed State Cuts-Medicaid

10. Forced Response By HMH To Medicaid Cuts

11. Forced Response By HMH To Medicaid Cuts • Since 1927, we have provided charitable health care • services, delivering quality healthcare to the residents of • Walker County and the surrounding communities. • Our talented team of medical staff members is focused • on staying up to the minute with the latest technologies • and treatment solutions, while still providing our patients • with friendly, down to earth service that they’ve grown to expect from this neighborhood hospital. No matter what changes the government has in store for us, our mission and vision will never change.

12. City Council Meeting – April 19, 2011 REGULAR SESSION [6:00pm] 1. CALL TO ORDER 2. PLEDGES OF ALLEGIANCE AND INVOCATION U.S. Flag Texas Flag: Honor the Texas flag. I pledge allegiance to thee, Texas, one state under God, one and indivisible. • PROCLAMATIONS AND PRESENTATIONS a. Proclamation for National Autism Awareness Month 4. PUBLIC COMMENT a. Related to any matter not on the agenda – 2 minutes per speaker b. Related to any matter on the agenda – 5 minutes per speaker

13. City Council Meeting – April 19, 2011 5. PUBLIC HEARING • City Council will hold a public hearing to receive citizen input regarding changes to the Development Code as submitted by the Planning and Zoning Commission. [Aron Kulhavy, Director of Public Works] - Chapter 4, Development Districts – the proposed addition of Section 404 Mobile and Manufactured Homes to prohibit future placement of Mobile Homes constructed before June 15, 1976, granting legal non-conforming status to all Mobile Homes legally in place, and adding skirting requirements. - Chapter 15, Definitions – updating the definitions of “Mobile Home” and “Manufactured Home”.

14. City Council Meeting – April 19, 2011 6. CONSENT AGENDA (Approval of Consent Agenda authorizes the City Manager to implement each item in accordance with staff recommendations. An item may be removed from the Consent Agenda and added to the Statutory Agenda for full discussion by request of a member of Council.) a. Approve the minutes of the City Council Regular Session held on April 5, 2011. [Lee Woodward, City Secretary] b. Approve Resolution 2011-13, to accompany the advance funding agreement with TxDoT for the installation of a new traffic signal on Highway 75 at Boettcher Drive, which was approved at the April 5, 2011 meeting. [Leonard Schneider, City Attorney] c. Consider approval of contracts to purchase water and wastewater supplies maintained as inventory in the warehouse and/or used for special projects. [Billie Smith, Procurement Manager]

15. City Council Meeting – April 19, 2011 6. CONSENT AGENDA (Approval of Consent Agenda authorizes the City Manager to implement each item in accordance with staff recommendations. An item may be removed from the Consent Agenda and added to the Statutory Agenda for full discussion by request of a member of Council.) d. Approve Ordinance 2011-30, temporarily amending the traffic schedule by changing the posted speed limit on a section of State Highway 19 for the duration of the Texas Department of Transportation’s (TxDOT) highway improvement project C 109-9-47, CSJ 0109-09-047, 2nd reading. [Aron Kulhavy, Director of Public Works] • Consider the award of bid for street improvements for Avenue D extension [Tom Weger, Project Manager] f. Consider the award of bid for street improvements for north Sam Houston cul-de-sac. [Tom Weger, Project Manager]

16. City Council Meeting – April 19, 2011 7. STATUTORY AGENDA • Presentation, discussion, and possible action to approve the final audited financial statements for the fiscal year ending September 30, 2010, presented by Ken Davis. [Winston Duke, Finance Director] b. Presentation, discussion, and possible action to approve Ordinance 2011-33, to prohibit future placement of mobile homes, require skirting for all mobile homes and manufactured homes, and revise the definitions of a mobile home and manufactured home, 1st reading. [Aron Kulhavy, Director of Public Works]

17. City Council Meeting – April 19, 2011 8. MAYOR/CITY COUNCIL AND CITY MANAGER REPORT a. Presentation, discussion, and possible action on formal complaint filed by John Cromer. [Councilmember Woodward] b. Discussion regarding flags at Oakwood Cemetery. [Councilmember Woodward] c. Presentation, discussion, and possible action on issues, information, and evidence relating to Citizen John Cromer’s formal complaint concerning the residency of Keith Olson and the City Council’s obligation to enforce the City Charter’s residency requirement. (Specifically, expect the motion “that Council use its Charter powers to take action under Section 4.05, Investigative Body, and /or Section 4.02, Qualifications, to enforce the Charter residency requirements as it relates to the eligibility of Keith Olson to serve on Council.”) [Councilmember Wagamon]

18. City Council Meeting – April 19, 2011 8. MAYOR/CITY COUNCIL AND CITY MANAGER REPORT d. Discussion of Economic Development Ad Hoc committee. [Mayor Turner] e. Presentation, discussion, and possible action to approve contract with Bickerstaff Heath Delgado and Acosta, LLP, for initial assessment only for redistricting. [Mayor Turner] f. City Manager’s Report • Updates on City construction, grants, studies, City projects, City purchases, and economic development. • Update on Highway 19 • Discussion of I-45/Highway 75 North interchange • Update on plasma plant visit • Discussion of Economic Development

23. City Council Meeting – April 19, 2011 9. PUBLIC COMMENT a. Related to any matter not on the agenda – 2 minutes per speaker 10.MEDIA INQUIRIES RELATED TO MATTERS ON THE AGENDA 11. ITEMS OF COMMUNITY INTEREST (Hear announcements concerning items of community interest from the Mayor, Councilmembers, and City staff for which no action will be discussed or taken.) a. The Farmers Market will begin Saturday, May 7, from 8-noon. b. The City will be closed for Good Friday on April 22, 2011. • Town Creek Music Festival will be held downtown on May 14, gates open at 3pm. • There will be an Easter Egg Hunt at the Wynne Home Wednesday afternoon. f. Thursday is the 175th Anniversary of San Jacinto Day!

24. City Council Meeting – April 19, 2011 12. EXECUTIVE SESSION • City Council will convene in closed session as authorized by Texas Government Code, Chapter 551; Section 551.071 – consultation with counsel on legal matters including current and pending litigation, including, but not limited to, Altom v. the City of Huntsville. [Leonard Schneider, City Attorney]

25. City Council Meeting – April 19, 2011 13. RECONVENE • Take action, if necessary, on item addressed during Executive Session. 14. ADJOURNMENT

26. The City Council is currently in Executive Session and will reconvene before adjourning.