COMMUNITY'S CHALLENGE & THE POWER OF COLLABORATION

Fred Butler, Executive Director of the Community Action Network (CAN) - Mr. Butler made a few introductory comments and cited a recent Forbes Magazine report that designates Austin as "The Best Place for Business." Next, he introduced Pat Hayes as an instrumental force in focusing on Health issues.

Pat Hayes - Ms. Hayes thanked each of the participants for committing their time by attending this forum. She explained that one of the purposes of the work to be accomplished in the forum is to identify three to four areas that will advance and have a powerful impact on the community. She emphasized that the forum's activities will focus on our communities health in the broadest sense. In order to paint the picture of where our community is, she cited the following information:

• Central Texas is healthier than other counties and it has slightly improved from the past.
• 20-25% of people in this region lack health insurance and this population is disproportionately Hispanic. This population does not have a primary care home and they see their health as poor.
• Central Texas is growing dramatically with the growth being disporportiately Hispanic.
• Prevention is more cost effective than treatment but less than 5% of funding is spent on it.
• We have a prosperous 2.1% unemployed rate that is matched with 12.9% of residents in central Texas under the poverty level.
• Of the uninsured, 70% are working. We are talking about the working poor.
• In 1997, over 17,000 small businesses dropped their insurance coverage of employees.
• Huge driver is government policy. For example, the Balance Budget Amendment has impacted local hospitals by millions of dollars.
• It appears that a bipartisan policy effort intends to make it difficult to be a recipient of Medicaid benefits.
• Emergency care utilization is rising faster than the growth of the population.
• There is a radical decrease in access for mental health and substance abuse, acute care, nursing homes, and other services.
• Families experience complex bureaucratic systems, creating increased and duplicate paperwork for those less skilled at traversing the system.
• Some people cannot find access to dialysis services.

Ms. Hayes pointed out that although there are tremendous challenges in the field of health care and human services, the community is at a point wherein an opportunity to substantially improve the system of care is occurring. The following are a few points identified as opportunities in our community:

• We live in a community with a multiplicity of assets; Central Texas is a higher education community, one with leadership and one concerned about health care. Many other communities lack these assets. Using Maslov's hierarchy, we are a community that is at a higher level.
• We are at a real fork in the road. At one side of the fork, funds are decreasing and for many the thought is that the best strategy is to take care of my own niche ("hunkering down") because the other solutions may be too big for me. The other fork is an opportunity to create a community solution. Intuitively we think self-protection will optimize my ability. This point of view is innocent in that we are so profoundly interdependent. Example, air quality - two thirds of our problem comes from Houston. So much for hunkering down, we can never solve the problem alone. Hi-tech has no greater problem than getting the workforce they need. In our community 12.9% of our workforce is living below poverty level and may not have been educated beyond 8^th or 9^th grade. We need to look at how we are dependent on each other.
• We are profoundly interdependent. This story provides a simplified example, a mom was in the kitchen and her kids were playing on the back porch. They are shouting and screaming because they want an orange. She splits it. One child eats half of the orange and throws away the rind. The other takes half the rinds and mixes it with water for paint and throws away the other. If their mother had asked what the orange is for, then they both could have had 100% of what they wanted. Instead they got 50% and 50% was wasted.
• Many of you have been involved with the Indigent Care Council (ICC) and now the Robert Wood Johnson (RWJ) grant for planning and designing a new system of care. The RWJ coalition is a good example of finding a solution and working together.
• Back to fork in road, we are at a place where we need to make a decision. Will each of us take care of ourselves and hunker down or will we look at a larger pie, a bigger picture that is dependent on us working together?

Five aspects of collaborations:

Central Texas can be the richest and also have the highest quality of life for those that live here. You can make a difference with smart directional right solutions that you provide today.

Fred Butler - Mr. Butler introduced Judge Sam Biscoe. He explained that Judge Biscoe is known by just about everyone. He is known for his willingness to be involved. Mr. Butler provided an example of CAN's need for a chair on a committee and Judge Biscoe volunteered. He is also known for his willingness to listen, to collaborate, and a sense of humor.

Judge Sam Biscoe - Judge Biscoe began by remarking on Fred Butler's ability to sound like a campaign manager; then he discussed the importance of collaborations. He began by describing that it has not been so long ago when to collaborate had a negative meaning. It meant to cooperate with an enemy invader. Today it means people coming together, brainstorming, and trying to find facts in order to find solutions to important issues.

Next, he discussed the importance for all of us to bring the same mount of energy and academic power as we do to address environmental and other issues in our community. It is important to get input and work together. Judge Biscoe mentioned some of the successes that have been achieved through collaborations

He described a recent community awards banquet, where various collaborative efforts have made this community a better place to live, work, and play. He emphasized that this forum is important, collaborate and you will make a difference. Implementation is important and it is his view that this community is ready to make reasonable recommendations that will be implemented. Action has been lacking in the past.

When Judge Biscoe thinks of collaboration, he envisions planning and then sharing the information with everyone. Another important component is to identify resources. We need to know that these resources will change lives, when you have a plan someone needs to monitor and evaluate whether the implementation is working. He is amazed that people never admit that a program does not work but only that it works and needs increased funding. The community needs to challenge itself to know if something works and we need a process to measure if it works.

At a recent Resource Council, $3.8 million dollars from the Tobacco settlement funds have been identified for Travis County. Judge Biscoe would like to see these funds utilized in Health and Human Services. He recommends, we send letters to try and secure these resources.

Judge Biscoe encouraged the audience to bring specific programs forward and let him and others know what is needed. The funds need to be used not to invest in the future but to establish a one time investment into a program and keep it going. Health and Human Services is God's work. We need to work together whether we like each other or not because collectively will operate better programs.