A bill for an ordinance approving a proposed Fiscal Year 2021 Appendices to the Second Amended and Restated Operating Agreement between the City and County of Denver and Denver Health and Hospital Authority, providing for the amounts to be paid for services by the City and County of Denver and by the Denver Health and Hospital Authority for Fiscal Year 2021. Approves the 2021 Denver Health and Hospital Authority operating agreement (DDPHE 202056359). The last regularly scheduled Council meeting within the 30-day review period is on 12-7-20. The Committee approved filing this item at its meeting on 11-4-20.
11 Eyes Council Bill 20 Dash 1128 has passed. Councilmember Sandoval, would you please put council Bill 1138 on the floor for final passage? I move that council bill 20 dash 1138 be placed upon final consideration and do pass. Second. Thank you. It has been moved and seconded by Councilman Hines. The 30 minute courtesy public hearing for Council Bill 20 Dash 1138 is open. May we please have a staff report? Thank you. Madam President will send here from dpkg with just a quick introduction. I'm joined by Meghan Preso, the Public Health and Environment Contracts and Grants Manager and the Contract Administrator for the operating agreement who will be giving a short presentation. We're also joined by colleagues from other city agencies to address questions. And by Denver Health and Hospital Authority representatives, including CEO, Dr. Rob Winston, associate CFO Brad Kimball and others. And with that, I'll turn it over to Megan. Evening. Council members. I'm going to share my screen here. Everyone see? Great. Thank you for having us this evening. Well, already provided introductions. I'm the contract administrator you for the 2021 operating agreement. And thank you for your time this evening. Quickly a little bit about the structure of the agreement. I know many of you are familiar with it. Roughly 16 city agencies and over 40 to 50 people at the city managed the agreement all the way from budget to monitoring performance and many other aspects of the agreement. It's divided into three parts. The first part is considered Appendix A and the course services. These are the services which the city purchases from the authority. That includes examples here, like the medically indigent payment, EMS services, public health, Denver Cares, Prisoner Medical, etc.. The second section of the agreement is Appendix B. These are considered non-core services. These are services which the city may purchase in the hospital but could have multiple providers through a selective bidding process. These examples of these include first line jail, medical services, treatment on demand, and many others. And then the last section of the agreement, Appendix D are the flip and reverse. There are limited services, the hospital purchases from the city. And these some examples include payroll and legal services related to for service employees that are at the hospital. Radio support fuel man one. One call taker and many others. A little bit about. The 2021 agreement itself. There are 39 sections in the operating agreement. As you can see in the chart here, 28 of those sections remained unchanged. Ten of them had relatively minor revisions, and one of those has been removed or suspended in 2021. In 2017, I believe there was an audit of the operating agreement and lots of robust changes occurred in 2018. Therefore, the minimal changes this year. Couple of things to note. The oversight and accountability provisions that were updated and called out by council in 2020 are remain in the 2020 agreement as well. And as I mentioned, one section of the agreement due to budget reductions has been suspended for the 2020 year and that's the Marijuana Public Health Impact Monitoring and Epidemiology section. I'll quickly try to run through some highlights of each appendix. These lists the general changes in each section with some a few small ones not noted here, but these are the major ones. So for the course services in appendix A key changes to the emerging emergency medical services at the airport. It was just an update updated time that the second ambulance is dedicated to the airport. Some changes in public health services. We added some language around potential mid-cycle negotiations, language around addressing public health information between the two entities. Some routine updates to performance metrics and targets, and then some minor updates to the emergency preparedness procedures. Partially based on my experience with covered medical services for prisoners. We just updated the time the sheriff's department has to arrange for transport of a patient. And then lastly, just some courier services were updated for the Office of the Medical Examiner. Highlights of changes in Appendix B, the caution outline. We clarified some rules and kind of oversight responsibilities within those sections for Nurse Swine. We updated details regarding medical providers that provide that second level triage at Nurse Lynn and broader the options for external language interpretation services. For health care at the jail, added health services administrator position to oversee the nursing functions removed in additional limited term health care staff and added some assurances that the city will provide some space for health services to perform the required requirements outlined in the contract. As mentioned before, the Marijuana Public Health Impact Monitoring and Epidemiology section has been removed in 2021, and then the At Risk Intervention and Mentoring Program updated some some numbers related to the number of individuals that they will provide service to and the number of positions and associated costs, although there was no overall increase to the cost of the program. And finally, highlights in appendix Appendix C and there's obviously just one. And that was just to add Internet access and maintenance for the mobile routers and the paramedic vehicles. A little bit about the budget. Similar to city agencies, the city requested that the hospital take a reduction in 2021 to their operating agreement cost and the total contract amount for 2021 is 61 million plus. It's comprised of a $27.7 million payment for patient care services and the remaining 33.8 million roughly for other core and non-core services . Obviously, it also includes that approximate revenue for the city provided services at roughly $3.7 million. The graph on the left provides a distribution of the core services budget, and the graph on the right talks a little bit about the total cost of the medically indigent patient population. The orange portions of the bar graph representing the city's portion of those payments. And in conclusion, I just want to thank you all for your time. I know that this is a rather extensive agreement and there's many services, so appreciate that it's such an important decision being considered today. I also want to make sure that we keep in mind the importance of executing the contract by January 1st. We're wanting to make sure that we avoid any gaps in critical services for vulnerable residents in Denver. And for many of these services, there are likely other providers that are able to step in, and certainly not at this point in time between now and January 1st to provide those same services with that, that concludes the staff presentation. Thank you for your time. All right. Thank you, Megan. We have 22 individuals signed up to speak this evening. And just a quick reminder that this is a 30 minute courtesy public hearing. And so we'll go ahead and start with our list of speakers and most likely will not be able to get through them all, but would ask the speakers if you feel like you're repeating information or information has already been shared. If you could limit your comment so that we can get through as many individuals as possible. And so our first speaker up is Justin Harper. There you go. Go ahead, Justin. Hello? Can you hear me okay? Mm hmm. Can you hear me okay? Yeah. Hi, everyone. And thanks for coming. My name is Justin Harper. I'm a paramedic. I'm one of the assistant chiefs with the Denver Health Paramedic Division. I'm a Colorado native. I grew up in Denver in the Capital Hill neighborhood, as a matter of fact. I'm a product of the Denver public schools and I'm this I graduate the proudest I graduate, I should say. I currently live in the park neighborhood of Denver with my sons, who are also attending Denver public schools. So I chose to become a paramedic, and I joined Denver Health in 2000. And it was really my opportunity to give back and to be a part of this community in a different way. And really, Denver health affords that opportunity in many ways for paramedics to contribute. And, you know, speaking of the contribution, the Denver health paramedics were on more than 130,000 calls per year for service. It's definitely the largest emergency medical services system in the state and certainly in the region. And running such a service comes with a lot of challenges. But I think that we manage these challenges well and we find ways to help people, and we find ways to help beyond just the response of the paramedics. We actually in the last two years, we've trained people in CPR. First aid stopped the bleed, over 7000 people in the last two years in these courses. We've also trained over 550 EMTs and paramedics in the last three years. And so the impact of this health care education and it's a great example of how we reach our community in different ways. And it can't be understated. You know, one of the things that we know as paramedics is that people don't necessarily survive out of hospital cardiac arrest if they don't have bystander CPR. We know that you can bleed to death from a major injury for four from excuse me in less than 3 to 5 minutes. And so providing this community training and helping people to be able to help themselves and others we know is vital. And that really speaks to who we are and how we're embedded in this community. The Denver Health Paramedic Division exists to serve our community. Beyond the ambulance response or excuse me, we are a core city service that contributes to the greater good of this amazing city. The Denver health paramedics are based out of an incredible hospital with integrated health care services. And, you know, leveraging the departments that we have within the hospital and bringing that care to the city is really what we're all about. So thank you for the opportunity to speak on behalf of the Denver Health Paramedic Division. And thanks for having me. All right. Well, thank you, Mr. Harper. Next up, we have comrade defense. Hello again. Employees of. Denver residents. Oh, I saw you shaking your head. Madam President, I'm so sorry to inconvenience you one more time for a whole 3 minutes. So I just want to talk about. The fact that I actually I support being able to make sure that our people, the residents and citizens of Denver have access to health care. I believe in something called Medicare for All, though I don't believe that Denver Health, which is a for profit organization, should be receiving more funding. Instead, we should fund Social. Social Security. We should fund Medicare and Medicaid. So that those who are not lucky enough to still be employed in the middle of a pandemic can still get help. And yeah, of course, you know, the emergency rooms are going to accept you and they're going to they're going to treat you as though they're going to kick you out the door. And that person who just got here just got out of the hospital with maybe little to no clothing, might return to where they thought their camp was, for it to be fenced off and for the police to have literally thrown away all of their property. Brutalizing them again. Yeah, I know, I know. I keep bringing it up. And I'm so sorry, Madam President, but it irks you. But honestly, I'm not, because you cannot continue business as usual when we are looking at thousands of people who are unhoused or housing insecure in the middle of a pandemic where they can't even get a job, and those who can't get a job have to wait 30 days for health care coverage. So why do we not instead give money to Medicare, do something like California has done, and build their own their own Medicare? So that we can make sure that we that the residents and our lovely tourists have health care when they need it. Also November 30th. I want to go on record saying this. November 30th, the city and county of Denver plans to sweep. Yeah, I use the word sweep because it's treat it like trash to you as like trash. 300 people that you sent there, the Denver police sent to the Arkin's camp and that, oh, you're going to sweep up. Where are they going to go? You're going to destroy property. You're going to traumatize more people. And so one last time, I just want to say. Thank you, Madam. President. Thank you for joining us tonight. Our next speaker is Cyprus Charles. Looks like we're trying to get Mr. Charles connected up. All right. I think you're in the panelists, Mr. Charles. Go ahead. All right. We must be having some. Technical difficulties. We'll go ahead and go to our next speaker. Sandra Parker Murray. Hello. Good evening. My name is Sandra Parker Murray. I am a member of the. Community Workers Alliance for a Healthier Denver. I served on the Paid Family. Leave Task Force in 2019. I'm here to speak. In support of the passage of the Denver Health Operating Agreement and request that you also take measures to protect workers as they protect us, to keep us and the community safe. Denver Health Frontline workers must have proper protections living wages, readily available COVID 19 testing, contact tracing, full pay pandemic leave when they test positive. And just as importantly, the freedom from intimidation and fear in joining their union. Denver have workers cannot do their jobs as caregivers if they do not have these basic protections. I've been a paid family leave and union activist for two decades. I'm here to ask you to hear my message. Those closest to the problems are closest to the solution. Listen to them. Denver health workers and community members have been going to the Denver Health Board throughout the pandemic to raise issues about their safety, their working conditions, patient care, community health, wages, racism and the right to have a union without retaliation or intimidation. They are saying that existing power relationships in the workplace have not been enough to keep people safe. Denver Health Union busting has real consequences on people's lives. My elderly mother suffers from Alzheimer's. She's contracted COVID 19 from a low wage care provider in her nursing home. I believe that if my mother's caregiver had all the workplace protections she needed living wage, paid family leave so she could afford to stay home when sick. A union proper p. E. She might not have made my mother sick. In Colorado, black residents like my mother make up roughly 6.5% of deaths and 10% of hospitalizations despite being 4% of the population. Hispanics are 22% of the population, but have a much higher percentage of cases 38%. I know that listening to the voices of frontline workers is necessary in eliminating racism in health care. The amazing Denver health staff have come together to form a union with an agenda of dismantling racism, and currently top executives approach to their group of workers is to discourage staff from joining the union and to otherwise ignore its existence. Leaders cannot keep workers safe in a pandemic or dismantle racism while at the same time running an anti-union campaign. They cannot claim to listen to workers and ignore their collective voices. We understand now, in this new pandemic world how dangerous that is. What is needed now is worker protections, not worker intimidation. Thank you for your consideration. Thank you. Our next speaker is Lisa Ghanem, Gwyneth. Sorry about that. We should go ahead and correct me. That's no problem. When I saw it the first time, I stumbled upon it as well. Good afternoon, everybody. My name is Lisa Green and thank you for helping me. I have been with Denver Health eight wonderful years. It's really been the opportunity of a lifetime. I am a professional addiction medicine systems developer. I've been in the field treating this patient population all of my career, and I cannot imagine a different. A different job. So today I'm going to talk to you about treatment on demand and specifically talked to you about the opioid crisis and how we treat persons with opioid use disorder . Historically, most patients have received medication assisted therapy through an opioid treatment program, and opioid treatment programs have very limited access. Typically, we are open Monday through Friday, 5 a.m. to 1:30 p.m., so leaving a substantial amount of time available for persons that may be seeking treatment without access to care. It was within the city's collective impact initiative that treatment on demand was imagined. This program, led by Denver Health and Denver Department of Public Health and Environment, is a collaborative partnership which successfully transformed Denver's system of care for our community members and really. Helped leverage. Our collective ability to fight the opioid crisis. A Denver Health Emergency Department. We have medical staff and licensed clinical social workers beginning medication assisted treatment services and treatment referral planning onsite 24 hours a day, seven days a week. This is why we call it treatment on demand. All M.I.T. inductees engage in a bio psychosocial evaluation. They work with the physician to inject on buprenorphine, and we do triage planning efforts that begin on site at the bedside and focus on activities needed to prepare the community member for access to their ongoing care. The impact of this program has had on the community. When we put into context that Denver County ranks among the top six counties in Colorado with the highest rates and numbers of both opioid use and fatal overdose. And this program was the first line of defense. The Denver Health Emergency Department is the first in the state to provide an induction and continues to be the only emergency department in the state to dedicate specialized social work teams to fully enroll persons into treatment. This program has successfully increased admissions by 54%. Denver is leading a medication assisted treatment and having access 24 hours a day, seven days a week. It is my professional pleasure to work with Denver Health and the City to make this program available for our residents. Thank you and good evening. Thank you. Our next speaker is Valerie Collins. There you go. Go ahead. Valerie. Okay, great. Good evening. Thank you for. The opportunity to comment. My name is Valerie Collins, and I'm an attorney. With Towards Justice, a nonprofit law firm that represents workers involved in various workplace. Injustices. But most. Recently, as you can imagine, a lot of our. Work has involved. COVID related workplace issues. And I'm sure everyone by now has seen all of the kind. Of cheesy commercials and yard signs applauding. Health care workers while they are. Literally giving their all to. Keep our friends and our family and our. Community safe. And while that community recognition. And support is. Wonderful, what is far more critical is. For health care institutions such as Denver Health. To support their workers. And one of the most fundamental ways institutions can do this. Is to create an. Environment where open communication, including criticism, is, at the very least. Doesn't lead. To retaliation or the fear of retaliation. And today, I'm here to tell you. About a complaint that George just has filed with the Colorado Department of Labor and Employment on behalf of Denver health workers related who in turn are filing on behalf of the state of Colorado. Because Denver Health has fallen short in this area. Under Colorado's new whistleblower law, employers can. Designate organizations such as Denver Health Workers United to pursue anti retaliation whistleblower legal action based on their own experiences, but on the behalf of the state to protect whistleblowers. And that's what we've done here. Specifically, the. Complaint explains. How Denver Health has. Repeatedly retaliated against employees who have. Spoken out about the. Extraordinary stream that they're under while trying to protect. Not only their patients, but. Themselves. Other employees have faced backlash for asking Denver Health to confront the long standing public health emergency of systemic racism. Which has only been aggravated by the ongoing pandemic in the U.S.. Employees are seeking an order. Essentially just requiring Denver Health. To comply with the law by allowing. Workers to speak. Out without the fear of retaliation. Now more than ever, it. Is just critical to support these workers who speak out regarding. Public. Health and workplace safety, particularly regarding COVID and systemic racism. Not only is this activity legally. Protected by law, it's essential to protecting workers and the public. We ask if the Denver. City. Council stand with Denver health employees and workers everywhere against any attempts to silence them. I thank you very much for the opportunity to comment. Inc u. Our next speaker is Sarah Young. Hello. My name is Sarah Jungles. I live in Council District ten and I work as a certified nurse assistant for Denver Health on the main campus and Council District three. I joined Denver Health Workers United because I believe many workers like me are extremely underpaid for the work that we provide. On January 1st, my base pay 14, $14.35 will not meet the city's definition city of Denver's minimum wage increase. And I'm not alone unless most support staff won't meet minimum wage. So even with our less than livable wages, we are expected to provide excellent care to everyone in this community. We frequently have to care for aggressive and combative patients while at work. It's not uncommon to have patients physically, verbally and even sexually assault us while at work. And while this is happening, our thoughts have to be on keeping the patient safe, even over our own safety. Many of times, even if we're not dealing with these types of patients, it's not uncommon for us to be so short staffed that one CNA is doing 2 to 3 jobs at once. This is not safe for us and it's not safe for our patients. The COVID 19 pandemic has just worsened these issues and caused more safety issues for the patients and staff. Frequently, assignments are made not considering the transmission of the virus from patient to patient. I frequently have assignments where only half of my patient load has COVID 19 and the other half does not. Even with the best precautions, I know that I'm greatly increase in the chance of spreading the virus. From from one room. To the next. Most of us live in constant fear that we're going to be the one who gives COVID 19 to a patient. You don't have it before they enter the hospital. So not only do we have to worry about potentially killing a patient. After a burst back home to our families and doing the same. This intensifies in situations we've been asked to sit inside of COVID positive rooms, to keep a patient safe for hours, and even to. Our entire 12 hour shift. Without asking. Us for suggestions on the many ways we keep both of our our patients and ourselves safe. They have decided to sacrifice us to COVID 19 and increase our chances of catching this violent virus exponentially while paying us an unlivable wage, not even offering us as little as hazard pay. It is for these reasons, and many more employees decided to unionize at Denver Health to try to make our voices heard. We created and have been a union since the end of May, and our executive staff refuse to acknowledge us as why we're here to ask for your assistance in allowing us to continue to make positive change at Denver Health for our fellow staff members, for our community, and without fear of retaliation. Thank you for your time. Thank you, Sarah. Our next speaker is Peter Della. Leaving Council. GREGORY okay. Go ahead. My name is Peter Delvecchio. I'm a Denver paramedic. I worked at Denver Health for almost two years. I'm here speaking on my own account. And as a proud member of Denver Health Workers United, I ask that you approve the Denver Health Operating Agreement. We urgently need the money to pay for the emergency services my coworkers and I provide every day. The vast majority of patients are uninsured or underinsured and rely on the safety net, which the Denver health provides on my right shoulder patch. Officially becoming a paramedic of the city and county of Denver was one of the most difficult and single greatest achievements of my career. I've worked at many agencies over the last decade, but I've never seen the dedication and expertize which I've seen with the Denver health paramedics. If you get shot, stabbed or otherwise brutally injured, data shows that you have a better chance of surviving in Denver than anywhere else in the country. This is due to the speed, skill and expertize of the Denver paramedics and the staff of Denver health. Our prowess in treating medical conditions is followed close behind our trauma care. Prior to the pandemic, working on the streets of Denver with challenging, engaging and extremely rewarding. I still get the same satisfaction from my job during the pandemic, but it comes with an intense level of stress. Since March, fear of spreading the virus to my family comes every time I walk through the door. Frustration comes when an encounter a person society has forgotten. Anger comes when I am assaulted by the citizens who are at the end of their ropes. Fatigue comes from significant daily call volume. Despair comes when my patients die. These things are to be expected during the pandemic. These are things I can handle. I can't handle being issued protective equipment, which won't survive the rigors of the ambulance. I can't handle a lack of regular testing for a virus which spreads asymptomatically. I can't handle seeing turnover of expertize because we're paid significantly less than surrounding agencies. I can't handle seeing Denver health executives paid bonuses, which are equivalent in value to hazard pay. We've been promised I can't handle constant phone calls from the Denver health billing environment for bills, for treatment from being assaulted on the job. I can't handle being actively targeted for making my voice heard. We will make it through this pandemic. But the management of Denver health is making it difficult. I used to think that being a union paramedic would just be a minor benefit. I now know that our collective voice is essential in protecting the welfare of our patients. Denver Health workers are the safety net. We work tirelessly to protect the integrity of this network. We're the first to see when someone might fall through. So it is essential for workers to have the ability to sound an alarm. Strong workers are aggressive in protecting their patients. A strong union means a strong safety net. A strong union means. Lives saved. We all need to do our part to fight COVID 19. The public need to wear masks. Paramedics need to run, call. Nurses need to treat patients. Doctors need to get care. Management needs to support workers. Our leaders need to keep us all protected. I ask you to pass the operating agreement for Denver Health and continue to vigilantly protect our constitutional right to organize. Thank you. If you have any questions. Thank you, Peter. Next up, we have Michelle McDaniel. Good evening. I am Sean McDaniel. I'm the resident in District nine, but more. Importantly, I'm an outreach worker for Grasp Congress Science Project as well as a program manager for AIM, the At Risk Intervention, a mentoring program at Denver Health. One of the programs funded by the operating agreement you were considering tonight. I'm not a numbers person, but I know how important they are. So I will begin with just a. Few to put into context how important your investment. Is to the program. Our budget of. $163,993. Pays for 2.25 outreach workers to be subcontracted from grasp. 2.25 Outreach workers with collectively 38 years experience that are on call 24 hours a day, seven days a week. 51 weeks a year. Yeah, we actually do take the week of Christmas off. In 2019. 163,000 paid for the. 266 interventions that AME and grass provided. To individuals at Denver Health, as well as the services we provided to 384 individuals in the community. It's supported the 27 critical crisis. We responded to. The 40 trainings. We provided the two medical pipelines programs that we support. The numerous boards, councils, community organizations that we are a member of and partner with. We are still on track to meet, if not exceed. Our 2020 goals, not because we are. Considered essential workers, but we believe that the work that we do is. Essential and because nothing, not even a pandemic, will stop us from serving our community. $463,000 may pay for the only hospital based violence. Intervention program in the Rocky Mountain region, but supports the collaboration with other hospital. Based violence intervention programs across the country, the Health Alliance for Violence Intervention. The hobby and its efforts made towards ending violence. Addressing trauma and promoting healing. Your 163,000 pays for the hours. We sit next to a young person who has just been shot and may be considering what to. Do with the rest of their life. That is, if they make it. It pays for the minutes we get to spend. Apologizing to the mother. Who just lost her son. And the second that we have to. Stop an angry. And confused kid for making a mistake that could. Impact the rest of their life or someone else's and has one mission. Capitalize on the teachable moment to provide trauma informed. Care. To violently injured patients and provide outpatient case management by culturally competent. Community outreach workers to prevent recurrent injury. And promote client wellness. We have one vision. Through a reciprocal. Understanding of lived experiences. Create a culture of healing throughout the medical community that connects traumatized patients to needed resources and supports the. Overall wellness of both parties and health care workers alike. And although technically immigrants were two programs working together, we are one team that needs your continued support. Thank you so much for your time and consideration. Thank you. Our next speaker is Jacob Otto first. What? Can you hear me okay? Mm hmm. Go ahead, Jacob. My name is Jacob. All too fast. I'm a resident and city council district nine. Councilman Seelbach is district. Tonight, I am speaking as a member of Denver Health Workers United and as someone born and raised in this city. There's little more that I cherish in this community. And Denver Health has a special place within it. I've been a paramedic to Health for two years. The first that I asked you approve the Denver Health Operating Agreement. That money will help fund the Denver health paramedics and allow us to always come for help when called no matter what the problem or the person calling. Denver Health paramedics have a reputation in this region and nationally as the best and the brightest. Our medicine is strong because Denver health pushes us to be strong and because our coworkers expect that when we are working, we don't just represent ourselves individually. We represent the paramedics as a whole. This is truly a privilege. It is not taken lightly by me or by any one of my coworkers. To say that this pandemic has been challenging would be, to put it lightly, setting aside the especially while it's summer, caring for a sick coban patient pre-hospital, he comes with an exceptional number of risks and very little perceived reward. The process by which the virus kills a person is not by any means traditional. Many of the treatments available to us are not effective and increase our own exposure. How would you feel to be responsible for the continued life of a person who is dying in front of you? How would you feel to have no way to give this person even a chance of relief without possibly giving the same disease to your family? How would you feel to have this death disregarded daily in the news this weekend, I was part of patient care with two very sick COVID patients. The first was a man in his thirties who is now on a ventilator in the ICU, who went from a weak and speaking to unconscious and incomplete respiratory failure in less than 30 seconds. The second was a man in his 60 who died in his home in front of his wife, myself, my partner and a fire crew attempting to resuscitate him for nearly 40 minutes while she watched. In my attempt to save these patients lives, I was exposed to the virus. I would and I will do it again in a heartbeat. But during the pandemic, I have never developed symptoms. This could be because I'm careful. This could also be because I'm one of the possibly 40%, according to CDC best estimate, of persons who are asymptomatic and carrying the virus with no symptoms. I have never been tested for the virus. I love my job, I love my patients, and I don't want to be the reason that they're sick. This club is one of the largest reasons I am proud to be part of that union at Denver Health. We formed our union in this pandemic to raise up our voices and work to improve care for our patients and safety for each other. Doing my job and it's we will times without regular COVID testing for myself or my coworkers. I now understand that having union a union to give us an independent and collective voice at work is essential. There is no way for me to change anything alone, but without my coworkers and through the union, we can make change and save. Save lives, our patients, and possibly our own. It's important that we all do our part. People at home need to wear masks when around others and wash their hands frequently. The second hand endeavor needs to improve funds for a hospital with every penny available in order to protect health care workers and the community as a whole. My fellow paramedics and I will continue to alleviate suffering and preserve life. Thank you for your time. Thank you. And we had 30 minutes for the courtesy public hearing. And so our last speaker is Frederick Karachi. Great. Good evening. Can you hear me okay? Go ahead. Hi. My name is Fred Karachi. I'm a general and trauma surgeon and I've worked at Denver Health for ten years. Before I began working at Denver Health. I completed a trauma surgery fellowship here under the mentorship of Dr. Jane Moore and obtained a master's degree in public health with a concentration in racial and socioeconomic disparities in surgical care. As a trauma fellow, it was immediately apparent to me that Denver Health was special. Before that, my impression was that hospitals could not simultaneously fulfill the missions of both safety, net care and academic excellence. The Denver health model shattered this misconception because we conducted the primary research, design, the protocols, and developed the new techniques that the rest of the trauma world followed and then apply them to our underserved patients. Since I'm the child of poor immigrant parents, it remains tremendously fulfilling to me to provide the best care to our patients who in many other communities would not have access to it. As an attending, I direct our bariatric surgery center. Weight loss surgery cures debilitating diseases such as diabetes and high blood pressure, and decreases health care costs for patients and their children. Here, our academic focus led us to become accredited as a center of excellence. This accreditation was particularly meaningful for our team because we became only the third safety net hospital in the country to achieve it. And it also opened doors to our community in terms of increased resources to combat obesity at its origins. In addition to clinical excellence, we worked hard to improve access to bariatric surgery regardless of ability to pay and now for completely funded bariatric surgery. Two Denver County Residents Without Insurance. Earlier this year, I had the privilege of becoming the president of the Denver Health Medical Staff. This role brings me face to face with the issue of physician well-being and burnout magnified exponentially during the COVID pandemic. I am proud of the commitment of our hospital to addressing health care worker, mental and physical fatigue, and the numerous free, confidential resources available to keep our practitioners safe and healthy. Next week, I will complete a one day training to join over 50 volunteer volunteer providers in our resilience in stressful events. Arise Employees Psychological First Day Program. Finally, my role in the medical staff leadership has involved sharing our Medical Necessity Committee, which last year alone authorized charity funds to over 900 uninsured Denver County residents to undergo elective surgery procedures to restore quality of life and the ability to work or live independently. In many cases, we approved these surgeries after other hospitals with which the patients had prior relationships had denied them. There are, of course, many other examples of the effect that Denver Health has had on our community. I'm fortunate to have been part of impacting access to high quality surgical care for our city's most vulnerable members. It remains the most important reason that I work here. Simply put, Denver would and could not be Denver without Denver health. Thank you. Thank you. And I'd like to thank the other folks who had signed up to speak tonight. And unfortunately, that's the 30 minutes that we had for the courtesy public hearing. And we also have another hearing after this one. And so concluding our speakers questions from members of Council on Bill 1138. We have Councilwoman CdeBaca. Thank you, Madam President. I have a few questions. Is there. So I have been trying to find a transparent wage and salary scale for all the employees at Denver Health. Does that exist? This is Robin went to see them, the CEO here at Denver Health. There's there's not a single published wage and salary scale, depending on the particular position. We use a variety of different salary surveys that are used to set the wage wages for different positions. And has there been an analysis of the pay equity within the organization that is public? Um, we have, we actually have done an analysis of pay within the organization where we've compared every individual employee's salary to the 50th percentile for that particular job. Within each category, we said wage rate, salary range is based on market information that we have available. Our organization aims to pay approximately the 15th percentile for all of our employees, employees to come in. They start below that and then they can, over time, go above the 50 percentile. We actually just recently completed an analysis of all jobs to see how I would compare to the 15 percentile in total Denver Health with slightly above the 50th percentile for all positions at Denver Health and the positions at the lower end of the wage scale, primarily in our service. In our service, jobs were the highest above the 50th percentile on average. Now, of course, some people coming new into the organization may start below the 50% now, but over time they will increase, the salaries will be increased so that they can get above the 50% jump. And since Denver health is a public health entity, I'm wondering if it's not. Is that data public? Lake City employees are salary information is public information. And even without the scale, is Denver Health's salary information subject to Cora? It is. And our salary information has been requested via request. And when when it is requested, we provide. Awesome. And I believe, Madam President, there was somebody who was present on the line to answer questions about the immigrant workforce at Denver Health. Is it possible to call up Sochi Gaitan? We can. So she has her hand raised. We'll go ahead and move around to panelists. Hi, Sochi. I'm curious about some of the things that we've discussed regarding the immigrant workforce at Denver Health. Could you talk to me a little bit about what you are aware of there? Yeah, the city councilwoman said about the thank you. Thank you for the opportunity. And the question I wanted. To share a few thoughts as I identify as a mexican born in Mexico, raised in Denver by immigrant. Parents, and. I'm a member of the Community Worker Alliance for a Healthier. Denver. Also speaking as co-chair of the Colorado Latino Forum. And so as an immigrant, I know that in all diverse immigrant communities, Denver Health has been the main resource for health care needs for our community. And so we deem it to be a really valuable one. I personally spent over 90 consecutive days last summer at Denver Health with my immigrant father who passed away of liver cancer late last year. I personally witnessed many inequities taking place for patients, but as well as workers. And so I just wanted to share with you all that there's community leaders like myself that are seeking to eliminate these health inequities, these and trying to keep our community safe, but building equity and solidarity with those workers at Denver Health. And so I wanted to share. A few thoughts about that. So I appreciate the. Question that. I believe that city council should be able to uplift the health care workers by really supporting, supporting and voting yes. On this bill. I believe that our Denver health workers are the true foundation of that hospital. And we know that those that workers rights and community. And the. Safety of our community, it's all interconnected. And Denver health care workers, they should have a right to free association in unions and. They don't have that right right now. There's public funds being spent on diverting from patient care and worker safety to anti-union tactics. And we were hearing reports. To the Colorado Latino Forum that the custodial. Workers were discouraged from forming a union. So we're really concerned. And we know that this pandemic has compounded those inequities for our marginalized workers, especially our custodial workers, nurses, etc.. So justice. Is required and we're. Carrying that burden as people of color. We're carrying the burden of racism. And COVID 19. So thank you for asking the question, allowing me to share a little bit about. What we're hearing from workers at Denver Health. Please recognize that there's that paradigm. Paradigm shift is taking place. Right now in institutional racism. So I want to urge. You to vote yes. And real quick, is it possible to ask Miss Valerie Collins, the attorney addressing the U.N., asking for more information on what the response from Denver Health has been since they have filed their complaint? Sure if we can get Ms.. Collins to go ahead and. Raise her hand and we'll get her moved back into the panelists. Are we are we not seen? I'm not seeing this, Collins. I don't think she's still in the meeting. Can can Denver help respond to how they're correcting the allegations of union busting? How is that being addressed? So again, this is Robin Wisniewski. Denver Health is not engaged in any any activities of union busting. So I can't tell you that I can't respond to that because we aren't doing it. And Ms.. Ms.. Collins mentioned a complaint, but we haven't seen anything, so I can't it would not have been a response since we haven't seen anything from from. Let's let me reframe the question. How our employees how are workers in this time being helped or supported in their efforts as they try to exercise their rights to unionize? All our employees are being supported in many ways as we go through the COVID crisis. I think that you heard from a number of the people who spoke about COVID and the impact that it has had on health care. Workers speak about some of the things, including the PPE, that we are providing to our employees who certainly have a great deal of expertize in infectious medicine. Dr. Pryce spoke about the work that she has been doing. We have highly, highly infectious disease teams that go out and do education for our employees. We're making sure that they have the appropriate PPE and a work environment that allows them to stay as safe as we can possibly manage for them. All of our employees are free to interact with us, and we we do this regularly to find out what issues are of concern to them and how we can address anything that may be getting in the way of their ability to do their job safely and effectively to care for patients. Dr. Pratt, you mentioned the RISE program, and that's one that we have focused a great deal of time and energy on. It really is intended to help health care workers in particular, who are facing extraordinarily stressful events, although I'll confess that a pandemic may have been more than any of us ever expected to have to address and deal with the psychological challenges of living through the sorts of anxiety and stress that our employees are facing today. So we have worked to make sure that they have access to those. We've also been deeply involved in a lot of work around identifying issues and problems that our employees bring forward and then working to resolve those, including things around human resources, policies, work environment issues they may face in the in the workplace. So as we have spoken to our employees and identified issues that are of concern to them, the entire management team is working on different solutions to those issues. And as a funder and partner, what kind of assurance can we get as the city of Denver that you all will keep us in the loop about what is going on. And what allegations are being made throughout the next year of this contract. So I think there are a couple of things that I would suggest in Campbell, and I certainly be very interested in any additional ideas and suggestions you would have. So one of the things that we started to do, and I hope that this is helping our employees and I hope it's valuable to city council as well. We have a number of initiatives that we feel are particularly important to Denver Health and the people that we serve. We've got work going on and I think I've talked to most of the council about this as an anchor institution in the community. Denver Health provides a great deal of health care, of course. We also are deeply involved in education and research. But the other piece of who we are and who we stand for is as an anchor institution. And for Denver Health, what that really means is, in addition to providing for the the physical and mental health and well-being of the people that we serve, we have an ability to offer economic opportunity to the to the community that we serve. So everything from the work that we're doing to try to make sure that our employees can earn a living wage, some of which will be through salary. But there are many other things, and I've spoken about some of those career pathways, making sure that the kinds of work supports that are available to people like child care support, earned income tax credits, those types of things that can really help support families and strengthen them during the kinds of economic challenges we're going through. We've got a lot of work going on in that. We're also addressing issues of diversity, equity and inclusion. And I've said to all of the council members that I've spoken to, Denver Health is made up of people, and like any organization, like any group of people, there is work that we can do to improve diversity and equity and to address what really is the structural and systemic racism that exists in our society. Denver Health has signed on to racism as a public health crisis and really committed to addressing issues of diversity disparity both inside our organization and in the communities that we serve. And then finally, we have been working with our employees and identifying anything that gets in the way of their being able to do their job effectively, to have a work environment that allows them to flourish and to truly do what they came here to do. This is an extraordinarily mission driven organization, and I can tell you without exception, every single person who works at Denver Health cares to the core of their being about who we are and what we do. So we are we send out about every other week. We send out a communication with all of the different things that we're doing. And we're summarizing that. And we sent it off to City Council a number of times now, and I hope that that has been helpful to you. As I said before, I will come and talk to all of you or any of you individually. If there are issues or concerns that any employee brings to you, please send them to us and let us have an opportunity to employees. We want to make sure that we hear concerns and then we have an opportunity to address those and to make changes where we need to. Because undoubtedly there will be times when changes are necessary. Thank you. And my last question is for Katie Bakes. Is Ken Baker still on the line? You got me. There's a handsome. I will get her promoted. And then. This is the last question I. Have. Great. All right. Thank you. All. Katie, my question for you is about the employee survey. Can you tell me a little bit about that employee survey that we discussed? You mean the Press Ganey survey? Yes. I have not seen it in its totality, but my understanding is that it is pretty dismal and much worse than it was previously and is peppered with concerns of lack of trust for executive leadership. I did have a statement prepared. I know and appreciate everybody's time. I personally have been targeted for speaking up and speaking up about concerns about equity. I run the same program that Michelle McDaniel so eloquently described. My job is currently. Under threat because I have spoken. Up and. I unfortunately am very disappointed by our leadership. I agree that the. Staff at Denver Health. Make up the heart and. Soul of Denver Health, and I have recently joined Denver Health Workers United because I understand that if I, as. A. Professor of emergency medicine and pediatrics. And. Being at Denver Health for 20 years can be retaliated against by the highest levels of our administration. That I cannot imagine. What frontline workers who don't have my title and come from underrepresented minority backgrounds must feel when they are trying to speak up. About their workers rights. Thank you. Misspeaks Ms.. Signer or Robin. I'm wondering if there's a potential. For you to. Report out to us. On on. Terminations and if people were. Union affiliated. I'm curious to monitor who is being let go and if they are union affiliated. Is that a possible report out that you could include with your other report outs to us? Well, I certainly can't report out to you about union affiliation because I don't know. And we don't if that is something that if an employee is involved, that's up to them. And we don't ask the question, nor do I have any idea who the employees are who might be involved in terms of termination. What I'd like to do, Councilwoman, is just have an opportunity to speak to general counsel. I do want to be careful that when it comes to situations of employees that we're protecting, we're protecting our employees privacy and rights. And I would want to talk to them before I give you an answer on that. If that's if that's okay. That would be awesome. And if it's possible to have a form at termination, asking the employee if it's if they're if they're authorizing you to release that information, that would be really helpful for us to monitor. Thank you. That's it for my questions. May I make one final comment? May I make one final comment that's related to that? Very briefly, please. We've got four other people in the queue of questions. I just wanted council to know that I before I joined Denver Health Workers United, I was called by my supervisor and H.R. because I was reported for recruiting people to the union. I was not a member of the union at the time, nor was I participating in that. I think that kind of direct. Discussion. Puts fear into workers. It certainly put it in to me, and I think. It goes counter to the statement that there is no effort to undermine the. Union. I thank you for sharing that, Councilman Torres. Thank you, Madam President. Just one question, and I'm sorry if I missed it. In the prior line of questioning, one of the commenters mentioned that they currently do not have a salary that meets the city's January one minimum wage level. Does Denver health. Come into line with the minimum wage increases. Robin, I see you coming in there. But let me let me finish the question real quick. But I do know that you had mentioned raises. I'm just curious what the status of that looks like and whether or not you're exempt. We are not exempt from that. So when the city's minimum wage went into effect last year, I think it went to 1277 or 1287. Denver Health raised the minimum wage here to $13 an hour. And we'll be raising our salary again to meet the minimum wage, I think. I think we may be going to $15 an hour. So and then this year we did the we did merit increases for our employees. And our plan is to do the same thing again again next year. So we will we will be compliant with at least the minimum wage in the city and county of Denver. Okay. Thank you. That was my only question. All right. Next up, we have Councilman Hines. Thank you, Madam President. I thought I was later in the queue, so I was slightly underprepared. I. I want to ask Miss Biggs if she's still here. I want to ask one more question. She might have severe. All right. Well, moving on to other issues. Just so maybe it's you. You said that you had been retaliated against and you gave one example where you perceive the retaliation is do you have other examples or is that the primary example? I'm just curious. Yes, sir. Thank you. I do have other examples because of the limitation in time, my statement only included. What had happened with AIM. But I have experienced. Retaliation multiple times. For speaking up. Would you say provide one more example? I'm not. You're right. Because of time. I don't I don't know if I can ask you for all of them, but perhaps one of their example. I've been retaliated against for advocating, for aim and to continue funding that we received through the city. I was told that I had undermined our CEO, Dr. Wittgenstein, because I had spoken to my colleagues in emergency medicine and trauma and they had written in to support the program to prevent it from being cut from the city budget . And I was told by my direct supervisor, Dr. Nussbaum, that Robin had met with him and that she had told him that he did not like me because I undermined her authority because of the support for aim. She was forced to change her mind and keep AIM in the. City budget and. That she would no longer support me and undermine the programs. I run. Okay. Thank you. Thank you for. I'm. I'm hesitating because I'm thinking, What do I do? I want to try to go down and try to get by. But thank you for that that that answer. I was trying to decide if I want to get more clarity or not. I think that's good enough. Thank you. Thank you very. Much. And then one previous person testifying said that claimed that Denver Health is a for profit institution. Is that the case? No, no, no. It's not. For profit. Okay, I've. I figured that. I just wanted to make sure that I was not misunderstanding. Okay. So it doesn't appear that there's anyone who's asking us to vote no on the contract, but there does appear to be some concern about worker protection and worker organization. Is that right? I think the contract is silent on worker organization. Does the contract have any opportunity to to say anything for or against worker organization? And this is making the contract administrator and we can also promote the city attorney if we need to hear much better. It does not. It's silent on that, similar to any other kind of labor laws or otherwise. It doesn't dictate how Denver Health complies with those or not. Okay. Thank you. And that's why I don't I don't need the attorneys perspective. I think that's fine enough. Thank you. The. I think, Dr. Weinstein, I think you and I had talked about this before. I just want to. Should the Denver health workers want to unionize? Is that something Denver Health would support? Our our sense is that working directly with our employees on issues that they raised is the best way for us to resolve those. And that is the approach that we've taken. At the same time. At the same time, we're not we're not involved in or interfering with the union activities that employees may engage. Okay. Up. And this is a contract. We can either vote yes or no on and we can suggest amendments. Right. This is I mean, this is like every other contract we can suggest in there. I see a bunch of heads nodding at them. I don't know if everyone watching the Zoom call or Tally can see that, but multiple colleagues are nodding your head. So I'm just going to keep going. The does the contract or I forgot to ask does the contract ask talk about access to PPE for its workers, though it's something else that was also discussed as a concern . I think it's dependent on the section of the contract and what what type of work is being, you know, provided in each section. I'm not sure the level of detail in the operating agreement gets to the level of detail that states what type of PPE and the amount of PPE. I think that's somewhat dictated by the kind of overarching services provided and Denver Health's kind of rules and regulations associated with PPE. So I don't think the contract gets into the level of detail you may be describing. Okay. That's fair. I mean, it's it's a bunch of money, so I can understand why you might not have. 87 and 95 masks or whatever. I get that. So perhaps I could ask this. Do Denver Health Workers have adequate PPE? So. So, Councilman. Oh, I'll start answering the question and then I'm going to ask Dr. Price to jump in, because she really is our infectious disease expert. So Denver Health has adequate stock of PPE to take care of our employees. We have very specific guidelines around the type of PPE based on the risk that the employee has in different situations. Of course, like every other health care provider in the country, the way that PPE is used today is different than the way it was used a year ago. Obviously, the pandemic has been, as I said, it's not just it's not just in health. It's not just Colorado. It touches the United States. The entire world is in the grips of this. So it has changed how deeply is used. But we do have adequate stocks of PPE and that Dr. Price can share with you some of the over kind of the overarching principles that we use. And frankly, we would be happy to send to the entire council the same communication that we send to all of our employees that lists all of the main pieces of PPE that are important for them. And we provide them on a weekly basis a list of all the PPE we have in the stock that we have available to us so that everybody can know exactly what we've got and make sure that they're feeling comfortable because we have a lot of people who were concerned at the beginning, particularly of the pandemic, when it was really hard to get to get some of the items that we needed that we would run out. And so we started sharing with our employees, this is what we have. So perhaps Dr. Price can jump in and just share some information with you. So hello, counsel and hello. Thank you for asking this question. It's this was one of the most stressful efforts during the first wave of COVID. And not only to those of us trying to make sure we never ran out, but to those on the front line. All of us were hearing about shortages nationally of PPE. All of us were hearing about our colleagues running out of PPE and other places having to use their masks for a week at a time, having to bake them at home to sterilize them. We did none of that at Denver Health. We followed our crisis standards of care guidelines for PPE from the state of Colorado. We actually exceeded what the CDC recommended. And as part of transparency, because it's so important when you are going to see a patient that you can feel confident in your PPE. We started sharing with our staff our days on hand of PPE. It wasn't always pretty, but there were always PPE. And what we do is we take our stock and we look at that week of use, the week prior, and we say, okay, based on use for that week, that volume of use, how many days on and would we have as PPE if we started the entire supply chain stock? And we don't take for granted that that supply chain is going to keep coming in. We actually do plan for one day it could stop and we provide those data to our staff and weekly emails and we have been doing that since the beginning of this pandemic. I am happy to include the City Council on all of those data so you can monitor it with us. And my gosh, if you ever see any red on that chart or numbers of days on hands that you don't like, we would happily take your help in sharing the PPE. The other piece of this is making sure that our staff are confident and able to use the PPE effectively that they have. And we have been very deliberate in our training and utilizing these wonderful employees, these talented staff who I've been working with for 18 years to help educate each other and support each other in confidence and use of PPE. Okay. And so, Madam President, just one final question. I went to the Denver health paramedics luncheon and they were doing a fundraiser for paramedics because apparently the paramedics don't have enough shirts as they switch shirts from one call to the next. And and so the luncheon was doing a fundraiser for t shirts. For the paramedics. Is this. Yeah, the fundraiser, actually, the main the main beneficiary of the fundraiser is the paramedic scholarship. So getting going for training to be a paramedic is, um, you get through school and you pay tuition. The fundraiser is intended to, um, to help raise money for scholarships for that we do. However, also we bought, um, we bought paramedics different out of uniform uniforms. It is. I'm sure you're used to the fact that the Denver health paramedics have traditionally worn a white shirt. What we found when we got into the pandemic is that they were uncomfortable, that they were going from cold, cold, cold with the same shirt. And so we ended up for the summer. We had t shirts for the winter. They're actually going to be longer, long sleeved shirts. They're all blue. Um, and we have, we've had a lot of people say, can I help support the paramedic by donating money for t shirts and shirts, etc.. So, so some of it was used during that. It was, it's a way to connect to the community who really does want to support our first responders during, uh, during this crisis. But the very large bulk of the money that was raised is going into scholarships for people, particularly people of color, people who live in poverty to go through training to become a paramedic. It really you heard from you heard from more than one paramedic tonight. It really is an amazing profession for somebody to get involved in, to have an impact on the lives of people at their most vulnerable point in time. When they i, i, i have called 911 myself. That is a moment in time when you are afraid for yourself or a family member. And when the paramedics show up, all of a sudden, you know, things are going, you've got somebody there who can help and everybody wants to help the paramedics and the first responders. And so it's within that spirit of letting people help by supporting the cost of t shirts and church for the paramedics. But the bulk of the money is going into scholarships for people who couldn't afford to become a paramedic otherwise. Okay. Thank you. Thank you, Madam President. Thank you, Councilman. Councilwoman Zoya. Thanks, Madam President. So thank you. For for being here. Really appreciate it. Really appreciate the the comments that we heard and and and the information that we're getting from the Denver health leadership. So I just want to know kind of from the perspective of our legal team and if we were to if there were seven people who felt like, based on the testimony we heard tonight, this was not a contract or a relationship that we wanted to support anymore. What would happen then? Hi. I I'm fairly new to the city, but my sense from the years that this has been approved over and over, as there'd be starting January 1st, a pretty huge gap in services that are paid for under the agreement, because I believe language is written that essentially for core services under the agreement, Denver Health has sort of the first right of refusal. And again, maybe we'll call up Mitch Bear, the attorney, to probably speak more eloquently on this than I. But first, right of refusal for those, of course, services. Unless that's the case, there's no backup option. Unless they defer to a second party, there's no backup option. And for the non-core services, we would have to go through a procurement process to identify alternate service providers for every portion of the agreement that wasn't approved for those services. And obviously, the services in the agreement that the city provides back to Denver health would not be provided as of January 1st as well. And we're talking about a huge breadth of potential services and things that are critical on a day to day basis. Okay, thanks. So so it would be safe to say it would be incredibly irresponsible governance to vote down this contract tonight and not have any sort of backup option for, you know, our health services in the middle of a pandemic. Yeah. I mean, I don't you know, it's hard to, but personally. Yes. And I think it's an obvious yes for the city. The Denver health serves a great number of the vulnerable, you know, residents in our city, even more so in the pandemic. And although these are kind of, you know, difficult conversations to be grappling with today. Yes, I would say yes. Okay. Fair. I mean, I agree with you. I'm just but that's what I'm asking the questions. Right? I mean, we're required. And I think it's important for the community and the people who are watching to sort of understand the breadth and depth of what this contract actually does for our communities. So wanted to make sure that we kind of got that out there. So. So but that said, right. There's if this is a concern, what does this look like for 2022? Are there conversations we can be having with Denver Health now to potentially talk about some of these concerns or address some of these issues for the 2022 contract? Or when would that start or what do those conversations look like? I guess how do we address the situation? I guess my question is how do we address the situation proactively in the future so that for the 2022 contract, we do not find ourselves over a barrel, so to speak, with zero backup options in the middle of a pandemic for providing city services when it comes to a health provider and not being happy with. The. Way our health provider and not having any other options and and not having any other. Choice, I guess. Yeah. Negotiations for 2022 start as early as the spring. March-April timeframe is when we start conversations with city agencies around what's working in the operating agreement for the work that they're receiving in the services that are being provided. You know what? What would they like to address and change? And that's when the negotiations start as early as April timeframe. And so, you know, Will is probably best suited to maybe talk about process here. But I think leading into that time frame, hearing thoughts and input from city council, from residents, from folks across the city who agencies that are receiving the services and supporting this work, I think receiving input in that time frame leading up to April, there's plenty of months of negotiation happening between April and say today in the fall, but negotiations start as early as the spring of next year. Okay, great. Thank you. Thanks, Madam President. All right. Thank you, Councilman Sawyer. Councilwoman Ortega. Thank you, Madam President. I first want to make a comment and then I have two brief questions. I want to thank the employees who reached out to talk with me and to share some of their concerns. I also want to thank Dr. Wittgenstein and Dr. Price for giving back to me and their willingness to sit down and meet and talk with the employees who I met with. And so basically where in the in the middle of just waiting to get the names of the employees who who are willing to be part of that meeting to sit down, to share their detailed and specific concerns about what those those issues related to safety and, you know , just practices where they feel like their their safety or the public safety has been compromised, whether it's from the paramedic unit or the nursing unit or any of the the doctors who are willing to come forward. So. And it's not always easy when people have to be brave to step up and speak out. And so I appreciate everybody on all sides and their willingness to sit down and figure out how do we how do we get through this? I wanted to ask Valerie Collins if she could come back on, if she's still available to answer two quick questions. I think the councilwoman had tried to call her up before and I don't believe she will. Let me see if someone else is available, can answer these two questions. I'm trying to find out if and maybe Dr. Woodson can answer the first one. Are you aware of other public hospitals that have their employees that are unionized? So that's one question. And then the second is, I'm just trying to find out, has there been any identified date or timeframe in which there's a hope and expectation to have a. Vote of the employees? And we do have Ms.. Collins backup as well. So we'll go ahead and let the Denver health answer and then we have in this column. Okay, great. Thanks. So, Councilwoman, I am aware of other other public safety institutions that have a variety of employees who may be denied. And I'm not aware of any event, any dates in relation to your second question. Okay. All right, Miss Collins. Do you want to address either one or both of those questions? We might have to have you unmute, Ms.. Collins. All right. Well, we might not. We thought we had her promoted. Yep, we got her on. But for whatever reason, we're not getting a response. Councilwoman, I'm sorry. Okay. All right. No problem. Thank you for letting me ask those questions. And I do look forward to helping facilitate that conversation. That's one of the things that I was asked by the employees when I met with them if I was willing to help facilitate getting a meeting together. And one of the board members was involved in helping to make that happen. And Dr. Weinstein felt that it was more appropriate to have Dr. Pryce be the point person who oversees, you know, part of the operations of the hospital. And so we're in the middle of trying to get that coordinated. So thank you so much. All right. Thank you, Councilwoman Sandoval. Thank you, Madam President. And I'd also like to thank all. The speakers in Timber Health for joining us this. Evening. So, Dr. Weinstein. On Tuesday. On May 19th, you received a letter from 14 state senators, 29 state representatives, three U.S. Congress members and nine city council members. Do you remember getting that letter? I do. Did you respond to any of them? Did you respond to anybody? I did not. Why what? Why wouldn't you respond to a letter that came from 14 state senators, 29 state representatives, three US Congress members, and nine city council members. The the letter was a statement of support for employees who are interested in unionize and didn't require a response. So as a public hospital, you don't think that acknowledging a letter from 14 state senators, 29 state representatives, three U.S. Congress members and nine city council members doesn't elicit a response. Councilwoman. The letter came as a statement of support for activities that the employees were engaged in and didn't ask any questions. It didn't require to request a response. And we did not feel that there was anything that needed to be responded to. Okay. I'll just say that I get a lot of letters of support on my council office and I get a lot of inquiries in my council office, and I acknowledge every single one of them. I feel like that's my duty as a public servant is to acknowledge them. So you and I may have just have to respectfully disagree on that one. Um, so under this operating agreement, there's the Denver Public Health and the Denver Department of Health and Environment. There's a shift taking place. I would like to know how long has Denver Health known about the shift that would affect the funding? Um. Can you help me understand what shift you're talking about? So basically the Denver the Department of Denver will take over what Denver Public Health is doing. That is not what is in the agreement. We have agreed that next year and frankly, we were hopeful that we would be past the pandemic when we had the conversations that Denver Public Health and DDP would enter into conversations about how public health services are organized in the city. Obviously, coming through the pandemic, we both had significant learnings about how to handle a pandemic, how services work effectively, where there may have been points, opportunities for improvement. So we agreed that we would sit down and have a conversation about those. There is no wholesale shifting of responsibilities from Denver Public Health to simply an agreement that we will have a conversation. And if we agree that there are any any services where there should be a change based on the mutual agreement of Denver, Denver health and the city, that we would work through that in 2021. We've come through a situation that, frankly, none of us had ever seen before. I think to not sit down and have a conversation about what did we learn and how can we organize ourselves differently, perhaps so that we can better serve the people who live in the city and county of Denver? It wouldn't have made sense. So that's what the operating agreement change said. Okay. So I've heard comments about the employee engagement survey. Is there any opportunity to send those to all of the city council members? The results suggest. That we that is not something that we would send to city council. I'm happy to to to share with you that the employee engagement survey is something that we do approximately once every year to 18 months. It's a follow up to the work that we did with our leaders in the organization after the situation we had in the spring and we asked for it, we told our employees that we would come back to them and ask them for information about a whole host of things that go on in Denver health, much as we do each year. And we did it again this year. So can you can share any like high level results with any of us? Um. Let me. Let me pull out what we can share. Okay. That would be great. I would like to see that survey. It's been brought up several times in public comment and through the conversations that I have still as a voting member of Council on the operating agreement, I would love to see what the employees of Denver Health are saying. So as much as you could share would be greatly appreciated. And just a few more questions. So regarding diversity, equity and inclusion, are you currently working with the Denver Office of Social Equity and Innovation? We are not we're not working with them yet, although we're as we're working right now with the Equity Project, which is an organization based here in Denver that focuses on diversity, equity and inclusion in organizations much like Denver Health, where just we've just started that engagement and we will be working with with them and then we will be engaging the city's office because they've got some expertize there as well. Great. Thank you. And one last question. How are you engaging with communities specific necks with this recent surge of COVID cases to minimize and equitable health outcomes? Um, there are, there are a number of things that Denver Health does, and there's additional things that we are also doing. We have, as you know, community health centers that are scattered across the city and county of Denver. And so they're deeply embedded in their neighborhoods. We engage with various different neighborhoods and groups that live in those neighborhoods through the clinic. We also have we have a patient advisory committee. We have a the Community Health Services Board. And you heard from Carol Lewis is the chair of that. The Community Health Services Board is the group that oversees all of our community health centers. They have 51% or more of the members of that board are actually patients of Denver's Denver health. And there's a wide diversity of representation on that. We use that as a way to bring in additional information. And most recently, we've started a community engagement committee of the board of directors and paired who is the chair of our board can speak to it. But but really it was intended to be a way for both management and the board to look at issues around diversity, equity, inclusion, or our role as an anchor institution and how we can advance economic opportunity in the community and really make sure that we are continuing to move towards the vision of bringing both bringing opportunity out into the community, but also bringing community voices. And we have a number of community organizations. I think, Councilwoman, it's about ten, although I don't remember the exact number of different organizations from the community that have been asked to join that committee and help bring additional voice of the community back into the organization. We also do things like regular community engagement surveys. We did a community engagement strategic plan about 18 months to 18 months ago or so, obviously COVID. And it's trying to kick in for a lot of things. There are there are differences. And the COVID has had a disparate impact on a number of populations. We are looking at, um, through our public health department and our community health services division. Where has there been different impact on different populations and how can we help to remedy some of that? The mobile health ban you heard about, for example, we have areas of our communities where there are high rates of cases and low rates of testing. That mobile health ban is intended to help rectify that and bring out into the community that has been so significantly affected. Additional resources, both testing but also care and education around COVID. Um, at this time for exactly that reason, we're very concerned about the disparate impact that coping with that. And you've heard the reasons for it a lot of times on this. The people are essential workers. They, they go to work because they have to and then they are at higher risk of potentially contracting COVID. And for many people, um, with, with complications and comorbidities, the impact is even more significant. But I'll let I'll let Pia also speak to that. Good evening, council members and commentators. My name is Pia Dean. I am a Denver native and a Denver resident. I live in area code 80209. I am the chair of the Board of Denver Health and Hospital Authority, and we specifically wanted to get to this specific issue of how do we get more community voice in at the highest level of the organization. So we in the last year have created this committee, engagement committee and are in the process of inviting and I think it's closer to 15 different entities have now agreed to be part of that. We've only had no's from two and both because they were overwhelmed by the requests they were getting for help from their own community. So the goal is to have that information pulled in and to create partnerships. It works toward the entire institution concept where we're both hiring locally and in sourcing locally, but also hearing from the fair communities that we serve. So. That's been the approach from the board level. Okay. Thank you, Madam President. All right. Thank you, Councilwoman Sandoval. The public hearing for Council Bill 20, dash 1138. Oh, I'm sorry, Councilman Torres. Okay, you're getting in there. All right. The public hearing for Council Bill 20, Dash 1130 is closed. Councilwoman Torres comments. Thank you so much, Madam President. Denver Health mine is just, I think, a message and a plea. Basically your crucial institution in Denver. And I know and you know the work that you do in District three is immense. Your main campus is in District three, West Side Clinic, and your clinic and across the street from the Colfax and Perry location. Your value is based not just on transactions and services, but on trust. And it's critical that you regain trust if you lose the confidence of your team. Denver Health will implode. Either this is your commitment to rectify or it isn't. People don't become nurses, therapists, EMTs, medical assistance because they're going to make millions of dollars. They do it because they want to be of service to individual and community health and well-being. It doesn't serve the city to vote down this operating agreement. It does, however, serve the city for you to be a better employer, to respect the right of your employees, to organize and give them a workplace that they feel safe and that they can be proud of. The health of our entire city depends on it, and never more than what we've seen lately in a pandemic. So I just implore you to be that employer, to be that entity and that institution in Denver. And I ask you to let me know how I can help you. Thank you. Thank you. Councilman Hines. Thank you, Mr. President. I want to thank everyone at Denver Health who is here. I, I owe Denver Health my life. I might have said this before, but I think now is a good time to say it again. I was in a crash and ah, ah, ah. Sorry. I was in a crash on August 26, 2008 at 18th and Logan. It's very close to Kaiser Saint Joe's, Purcell, Kindred and the ambulance went the other way and went to Denver Health and and it was thanks to thanks to Denver Health that I survived. I spent eight days in secure surgical ICU and another five days in stepped down. And I, I don't remember much about it because I was on some pretty heavy medication at the time. But. But I do, I do remember snippets of being at Denver Health and I and I and I understand and respect. The work that you do. And I want to thank you for all that you do for for underserved communities, for me and so many other people. I also I invite you to in this time when we have so many health workers just, you know, at wit's end, at breakdown stage, there was a Denver Post article on Sunday that that talked about by National Jewish actually as what it was. And it had some really stark black and white photos. And and I'm I'm concerned that that our workers are are in trouble. I know I'm not a health worker myself, but but from what I hear from other health workers, I'm concerned. So I hope that you lift up our health workers, as you mentioned, your you know, your hospital and just and frankly, any organization and a city for that matter, what is a city but its people, you know, the hospital is no better or worse than the people who work there. And so I just want to make sure that they have what they need to succeed. As my colleagues will recall, I was the lone no vote for providing PPE to the and to small businesses. And the reason I said that is because I wanted to make sure that health workers, front line workers, had PPE. And I couldn't get an answer on whether our health workers in Denver had access to food. So I care very much about our workers. I want to make sure that they can succeed. The the hospital itself, the building did not save my life. It was the people who work there. So so I thank you so much for your for your efforts, for your leadership. I, I hope that you continue to keep workers in the forefront. And, and and I would challenge you to push them even more in the forefront. Thank you, Madam President. Thank you, Councilman Hines. And just a quick time check. I know we still have some folks that are staying on the line. We have one more courtesy public hearing that will begin immediately after our vote on this. And we have three more folks in the queue. Councilwoman Sandra. Foster. Thank you, Madam President, and thank you, Denver Health for all that you do. I am looking at your values and you talk about excellence, compassion, relentlessness, stewardship and learning. And I really believe that you do care about those values. I just hope that as these your workers who are unionize, that you respect those values as well, that you expect excellence from them, that you offer them some compassion, that you offer them learning opportunities. I believe that Denver Health is a foundation in Denver. I don't ever remember. I always remember it in general. And my whole entire life I've known that you can go there and you can get services that are needed. And to everyone else's point, you don't go into the health care industry to make a lot of money. You go into service, same as city council. I'm here to serve the people. And so I feel a bit disappointed that once again, a whole entire letter was sent. I in all my years on council, I've never seen so many people come together from the US Congress to city council to state reps to senators, all to sign on a letter of support and to not receive a response does not feel very like bridge building. It does not feel very good. I get tons of emails and my job as an elected official who takes public money is to respond. To the people. So I implore you to actually work with us. We are not the enemy. We want to see you succeed because your success means success for the people of Denver. Your success means health care for the people of Denver. And. Health care for those who are disadvantaged. So I will be supporting this tonight, but I will be making sure that I do my homework and check on the operating agreement next spring. So I'm much more involved and we don't have to have a public hearing like this late into the evening next year. Thank you, Mr. President. Thank you, Councilwoman. Councilwoman Sawyer. Thank you, Council President. I won't repeat what all of my colleagues have said, but I agree with it 100%. I think everyone is spot on and I'm very appreciative of all of their comments. And I and I agree 100%. And I just want to say how frustrating I think I am, how frustrated I am, and how frustrating I think it is to find ourselves in this position again where we have no other choice. We are out of time. We have no other option. We are forced to vote yes on a contract we are not happy with. As a provider, we are not happy with because we have. No other choice. We've been given no other option, and we were not a part of the conversation to begin with. And I think that that's not acceptable. And so to Didi G to the administration, I think that this needs to be a part of a conversation where we come together and talk about how our values as a government won't need to be reflected in the contracts that we have and in the contracts that we approved moving forward . I think this is something that keeps coming up repeatedly and and has come up several times. Over the course. Of this fall and this year now. And so, you know, once is maybe a one off. Twice is a pattern. Three times. Four times. Now, this is for sure a pattern. And it's something that we need to come together and and discuss, I think. So I just wanted to put that out there. Thanks so much to everyone who spoke out tonight. I really appreciate it. And I will be supporting this not because I don't know, because I want to, but because I have no other choice. Thank you. Thank you, Councilwoman CdeBaca. Thank you, Madam President. I echo my colleague's sentiments tonight, and I want to thank the workers for all that they're doing to really put their lives on the line to protect us. And I want a message to be sent to Robin and the board, I think. That you all. May see tonight's vote as a victory. But this is personal for me. These are my I have friends and family members who have devoted their lives to Denver health. And the ability to know what's going on from the inside is not going anywhere. And so we will be paying attention to exactly what is going on in there. From the emails you send to employees, to the trainings that you're doing, to the PowerPoints that you're doing, we see them all. And the only thing saving this contract in this moment is the fact that we have a city that is dying, literally dying, and we have to vote tonight to protect them. But this is not a. Vote of confidence in Denver health at all. And I want that to be very clear. Thank you, Madam President. Thank you. Next up, we have Councilwoman Canete. Thank you very much. I first want to thank all of the speakers. You know, the high level, you know, surgeons, the front line EMTs. And I think that what is really clear is that there is incredible pride and there is an incredible array of really high quality services being provided by this hospital in our community. And it is special. There's not a competitor. There's not another public hospital that takes every person, regardless of insurance, regardless of immigration status. And that's okay, right? Because that is what a safety net is. A safety net doesn't, you know, compete based on profit or price. It just serves everybody. I really want to appreciate the thoughtfulness of the speakers, and I think it's telling that as frustrated as clearly some of the workers were, they are putting the hospitals best interests ahead of their own personal feelings and were united in supporting this contract moving forward because it's in the best interests of the hospital . And I ask, I think the management and the the the board to really reflect on that. Right. And I think, you know, we don't spend a lot of time talking about what a union is in these debates. It ends up kind of being more of a political back and forth about who did what and how unfair it was. But the essence of what we're talking about here is this idea that there can be value to a collective voice. And this is the disconnect I keep hearing. I heard it tonight, which is we're interested in hearing from our employees directly. And it misses that employees have an opinion about how they communicate and where they choose to communicate collectively. There's a reason there, and it might actually have value to you as a system, as a hospital system. And other employers, for example, will find that you might have 100 requests from employees and you maybe can't afford 100 requests . But if those employees collectively prioritize what they think is most important and narrow it down to two or three, then how powerful that can be for you to work with them collectively on those two or three priorities. Those are the essences here about and problem solving, right? That's the other essence that, you know, we're a collective group of employees can share ideas for efficiency or improve patient care. I heard that tonight. I heard interest in making sure there wasn't disruption in personnel. Right. That that the protective equipment is related to absences. That testing is related to not infecting patients. I heard patients at the center of the conversation tonight, and I guess I would ask that there's a script sometimes I've, you know, watched this for many years where, you know, oh, this must be bad. We must try to stop it. We must have consultants, we must have closed door meetings. And it's a script that that doesn't pause to reflect and what the potential benefits are, what the potential opportunities are, and the value of just being neutral, the value of just allowing the workers to decide how they want to communicate. You don't lose your opinion. And as a management team you don't lose your opinion as a board, you simply have an opportunity to have a more organized conversation. That's the value here. And so I ask that we reflect on those things. I actually am proud to vote on this contract tonight, but I do that with the hope that this conversation creates new questions and reflections, that I don't just keep hearing the same script that that frankly isn't engaging with the underlying question of what's the opportunity here, what's the potential benefit, and what might be better for patients in the long run in terms of an organized communication with a group of employees who can prioritize and not you won't be able to do everything. You are a public hospital, you are as limited as we are as a local government. But I just think it's important to reflect a little bit on these underlying pieces. So so I am proud to support Denver Health tonight and I am proud to support the Denver health workers. I don't believe this is a choice between the two of you. And I don't believe either of you in the end believe that you can make a choice between the two, that that is that that you are inextricably linked and being neutral and allowing the employees to make some of the choices about how they communicate with you. I hope that we aren't here next year, but I move forward with the pride that you are all interrelated and you have the power to improve our community working collaboratively. And I hope that happens. Thank you. Madam President. Thank you, Councilman. Councilman Herndon. Thank you, Madam President. I just wanted to win support. Show my support for the contract. I do not feel forced to vote a particular way. I am happily able to support this contract. I remember back in 2011, 2012, when Denver Health opened the Montello clinic and the work that that and I actually have to but I just speak specifically to my Belo the work that that clinic does for that community is just a taste of the great work that you all have done for years. And from the author out, every worker who's a part of this team. Thank you for that and thank you for all you do. I think about losing my grandmother to COVID and who was the health care worker that was with her when she took her last breath. And I think about my family members that I know that work in the health care industry and dear friends and thank you for all that you do during this pandemic and even before, because that's very real and personal to me. And I. Second Councilwoman Canisius, I don't I don't believe this should be about picking a side. I willingly support this because of the great work that you do. And I thank the leadership team because issues have been brought forward today. You did not have the appropriate time to respond to defend yourself. And I could have asked questions. But this isn't the right forum to do that. This should need to be not publicly at a city council. Mary, But I trust that you have heard some of the concerns and that you will address them. And so that's why I feel very good saying, yes, I will support this and thank you for all that you do each and every day. Thank you, Madam President. Thank you, Councilman Herndon, and I'll just chime in. Definitely. Thank you all to all of the speakers and and the hospital care workers who had an opportunity to sit and visit with some of you recently. And really what you're asking for is not off the charts. It's to have a plan. It's to value your safety. It's to improve your work culture. It's to lower the bureaucracy that you work in. And I hope that this gives the folks that testified tonight a voice and an opportunity to share that. But knowing that there's hundreds more that have some of these very same concerns, and I look forward to paying attention to what's happening a bit more and hearing from those employees and folks on both sides so that we can get to a better place to protect people who are, in turn, protecting the public. Madam Secretary, roll call. Black I. See the Barca I. Clark. I. When I. Herndon. I. All right. I. Cashmere high. Can I? Ortega. I. Sandoval. I. Sawyer. I. For us. I. Madam President. I. Madam Secretary, please close the voting and announce the results. 39.