A bill for an ordinance approving a proposed Fiscal Year 2022 Amendment 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 2022. Approves the 2022 Denver Health and Hospital Authority operating agreement (ENVHL-202160644). The last regularly scheduled Council meeting within the 30-day review period is on 12-31-21. The Committee approved filing this item at its meeting on 11-10-21.
13 I's Council Resolution 21, dash 1271 has passed. We want to thank Michael Carrigan and the other representatives from the organizations that were here and the members of the public. Council is now convened as Denver City Council. Councilmember Flynn, will you please put council bill 20 1-1219 on the floor to be ordered published. Thank you. Madam President, I move that council bill 21. Dash 1219, be ordered published. Thank you. We have it moved and we've got it seconded there. Thank you, folks. The public hearing for Council Bill 21, Dash 1219 is open. And may we have the staff report, please? Thank you, council members. My name is Megan Presa and with the Department of Public Health and Environment and I have a brief presentation I'll go through fairly quickly here. Many of you have seen it. So we will go through rapidly. In addition to myself, we have a number of our Denver health colleagues on the line virtually, and they're available to answer questions as well as some of my city colleagues over here. The 2022 operating agreement between the City of Denver and Denver Health and Hospital Authority covers a number of services for the city. Those are included core services. And some examples are listed here noncore services and then some services that the city provides. Back to Denver Health. The contract for 2022 includes 36 services total. Relatively few language changes in 2022, with the exception of section 83, which is the public health section. As you can see, 27 are unchanged and nine of those sections had relatively minor changes other than a three. And two of them were removed. Because they're handled in another agreement are no longer necessary as a capital project. Some highlights of the core services. Patient Care Services just received some minor updates to the metrics to align with COVID 19. I'll get to the public health services in A-3 in the next couple of slides. And the third section of aa3 or eight just had an updated call answering protocol for the Rocky Mountain Poison and drug safety, digging into a3a little bit more. The Public Health Institute at Denver Health transferred a number of services back to the. City this year, including. Epidemiology and disease investigation, preparedness and response informatics, the chief medical officer, position and Vital Records. This will provide future cost savings efficiencies and a more seamless public health response and services to the city. Reduce the risk of redundancy. And this was further highlighted by the COVID response and the need to bring those two entities under one umbrella for emergency response. This resulted in 23 plus new F2, EAS and DDP. The remainder of a three that stays with Denver health are the four public health clinics listed here infectious disease, immunization and travel, sexual health and tuberculosis clinics. And there were some minor language changes around communication and data use, as well as further defining invoices and financial requirements. A few highlights from Appendix B The Caution Outline updated updated. The allowable time to respond to a records request and updated some protocols to address when the provider exhibits a pattern of. Performance inconsistent with. Existing standards of medical care. And the there is a section added to the health care at the Denver County Jail and Downtown Detention Center to work towards an electronic medical record system in the jails. A few minor changes to Appendix C Denver Health Approved Paying for two additional emergency communication operator positions. This is to support the EMS calls and to 911 and then some minor updates to the minority and women business enterprise program. The budget for 2022 is roughly $63.6 million. Almost half of that is for that patient care formally referred to as the AMA payment. And the other 33.9 million is for other core and non-core services. The city will also have an approximate revenue of about 3.5 million for the services we provide to the hospital. I won't go into the details here, but this is the details of the budget increase. A few of them are related to reductions that Denver Health took during the COVID economic downturn. A number of them are related to wage inflation and a few other minor changes to budgets and different sections of the agreement. That's it. Thank you. All right. Thank you. We have 13 individuals signed up to speak this evening and all of them are joining us online. Our first speaker this evening is Robin Wittgenstein. Do we have Robin in the queue? Okay. We'll go ahead and move on to our next speaker. Jesse Paris. Yes. Good evening. Members of council cannot be heard. Yes. Yes. My name is Justin Boston Paris and I'm represents the black swan symbol of the self defense housing vaccine command for social change was the Unity Party of Colorado and front line black males. And I'll be the next male member in 2023. I'm in favor of this budget proposal tonight. Please pass this. That's all I have to say. Thank you. Thank you. Our next speaker is Tess Dougherty. Hi, Councilor. My name's Test and I'm live in District nine. I, I, you know, I was in the board meeting when Bob McDonald announced that the, the switch was happening and that they'd been working on it to take, you know, give control back to the city instead of Denver health. And I guess I, you know, my own experiences at Denver Health have been pretty, pretty terrifying. I, I appreciate the services like the, you know, the STD clinic and the immunization clinic that they have. You know, I think that that those are very helpful services and actually deserve more funding but but personal experiences at Denver Health, my experience with hearing people tell me stories about Denver health have been pretty terrifying and gravely negligent. The the amount of people who are unsafely discharged from Denver health after being taken there if they're experiencing homelessness is is just absolutely alarming and terrifying and and not to mention the treatment of people. Denver Health regularly ignores requests from from service service providers who are sending in orders for people experiencing homelessness, and they just somehow get lost on the way to Denver Health in a fax machine, I guess. And that's pretty just despicable. But you know, what's really, really sad is that I don't I don't have much faith that the city of Denver is going to do much better. I actually am more scared that it's going to be in the hands of the city of Denver based on the treatment of people experiencing homelessness by the city of Denver. And that's really, really fucking sad and scary. Do better, please. All right. We're going to move on to our next speaker and I believe we've got Robyn Wittgenstein in the queue. Robin, you might need to unmute. I don't know if you intended for this to be Dr. Wittgenstein or me. But I'm in the queue, so. Well, we have Dr. Weinstein signed up as one of the public speakers. We're going to go ahead and we'll move on and see if we can get that figured out. Our next speaker is Connie Pryce. Hello. Thank you. I'm Connie Silver Price. I am the chief medical officer at Denver Health, and I'm also a resident of the city and county of Denver as a mission focused safety net provider. Denver Health is proud of the role we have played in Denver for over 160 years. While the COVID pandemic has continued to challenge us in ways we could not have imagined, it also demonstrates the essential value Denver Health delivers to everyone in our community. Two years into this pandemic, our dedicated Denver health staff continue to rise to the challenge. Since the pandemic began, care has been provided to over 3000 COVID 19 patients in the hospital, countless others who have received care remotely via our virtual hospital at home program, saving hospital beds for the sickest of the sick. And we have given over 100,000, 140,000 persons, the COVID 19 vaccination, to help contribute to over 80 to 90% of the city of Denver being vaccinated in all but the youngest age groups. Over 27% of our 5 to 11 year old age group has also recently been vaccinated, with the recent approval by the FDA. In this age group and our school based health centers and our vaccine outreach teams in partnership with our city have been hosting events at schools and in low income areas of Denver this week and for the remainder of the semester. And when monoclonal antibodies which prevent progression to those at risk for severe disease from COVID and prevent them from getting hospitalized or getting severe illness. When those became available, Denver Health was the first institution to make it available to our community. While dealing with this pandemic, we continue to provide everyday health care exceeding pre-pandemic volumes for many of our services. Now in our emergency room and urgent care centers, our hospital, our ambulatory care centers, and in outpatient behavioral health visits due to the well-documented impact of the pandemic on mental health. We did this while maintaining high standards of clinical care meeting or exceeding performance goals across a range of services. We also maintain our reputation as a leading trauma center and currently are caring for record numbers of trauma patients. Also, an impact of this pandemic. Even with all those accomplishments in our medical care, we are well aware that this is only part of the solution. That is why Denver Health continues to invest in our community and social determinants of health. We have been improving access to food, education and well-paid jobs in housing. And so in partnership with the Denver Housing Authority, we continue to work to convert a former administration building to a transitional senior housing project to allow for safe discharge for patients who are too frail to go home. We are also working with our community to help people who are experiencing homelessness get back on their feet. And thank you very much for my 3 minutes. Thank you. Our next speaker joining us online is David Hagan. Thank you, Counselor, for allowing me to speak tonight. This is going to be one hell of a sandwich. Back in September. A friend of ours that we've been advocating for experiencing homelessness was left in her bed for two weeks after being struck by a car. I met in two weeks without being taken out of her bed. You could smell or moved. You could smell her from two doors down. We were assured that she would be given a bath, cleaned and moved after that. And we were also assured that she would be released to some sort of housing that would be of assistance to her because she was not going to be able to take care of herself. What the Denver health do they release her to the 48th Street shelter. It took them half a day to get her there. They not they kind of knocked her over. She was laying on the sidewalk and then they made her stand up on a leg that she almost recently had amputated. This is what experience she had. Mine wasn't that bad, but I was definitely left alone there. It wasn't the greatest experience, but I'd like to focus on her experience. And then I'd also like to think in the jails. Why is it that we take Medicaid away as soon as you get to jail? Then why is it that we're making the the inmates pay for everything out of their own pockets without having any money because they're in jail? So it makes it really difficult to have any money. And getting services while in jail has been very difficult for the people that I've spoken to. It's been almost non-existent, to be quite honest. Meds, medication is not been provided for people that we've spoken with. Mental health. That's just a joke. I mean, that might as well not even talk about that because it's not it's completely non-existent. So I hope that in this budget that's going on. We have some money for these things and we're going to start paying attention to and advocating and making sure that these things happen and that the people that are marginalized in our community because this is not acceptable, it's disgusting. And then also, I just wanted to say before I get off here, Hines, that Walnut, Larimer, Lawrence are all in the right now. And then that stuff spreads over and then gentrification happens, money goes up. So it's not just. Asking that you stay on the tour. Thank you so much. Have a good time. All right. We'll go to our next speaker, Pastor Topaz McBride. Good evening. So. I feel a little a little kind of. Out of sorts just because I just. Jumped on. So I don't even know where I'm coming in at, however. I do want to. Express my concern on behalf. Of the different organizations. That I am representing this evening, which include the Greater Denver Ministerial Alliance. And. Community. I'll just stick with that. And community concern about the respect of. Workers. Across the board as it relates particularly to. Employees of color and and really. Allowing them a voice and. The. Support. That is deserved and necessary in this particular climate in which we're living in being treated with the same professionalism and humanity that all workers deserve. In a press conference and prayer meeting that was held in front of Denver Health a few months ago, back in the summer, I had an opportunity to hear from several Denver health workers and how they were being treated and the evident discriminatory practices and lack of equity that comes from Denver Health. Even with the. Support of the Union, there is a lack of equity. And so I'm here to speak against that. I'm here to speak against the. Implicit. Biases within the health care system that are. Reflected from employees to patients. To differences in how. Patients are treated. There were a couple of. Families that came. To the Denver Ministerial Alliance, and I was saying a couple, but actually there were several, but there were a couple, a couple who were willing to be public with regard to their specific cases and names. And it was evident that they were treated with much bias. And and it was because of the color of their skin that was evident. Once the investigation was done and there was a comparison in the. Outcome of those particular cases and other cases. The community is what Denver Health is supposed to be available to support community. At large regardless of race, ethnicity, gender, etc.. And when you take an oath as a health care professional, then the expectation is that you are going to be. Committed to the oath that. You've taken. To support. Patients, that that's the. Time we have allocated for you before. Thank you. Thank you. Our next. Speaker. Is Juliana Thomas. Good afternoon and thank you for the opportunity to address you today. Members of the Council. My name is Juliana Thomas and I am a proud retired union member and I am very active in our community. Presently, I am a volunteer at the Redeeming Love Fellowship Church. I helped to run a food bank there, along with the volunteer at Sidney Elementary School as a substitute teacher. Social emotional. So my thoughts tonight are the same as present as the previous speaker about the injustice that has been taking place at the U.S. health. Most humanitarian efforts, I would like to say, such as hospitals, daycares and orphanages where initiative by Christians. My faith in God tells me that there must be a difference in the world in how we treat one another. We are taught to love our neighbors and ourselves is when we as Christians use our influence to try to correct the moral and ethical issues that go on. This is where we are meet with the contention, which I'm glad to be to be a part of. When a group in society is oppressed or is suffering and is constantly denied the privileges and rights of the institution that the majority enjoys. It is called social injustice. Therefore, it is unfair and will ultimately lead to contention, discourse and uprising such as what we are seeing in our society today. Injustice is sin and it should not be tolerated. There should be no respect to persons. There should be no differences. And in how we treat one another and how we do our jobs and how we go about serving our community. One thing that I stand by, God is not mocked whatsoever a man. So that's what he's going to reap. Now, I was also a part of the community praying for racial justice at the Denver Health. We prayed that day for Denver health leaders to do a couple of things. Three things in particular that I remember. First, that Denver health leaders would have the courage to honestly face institutional racial injustice. Second, that Denver health leaders have the humility to accept community responsibility. Third, that Denver health leaders have the moral strength to respect the rights of their workers. As Denver Health Council, one of our pastors who prayed that day said, We wanted to ask God to shake every house so that our elected officials use their power to guide Denver health on a path of demonstrating racism or dismantling excuse me, racism and protecting workers rights. I ask you all tonight, have you done all that you can do to support the workers who are courageously united to make Denver health the best place to give and receive care? It is our responsibility to stand up for those that are treated unfairly, and I stand with those that are fighting against the injustice at Denver Health. Thank you for your time this evening. Thank you. Our next speaker is Brook Bender. Nor can you hear me? Yes. Wonderful. Thank you. My name is Brooke Bender. And I am. The administrative director of our Center for Addiction Medicine at Denver Health. I am representing the entire entity of Denver Health as our Center for Addiction Medicine crosses over all of our services. Denver Health Chem Center for Addiction Medicine aims to do things differently than many traditional health care systems. By identifying patients wherever they enter our system, assess their substance use needs, and link them into inclusive and compassionate ongoing care if and when they're ready for treatment. Much of our. Model would be impossible. Without funding. From the City Operating Agreement. For our Treatment on Demand program. This program funds three full time substance treatment therapists to meet patients in the emergency department and hospital at bedside to conduct a full bio psychosocial intake, assess needed level of care, and link patients to next day outpatient follow up. A Denver health or within one of our community partnerships. The City Operating agreement has allowed us to innovate and expand. Over the last few years. We started in 2019. As a city pilot program just in the emergency department, and over the last couple of years have expanded to our inpatient unit and serving patients with opioid use disorder, alcohol use disorder, stimulant use disorder and poly substance use. In addition, we've expanded to also outreach to patients post overdose in our emergency department. We've been over the last couple of years due to COVID increased numbers of overdoses. Occurring within the city and county of. Denver. Many emergency departments are stabilizing those patients that they can and sending them back out into the community. Our treatment on demand therapists outreach. Those patients offer support and linkage to treatment. What we've seen so far is an increase in patients entering treatment through this program every year, including during COVID. As of this. Year. In October, 380 patients were served by this team with an average linkage rate of 60 to 70% to ongoing services. Our patients are showing gratitude for this program. A couple of quotes they've shared with us are the compassionate staff at Denver Health saved my life by helping me believe my life was worth saving. They were super kind and genuinely there to help me. No judgment. Our hopes for next steps for the treatment and demand program is to expand beyond the three treatment providers we have . We're only reaching a small portion of the patient population within the hospital that have substance use disorders due to a limited capacity of the team. We also want to offer learnings and technical assistance, including for clinical consultation to other emergency departments and hospitals interested in building their own treatment on demand models. Thank you very much for your time tonight. Thank you. Our next speaker joining us online is Julia Aureliano. Hey, can you hear me okay? Yes, go ahead. Hi. Good evening. I'm Julie Ariana. I'm assistant chief paramedic for Denver Health X. I've been with Denver Health. I'm the paramedics first. Our operations. Let me see. Your microphone seems to be going in and out a little bit. Maybe if you go ahead and speak louder and we'll let you know we're here and. Yeah. I'll talk louder. Can you hear me now? Yes. Okay. So I am currently overseeing our operations out of the airport. We have paramedics there 24 hours a day. As you know, Denver International Airport is very busy. It's the third busiest airport in the nation, the eighth in the world. They see about 69 million passengers every year. Just in 2021, Denver paramedics have run over 6000 calls and transported almost 2200 patients from the airport alone. You know, this is an important operation for us, the airport being. You know. Kind of a vulnerable population out the location wise from where any medical help could get there. So those 60 over 6000 patients would be calls that would have to come from our downtown 911 system. So having our paramedics there is is vital to serving that population. That number is also significant considering that the first five months of. This year there was. Very limited airline traffic. So our numbers are very close to what they were in 2019, which was 12 months of a busy airline traffic. So we are committed to being a great partner with the airport and a great partner with the city. We play an important part with our our partners out there in public safety, the police department and the fire department, and supporting taking care of all of those those passengers out of the airport. Thank you for your time. Thank you. Our next speaker is Elizabeth Epps. Elizabeth Banks. Evening. Thank you. Go ahead. Good evening, City Council. It's been a while since I've been with you, but I'm still Elizabeth Epps. And I founded and served as the executive director of the Colorado Freedom Fund. The Colorado Freedom Fund. We pay ransom. We pay cash bail for our neighbors trapped in Colorado cages most often the Denver City cage. The Denver City cage, where far too many people are transported after incidents that happen there at Denver Health. I'm here this evening just to briefly address the patient to prisoner pipeline. No one who seeks medical care at Denver Health should ever have to think about seeking that care because they may delay that care because they may encounter law enforcement. We we should all agree that hospitals should be patient sanctuaries, which balance the rights of vulnerable patients with the need for public safety. We know from our work at the Colorado Freedom Fund that Denver Health at times functions as a really active, aggressive, willing participant in this patient prisoner pipeline. I mean, this in the most direct, direct way, counselors at the Colorado Freedom Fund, we regularly pay bond several times a month for people disproportionately black and brown women who are accused of assault, where the assault at issue is flinching, panicking, spitting or otherwise being less than one's best self when in the custody of a Denver health employee. Institutional racism impacts everyone, and our health care system is not immune to that. Denver Health Hospitals Already it's really, really must meaningfully acknowledge, confront and work to dismantle these oppressive systems within those halls of Denver health. So counselors, even as we ask you, of course, to vote yes on the operating agreement. We also want to remind you that, you know, Denver Health can start with transparency around the report that the executives commissioned the equity project to complete and can continue by honestly posing the question, how does racism operate here? We're here. Is at Denver or how Denver Health should partner with community with their workers and their union patients to learn the answer to that very question. Denver Health really does need a careful and transparent review of policies which allow racism to operate. Just one solution is safe staffing so that workers have the support they need to provide the best care while also actually interrupting racism. Another solution would be providing real anti-racism training for workers building systems which support them in coming forward when they experience or witness racism together with his patients, the community and workers. Denver Health really can disrupt this patient, prisoner, pipeline executives and top leaders. They just can't do this alone. So while we need you to approve the operating agreement, of course, we also need you as councilors and the mayor's office to do everything in your power to support community members and workers who are actually doing the work to dismantle racism at Denver Health. We call on you to do just that, to create more accountability and transparency in the city's contract with Denver health patients. Workers, indeed, very community health depend on it. Thank you for your time. Thank you. Our next speaker is Carmen Casali. Hi. This is Carmi. Can you hear me? Yes. Hi. I'm Carmen. Sally. I'm a registered nurse. I'm also the health services administrator at the Denver Sheriff's Department for Denver Health. I worked at the. Facility for 22 years. I am certified in correctional care. I'm also a NCC HD. Survey surveyor for jails across the United States. I was very excited to see the electronic health record. In the operating agreement going into next year. At 22 years we have utilized a paper record and we have been very effective and very efficient with the paper record, but we have not been able to be as efficient as we should be able to be. Patient safety is our number one priority and electronic health record is going to help us expand and increase our patient safety. Right now, with a paper record, we have paperwork that we have to locate, that we have to find. One person is only able to have the chart at one time. So, for example, of both a psychiatrist and a doctor need to see the chart. They have to wait. They have to take turns. Legibility can be an issue with the paper. Record storage is an issue for the paper record. We are having to transport our charts back and forth to a warehouse between both jails. When patients book in, we do not have the patient history, so. We often have to start all over with our patients that are very well known to us. And until the chart does arrive, at times, finding information can be challenging in a paper record. There is nobody outside of the jail that can review the paper record, such as outside Denver Health Doctors. There's really no ability for data collection. It can be challenging to determine. Medication compliance on current medication paper records that are going out to the housing units. It's a manual transfer process to transfer information from one jail to the next jail. The cost to maintain staff at the Denver Health Warehouse, which staff that could be rerouted to help at the jails would be beneficial. Miss filling in charts. Is definitely. Occasionally happens. At times we cannot. Find a chart urgently when we need it. The Denver Detention Center is five floors with multiple exam rooms. There's no audit. Trail. A paper record can be altered where an. Electronic health record has a very robust tracking system. Cost of just a paper chart, I think, eventually will outweigh what the. Cost of an initial chart will run us. And it's definitely a challenge to complete release of information, requests of information for community members into facts and scandals. So super excited for the electronic health record and look forward to hopefully. Being able to start the process and implement that into correctional care for the patients. Denver Health serves at both Denver jails. Thank you. Thank you. Our next speaker is Sarah Rowan. Madam Chair and City Council Members, thank you for the opportunity to speak today and also thank you to all the other speakers who brought forth so many important points. My name is Sarah Rowan and I'm an infectious disease doctor at Denver Health. I live in Denver and I'm fortunate to live one block from the Park Hill State outdoor space. I'll be speaking about our four public health clinics, each of which serves a vital role in the Denver metro. I personally see patients in two of those clinics, the sexual health clinic and the infectious disease clinic. The Sexual Health Clinic is the largest provider of free and low cost sexual health services in the Rocky Mountain region. We offer those services to about 15,000 patients per year. In addition to testing and treatment for sexually transmitted infections, we also provide access to contraception and comprehensive HIV prevention services, including the HIV prevention pill. Also, if patients test positive for HIV anywhere in the city, we've worked hard to make sure we can offer immediate HIV treatment at no charge. Our outreach arm, which I supervised, provides free HIV, Hep C and STI testing at community sites throughout the metro. When the pandemic hit, our team leveraged our experience, our medical expertize, and our community partnerships to be the first agency to provide free community based COVID testing in conjunction with numerous nonprofits and shelters. Additionally, we provided technical assistance to other agencies and testing infrastructure as testing infrastructure was developed in the city. We worked closely with homeless service providers in our community and we spent a great deal of time serving those who are houseless and unsheltered caring about the tragedy at the rescue mission. The reference to Salvation Army. These are all very familiar sites. Our infectious disease clinic provides care for 1500 patients living with HIV. We're one of the largest insecure sites in the state. We have national leaders in HIV research and treatment. We treat hepatitis C, which is prior to COVID, was responsible for more deaths than all other reportable infections combined, and the incidence has skyrocketed in the face of the opioid epidemic. Through our community partnerships and coalitions, we're continually innovating new ways to bring Hep C and HIV treatment to people where they are, rather than rigidly demanding that people come to us. Our other two public health clinics or at the immunization clinic, which provides free and low cost vaccines to anyone who needs them and their role in the COVID vaccine response has been invaluable. The Metro Tuberculosis Clinic provides free services for the region, ensuring that tuberculosis does not spread in our community. And the patients with active and latent TB, many of whom recently arrived in the United States, receive excellent medical care. In summary, our clinics are instrumental in treating and managing conditions of public health significance conditions that, if gone untreated, lead to high costs for our community through outbreaks, costly hospitalizations and unnecessary suffering. Thank you. Thank you. And our last speaker this evening is Rosario CdeBaca. Rosaria, we might need you to unmute. I think we're still showing that you're muted. Okay. Our producers are letting me know. It looks like you're. Not they are now. We're not seeing anybody at the computer. So we're going to go ahead and move on here. That concludes our speakers this evening. Questions from members of Council on Council Bill 21, Dash 1219. Council members say the Barka. Yes. Thank you. I have a couple of questions that were sent to me from workers at the hospital. There was a an equity study that was done by the equity project. And workers are wondering why Denver Health is refusing to produce the study and share the results, specifically with workers who participated, even if not with the rest of the general public. I'm going to have to defer to the Denver Health Partners if we can promote Stephanie Signer. Take your money. Hello, this is Robin with the CEO, Denver Health. I apologize for not being able to speak before we had some technical difficulties. The equity the equity study that Councilman CdeBaca asked about was conducted under attorney client privilege. And it was done so so that the confidentiality of the employees who participated would be protected. We have shared generally the results of the equity study with our organization, and I have offered to sit down with any member of city council who would like to hear the results of that study. Thank you. Abstract. Of that study. As we said, the study was conducted under attorney client privilege and is not going to be released its entirety. But we're happy to sit down and share with you the same information that we shared with our with our employees that came out of that. So does that mean that there were no disparities found or what was the point of doing the study? So the study was intended actually to, uh, to hear the voice of employees at Denver Health, and it was not just employees. We also conducted stakeholder interviews with people both inside the organization and now. And it was intended to allow people to speak frankly about the experience of being a person of color inside Denver health the findings and that. And we shared them with our our employees as well as with community organizations outside of Denver Health and certainly with our board of directors really fell into four buckets. One of them was that race matters. Denver Health, like all organizations made up of people, have issues dealing with systemic racism, disparities and issues that affect the day to day lived experience of people of color in our organization, as in our society. And our employees came forward and told us about some of those. There was also some concern that, um, as the institution dealt with issues of systemic racism, of health equity, health inequities that exist in our society and that affect our patients as all patients unfortunately are affected across the country, that there would be there was some concern would we take this seriously? Would we move forward to address these issues? There was there were themes around transparency and communication, making sure that we did, in fact, actually share the results of this of the work out. And then, more importantly, give voice to people in our organization in developing the plan that we would use to address the findings. And then finally, the last finding was around our role as an anchor institution, which, as you might imagine, is extremely is supported by by our entire workforce. The idea that Denver health can be part of the solution to both economic challenges that our our patients face, our communities face, but also issues around how to promote opportunity for people of color, especially those who historically may not have had opportunity, was something that was embraced by our employees. But the point was also that we have many employees who have who've experienced the same the same lived experiences, the same economic challenges, the same issues that the people throughout our society have. And so we pulled all of that together and working within the organization, with our city council, with employees across the organization, with our equity steering group, we have developed a three year strategic plan that is Denver Health's commitment to addressing issues of systemic racism, of of the challenges that people of color face both inside our organization and their everyday lives. And we are now we've released the draft to to our CEO council, to others, to our board of directors. And we're in the process of releasing that to the organization as a draft. And the reason we're just we're releasing it as a draft is because these issues have been widespread and historic. And we fully expect that even with the initiatives that we've identified to address some of the feedback that we've gotten, this is going to be a work in progress for a very long time to come. We've identified a number of things in each of the the findings around creating and engaging work, workplace, engaging, inclusive, workplace, addressing issues of inequity for patients in conducting and creating and ensuring that we have a fair and accountability system and a fair and just climate and then making sure that we have the infrastructure that we need to address these issues. We released the report, the the study, the three year strategic plan. And we're now in the process of actually developing very detailed work plans for each of the initiatives again. And as I've shared with you, Councilwoman. These are longstanding issues and problems. Denver Health has never and we'll never say that we don't have many of the same issues that every other organization in our society has. What we are trying to do is understand what those issues are inside our organization, how we can address those working with our employees, and how we can address those issues, working with community members and patients to address the health inequities and disparities that exist. So we're moving forward with that plan. And as I said, I'm happy to sit down and go through that with you, and we'd be delighted to hear the ideas and suggestions you have for how to move forward on some of the things you hear from your constituents as well. The study conducted. I'm sorry. I didn't hear your question. When was the study conducted? The study was conducted in late in 2018, 2020. I believe going into 2021. Include attrition rates disaggregated by race and ethnicity. No, this study does not. This was intended to give opportunity for the voice of our employees in our community to bring the issues forward. Do we have attrition data over the last couple of years disaggregated by race and ethnicity? We we have we have some employee data, although I will tell you, we're in the process right now of working to gather that information. The most recent information is, of course, challenging given what's going on in the labor market. But we are we are working together that. And what is the current attrition rate? I don't have the answer to that question right now, but we can certainly get that to you. Additionally, what efforts are being implemented or taken to secure hazard pay or premium pay for the frontline workers that took on the risks early on in the pandemic? So Denver Health is not paying hazard pay to any of the health care workers. However, we have done a number of things that are intended to address the the workload that our staff has been experiencing over the last. 18 months. I'm just going on two years, frankly. We have introduced critical staffing, incentive pay. We have introduced and increase specialty pay for those health care workers that are particularly impacted by COVID. We have, unfortunately, like all other institutions in the entire country, we have we are experiencing labor shortages and oftentimes are asking our employees to work extra overtime shifts. We have voluntary overtime agreements in place with them so that if people volunteer to step forward and take on extra work, if that fits within their their particular life situation, they get paid not only their their pay plus and overtime rates, of course, if they're working overtime, but there are additional bonus payments made to them after they can. They conduct a certain number of shifts. We have recently announced are in the process of implementing an increase for all in compensation for our employees, raising our minimum wage to $17 or and giving 3% salary increases. So $70 or 3%, whichever is higher and making sure that we have that available. As you know, Denver health is a safety net institution and we are using the resources that we have available to target those dollars as best as we can at the front line and the central hospital workers who have struggled throughout all of COVID . So the employees, the frontline workers got a 3% increase in salaries. Will there be another 20% increase for the executives like there was last year? So the 3% increase will actually be effective December 5th. So employees will seed in their, their salary, their paychecks. Uh, I think it's December 28. The increases other than just the 3% increase, um, we also could doubt that, like shared with you every year we conduct salary surveys where we look at the wages that are paid at Denver Health and we compare those regionally to wages paid for similar roles across across the region. Where necessary, we make market adjustments in compensation for any role that has fallen out of line with the market. Um, Denver Health organizational philosophy is we look to pay at the 50th percentile for all roles in the organization. When those roles have when the compensation for those roles is different than the market surveys show us, we make adjustments for those. So it will depend on what has happened in the marketplace for any given role. We will be looking at additional market adjustments in the beginning of 2022 as we get the salary of the salary survey information for, um, for roles here at Denver Health. Are you seeing that any of those efforts are improving the attrition rate? That's a really good question, Councilwoman. Um, I would say this. The answer is yes in that Denver health at the last point in time where we could collect information about vacancy rates at hospitals, nearby hospitals in the region, Denver Health was actually faring somewhat better than other institutions. But I'm going to say that's within the context of we are all in crisis at this moment in time. So everyone is struggling with staffing. And again, it's not just Denver Metro, as I'm sure you know, it is. Hospitals across the country are having a really difficult time right now. Institutions are somewhat less willing to share information more recently. So we have not been able to update that in the last month or so. But um, through the time period that we were able to get information while we were also in crisis, we were doing a little bit better than some of the other hospitals. And I know you don't have the actual attrition rate for Denver health, but it sounds like, you know, the area's typical attrition rate. Do you what is that? It's again, it's going to vary pretty significantly by job role, I can tell you. For nursing, for example, at Denver Health, our, um, our turnover rate has, has historically been significantly lower than national rates for nursing nursing personnel. So, you know, again, it will vary by job click, job, class and role. Denver Health generally has run a lower turnover rate than many institutions and where there are national numbers available, like in nursing. Denver Health has historically done better than the national averages. Benedict. We had information and we're taking note the whole ceremony to get back with you from the safety committee to give us a presentation on the study. It would be nice to see the actual attrition rates and the comparisons by job classification as well as if it's possible disaggregating by employees by rate that race and ethnicity as well . Thank you. Thank you. Council members say to Barker and thank you, Doctor Wittgenstein, for your answers. I've seen no other folks in the queue for questions. The public hearing is closed. Comments by members of Council on Council Bill 20 1-1219. Not seen any. Give it a second. Councilmember CdeBaca, you're up first. Thank you. I would just like to share that I have been appalled by the lack of leadership of this organization, especially when it comes to racial equity within the organization. Several times I've had conversations with leadership to really discuss what it means to create equity, and it falls on deaf ears over and over. And while we desperately need this agreement to pass tonight, I encourage my colleagues to dig deeper with this organization. Talk to board members, continue to raise the concerns because what is happening on the inside of this organization is really disappointing, given this is our health authority. And so tonight I will be a yes, but I am extremely disappointed. Thank you. Councilmember CdeBaca, Council Member Sawyer. Thanks, Madam President. I have some concerns as well. I really do appreciate Denver Help's partnership with the city. You know, they provide an invaluable service to the residents. And I especially want to thank our nurses, our tax, our doctors and the staff who continue to put themselves in harm's way during the pandemic to protect the health of our community. Like I said, I've got concerns. I'm I'm not convinced by some of the answers that I've heard this evening. I wasn't convinced by some of the answers I heard in my briefing. I wasn't convinced by some of the answers I heard at committee. We don't have a choice but to approve this agreement in the middle of a pandemic. This is our. Hospital. Authority. So, you know, I want to again stress the importance of partnering with all employee representatives. I think it's important to find solutions that make the staff feel supported and included. We've had this discussion before, and I think, you know, it's not a it's not an overnight fix. And I appreciate that the leadership of a DHS is working hard to do to implement some changes. I'm not sure it's enough, and I'm. Not sure it's. Happening fast enough. But that said, I believe in the mission of DHS and the services that they provide to our community. So I will be a yes tonight. Thinks that a president. Thank you, Councilmember Sawyer. Councilmember Sandoval. Thank you, Madam President. I have similar concerns with my colleague when you continue to hear from paramedics who are leaving the industry. Yet at the same time, I have a friend who's an ER nurse and the industry is suffering because of the pandemic. And I believe that Denver Health plays a vital role in the history of Denver and for all of our residents. I support the workers who are trying to unionize. I hope you I stand in solidarity with you. And I hope that. People don't always the general public doesn't always understand that there is a separation between Denver health and the city county of Denver. And so if they look bad, we look bad. And I just want to support all of our health care workers. And yet, at the same time, this is the second year that we've had public comment during a hearing on this contract where people are coming, complain that is a sign of something that is not working. So I hope that we can work on this and make sure that there is not this type of discord when this contract comes forward. Thank you. Thank you. Councilmember Sandoval, Councilmember Hines. Thank you. Council president, I think. You know, a hospital is a location where people don't want to spend time. They're not. No offense to all the workers and in the institution. I would say that I've spent too much time in as an inpatient in Denver health since the last hearing that we had. I spent 16 days in Denver Health in August. And I just I want to commend all the people who work at Denver Health. I heard time and time again, you know, as a as a you spend too much time in the hospital. You get to interact with a lot of employees who work at Denver Health. And I just I heard so many times that people really buy into the mission level one care for all. And people said that they work at Denver Health because of that mission. And I just I want to thank the workers so much from the techs for the janitorial staff up to the positions because they really are passionate about making sure that they can heal those who are are are hurting. So they certainly helped me. And again, it's not that I wanted to be there, but but I was there nonetheless. So I just wanted to thank the workers. As I understand it, this is you know, this is something that the city is interested in. Denver health, um, you know, doesn't make a lot of money from this. So it isn't as if it's, you know, just the hospitals losing a lot of revenue. So I think it makes sense to support the what we're talking about this evening. Um, I recognize that Denver Health has some work to do with the relationship between the authority and the employees. Ah, the administration and the employees. And I hope that continues. Thank you. Council President Thank you, Councilmember Hines. And I'll wrap up here. I think it's very clear that a lot of our institutions are taking another look at how they look at implicit bias, how they really walk the talk or implement the work to make sure that their institution is an anti-racist, anti oppression institution organization. And that work is going to take decades to accomplish. But it's important that we show progress to the folks who are spending day in and day out serving others. And, you know, the paramedics are a group of folks that are important to us as well. And our certified nursing assistants, a lot of folks just go to nurses, doctors, etc.. But really the certified nurses assistants are the seniors are the ones that really do a lot of that work and they're telling us their stories. And I think that we should listen to them and make sure that the board and the leadership are implementing different procedures, different trainings, whatever they need to do to address this need, they need to be doing it. And I have to believe that they are working on that. And I look forward to the upcoming reports on where they're at and the next plans. Madam Secretary, roll call on Council Bill 20 1-1219, please. Ortega. Right Black. I see tobacco. I. Clark. I. When I. Herndon, I. Himes. Cashman can reach Sandoval. Sawyer, i. Torres, i. Madam President. I. Madam Secretary, close the voting and announce the results. There are 13 eyes. 13 Eyes Council Bill 20 1-1219 has passed.