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HomeMy WebLinkAbout11-22-1996 Called Meeting CALLED MEETING COMMISSION CHAMBERS November 22, 1996 Augusta-Richmond County Commission convened at 12:09 p.m., Friday, November 22, 1996, the Honorable Larry E. Sconyers, Mayor, presiding. PRESENT: Hons. Beard, Bridges, H. Brigham, J. Brigham, Handy, Kuhlke, Mays, Powell, Todd and Zetterberg, members of Augusta-Richmond County Commission. Also present were Lena Bonner, Clerk of Commission; James B. Wall, Interim Attorney; and Cathy T. Pirtle, Certified Court Reporter. MAYOR SCONYERS: Good afternoon, ladies and gentlemen. Thank you for coming to our Special Called Meeting of the Augusta-Richmond County Commission. The Reverend Robert Anderson, Pastor the Pine Grove Baptist Church, will bring our Invocation. If you'll remain standing, we'll have the Pledge of Allegiance to the Flag. THE INVOCATION WAS GIVEN BY THE REVEREND ANDERSON. THE PLEDGE OF ALLEGIANCE WAS RECITED. MAYOR SCONYERS: Ms. Bonner? CLERK: Discussion of Employees Benefit Package. MAYOR SCONYERS: Mr. Etheridge? MR. ETHERIDGE: Mr. Mayor, Commissioners, we're here again to discuss the employee benefits package. And I think that we have resolved one of the issues regarding the employees benefits package, and that is the life insurance. There's really three phases of it that I think we've talked about. I talked about this with Jim the other day. There's the health, the life, and the LTD. After a real good conversation the other day with Mr. Bill Kuhlke, I think there are still some concerns that have been expressed about the LTD part of it. And I do not want to bog things down today because the health side of it is really the real key issue right now. And if there are some uncertainties that still exist, that we need to look at some other alternatives, we need to look at some -- you know, some other ways than just the LTD package that we put together. I would like not to discuss that today and address that at a later date possibly, if that's okay with y'all. With that, I'm going to turn our presentation over to John Fortin from Foster- Higgins unless there's some questions that somebody would like to address to me. MAYOR SCONYERS: Mr. Todd? MR. TODD: Why you wouldn't want to discuss that aspect of it today? MR. ETHERIDGE: I'm more than ready to discuss it, Mr. Todd, but I think that we need to move forward with this package, and I don't want to bog down with the LTD plan because I think that we need to have some further lengthy discussions about the LTD before we implement that, and that's why I'm saying that. I think that there are some -- I truly think that there's several Commissioners that really don't feel comfortable with it, and I want to make sure that you understand there are alternatives and there's other things before a decision is made by this board here. But if y'all decide to talk about it, we'll be glad to talk about it. MR. TODD: I've been waiting, I guess, a week and a half or two weeks to resolve the issues, and I think any issue that's concerning the employees benefits package we should go on and deal with it and get it out of the way. I can understand that, in the sake of time and not derailing what we have, that we may want to wait till later, so I have no problem either way maybe. MAYOR SCONYERS: Anybody else? Mr. Powell? MR. POWELL: Mr. Chairman, we've got all these people down here, and asked them to come on a short notice, and I think we need to go ahead and find out what's -- answer our questions and make a decision. MR. ETHERIDGE: I'm all for that, but if we could, could we -- if we're going to talk about long-term disability, could we talk about that last today possibly? MAYOR SCONYERS: Let's go ahead and focus on the health part of it. I think that's what we're all here for. MR. ETHERIDGE: Yes, sir. MAYOR SCONYERS: So if John will take off on that, let's resolve that issue first. MR. ETHERIDGE: Sure. MAYOR SCONYERS: John? MR. FORTIN: My name is John Fortin and I'm with Foster-Higgins, your consultant. Just very briefly, by way of background, I am an actuary. I've been an actuary for 29 years, so I do the numbers. I want to assure each of you on the Commission that I'm totally objective, impartial, and here to give you the pros and cons of all sides. I know in the heat of the battle some competitors might sell their side pretty strong, or oversell their side, but we're going to balance and give you the pros and cons, the facts that you need to make decisions. Having said that, you can't go wrong today. The best two bids are both excellent; okay? They're both significantly better than what you have right now. You'll save a great deal of money either way. You can't lose. Both are quality hospitals, quality physician networks. You can't lose. There are some differences, and I'd like to kind of walk through those if I may. We've been taking information that comes in almost daily and almost by the hour, just updating information from various bidders. And to remind everyone where we were, basically this Commission voted for an approach, 1-D, at the last formal meeting where we discussed benefits. And at that time 1-D was your preference. Unfortunately, that option went away. One of the parties involved had the legal right to withdraw from that offer, and that's why it is no longer on the table. The two leading offers for your PPO plan are what were called 1-C -- option 1-C and option 2-B. Now, we've updated both of those to reflect the most recent information from those two parties. Both of them have stepped forward and given better discounts than they were giving before. And just to quickly walk through them, bidder 1-C is still SAS. That's a subsidiary of Blue Cross/Blue Shield of Georgia. The other bidder remains University Health Link, which is part of University Health System. In terms of ballpark number of physicians, it changes daily. Both are recruiting physicians and growing. At this moment I understand that SAS has approximately 700 physicians in-network. And I know there are representatives of Blue Cross present. They could possibly update if you want the exact numbers. My information is that University Health Link is about 350. And, again, they could update you in terms of the exact numbers as of this moment. If we're way off, we want to make sure that they correct that. I know things do change rapidly. The major Augusta hospitals, SAS has four signed up right now. University is the only hospital in Augusta which is a major hospital. Now, both of these networks have area hospitals. They all have additional hospitals, but that's the major difference. In terms of third- party administrator, SAS would actually pay your medical claims, they would do the utilization management -- they would take care of the administration. University Health Link has found a new partner as a subcontractor. They've been identified as Advanced Data Solutions. They're not totally unknown to us. They did submit a bid previously, so we do have some information about ADS. We've revised the cost estimates, and at this point in time the low bidder does come out to be 1-C. And the other bidder is very close. They're approximately $150,000 higher than the low bid. To show you how that impacts your budget for calendar year '97 -- I think Mr. Zetterberg in particular wanted to see specifics on that. We show you that -- and this will look familiar. The first column, 1996, we're projecting $7.5 million for this year. Calendar '97, if you don't change your eligibility -- some of your employees aren't eligible for 90 days to get coverage. It will cost you $6.994 million approximately. If, on the other hand, you take our recommendation and liberalize the eligibility and cover people after 30 days, then the total becomes $7.199 million. Now, we've showed some assumptions in terms of number of lives and so forth, and one of the key assumptions is Number 5. We're anticipating a February 1, 1997 effective date. I know we're all hoping for January 1, but at this point that will be impossible. If we can make a decision today, we still feel comfortable that February 1 is possible. If for whatever reason we can't reach a decision today, I would suggest that we think in terms of a March 1 deadline for effective. Mr. Mayor, that's where we are right now. I'm prepared to answer any and all questions as best as I can, but having said that I'd like to just leave this with you and ask what comments and questions you might have. MAYOR SCONYERS: John, clarify one thing for me. For every month we wait it's going to cost us approximately $100,000; is that correct? MR. FORTIN: That's correct. MAYOR SCONYERS: Okay. I just want to make sure everybody understands that. Mr. Todd? MR. TODD: Mr. Mayor, my question would be, is there any industry or trade secrets that would be detrimental to one entity or the other if they participate in a plan, as far as third-party administrator plan, that would -- and if the -- and if that TPA is a subsidiary of one party or the other? MR. FORTIN: As I understand your question, you're asking whether either of these two options, 1-C or 2-B, would be a problem in terms of it being unfair to the parties involved and -- MR. TODD: Yes, giving one party or the other an unfair advantage. And I'd like to deal with 1-C, I think, or the SAS entity. MR. FORTIN: In my opinion, SAS already has a significant amount of information about all of the hospitals in town and the physicians in town. In my opinion, that shouldn't be an issue. Under 2-B, clearly there's no issue whatsoever, because University would be working with its own data. MR. TODD: Is it also my understanding that the bid specs called on the entity that bid on the package to come up with a third-party administrator? That was part of the bid package? MR. FORTIN: Yes, sir. It was our vision that you as a Commission would want to look to one party and that one party would be responsible for delivering all of the services. So the subcontractors that they line up, you know, would be the responsibility of the overall contractor to deliver all of the services under one package. MR. TODD: Yes. Mr. Mayor, I have the same question for all parties involved, so I would hope that they would make a note. Because certainly I feel that if we have an entity saying that they are compromising their industry secrets, then -- to participate, then before I make a decision that's going to cost this government and the taxpayers an additional $150,000 I would certainly expect them to, you know, show me where it's going to do so. MAYOR SCONYERS: Mr. Brigham? MR. J. BRIGHAM: John, is it normal procedure for a person to ask that the supplier pick their own third-party administrator, or do we -- is it normal that usually the other -- that the group that are doing -- looking for the cost control, which is the customer, I guess, which is us, that we normally pick third-party administrators? I want to understand why the procedure was written this way. MR. FORTIN: Again, that's a good question. You know, what makes sense in terms of being normal? Is it right to bid each piece separately, bid a network, bid a utilization management company, bid a drug vender, behavioral health vender, bid, you know, every piece separately, claims processor, and build it yourself, or is it better to go with one contractor and let them find their own? In our opinion, we looked at that, and our clients are trying to privatize. They're trying to get the experts to run their business and, you know, let the employer run the kind of business they're in. Manufacturing companies are doing manufacturing. Chemical companies doing chemicals. They're trying not to be the experts of managing the benefits programs. That's why they're trying to outsource it and let someone else manage it for them in general. That's the trend we're seeing. MR. J. BRIGHAM: That's great, but the third-party administrator is the person I understand that we're looking for to look at costs, and the person that's hiring the person to administrate is the person I feel like that person -- that company is working for. Now, I'm the one paying the dollars, and you're telling me the person providing me the service is the one that's going to determine who's going to watch their cost. That's my concern with it. MR. FORTIN: As I understand the question, if the contractor -- and I think you're question is if the contractor chooses subcontractors, and if you're at risk, if it's self-insured and it's your claim dollars, then it's concern that they may not deliver a cost-effective program. And I share your concern. If we're fully insured we wouldn't need to be concerned. They would be at risk. But in a self-insured arrangement like you have, you do have to look at that. So it's not just the unit costs that we're looking at. It's not just, for example, does it cost $1,000 in the hospital per day; it's how many hospital days will there be? Is the medical care necessary. And those are very real issues that are very important as you try to come up with the right solution that addresses what costs really will be next year. So you do have to worry about who's doing the utilization management, who is responsible and accountable. In that regard, we've put together performance guarantees where not only do they have a three-year contract guaranteeing their charges and their discounts, but there are performance guarantees on their ability to perform under the contract. But you're right, some approaches will lend themselves to be better than others because there's more independence of the contractor looking over the subcontractor. It's not self-dealing. Did that answer the question or comments? MR. J. BRIGHAM: I think you talked around it, but I don't think you answered it, but that's okay. MAYOR SCONYERS: Mr. Kuhlke? MR. KUHLKE: John, the two proposals you are showing here -- and I understand that University made a proposal outside of the request for proposal. Is 2-B the proposal that University made? MR. FORTIN: Well, originally University put forth a proposal, and when we scored that proposal they were ranked highest in points. But at that meeting we were telling you that they need to allow dual choice, they need to allow an HMO side by side their quote, and it was unclear from their bid whether that was going to be allowed or not. We also had to come back with performance guarantees. So at that point the Commission said, okay, go forward with the top bidder and see if they'll allow dual choice and performance guarantees. Also, you know, if that doesn't work, go back to the next bidder, Blue Cross, and see if they will allow choice and performance guarantees. So at that point, you made a decision to go forward with talking to the vendors, and there's been a series of dialogue with each party saying, okay, what can you do, what can't you do? There's been a lot of changes since then. Some subcontractors pulled out. They said, well, I won't be a subcontractor to that contractor. Just this week -- early this week we had a meeting with both University here in Augusta and with Blue Cross asking them, you know, what's your best and final offer, who is your subcontractor. And so it's a series of meetings that we've had to come up with the information you're looking at right now. So what you're looking at is different information. Their initial bid was a bid where they were the network and they were working with a subcontractor named PAI, but that deal fell apart. MR. KUHLKE: Why did it fall apart? MR. FORTIN: PAI chose not to be a subcontractor, and it relates to -- they're actually part of Blue Cross of a different state, and it's unclear whether they can actually do business in this state. I'm going to try and answer another question also. The gentleman previously was asking about does it make sense -- does it make sense to have a TPA looking over the shoulder of a network, and I tried to answer the question. Let me try again. University is the contractor, and they're also the University. They are the hospital. There may be an issue in some people's minds, can they be effective at cost management? Can they be cost effective? Will they allow too many hospital days? But I haven't raised that issue and, you know, I'm not sure that most people are overly concerned about that approach. Clearly, if Blue Cross is the contractor and another, you know, series of hospitals under them, there is no issue because there's no financial possibility of coming out ahead by paying too many claim dollars and allowing too many hospital days, they aren't the hospital. Yes, sir? MR. ZETTERBERG: Is it true that under the original proposal made by University Hospital, if taken alone as a PPO, the cost using the third-party payer in South Carolina, that cost would have been the lowest cost of all of the offers and the County would have saved money? What I'm trying to get at is I don't want us to just quibble now over cost, because originally the lowest cost provider was the University Hospital under a PPO arrangement only. MR. FORTIN: No, the original proposal by them -- MR. ZETTERBERG: But you ranked them by cost and technical criteria? MR. FORTIN: Correct. MR. ZETTERBERG: And in both those cases they were significantly below - - or above or below, whichever you want to call it, either cost or performance, than any other of the proposals. Now, I will tell you right up front I'd like to see us all be able to participate in this, but if we're going to look at cost alone, it appears to me that we really need to go back and look at the first choice. MR. FORTIN: The first choice -- and our letter addresses that. I can either show it to you or read it to you, but the applicable provisions -- this is a letter dated October 3rd, addressed to Mr. Etheridge, and it's labeled confidential, and it's a two-page letter. I can share it with you if you'd like. But on Page 2 we explain that they would be the right bidder for you, but we need the same employee contribution for the HMO. So only if you have an HMO side by side with them, when we wrote the letter, would we conclude that they would have the best bid as of October 3rd. Only if on October 3rd they were willing to go with the HMO at that point. Now, since that time a lot of things have happened. MR. ZETTERBERG: Well, I think one of the things that happened is that Blue Cross of Georgia came in and told Blue Cross of South Carolina that they didn't want them to be the third-party payer, and that's what was a major distortion in the system. Again, let me say that I hope that we could come to some sort of an agreement that if in order for the employees who we are bargaining for at this particular point, would have real total choice by being able to participate in both the PPO with University Hospital and the HMO option. MR. FORTIN: Well, I think that that's a good point. There are two questions: what is the best financial offer today for Augusta-Richmond County; and, also, the other question is, what is the best offer today for employees? Those are the two questions. As of today, not as of a month ago, or two months ago, those offers were withdrawn. The two best offers we were looking at both went away. One subcontractor pulled out of one and another subcontractor pulled out of the other, so both of those top two went away. Fortunately, the ones that have now surfaced are better than either of those two initial offers. MR. ZETTERBERG: The best option for this government would be having the Blue Cross option with the HMO and allowing -- and Blue Cross allowing the University Hospital to do business directly with the third-party payer. And I consider it a constraint of trade, although it's probably not anti-trust because the insurance business isn't covered by that, but certainly if we were to get our best option and the best dollars worth, we would allow -- they would allow University Hospital to deal with the South Carolina Blue Cross as the third-party payer. That would be the best option for us, but we can't get that because somebody's standing in our way, artificially so. MR. FORTIN: Comments? Questions? MAYOR SCONYERS: Mr. Beard, and then Mr. Powell. MR. BEARD: I just have maybe a couple of questions to ask here, and that is with the major hospitals that are listed, Item 3 there in the proposal. I see in 1-C you have the four major -- four hospitals involved and in 2-B you just have University. Does that mean that we would have -- that the employees would have a choice in 2-B or still back to that just one hospital? MR. FORTIN: Under the current arrangement there would be an 80 percent -- employees can always go to any hospital they like. The issue is really are you going to be paid the 80 percent co-insurance for an in-network benefit or a 60 percent co-insurance for an out-of-network benefit. Under 1-C you could go to University, you could go to MCG, Augusta Regional, St. Joseph's, and get 80 percent benefit. MR. BEARD: Yeah, but if they go to the other it would be 60/40; is that what you're saying? MR. FORTIN: Under 2-B you could go to University and get 80 percent or you could go to the other three majors and get 60/40. MR. BEARD: The other hospital, 60/40? MR. FORTIN: Correct. MR. BEARD: I guess the other thing that I would have in mind is that -- but I think you answered that with Mr. Zetterberg, and I think Mr. Zetterberg was right when he said at the beginning there was a difference there, because we have the two sheets there where University was included in this as one of the best possibilities here. But I guess we should eliminate that and concentrate on what you've presented here today. One other question, and I'm not sure this should be asked here or not, but how objective can you be if there are litigations involved? MR. FORTIN: That's a fair question, Mr. Beard, and I believe you're asking really about in the newspaper there's been some stories and words like illegal and collusion and slander, and all that's kind of floating around. And, Mr. Mayor, I wish this hadn't come up, but since it has come up I'd like to address that issue. I think it's an important issue. Our firm has done this for a long time. Our business -- we've been in business 150 years. We have over 100 offices. I've done this for 29 years as an actuary and I've never been involved in anything like this, though I've done a lot of work in public sector. I'll briefly read my response to Mr. Taylor, who's the president and CEO of University Health Link, and I handed this to Mr. Taylor and to his counterpart at University Hospital on Monday: "Dear Mr. Taylor: Based on newspaper stories and paid ads describing University's attack on our firm's integrity, I am personally outraged. Comments attributed to University are false and slanderous. Accordingly, we have engaged legal counsel to set the record straight. Further dialogue by our firm on these issues will be through counsel." And it has. "Despite the comments attributed to University, we will continue to provide objective, professional consulting advice to Augusta-Richmond County. We stand ready to assist our client in working with University and others to reach agreement on a competitive, cost-effective benefit program. Sincerely." And in that regard, I'll share with the Commission -- here's a copy. I'll share a copy of that letter which was addressed to University and also a letter from our legal counsel explaining in more detail the nature of the slander and liable against our firm and what we're going to do about it. I don't want to burden you with it. It's not why we're here today. There will be another forum where we address, and that's for another day and another time. But I want you all to understand that we're perfectly objective and professional and independent and unbiased in the counsel we give to you. We have no reason to back either side. I'll also share, a couple years ago we were in the public sector in this organization called Fulton County. The leading bidder was CIGNA and we recommended CIGNA. Blue Cross protested vehemently. And, you know, so half the time we're always picked on by one side or the other. Whoever doesn't get the business will try to attack us and win the credibility. That's how they'll try to win. We've got another presentation next week at Gwinnett County. I'm not going to share with you who the leading bidders are, but I can assure you probably bidders two, three, four and five will all contest it. And it may be Blue Cross today and Aetna tomorrow, and that's the nature of the public sector. Yes, sir? MR. ZETTERBERG: I think one of my concerns was that when I read the paper, it -- when you ended up saying that University was a very expensive hospital when we were talking about the 35 percent discounts. I found that very unusual to be in that kind of a paper where it didn't qualify any of the other hospitals. What was the basis for that? Were you trying to say that University Hospital's option at 35 percent discount was much higher? Because inside the study that you did it was not true. MR. FORTIN: Again, Mr. Zetterberg, that's not something I was going to bring up today, but since you have let me take a few minutes. It's a very important issue. In our report that we delivered we put together a spreadsheet which showed all of the information that you needed. And the comment was made next to University's bid that it's an expensive hospital. In other words, their list prices are expensive. And that's what caught the attention of University. That's when they started saying that we were slandering them and that's when they got excited. Let me give you some background on that. Hospitals have their list prices that are a certain retail list price, and then employers come along and get something below that. They negotiate a 10 percent discount, 20 percent, 30 percent, 60 percent discount. So the list prices of what we're talking about -- when we said that University's list prices were high, we stand by that remark. MR. ZETTERBERG: Let me just ask you a question. Inside the paper -- and I'm only confused on this part. I mean, I think I clearly have stated that I would like all participants to play. But if in your grading the University's cost structure was the lowest and they offered a 35 percent discount, high cost was irrelevant. The statement was irrelevant. How could it be? How could you grade it as the lowest cost hospital or the lowest cost option and call it a high cost hospital? I mean, you can't have both ways. MR. FORTIN: In our report's spreadsheet it said a very good discount from University, very good discount from expensive hospital, and we stand by those remarks. The important point is what is the best low net cost. That's the most important issue. That's the most important issue. And since you raised the issue -- I can't reveal the exact charges and exact discounts because the hospitals won't let us; okay? You know that. But University has said it's a 35 percent discount. They've said we're giving 35. Let me assure you, under Blue Cross they've negotiated discounts greater than 35. 40, 50, in excess of 60 percent from certain departments from hospitals here in town. It's larger discounts; okay? And since you asked, let me hand out another item. MR. ZETTERBERG: Well, just let me ask you just one simple question. How could you grade them the lowest cost hospital in the study that you did? MR. FORTIN: You're asking in our original bid? MR. ZETTERBERG: In the original bid, how did you -- and that was what - - and that was the same study that you called them a very expensive hospital. MR. FORTIN: Right. As of that time frame, October 3rd, roughly early October, our report said that they were the lowest cost PPO. And we said that. That's why we're surprised when they attack our report. They were the low -- MR. ZETTERBERG: We never saw that, by the way. All we saw as a Commission was the piece of paper that said from a very expensive hospital. MR. FORTIN: Right. What we said was they were the low cost bidder for the PPO at that point in time. So we agreed that their PPO was the best at that point; okay? But in giving detail we said, by the way, the way they got to there from here was they're an expensive hospital with a very good discount. That's how they got there. That's how they got there. So we were recommending that you go with them over a month ago. Unfortunately, that bid went away. The subcontractor pulled out. Also, for what it's worth, you know, in the newspapers we've had University Hospital -- I guess we hit a nerve, but, you know, they've acted very strongly to the expensive word. We stand by the word. Here's an independent data company called HCIA. All they do is analyze health data. They're actuaries and statisticians. We had them do a special, independent, actual run for us in the last few days. And we said, okay, look at just this market, just Augusta, and look at the five most common procedures, diagnoses, in Augusta just to show us what the charges are. Now, we already have the data, but we couldn't reveal it to you because they wouldn't let us. But this is public information. Freedom of Information Act, MEDPAR data. And what it show is out of the five most common procedures in this community University Health is the most expensive on three out of the five procedures. They're the second most expensive on two out of the other five. And so we stand by our remarks. But we weren't deprecating their quality and we weren't deprecating their financial bid. We're just saying that they had a very good discount of some very high charges. Now, that was as of over a month ago. You're asking us today, out of all the options on the table today, who stacks up the best. Some have gone away, some have improved, and that's where today's handout updates the two best options. And they're both good options. If you want solely price, the best option is 1. If there are some other factors, you may find comfort going in the other direction. MR. TODD: Mr. Mayor? MAYOR SCONYERS: Mr. Todd? MR. TODD: John, if one store has a suit on sale that costs $400 with a 50 percent off and another store has a suit on sale -- I mean, another store has a list price of $150, then I guess you're telling me that that list price of $150 is the better than the store that has the suit for $400 with a 50 percent off. Is that my take on what you're saying as far as the -- MR. FORTIN: Really the list prices don't matter. The list prices don't matter. Totally irrelevant. What matters is what you will pay as a consumer. That's what matters. That's the only thing that matters. Now, to help understand what is a good deal -- you know, I don't admit myself to a hospital, and none of you do either. You go to your physician. The first step -- and they've been kind of left out of this dialogue is the physicians. They really control medical healthcare delivery, like it or not. So let's talk about physicians for just a second. Under the University approach there are 350 fine medical people coordina-ting care. On the Blue Cross side there are 700. So do you want to get discounts from 350 or from 700? If you go with the smaller network, you know, Mr. Beard, Mr. Powell, you'll go home tonight, you'll tell your wife, you know, children, the Council met and, by the way, you're going to have to change your doctor; okay? Because you've got twice as many doctors in one approach as the other approach, and so there are a lot of folks going to be changing their doctor. A lot of doctors don't have admitting privileges everywhere. Some have more than one hospital they go to, some don't. So you have to really look at the number of physicians because that drives discounts on the physicians and disrupting -- you know, forcing people to change their medical doctor. So from an access point of view and a cost point of view on physicians, Blue Cross comes out way ahead. Next question, you know, okay, once you get into the hospital, are you going to get good discounts or not? Forget the expensive, forget the list price. Are you going to get good discounts or not? On University you've got really good prices at one hospital. Under the other approach you've got really good discounts at three hospitals, really good price at three, and one just average. Again, the Blue Cross approach is better at the physician level. More choice, more doctors, more discounts, and less disruption to employees. And at the hospital level, more choice, more discounts, less disruption. MR. TODD: Let's talk about bottom line, Mr. Mayor. As far as the bottom line go, are we saving approximately $1 million with the C versus B? MR. FORTIN: The question is -- MR. TODD: In choice C or choice B, what are the overall savings in that package? Is that the $150 [sic] that we're talking about as far as PPO, or we're talking about total package approximately $1 million? MR. FORTIN: Right. In our early October letter we described about $950,000 total savings by going out to bid on life insurance and medical and so forth. 950,000 of total savings by going out to bid. If you don't change your plan design and don't change anything, you know, you'll be $950,000 more expensive just because of these new vendors coming in. In the meantime, you know, we've talked about changing plan design, changing eligibility, changing all this, and the net result lowers the savings because we felt that the employees benefits package wasn't as competitive as it needed to be, and that's why some of the savings were shared with the employees. MR. TODD: Mr. Mayor, I'd like to hear from University Health Link as far as some questions that I have and from the other healthcare providers, be it MCG, Columbia or Augusta Regional, et cetera, St. Joseph. MAYOR SCONYERS: Could we have a representative from University Health Link, please? MR. J. BRIGHAM: Can I ask John a question first? MAYOR SCONYERS: Well, why don't we go ahead and take care of Mr. Todd. MR. J. BRIGHAM: Okay. Well, I thought -- before we started on them, I thought we could try to get through with him, if you don't mind. MR. TODD: I'll yield, Mr. Mayor. MAYOR SCONYERS: John, come back please. MR. J. BRIGHAM: John, is both proposal C-1 and B-1 both PPO's? MR. FORTIN: Everything that we're looking at on the handout would be a PPO structure, which co-exists side by side with an HMO, so each January 1st employees would have an option of going into the HMO or going into the PPO. Those are the -- MR. J. BRIGHAM: If C-2 is a PPO, why would we need an HMO? MR. FORTIN: Well, in our opinion -- again, we've studied this for months and months. There are strong advantages of having an HMO. Under an HMO program it's fully insured. They're not just guaranteeing discounts, they're guaranteeing total costs, and they're guaranteeing it for three years. So you've really set up a horse race. By having an insured -- fully-insured approach, putting people at risk, guaranteed fixed cost three years, you're locking in someone. The self-insured, you're getting nice discounts, but still utilization could be high and you're still rolling the dice in terms of what it's going to cost you. By having them both side by side you're getting broader choice, setting up that horse race and saving money. And by the way, groups of your size, over 70 percent offer choice, and it's rising rapidly. HMO's are really catching on, that's why you're seeing them. MAYOR SCONYERS: Mr. Kuhlke? MR. KUHLKE: John, I remember Mr. McKie gave us some statis-tics on the utilization of the hospitals, and I think that they said that University's usage was 47 percent and then the rest was -- made up the difference. Those percentages that were given to us, how far back did you go to establish those percentages? MR. FORTIN: We used the most current information that was furnished to us by Allen Medical and the third-party administrators. And we don't like to use just a fraction of a year because there might be a cyclical distortion or a large claim, so we use calendar -- MR. KUHLKE: Did you use one year, two years, three years? What? MR. FORTIN: We looked at calendar '95 as a basis for that. And you're right, the total was somewhere around 48/49 percent of the healthcare dollar. MR. KUHLKE: Was that on billing? Was that on billings? MR. FORTIN: On paid claims. And that was for city plus county combined -- I'm sorry, county was right at 48 to 49 percent. MR. KUHLKE: Okay. Would not -- if you only looked at one year -- and I asked John Etheridge this the other day. If you only look at one year coming up with that statistic, and there were significant claims in that one year one way or the other, wouldn't that skew that statistic pretty severely? Shouldn't you look at more than one year on something like that? MR. FORTIN: Well, the big picture is, you know, about 35 to 40 percent of your claims -- visualize a healthcare dollar. You know, one dollar. About 35 to 40 pennies in a dollar go to the physician. Now, in any one year it might be 35, it might be 40. Last year it was about 40 pennies in the dollar went to the physician. Another 40 pennies in the dollar went to the hospitals. Another 20 pennies in the dollar went elsewhere: prescription drugs and durable medical equipment, smaller ancillary services. So we're really talking about 40 pennies in a dollar, which is the hospital component; okay? Now, of that 40 pennies in a dollar, about half of it goes to University. Now, you could argue it's 20 pennies in a dollar, or 19, or 21, 18. It's somewhere about 20 pennies in a dollar go to University in an average year. Some years 21, some 19, some 18, 22. So when you're talking about a discount from University, you're talking about a discount off 22 cents in your healthcare dollar. Some people would argue 19 versus 22. It doesn't matter. That's what we're talking about. We're not talking about the physician component, the ancillary medical component, or the out-of-network. Their component is about 20 cents on the dollar, plus or minus a few pennies. But that's confusing when the newspaper article is talking about charges and paid and county and city and -- all of this is very confusing, and that's where objective -- we have spread-sheets where we've done our homework, it's just that we can't share it with you because it's illegal for us to share with you the exact discounts by hospital and utilization by hospital. That's why you paid us to do it for you. Any other questions for me before you move on? MAYOR SCONYERS: Are you through, Mr. Kuhlke? MR. KUHLKE: Yeah, I'm through. MAYOR SCONYERS: Mr. Brigham? MR. H. BRIGHAM: My question, you've answered it, but in the light of what Mr. Todd has asked for the various organizations to come up and make a comment, you made some statement about the 700 doctors versus the 350 doctors, and it's going to be interesting to see how that plays out with the answers that they will give hopefully addressing this. Because you said it's going to make the difference, and it's going to be interesting to see how we're going to be able to compare what you said with what the various -- I'd like to know if you want to repeat it for them so they'll hear it. MR. FORTIN: We definitely need to focus on more than just hospitals. We need to focus on physicians. They really drive healthcare delivery. And I think both sides of the dispute should, you know, put their best foot forward and explain why their approach makes more sense. They've got the details. But I'm more than happy to answer any questions that I'm legally able to answer. I've been about as specific as I can get without talking about proprietary information. Yes, sir? MR. BRIDGES: I just want to make sure I understand this completely. Both of these proposals, 1-C and 2-B, that you've given us here today have PPO and HMO? MR. FORTIN: Side by side. MR. BRIDGES: So that the employee has a choice between -- in either program? MR. FORTIN: Yes, sir. Your first decision is which PPO do you like. You know, which one. But I'm assuming you'll still -- the next agenda item is which HMO do you like, and then you'll be done with benefits for the day unless you want to talk about LTD. But either one is a fine choice. I'm not putting down either side. They're both excellent quality, excellent cost. MR. KUHLKE: Is the four hospitals under 1-C? Is University in there? MR. FORTIN: Yes, sir. MR. KUHLKE: They're in there? MR. FORTIN: MCG, University, Augusta Regional, St. Joe's. So you as an employee or spouse, children, would get an 80 percent benefit from all four. Under the University approach, if you go to University you'll get an 80 percent benefit, but you'll get 60 percent if you don't go to University. Same with the physician side. MR. KUHLKE: If we only offered a PPO, period, would that be the cheapest thing for the taxpayers and also give the employees what they need? MR. FORTIN: That would be the most expensive thing. MR. KUHLKE: That would be the most expensive? MR. FORTIN: In fact, we don't even have that option available today. University withdrew it because their subcontractor wouldn't do it, so as of today we don't even have that on the table. But that would be the most expensive thing. You'd be giving monopoly to one hospital on a self-insured program, which would be the worst possible approach I could think of. Any hospital. Not to pick on one hospital over another, any hospital given exclusive on a self-insured approach would be the worst approach to take. MR. TODD: Mr. Mayor, one final question for the consultant. The buzz word now as far as HMO go is whether the doctor and patient have last word on the procedure, a needed procedure, or whether the HMO or the third-party administrator have that final decision. And certainly I think the correct thing to do or the moral, right thing to do as far as I'm concerned is let the doctor and the patient have final say on a procedure if cost is influencing whether it will happen. Do this HMO incorporate that and allow for the doctor and the patient to have final say? MR. FORTIN: All of the HMO's -- you know, when they're at risk you have to worry about your question. Who has the final say? Is it the doctor? Is it the HMO? Is it the patient? And that's where -- if you go forward with an HMO program, we want to educate your employees and tell them exactly what an HMO is. How does it operate? What's a medical emergency? It's not for everyone. Many people love HMO's, many people should not be in HMO's. So up front we'd have to educate people. And for those who like it, it's a great approach, but it's not for everybody. To answer your question, the patient always has final say over having treatment done. It's always the patient and the doctor. The problem is reimbursement, you know, will it be paid for by the HMO or not. And that's where we need to be very careful to make sure that it's a reputable HMO. So in our analysis of HMO's we made sure they were reputable. Now, if they're going too far and withholding care, they will be sued, and so they have to be very careful not to go too far in withholding care. They have to make sure the person needs care, but they can't withhold care. MR. TODD: Thank you. MAYOR SCONYERS: Any more questions for John? MR. FORTIN: Thank you. MAYOR SCONYERS: Thank you. MR. TAYLOR: We appreciate the opportunity to be with you today. We're handing a sheet around to start with. The inference of high cost for University has concerned us, and we pulled some data together for your consideration. We, too, have limited information that we can access. The largest single payer in this community and in most other communities is the Medicare program. It's the over-65 individuals. Now, it's not a commercial market, granted, but it does give us some comparison of charges across the market. When you look at discharges in the market, 9,118 -- looking at 1995 data, over 9,000 discharges from the Medicare program occurred at University Hospital. The charges for all those discharges were $138,200,000 for an average charge at University of $15,158 for the average Medicare patient during 1995. Medicare cost reports are Freedom of Information items, and we routinely request them on a lot of hospitals just to keep up with where we are from the hospital's perspective. The other three hospitals in the market for their fiscal year 1995 had a total of 7,849 cases, with an average charge of $145,985,000. The average charge for the other three combined was $18,599 for the Medicare program. Again, it's the largest single payer that we all service, whether we're physicians or whether we're hospitals. Just to put something in front of you to consider as you hear the -- some of the other data that's been presented today. In addition to that I'd like to take you through, if I could have about 10 minutes, some information that we think makes a strong case for your consideration of the University Health Link PPO, and it's another handout that we'll get to you. Page 1 of the document you're familiar with. It is the ranking that shows what we had on the table from a pricing standpoint, what's price effective for you. We've maintained those provider discounts to you alongside an HMO. So the same pricing that we had on the table originally, the providers have come forward, as Mr. Fortin mentioned, and we've maintained that aggressive pricing for you. So we pointed well initially, and we think we point well today. Page 2 looks at some assumptions that were made about enrollment for the plan. It assumed that 905 of your employees would enroll in the HMO and that 1,141 would enroll in the PPO. If you flip to the next page -- and this is all -- these three pages are from that October 3rd packet that some of you received on the subcommittee, I believe. The center of that page priced -- for 1997 priced 905 employees choosing the HMO at $3,646,000 and priced 1,141 employees choosing the PPO, priced it at $3,510,000. MR. TODD: What was the first number on the HMO again, the dollar amount? MR. TAYLOR: It was $3,646,000. MR. TODD: Perhaps I'm looking at the wrong -- thank you. On the wrong side. MR. TAYLOR: If you flip to the next page, we did an assumption. This question's been raised a couple times. Just from a pure pricing standpoint, on a per contract basis, the evaluation and just working through the numbers we just went through, the per employee cost of the PPO was $3,077 and the per employee cost of the HMO was $4,029. So from a pricing perspective, the PPO was the most cost-effective. MR. ZETTERBERG: Which page are you on now? MR. TAYLOR: I'm on Page 4. MR. TODD: May I ask, where did you get these statistics? MR. TAYLOR: The page just before this one assumed enrollment of 905 and 1,141, so assumed HMO enrollment of 905 employees and assumed PPO enrollment of 1,141 employees, and then the total cost, so we -- MR. TODD: Divided them all into -- MR. TAYLOR: Divided them, right. If you assume just what's the cost of providing the HMO, you can see that the cost over the three-year period of time is significant for providing the HMO. Now, we understand you want cost, and that's fine, but just to give you an idea of how cost-effective we believe our original bid was and how cost-effective we believe the bid that you have on the table now for our PPO is. If you'll flip on to Page 5 with me, the 905 and the 1,141 represent the total employees for the combined city-county government: 2,046 employees. 44 percent would choose the HMO and 55 percent would choose the PPO. We tried to estimate what University's penetration would be of those employees that chose the PPO, so we assumed that out of 2,046 employees, 43 percent would prefer to seek service at University. That's 887 employees. So if you look at our market share, our typical market share exceeds that number, in fact, for most groups. If you look at Medicare again, our Medicare market share exceeds 43 percent. If you look at the combined city-county government and conservatively estimate the numbers that you've already seen, the average utilization at University over the past few years is about 43 percent. So of your total employees, about 43 percent of them would choose University and University physicians, or a total of 887 out of your 2,046 employees. Now, the only way to access University in the two plan options on the table is to choose the PPO. None of the folks who choose the HMO can be paid for service at University, so all 887 of those employees, if they choose University, if they prefer University, will enroll in the PPO. And the enrollment for the PPO was assumed to be 1,141, so University's penetration in that enrollment is 78 percent. Again, folks who choose the HMO, those 904 employees who choose the HMO, cannot be reimbursed for service at University, so the only way to access University is to enroll in the PPO. So we think our penetration in our network for those who enroll in the PPO is 78 percent. That number is important, and that number needs to be believable to you. Any questions from you about how that number was arrived? MR. TODD: No, but I would assume that it's an assumption that, once we give the employees choice, that they're still going to choose University? MR. TAYLOR: They have choice. Our market share exceeds this for folks with choice. That is an assumption, granted. It is assuming that they would continue to prefer University. MR. TODD: Yes. Okay. I don't have a problem with how you come up with the numbers, but I just wanted to certainly -- MR. TAYLOR: Okay. Again, that number is important, because you've got to make some assumptions, and we're going to build some information off of that assumption. If you'll flip with me to Page 6. What we have on the table is a 35 percent discount, and that 35 percent discount would apply to 78 percent of the service in the PPO, so you'd be paying 65 cents on the dollar for 78 percent of your planned experience in the PPO. So for 78 of 100 dollars, your net cost is going to be $50.70 for $78 worth of charges. You get no discounts from 22 percent who choose other providers, so you're paying 100 percent -- so you're paying $22 of $22 of charge. Your net cost on $100 of charge is $72.70, an effective discount given the penetration assumptions of 27.3 percent, so you're saving $27.30 on $100 worth of charge under a University PPO. MR. TODD: I need another clarification. You're now telling me that the University PPO would actually be cheaper than the HMO? MR. TAYLOR: Absolutely. MR. TODD: Well, that's just a -- we'll go on assumption again. MR. ZETTERBERG: But's that's -- isn't that only if you have South Carolina Blue Cross as a -- MR. TAYLOR: No, sir, it's not. This is -- these are discounts that we have held under the current relationship -- provider discounts from the hospital that we have held under the current proposal that's in front of you now using ADS as an administrator. MR. ZETTERBERG: And what you are trying to convince us is a sole option to use University Hospital? MR. TAYLOR: This is the effective discount under a University PPO to run alongside of an HMO. I'm not trying to convince you that you ought to limit choice, I'm trying to convince you the most cost-effective PPO to offer your employees beside the HMO is the University PPO. MR. TODD: Mr. Mayor? MAYOR SCONYERS: Mr. Todd? MR. TODD: Let's just assume that I'm buying into your assumptions. Can I assume also that you can guarantee us $950,000 savings over what we spent last year? I mean, if you're correct in your assumptions as far as this go, that it's cheaper, then either the consultant has sold me a bill of goods or you're trying to sell me a bill of goods. And can we assume also that you will save us $950,000 over what we spent last year in a contract here today? MR. TAYLOR: Mr. Todd, the information that I've shared with you and the discounts that I've shared with you were the discounts that the consultant evaluated. MR. TODD: Yes. Have you prepared those against HMO's for similar charges? MR. TAYLOR: I have not. I've pulled some information that the consultant's package to you included, and that's all I've done. MR. TODD: Yes. Okay. Well, I'll take that as advisement then and that also the consultant's opinion of what he provided me was different from what you are providing me. Thank you. MR. TAYLOR: If we move to Page 7. and I'll be quick. In the box is what the University PPO pricing -- the effective pricing for the University PPO. It's $72.70 of $100 of charge, and it's an effective discount of $27.30. If you compare that to an all-provider PPO, University's discount under the prudent buyer program, which is the program that would bring University to the plan that Blue Cross would administer, is 10.5 percent -- 10.56 percent, effective January of 1997. On $78 of charge, you'd pay 89 cents on the 2 dollar. It would cost you $69.80 for our share of the PPO business. In order to break even with $72.70 from the prior page, you'd have to make net payments to outer-network providers of 13.2 percent, or you'd have to be getting discounts from other providers in the market, PPO discounts of 86.8 percent. If you look at B, we assume that those discounts from other providers are 50 percent. How would that compare with your effective discount? Our number -- University's number at the top remains the same. 50 percent would be your discount from other providers. Of $22 of care, you'd pay $11. Your effective payment rate would be $80.80. Your effective discount is 19.2 percent instead of 27.3. And we figured another table at the bottom that assumed 35 percent was the discount that you got from other area providers. We don't know what those discounts are, obviously. And then the last page in the handout, we just computed what those discount comparisons mean to you. We think a University PPO can save you 391,000 as compared to option B, and we think it can save you 550,000 as compared to option C, depending on where those discounts are from other providers in the market. So we believe that what's in front of you as a University ADS PPO -- is the most cost-effective PPO that's on the table. MAYOR SCONYERS: Mr. Brigham? MR. J. BRIGHAM: The only thing I see wrong with your assumption is that you assume that all your utilization is going to be from the PPO, you don't assume that any of your utilization is going to occur from the HMO. MR. TAYLOR: There's no provision for payments outside of the HMO network, and University's not in the HMO network, so we will not have significant utilization from HMO enrollees. There's no coverage to our system, so an employee won't choose to come. MAYOR SCONYERS: Mr. Kuhlke? MR. KUHLKE: Robert, on your assumptions you are making the assumptions that none of the other PPO people are offering any discounts; is that true? MR. TAYLOR: For the University PPO there are no other discounts. MR. KUHLKE: I think what I'm getting at here is where you -- on Page 6 where you're showing your discount at 35 percent, you're showing the others with 22 percent utilization but offering no discounts. MR. TAYLOR: Right. MR. KUHLKE: And they are not offering any discounts? MR. TAYLOR: Not under a program administered by ADS and proposed by University Health Link, no sir. MR. KUHLKE: Okay. Why, based on this analysis -- and I think I understand it. Why is the consultant saying that you are $150,000 higher? MR. TAYLOR: He made assumptions in his calculations different from these evidently. MR. KUHLKE: Has he seen this? MR. TAYLOR: No, sir, he's not. MR. ZETTERBERG: Mr. Taylor? MR. TAYLOR: Yes, sir. MR. ZETTERBERG: Now, this is the PPO running right aside of the HMO? MR. TAYLOR: It is indeed. MR. ZETTERBERG: Both options? MR. TAYLOR: It is indeed. MR. ZETTERBERG: So what you're saying to us is the $150,000 is not valid? MR. TAYLOR: Not under the assumptions that I made, which I believe are valid. MR. ZETTERBERG: The PPO clients that you have today all came from one organization; right? I mean, that's one of the reasons why it's such a large percentage. I'm making an assumption that -- I'll make an assumption that most people, whichever healthcare -- health support system that they were in, they -- there's a good chance that a lot of them will stay where they are; is that a good assumption or a bad one? MR. TAYLOR: Well, let's take the city employees as an example. Of those 900-and-some employees, University penetration was about 30 percent. Now, they were encouraged to use other networks in a PPO-like environment and 30 percent of them chose University. So those who have relationships with physicians and confidence in the hospital will not choose to enroll in an HMO that precludes their accessing University. So I don't believe all city employees will choose an HMO. I do think that some county employees will choose an HMO. So, you know, I think you'll see some crossover. MR. ZETTERBERG: Okay. No way to tell at the moment, though? MR. TAYLOR: Not until you enroll, I'm afraid. You can make some assumptions, but until they enroll it's difficult to say. MR. ZETTERBERG: And the only way that we'll really test the validity of what you're saying is if we select an option that allows you to be a PPO? MR. TAYLOR: I think that's right. MR. ZETTERBERG: Then you come back and we'll measure that next year. MR. TAYLOR: That's right. That's right. MAYOR SCONYERS: Are you through, Mr. Zetterberg? MR. ZETTERBERG: Yes, I am. MAYOR SCONYERS: Mr. Beard? Mr. Bridges? MR. BRIDGES: Mr. Mayor, I guess I want to make sure I understand the procedure we're going to use today. First we're going to either vote for one - - the two proposals that were put forth by Foster and Higgins, and then after we do that we're going to determine which PPO and which HMO we're going with under each, whether we choose the 1-C or 2-B; is that right, John? MR. ETHERIDGE: Let me make a comment on that, Mr. Bridges. The proposals that John has presented under 1-C and 2-B -- and if I'm wrong y'all correct me. 1-C is a Blue Cross/Blue Shield administered program. All four hospitals participate. That is an HMO and a PPO. 2-B is an HMO and a PPO, with University administering the PPO is what that is, 100 percent. Does that answer your question, Mr. Bridges? MR. BRIDGES: Yeah, but if -- so then if we choose 1-C we will still be determining who the PPO is and who the HMO is? MR. ETHERIDGE: No, sir. They -- right now it's -- 1-C is the Blue Cross/Blue Shield HMO and the Blue Cross/Blue Shield PPO. 2-B is the Blue Cross/Blue Shield HMO and the University Hospital PPO. MR. TODD: Mr. Mayor? MAYOR SCONYERS: Mr. Todd? MR. TODD: I guess I have a question for Mr. Taylor in reference the dollars difference in the Medicare. And the question is, do any of the other institutions receive state or federal indigent care funds? MR. TAYLOR: There are two institutions in this market that receive federal disproportionate share funds: MCG and University. So there is another one. MR. TODD: Okay. And would that be a factor in cost as far as the others go, that one out of the three and with University -- could I assume that? Well, if you don't want -- if you don't feel comfortable with answering that, you know, I'm not pressing for an answer, but I just want to make that point. MR. TAYLOR: Okay. I'm not sure how to respond to that, Mr. Todd. MAYOR SCONYERS: Mr. Brigham? MR. J. BRIGHAM: Mr. Taylor, basically the difference between the two proposals, from your prospective, is University, if we allow them to be the only source of PPO, is going to offer a 35 percent discount; if we select the Blue Cross PPO and HMO combination, University is only going to offer a 10 percent discount off the bill, or 10.5 percent? MR. TAYLOR: Yeah, I think that's fair, Mr. Brigham. MR. J. BRIGHAM: Then based on the bigger number of participation, since you said it's all going to be PPO, is the way you figured the difference in the savings? MR. TAYLOR: Yes, sir. MAYOR SCONYERS: Mr. Wall? MR. WALL: Mr. Brigham, if I understood your question correctly, I think there may be some misunderstanding. The 2-C or whatever the initial -- 2-B is a side-by-side HMO/PPO. There is not -- and, Mr. Taylor, if I'm wrong, correct me, but my understanding is you're not talking about a 100 percent PPO, you're talking about a side-by-side PPO/HMO. MR. TAYLOR: I am. MR. J. BRIGHAM: I understood that part. My part was I was trying to figure out why the difference in the cost, and basically he's saying the difference in cost is about 20 percent -- 22/23 percent difference. MR. TAYLOR: Yeah, C is 20 percent. MR. J. BRIGHAM: 24 percent, isn't it -- 24.5 difference? MR. TAYLOR: Right. MR. J. BRIGHAM: Then your list price is going to be the same either way, it's just the amount of discount that's being offered? MR. TAYLOR: That's exactly right. MAYOR SCONYERS: Mr. Todd, do you want to ask a question? MR. TODD: Yes. Is it my understanding that the argument that you made, or let's say the presentation that you made in the sense that we're not argumentative, is that a HMO stand-alone without a -- I mean, a PPO stand- alone without a HMO would be in the best interest of the county? MR. TAYLOR: Mr. Todd, I didn't argue that. I understand that the county would like to see choice for their employees and respect that, so I -- MR. TODD: Yes. Okay. Then is it University Health Link's position that they cannot participate in a HMO/PPO with the TPA being SAS, but you can participate in an arrangement under 2-B where the ADS would be the TPA? MR. TAYLOR: The HMO that's been offered does not include University and is administered by Blue Cross of Georgia. Blue Cross of Georgia's network partners in this community don't include University Health Link. And, you know, we've discussed before, we believe -- we have some difficulty with participating in a situation like that. MR. TODD: A question that I raised earlier, you know, basically fringed on, I guess, what would be your concern on participating in a plan like that, and would it compromise your, I guess, industry secrets, et cetera? And I guess from listening to the consultant on what he can and cannot talk about, that we may have a problem, but would you have grave concerns if -- MR. TAYLOR: Well, I'll just tell you what my personal concerns, Mr. Todd. A third-party administrator will provide services to any employer, and part of those services will be interpretation of medical experience. And if you are competitive with someone that's interpreting your data, we would have concerns about that data being interpreted to an employer fairly, and that's the sum total of our concerns. MR. TODD: Okay. So it's not industry that you're worried about but it's the patient; is that what I'm picking up on? MR. TAYLOR: It's interpretation of the data in total and how we are reflected to the employer. MR. TODD: Yes. So you trust ADS to be more objective -- or more so to be objective than you do SAS? MR. TAYLOR: That's our opinion, yes, sir. MR. TODD: Okay. Have you ever had any problems as far as any other TPA as far as not being objective when interpreting -- MR. TAYLOR: Yes, sir, we have. That's the reason we're concerned. MR. TODD: Yes. I must be honest and say that over the years, whether I've had problems in some other areas as far as University go, I've been a supporter of the PPO. But, you know, when I have $950,000, you know, dangling in front of me I shall, in the interest of the taxpayers, reassess the situation. And my concern is the $950,000 and not necessarily any other aspect of University Health Link, et cetera, and I want to make that perfectly clear. MR. TAYLOR: I understand. MAYOR SCONYERS: Mr. Kuhlke? MR. KUHLKE: I was just going to suggest that we might hear from Blue Cross. MAYOR SCONYERS: Did anybody else want to ask University anything? We'll listen to John, then we'll go back to Blue Cross. MR. FORTIN: I just want to say I have some comments, and I can make them now or at the end, either way. But there are some differences obviously between Mr. Taylor's remarks and mine, and I can address those at whatever point is most appropriate. MAYOR SCONYERS: Why don't we go ahead and listen to Blue Cross and then make you wrap it up for us. Thank you. MR. ECKERT: Mr. Mayor, Commissioners, again, I appreciate the opportunity to speak before you. We'd like to give you a handout, which some of you may have received previously, but there's a chart in there I'd like to refer to if I could. And I'll wait until that gets passed around. While that's being passed around, I guess I'd like to echo some comments I heard earlier, that you are in a unique position of having an opportunity to choose between two alternatives which appear to be quite attractive to you. I want to reemphasize that the consultant apparently has indicated that with the best and final offers that were presented, that the BlueChoice PPO option provides you with the low cost option for the PPO. But what I'd like to ask you to do is if you'll look at Page 3, or the last page of the handout, there's a comparison, and I think that this is really critical. And I appreciate Mr. Taylor's comments because I think that they're helpful in this regard as well. If you look at the comparison between the BlueChoice PPO option and University Health Link, on a hospital basis in Richmond County, as has been stated already, there are four facilities under BlueChoice. Under the Health Link option there is one. State-wide, BlueChoice has the opportunity of participating in 107 facilities as opposed to, I believe, approximately 10 in the Health Link network. Blue Cross also has the opportunity to participate in our national PPO network. So to the extent that your employees were ever traveling on vacation, business, work, other reasons, and they had an illness outside of the area, they can take advantage of those hospitals and those discounts. On the physician side, it has been mentioned earlier that in the Augusta area there are approximately 706 physicians that participate in BlueChoice PPO. As has been stated, Health Link has approximately 350 physicians. An important point, a very important point I think for you, is that of those 350 physicians roughly two-thirds are under direct contract with BlueChoice PPO. And if you include hospital-based physicians which are paid at in-network level, approximately 70 percent of those physicians would be at an in-network level. It was stated earlier that -- Mr. Taylor emphasized the fact that 43 percent of the county employees were utilizing University Hospital on an exclusive PPO. I think that's very important to note that two-thirds of the county employees are utilizing other hospitals in Richmond County when they're participating in a plan design that apparently supports a single hospital. So when you look at the taxpayers and when you look at your employees, you have an opportunity to offer a very cost- effective product, one which provides choice, and we have done that in a manner which is inclusive to University. And I think you need to also understand that the other hospitals in Richmond County have made a point, as part of their commitment--I said this at an earlier meeting--to the success of the consolidated government, to offer this level of discounts while including another significant player in the market, University, as part of their contribution. That is truly unheard of, and an invitation exists to Health Link to participate in that. That's up to them. I mean, you cannot -- I'm clearly not encouraging you to insist on University as the sole option. I think you can insist on University to be given the opportunity to participate, and we've given that opportunity. The other thing that I'd like to just highlight is that it was pointed out -- I don't think we're really talking about the HMO, but that University is not a participant in that. But employees will have the opportunity to make that decision on the front end. If that product's right for them, they'll choose that product. If it's not, they'll choose the PPO. Because one thing I can absolutely ensure you, that while an HMO is not for everybody, there is not another healthcare plan operating in this market that will provide higher quality care for those people, and I think that's really important to note. I appreciate your time. MAYOR SCONYERS: Do y'all have any questions for -- Mr. Todd? MR. TODD: I think I raised the question to Mr. Taylor, but as far as the HMO go, where is the final decision whether a procedure is going to be paid for? Where does that lie, with the doctor and patient on whether to have that procedure or with the TPA? MR. ECKERT: Those decisions rest with the physician. I mean, we've got a benefit plan that was structured in a very unique way. It was put together in combination with a group of physicians here in town, which is unique, an insurance carrier and a group of physicians partnering together. And as I said earlier when I was alluding to quality, when we first -- the very first meeting we had, what those physicians said is we want to put together a healthcare plan that we're comfortable sending our family members to. Many of these physicians are part of this. They offer this plan to their employees. I think that they've been involved in the initial planning, the development of this program, the ongoing operations and governance of it. They are very keenly aware of delivering high quality care to those employees -- to the members of our plan. MR. TODD: I guess it's been stated, Mr. Mayor, that the entity or acronym SAS is a subsidiary of Blue Cross/Blue Shield -- MR. ECKERT: Of Georgia, yes. MR. TODD: -- of Georgia. And do you see any problem as far -- have you had a problem in the past with this entity being objective when talking to the patients about options and quality of care of other participants? MR. ECKERT: There's going to be no problems whatsoever with SAS in terms of its interactions with members. No, sir. MR. TODD: Mr. Mayor, then my next question would be, to Blue Cross/Blue Shield, would you have a serious problem with the TPA, acronym, I guess, ADS? MR. ECKERT: Well, the issue is that that's a -- I mean, that's a separate TPA administering a separate benefit plan solely for University Hospital and University Health Link, so it's just a -- I can't evaluate the capabilities of that TPA. I think that -- you know, one other issue that is important in terms of the BlueChoice PPO, to the extent that employees and their dependents go out-of-network, there's a very significant protection for those individuals in that because of the large proportion of physicians and hospitals in this state that are covered by our participating physician and prudent buyer agreements, they're protected from balanced billing. The other issue in terms administering that -- MR. TODD: If this TPA is not going to be doing the overall, then I don't think it's fair for you to have to answer it, and probably not fair to University either, so I'll withdraw the question or concern there. MR. ECKERT: Thank you. MAYOR SCONYERS: Mr. Brigham? MR. J. BRIGHAM: My question concerns about the discounts since you didn't address that. Could you give us some idea of what kind of discounts we're talking about off the list on the BlueChoice PPO? MR. ECKERT: Well, yes, I can. And I think it's important to emphasize earlier I think it's been mentioned that discounts off lists are not the key issue, it's the bottom-line number. MR. J. BRIGHAM: Well, we've got to start somewhere. MR. ECKERT: Right. But the discounts off list range anywhere from 30 percent to in excess of 60 percent off of list price. To come up with a number that when evaluated in terms of utilization of network facilities and University, you end up with a bottom-line number which is lower. I would -- I had a hard time making a linkage between an earlier statement that the existing county employees, where University is an exclusive network, 64 percent of those people are using non-network hospitals, yet in a new approach where University is the exclusive hospital it will be 78 percent. That was kind of a disjoint to me. I didn't understand why people were going to change their reasons to use one hospital. MR. J. BRIGHAM: I believe what they were saying is that all the University subscribers in the county system are on a PPO, and they're going to have the choice. And what they base their assumption on, from what I gathered, and maybe you can help me with this, is that their percentage of the market was roughly 53 -- 43 percent of the market, and that they would assume that all 43 percent would come from the PPO side. MR. ECKERT: My understanding was that the existing PPO offered to the county, which is exclusive, didn't reflect that type of utilization. MR. J. BRIGHAM: I thought the existing -- maybe we need to get somebody to correct us, but I thought the existing showed a higher percentage than that out of the -- even for the last year I think it showed 47 percent usage. MR. ECKERT: 47 percent, right. MR. J. BRIGHAM: Yeah, that was 47 percent. So from what their cost figures, they're using 4 percent less. It's hard to argue with that based on one year of usage. What my concern is what you think, since they're saying that their discount is 10 percent with y'alls network. MR. ECKERT: Right. MR. J. BRIGHAM: And I assume that's correct. I assume they know what they're talking about. What I'm trying to decide in my mind is what is your - - you know, what overall is going to be my average discount. Can you give me any indication as to what that's going to be? MR. ECKERT: I believe that the consultant has evaluated that. I can tell you that three out of four hospitals will be giving you very, very aggressive discounts. MR. J. BRIGHAM: As high as 35 percent? Or higher? MR. ECKERT: As high as 60-plus percent. MR. J. BRIGHAM: 60-plus percent? Is that on procedures or overall percentage or what? MR. ECKERT: That is on charges incurred at that facility. The other advantage is that on an inpatient basis, those charges are based on a per diem amount so that you can be assured that your costs are going to be consistent over a 12-month period of time. In other words, I'm not going to give you a 30 percent discount today or a 60 percent discount and go raise my prices 20 percent tomorrow and have it evaporate. That's an important factor. Not just discount; what's the bottom line, how long is it in effect. So, again, I think you've got an opportunity to vote on a plan which seems like a win for everybody: low cost for taxpayers, good choice for employees and their dependents, coverage across the state, coverage across the county, protection from out-of-network balance billing charges providers. You've got a good opportunity. MAYOR SCONYERS: Mr. Beard? MR. BEARD: Mr. Mayor, I think we've heard from all the parties involved, and at this time I would like to move that we vote for 1-C. MAYOR SCONYERS: I have a motion by Mr. Beard. Do I hear a second to Mr. Beard's motion? MR. BRIDGES: Second. MAYOR SCONYERS: Second by Mr. Bridges. Discussion, gentlemen? MR. TODD: Yes, Mr. Mayor. It seems to me that -- and I'll do this as a point of information, too, is that we've already had a vote on this issue and that the action that we would have to take would be to either ratify that initial or rescind -- if we don't have a contract because of someone pulled out, et cetera, that we would rescind that action early on for the special meeting, then vote on a plan. And my comments in this discussion is that, one, it seems to me that if we -- if I'm understanding it, if we go with 1-C, then we lose the participation in a PPO as far as University Health Link go. That's not my understanding? MR. J. BRIGHAM: We lose the discounts. MR. TODD: We lose discounts then -- points. Then the question is, which is the greater of the two, the $150,000 that we would spend in addition for a TPA to just administer the University Health Link side of the PPO or the discount points -- assumed discount points or discount points, assuming that X number is going to use University if you want to buy into that assumption. So I think that what we've got to do is that we've got to make the decision that's in the best interest of the taxpayers, and that's all I'm trying to point out. And I wonder could someone, before we vote on this, give us the difference in the projected dollar amount, and I would call on the consultant in the Comptroller's Office to do that, Mr. Mayor. Which is the greater, the $150,000 or the discount points that we anticipate losing projected on a conservative number of individuals that would still use the PPO at University Health Link? MAYOR SCONYERS: Mr. Todd, let's solve the first part of your question. Mr. Wall, tell us about that. MR. WALL: Mr. Mayor, the 1-D which was voted on last time involved University Hospital operating under the South Care Network along with the BlueChoice program, what I'm going to refer to as PPO. University Hospital has written a letter. Blue Cross has acknowledged the fact that the current contracts existing with SAS prohibit both of them, absent an amendment, from carrying out that option. So 1-D is, at this point, a practical impossibility since University has said that they will not seek an amendment of the contract. So, in my opinion, nothing needs to be done except vote on either the 2-A or the -- I'm sorry, the 2-B or the 1-C, or the motion that's before you. MAYOR SCONYERS: Do you want an answer on the other part of that now? MR. TODD: Yes, sir. Mr. Mayor, you know, certainly I would if we're -- you know, we're fixing to make a decision, and if the points lost, assuming that X number is going to go to University Health Link, is greater than the $150,000, then even though it seems complex and complicated, I think it's incumbent upon us to make the right decision, or at least if what we're doing is what's in the best interest of the taxpayers as far as cost go, that we need to be able to make that decision. MAYOR SCONYERS: John, can you answer that? MR. FORTIN: I'll try to address what I heard earlier and try to focus on cost. I think that's really what people are interested in. You've heard both sides kind of give a lot of talk about their discounts and their charges. Well, they're focusing on the hospital side primarily; okay? And what they've said was basically accurate in terms of they are giving excellent discounts. But the bottom line, when you look at discounts and administrative costs, the bottom line -- not just hospital, physician and everything else, the bottom line is that the Blue Cross approach, 1-C, will save you $150,000 per year over three years. It'll save you $450,000 net savings. And to clarify, you know, we've heard a lot of testimony about PPO's are cheaper than HMO's and so forth. Some of that's irrelevant. An HMO has 100 percent benefit. A PPO has an 80 percent benefit. Obviously an HMO costs a little bit more, because you're getting more. Some of these arguments on both sides, they're not material to your decision. I think you'll find that some of the facts that I heard -- and I was here during the entire remarks by Mr. Taylor, so I have, you know, a couple of different opinions on Mr. Taylor's facts. I didn't hear all of Blue Cross facts. I was out for a couple of minutes. Well, Mr. Taylor, I think, said something like right now he thinks that out of the city group 30 percent like University. If I heard correctly, that on the city side of the house 30 percent have voted with their feet and gone to Univer-sity in the past. That's contrary to the facts that we have. Your third-party administrator tells us that actually 12 percent went to University Hospital, out of the paid claims, compared to the 30 percent. So that number, I think, accounts for some of the differences you're hearing on the two sides. We have a little bit different set of facts. But, also, the hospitals are talking mostly about hospitals. I'm talking about your whole healthcare dollar, the physician component as well. To answer your question also, the new subcontractor identified by University, they're basically very low in technical scoring. In terms of service and their capabilities overall, it's very low. We ranked them seven out of eight. And that's -- again, when you're asking our opinion versus someone else's opinion, where's the difference? Our opinion is that they don't do as good a job as someone paying claims, and in -- MR. ZETTERBERG: Would you say that again? MR. FORTIN: The Advanced Data Solution subcontractor that University has identified, we ranked them number seven out of eight vendors. So our professional opinion is they don't do as good a job service-wise, management- wise, reporting-wise. And, frankly, the third-party administrator doesn't analyze your experience. That's the consultant's role. Third-party administrators pay claims. There's no physician management. That's why there are consulting firms around like ours. There are others around, too. So there are several differences between the cost numbers you've heard on both sides. The bottom line from the employer's point of view is you'll save about $450,000, in our opinion, overall net savings by going with Blue Cross. Second question -- I said there are two questions. Second question: Where do the employees come out in all this? The employees under the University approach will do just fine if they go to University. Now, I don't know whether 10 percent or 90 percent or zero or 100 percent will go to University. We could debate that all day long. No one knows. But those who don't go to University will suffer very seriously, because they'll be paying 40 percent out of every single dollar in hospital if they choose to go out-of- network. This will be a very big ticket item if they don't go through University. The employees will have a much broader network with Blue Cross. They'll have a much broader physician network and hospital network, so there's no question in my mind that the employees come out far superior in one side of the house. Yes, sir? Comment? Question? MR. ZETTERBERG: I'd like for you to go back and revisit the -- Mr. Etheridge is an employee of the city and he wants to use -- under the Blue Cross option, he wants to use University Hospital. That's his choice. What does it cost him on out-of -- is he out-of-network then? MR. FORTIN: No, in-network. Under the Blue Cross approach, they've got a contract with each of the four major hospitals, so it's 80 percent co- insurance and the employee pays 20 percent. MR. ZETTERBERG: And that's the prudent buyer program? MR. FORTIN: Right. It's a 20 percent employee share up until a certain maximum, and at that certain maximum dollar amount that that employee incurs, then the employee doesn't pay anything beyond that. Paid in full. MR. ZETTERBERG: Now, we have heard a difference -- you're saying it's $450,000 more expensive and Mr. Taylor has said that it is not. MR. FORTIN: He said it's more cost-effective on the University approach. That's correct. So it's totally different opinions. MR. ZETTERBERG: Which one of you am I going to believe? MR. FORTIN: Well, I don't know who their actuary was who came up with those numbers. But it's your call, sir. Tough question. MR. HANDY: Mr. Mayor, I've got to go. I'm going to call for the question or, yes, I'm going to be back in somebody's hospital, which I don't want to be. MR. H. BRIGHAM: Mr. Mayor, I'll just ask one question to follow up what Mr. Zetterberg said. MR. HANDY: Mr. Brigham, it ain't going to change anything. I need to go, seriously. MR. H. BRIGHAM: Yes, sir, I understand that. MR. HANDY: All right. MAYOR SCONYERS: Well, why don't we sweep around one more time. We'll start with Mr. Todd, and when we get back to Ulmer that's going to be it. So, Mr. Todd, you got anything to say? MR. TODD: I'm going to yield, Mr. Mayor, and not say anything else. I think I've said enough. MR. J. BRIGHAM: One question, Mr. Mayor, and I'll let it go at that. John, why would I as an employee choose a PPO if the county chooses to have University and not go there and go somewhere else if I could choose the HMO? I think that's the crux of the matter. MR. FORTIN: You're saying if you're an employee and your signing up January 1st for your coverage, which coverage would you sign up for? MR. J. BRIGHAM: Right. If I chose to be a member of the PPO, and I get this greater discount here from all the members of the PPO, why would I choose to go to another hospital? Why wouldn't I have chosen to be a member of the HMO? MR. FORTIN: Well, yeah, you as an employee will always have to look at your physician that you want to work with, and he or she will drive which hospital you go to. It's usually a physician choice more than anything. But you look at your provider directory and you see which physicians are the best for you. You look at which ones you go to, your wife goes to, your kids like, and out of provider directory, that drives a lot of decisions. MR. J. BRIGHAM: Okay. MAYOR SCONYERS: Mr. Mays? MR. MAYS: Yes, sir, Mr. Mayor. First let me apologize. I came from on the other side of Duluth, Georgia, in about an hour and 55 minutes, and I hope no members of the Georgia State Patrol are in the audience right now. And when you enter the room last you're supposed to say less, so I'm going to abide by that. I think I made probably pretty enough comments when this thing was first discussed. I've heard from various parties direct, indirect, I've seen everything from letters to full page ads in the daily newspaper, and my position really has not changed from the night that I left here on that particular time. In fact, if anything, I'm probably a little bit more ticked off today than I was on that same night, and I won't go into that because you all have been sitting here very patient and having to deal with that. Now, I may not even vote for either one of these plans, and I may abstain on it. I do think that the first one does give us a choice, but, you know, I find it still very, very alarming, and I have to be concerned about it, that when we talk about choice -- and that's what the bottom line should be. I think that relationship between a person and who they receive their health care from, whether it's personal physician or choice of hospital, should be the bottom line in what's considered in this. And those of you that were here, those of you in the media, know how hard I fought the situation of a mandatory PPO when our employees didn't have a choice, but yet people were the recipients of those employees. But yet I find now that if that's not going to be on the table, then the discount ratio gets to be a little different, and that's kind of hypocritical. And, you know, when you're getting it your way, it's all right, but when you're not getting it your way, then you change the rules of the game. I'm not going to disagree with Mr. Wall, Mr. Mayor. I think Jim's the attorney; he's right on that. I probably would have rather seen us rescind what we did. And I also hope that at some point that University does put in writing, since I've seen every darn thing else in writing in the last week from one full page ad to another one. I'd hope that a withdrawal and rejection would be in writing in reference to the discounts and everything else. Now, you know, I still say this, hijacking, I think it's blackmail still. I think this thing gives a point of choice. And I think that from a professional standpoint not to be able to work any better than this, it says something about the healthcare system in general when people can't come together and make something work. And we have to do it, I think, for our 2,700 employees, whatever we're doing, that for them being best. And, again, to be jerked around like this -- this is better than nothing, but I think to lose what was the best plan on the table that gave everybody clear choice -- clear choice --and I remember a specific symposium that a certain hospital held when it fought national healthcare, and their reasons for holding it were that it took away the choice of people. And I see the same folk basically who put that symposium together now today making choice unavailable with the way they've hijacked this darn thing here that's in front of us. So I'm probably going to vote present and hope that y'all have enough votes to pass it. If you don't, on the second go-round, Mr. Mayor, I will vote for 1-C. But out of protest, I think the first proposal that we voted on that night was the best one for our employees. I'm going to stick to that. And if it fails by one vote, we can sweep it again and I'll vote for 1-C. Other than that, I'm going to vote present. MAYOR SCONYERS: Mr. Brigham? MR. H. BRIGHAM: I yield in the interest of time for Mr. Handy. MAYOR SCONYERS: Anybody else? MR. BEARD: Call for the question, Mr. Mayor. MAYOR SCONYERS: Do y'all want the motion read? MR. TODD: Mr. Mayor, I move that we dispense the reading of the motion and any further delay and vote. MAYOR SCONYERS: That's fine with me. All in favor of Mr. Beard's motion, let it be known by raising your hand, please. I count five. Is that what you count, Lena? CLERK: Five. MAYOR SCONYERS: Opposed likewise? MR. MAYS: Mr. Mayor, I'll switch and vote and make it in order to save it because that's the only game going. I'll vote present to make it six. I won't deny our folk that. But I'm going to have a hell of a long memory regarding this. MAYOR SCONYERS: Wait a minute now, are you voting present or are you voting? MR. MAYS: No, I'm going to -- I said if you didn't have enough votes to get what's the best deal on the table passed, I'll change it and I'll vote with the five that's on there to deal with 1-C. And I'll vote for that, but only under those conditions, and you don't have enough votes to get it otherwise unless I vote. MAYOR SCONYERS: Well, let's see the show of hands now, then. All in favor of Mr. Beard's motion, let it be known by raising your hand, please. That's six votes. Did I miss two hands? Now, y'all got to -- why don't we have a voice vote one time and let them tell it like it is. CLERK: Lee Beard? MR. BEARD: For the motion. CLERK: 1-C? MR. BEARD: 1-C. CLERK: Ulmer Bridges? MR. BRIDGES: Yes. CLERK: Henry Brigham? MR. H. BRIGHAM: No. CLERK: Jerry Brigham? MR. J. BRIGHAM: No. CLERK: Freddie Handy? MR. HANDY: No. CLERK: Bill Kuhlke? MR. KUHLKE: Yes. CLERK: William Mays? MR. MAYS: I have to. Yes. CLERK: J.B. Powell? MR. POWELL: Yes. CLERK: Moses Todd? MR. TODD: Yes. CLERK: Rob Zetterberg? MR. ZETTERBERG: Yes. MESSRS. H. BRIGHAM, J. BRIGHAM & HANDY VOTE NO. MOTION CARRIES 7-3. MAYOR SCONYERS: Do y'all want to bring up about the LTD right quick and solve that and be through with it? Well, while we're on a roll, how long is it going to take to do that? MR. ETHERIDGE: Well, I have -- I really don't know and don't want to make any predictions. It depends on how many questions that come up, but -- MR. KUHLKE: Mr. Mayor, let me share with my colleagues what I talked with John about the other day. I have -- I may have no problem with long-term disability, but I think we presently have sick leave that's a cumulative type thing that there is a cost involved in that. And I think if we're going to look at long-term disability, I think that Mr. Etheridge needs to come back to us to see if there are going to be any changes in the policy that we presently have that would show us maybe some cost offset for the cost of the long-term disability. And that information, I don't think he's got it completely available at this point, and I would have a hard time voting for that part of the policy until I get some assurance that we do have some flexibility in maybe reducing costs by modifying the policy. MR. ETHERIDGE: Well, at this time we are. Mr. Bill Lee is doing a benefit analysis for us, and that will bring a lot of things to attention that will, you know, reinforce what -- the information Mr. Kuhlke's looking for. MAYOR SCONYERS: Mr. Powell, then Mr. Todd. MR. POWELL: Mr. Chairman, I'd like to make a motion that we table it until we get back that study. MAYOR SCONYERS: Table or postpone? MR. POWELL: Postpone it. MR. TODD: Second. MAYOR SCONYERS: Motion by Mr. Powell, seconded by Mr. Todd. Discussion, gentlemen? MR. BRIDGES: John, how long is that going to take to get that study back? Will it cost us any money putting this thing off? MR. ETHERIDGE: No, because that was -- we were going to pay for that with the money we were saving on the healthcare. I mean, that's how we were paying for that. And so, you know, we're not going to lose any money by putting this off, no. MAYOR SCONYERS: John, well, let's finish up the benefits package and we'll be through with it then, other than the LTD. MR. ETHERIDGE: Unless there's some legal concerns. Are there any legal concerns, Mr. Wall? MR. WALL: No, sir, Mr. Etheridge. MR. ETHERIDGE: Okay. Just wanted to make sure. Today we've concluded - - we know what we're going to do with our healthcare package. The life package was approved Tuesday. The LTD was the only final section of that. So we could go ahead and, you know, begin the process of having open enrollment, but it will be, I think, February the 1st before we can get everybody enrolled, it won't be January 1st. MAYOR SCONYERS: Thank you. MR. TODD: Mr. Mayor? MAYOR SCONYERS: Mr. Todd? MR. TODD: I sure would like to known that we were going to pay for this with the money we saved from healthcare before I made a decision on the healthcare. And maybe it was conveyed somewhere where I missed it, but -- and I think that in the future we've got to do that. If there's a cost attached, then we need to identify how we're going to pay for it. And that's my comments, and I'm ready for the question. But, you know, certainly if this thing -- am I hearing this thing is going to cost us all of the $950,000 that we're supposed to be saving, or $450,000, or what's the dollar amount? MR. ETHERIDGE: No, sir. No, sir. MR. FORTIN: Sir, I think what I'm hearing is you may want to put in a LTD program, you may, but you'd like to take a look at the short-term disability program first because it may be possible to do some savings on the STD side and move them over to the LTD side so you'd have a neutral, better structured program on your disability. I think that's what I'm hearing, and I think that's where -- MR. TODD: And would this be a volunteer plan? MR. FORTIN: One question is what's the cost of the LTD. It's on the order of -- your medical is here. Your LTD is much, much, much lower. Your health plan, as everyone knows, is like $2,500 per person per year. LTD is $80 per person. It's very cost-effective. But, still, what I'm hearing is that there hasn't been sufficient detailed study of the short-term disability side, and so what I'm hearing is it wouldn't make sense to do one without looking at the other first. MAYOR SCONYERS: Are we ready to vote, gentlemen? MR. BEARD: Yes. MAYOR SCONYERS: All in favor of Mr. Powell's motion to postpone, let it be known by raising your hand, please. MOTION CARRIES 10-0. MAYOR SCONYERS: Now, the next order of business, gentlemen, I think we need to go into a personnel meeting. CLERK: The next item is discussion of personnel matters and department head positions. MR. TODD: Mr. Mayor, I so move that we go into executive session to discuss personnel matters. MR. H. BRIGHAM: Second. MAYOR SCONYERS: Motion by Mr. Todd, seconded by Mr. Brigham. Discussion, gentlemen? MR. TODD: Mr. Mayor, I also see legal matters here also, so I'm going to include -- or amend that motion to say personnel and legal in case Mr. Wall has something. MR. KUHLKE: How about real estate? MR. TODD: If we're going to take the Clerk in we can do real estate. I'll add real estate in there, and we'll call for the Clerk when we start dealing with real estate. MAYOR SCONYERS: All in favor of the motion, let it be known by raising your hand, please. MOTION CARRIES 10-0. [LEGAL MEETING, 2:05 - 3:59 P.M.] MAYOR SCONYERS: The meeting will come back to order, please. Ready, Ms. Bonner? CLERK: Yes, sir. First item, Public Works Director. MAYOR SCONYERS: Mr. Powell? MR. POWELL: Mr. Chairman, I nominate Michael Greene. MR. HANDY: Second. MR. TODD: Mr. Mayor, I move that nominations -- nominate Michael Greene for what, Mr. Mayor? MR. POWELL: Nominate Michael Greene for Public Works Director -- Interim Public Works Director. MR. TODD: Thank you. I move, Mr. Mayor, that nominations -- for what position, Urban? Suburban? MR. POWELL: Mr. Todd, you know what I'm -- MR. TODD: Yes, but I need a clarification for the record if I'm going to vote for it, Mr. Mayor. MAYOR SCONYERS: It's for Interim Director, to take effect at the retirement of Mr. Gooding until such time as the departments are reorganized; is that correct, Mr. Powell? Is that what we want to do? MR. POWELL: That's correct, Mr. Chairman. MR. TODD: For the Suburban District? MR. POWELL: That's correct, Mr. Todd. MR. TODD: I move, Mr. Mayor, that nominations be closed. MR. H. BRIGHAM: Second. MAYOR SCONYERS: Discussion, gentlemen? Mr. Bridges? MR. BRIDGES: That's it, I just wanted that clarification. MAYOR SCONYERS: Okay. MR. TODD: Yes. Mr. Mayor, wording is everything. MAYOR SCONYERS: Thank you. All in favor of Mr. Powell's motion, let it be known by raising your hand, please. MOTION CARRIES 10-0. CLERK: Next, Purchasing Director. MR. TODD: Mr. Mayor, I nominate Ms. Geri Sams. MR. BEARD: I'll second that. MAYOR SCONYERS: Motion by Mr. Todd, seconded by Mr. Bridges -- I mean, Mr. Beard, excuse me. Discussion, gentlemen? Other nominations? MR. J. BRIGHAM: Mr. Mayor, I nominate Cheryl Newman -- Nelson. I'm sorry, I do that all the time. MAYOR SCONYERS: Do I have a second to Mr. -- we don't need a second on a nomination, do we? MR. J. BRIGHAM: I don't think a nomination requires a second. MR. TODD: Mr. Mayor, I move that nominations be closed. MR. BEARD: I second that. MAYOR SCONYERS: Discussion on that, gentlemen? All in favor, let it be known by raising your hand, please. MR. POWELL: Which one? MAYOR SCONYERS: Just for the motion nominations to be closed. MOTION CARRIES 10-0. MAYOR SCONYERS: We'll vote in the order they were presented. That would be Ms. Sams first. All in favor of Ms. Sams, let it be known by raising your hand, please. MESSRS. J. BRIGHAM, KUHLKE & ZETTERBERG VOTE NO. MOTION CARRIES 7-3. CLERK: Housing and Neighborhood Development Director. MR. BEARD: Mr. Mayor, I nominate Ms. Patterson. MAYOR SCONYERS: Mr. Brigham? MR. H. BRIGHAM: I would like to nominate Mr. Keven Mack. MR. TODD: Mr. Mayor, I move that nominations be closed. MR. J. BRIGHAM: Second. MAYOR SCONYERS: I have a motion by Mr. Todd, seconded by Mr. Brigham. Discussion, gentlemen? All in favor of Mr. Todd's motion that the motions be closed -- or the nominations be closed, raise your hand, please. MOTION CARRIES 10-0. MAYOR SCONYERS: Ms. Patterson. All in favor of Ms. Patterson, raise your hand, please. [VOTE TIES 5-5] MR. TODD: Mr. Mayor, I call for a roll call vote. MR. H. BRIGHAM: Mr. Mayor, I think in this instance you have the privilege of breaking the tie, and I would like for you to exercise your privilege as Mayor of the second largest city in the state of Georgia. MAYOR SCONYERS: I just realized one problem we've got, gentlemen. We don't have a Ms. Patterson that applied for the job. MR. H. BRIGHAM: Well, I move that Mr. Keven Mack be unanimously claimed as the person of -- MR. BEARD: Mr. Mayor, there was a mispronunciation of the name, and I don't think that we could rule that out. We would have to vote on it. MR. TODD: What is the name, Peterson? Is it something similar? MAYOR SCONYERS: I didn't make the motion. MR. BEARD: It's Peterson, I'm sorry. If I said Patterson, I was in error. It's Peterson. MR. H. BRIGHAM: See, they may send the wrong lady up here, Mr. Mayor. We can't vote on a person like that. MAYOR SCONYERS: We don't have a Peterson either, gentlemen. MR. J. BRIGHAM: Mr. Mayor, you know what we're trying to do. MR. TODD: What's the lady's name from Mississippi? MAYOR SCONYERS: The last name is Richardson. I mean, I would hate to vote for somebody and didn't know their name. MR. TODD: Yes, Mr. Mayor. And I'll call for a roll call vote, too, when we get a clarification. MR. POWELL: I move that we accept Mr. Beard's correct pronunciation of the lady's name. MR. H. BRIGHAM: I second that. MAYOR SCONYERS: We've got it straight now. Roll call vote, Ms. Bonner. CLERK: Mr. Beard? This is for Ms. Richardson. MR. BEARD: Yes. CLERK: Mr. Bridges? MR. BRIDGES: Are we -- CLERK: We're voting for Ms. Richardson. MR. BRIDGES: No. CLERK: Mr. Henry Brigham? MR. H. BRIGHAM: No. CLERK: Mr. Jerry Brigham? MR. J. BRIGHAM: Yes. CLERK: Mr. Handy? MR. HANDY: No. CLERK: Mr. Kuhlke? MR. KUHLKE: Yes. CLERK: Mr. Mays? MR. MAYS: No. CLERK: Mr. Powell? MR. POWELL: No. CLERK: Mr. Todd? MR. TODD: Vote present. CLERK: Mr. Zetterberg? MR. ZETTERBERG: Yes. MAYOR SCONYERS: Well, that's six votes, wasn't it? CLERK: Yes, sir, but it was four to five, with a present. You had four yes's, five no's, and one present. MR. BEARD: Mr. Mayor, I move that we reconsider that department. MAYOR SCONYERS: Well, we've got another nomination to make here. We've got to vote on the next one, which was Mr. -- MR. HANDY: Mr. Keven Mack. MAYOR SCONYERS: Keven Mack, right. MR. TODD: Mr. Mayor, I change my vote to in the affirmative. CLERK: So that's five-five, Mr. Mayor. MAYOR SCONYERS: Well, I'm going to vote negative. MESSRS. BRIDGES, H. BRIGHAM, HANDY, MAYS, POWELL & MAYOR SCONYERS VOTE NO. MOTION FAILS 6-5. MAYOR SCONYERS: Now we'll go to Mr. Mack. CLERK: Okay, Mr. Mack. Mr. Beard? MR. BEARD: No. CLERK: Mr. Bridges? MR. BRIDGES: Yes. CLERK: Mr. Henry Brigham? MR. H. BRIGHAM: Yes. CLERK: Mr. Jerry Brigham? MR. J. BRIGHAM: No. CLERK: Mr. Handy? MR. HANDY: Yes. CLERK: Mr. Kuhlke? MR. KUHLKE: No. CLERK: Mr. Mays? MR. MAYS: Yes. CLERK: Mr. Powell? MR. POWELL: Yes. CLERK: Mr. Todd? MR. TODD: No. CLERK: Mr. Zetterberg? MR. ZETTERBERG: No. MAYOR SCONYERS: Yes. CLERK: You vote yes, Mr. Mayor? MAYOR SCONYERS: Yes. MESSRS. BEARD, J. BRIGHAM, KUHLKE, TODD & ZETTERBERG VOTE NO. MOTION CARRIES 6-5. CLERK: The Fire Chief. MAYOR SCONYERS: Mr. Powell? MR. POWELL: Mr. Chairman, I nominate Dennis Atkins as Interim Chief. MR. TODD: Mr. Mayor, I'd like to make a substitute -- well, I'd like to make a nomination also, Mr. Butch Murdock as Interim Chief. MR. HANDY: Mr. Mayor, I move that nominations be closed. MAYOR SCONYERS: Well, Mr. Bridges had his hand up first. MR. HANDY: I'm sorry. Go ahead. MR. BRIDGES: Mr. Mayor, can I make a motion? MAYOR SCONYERS: Well, right now we're in nominations unless you want to close the -- unless you want to nominate somebody. MR. BRIDGES: No, I'll leave it like it is. MAYOR SCONYERS: All right. Do I hear a motion that the nominations be closed? MR. HANDY: I already have. MAYOR SCONYERS: Thank you, Mr. Handy. MR. J. BRIGHAM: Second. I'll ask for a roll call vote, please. MAYOR SCONYERS: Thank you, sir. Was there any discussion first? All in -- no, we're going to roll call vote. CLERK: Okay. On the position of Interim Fire Chief, Dennis Atkins. Mr. Beard? MR. BEARD: Yes. CLERK: Mr. Bridges? MR. BRIDGES: No. CLERK: Mr. Henry Brigham? MR. H. BRIGHAM: Yes. CLERK: Mr. Jerry Brigham? MR. J. BRIGHAM: No. CLERK: Mr. Handy? MR. HANDY: Yes. CLERK: Mr. Kuhlke? MR. KUHLKE: No. CLERK: Mr. Mays? MR. MAYS: Yes. CLERK: Mr. Powell? MR. POWELL: Yes. CLERK: Mr. Todd? MR. TODD: I vote present. CLERK: Mr. Zetterberg? MR. ZETTERBERG: No. MESSRS. BRIDGES, J. BRIGHAM, KUHLKE & ZETTERBERG VOTE NO. MR. TODD ABSTAINS. MOTION FAILS 5-4-1. CLERK: Mr. Murdock. Mr. Beard? MR. BEARD: No. CLERK: Mr. Bridges? MR. BRIDGES: Yes. CLERK: Mr. Henry Brigham? MR. H. BRIGHAM: No. CLERK: Mr. Jerry Brigham? MR. J. BRIGHAM: Yes. CLERK: Mr. Handy? MR. HANDY: No. CLERK: Mr. Kuhlke? MR. KUHLKE: Yes. CLERK: Mr. Mays? MR. MAYS: Yes. And I would like for the record to state that with the retiring of our current Fire Chief this is one that I don't think that we can jockey around on. Someone in a temporary position is going to have to be appointed, and I don't think this can linger past us going yes and no all day long, or abstention will not give the Mayor the right to vote, and I'll cast a vote for Chief Murdock. CLERK: Mr. Powell? MR. POWELL: No. CLERK: Mr. Todd? MR. TODD: Yes. CLERK: Mr. Zetterberg? MR. ZETTERBERG: Yes. MESSRS. BEARD, H. BRIGHAM, HANDY & POWELL VOTE NO. MOTION CARRIES 6-4. CLERK: Animal Control Director. MR. TODD: Mr. Mayor, who is the nominee from the committee? MAYOR SCONYERS: Jim Larimore. MR. TODD: Mr. Mayor, I would like to nominate Mr. Jim Larimore. MAYOR SCONYERS: Other nominations? MR. J. BRIGHAM: Mr. Mayor, I'd like to move that nominations be closed. MAYOR SCONYERS: I have motion by Mr. Brigham. Do I heard a second? MR. TODD: Second, Mr. Mayor. MAYOR SCONYERS: Seconded by Mr. Todd. Discussion, gentlemen? All in favor of Mr. Brigham's motion, let it be known by raising your hand, please. MOTION CARRIES 10-0. MAYOR SCONYERS: Why don't you do a voice call vote on this one, too. CLERK: Okay. Mr. Beard? MR. BEARD: Yes. CLERK: Mr. Bridges? MR. BRIDGES: Yes. CLERK: Mr. Henry Brigham? MR. H. BRIGHAM: Yes. CLERK: Mr. Jerry Brigham? MR. J. BRIGHAM: Yes. CLERK: Mr. Handy? MR. HANDY: Yes. CLERK: Mr. Kuhlke? MR. KUHLKE: Yes. CLERK: Mr. Mays? MR. MAYS: Whoever it is, yes. CLERK: Mr. Powell? MR. POWELL: Yes. CLERK: Mr. Todd? MR. TODD: Yes. CLERK: Mr. Zetterberg? MR. ZETTERBERG: Yes. MOTION CARRIES 10-0. MAYOR SCONYERS: Thank you. That's the last one we've got today? CLERK: Yes, sir. MAYOR SCONYERS: Do I hear a motion to adjourn? MR. BRIDGES: Mr. Mayor, a point of information. On this Fire Chief, have we said that we're going to go out and advertise for this position or do you need a motion on that? MAYOR SCONYERS: Whatever y'all want to do. MR. POWELL: Mr. Chairman? MAYOR SCONYERS: Mr. Powell? MR. POWELL: I'd like to make a motion that we waive the educational requirements and hire within. MR. HANDY: I second. MAYOR SCONYERS: I have a motion by Mr. Powell, seconded by Mr. Handy. MR. BRIDGES: Mr. Mayor? MAYOR SCONYERS: Mr. Bridges? MR. BRIDGES: I make a substitute motion that we advertise for a Fire Chief outside. MR. TODD: Mr. Mayor, I second the motion. MAYOR SCONYERS: Motion by Mr. Bridges, seconded by Mr. Todd. Discussion on either motion, gentlemen? MR. TODD: Mr. Mayor, yes. I think that to change the criteria in the middle of the stream certainly will create a situation. I understand that both gentlemen that have a application in, or all three or ever how many, is probably equally qualified in the sense they have education as far as fire services education go. They have -- they meet the criteria as far as experience go. Both of them are chiefs: one of them is -- in the structure that we're operating under now is possibly assistant chief, another one is a battalion chief. Both of them love fire services, and certainly I think that both of them would probably make us a fine Chief. But we set a criteria and we set that criteria, you know, a few months ago. And there has been individuals that either put in for positions and wasn't considered because they didn't have a degree or they have been denied the opportunity to put in by virtue of the qualifications that we put on it that you had to have a degree or you had to be grandfather-claused in by virtue of holding a department head position as of December 31st, 1995. I'm not going to get into the legality or possible legality part of this, but this is something that I certainly could not -- I would have to do what's in the best interest of the taxpayers and what the County Attorney advise me to do, but I feel it's morally wrong to do this. And certainly I feel that we should advertise community-wide, hire a Chief that meets the qualifications that we set forth, and hopefully in doing this, that we would consider fire services experience when we do this. Thank you, Mr. Mayor. MAYOR SCONYERS: Thank you. Coming around, gentlemen. Anybody? Mr. Powell? MR. POWELL: Mr. Chairman, I think that we'd be making a grave mistake and sending a bad signal back to our employees if we didn't give them the opportunity to advance. And we've got two young men who have dedicated their entire life to fire service in Richmond County and Augusta, and I think we'd be making a grave mistake to close the door on one of our own. MAYOR SCONYERS: Thank you, Mr. Powell. Mr. Handy? MR. HANDY: Yes, sir, Mr. Mayor. I'd like to just make a statement, that coming up in life or coming up working under a certain person has caused negative against a person here today. I've heard statements made that the reason why Dennis is not being accepted, because he's so close to Bill. He needed to be close to Bill to be able to learn. And when you're not going to give a person an opportunity to learn, then when that person get up in a position, they're not prepared to take over in case something happens to the head man. So we did something here today and we voted against a man because of his closeness to his former supervisor. That's all I have to say. MAYOR SCONYERS: Mr. Bridges? MR. BRIDGES: Mr. Mayor, I want to clarify that in my motion it included the same education requirements that we've had and we've been consistent with in all the other departments. And the only reason that I'm voting to go outside on this is because one of the people did not have a degree. If one of them had it, I'd have said fine, you know, shut it down, but that's not the case. And if we're going to be consistent, then that's what we're going to have to do is go outside and look and see what we've got there. And I think it's important that we've got a gentleman in an interim position that has no interest in this, the permanent position, and if we're going outside everybody can apply again, and let's just leave it at that. MAYOR SCONYERS: Mr. Brigham? MR. J. BRIGHAM: Mr. Mayor, I think we're making a serious mistake. If this is going to be the first, it's going to probably be the first of many that -- if we waive the educational requirements in this, therefore, I'm going to support the motion to go outside and advertise this position. MAYOR SCONYERS: Mr. Mays? MR. MAYS: Mr. Mayor, I hope I made myself real clear for the record, that I don't want to see our community and this department be without a situation where somebody is in charge, and I went ahead and voted to get that off of that hassle today because I think we'd have been 5-4-1 till nightfall in dealing with that. And I've had the opportunity to work with the former Chief of the Richmond County Fire Department, and that was one of the reasons I went ahead and voted, so that we would have a Chief. But I think it's very bull-headed if we are not looking at the fact that everything that we do doesn't have to be written in stone. I was real concerned about what the bill said versus what requirements we put on in terms of dealing with jobs. And, quite frankly, Dennis Atkins or Jerry Newman or probably even some of the other folk that work within the former two departments, I feel and I think a lot of other people can feel comfortable when they lay down at night that their lives are in good hands. I think some common-sense judgment probably -- if any one department needed to be looked at, it was probably in fire service. And in terms of the times and hours that a lot of these people work -- maybe, yes, it's not dealing with a four-year institution in terms of a bachelor's or master's degree, but in other areas of training, I think that does qualify or probably make them more qualified than in some areas of where other people are. We look at law enforcement and -- and that's no knock on law enforcement, but their certification is totally different and separate and apart, and probably if you went down through there, I don't think you're going to find, particularly on the salaries that we pay, that many criminal justice majors holding degrees. So while I'm going to be fair in terms of us going ahead and having a Chief today, I'm also going to be fair enough to think that I can reserve the right that what little mind I still got, that I can change it enough that we can waive what we've done in terms of looking at this on a common-sense basis, not to exclude anybody who might apply with a degree, but that we don't exclude people that have the experience and training in terms of fire service and of keeping within our own department, and I'm going to vote for that particular motion which would waive that. I do think that, like some other things that we've had to change, that we've had to go back and restructure, we've done a lot this year. A lot. Whether we get credit for it all the time or not. And all that hasn't been right, but we make mistakes. We're human. I think this is a chance to help deal with one of those things that we can correct, and I think this will be fair to our people that we have out there that are working in our fire service. I think for those who are concerned about somebody getting a so-called leg up, I think you've pretty much taken care of that today, and I think the fire service rests in the hands of someone who is in charge. But I think to totally exclude in terms of what we have within our own department, I'm going to say the same thing that I said some months ago, that I think I would hate to work for y'all for that long in places, and I'm not being personal with Jerry or with Dennis, to think that somebody that we have in these department areas couldn't one day be at the top of it. And if a man is riding on the back of a trash truck, he ought to one day want to be Public Works Director. And I'm going to shut up with that, but I'll vote for the motion to do the waiving. MAYOR SCONYERS: One thing I think we need to make clear, too, is that this does not take effect until Chief Maddox retires, period. I just want to make sure there's no misunderstanding about that. Isn't that correct, Jim? MR. WALL: Well, I think it needs to be clarified. When you say Interim Fire Chief, I assume that that was to take effect upon the retirement of Chief Maddox. MAYOR SCONYERS: That's correct. MR. TODD: Mr. Mayor? MAYOR SCONYERS: Mr. Todd? MR. TODD: A point of information. I would think that the same criteria that we set forth for other department heads would be the criteria that we would have as far as fire services go, and if that's what we set forth, then certainly I'm willing to live with it. And maybe if we are on a sidebar discussion of when it takes place, that we could have a ruling from what we've already agreed to and what we have in motion for every other department. MAYOR SCONYERS: Mr. Todd, on the rest of them we have been able to get together and appoint a department head. It's a shame that we can't do that today, but that's beside the point. MR. POWELL: Mr. Chairman, I call for the question. MR. J. BRIGHAM: Mr. Chairman, are we going to still debate this point or not? MAYOR SCONYERS: No, sir, the debate is over with. You have two sweeps, the second sweep is over with. I did allow Mr. Todd to go one more time. If you got one more thing you want to say, I'll allow you that, and that's it. MR. J. BRIGHAM: Well, I understand that in the interest of time, but I think we've got some more points to be made. Like I said the first time, and I'm not going to repeat it, this is the first waiving of educational requirements -- we have with educational requirements, and we had trained, qualified people in other positions or that have applied for the job, and I don't -- I think we're setting a bad precedent. The other one that I want to make is that I notice the old city went out and looked for a Chief of Police that was not inside the department and it has the same loyalty factors involved in any public safety as the old Police Department and it did the old Fire Department. I don't know whether they made a good choice or not, but I can remember that Chief McLane was not a member internally of that department. I do not think we need to waive the educational requirements. I think we're making a bad precedent to be set, because this will not be the only department head that we'll end up doing this with. MAYOR SCONYERS: Mr. Brigham? MR. H. BRIGHAM: Mr. Mayor, I just would hope that the two gentlemen before us that are in question now would certainly be given every opportunity to become Chief. And if we go with this motion not to waive the requirements -- and they may or may not have the requirements at this point, but I think they ought to be given the opportunity to have the requirement, Mr. Newman and Mr. Atkins. So I would urge you to let's waive the requirement. MR. MAYS: Or anyone else. MAYOR SCONYERS: Anybody else? Rob? MR. ZETTERBERG: [Indicates negatively.] MAYOR SCONYERS: Lee? MR. BEARD: No. MAYOR SCONYERS: Are y'all ready to vote, gentlemen? MR. BRIDGES: I'd like to hear the motion again, Mr. Mayor. MAYOR SCONYERS: The substitute motion first. That was Mr. -- excuse me, go ahead. MS. MORAWSKI: The substitute motion made by Mr. Bridges was to advertise from outside the government. MR. ZETTERBERG: I'd like a roll call vote on this. MR. BRIDGES: Mr. Mayor, could I make a point? That anybody can apply for that inside or outside; it's just to advertise, you know, regionally or whatever. MR. TODD: Mr. Mayor, a point of information. Is that motion that Mr. - - the substitute motion is to not waive the requirements and to advertise outside? MR. BRIDGES: That's correct. MR. TODD: Thank you, Mr. Mayor. MR. KUHLKE: Mr. Mayor? Excuse me. I thought Ulmer's motion was to maintain the education. MR. BRIDGES: That's correct. CLERK: It was. To advertise outside with the -- MR. KUHLKE: Open solicitation? MR. BRIDGES: That's right. I'm sorry. MAYOR SCONYERS: They want a roll call vote, Ms. Bonner. CLERK: Okay. These are done in alphabetical order, as required by your rules and policies. Mr. Beard? MR. BEARD: No. CLERK: Mr. Bridges? MR. BRIDGES: Yes. CLERK: Mr. Henry Brigham? MR. H. BRIGHAM: No. CLERK: Mr. Jerry Brigham? MR. J. BRIGHAM: Yes. CLERK: Mr. Handy? MR. HANDY: [Absent] CLERK: Mr. Kuhlke? MR. KUHLKE: Yes. CLERK: Mr. Mays? MR. MAYS: No. CLERK: Mr. Powell? MR. POWELL: No. CLERK: Mr. Todd? MR. TODD: Yes. CLERK: Mr. Zetterberg? MR. ZETTERBERG: Yes. MESSRS. BEARD, H. BRIGHAM, MAYS & POWELL VOTE NO. MOTION FAILS 5-4. [MR. HANDY OUT] MAYOR SCONYERS: Go back to the original motion Mr. Powell made. MS. MORAWSKI: The original motion by Mr. Powell was to waive the educational requirements and hire from within. CLERK: Do you want a roll call vote? MAYOR SCONYERS: Same thing. CLERK: Mr. Beard? MR. BEARD: Yes. CLERK: Mr. Bridges? MR. BRIDGES: No. CLERK: Mr. Henry Brigham? MR. H. BRIGHAM: Yes. CLERK: Mr. Jerry Brigham? MR. J. BRIGHAM: No. CLERK: Mr. Handy? MR. HANDY: [Absent] CLERK: Mr. Kuhlke? MR. KUHLKE: No. CLERK: Mr. Mays? MR. MAYS: Yes. CLERK: Mr. Powell? MR. POWELL: Yes. CLERK: Mr. Todd? MR. TODD: No. CLERK: Mr. Zetterberg? MR. ZETTERBERG: No. MESSRS. BRIDGES, J. BRIGHAM, KUHLKE, TODD & ZETTERBERG VOTE NO. MOTION FAILS 5-4. [MR. HANDY OUT] MAYOR SCONYERS: No action. MR. BEARD: I move we adjourn. MR. TODD: Mr. Mayor, there's another item on the agenda, legislative initiatives or concerns. MAYOR SCONYERS: Well, I think you can give those to Ms. Bonner and we can present them Tuesday night. MR. POWELL: Move we adjourn. MR. TODD: Second. MAYOR SCONYERS: This meeting is adjourned. MEETING ADJOURNED AT 4:28 P.M. Lena J. Bonner Clerk of Commission CERTIFICATION: I, Lena J. Bonner, Clerk of Commission, hereby certify that the above is a true and correct copy of the minutes of the Called Meeting of Augusta-Richmond County Commission held on November 22, 1996. _________________________ Clerk of Commission