Mayor.

There you go.

I'll get one print out.

So do the one we get homework.

So anybody can work.

Yeah, yeah.

That's right.

That's right.

One free ride professor is for November 13th, 4 p.m., let's go ahead and start with our first agenda item, which is a presentation discussion regarding ambulance service in the city of Norman.

And I'd like to recognize Kyle Hurley to present.

Okay.

All right.

Thank you for having me here.

I've never gotten to present in front of you at this group for things.

So when people think of public safety, usually they're thinking about police and fire, which is you know the municipality that you all oversee.

But MSTAT is a partner or is a department of Norman Regional Health System.

We have been the sole EMS provider in the city of Norman since September of 1995.

Prior to that, it was with Norman PDEMS from 1978 until 1995.

So it was a municipality, and I don't know what happened.

That was before my time, but uh the city uh parted ways with EMS and it was acquired by um by the health system prior to 78.

I think it was through like a Hearse or something like that.

So I can't I can't get that part back.

But anyway, so uh I was asked to present just kind of just a general overview of like you know what we do, our response time, some of the metrics that you know we follow.

Um and I can talk about you know our relationship with the health system since you know I am I I work for Norman Regional, so we're a department of the health system, so interrupt me at any point and I will answer things.

So just to uh just to start the overview.

We have in our fleet, we have 21 ambulances.

Are they all deployed at once?

No.

Um, but and we'll get into the staffing here in just a little bit.

We do have six support vehicles, so those would be like supervisor vehicles.

Uh, and then as far as our staffing goes, we have five ambulances that we staff 24 hours a day.

So, and you know, we work very closely with the Norman Fire Department.

So if you think about the nine stations, we have we have three here in Norman, but they have multiple ambulances per station.

Um, but then we will ramp up during our volume as it peaks up like during the day.

So at three in the morning, we're not doing a whole bunch.

At 3 p.m., we're doing everything.

So past two of my trucks on the way here.

Um, and so and then on other days, such as, and I'll talk about like like OU football coverage and stuff, you know, then we ramp up, you know, even more, you know, from there.

Uh so these are the locations of the three fire, excuse me, three ambulance stations uh in Norman, and then we also have a station of Moore, as some of you may know.

Um we also have a contract with the uh city of Moore.

Chief Marlar is here representing Moore.

Um, and so we've had that contract since 2015.

We also respond to the city of Goldsby, uh, so we have a contract with them for the very northeastern portion.

So we do go into McLean County as well.

Now, as compared to Norman Fire, which is limited to the city limits, we also go into uh unincorporated Cleveland County as well.

So we will go all the way to Pott County Line, we will go north into some unincorporated areas where we will have either more fire or we will have most likely Oakland City fire respond as well.

Okay, I have a question for you.

So all those ambulances are dispatched from those four locations no matter where they go in Cleveland County, or speed.

Yes, that's correct.

So or wherever they're located at the time, they may be you know in transit for things, but yeah.

So but those are our four, those are the only four stations that we have.

And it is Norman PD dispatch, yes.

So we have two different dispatches.

So in Norman, we use City of Norman dispatch and more we use the City of Moore dispatch.

So and our radios, you know, go back and forth between the two.

Um yes, those are our two dispatchers.

So we do not dispatch ourselves.

I do not want to get into the dispatch business.

We are happy to pay you all money to do that for us.

So we push money back into the city of Norman.

So just so you know.

Okay, so those are the locations of things.

So I'm just gonna go into because since this is my first time presenting, you know, everything about uh about what we do.

I'm just gonna go a little bit into the licensures here.

So we have three basic licensures.

We have an EMT emergency medical technician, so that takes about a semester of college, and what they can do is exactly as the name implies, they can do basic functions in there.

So they can do assessments, they can help out with certain trauma bandaging and things.

They have very limited knowledge when it comes to say like anatomy and physiology, they're not really giving a lot of medications.

Then if they do another semester, they can get what's referred to as an EMT advanced and they can do a few more things.

If they're not breathing, they can start IVs, intravenous lines on patients that can get some fluids.

And then the highest licensure that we have is a paramedic.

And so that is about anywhere between 18 months to two years of schooling.

If you're equated to something on the hospital side, be like a registered nurse, you know, but for the pre-hospital setting, and they can basically do anything.

We all work under the license of medical directors.

So Dr.

Trey Kramer is our medical director right now.

And so he writes the protocols that we can do.

So if you're used to watching, I almost included the slide in here to see if anybody caught stuff, but like you're used to watching like you know emergency back in the day with Johnny and Roy.

I mean, they had a call in for every single little thing.

Can I do this?

Can I do that?

It's so much more efficient now to do the training ahead of time so that people are understand that they can operate under certain protocols, so like SOPs, you know, in a sense.

That way we don't have to call in the event of an emergency.

We only have to call for just like a few things.

So that just speeds up patient care and gets us, you know, where we need to go faster.

But the paramedics can do, I mean, basically anything, uh IV medications, airway management, anything that would be required short of uh surgery in the field.

I mean, we can basically do that, which that does happen sometimes if we call surgeons out, but that's pretty rare.

And then uh the the other one we have, and it's not really like a licensure, but it's just more advanced training, is that we also have a critical care paramedic, so that's additional training outside of paramedic school, and basically this doesn't apply to the pre-hospital setting as it does between interfacility transports.

So, for example, if we have a patient who is brought to an emergency department and they need a level one trauma center, Norman Regional is a level three trauma center, which means they can do a lot of trauma, but they can't do all traumas.

So at the level one trauma center in Oklahoma City is at OU.

There's a level two trauma center at Baptist.

We also have uh trauma centers up in Tulsa.

But what we would do is let's say the patient is connected to a whole bunch of ventilators and medication IVs and blood tubing and everything, that's gonna require specialized training.

And so, and that's a little bit more beyond paramedic school, so they get their critical care paramedic.

So, pretty much any patient type that needs to go between Norman and another facility, we can transport those patients.

Now, if it's gonna be farther away and time is critical, then that's where you know we would recommend to the hospital that that person needs to go by air.

So if if it's an emergent and they need to get up to Tulsa for some reason, then we're gonna say, hey, you know what, we need to call for a helicopter.

Okay.

All right, and then we also have some kind of some other specialty training within here.

Um, so we also do disaster response.

So we have a disaster medical response team, and uh they have specialized training, and basically they will they get employed any time that we're having anything that is going to have the potential for being a mass casualty incident or an MCI.

All the medics are trained in ICS, um, and then we uh we would deploy them, you know, as necessary.

So we will put a lot of them on call during storm season, which as you all know starts January 1st and ends December 31st.

Um so but any time that we have something to where we feel like there is a credible significant event, then we will put the DMRT team, you know, on standby.

Hazardous materials, we do still do a little bit of the training for that.

We leave the majority of that to the fire services because they they train more, they they're the experts in that.

But we also do have medics who are hazmat operations and tech level trained.

I'm tech level trained.

Um, but the medics mostly focus on the medical side to things.

So, whereas the firefighters are going to be looking at how can we plug this, how can we dam and dyke, how can we mitigate this hazardous response?

The medics are gonna be thinking, okay, what are the what are all the different chemicals that are being you know used or people being exposed to in this, and what do we have that we can counteract things?

Okay.

So uh critical care I already mentioned, and then um we also have our SWAT medic team, um, so that works closely with the Norman Police Department and the OU police department, Cleveland County Sheriffs, Moore Police Department.

So these are so these are uh paramedics and EMTs who train alongside the SWAT officers.

Uh they do not carry weapons.

I mean, their whole purpose is to one be there for the officers and two also be there for any victims they may encounter.

They um they do drills all the time.

When we opened up our Norman Regional Nine facility a few years ago at Southeast 12th and Highway 9, um, we did uh before it even opened up, we did some drills in there.

So, and David, our council member, I think you know, one of your teams, you know, was down there, you know, for that.

So it was really good to go through that.

We did an armed intruder drill, and so we we got a lot of really good uh information, you know, out of that.

So um, and so anytime that there's a warrant service being served, you will have our SWAT SWAT medics, you know, there for the for the officers.

Okay, and then the other one on here, bike medic, you can see Justin up here attending to someone at an OU football game.

That is this is something that is actually somewhat unique to us.

So we've traveled for or actually for a lot of you all who've traveled around to other sports venues and seeing you know like what sort of medical response they have.

Most places are kind of like think of it similar to what you'll see up at Paycom if you're going to a thunder game, you know, they have some first aid rooms in there, and it's like if there's a problem, then you have to go find them, or you have to flag somebody down.

Whereas for us, we have bike paramedics who are all over the stadium, and we just we have found that is the quickest, fastest way to get to patients.

And they have in their satchel bags, they will have um just it's they're like the little mini ambulance.

So they can pretty much do the majority of things that we can do in the back of the ambulance, but we're doing it in section 19 road 20.

You know, so it just depends on what it is.

Um, and we also have a Gilmer Jones facility.

I'll just kind of like move into our special event responses.

So for OU football games, I mean, just like Norman PD and everybody else, I mean, we ramp up as well.

So, and just because things are happening at the stadium doesn't mean that there's not going to be a wreck at Highway 9 and 84th.

Okay, so the city operations, you know, still continue with things, but we ramp up quite a bit.

As you can see on the picture on the right, um, that is our Gilmer Jones.

So if you're not familiar with the stadium, just inside um gate six, and uh below section 19 is the Gilmer Jones Medical Facility, and so Norman Regional has the contract for providing emergency services at no cost to anyone who's inside the stadium.

And so we go inside the stadium, outside the stadium.

Uh we also have crews down on the field and also kind of strategically placed throughout the stands, so that if something you know happens anywhere, um, our dispatch center, uh which is obviously located over the ECLC during that time will let us know where patients are.

So it's me.

Yeah, I'm curious.

Uh, do you have an average for how many events that you see at one of these special events, like a game or even Norman Music Fest?

Sure.

So for an OU football game, uh, earlier in the season, we will run anywhere between, oh, I would say 60 to 100 patient contacts.

Um, so and that's usually heat related uh earlier in the season, and then by the time we get to the last game, that's probably gonna drop below 30.

So, and then some of those will go to the Gomer Jones facility and some of those will not.

Um, so one of the nice things about having paramedics on bikes in the field is that if we see somebody who goes and we go, hey, you know what, Councilmember Hinkle looks like he's uh maybe just had a little too many to drink, you know, we can probably get him over to the um over to Gomer Jones, and you know, we can get an IV in you and we'll get you hooked up so you can get back over to Section 104 and you know cheer on the Sooners.

So, however, if we go, you know what, um they've got a they're having a heart attack, that doesn't need to go to Gilmer Jones, that needs to go to an emergency department and to a cardiac cath lab.

So we can see that there in the field, and then we will take them from wherever that person is right there, and we'll take them straight to um to an ambulance and then we'll transport them out.

Yes, I was just curious on what is the uh highest level of care that you can provide at the Gilmer Jones.

The highest, so we have an emergency room physician there, and we also have emergency room nurses there.

Uh but it's uh to answer your question as far as like the level of care, they're able to start IVs and get some fluids, and they can give certain medications.

They do have a defibrillator there.

They have, and we have an ambulance on standby in there, so we can provide all the normal care that we can for an ambulance, but uh things that like a physician would not be able to do in there is if somebody had an impaled object, you know, like in their chest and stuff, or not they're not able to you know crack open their chest and do that sort of stuff.

So but we recognize that stuff pretty early.

In other words, if we see something that's like, oh, we can't do this here, we're gonna call for an uh a street truck and we're getting them transported out pretty fast.

Okay.

Yeah.

Okay.

But you can see a list on here of the other events that we do.

Um so, but back to the the question about like Norm Music Fest, we will see Norm Music Fest is pretty pretty chill on our side.

Uh the things that we will see are usually intox related, um, and usually they're going through the police department.

So if they go through us, um, I mean they've they've got to be you know pretty intoxicated.

Uh, but we will have probably a dozen or less calls, and and the majority of those do not get transported.

So I would expect more, but that's actually good news.

Yeah.

But if I if I were to go to the next line down to the media fair, we are going to see more things there.

Um because we I would say that we have a different um patient demographic that we will see out there, people in a variety of different uh health conditions, um, and depending on how warm and hot it is and how much people have had to drink at that event, um, and depending on how much uh sword play they're doing, you know, we may see some traumatic events as well.

So, but typically medieval fair is it's less trauma, it's more medical.

I mean, we'll see a lot of you know sick people who want to go out there.

I mean, it's a very neat event, but we will you know encounter that, and we will have bike medics out there, it's just faster to get to the patient, that's what we've determined.

Okay, and then we have a really good working relationship with the athletic departments, you know, not only for OU but for Norman, uh, the city of Moore, also little acts.

So on any given Friday night, now that every high school has its own stadium.

Congratulations to all this to all of them.

Now, the the challenge for us is that now we are doing standbys for every single one of those.

So if all of them had a home game on the exact same night, we would have to cover six stadiums, so three and more, two in Norman and one little X.

So that doesn't happen very often, but and we're happy to do it, and uh we've got a good working relationship with all those different areas.

Okay.

Okay, getting into some other things on here.

So one of the things that I want you all to know is that we do surveys.

So for every patient that we transport that we take to one of our emergency departments, they will get a survey.

And that's the same thing, and that is one of the benefits of being a hospital-based EMS uh service is that Norman Regional sends out surveys to everyone who uh is seen in the emergency department comes in for a outpatient lab or whatever the case may be, and they will get this, you know, like a day or two later, and it's basically how was your rhyme?

You know, how did we do for things?

And I'm really pleased to uh present that you know we have really good survey data on this, so very few critiques on things.

So we're also with the person a very short amount of time.

Um I'll tell people I'm like, you you can be nice for 30 minutes.

Okay, you should be nice all the time, but you can definitely be nice for 30 minutes.

Um, and so but we get this.

I report this out in our quality committee.

Um, so we also have just so you know, we have a quality committee that meets on the third Thursday of every month, and we have representation, uh, three areas from the city of Norman from Norman Dispatch, Norman PD, and Norman FIRE.

So we also have more fire and more PD and more dispatch, you know, and basically all kind of our key partners, and then some partners within the health system.

So, and we report out on all this data, and so we will show the survey scores, good or not so good, um, and then individual comments for things, but we do get feedback from our patients, you know, how can we do better?

So that's part of it.

Kind of run through the numbers just a little bit, so I can't.

Oh, yes, of course.

So, what we're looking at on here is so this is referred to as a net promoter score.

And so the we're also tied to the emergency department survey scores, which means that they're not just getting an EMS survey, they're getting an emergency department with a few EMS questions, and the questions are these right here.

Um, that zero to ten really relates to the emergency department visit.

So on every single Norman Regional survey, they will say on a scale of zero to ten, how is your visit?

You know, and so, and then moving down here, a nine or a ten is considered a promoter score.

That's the green.

The amber there in the middle is a passive score, that's a seven or eight, and anywhere from zero to six, that is a detractor score.

In order to get the net promoter score over here, that is you take the promoters and subtract the detractors, and that gives you this net promoter score.

And then you can also benchmark that amongst you know, like other like facilities.

So there isn't as much EMS data in here because everyone kind of does their own thing.

So, like other agencies will probably just do kind of like a homegrown thing where there's somebody who works there who will make phone calls.

We use a national uh survey group here, um, so which is very nice, but they can benchmark us.

Um, but all the scores that we see on here, like 87 through 72, these are all, and I know the scale, you know, is is gonna be new for everybody, but I mean, these are all really good.

I mean, I like seeing green graphs on here because this tells us that you know, compared to other EMS agencies that use NRC, we're doing really well.

So it's like a light scale, and then uh the uh the gap, I guess it's between your benchmark and your score.

Yes, and the gap is similar, and that is that who does similar, who who picks the similar uh NRC does.

Okay, yes.

All right, moving on to our call volume.

So you can take a look at from 2015 until and this is uh by calendar year, and I have it broken out by town.

Um Norman tends to grow the volume just a little bit, and I will in the next slide I'll show you how our volume breaks out because we do more than just 911 calls.

Um, and then you can see how that breaks out between Norman and also the city of Moore.

I do want to point out if you're able to see it here from 2023 calendar year to 2024, how it just dropped a little bit, kind of you know, a little bit flat.

Part of that had to do is that we lost 2800 calls when we closed the Porter Campus because we were moving people between campuses between Porter and Helplex.

You know, you can't a patient walks into Porter emergency department and they needed you know, X, Y, and Z.

Well, that wasn't offered at the Porter Campus, so now we have to transport that patient to the helplex, and then vice versa, if somebody walked into the helplex.

So that was about 2800 calls per year.

But we've also seen an increase in the number of transports that we do out at Norman Regional 9, because as the volume is no longer at the Porter Campus, it's people still need to come into the emergency department.

Where do they go?

The majority of them go to the Norman Regional Hospital, what we used to call the Helplex, and then the others go to Norman Regional 9.

As more people go to Norman 9, there's more people who need to be admitted.

And so, and since it is not a hospital, it's a freestanding emergency department, there are no inpatient beds there.

And then what we do is they will call us and they will say, Hey, you know what this person needs to be admitted, and we will take them at no charge.

So any time that we move a patient, and so this would be a I know this is a good uh constituent question that gets asked is do we charge patients that we move between our facilities and the answer is no.

So if we pick you up in the field and take you to the emergency department, yes, that is a bill.

If we if you're at the emergency department and they say, hey, we need to send the send you to OU for something we can't do, that's a bill.

But any time that we move people between our facilities, there is no charge for that.

Yeah.

This slide here you mentioned about going south outside the city limits.

And so is that a third category?

So that I I I lump I lump Goldsby into I lump any of those sort of things into like the Norman numbers and stuff.

So there's a little bit of Goldsby, we don't we run about it's it's it's about 300-ish calls in a year, and anything that is inside Cleveland County that is just outside of Norman City limits, I mean, that's probably I mean 10 calls a year, if anything.

So I would say it's very minimal.

Um where we have seen a lot of growth is we have seen a lot of growth in the city of Moore.

Um, as Chief Marlowe, I'm sure could confirm, you know, in more, I mean, it just the 911 volume continues to grow at a higher percentage rate than we see in Norman.

Um, so more is interesting in that they will do nothing, and then they will do everything like that.

Um, so for example, uh, like we have two ambulances up there 24 hours a day, and then we have a third ambulance that shows up, you know, kind of like a midship during our peak periods.

Um, but we had like Tuesday morning between 6 45 and 7 30 in the morning, we had five calls drop, you know, like during that time.

So that's unusual and stuff, but we're able to backfill that with ambulances from Norman.

And if we're not able to, then we do what's called mutual aid and we call for IMSO, we call for somebody else to help us out.

Here's how um our calls break out as far as what different types.

This was for the month of August, but this is pretty representative of the entire year.

Um, so emergency response, the 74% on here, this is going to be for 911 calls that we're doing.

This 14% up here, this is going to be emergency interfacility transfers.

And we say emergency, it can be code one, which is no lights or sirens, or it could be co-3, which is lights and sirens.

Um, so but that is moving people between our facilities.

Um, this we also have uh this other routine medical transport, that's the 10%.

Those are patients at the hospital who need to be discharged and have to go by ambulance.

So if we're taking somebody back to a nursing home or to a long-term acute care facility or back to a residence, you know, and they have to go by ambulance, and that's kind of what falls into there.

And then we have some other things in here as well.

As far as our disposition and what this means is that as we respond to a call, what you know, what sort of transport mode do we have from that?

The majority of the call transports that we have, the 64% is non-emergent.

So we try not to use our lights and sirens if we can avoid it.

And we actually have a study going on right now to see if we can use less lights and sirens on the way to a call.

So right now, if you call 911, you got a step toe, ambulance, lights and sirens.

So there are other systems that are trying to decrease the amount of lights and sirens, you know.

But that that's a uh the project that we you know, we will work on with the fire department and dispatch, you know, to have you know better criteria for that.

So because what may come out as you know just sounds like a simple fever.

Now this person is in septic shock and they're about to go into cardiac arrest.

So that's why having good robust um you know, dispatch, which our dispatch is fantastic, you know.

I mean, they they screen things very well, but it's also you know, the they can only base things off of the information that they are given, and nothing is going to replace doing a in-hand, you know, on the scene hands-on uh assessment, you know, by a licensed person.

Uh why would you want to increase the number of no lights and sirens?

I don't.

No, I would I would want to decrease it.

No, I mean, uh we restate that.

Oh, why would you want to uh decrease the number of lights and sirens?

So lights and so basically it's it's going to be the risk factor on there.

So every time that we turn on our license sirens, I mean there is a risk to ourselves as well as to the general public.

Now, all the medics go through emergency vehicle driver training every single year.

We have cameras in the ambulances that have gyroscopes that get set off if there's too much of an acceleration, a J turn, a deceleration.

Um, if they if the medics get on their phone, which is against policy and illegal, um, if they get on their phone, then that alerts us if they don't have their seatbelt on.

So we have all these things, you know, too, and we and we use it more for education, we're not trying to get anyone in trouble.

Um, but we also know that I mean, driving licensed irons and navigating through traffic, it's dangerous.

So there was a call 10 plus years ago in Oklahoma City at 10th in May where there was a medic who was driving 80 miles an hour down 10th Street and collided with someone and they killed him, and that paramedic went to jail.

And so I don't ever want you know that situation.

So anything that we can do to decrease the risk, you know, associated with responding to people, the better.

And if we're able to feel more comfortable with the EMD dispatch, that's our mercy medical dispatch, um, to where we say, you know what, I think that step toe is probably really a step toe.

Do we need to scream through you know town, you know, for that?

I would say no.

You know, I'd like to decrease the risk to not just you know my medics and the ambulances, but also to the citizens who are driving through not expecting that an ambulance is going to be coming through.

So is that answer your question, sir?

Absolutely.

Okay, good, thank you.

And then destination on here, Norman Regional Hospital is the number one place that we take patients to.

I also want everyone to know that we will take patients where they want to go.

And that is a question that we get asked.

It's like you work for Norman Regional, does that mean that you have to take patients to Norman Regional?

No, it does not.

Um, if somebody says, Um, you know, I'm established with a physician up at Heart North, let's go.

Now, at the same time, if someone has a critical situation to where we feel like a closer, more appropriate facility is warranted, then we will have that conversation with them.

So if we are at you know, Southwest 24th and Highway 9 and somebody is having a heart attack, and they say, Well, my cardiologist is up at Heart North.

I'm gonna say, well, we can take you up there, but I can't promise that you're going to get up there that you're increasing the risk of you going into a lethal cardiac arrhythmia and dying on the way up there.

However, we've got a cardiac cath lab.

In fact, they're on the phone right now, prepping for you as we speak.

And so we consider time as muscle, just like with strokes, time is brain.

And so if we can get you there sooner, and we'll get that correct, and then if we need to get you up there later, let's do that.

And I mean, nobody nobody says no to that.

They're like, Yeah, give me to the closest place.

So, yeah, but we will take patients where they would like to go.

Now, within reason, if somebody says, hey, you know what, I've established with my doctor at Parkland in Dallas, I'm like, so probably not.

Okay, and then destination summary, that's just the percentage on here for things.

We also have some other measurements that we have, uh, so like out of shoot times.

This is how long it takes from the moment that we are dispatched from a call until we go en route to the call.

So we want to make sure that the medics are getting en route as quickly as possible.

We keep this, we try to keep this underneath uh under a minute, and so and that's that's pretty consistent for things.

And we have seen some deviations with this, um, where um, and sometimes this is like in the overnight hours, and it may take somebody a little bit longer to get in service because some of the medics have worked 24 hour shifts, which we are changing away from that.

Uh, but when they have done that in the past, they may be asleep because we have stations, just like say the fire department, and so if that gets up a little too long, we can track this down to the individuals.

And sometimes we find out there was a problem with the station tones going off overhead, so they weren't able to hear things, so it wasn't their fault, you know, it was our fault.

So, but that is something that we track.

Another one of the things we track is the response times.

How long is it taking us to get to a call?

So this graph is for the last 180 days, and this shows the response time, the 911 response times in the city of Norman, right here, and that is eight minutes and three seconds.

Okay.

Now, um, this stays pretty consistent.

Um, and this is all throughout Norman.

So if you were to ask me, and I I'm not able to break it down by ward, but if you needed to buy zip code, I mean that's information I can provide to you all.

So I will tell you that if we're going out to 73026, then that's gonna take us a little bit longer.

That actually goes up to about 13 minutes, as you might expect.

Okay, so but the nice thing is that we've got station five, we've got station six out there, and so and Norman Fire Department is ALS, so they're gonna have paramedics on the fire engine.

So the patient's still getting care.

So, in other words, we're not delaying the care, we're just delaying how long it's taking to transport, you know, before we get there and stuff.

So, but the nice thing is that if the firefighter paramedic has already started the IV, put them on the monitor and said, here's what's going on, everything, we grab them, we go, scene time is so much so much um shorter.

And so we really appreciate our fire partners both in Norman and in Moore for being able to do those sort of things.

Now, one thing I do want to point out to you all, and this is just some interesting information, and we go over this in our quality meeting, these are the transport times.

So I was showing you how long it takes to get to a call on average.

Now, how long does it take to transport somebody realize that when we're going to a call, we're going licensed irons when we're transporting, you know, 64% of the time we're transporting without license irons.

So, how long is it taking us to get to places?

Well, the um the time range that I have on here, if you can see is from the beginning of January of 24 until June, the end of July, excuse me, of 24.

The reason I picked that date range is because that is right before the Porter Campus closed down.

So basically up to this point, we had two hospitals in Norman that we could take patients to.

We could take them to Norman Regional Porter Campus or to the Helplex campus.

After the Porter Campus closed down, the majority of the patients that we transport are going to Norman Regional Hospital at Tecumseh N36th.

And so that has now extended our transport time.

So if you look at this for 1336 before portal close, and then I take a look at the rest of the calendar here after that, now we're up to 1506.

And so that's it's a little bit more than a minute.

But I mean, if we need to go license sirens, you know, we will still do that.

We do take patients to Norman Regional 9.

We also have a facility in the city of Moore, so at 700 South Telephone Road, just north of the Warren Theater, and we will transport patients up there.

However, if we see a patient that we feel is most likely going to get admitted, in other words, they'll probably need to go to the ICU or be seen overnight.

We're most likely going to transport them to Norman Regional Hospital or their you know their destination of choice.

Um because if we take them to our facility in Moore or to Norman Regional 9, then we're gonna have to go pick them up later.

And so what we're doing is we're saving them and us an extra transport.

Okay.

And then before we get back in service, and different hospitals have different um turnaround times for that, or what we would call patient offload times.

And so Integers Baptist in the month of August was you know the highest up here, so it was taking you know around like 12 or so minutes, you know, from the moment they arrived at the facility until they handed the patient off.

Normal regional hospital is down here at fourth at about eight minutes.

So I mean that's that's a that's a decent turnaround time.

Um the city hospitals, it just kind of depends.

I mean, they all get busy like everybody else gets busy.

Um so what we try to avoid is what we call wall time or bed delay, where you show up to an emergency department, say, Hey, I have a person, we need a room, and they go, We're full, you're gonna have to wait.

And so what ends up happening is that the ambulance and patient wait with the patient on the cot against a wall, and they wait there with them until a bed becomes available.

Right now, nobody's waiting anywhere here in about a month or two, it's gonna get a lot busier because it's gonna be sick respiratory season.

More people are coming into the emergency department, more people getting admitted to the hospital and they're staying longer times.

So a lot of people don't realize that the fuller a hospital is that impacts 911 responses, you know.

So, but we also try to staff accordingly.

Is this kind of like a plug for getting your vaccinations?

I yes, I will I will I will go along with that.

So, yes, absolutely get your vaccinations.

So, all of them.

Um, and that's just offload time just for the normal regional facilities.

But they they have very quick turnaround times, so and that's just the percentage of time on here.

Um, so 80% of the time we're getting a patient turned over in under 10 minutes, and that's perfectly fine.

So, just some quality metrics also that we follow that we're very proud of our STEMI metrics, and that's an acronym standing for ST elevation myocardial infarction, and that's a fancy way of saying heart attack.

Okay.

Um, so we are um I'll I'll show the award here in just a little bit, but we're very proud of the amount of times that we're able to get patients to a cardiac catheterization lab very quickly.

Uh, we're measured by the American Heart Association, and so we get awards, you know, from them or recognition, you know, for the fast turnaround times we have.

I'm just gonna skip down to this this little thing.

Do do so we have the American Heart Association Mission Lifeline Gold with honor roll, which is the first time you're seeing that sort of award, but I will tell you that we're the only EMS service in the state of Oklahoma that has this, and we get it every single year.

And this is also another benefit of being a hospital-based EMS service is that you know we work with our hospital, and this isn't a dig at any other service or IMSA or anybody, it's just they gotta work with everybody, and that that can be challenging.

Um, so we work with Norman Regional, and I mean we're getting patients into our cardiac cath lab so much faster.

So all of our heart attack metrics, you know, on here look really, really good.

So uh this the STEM alert or the heart attack alert, what that means is that 100% of the time we recognize that somebody is having a heart attack.

We can see that with our cardiac monitor.

We call the hospital immediately and we say they're having a heart attack, and then if it's two in the afternoon, they will clear a table, you know, for a cardiologist to get ready for the patient.

If it's two in the morning, they're paging that person out.

So they're not waiting until we get to the hospital, and then the team gets paged out.

And so, and that's another reason why if you know somebody's having chest pain, call 911.

I mean, for people who think, well, I think it'll just be faster, like if I drive them in.

You may physically get there faster, but we're gonna get to you sooner.

We're gonna start treatment care, and then we're also gonna get all the systems paged in place that you need to have done.

The other thing is that, and we've seen this several times, and it's unfortunate is that you know, somebody's having you know a heart attack, the wife throws the husband, you know, into the car and it starts you know driving very quickly to the emergency department, and then something happens.

You know, she's driving or he's driving, you know, and then they get into a wreck, or worse, is that the patient goes into a lethal rhythmia and they go into cardiac arrest, and then they have to pull over and call 911.

Whereas if they'd called us early, we could have gotten to them sooner, seen them on our monitor, give them medications, given electricity if we need to.

So chest pain equals call 911.

Um, and then our stroke metrics as well.

We're very proud of uh the care that we deliver to to our stroke patients.

Very similar sort of thing.

We look at our scene time, and what percent of that time is under 20 minutes, um, 14 minutes.

I mean, that's very quick to get in there and recognize that someone is having stroke-like symptoms.

And if they're having what I would call a more severe stroke, then we will take them instead of normal regional, we will take them up to OU.

OU can do a few more things that normal regional cannot, and part of that has to do with doing clot retrieval.

If they have an ischemic stroke where it's a clot in there, they can actually go in and grab that plot and pull that out.

We're not there just yet.

Um, we will give like a medication that will go in and break it away.

It's called a thrombolytic.

Um, but the medics can recognize the difference in the field through the training that we give them on this type of stroke goes here and that type of stroke goes there.

So very proud of our stroke metrics.

Um, let's see, and then trauma metrics, the same sort of thing.

In the past, you know, what one of the things that we would do for a trauma patient is that we would do everything that we could on the scene as much as we could was start the IVs, go on the monitor and everything.

But you know, what literature has shown time and time again is that the best thing that we can do is get them to the hospital.

We can try to start the IV and route because um they have what's called this golden hour, which is after a traumatic event, uh if the person gets into the uh gets to the surgery within an hour, I mean that's like that golden hour window.

Um, so starting the IV on them, we're gonna do it, but we need to get out of there pretty quickly.

So that's where our fire departments are very helpful in extricating, you know, patients, you know, who are um you know stuck into a car and stuff because while they're in there, I mean they're not you know in surgery and stuff.

And the majority of the level one trauma patients need to be in surgery and they need to be in there very quickly.

So there isn't anything I can do to fix them.

There isn't anything that the emergency department can do to fix them, they need to be you know at surgery.

And if it's at, and depending on where it is in Norman, um, if it's at, you know, if it occurs at Tecumsen I-35, we're gonna grab them and just head north.

Uh, if it's occurring at 120th and Cedar Lane, you know, or Etowa, then most likely based off of the mechanism, how it gets called in the mechanism of injury, um, we will probably call for a helicopter while we're there.

So, or before we even get there, because we're like, you know what, that head-on collision at 120th and highway nine, I know someone's going to the trauma center, and it's gonna take us you know that 13 minutes to get out there to them, everything.

So, in that situation, I'm just gonna say call a helicopter.

You know, and if we don't need them, we'll tell them to go away.

But if we do need them, thank God they're there, because then they can get to that patient to owe you even faster.

And then the last thing I'll show you on here is just our intubation metrics, and that's the uh the breathing tube I was talking about.

So that's just another thing that we measure.

Um that is considered a higher risk you know procedure.

So if someone is not breathing in the field or if they're having difficulty breathing, um, just like a patient getting prepped for surgery where they are paralyzed and they're made to go unconscious and they put a breathing tube in you, they're doing that under mostly a controlled setting where you know the person hasn't eaten for 24 hours, we're going on whatever you know is there and stuff.

So it's a very risky procedure, but the medics are trained in that and we follow that metric.

So when we do that really, really well.

The only other thing I will say is that another one of the points that uh Daryl had mentioned in the email had to do with the subscription service.

I know citizens have had questions about that, and they also have uh in the city of Moore.

We we at this time we do not offer a subscription service.

IMSA does that, um it's about like 350, 365 like a month, and that's put on the water bill.

Um Wadleys does that, they're out of Purcell and they do the southern portion of Goldsby and they do $10, you know, on the water bill, and everybody has a little bit different.

I mean, IMSS is lower because they have so many water meters, right?

Um basically the way that works is that um the citizen is billed for that, and then you know, at the end of the month, and the city, you know, pays the ambulance service for that.

And then if someone who lives in that residence had to call 911 within that service area, then and they can you know prove, hey, you know, I live at this place, and you know, we opted into this program, then you know the insurance still gets billed, but there if there's anything left over for a patient bill, then that gets wiped.

So if it meets certain criteria, that's how others operate.

So, in other words, if you if you call for that stub toe and insurance is denying it completely, we that may get denied all of a sudden and you have to pay the full amount.

So we have not done that.

Um part of it is that there was a ruling back in the early 2000s from the officer of the inspector general that said that hospital-based EMS services cannot do this, but I think that has since you know changed.

So, I mean, that that is an option.

Uh, I mean, if there is enough interest in that, if we were to do something like that, you know, we would want to do it in both Norman and more and Goldsby, you know, to a certain extent.

Um, we're not sure what that would look like and stuff.

So, but I know that there has been interest in that.

Yeah, because my question would be for people who are not on city services like trash and water, then how would they opt in?

I think that would be something that we would work out, you know, with the city, you know, how however you all would like.

Um, so I mean, I would, you know, get with I'd say finance and legal and just say, all right, you know, what makes sense for this?

I mean, would that require a vote, you know, since it is on the utility bill?

Um, but if it's citizens saying I want to opt into that, I don't I'm not sure how that would work exactly, but that's something that we could explore.

Okay.

Councilmember now five.

Uh a little bit to that.

My brothers actually use that in uh Oklahoma City, and that's why I was the one that originally started bringing that question up.

Oh, yeah.

And he told me that uh if you don't have say you're renting somewhere and you don't have a utility bill per se, then you could just pay into the city that you're whatever the yearly fee would end up being.

Yeah.

Absolutely correct.

So that again, that that is not something that I mean, we have explored in the past, but I've been getting more questions about that, and that is definitely something that um yeah, we we can absolutely look into.

So maybe even a higher elevation view.

You what is uh MSTATS budget, the cost of operations for the current fiscal year?

What is your budget?

I'm at about nine million.

And how much revenue does MSTAT bring in?

I'm probably closer to a little higher than that.

Okay.

So in other words, we we make money and push money back into the health system.

Okay.

Um we have we have the the capabilities in our Tyler technology.

Thank goodness we started that upgrade handful of years ago.

We we are capable.

Um with uh my conversation with Kyle about that maybe a legal thing now with a hospital-based um ambulance service.

Uh, if there is consensus, the council you would like us to explore that, we'd be happy to do that and bring you back those findings.

Uh and we would invite uh Mr.

Hurley to sit down and join us in that conversation to see if what is required uh for us to be able to proceed.

Would it require a vote of the people?

I kind of agree it's not this is not a utility service, it's just a billing mechanism, and you don't have to include that in your in your payments.

So I think we can get there.

Um, and we'd be happy to do that homework assignment on behalf of the council.

I would just ask because we do have the same employer and everything.

Also, is that something you feel like the health system right now would be open to looking into at least about what that would look like?

Short answer, yes.

So I mean, I think that I mean this because this would be a different revenue source for us, and so in my mind, and the way other services use this all give McLean grade a EMS, which is out of Blanchard and Newcastle.

So they're what's called a 522 district, and they get um out of the lorem, but that's by school district.

Um, so they when they so the way their budget works is would probably be similar to like how this would work if we were to go to this, is that our operational costs are paid you know for by our billing patients, and so that's taking care of the majority of that.

If we were to go something like this, then this would probably be more for capital needs, you know, than anything else, because Norman Regional does have a capital budget, and so if we're doing things like we're needing new ambulances, we're needing you know those large ticket items, you know, then we just like all your city departments, you know, compete for the same capital money.

If we were to have a different revenue source, you know, for that.

Um, now the the downside to that, well, I shouldn't say the downside, but you know, one of the things that I would have to look at is that we do get certain patient revenue, you know, from citizens, and if we're saying, hey, you know what, we're gonna wipe that because it's gonna be part of a sushi program.

I need to you know figure out you know what that would be.

That revenue offset is so um because it's one of those where I mean I would my preference would be for to sign everybody up and have them opt out as opposed to have everybody opt in so that it would make you know financial sense for us.

Um, but yeah, I mean, as far as this being like a different you know, revenue source, I mean, for for our capital specifically, I think that would be really good.

That would be helpful, especially if we're talking about doing a sort of joint venture with Norman on say like future stations, you know, and stuff, or any other joint projects, you know, that we're looking into.

So I thought I saw Councilmember Netflix.

Wouldn't generically speaking, um, we send out about 44,000 utility bills a month.

So how many, you know, what percentage would opt in?

And then you also I guess this would also have to be something that went to more city council as a possibility for them to opt in, also, right?

Yes.

If if we was to do something here, yes, we'd try to replicate it at more with our city council also.

And and I and I've had conversations, Daryl, with your counterpart, Brooks Mitchell up there about the very specific thing, because he's had inquiries, you know, as well.

So um I'm interested in exploring.

Oh, council member first.

So it covers the delta from what their insurance doesn't pay the ride.

So I guess you're right, that's 750, 800 bucks right.

Uh that's a little bit higher.

So we we we we start ours probably about 1200 and then it ramps up to about 1800.

So, but as far as like, but we will, but we also have contracts with each of the major payers and stuff.

So I mean, whatever, you know, they whatever the arrangement is in there.

So even if it's for say 1400, but you know, Blue Cross says we're only gonna pay 500, then you know, we deduct all that.

And so more times than not, there's there's very little things out there that um the patient has to pay for.

We have 33,000 um trips that we do every single year as far as transports is probably closer to 21,000.

Then one more time, it's the delta, right?

Covering the delta.

So if someone doesn't have any insurance, we're happy to that.

So then we would have to come up if we're talking about a subscription service.

I mean, we would have to come up with what that looks like and stuff.

So because we are, I mean, we already have that right now.

I mean, we have a whole bunch of uh um we would call self-insured or no pays and stuff.

And so I mean the hospital has a um a charitable and a bad debt policy, you know, that relates to that.

So I'm sure it would apply to that somehow.

But I mean, since we haven't explored it, I I couldn't tell you, you know, what we would do with that.

But we would come up with something, yes.

Any other questions?

Any other thoughts about uh exploring?

Like, do you have consensus to well?

I guess then we'll just get back to staff at another committee meeting to figure out the finer points.

Absolutely.

Okay.

We will move expeditionally.

Thank you for your time to take this.

Thank you.

Thank you very much.

All right.

How many how many rescue divers do you guys have?

Uh one.

Just one.

Just me.

Yeah.

We got one for the pond.

Yeah, one for the pond, right?

Exactly.

Okay.

Thank you all.

Save the lawn mowing guys every time they tip a mower in it.

Oh, yeah.

All right.

So now we're going to move on to a presentation and discussion regarding the use of portable restrooms in city parks.

And I'd like to recognize Jason Olson to present.

Perfect.

I have a I think we have Ben from, if he's still on, Ben from Rack and Figure Off House how to use this too.

But the uh Ben from uh Thrones, he he is we had a conversation and we've talked about it with him several times.

Uh he has this uh what we think is kind of a unique uh perspective and solution uh to some of the the things that you all have been asking for.

So I'll turn this over to Ben and let him hop into his presentation.

Thanks, Jason.

Um hi everyone.

My name is Ben Simons.

I'm based out in Seattle.

And as Jason mentioned, I work with a company called Throne Labs.

Um we um manufacture, install and service public restrooms across the country.

Currently, we are in the uh DC area, Ann Arbor, Michigan, um Bay Area of California, and LA County.

Um very broadly, um, Throne's a very mission-driven company.

We're on a mission to expand access to clean and delightful restrooms.

Um we believe that's a very important human right.

So our goal is to build a restroom that not only everyone is able to use, but also one that will actually be um pleasant to use and enjoyable to use because it's clean and well maintained.

Um we have built restrooms everywhere from Beverly Hills, so places where there's really, really high standards for what a restroom should look like, all the way to like downtown LA near large homeless encampments.

So really that goal is to create a delightful restroom experience, but one that is also robust enough and uses some technology that we'll walk through today to make sure that even when um it is treated roughly by folks, one it can get clean quickly, but also we can add some accountability to the restroom experience.

So because this is a really, really unique product, um, I'm actually going to start by playing a really quick video that I'm just gonna talk over.

It's about 20 seconds, and it'll just give you an idea of what these actually look like, and then we can talk about a couple of the really specific things that are important to um to how thrones are used and why they're so successful across the country.

So should play here.

Did not play.

Okay, cool.

So typically people are going to use their phone to enter a throne, they're gonna scan a QR code, the door is gonna open.

It is completely touchless, which is really important.

It does have running water for a toilet and a sink.

It has ventilation, it has heat, but really importantly is it can be dropped off with a forklift and activated within a couple of hours.

So there are no utility connections for water and sewer required for a throne.

Um, also very importantly is that as you can see, everyone looks pretty happy in this video.

Um, we're constantly asking our users for feedback on how the throne looks.

Is it clean?

Is there any damage?

Is there anything that needs to happen to make sure that it is usable?

Um, so that they are able to communicate with us.

And um, what's also really important is we're actually able to communicate with our users as well.

Um, here on the left side is pretty standard features and benefits that you're gonna see in any public restroom worth of salt that throne also has.

You're gonna have your running water sink and toilet, as we discussed, climate control ventilation.

We provide all the cleaning and all supplies.

What's gonna make throne really unique comes back to that um that communication and accountability um piece that we just discussed.

So when you enter a throne, as shown in the video, you're gonna scan a QR code, it's gonna auto-populate a text message on your phone.

When you hit send on that text message, the door is gonna slide open.

The first thing you're gonna hear when you walk in is a voice in English and then a voice in Spanish telling you that you have a 10 minute time limit to use that restroom.

At that 10 minute time, the lights are going to start flashing and a voice is going to start playing at 10 minutes and 20 seconds, that door is actually just gonna slide right open.

Um, there are warnings at five and eight minutes to make sure that no one, absolutely no one is surprised by this.

And it's also written on the walls all over the throne.

Um, but this is really important for a couple reasons.

One of which is actually like if there's a health emergency inside of a throne, um, there is no chance that that person is just gonna get locked in there until someone realizes and then the police come.

Um, but two, it stops people from loitering, it stops people from camping.

Um, so that that's one thing that's gonna happen.

Another thing that's gonna happen is you're gonna get a text message on your phone and it's gonna say, hey, from a scale of one to five, how clean is this restroom?

Are there any issues?

Are there any pictures that need to be taken to show us what's going on?

So they can communicate with us.

But if a user does decide to go past that 10 minute time limit, or maybe they're smoking inside a unit, that communication goes both ways.

So we can actually text them and say, hey, you're misusing this throne.

If you continue to do so, we're gonna restrict your access.

So again, thinking about accountability, not only for the sake of accountability, but also because of deterring.

Um we want this restroom to be usable for everyone because everyone wants to use the restroom.

So this is a case study from one of our roughest sites.

It's in downtown L downtown LA in Westlake MacArthur Park.

Um, five point six percent of users um actually did reach that 10 minute limit.

However, only 0.7% of users end up having repeat offenses.

So what does this tell us?

It tells us that yeah, we have you know a good five and a half percent of the public in this location that are gonna misuse a restroom.

But when we tell them that, hey, if you continue to do this, we're gonna not let you into this nice clean restroom anymore.

Their behavior does change very dramatically.

Um, so as you can see, after one minute, actually 33% of users are um excuse me, 67% of users are gone after one minute, going all the way to um actually five minutes over, where you have about 5% of users, as I mentioned, that are staying in there.

Um if they do not leave after a certain amount of time, um, we can come out to check on that individual.

If it's like an actual situation that we cannot deal with, we typically in this this scenario, our partner's LA Metro just call Metro Security.

You can also call the police, um, depends on the partner.

But point is that this um kind of loitering prevention and accountability tech leads to really strong outcomes around things like loitering, smoking, and misuse in general.

Um so not only thinking about software tech like that, but also just typical um general anti-vandalism design.

Our wraps, interior and exterior, are all graffiti resistant.

Regardless, if a throne does get tagged, we do remove that.

It's not on you.

Our interior wallpaper is very purposeful.

People don't tend to tag services like this.

There's just too many colors.

If someone does etch it, we'll just paste a new leaf right on top of that etching really quickly.

So again, thinking about that like broken window theory, we keep a restroom really clean.

People are more likely to keep it clean.

We also have a quick peel mirror.

So if anyone enters into that mirror, we can just peel off a mirror, no problem.

And then broadly, our kind of modular design means that pretty much all repairs can just be done on site.

All repairs are done by our techs.

So again, if someone vandalizes a throne, that doesn't cost the city any extra money.

That's part of our service plan, and our techs fix that.

To give you an idea of how successful we are at keeping thrones available, average uptime across all of our 85 thrones across the nation is about 95%.

So 5% of the time, thrones are either being cleaned or there's some issue that requires us to shut it down.

For instance, in this case, a user texted us and said, hey, there's defecation all over the urinal.

For us, that's a health hazard.

Our 24-7 remote monitoring team is going to shut down the unit, set a task for a cleaner to come out on an immediate basis, and then they're going to get that unit cleaned up and then get it reopened as soon as possible.

So we're relying on these messages, not only the text and video, but also an actual clean score that they give us to calculate what we call clean risk.

What are the chances that a throne is dirty?

So we're using that score.

We're also using the number of uses since the last clean, the number of uses since a last review, and the overall volume of usage.

What this all means to put it simply is that for the most part, thrones get cleaned on average every 15 uses.

In the world we live in today, that's just how frequently bathrooms have to get cleaned to keep them at a 4.3 out of five average cleanliness rating.

So that's that number that we are striving to hit across all of our markets.

Out of five, our users have given us an average of 4.3 for how clean a restroom is, which again, working in tough areas like downtown LA and also areas with a really high expectation like Beverly Hills is pretty unheard of.

Other things that you would expect to see out of a throne, we do community surveys.

Excuse me.

Do community surveys.

91% of people typically say that thrones are either good or great options for restrooms.

And then we also see just impacts on the community as a whole.

In downtown Santa Monica, we actually saw 70% decrease in public defecation.

In LA in general, they've typically seen a 50% decrease in public defecation.

So you give someone access to a clean restroom, they're going to use it.

Couple case studies here.

I'm not going to bore you guys with a ton of numbers right now, but I'll send over this deck after our call.

But basically, um this details that defecation count here.

LA and LA Metro actually does count how many, you know, number twos they're picking up off their streets.

So they have really solid numbers off of this.

LA Metro has at this point, we serve more than 250,000 uses across the country.

We're at more than a million uses at this point.

So as I mentioned, no hookups for water and sewer for your climate, we would likely need a power connection, just 120 volt because it gets pretty cold in the winter time.

Wouldn't be any issue in the summertime whatsoever.

And the question that everyone probably wants to know is well, how much does this cost us per unit?

Um, very reasonable question.

So our pricing structure works in a pretty unique way.

Um, when we're entering a new market, we'll we'll um charge a deposit typically to enter a new market that will then be taken out of the um monthly invoices as it goes.

But when we're just installing a new throne in an existing market, there's no upfront cost whatsoever to do that installation.

We just charge an annual cost that's billed monthly for the throne itself, all the servicing and all the install uh the service, the installation, excuse me, and all the servicing.

Based on the location, we're gonna select a service tier for that unit specifically.

Um, so a hub throne is gonna get cleaned on average two to three times per day on a busy Saturday, a lot of usage.

That clean risk is gonna go up pretty quickly.

So we're gonna be cleaning it probably 10 times that day.

On a rainy Tuesday, we might clean it once.

Um, so this includes everything you would need for the year for that throne.

Um something really important um to know, just as we are not currently in the kind of Norman Oklahoma City market.

Um I talked to Jason about this a few months ago, but kind of things changing on our end a little bit.

We're at this point a minimum deployment of minimum 15, more likely 20 units to actually enter a market um with the expected runway after a year or two to get up to about 25, 30 units across the metro area, which is typically we consider within about a 45 minute drive of our headquarters.

Um just thinking numbers, those are the kind of numbers that we need to see to actually enter a market to provide a cost-effective service model.

Okay, so that's my spiel.

Figure we get it all out in the open, and I'm assuming people have a lot of questions.

So I'm happy to pause now and uh have more of an open conversation.

Okay.

Um council member Bruce.

So what's the what's the smallest community you're in?

Um probably the smallest area we're in is Detroit.

Um, Ann Arbor Detroit region is our smallest market right now.

Uh Councilmember Hinkle.

On for the staff that cleans the toilets and stuff, I don't know if I missed it, but where do they come from?

Are they hired locally?

Is that something that you guys already have a footprint in this market regarding, or would that be something that you're building as you come into the market still?

Yeah, so we're building that from scratch as we enter a new market.

So that's one of the reasons that we have that pretty high minimum quantity of units to start it to enter into a new market, because we have to have cleaners and techs that are trained up specifically on a throne, right?

It's not like going into a port a potty and power washing it.

Um these are really high-tech restrictions.

They do require trained techs um and uh coordination with a remote monitoring team.

So it's something that we hire locally to do all that work.

And how many local techs uh for a rollout do you hire typically?

Um depends on the number and depends on the kind of how dense the deployment is.

Um right now in the Bay Area of California where we have 22 units or so deployed.

Um I think we have two or three techs um and then quite a few more cleaners than that.

Okay.

Councilmember no fire.

So what's the lowest number of units that you would scale out or roll out?

Um yeah, so the the absolute lowest we'd start with is likely is probably 15.

But to be honest, that number is just going up pretty frequently because we have so much interest.

So next year um we're just about to solidify deployments into San Diego and Seattle.

Um, so that lowest number is you know 15 to 20.

And then again, we would need to have like the runway to be able to increase that to 25 or 30 over the year or so after that first deployment um to really be able to scale that for us.

Councilmember no fire.

Would this be scalable for special occasions or is it that's a set number for the year?

Yeah, it's a 12-month contract.

Any other questions?

Councilmember Gainesary.

Yeah, if we was able to get other municipalities involved in the rollout, could that help bring down our initial cost investment by getting others local within that 40 mile radius?

Yeah, definitely.

Um, typically the way that we'll enter a new market is we start with kind of what we call like our flagship customer, I guess, which is actually doing a vast majority of that minimum quantity.

Um, so in the case of Seattle, you know, our flagship customers actually the city of Seattle, but we're also working with the transit agency.

We're also working with the you know the county just south of Seattle to add a couple to that.

Um so in your instance, in your case, it wouldn't be rare for like Oklahoma City to be a flagship customer that's gonna move forward 10 or 15.

Um, and then you guys are within their service area, so we would be able to do a lower quantity in Norman.

Well, if there are no other questions, uh I guess this is if Ben wants to stick around, he can, but he doesn't have to.

Thank you, Ben.

Yeah, of course.

Thanks everyone for taking the time.

Um, thank you for your questions, and um happy to hop on and answer more whenever.

So just let me know if we can help.

Thank you, sir.

Thank you.

Okay.

Thank you.

Bye-bye.

With the Olympics coming to Oklahoma City.

I just would like to add that uh since the last oversight meeting or whatever we talked about thrown last time.

Um, I've been in contact with CSC MHC, and they would be interested in also hosting one because they recognize uh their clients, even if they're closed, also deserve the right to use a bathroom.

Uh but it I feel like there would still be more work to get others to sign on.

So and then Councilmember Hinkle, you had your hand in the back.

I'm just gonna ask if has Oklahoma City expressed any interest in this, or so we send it to Daryl and Darrell send it out to city.

I've uh tried to send that out to all the city managers.

We meet monthly at the ACOG office in Oklahoma City.

Um, and it it'll be a we're all on the same fiscal year, and it'll be one of those conversations where they build it into the 26-27 fiscal year budget as part of a new program.

Um, it it's a level of service, unlike anything we could match.

We there's no way we could service the restroom three or four times a day.

Uh special events, we got more bodies, more hands on deck uh to keep the facilities fully stocked.

Um, but the this is an incredible mouse trap with uh data analytics and and metrics and uh safeguards built right into it.

Um I don't see our budget capable of absorbing 15, but the goal is to develop that market in the in the metro, and then council has the opportunity to identify those most heavily trafficked areas where this makes sense.

So we're gonna keep pushing until uh the market makes itself available to us.

And we do get to move them once a quarter.

Yeah, as they're part of the contract.

Yeah, you get to move once a quarter.

They also uh work work with your low local agencies to deal with homeless, and they'll they'll give them if they don't have phones, so um base basically give them business card with their own unique QR code.

Uh and you know, when you start talking about you know when we start talking about parks and and restrooms like that, uh, I mean, we could probably put together some math, and you know, you you start talking about the the capital costs and then the ongoing cost of us having to service those restrooms and put supplies in the restroom.

I I would think that this might you know if you start talking over a four or five year period, it might be pretty close.

Especially when they include all the maintenance, all the upkeep inside when somebody does try to destroy it or something like that.

That's all on them to replace rather than our maintenance guys going out there.

So a long-term period, of course, a permanent restroom is probably gonna um be cheaper on a long-term period.

But uh, we're we uh we're trying to get one out of Reeves, and when we had it designed, and then uh a cost estimation of it, it was almost uh it was 400,000.

And the last one what we built at Griffin was um well over 300,000, and these are just small bathrooms.

You know, they have to run plumbing, plumbing electricity, and uh we have to hit commercial standards, ADA standards, it gets expensive.

Yeah, council member Hinkle.

That was my other question I meant to ask Ben, but uh if there's no plumbing or anything that goes to them, do they just come empty them out like an RV?

Yeah.

So that they pump the fresh water in there and they take the uh the waste with them.

Very cool.

Uh so direction from us is please go find people in the market and I guess figure out what that might look like in our budget for next year if we can get momentum.

And council members in your uh duties uh when you bump into your counterparts in some of our neighboring agencies to continue to push that button and and ask them if they have been made aware of this because I mean, even a small agency, if you had one in a central park kind of location with this super high level of service, uh he didn't cool to me.

We don't have one with air conditioning.

That's really not a thing in anything we built.

Um it will be a little shocking first time you go in there and it talks to you.

That may well or when you're setting there in the door just opens.

So for OU, are you also speaking to them?

Uh I have not yet.

Uh, but I was telling council member grant the level of service that receives kids in the dorm, their restrooms don't get clean like that.

That's that's a whole new level of service.

And you think about the the expanse of their campus and other properties that they own, not just right here uh at OU Central, that they may have applications.

So Brian Holder Reed is their facilities guy, and I'll be sharing it with them.

The presentation they've given us permission to share that.

Yeah, I would be interested, like uh a pure city, like we compare ourselves to Ann Arbor all the all the time.

Uh I'd be interested to see where they they have theirs placed.

Well, now we have new relationships with our friends in Ann Arbor since we had to slap them around on the football field a little bit.

Uh but uh Mr.

Uh Milton uh Doohone is their city manager, and and uh I'll give him a call and ask him how it's going and where where his would the core is.

They're quite for the company itself, you know, if you're thinking about going on to know you or whatever in Oklahoma City and run the stadium for the thunder or anything like that.

Is there any way that they can change the outside with that was one of their options?

Could you put a custom wrap on there where I know you it just it just blends in more?

You know what I'm saying?

That was one of their options you can bug in our books.

Okay, go away green.

And too, you could um theoretically after football season move it somewhere else.

Yeah, yeah.

Exactly.

Um, there are no more questions or disturbs.

I just would be remiss if I didn't say I trust you guys to flesh out the solution on this.