* This transcript was created by voice-to-text technology. The transcript has not been edited for errors or omissions, it is for reference only and is not the official minutes of the meeting. [CALL TO ORDER] [00:00:03] NINE THIRTY FOUR. UM, SO I'LL CALL THIS MEETING TO ORDER, AS I UNDERSTAND WE DO NOT [Public Communication: General] HAVE ANY PUBLIC COMMUNICATIONS TODAY, SO THANK YOU STAFF. UM, I WILL [1. Approve the minutes of the Public Health Committee meetings on May 11 and May 12, 2022.] ENTERTAIN A MINUTES, UH, APPROVAL PLEASE. THE MAYOR MOVES APPROVAL COUNCIL MEMBER. UH, FONTUS SECOND, ALL IN FAVOR SIGNIFY BY RAISING YOUR HAND. THAT IS UNANIMOUS ON THE DAYAS WITH COUNCIL MEMBER HARPER, MADISON OFF THE DIOCESE. [2. Discussion and possible action on harm reduction strategies to address the opioid overdose crisis.] SO COLLEAGUES, WE HAVE SEVERAL BRIEFINGS TODAY. NO, WE HAVE JUST ONE BRIEFING TODAY. UH, COUNCIL MEMBER KITCHEN. AM I CORRECT IN THINKING I NEED TO FIND THE NOTES FOR MY STAFF HERE? UM, AM I CORRECT IN THINKING CENTRAL HEALTH IS HAPPENING AT A LATER DATE? OUR CENTRAL HEALTH BRIEFING? I BELIEVE THAT, SO I FELT WE WERE GOING TO DO IT TODAY, BUT I GUESS NOT. SO, YEAH, I'LL, I'LL FOLLOW UP ON THAT IN JUST A SECOND. ONCE I REVIEWED MY NOTES, I BELIEVE WHAT HAPPENED IS THAT WHEN WE NEEDED TO CANCEL OUR MEETING LAST WEEK, BECAUSE THREE OF US HAD A CONFLICT AND WE COULDN'T REACH QUORUM, WE IN ENDEAVORING TO RESCHEDULE, WE COULDN'T GET OUR PRESENTERS AND OUR CO AND ENOUGH OF US HERE ON THE SAME DAY. AND I BELIEVE CENTRAL HEALTH HAD A CODE THAT WHAT HAPPENED. YEAH. SO I THINK, I THINK THAT IS WHAT HAPPENED, BUT I'LL CONFIRM THAT HERE IN A MINUTE. SO WITHOUT FURTHER ADO, I WOULD LIKE TO MOVE ON TO [3. Briefing regarding harm reduction strategies to address the opioid overdose crisis and an update on City actions since the passage of Resolution No. 20180524-038.] OUR BRIEFING ON HARM REDUCTION STRATEGIES. AND AS I UNDERSTAND, WE HAD SEVERAL SPEAKERS, SO I'D INVITE THEM TO, UM, UH, I BELIEVE, LET'S SEE, ARE WE BEGINNING WITH AN INTRODUCTION FROM OUR STAFF OR ARE WE BEGINNING WITH OUR SPEAKERS? LET'S LET'S INVITE OUR SPEAKERS UP AND IF YOU WOULD PLEASE INTRODUCE YOURSELF AS YOU COME UP. HI, GOOD MORNING. GOOD MORNING. AND THANK YOU FOR YOUR WILLINGNESS TO SHIFT FROM LAST WEEK TO THIS WEEK AND TO BE HERE TODAY. WE APPRECIATE IT. YEAH, OF COURSE. UM, SO I'M KATE GRAZIANI I'M WITH THE TEXAS HARM REDUCTION ALLIANCE. UM, AND THIS IS PAULETTE PAY EVERYONE. UH, GOOD MORNING. MY NAME IS PAULA SOLTANI I'M WITH THE TEXAS HARM REDUCTION ALLIANCE AND I'M THE ORGANIZING DIRECTOR. UM, AND I THINK WE WERE INVITED HERE TO TALK TO YOU ALL ABOUT THE OVERDOSE CRISIS THAT WE'RE IN THE MIDST OF AS A COMMUNITY. UM, WE HELD A TOWN HALL, UH, LAST MONTH TO DISCUSS WHAT WE FEEL LIKE IS A PUBLIC HEALTH EMERGENCY. UM, AND THEN THE COUNTY RECENTLY PASSED THEIR DECLARATION, UM, AROUND THE PUBLIC HEALTH CRISIS RELATED TO OVERDOSE DEATHS. SO I THINK OUR BRIEFING TODAY IS GOING TO TALK THROUGH A LITTLE BIT ABOUT WHO WE ARE, WHY WE'RE HERE, WHAT'S GOING ON WITH OVERDOSES IN OUR COMMUNITY RIGHT NOW, AND THEN SOME STRATEGIES, BOTH SHORT-TERM AND LONG-TERM STRATEGIES THAT WE NEED TO BE LOOKING AT. UM, SHOULD WE JUST GO THROUGH THE SLIDES? I DON'T KNOW. HOW DO WE DO THAT? UM, YOU CAN ASK, YOU CAN ASK THE STAFF TO ADVANCE THE SLIDE. THANK YOU. NEXT SLIDE. UM, YOU CAN, YOU CAN KEEP GOING THROUGH UNTIL WE GET TO THE PRESENTATION OR YOU CAN NEXT ONE. YEAH. SO THIS IS OUR AGENDA FOR TODAY. UM, DO WE HAVE A TIME LIMIT? WHAT, HOW MUCH TIME ARE WE ALLOTTED? OKAY. UH, WE WELCOME, SORRY, CHAIR. THE VICE CHAIR. THAT WAS NOT ON THE, I DON'T THINK YOUR MIC WAS ON. THERE'S NOT A TIME CERTAIN OR A TIME LIMIT FOR THEIR PRESENTATION. OKAY. I THINK WE HAD, UM, TALKED WITH THE SPEAKERS ABOUT AN ESTIMATED TIME. UM, DOES 15 MINUTES WORK FOR YOU ABOUT 15 MINUTES SO THAT WE HAVE PRESERVED ENOUGH TIME FOR Q AND A, BUT IF CERTAINLY IF YOU NEED MORE TIME, WE CAN DO THAT. NO, I DON'T. IT'LL BE A SHORTER PRESENTATION TO MAKE SURE THERE'S TIME FOR DISCUSSION. UM, OKAY. NEXT SLIDE. UM, SO JUST TO START, UM, AND I KNOW THAT Y'ALL HAVE LOOKED AT THIS ISSUE MANY TIMES OVER THE YEARS. UM, SO I HOPE YOU KNOW, MOST OF THIS, BUT IT'S IMPORTANT FOR US TO START WITH THE WAR ON DRUGS TO KIND OF CENTER THE CRISIS THAT WE'RE IN RIGHT NOW. UM, ONE OF THE THINGS I WANT TO EMPHASIZE IS THAT, ALTHOUGH WE TEND TO KIND OF LOOK AT INDIVIDUAL CHOICES WHEN IT COMES TO OVERDOSE AND DRUG USE, IT'S REALLY A SYSTEM LEVEL PROBLEM. THAT'S FUELED BY CRIMINALIZATION AND THE WAR ON DRUGS. UM, AND WE HAVE SPENT SO MUCH MONEY ON THE WAR, ON DRUGS AS A NATION AND AS A COMMUNITY OVER THE LAST 50 YEARS, REALLY TARGETING BLACK AND BROWN COMMUNITIES, POOR COMMUNITIES, AND IT HAS DONE NOTHING TO CURB DRUG USE. UM, SO ALL THOSE RESOURCES, THE VIOLENCE THAT IS COMING, THE NAME OF THE WAR ON DRUGS HAS LED US TO WHERE WE ARE NOW, WHICH IS IN THE WORST OVERDOSE CRISIS THAT WE'VE SEEN. UM, AND REALLY THE WAR ON DRUGS, WE CONSIDER A HUMAN RIGHTS DISASTER. UM, NOT ONLY FOR THE, THE VIOLENCE THAT'S CAUSED IN COMMUNITIES, BUT [00:05:01] ALSO BECAUSE OF ALL ITS IMPACTS BEYOND, UM, THE IMMEDIACY OF ARREST AND INCARCERATION AND VIOLENCE. SO CRIMINAL HISTORY AFFECTS EDUCATION, HEALTHCARE, HOUSING, IMMIGRATION, EMPLOYMENT, EVERYTHING. AND SO, UM, WHAT THE WAR ON DRUGS HAS DONE IT HASN'T CURBED DRUG USE, BUT IT HAS DEEPLY DESTABILIZED PEOPLE'S LIVES. UM, TRAPPING PEOPLE IN POVERTY, TEARING APART FAMILIES, UH, PEOPLE LOSE THEIR HOUSING, THEIR JOBS, THEIR, THEIR INCOME OVER THE WAR ON DRUGS. AND SO, UM, BOTH CRIMINALIZATION AND THE ILLICIT DRUG SUPPLY AND HOW THAT BECOMES INCREASINGLY, UM, ON REG IT IS UNREGULATED. IT BECOMES INCREASINGLY DANGEROUS. PLUS THIS DESTABILIZATION OF PEOPLE'S LIVES TOGETHER, UM, HAS KIND OF PUT US IN THE POSITION THAT WE'RE HERE TO TALK WITH Y'ALL ABOUT TODAY. SO WHEN WE TALK ABOUT SOLUTIONS, WE HAVE TO KEEP THAT IN MIND, IF WE ACTUALLY WANT TO MAKE A DIFFERENCE IN WHAT'S HAPPENING ON THE GROUND RIGHT NOW, NEXT SIDE, THANKFULLY, UM, THE HARM REDUCTION MOVEMENT HAS A LOT OF, UM, ALTERNATIVE WAYS OF ADDRESSING DRUG USE. UM, IT'S KIND OF, I THINK ABOUT IT AS LIKE THE ANTIDOTE TO THE WAR ON DRUGS, UM, AND HARM REDUCTION. WE TALK ABOUT IT AS A PRACTICE, BUT IT'S ALSO A SOCIAL MOVEMENT OR AN OUT OF THE AIDS CRISIS, UM, LED BY DIRECTLY IMPACTED PEOPLE WHO ARE DYING, UH, REALLY CREATED A HARM REDUCTION MOVEMENT TO KEEP PEOPLE ALIVE AND TAKE CARE OF EACH OTHER. UM, AND SO IT FOCUSES ON REDUCING THE RISKS ASSOCIATED WITH DRUG USE, UM, KEEPING PEOPLE ALIVE. AND IT ALSO, UM, IS A SOCIAL JUSTICE MOVEMENT THAT REALLY CENTERS THE RIGHTS AND DIGNITY AND RESPECT FOR PEOPLE WHO USE DRUGS. UM, BECAUSE IN OUR SOCIETY WE'VE DECIDED THAT PEOPLE WHO USE DRUGS ARE BAD. UM, AND WE DO NOT SEEM TO CARE ABOUT KEEPING THEM ALIVE. UM, IN FACT, WE'VE FUNNELED THEM TOWARDS DEATH AND THAT'S WHAT WE'RE SEEING RIGHT NOW, UM, WITH THIS OVERDOSE CRISIS. UM, I THINK Y'ALL ALL KNOW A LITTLE BIT ABOUT HARM REDUCTION. I KNOW I'VE PRESENTED BEFORE. UM, WE'RE GOING TO GET INTO THE TEXAS HARM REDUCTION ALLIANCE IN A MINUTE, BUT I THINK Y'ALL, MIGHT'VE WORKED WITH THE AUSTIN HARM REDUCTION COALITION YEARS AGO. UM, NEXT SLIDE. UM, BUT SOME OF THE COMMON STRATEGIES AROUND HARM REDUCTION LOOK LIKE SYRINGE ACCESS. SO MAKING SURE PEOPLE HAVE ACCESS TO A STERILE SYRINGE WHEN THEY'RE INJECTING DRUGS, UM, MAKING SURE THEY HAVE A SAFE PLACE TO DISPOSE OF THEIR USE SYRINGES. UM, ANOTHER COMMON STRATEGY IS MEDICATION ASSISTED TREATMENT, WHICH, UM, I THINK MIGHT'VE BEEN WHY CENTRAL HEALTH WAS INVITED, BUT SUBOXONE OR BUPRENORPHINE IS ONE COMMON MEDICATION. AND SO IS METHADONE. UM, BUT THEY LOOK VERY DIFFERENT IN OUR COMMUNITY. ACCESS LOOKS VERY DIFFERENT. UM, THEY'RE REGULATED DIFFERENTLY. ANOTHER BIG ONE THAT I'M SURE Y'ALL ARE AWARE OF IS NALOXONE AND ACCESS TO NALOXONE. THE OVERDOSE REVERSAL MEDICATION WOUND CARE IS HARM REDUCTION, RIGHT? SO FOR FOLKS WHO ARE, UM, INJECTING DRUGS, PRIMARILY THE ABSCESSES AND WOUNDS, THEY INCUR CAN LEADS IT INTO CARDITIS AND HOSPITALIZATION AND DEATH. AND SO WOUND CARE IS EXTREMELY IMPORTANT ON THE FRONT END TO KEEP PEOPLE HEALTHY, UM, SAY FOR USE EDUCATION. THIS IS REALLY WHEN WE THINK ABOUT PREVENTION AND DRUG EDUCATION, THIS IS REALLY IMPORTANT BECAUSE, UH, SIMILAR TO SEX EDUCATION, WE UNDERSTAND THAT KIND OF ABSTINENCE ONLY MODELS ARE NOT WORKING. UH, WE HAVE TO ARM PEOPLE WITH GOOD INFORMATION ABOUT DRUGS AND HOW TO USE THEM MORE SAFELY SO THAT THEY STAY ALIVE. UM, AND SO THAT'S A HARM REDUCTION STRATEGY, YOU KNOW, WHICH DRUGS DON'T YOU MIX. UM, HOW DO YOU USE WITH A BUDDY SO THAT YOU'RE NOT ALONE, IF YOU DO OVERDOSE, THINGS LIKE THAT, DRUG TESTING IS A BIG ONE. UM, SO I'M SURE YOU ALL HAVE HEARD ABOUT FENTANYL TESTING STRIPS, RIGHT? WITH THE SU THE DRUG SUPPLY INFUSED WITH FENTANYL AT THE MOMENT. UM, FENTANYL TESTING STRIPS HAS A BIG, BEEN A BIG TOPIC OF CONVERSATION IS JUST ONE TOOL IN OUR DRUG TESTING ARSENAL, RIGHT? SO WE HAVE, UM, WE CAN DO MUCH MORE COMPREHENSIVE DRUG TESTING. SO PEOPLE KNOW NOT ONLY IF FENTANYL'S PRESIDENT, BUT HOW MUCH, UM, AND WHAT OTHER DRUGS MAY BE PRESENT. UM, AND THIS IS IMPORTANT AS THE DRUG SUPPLY WILL BEGIN TO SHIFT, RIGHT. UM, WHICH IS WHAT HAPPENS WHEN WE FOCUS ON ONE PARTICULAR SUBSTANCE WITH OUR POLICIES, UM, THE DRUG SUPPLY SHIFTS, AND WE SEE A NEW SUBSTANCE IN THIS POP-UP, UM, AND THEN SAFER CONSUMPTION SPACES OR OVERDOSE PREVENTION CENTERS JUST WHERE PEOPLE CAN USE, UM, SAFELY UNDER OBSERVATION WITH ACCESS TO SAFE EQUIPMENT, UM, AND CONNECTION TO SUPPORT AND RESOURCES IF THEY WANT IT. UM, WHICH IS SOMETHING I KNOW IT'S, [00:10:01] YOU KNOW, NOT ALWAYS WELCOME TO TALK ABOUT THINGS THAT ARE HAPPENING, UM, IN OTHER PARTS OF THE COUNTRY, BUT IN THE EMERGENCY SITUATION WE'RE IN RIGHT NOW WITH THE OVERDOSE CRISIS, WE HAVE TO LOOK AT COMMUNITIES THAT ARE IMPLEMENTING STRATEGIES THAT ARE WORKING. AND WE SEE THESE PROGRAMS WORKING IN PLACES LIKE NEW YORK, WHERE THEY'VE SAVED OVER 300 LIVES, UM, TO DATE. AND THEY'VE ONLY BEEN OPEN FOR SIX MONTHS. NEXT SLIDE. UM, JUST TO, JUST TO BE CLEAR ON THE EVIDENCE HARM REDUCTION STRATEGIES ARE, ARE SUPPORTED WITH LOTS OF EVIDENCE. WE SEE, UM, SYRINGE ACCESS IS CRITICAL TO REDUCING HIV AND HEP C UM, INFECTIONS. AND WE ALSO SEE THAT SYRINGE SERVICE PROGRAMS AND HARM REDUCTION PROGRAMS ARE AN IMPORTANT POINT OF ENTRY INTO CARE. UM, NOT JUST DRUG RELATED CARE, BUT ALL TYPES OF CARE, UM, BECAUSE HARM REDUCTION PROGRAMS BY, BY THEIR NATURE ARE LOW BARRIER, LIKE NO BARRIER PROGRAMS. UM, FOLKS WHO DON'T NORMALLY ACCESS MAINSTREAM SERVICES ARE GOING TO UTILIZE A SYRINGE SERVICE PROGRAM. AND THEY'RE FIVE TIMES MORE LIKELY TO ENTER TREATMENT THAN, THAN FOLKS WHO ARE NOT ENGAGED IN THOSE TYPES OF PROGRAMS. THAT'S WHAT THE RESEARCH SHOWS IN OTHER PLACES. NEXT SLIDE. UM, SO A LITTLE BIT ABOUT US AND WHAT WE DO. UM, I HOPE Y'ALL KNEW ABOUT THE AUSTIN HARM REDUCTION COALITION THAT WAS HERE IN OUR COMMUNITY FOR 20 PLUS YEARS. UH, WE ARE A DIFFERENT ORGANIZATION WE FORMED IN 2019. UM, SO WE'RE NEWER. UM, BUT WE WERE FOUNDED BY MEMBERS OF THE AUSTIN HARM REDUCTION COALITION. UM, WE HAVE A ROBUST HARM REDUCTION PROGRAM. WE HAVE A DROP-IN CENTER NOW IT'S THE ONLY DROP-IN CENTER HAVE IN AUSTIN FOR PEOPLE WHO ARE ACTIVELY USING, UM, WE HAVE AN OUTREACH TEAM AND YOU CAN SEE OUR MOBILE CLINIC THERE IN THE PHOTO. THAT'S A BRAND NEW MOBILE CLINIC, UM, THROUGH A GRANT FROM, FROM AUSTIN PUBLIC HEALTH. UM, SO WE'LL BE INCREASING THE SERVICES WE CAN PROVIDE OUT IN THE COMMUNITY, WHICH IS A BIG PIECE OF HARM REDUCTION IS YOU GOT TO MEET PEOPLE WHERE THEY'RE AT. UH, WE ALSO DO LOCAL AND STATE LEVEL ADVOCACY BECAUSE THERE ARE MANY BARRIERS TO PROVIDING COMPREHENSIVE HARM REDUCTION IN TEXAS. UM, SO WE KNOW WE HAVE TO CHANGE LAWS IN ORDER TO EXPAND ACCESS. AND WE ALSO TRAIN, UM, ON WHAT HARM REDUCTION IS AND HOW TO IMPLEMENT IT IN YOUR PROGRAM. WE KNOW THAT WE HAVE TO TEACH SERVICE PROVIDERS AND OTHER LEADERS IN OUR COMMUNITY HOW TO DO HARM REDUCTION IF IT'S GONNA MAKE A DIFFERENCE, UM, FOR, FOR PEOPLE WHO ARE DIRECTLY IMPACTED, WHO ARE ENTERING THOSE PROGRAMS. AND WE'LL TALK A LITTLE BIT MORE ABOUT THAT, I THINK LATER, UM, NEXT SLIDE. RIGHT. SO JUST WANT TO ACKNOWLEDGE THAT, UM, WE, WEREN'T A PART OF THIS, UH, WORK THAT Y'ALL DID BACK IN 2018 TO LOOK AT THE OPIOID CRISIS, UH, OTHER LEADERS IN OUR COMMUNITY WHERE WE'RE, UM, BUT WE WANTED TO BRING THIS INTO THE CONVERSATION BECAUSE I KNOW Y'ALL LOOKED AT THIS AS A PROBLEM FOUR YEARS AGO, AND HERE WE ARE KIND OF IN THE WORST CRISIS THAT WE'VE SEEN. SO WHAT, WHAT LESSONS CAN WE LEARN FROM WHAT Y'ALL PUT IN PLACE THEN? HOW CAN WE DO THINGS DIFFERENTLY THIS TIME AROUND, UM, WE DON'T WANT TO PASS ANOTHER RESOLUTION THAT DOESN'T MAKE A DIFFERENCE IN SAVING PEOPLE'S LIVES. UM, AND MAYBE THIS CAN BE PART OF THE DISCUSSION SINCE WE WEREN'T A PART OF THIS RESOLUTION WOULD LOVE TO HEAR KIND OF WHAT CAME OUT OF IT OR WHERE YOU FELT LIKE YOU FELL SHORT. UM, AND WITH THAT, I'M GOING TO PASS IT OVER TO PAULETTE. WHO'S GONNA KIND OF TALK ABOUT THE CONTEXT WE'RE IN RIGHT NOW AND WHAT WE'RE WORKING ON. HMM. SO I THINK EVERYONE HERE HAS BEEN SEEING SOME OF THE HORRIFIC HEADLINES EVERY SINGLE DAY THAT COME OUT ABOUT RISING OVERDOSE DEATHS ACROSS THE COUNTRY. UH, AUSTIN AND TRAVIS COUNTY IS NO DIFFERENT. UM, THE LATEST DATA THAT CAME OUT LAST MONTH, A WEEK AFTER WE HELD OUR TOWN HALL, SHOWED THAT OVERDOSES HAD RISEN ONCE AGAIN FOR IN 2021. UM, A LARGE PART OF THAT WAS FENTANYL RELATED OVERDOSE DEATHS, WHICH JUMPED BY 237% IN TRAVIS COUNTY. AND SO JUST TO PUT IT MORE INTO CONTEXT, DRUG TOXICITY IS NOW THE NUMBER ONE CAUSE OF DEATHS ACCIDENTAL DEATHS IN TRAVIS COUNTY, BOTH AHEAD OF FALLS AND MOTOR VEHICLE FATALITIES. I THINK WHEN WE'RE TALKING ABOUT THE OVERDOSE CRISIS, SOMETHING THAT WE OFTEN DON'T NAME, AND SOMETIMES THE NEWS DOESN'T NAME IS THAT THIS IS SO DIRECTLY LINKED TO OUR HOMELESSNESS CRISIS AND IN AUSTIN. AND SO WHILE OVERDOSE STRESS ARE RISING, OUR HOMELESSNESS CRISIS HAS CONTINUED TO RAGE ON AND PEOPLE CONTINUE TO BE SWEPT DEEPER [00:15:01] AND DEEPER INTO PLACES WHERE THEY'RE NOT CONNECTED TO THEIR NETWORKS, UM, PLACES THAT ARE HARDER FOR US TO MAKE SURE THAT WE, WE ARE ABLE TO SERVE THEM AND OTHER ORGANIZATIONS LIKE OURS. UM, THE LAST DATA THAT WE HAD ON THE HOMELESSNESS, UH, POINT IN TIME NUMBER WAS 3,160 PEOPLE, BUT WE KNOW THAT THAT NUMBER IS MUCH LARGER THAN THAT. AND LASTLY, ALL OF THE STATE AND LOCAL DATA PREDICTIONS AND PREDICTIONS, EVEN FROM THE CDC SHOW THAT 20, 21 OR 2022 IS GOING TO BE EVEN DEADLIER THAN 2021. SO THERE'S SEVERAL ISSUES IMPACTING RISING OVERDOSE DEATHS. AS I MENTIONED, A TOTAL LACK OF HOUSING FOR PEOPLE EXPERIENCING HOMELESSNESS, UM, AND ALSO A REVOLVING DOOR, I THINK AS AFFORDABILITY BECOMES LESS AND LESS, UH, AVAILABLE IN TERMS OF HOUSING FOR PEOPLE, PEOPLE ARE LOSING THEIR HOUSING AND THIS IS DRIVING, UH, DRIVING TO CONTINUE TO OVERDOSE. UM, CONTINUED CAMP STREETS, AS I MENTIONED, IS, IS ONE OF THE WORST THINGS THAT COULD BE HAPPENING TO PEOPLE WHO ARE USING DRUGS AND ARE EXPERIENCING HOMELESSNESS AND GET FURTHER AWAY FROM THEIR NETWORKS. THEY'RE LOSING ALL OF THEIR BELONGINGS. UM, THERE'S A GENERAL LACK OF HARM REDUCTION, TRAINING, AND EXPERTISE IN SERVICE PROVIDERS. SO WE SPEAK SO OFTEN TO OUR PARTICIPANTS AT THE RA, AND THEY OFTEN POINT OUT HOW NOT, NOT ONLY ARE THEY TREATED WITH DIGNITY AND RESPECT AND COMPASSION IN OUR DROP-IN CENTER, BUT WE ALSO ARE UNDERSTANDING DRUG USE, NOT THROUGH THE LENS OF LIKE ABSTINENCE BASED FOR UNDERSTANDING HOW TO TRAIN, TRAIN, AND EDUCATE PEOPLE WHO ARE USING DRUGS. AND I THINK A LOT OF, UM, A LOT OF SERVICE WRITERS AROUND AROUND THE CITY ARE NOT TRAINED IN HARM REDUCTION AND IN PARTICULAR SHELTER PROVIDERS, UM, THE HOTELS, UH, AND THIS IS SOMETHING THAT I'LL TALK ABOUT IN A SECOND, BUT AS WE'RE TALKING ABOUT MORE SUPPORTIVE HOUSING UNITS COMING ONLINE IN THE FUTURE, THIS IS A REALLY, REALLY KEY AREA THAT WE REALLY NEED TO WORK ON. ENSURING THAT SERVICE PROVIDERS ARE TRAINED IN HARM REDUCTION AND, AND ARE ADOPTING THOSE VALUES. ANOTHER PART IS WEIGHTLESS FOR METHADONE. UM, THIS HAS BEEN AN ONGOING TOPIC IN AUSTIN AND TRAVIS COUNTY, PEOPLE WHO ARE READY TO, TO ACCESS METHADONE SOMETIMES HAVE TO WAIT 6, 7, 8, 9 MONTHS, UM, WHICH IS JUST UNACCEPTABLE. UM, HEALTH PROFESSIONALS ARE NOT USING UTILIZING HARM REDUCTION APPROACH IS, UH, THERE'S A METHADONE RIGHT NEAR OUR OFFICE WHERE WE'VE HEARD FROM SEVERAL OF OUR PARTICIPANTS THAT USE THAT METHADONE CLINIC, THAT THE DOCTORS THERE WILL, IF SOMEONE MISSES AN APPOINTMENT, THEY'LL BE DROPPED FROM THEIR REGULAR DOSES TO, TO VERY LOW AMOUNTS THAT CAUSES SO MUCH DISTRESS IN SOMEBODY'S BODY AND ENTIRE LIFE. UM, AND THEN LASTLY, THEIR CRIMINALIZATION OF SUBSTANCE USE AND POVERTY. SO WHETHER THAT'S EMBODIED THROUGH THE CONTINUED SWEEPS OR, UM, HARASSMENT OF, OF FOLKS AROUND THE COMMUNITY WHO ARE POOR AND, UH, USING DRUGS SO IMMEDIATE NEEDS, UM, NUMBER ONE AND SOMETHING THAT WE TRIED TO IDENTIFY THROUGH THE COUNTY'S RESOLUTION THAT WAS PASSED A COUPLE OF WEEKS AGO, WE NEED TO BE WORKING TOWARDS BUILDING A ROBUST HARM REDUCTION INFRASTRUCTURE IN AUSTIN. SO WHAT WE MEAN BY THAT IS THAT WE NEED MORE PEER DELIVERED HARM REDUCTION SERVICES THAT GO BEYOND THE RA, UH, THERE'S MANY SERVICE PROVIDERS THAT ARE READY AND WILLING TO TAKE ON SOME OF THIS WORK AND WORK WITH US TO BE TRAINED AND, AND COORDINATE WITH US. SO TUFIN SUNRISE NAVIGATION CENTER. UM, THE OTHER ONE'S FOUNDATION AND SUNRISE ARE TWO THAT WE'VE BEEN WORKING REALLY CLOSELY WITH WHO, WHO HAVE BEEN DOING SOME OF THIS HARM REDUCTION WORK, BUT NEED, NEED MORE SUPPORT TO DO IT WELL. AND, AND SO WE DON'T WANT TO BE THE ONLY DROP-IN CENTER AND THE ONLY HARM REDUCTION PROGRAM IN THE CITY WE NEED, WE NEED MUCH MORE THAN EXPANDING ACCESS TO NALOXONE. AND NARCAN IS ANOTHER BIG PIECE. UM, IN THE LAST MONTH THERE WERE A LOT OF WHAT WE PASS THROUGH THE RESOLUTION. UH, THE FUNDING IS GOING TO GO TOWARDS ACCESS TO NARCAN. AND THE REASON THAT IS, IS BECAUSE THERE'S A LOT OF SERVICE PROVIDERS DON'T EVEN HAVE NARCAN AND SERVICE PROVIDERS NEED TO HAVE IT, BUT SO DO LIBRARIES. SO DO, UM, FIRST RESPONDERS, UM, THE PARKS DEPARTMENT, THERE'S MANY GAPS IN NEED, AND REALLY EVERYBODY SHOULD HAVE ACCESS TO NARCAN. IT'S, IT'S, UH, AN AUTHORIZED [00:20:01] TOOL THAT SAVES LIVES. UM, NEXT IS REQUIRING RELEVANT AGENCIES TO MAKE AGGREGATED DATA RELEVANT TO THE OVERDOSE CRISIS AVAILABLE. SO REALLY TO UNDERSTAND THE OVERDOSE CRISIS, WE NEED TO HAVE DATA ABOUT DRUG RELATED ARRESTS, UM, EMERGENCY CALLS, HOMELESSNESS, UM, THE NUMBER OF SWEEPS THAT ARE HAPPENING ACROSS THE CITY. THERE'S A LONG LIST OF FOLKS. FOLKS WHO ARE DISCHARGED, UM, FROM, FROM PROGRAMS IS A BIG ONE HARM REDUCTION AND TREATMENT. WE'VE TALKED ABOUT THE METHADONE PIECE, ALL OF THAT INFORMATION. WE NEED TO START KIND OF GATHERING RIGHT NOW TO DO SOME IMMEDIATE RESPONSE AROUND URGENT NEEDS, BUT REALLY TO BE BUILDING TOWARDS FUTURE SOLUTIONS AS WELL. UM, STOPPING THE STREETS. SO I MENTIONED THIS ALREADY TWICE. I THINK, UM, THIS IS A HUGE, HUGE NEED. IF WE'RE GOING TO REALLY ADDRESS THE OVERDOSE CRISIS, WE HAVE TO STOP THE NE THE SWEEPS, AND WE HAVE TO INCREASE ACCESS TO HOUSING, WHICH IS THE NEXT BULLET, UH, IDENTIFYING AN INCREASING CAPACITY FOR HARM REDUCTION STRATEGIES AND NEW HOUSING DEVELOPMENTS IN SHELTERS AND TRANSITIONAL HOTELS. WE CAN'T CONTINUE TO SEE PEOPLE BEING DISCHARGED FROM SOUTHBRIDGE AND NORTHBRIDGE HOTELS BECAUSE THEY'RE ACCUSED OR, OR EVEN BECAUSE THEY'RE USING DRUGS. UM, WE CAN'T CONTINUE TO SEE SERVICE PROVIDERS, NOT UNDERSTANDING HOW TO SUPPORT PEOPLE WHO ARE USING DRUGS OR FORMALLY USING DRUGS. WE, WE REALLY NEED TO BE TRAINING, UM, AND USING MODELS THAT HAVE WORKED AROUND THE COUNTRY AND BRINGING THEM HERE. AND WE HAVE ALLIES AROUND THE COUNTRY THAT ARE WILLING TO DO THAT. SO THAT'S, THAT'S SOMETHING THAT WE'VE BEEN WORKING ON AND TALKING ABOUT ANOTHER PIECE, INTENTIONAL SPACES FOR COMMUNITY LED DISCUSSIONS ON URGENT NEEDS AND SOLUTIONS. THIS WAS A REASON THAT WE HELD THE TOWN HALL AT THE BEGINNING OF MAY. WE REALLY NEEDED TO BE IN FRONT OF DECISION MAKERS. UM, OUR COMMUNITY MEMBERS NEEDED TO SPEAK ABOUT WHAT THE URGENT NEEDS ARE. AND WE HAD REALLY HAD A HARD TIME DOING THAT IN, IN A MEANINGFUL WAY. AND SO CREATING A SPACE TO DO THAT IS IMPORTANT. AND WE SAW THAT IN THE COUNTIES RESOLUTION, WE WERE ABLE TO GET A STANDING AGENDA ITEM IN THE COMMISSIONER'S COURT, AND THEN LASTLY, OPPOSING PENALTIES AND FURTHER CRIMINALIZATION OF PEOPLE WHO UNKNOWINGLY POSSESS OR SELL, SELL FENTANYL ACROSS THE COUNTRY AND IN THIS STATE, THE KNEE-JERK REACTION AND IS TO CRIMINALIZE THE SELLING OR POSSESSION OF FENTANYL. AND OVER 50 YEARS OF THE WAR ON DRUGS HAS SHOWN US THAT CRIMINAL CRIMINALIZATION OF SUBSTANCES JUST CAUSES A, TO MORE TOXIC DRUG SUPPLY. AND IT DOES NOT GET AT THE ISSUES OF RISING OVERDOSE DEATHS AND EVERYTHING ASSOCIATED TO IT LONGER-TERM NEEDS SYRINGE SERVICE PROGRAM AUTHORIZATION. UH, TEXAS DOES NOT. WE HAVE ONE PILOT IN SAN ANTONIO RIGHT NOW, UM, AUTHORIZING CERTAIN SERVICE SERVICES. AND SO WE REALLY NEED TO CHANGE, I MEAN, CHANGE THIS AT A STATE LEVEL, BUT WE NEED ALL OF Y'ALL'S HELP TO DO THAT AS WELL. UH, DIVERSE HOUSING OPTIONS THAT MEET THE NEEDS OF CURRENT AND FORMER DRUG USERS, UM, SUPPORTIVE HOUSING. CAN'T JUST BE A MODEL FOR, FOR FOLKS WHO ARE READY. AND I PUT THIS IN QUOTATION READY FOR HOUSING. EVERYBODY IS READY FOR HOUSING, AND WE NEED TO BE ABLE TO MEET EVERYBODY'S DIVERSE NEEDS, UM, WHETHER THEY'RE USING DRUGS, WHETHER THEY FORMALLY USE DRUGS. AND IF THEY'RE NOT USING DRUGS AT ALL, SERVICE PROVIDERS SHOULD BE TRAINED AND EMBRACE HARM REDUCTION, VALUES AND STRATEGIES. AGAIN, THIS IS GOING TO TAKE A REAL CULTURAL SHIFT AND A LOT OF TRAINING AND EDUCATION TO, TO MOVE US BEYOND THIS, LIKE ABSTINENCE-BASED PUNITIVE MODELS. AND THERE'S A LOT OF RESOURCES OUTSIDE OF, OUTSIDE OF AUSTIN AND, UM, ACROSS THE COUNTRY THAT SHOW THAT THIS CAN BE DONE IN A, IN A REAL WAY, LASTLY, UM, OR THE LAST TWO ARE AROUND SAFE SUPPLY. UM, WHAT WE MEAN BY A SAFE SUPPLY, AND THIS IS SOMETHING THAT'S BEING TALKED TO, UH, TALKED ABOUT ACROSS THE COUNTRY AND HAS BEEN FOR A LONG TIME, IS EXACTLY THAT THAT PUSH AROUND. WE CAN'T JUST TARGET THE USE OF FENTANYL OR ANY OTHER SUBSTANCE. WE HAVE TO BE MOVING TOWARDS A SAFE SUPPLY WHERE PEOPLE WHO ARE GOING TO BE USING DRUGS, KNOW [00:25:01] WHAT THEY'RE USING. AND IF THAT'S NOT THE DIRECTION THAT WE'RE MOVING IN, WE'RE ALWAYS GOING TO BE LIVING IN THIS CONSTANT OVERDOSE CRISIS. AND LASTLY, OVERDOSE PREVENTION CENTERS, WHICH KATE MENTIONED, UM, THESE ARE THERE'S PILOT. THERE'S A COUPLE OF PILOTS IN NEW YORK THAT WE WERE ABLE TO VISIT, UH, AS A PRO ALL OF OUR STAFF WENT UP TO NEW YORK ABOUT A MONTH AGO, AND REALLY JUST LIKE THIS AMAZING, THESE AMAZING SERVICE PROVIDERS, UM, WHO ARE RUNNING THE FIRST OVERDOSE PREVENTION CENTERS IN THE COUNTRY, BUT THESE HAVE EXISTED FOR A LONG TIME OUTSIDE OF THE UNITED STATES. AND SO, AND REALLY THEY'VE EXISTED WITHOUT AUTHORIZATION IN A LOT OF PARTS OF THE UNITED STATES. SO WE AS A CITY AND AS A STATE, UM, NEED TO BE MOVING TOWARDS THESE BOLD SOLUTIONS. AND SOMETIMES THAT MEANS THAT WE'LL HAVE TO CHANGE AND THE LAW WILL HAVE TO BE BROKEN. AND THE HARM REDUCTION MOVEMENT HAS ALWAYS HAD TO, HAD TO BREAK THE LAW IN ORDER TO CHANGE THE LAW AND TO MOVE IN THE DIRECTION THAT, THAT, UM, WE NEED TO BE GOING IN. SO THESE ARE SOME OF THE LONG-TERM NEEDS, AND I BELIEVE WE ADDED A FEW RESOURCES. UM, THE NATIONAL HARM REDUCTION COALITION HAS SOME GOOD, UH, SOME GOOD HANDOUTS ON JUST THE VARIOUS HARM REDUCTION ISSUES. SO YOU'LL SEE IN THERE, SOME, SOME HANDOUTS AROUND SAFE CONSUMPTION SITES, UM, FENTANYL DISCUSSION POINTS AND VARIOUS OTHER THINGS. AND THEN, UH, I HANDOUT AROUND HOMELESSNESS AND HARM REDUCTION AND WHERE WE NEED TO BE GOING TO ENSURE THAT SERVICE PROVIDERS ARE, ARE, UM, THAT, THAT DEAL WITH THE HOMELESS POPULATION ARE MOVING TOWARDS HARM REDUCTION AND THEN DPA DRUG POLICY ALLIANCE. UH, ANOTHER KEY ALLY OF OURS HAS PUT OUT MANY, MANY RESOURCES, BUT ONE, A FEW ARE ON POLICING POLICING ON THE DRUG WAR. ONE IMPORTANT ONE IS ON DRUG EDUCATION RESOURCES. SO IT, DURING OUR CONVERSATIONS WITH THE COMMISSIONERS COURT, A LOT OF THE QUESTIONS THAT CAME UP WAS AROUND DRUG EDUCATION FOR YOUNG PEOPLE. AND THERE'S A WAY TO DO THIS, THAT ISN'T JUST BASED IN HARM OR, OR IN, IN ABSTINENCE. AND THIS IS JUST ONE, ONE LINK THAT SHOWS SOME OF THE WAYS TO HAVE CONVERSATIONS AS EDUCATORS, PARENTS, AND YOUNG ADULTS. AND THEN LASTLY IS, UH, A LINK TO A HANDOUT AROUND, UH, RETHINKING THE DRUG DEALER, UM, RETHINKING HOW WE CRIMINALIZE FURTHER CRIMINALIZED, PENALIZE, DRUG DEALERS, DRUG DEALERS OF FENTANYL, ET CETERA. AND WITH THAT, I THANK YOU. UM, THANK YOU BOTH SO VERY, VERY MUCH. I THINK YOU'VE PROVIDED, PROVIDED US WITH A LOT OF CONTEXT AND A LOT OF GOOD NEXT STEPS AND A LOT OF GOOD INFORMATION. UM, COLLEAGUES, ARE YOU ABLE TO STAY FOR A BIT? YES, THAT WOULD BE. SO WHAT I WOULD SUGGEST NOW, UM, IN THE INTEREST OF TIME, WE'RE GOING TO LOSE THE MAYOR HERE SOON, AND WE HAVE TWO PIECES OF THIS DISCUSSION HERE TODAY. ONE IS THE PRESENTATION THAT WE'VE JUST HEARD FROM THE TEXAS HARM REDUCTION COALITION. WE ALSO HAVE, UM, ASKED OUR STAFF TO BE HERE, TO ALSO TALK ABOUT THE RESPONSE TO THE MAYORS, THE RESOLUTION THAT THE MAYOR BROUGHT IN 2018, AND SINCE WE'RE LOSING THE MAYOR SOON, BUT I WOULD ASK IS THAT WE HOLD SPECIFIC QUESTIONS AT THIS POINT, UM, AND INVITE DR. PICHETTE, UH, TO TALK TO US ABOUT, UH, ABOUT WHAT HAS HAPPENED SINCE 2018. UM, FIRST I'M GOING TO INVITE THE MAYOR TO JUST VERY BRIEFLY, AND YOU'RE WELCOME TO SIT DOWN AND WE'LL CALL YOU AT YOUR, IF YOU'D LIKE TO GRAB A SEAT AT THE TABLE RIGHT BEHIND OR WHEREVER YOU'RE MOST COMFORTABLE. AND WE'LL INVITE YOU BACK UP HERE JUST IN A SECOND AS WE'RE AND WE'LL ENTERTAIN QUESTIONS ON BOTH PIECES. UM, MAYOR, WOULD YOU LIKE TO JUST SPEND A FEW MINUTES LAYING OUT THE RESOLUTION? I KNOW YOU'VE DISTRIBUTED HERE ON THE DYESS, ALONG WITH THE RESPONSIVE MEMO, AND IF YOU COULD KIND OF SUMMARIZE YOUR, THE WORK, THE DIRECTION AND THE, THE NEXT STEPS THAT WERE IDENTIFIED IN THERE, AND THEN WE'LL INVITE DR. PICHETTE TO TALK ABOUT THE WORK OF CHAIR. YES, THIS IS GREAT. I'M, I'M REALLY GONNA, I'M REALLY APPRECIATING HEARING THIS CAUSE I KNOW WE'VE, IT'S SOMETHING THE CITY HAS BEEN WORKING ON AND MAYOR INITIATED IN PREVIOUS YEARS. SO THIS IS VERY HELPFUL. I THINK IT'S ALSO IMPORTANT TO STATE THAT WE HAVE ANOTHER RESOLUTION THAT, UM, THAT WE MIGHT ALSO WANT, UM, UH, COUNCIL MEMBER FUENTES TO SPEAK TO. UM, SO THAT WE'RE SPEAKING TO BOTH OF THOSE RESTAURANTS. ABSOLUTELY. AND I THINK WE'RE POSTED TO DO THAT AS WELL. WHAT I, WHAT I, BUT LET'S GO IN CHRONOLOGICAL ORDER IF THAT'S ALL RIGHT. SO WE'LL START WITH, WITH THE RESOLUTION THAT THE MAYOR DID AND WHAT WORKED THE STAFF HAVE DONE. AND AS I UNDERSTAND, COUNCIL MEMBER, FONTUS YOUR RESOLUTION PICKS UP ON NEXT STEPS THAT RESPOND IN PART TO TEXAS AREN'T COMMISSION, UH, COALITION. SO I THINK THAT THAT'S THE CHRONOLOGY WOMEN ON KIND OF FOLLOW HERE, BUT WE'LL START WITH QUESTIONS AND THEN, UM, ASK, UH, COUNCIL MEMBER FUND AS TO LAY THOSE OUT. I'M JUST TRYING TO MAXIMIZE THE AMOUNT OF TIME WE HAVE HERE [00:30:01] WITH, WITH THE MAYOR AND OTHERS BEFORE WE START TO LOSE OUR QUORUM. AND I APPRECIATE THAT IN, AT FIRST, I WANT TO, TO APPRECIATE THE WORK OF THIS COMMITTEE ON THIS ISSUE, AND CERTAINLY THE LEADERSHIP OF COUNCIL MEMBER IN RESURFACING, THIS ISSUE AND GIVING IT THE, UH, THE, THE, THE URGENCY, THE SENSE OF URGENCY, I THINK THAT IS OTHERWISE LACKING. SO THANK YOU FOR YOUR LEADERSHIP IN, IN, IN DOING THAT. UM, THIS WAS A CHALLENGE THAT WASN'T HITTING OUR CITY AT THE SAME LEVEL, THAT IT WAS HITTING MANY OTHER CITIES ACROSS THE COUNTRY. IF YOU GO BACK HISTORICALLY, UH, CERTAINLY IN THE, KIND OF THE RUST BELT PARTS OF THE COUNTRY AND THEN SPREADING, BUT WE DID RAISE THE ISSUE BACK FOUR YEARS AGO IN 2018, UH, BECAUSE IT WAS BEGINNING TO REACH PRICES LEVELS, UH, AND IT APPEARED AS IF FOCUSED OR CONCENTRATED IN, IN A LOT OF THE MUSIC AND ARTS COMMUNITIES INITIALLY, UH, IN OUR CITY. UH, SO AS A COUNCIL, UH, WE PASSED THAT RESOLUTION, UH, 2 18 0 5, 2 4 0 38. AND I'VE ASKED THE STAFF TO, TO PUT THAT INTO BACKUP IN THIS ITEM, SO THAT SOMEONE GOING TO THIS MEETING COULD FIND IT IN ITEM NUMBER THREE, UH, AS WELL AS THE RESPONSE. UH, AND, AND BASICALLY THIS WAS A RESOLUTION FROM THE COUNCIL SAYING, HEY, THIS IS A GROWING CONCERN. UH, WHAT SHOULD WE BE DOING ABOUT IT? UH, SPECIAL FOCUS IN THE MUSIC AND ARTS COMMUNITY, BUT MORE GENERALLY WE NEED TO, WE NEEDED TO DO SOMETHING, THE STAFF, UM, UH, IN RESPONSE TO THAT CONVENED, UH, WHAT APPEARED TO BE A REALLY LARGE GROUP OF FOLKS THAT RESPONDING TO THE GROWING SUBSTANCE ABUSE CRISIS, UH, UM, MULTIDISCIPLINARY COLLABORATIVE AND A COORDINATED RESPONSE AND LISTED LOTS OF DIFFERENT ORGANIZATIONS BOTH SPECIFICALLY IN GENERALLY, AND THEN, UH, TALKED ABOUT NEXT STEPS IN TERMS OF PARTNERSHIP WITH RECOMMENDATIONS, HARM REDUCTION, TREATMENT, AND RECOVERY, UH, AS WELL AS OUTCOME MEASURES AND DATA. UH, BUT OBVIOUSLY IT'S PROGRESSED AND, AND, AND, UH, UH, THE, THE CHALLENGE HAS PROGRESSED AND, UH, AND, UH, I THINK IT IS IMPORTANT FOR US TO FIND OUT WHAT IT IS THAT'S BEEN DONE AND MAYBE TAKE A LOOK AT WHAT IT WAS THAT WE INTENDED TO DO AND SEE IF WE HAVE FACT DID THOSE THINGS. AND IF WE DIDN'T HOW WE FILL THE GAPS, UH, THE PRESENTATION THAT WE SAW TODAY FROM THE HARM REDUCTION ALLIANCE, I APPRECIATED THAT CONTAINS A LOT MORE SPECIFICITY THAN WAS IN THE STAFF RESPONSE. SO I HOPE WE DO PICK BACK UP. THANK YOU. GREAT. THANK YOU, MAYOR. AND THANK YOU FOR YOUR EARLY LEADERSHIP ON THAT ISSUE. OKAY. GOOD MORNING. I'M JANET PICHET. I'M THE CHIEF EPIDEMIOLOGIST WITH AUSTIN PUBLIC HEALTH, AND I HELPED KIND OF COORDINATE THE GROUP THAT RESPONDED TO THE LAST RESOLUTION IN 2018, UH, UNDER STEPHANIE HAYDEN, WHO WAS OUR DIRECTOR AT THE TIME. UM, YOU KNOW, UH, ONE OF THE THINGS I APOLOGIZE FOR THE TEXAS HARM REDUCTION, WE INCLUDED AUSTIN HARM REDUCTION IN OUR, UH, INITIAL, UH, GROUP OR IN THE INTERDISCIPLINARY GROUP THAT WE BROUGHT TOGETHER TO KIND OF HASH OUT AND IDENTIFY WHAT THE ISSUES WERE, UH, FOR OUR COMMUNITY. UM, AND, YOU KNOW, I THINK A LOT OF THAT THOSE ORIGINAL DISCUSSIONS WERE FOCUSED AROUND DATA AND TRYING TO BE ABLE TO, UH, PAINT THE PICTURE OF WHAT OUR EXPERIENCE WAS HERE IN THE AUSTIN, TRAVIS COUNTY COMMUNITY, UM, SO THAT WE COULD APPLY FOR FEDERAL FUNDING WHEN AVAILABLE. AND WE HAD A GOOD, SOLID, UH, SCIENTIFIC BASIS FOR SOME OF THE, UH, DATA THAT WE WERE PRESENTING. UM, SINCE THAT TIME, UH, SINCE AUGUST OF 2018, WHICH IS WHEN WE DID THE RESOLUTION, UH, AUSTIN PUBLIC HEALTH PARTICIPATED IN, UH, A FAIRLY EXTENSIVE, UH, NEEDS ASSESSMENT. SO ONE OF THE, ONE OF THE MAJOR THINGS THAT WE WORKED ON IN THAT, IN THE, IN 2019, AND I CAN SHARE THIS WITH YOU. UH, WE DID A NEEDS ASSESSMENT, AND THIS WAS, UH, IN PARTICIPATION WITH AUSTIN INTEGRAL CARE OR AT THE TIME INTEGRAL CARE, UH, CENTRAL HEALTH AND TRAVIS COUNTY HEALTH AND HUMAN SERVICES AND THE SOBERING CENTER. UM, YOU KNOW, ONE OF OUR RECOMMENDATIONS WAS NOT TO JUST SOLELY FOCUS ON OPIOIDS, BUT OTHER SUBSTANCES BECAUSE THE MEDICAL EXAMINERS DATA WAS SHOWING THAT A LOT OF DEATHS WERE USING MULTIPLE DRUGS OR ALCOHOL IN COMBINATION, UH, UH, WHEN THEY WERE IDENTIFYING OVERDOSE DEATHS. SO, UH, WE CAME TOGETHER AS A GROUP AND, UM, PART OF THE PURPOSE OF THIS NEEDS ASSESSMENT WAS TO TRY TO REALLY GET OUR ARMS AROUND HOW, WHY WIDESPREAD OR, UH, WHAT, WHAT SERVICES AND SUPPORT EXISTED IN AUSTIN AND TRAVIS COUNTY. UM, YOU KNOW, WHAT DIFFERENT PLANNING GROUPS ARE BECAUSE THERE'S A LOT OF, UH, [00:35:01] GOOD THAT'S HAPPENING OUT, OUT IN OUR COMMUNITY, BUT PEOPLE ARE OPERATING IN SILOS. SO WE WERE TRYING TO TRYING TO GET AN IDEA AND CAPTURE, UH, ALL THE FOLKS THAT WERE ACTUALLY PARTICIPATING IN THIS SPACE. UM, SO WE ALSO WANTED TO SEE, YOU KNOW, ARE THERE OVERLAPS IN SERVICE DELIVERY AND OTHER SERVICES THAT THEY WERE PROVIDING, UM, AND WANTED TO TRY TO ALSO, UH, GET AN INVENTORY OF WHAT TYPE OF SUBSTANCE USE OR MISUSE RESOURCES ARE AVAILABLE TO THE COMMUNITY AT LORD LARGE? SO THIS REPORT WAS FINISHED IN OCTOBER OF 2019, UM, AND IT TOOK A LOT OF WORK AND THERE WERE A LOT OF PEOPLE WHO PARTICIPATED IN THE SURVEY ASSESSMENT, AND I CAN SHARE THIS WITH Y'ALL IF YOU'D LIKE IT. UM, BUT, UH, IN, UH, FEBRUARY OF 2019, WE WERE NOTIFIED BY THE CENTERS FOR DISEASE CONTROL, UH, THAT WE WOULD, UH, THERE WAS A FEDERAL FUNDING OPPORTUNITY AVAILABLE TO AUSTIN PUBLIC HEALTH, UH, AUSTIN AND TRAVIS COUNTY. UM, UH, WE, TRAVIS COUNTY IN AUSTIN WAS LISTED AS AN ELIGIBLE CITY TO RECEIVE FEDERAL FUNDING, UH, FOR DISEASE SURVEILLANCE ACTIVITIES, LIKE MAY MAINLY LOOKING AT MORTALITY DATA, MAKING SURE THAT WE WERE CAPTURING. AND AGAIN, BEGINNING TO PAINT THE PICTURE OF WHAT WAS GOING ON AND WORKING WITH, UH, SEVERAL OTHER COMMUNITIES, THERE WERE 18 ELIGIBLE COMMUNITIES THAT WERE IN THAT FUNDING OPPORTUNITY. HOWEVER, UM, BECAUSE OF SOME FLAWS THAT THEY CALCULATED THAT THE CENTERS FOR DISEASE, UH, THE CENTERS FOR DISEASE CONTROL AND PREVENTION CALCULATED FOR MORTALITY DATA, UH, AND THE ESTIMATES THEY USED BY THE NATIONAL CENTER FOR HEALTH STATISTICS. UM, THEY YANKED THAT FUNDING FROM SEVERAL MAJOR METROPOLITAN AREAS. AND I THINK MOST OF THE CITIES IN THE STATE OF TEXAS, SO WE WERE ONE OF THE AREAS THAT HAD THE HOPE OF BEING ABLE TO GET FUNDED SIGNIFICANTLY TO SUPPORT THIS ACTIVITY. AND, AND THEN THAT FUNDING WAS LATER PULLED BY CDC. UM, YOU KNOW, WE, AS, UH, THE NATIONAL ASSOCIATION OF CITIES AND COUNTY HEALTH OFFICIALS, THEY HAVE A BIG CITIES, HEALTH COALITION WHO, UH, WROTE AND LOBBIED TO, YOU KNOW, TO CON CONSIDER ALLOWING THE FUNDING TO HAPPEN BASED ON THIS, UH, F S FLAW IN THEIR MORTALITY ESTIMATES. BUT, UM, SO BASICALLY THE MORTALITY ESTIMATES, WEREN'T SHOWING THAT WE HAD ENOUGH OVERDOSE DEATHS WHEN WE KNOW ON THE, ON, ON OUR LEVEL THAT THERE, THERE'S PROBABLY MORE DEATHS ON THAN WHAT, UH, WHAT THE CDC IS REPORTING. AND THERE'S ALSO A MAJOR LAG AND AMOUNT OF MORTALITY. LIKE WHEN WE GET MORTALITY DATA, THERE'S TYPICALLY A TWO-YEAR LAG PERIOD, UH, BASED ON, UH, WHEN WE GET INFORMATION. SO WE'RE, WE'RE ABLE TO PULL INFORMATION FROM OUR MEDICAL EXAMINER WHO HAS A BIT OF INFORMATION, AND THEN OUR OFFICE OF VITAL RECORDS WHO HAS DEATH CERTIFICATE DATA, UH, AND THAT TENDS TO BE MORE TIMELY. WE CONTINUE TO MONITOR THAT DATA. WE HAVE BEEN DOING THAT SINCE, UH, 2018 AND CONTINUE TO DO SO. AND, UH, WE'LL PRESENT THAT DATA, UH, IN OUR CRITICAL HEALTH INDICATORS REPORT WHEN IT COMES OUT. UM, LET'S SEE, UH, YOU KNOW, WE CONTINUE TO EXPLORE OTHER FUNDING OPPORTUNITIES AS WELL. ANY ANYWHERE THERE MIGHT BE A LEAD TO FUNDING. WE, WE DEFINITELY, UM, ARE TRYING TO, UH, SEE IF THERE'S FUNDING AVAILABLE TO, TO OUR COMMUNITY SO THAT WE CAN, UH, GET SOME DATA BEHIND THIS AND REALLY PAINT THE PICTURE, UH, SO THAT, AND SO THAT WE CAN GET SOME OF THESE PREVENTION PROJECTS AND HARM REDUCTION PROJECTS IN PLACE. UM, I KNOW EMS, THEY WERE NOT ABLE TO BE HERE TODAY, BUT THEY HAD ONE PROJECT THAT WAS ALSO FUNDED BY THE DEPARTMENT OF STATE'S HEALTH SERVICES. THAT WAS A, UM, WHAT THEY CALL IT INTERCEPT PROJECT. SO WHEN THEY MEET PEOPLE, THEIR COMMUNITY HEALTH PARAMEDICS MEET PEOPLE, UM, YOU KNOW, ADD AN ENCOUNTER. WHAT HAPPENS IS, UH, UM, THEY'RE ABLE TO TRY TO GET THAT PERSON INTO THE SOBERING CENTER AND LINK THEM TO THE PROPER CARE, UH, FOR RECOVERY AND THAT TYPE OF THING. SO, UM, THAT, THAT PROJECT WAS ALSO FUNDED BY THE DEPARTMENT OF HEALTH STATES STATE HEALTH SERVICES, BUT THERE WERE SOME ISSUES WITH HOW IT CAME OUT. SO THEY CONTINUED TO SUPPORT THE PROJECT, UH, THROUGH, IN KIND SUPPORT WITH, UH, FROM THE CITY. UM, COULD WE, UM, SHIFT IF YOU, TO SOME OF THE SPECIFIC, UM, JUST AGAIN, IN THE INTEREST OF TIME, WE'RE GOING TO LOSE THE MAYOR HERE AT 10 25. I WONDER IF YOU COULD ADDRESS, UH, SOME OF THE VERY SPECIFIC ACTION STEPS THAT WERE IN THE RESOLUTION. SO SOME OF THEM CERTAINLY HAVE HAPPENED. UM, THE THIRD, THE THIRD VIET FOR THE RESOLVE TALKED ABOUT THE CURRENT LITIGATION, [00:40:01] WHICH, WHICH HAS NOW BEEN CONCLUDED. WE ENTERED THE SETTLEMENT. UH, I KNOW COUNCIL MEMBER RESOLUTION THAT'S COMING FORWARD NEXT WEEK HAS SOME ADDITIONAL NEXT STEPS ON THAT YOU'VE TALKED ABOUT. AND YOU'VE TALKED ABOUT COLLABORATION. SOME OF THE OTHER STEPS THAT I WOULD BE INTERESTED IN YOU ADDRESSING ARE, ARE, UM, WHETHER OR NOT YOU BROUGHT FORWARD FUNDING REQUESTS. I GUESS PART OF THAT, MAYBE IT DIDN'T HAPPEN BECAUSE YOU HAD HOPES OF THIS OTHER FUNDING SOURCE. UM, THERE WAS DISCUSSION ABOUT STAFF RECOMMENDATIONS CONSIDERING WITHOUT LIMITATION INCREASED EPI EPIDEMIC, EPIDEMIOLOGICAL SURVEILLANCE AND MONITORING PUBLIC EDUCATION, HEALTH PROMOTION, EVIDENCE-BASED PREVENTION, HARM REDUCTION STRATEGIES, CRIMINAL DISTRESSED JUSTICE, DIVERSION, UM, INCREASED FUNDING FOR A RANGE OF TREATMENT, RECOVERY, NALOXONE KITS, AND FIRST RESPONSE TRAINING, UM, AND OTHER BEST PRACTICES. AND SO IF YOU COULD KIND OF ADDRESS THOSE, I KNOW FOR EXAMPLE, YOU MENTIONED THE SOBERING CENTER. ONE OF THE THINGS THAT'S HAPPENED SINCE IT'S, SINCE ITS INCEPTION, AND NOW IS THAT THE BOARD THAT I SERVE ON CHANGED ITS PRACTICES AND ITS POLICIES TO ALLOW FOLKS WHO ARE INTOXICATED AND POSSIBLY USING INTOXICATED, POSSIBLY THROUGH OPIOIDS OR OTHER KINDS OF DRUGS, TO BE ADMITTED, THAT WAS NOT THE ORIGINAL INTENT. AND THAT WAS A POLICY CHANGE THAT HAPPENED. UM, AND THAT'S, UH, I THINK OUR BEST EXAMPLE OF A CRIMINAL JUSTICE DIVERSION PROGRAM, IT'S MY UNDERSTANDING THE LOCKS ON KITS BASED ON SOME OF THE BUDGET QA THAT MY OFFICE AND OTHERS HAVE PUT FORWARD THROUGH THE YEARS THAT, THAT, THAT HAS INCREASED AMONG OUR STAFF. BUT COULD YOU, COULD YOU ADDRESS SOME OF THE OTHER VARIOUS SPECIFIC, UM, POINTS IN THE RESOLUTION? JUST SO WE HAVE A SENSE OF KIND OF WHAT I'LL TRY TO BE MY BEST IS PROBABLY, I KNOW DOCTOR WALKS IN A LOUD ALL OF ONE DAY ARE ON THE LINE AND THEY SAY, SINCE THIS IS LIKE COVERS A WHOLE BROAD RANGE OF THINGS, I SURE MY FOCUS HAS ALWAYS BEEN ON THE DATA. AND, UM, I WOULD INVITE THEM TO ANSWER THAT IF YEAH. YEAH. SO, AND I WILL SAY THAT, YOU KNOW, AGAIN, A LOT OF THESE RECOMMENDATIONS, PART OF THE CHALLENGE HAS BEEN THERE. HASN'T BEEN FUNDING TO SUPPORT MOVEMENT FORWARD. WE'VE TRIED TO MOVE FORWARD WHERE POSSIBLE, LIKE I SAID, JUST TRYING TO IDENTIFY ALL THE RESOURCES THAT ARE AVAILABLE. AND I, I DON'T KNOW IF YOU HAVE A COPY OF THIS, BUT I CAN SHARE IT WITH YOU IF YOU LIKE, THANK YOU. UM, YOU KNOW, AND I, WHAT I WOULD ACTUALLY ASK IS IF YOU COULD MAKE THAT AVAILABLE TO ALL OF THE COMMITTEE MEMBERS, I THINK THAT WOULD BE APPROPRIATE. AND, YOU KNOW, AS WE, AS WE TRY TO UNDERSTAND KIND OF WHAT, WHAT WORK GOT INITIATED, WHAT THE RESPONSE WAS, WHAT THE WORK WAS. I THINK IT MIGHT BE EXTREMELY USEFUL COUNCIL MEMBER FRONTIERS TO HAVE ALL OF THIS AS BACKUP TO YOUR ITEM FOR NEXT WEEK, IF YOU'D BE OPEN TO THAT. SO I WOULD REQUEST THAT WE HAVE, UM, THAT DOCUMENT, YOU JUST SHARED THE MAYOR'S RESOLUTION WITH THE CO RESPONSIVE NEMO. AND IF, UM, OUR SPEAKERS FROM EARLIER ARE AMENABLE TO THIS, HAVING THEIR POWERPOINT AS PART OF THAT WORK AS WELL. IS THAT, DOES THAT SOUND GOOD? YES, THAT SOUNDS GREAT. THANK YOU. SUPER. THANK YOU. SO AGAIN, FROM, FROM MY PERSPECTIVE, AS FAR AS EPIDEMIOLOGIC SURVEILLANCE AND MONITORING, UH, WE CONTINUED IT. WE HAVE BEEN DOING THAT SINCE, PROBABLY BEFORE, UH, THE RESOLUTION ORIGINAL RESOLUTION OCCURRED, UM, LOOKING AT DEATH CERTIFICATES AND ANY DEATHS THAT ARE COMING ACROSS, UM, THROUGH OUR OFFICE OF VITAL RECORDS. UM, AND WE CONTINUE TO HAVE WE'VE OVER TIME, CONTINUE TO FIND FUNDING SOURCES WHEN THEY'VE BEEN AVAILABLE. UM, WE'VE WORKED WITH, UH, DIFFERENT GROUPS FROM A MATERNAL AND CHILD HEALTH PERSPECTIVE GENERALLY, UH, FOR THE PUBLIC AT LARGE. UM, AND THAT TYPE OF THING I KNOW FROM A PREVENTION EDUCATION STANDPOINT, I THINK, YOU KNOW, BOOTS ON THE GROUND EMS THERE, COMMUNITY HEALTH, UH, PARAMEDIC PROGRAM HAS BEEN SORT OF INSTRUMENTAL IN DOING SOME OF THE EDUCATIONAL OUTREACH, UH, AND INTERVENTION AT, AT THE STREET LEVEL, UH, FOR ANY OF THOSE INDIVIDUALS THAT ARE INCLUDED. I KNOW, UM, AS FAR AS HARM REDUCTION, WE DID TAKE WHAT WE HEARD FROM THE TOWN HALL MEETING. OKAY. AND, UH, YOU WANT TO GO, OKAY, GOOD MORNING. I'M STEPHANIE HAYDEN HOWARD ASSISTANT CITY MANAGER. UM, WHEN WE REFERENCED THE RESOLUTION ITSELF, UM, THERE WERE TWO ITEMS THAT THE DEPARTMENT WAS ABLE TO, UM, CONTINUE TO MOVE FORWARD AS JANICE, UH, STATED, YOU KNOW, WERE ABLE TO INCREASE THE EPIDEMIOLOGY PORTION AND CONTINUE TO MONITOR, UM, THAT INFORMATION. UM, THERE CONTINUED TO BE CONVERSATIONS INTERNALLY BETWEEN, UM, EMS, AUSTIN, PUBLIC HEALTH, AND AT THE TIME THE, UM, OFFICE OF THE CHIEF MEDICAL OFFICER, UM, EMS WAS ABLE TO, UM, PROVIDE SOME, UM, THE KNOCKS ALONE TO FOLKS THAT THEY [00:45:01] WOULD ENCOUNTER. UM, BUT AS JANET DID STATE, UM, THERE WAS NOT, UM, SIGNIFICANT FUNDING THAT WAS PROVIDED, UM, TO GO HAND IN HAND WITH THE RESOLUTION. HOWEVER, UM, AFTER THE FACT, UM, THERE WAS SOME FUNDING THAT WAS, UM, PROVIDED AND AUSTIN PUBLIC HEALTH WAS ABLE TO DO A SOLICITATION. AND, UM, I'M GONNA TURN IT OVER TO LOTTA ASSISTANT DIRECTOR FOR AUSTIN PUBLIC HEALTH, AND AT LEAST HAVE HER TO WALK THROUGH, UM, THAT FUNDING THAT, THAT SOLICITATION THAT WAS RELEASED. AND JUST KIND OF TELL YOU ABOUT THE AGENCIES THAT ARE FUNDED, UM, INCLUDING, UM, AUSTIN, UM, HARM REDUCTION, LADA UH, YOU ARE, YOU ARE MUTED AND THANK YOU, ASSISTANT CITY MANAGER HIDDEN. HI, CAN YOU TRY, IF YOU COULD, UM, TRY AGAIN, WE'LL, WE'LL SEE IF WE CAN HEAR YOU, SO I'M SORRY. WE'RE STILL UNABLE TO HEAR YOU. YOU MIGHT NEED TO EXIT AND REENTER, BUT, BUT PERHAPS WE SHOULD, UM, FOLLOW UP ON THE, THE FUNDING PIECE. I CAN, UM, SHE SENT ME SOME INFORMATION. OKAY, GREAT. I KNOW SHE'S HAVING SOME, SHE WAS HAVING PROBLEMS KIND OF SENDING THIS TO ME TODAY. UM, BASICALLY A SOLICITATION WAS RELEASED IN DECEMBER OF 2020, UM, AND FOUR ORGANIZATIONS WERE AWARDED FUNDING. UM, TEXAS HARM REDUCTION, UM, WAS AWARDED, UM, $684,000 FOR, UM, SUBSTANCE MISUSE RECOVERY AND PEER LED HARM REDUCTION. UM, THAT DID INCLUDE THE ONE-TIME FUNDING FOR THE MOBILE UNIT THAT THEY, UM, SHOWN, UM, INTEGRAL CARE WAS FUNDED FOR A COMPREHENSIVE SUBSTANCE MISUSE SERVICE CONTINUUM, COMMUNITY CARE, UM, SUBSTANCE MISUSE, COUNSELING NAVIGATION, AND WRAPAROUND SERVICES, AND THEN COMMUNITIES FOR RECOVERY FOR PEER SUPPORTED RECOVERY PROGRAM AND SERVICES, WHICH INCLUDES WELLNESS AS WELL. UM, SO THOSE ARE THE AGENCIES THAT ARE CURRENTLY PROVIDING SERVICES WITH A CONTRACT WITH AUSTIN PUBLIC HEALTH. THANK YOU. THAT'S VERY HELPFUL. SO COLLEAGUES, WHAT I'D LIKE TO DO NOW IS MAYBE HAVE A FEW MINUTES COUNCIL MEMBER US, IF YOU COULD LAY OUT THE RESOLUTION THAT WE'RE CONSIDERING NEXT WEEK, AND THEN THAT'S OPEN IT UP FOR QUESTIONS. BUT I THINK THAT, THAT WE NOW HAVE A CONTEXT, A LITTLE BIT MORE CONTEXT OF WHAT WORK HAS BEEN INITIATED, WHAT WORK REMAINS, UM, AND WHAT OUR PARTNERS HAVE, HAVE IDENTIFIED AS NEXT STEPS. THANK YOU. THANK YOU, CHAIR. TOBO COLLEAGUES. UM, AS YOU HEARD TODAY, WE KNOW THAT WE HAVE AN OVERDOSE CRISIS GOING ON IN THE CITY AND IN THIS COUNTY, OUR COUNTERPARTS AT TRAVIS COUNTY HAVE, UM, ALSO DECLARED THE OVERDOSE CRISIS, A PUBLIC HEALTH CRISIS. AND SO WHAT, UH, WHAT MY ITEM DOES, WHICH EVERYONE SHOULD HAVE A COPY, UM, WHICH I JUST WANTED TO SAY, THANK YOU TO EVERYONE ON THE COMMITTEE WHO HAS, UM, IS IN SUPPORT OF THIS POLICY ITEM. AS EVERYONE ON THE PUBLIC HEALTH COMMITTEE IS A CO-SPONSOR OF ITEM NUMBER 53, AND THAT'LL BE ON OUR AGENDA FOR NEXT WEEK FOR COUNCIL CONSIDERATION. AND SO WHAT THIS ITEM SEEKS TO DO IS TO ALSO DECLARE A PUBLIC HEALTH CRISIS. UM, IT LOOKS AT CREATING IMMEDIATE AND LONG-TERM STRATEGIES TO INCREASE AWARENESS OF THE OVERDOSE CRISIS IN OUR COMMUNITY, AS WELL AS INCREASED SUPPORT SERVICES THAT ARE NEEDED. UM, SO IT DOES THIS IN A NUMBER OF WAYS, INCLUDING EQUIPPING, UM, ALL OF OUR FIRST RESPONDERS WITH NALOXONE AND INCREASING TRAINING AND THE LOCK SOON TO OTHER CITY DEPARTMENTS, INCLUDING, BUT NOT LIMITED TO APH APL AND OUR PARKS AND REC DEPARTMENT, IT INCREASES ACCESS TO MEDICATION ASSISTED TREATMENT, UM, AS WELL AS IT LOOKS AT EXPANDING INTER-LOCAL AGREEMENTS THAT WE HAVE CURRENTLY, UM, WITH PARTNERSHIPS WITH, UM, WITH THE COMMUNITY, UM, AS WAS PREVIOUSLY LISTED FROM ACM HAYDEN HOWARD, UM, BUT YOU KNOW, LOOKING AT INCREASING PARTNERSHIPS AND SERVICES SO THAT WE'RE ABLE TO EXPAND, UH, TREATMENT AND OPTIONS FOR OUR COMMUNITY. IT ALSO LOOKS AT, UM, EXPANDING PARTNERSHIPS BETWEEN OUR COMMUNITY HEALTH PARAMEDIC PROGRAM THAT DOES AN INCREDIBLE JOB RIGHT NOW WITH ASSISTING AND, UM, AND THEN IT ALSO TASKS OUR NEWLY CREATED PUBLIC HEALTH COMMISSION, WHICH IS ANOTHER ITEM THAT THIS, UH, PUBLIC HEALTH COMMITTEE HAS TAKEN ACTION ON AND CREATING THAT COMMISSION. UM, IT TASKS THEM WITH THE OBJECTIVE OF CREATING A COMPREHENSIVE LOCAL PLAN OF ACTION, UM, THAT, THAT PRIORITIZES STRATEGIES RELATED TO PREVENTION [00:50:01] TREATMENT AND SUPPORT SERVICES FOR SUBSTANCE USE DISORDERS. IN ADDITION, AS WE HEARD BOTH FROM TEXAS HARM REDUCTION ALLIANCE AND FROM STAFF, THERE IS A NEED FOR US TO COALESCE THIS DATA AND IT'S IMPORTANT FOR US TO HAVE A CENTRALIZED SOURCE OF DATA. SO THIS RESOLUTION ALSO, UH, DIRECTS THE CREATION OF A DATA DASHBOARD TO BE SHARED WITH STAFF DEPARTMENTS AND COMMUNITY ORGANIZATIONS. ADDITIONALLY IT AT THE PUBLIC, UH, RAISING PUBLIC AWARENESS ABOUT THE OVERDOSE CRISIS. AND SO IT LAYS OUT A PUBLIC HEALTH, PUBLIC EDUCATION CAMPAIGN, AS WELL AS WORKSHOPS, UH, TO INFORM THE LOCAL PLAN OF ACTION. AND THEN LASTLY, THE RESOLUTION ALSO UPDATES OUR LOCAL, UH, LEGISLATIVE AGENDA, OUR CITIES CITY OF BOSTON LEGISLATIVE AGENDA, UH, TO ENSURE THAT AS WE PREP FOR THE ADA TEXAS LEGISLATIVE SESSION, THAT WE SUPPORT THE LEGALIZATION AND ACCESS TO FENTANYL TESTING STRIPS, UM, AS WELL AS THE EXPANSION OF GOOD SAMARITAN LAWS AND TO BE AN OPPOSITION OF ANY BILLS THAT INCREASE ARRESTS OR SEVERITY OF CRIMINAL PUNISHMENT RELATED TO AN INDIVIDUAL EXPERIENCING AN OVERDOSE. AND SO, UM, IT DOES A NUMBER OF THINGS AND I WANT TO THANK, UM, MY TEAM AND EVERYONE HERE FOR ALL THE CONVERSATIONS THAT HAVE BEEN HAD, UH, WE'VE BEEN WORKING WITH OUR ORGANIZATIONS AS WELL AS WITH APH EMS, DR. S SCOTT, CENTRAL HEALTH INTEGRAL CARE COMMUNITY CARE. AND THE, AND, UM, DID I, IF I DIDN'T MENTION DR. WALKS OFF, SOMEONE HAD MENTIONED DR. WALKS AND THE TEXAS HARM REDUCTION ALLIANCE. AND SO WE'VE HAD SEVERAL CONVERSATIONS, UM, ABOUT THIS AND THIS RESOLUTION COALESCES THAT WORK INTO, UM, THESE STRATEGIES. THANK YOU. GREAT. THANK YOU, MAYOR. I'M GOING TO GIVE YOU THE FIRST OPPORTUNITY TO ASK QUESTIONS SINCE YOU HAVE A SHORT TIMEFRAME HERE, AND THEN WE'LL OPEN IT UP FOR GENERAL QUESTIONS TO THE TEXAS HARM REDUCTION ALLIANCE. THANK YOU. OR OUR, I DON'T THINK I HAVE A QUESTION. I THINK IN HEARING THE, THE REPORTING, I THINK THE WILL WAS THERE. I THINK THE INITIAL WORK WAS THERE, BUT THERE WAS OBVIOUSLY NOT FUNDING PROVIDED TO DO THE WORK. UH, SO I THINK IT'D BE REALLY HELPFUL AS WE GO INTO THIS NEXT BUDGET SESSION TO HAVE SPECIFICALLY CALLED OUT FOR WHAT IT WOULD TAKE TO BE ABLE TO DO THIS WORK SO THAT WE ACTUALLY GET THE OPPORTUNITY TO, TO, TO, TO PRIORITIZE, UH, THAT WORK. I MEAN, THAT APPEARS TO BE WHERE THE DISCONNECT HAPPENED. OKAY. I APPRECIATE THAT. THANK YOU. AND, AND I'M MINDFUL OF THE LANGUAGE THAT YOU, YOU DID DIRECT THE MANAGER TO BRING FORWARD, TO IDENTIFY THOSE NEEDS AND TO PREPARE ANY NECESSARY FUNDING REQUESTS. AND AS, UM, I DON'T BELIEVE WE GOT ANY NECESSARY FUNDING REQUESTS. SO I THINK IT IS. WE ALSO NEED TO LOOK AT WHAT PIECE OF THE PROCESS DIDN'T HAPPEN CORRECTLY. SORRY, I'VE FILLED UP MY MICROPHONE HERE. WHAT PIECE OF THE PROCESS DIDN'T HAPPEN CORRECTLY AS WE DIDN'T GET ADVANCED THOSE FUNDING REQUESTS THOUGH? I THINK COUNCIL MEMBER KITCHEN. I KNOW YOU WERE ON THE COUNCIL AT THE TIME. I BELIEVE YOU WERE ON THE RESOLUTION. I WAS ON THE RESOLUTION. IT PASSED PROBABLY UNANIMOUSLY OR NEARLY UNANIMOUSLY. SO I DON'T, I DON'T KNOW THAT WE CAN GET TO THE BOTTOM OF THAT, BUT I THINK IT'S AN ISSUE WE NEED TO ADDRESS. I AGREE. AND WE CAN CERTAINLY FIND OUT WHAT HAPPENED IN THE PAST. UH, BUT BY ALL MEANS, WE NEED TO MAKE SURE THAT IT'S PART OF THE, EVEN IF IT MAKE IT INTO THE MANAGER'S BUDGET, WE NEED TO KNOW SEPARATELY WHAT IT'S GOING TO COST TO DO THIS SO THAT THE COUNCIL HAS THE OPPORTUNITY TO, TO, TO REPRIORITIZE. IF WE WANT TO. I THINK WE JUST MISSED IT WHEN IT DIDN'T COME BACK TO US AS A FUNDING REQUEST. I THINK WE ALL JUST ASSUMED IT WAS HAPPENING. AND THAT WAS A, WE SHOULDN'T HAVE DONE THAT COUNCIL MEMBER KITCHEN. YEAH. I WOULD ALSO JUST SAY THAT WE CAN NEVER EXPECT ONE RESOLUTION TO RESOLVE EVERYTHING. THIS IS AN EVOLVING CRISIS. AND, UM, SO, YOU KNOW, WE CERTAINLY MADE, UH, EFFORTS IN THE PAST AND THOSE WERE GOOD AND, YOU KNOW, MAYBE HE DIDN'T FINISH EVERYTHING WE THOUGHT, BUT REGARDLESS OF ALL, THAT THIS IS AN EVOLVING CRISIS. UM, AND, UM, HAVING THE WORK OF OUR FOLKS ON THE GROUND, REMINDING US AND COMING BACK TO US AND SAYING, THIS IS, WHAT'S NOT WORKING, AND THIS IS WHAT NEEDS RAMPING UP. WE WOULD NEED THAT REGARDLESS OF WHAT WE HAD PASSED IN THE PAST. SO I THINK IT'S IMPORTANT FOR US TO REMEMBER THAT, THAT THIS IS THE OPPORTUNITY TO COME BACK AND SAY, WHAT'S, WHAT'S REALLY, REALLY CURRENT RIGHT NOW, UH, IN TERMS OF WHAT THESE FOLKS ARE SEEING ON THE GROUND FOR US TO FOCUS ON. SO, OKAY. I AGREE. UM, I SIMPLY WANT TO MAKE SURE THAT BECAUSE IT'S NOT A NICE, I'M ONLY IDENTIFYING IT BECAUSE IT'S NOT AN ISOLATED ISSUE OF THAT PROCESS, BUT, BUT ABSOLUTELY I THINK YOU'VE, YOU'VE WELL SAID, UM, WHAT THE CURRENT NEED IS, WHICH COUNCIL MEMBER FRONT AS IS RESOLUTION REALLY ADDRESSES. UM, AND SO I THINK THAT'S A GOOD SEGUE TO ASKING QUESTIONS OF OUR TEXAS HARM REDUCTION ALLIANCE, BUT COUNCIL MEMBER FUENTES, IT LOOKED [00:55:01] LIKE YOU HAD A QUESTION OR YES, JUST WANTED TO ADD ON AN IMPORTANT ELEMENT OF ITEM 53 IS THAT IT DIRECTS HOW TO SPEND THE OPIOID SETTLEMENT DOLLARS. AND THAT'S SOMETHING THAT THE COUNCIL DECIDED TO PARTICIPATE WITH. BACK IN DECEMBER, WE PASSED A RESOLUTION PARTICIPATING IN THE OPIOID SETTLEMENT DOLLARS. AND SO WE'RE GETTING OUR FIRST, UM, FUNDING SETTLEMENT THIS MONTH, UM, AND IS ANTICIPATED TO BE ONE POINT APPROXIMATELY 1.5 MILLION. UM, AND IT'LL, IT'LL BE SPREAD OUT THROUGHOUT A NUMBER OF YEARS. I MEAN, TRULY IT'LL BE 9, 15, 18 YEARS THAT WE'LL RECEIVE SETTLEMENT DOLLARS. AND SO WHILE THIS IS THE LARGEST AMOUNT OF FUNDING, THIS RESOLUTION SEEKS TO PROVIDE SOME, SOME DIRECTION ON HOW TO BEST USE THOSE DOLLARS. SO THE QUESTION I HAD FOR THE TEXAS HARM REDUCTION ALLIANCE IS JUST WANTING TO LOOK AT, UM, YOU KNOW, WHAT, UH, HOW CAN OUR SERVICE PROVIDERS DO, UH, DO BETTER AROUND HARM REDUCTION AND OVERDOSE PREVENTION? WHAT ELSE CAN OUR SUB SERVICE PROVIDERS BE DOING AS WE LOOK AT BUILDING A ROBUST HARM REDUCTION SYSTEM HERE LOCALLY, THANK YOU FOR THAT QUESTION, COUNCIL MEMBER AND THANK YOU TO THE COMMITTEE FOR HAVING US AGAIN. UM, SO I THINK I'LL TALK SPECIFICALLY ABOUT HOUSING, UM, HOUSING SERVICE PROVIDERS. SO WE HAVE BEEN HEARING MANY THINGS, UH, FROM OUR PARTICIPANTS. SO FOR EXAMPLE, AT SOUTHBRIDGE SHELTER, ONE OF OUR PARTICIPANTS MENTIONED THAT WE HAD DROPPED OFF SUPPLIES OR, OR ANOTHER ORGANIZATION HAD DROPPED OFF SUPPLIES, UM, MEANING, UH, STERILE SYRINGES, SAFER SMOKING KITS FOR FOLKS THAT WERE THERE. AND WHEN THEY WENT INSIDE WITH THE SUPPLIES, THEY WERE IMMEDIATELY TAKEN AWAY. WE'VE ALSO HEARD OF, UM, FOLKS WHO HAVE BEEN THREATENED ABOUT EVICTION FROM THESE SHELTERS, UM, AND JUST GENERAL THINGS AROUND THINGS LIKE SMOKING CIGARETTES, BREAKING RULES, UH, JUST PUNITIVE CULTURE, PUNITIVE, UM, POLICIES, UH, THAT REALLY MAKE A REVOLVING DOOR FROM WHETHER IT'S SHELTERS OR TRANSITIONAL HOUSING OR, OR EVEN PERMANENT HOUSING. UM, SO ENSURING THAT SERVICE PROVIDERS ARE WELL-EQUIPPED WELL-TRAINED AROUND HOW TO ADOPT HARM REDUCTION, CULTURE AND VALUES IS ONE PIECE OF IT. AND, AND ENSURE THAT THESE, LIKE THESE ARE ACTUALLY INSIDE THE CONTRACTS, THE WRITTEN CONTRACTS THAT THE CITY IS, IS, UM, GETTING INTO A RELATIONSHIP WITH SERVICE PROVIDERS AROUND. AND SO THERE'S A LOT OF SUPPORTIVE HOUSING THAT'S GOING TO BE COMING ONLINE IN THE FUTURE. IT'S REALLY, REALLY CRITICAL THAT, THAT ISN'T JUST SUPPORTIVE HOUSING FOR PEOPLE THAT DON'T USE DRUGS, OR FOR PEOPLE THAT FOLLOW A REALLY STRINGENT SET OF RULES. WE HAVE TO EXPAND, UM, WHAT THESE PLACE, WHAT THESE UNITS OF HOUSING LOOK LIKE, THE KIND OF SERVICES THAT PEOPLE GET, AND REALLY UNDERSTAND THAT THE, THAT THERE ARE DIVERSE NEEDS AND OUR SERVICE PROVIDERS HAVE TO MEET THE DIVERSE NEEDS OF PEOPLE. THAT'S, THAT'S JUST ON THE HOUSING PIECE. I DON'T KNOW IF YOU HAVE ANYTHING TO ADD ON WELL AND MORE BROADLY, UM, WE'VE LOST, UH, YOU KNOW, SERVICE PROVIDERS IN THE, DURING THE PANDEMIC. UM, WE LOST OS RECOVERY, FOR EXAMPLE, RIGHT? WE DON'T HAVE A GOOD NETWORK ALONG OUR WHOLE CONTINUUM OF CARE WHEN IT COMES TO SUBSTANCE USE SUPPORT. AND A LOT OF IT IS REALLY HIGH BARRIER STUFF, RIGHT? IF YOU DON'T HAVE INSURANCE OR MONEY, YOU'RE, YOU'RE NOT GOING TO GET ANY TREATMENT. AND THEN FOR THE LOW BARRIER THINGS LIKE OUR PROGRAM, WE'RE, YOU KNOW, WE'RE NEW AND WE'RE ALREADY LIKE WAY BEYOND CAPACITY. UM, AND THE METHADONE PROGRAM IS LOW BARRIER AND MUCH MORE AFFORDABLE. AND WE HAVE A LONG WAITING LIST BECAUSE THERE'S NO COVERAGE FOR IT. UM, WHICH IS WHY WE'VE BEEN WORKING WITH CENTRAL HEALTH TO TRY TO INCLUDE IT IN A COVERED MEDICATION UNDER THE MAT PROGRAM. THAT WOULD BE AN EXCELLENT STEP TO, TO BRING THAT TREATMENT, UM, MAKE IT MUCH MORE ACCESSIBLE. SO WE JUST HAVE A TON OF BARRIERS IN OUR COMMUNITY. IF SOMEBODY IS READY FOR HOW THEY WANT HELP, THEY'RE ASKING FOR IT AND THEY DON'T GET IT. SO IT'S ABUSING HARM REDUCTION INTO, INTO ALL SERVICE PROVIDE PROVISION, BUT IT'S ALSO LIKE OPENING UP THE, THE TYPES OF TREATMENT SO THAT PEOPLE HAVE CHOICE. PEOPLE HAVE ACCESS. UM, LIKE WE, THIS SHOULD BE EASY FOR PEOPLE WHEN THEY'RE READY FOR HELP. IT SHOULD BE LIKE, OKAY, GOT YOU. WE'RE HERE BECAUSE OUR TEAM IS READY AND WE'RE CONSTANTLY TRYING TO SUPPORT PEOPLE. AND, YOU KNOW, OUR TEAM RUNS INTO THOSE BARRIERS WITH FOLKS AS WELL. SO, UM, WE HAVE A INFRASTRUCTURE PROBLEM AS WELL WHEN IT COMES TO SUPPORTING PEOPLE WHO WANT TO CHANGE THEIR RELATIONSHIP TO DRUG USE. THANK [01:00:01] YOU. AND I, WE DON'T HAVE, UH, OUR HOMELESS STRATEGY OFFICER HERE COMMUNICATING WITH HER. I CAN SPEAK TO THAT. OKAY, GREAT. I WAS, UM, LET ME JUST EXPLAIN THE REST OF MY SENTENCE. I WAS EXPLAINING THAT WE DON'T HAVE OUR HOMELESS STRATEGY OFFICER HERE TO ADDRESS THE SHELTER POLICY. UM, AND SO I DID ASK OUR ASSISTANT CITY MANAGER. I'M NOT SURE IF YOU HAVE INFORMATION, BUT COUNCIL MEMBER, KITCHEN, I'LL INVITE YOU TO, TO SHARE WHAT, UH, YOUR CONVERSATION VIA TEXT HAS BEEN WITH DIANA. AND THEN IF OUR STAFF WANT TO WANT TO ADD NOW OR LATER, I'LL INVITE THEM TO DO THE SAME. YEAH, LET ME SHARE IT. AND THEN, UM, MAYBE OUR ASSISTANT CITY MANAGER MIGHT WANT TO ADD TO WHAT I'M SAYING, BUT FIRST OFF, THANK YOU VERY MUCH FOR BRINGING TO OUR ATTENTION, UM, THE CONCERNS THAT YOU ALL ARE HEARING OR SEEING ABOUT THE, UM, NORTHBRIDGE AND SOUTHBRIDGE SHELTERS. UM, I DO UNDERSTAND THAT DIANA GRAY, OUR HOMELESS STRATEGY OFFICER HAS, I THINK SHE SCHEDULED A MEETING WITH YOU ALL. SO YOU'LL, YOU'LL BE ABLE TO DIG INTO THE DETAILS WITH HER AT THAT MEETING. WHAT SHE HAS SHARED WITH ME IS THAT, UH, WE S WE GENERALLY STIPULATE HARM REDUCTION IN OUR CONTRACTS AND THAT THE POLICY AT NORTH BRIDGE, AND IT SHOULDN'T BE THAT, BUT THE, THE POLICY AT BOTH NORTH BRIDGE AND SOUTH BRIDGE SHOULD BE, UM, UH, THAT PEOPLE ARE NOT EVICTED FOR DRUG USE. OKAY. UM, THAT'S THE POLICY AND THAT SHOULD BE IN CONTRACT. SHE DID STATE THAT. ONE OF THE THINGS SHE WANTS TO TALK TO YOU ABOUT IS THAT SOMETIMES WHAT COULD HAPPEN IS TERMINATION FOR BEHAVIOR THAT MAY BE RELATED TO DRUG USE. SOMETIMES THAT CAN BE AN ISSUE, BUT REGARDLESS ALL THE DETAILS, ALL THE CONCERNS THAT YOU'RE RAISING, I KNOW THAT SHE HAS LET ME KNOW THAT SHE WANTS TO GO TALK IN DETAIL WITH YOU ALL ABOUT THAT, BECAUSE THERE MAY BE A DISCONNECT BETWEEN WHAT THE POLICY IS, WHAT THE CONTRACT IS AND WHAT'S ACTUALLY HAPPENING. SO WHAT Y'ALL ARE EXPERIENCING IS IMPORTANT FOR HER TO UNDERSTAND. SO I DON'T KNOW IF YOU WANT TO ADD ANYTHING TO THAT. OKAY. OKAY. YEAH. W WE'RE I'M MEETING WITH HER ON, ON MONDAY AND WE'RE LOOKING FORWARD TO THAT. THAT'S GREAT. GREAT. THANK YOU FOR THAT ADDITIONAL INFORMATION. ANY, ANY OTHER QUESTIONS? UM, I, I, UM, I JUST WANT TO SAY THANK YOU TO YOU GUYS. UM, THIS IS A VERY HELPFUL, I AM CURIOUS ABOUT, UM, AND THIS MAY BE A DIFFERENT CONVERSATION, UM, AND MAYBE, UM, OUR ASSISTANT CITY MANAGER CAN ANSWER IT. UM, I'M REALLY CURIOUS ABOUT WHAT WE'RE DOING AT THE, AT THE CITY, FOR THE, THE MAT TREATMENT. I UNDERSTAND THAT DR. S SCOTT IS INVOLVED, I THOUGHT WITH, WITH OFFERING MAT TREATMENT, OR PERHAPS NOT OFFERING, PERHAPS IT'S MORE PROMOTING IT IN SOME OR MAKING IT MORE AVAILABLE. SO I'D BE CURIOUS. WHAT, WHAT COULD YOU TELL US ABOUT THAT IS, UM, I'M GOING TO FOLLOW OUR MEDICAID COLLEAGUES MEDICATION. THEY HAVE NO ACRONYMS, SORRY, MEDICATION ASSISTED TREATMENT ASSISTED TREATMENT, WHICH IS ONE, YOU KNOW, ONE PIECE THAT'S, THAT'S HELPFUL WHEN PEOPLE ARE, ARE, ARE READY FOR THAT. UM, DOES ANYONE KNOW THE, THE LEVEL OF THAT ACTIVITY THAT'S OCCURRING AT THE CITY? NO. OKAY. THAT'S A FOLLOWUP ITEM. I'D LIKE TO UNDERSTAND THAT FROM DR. ASCOT. YEAH. ALL I CAN SAY IS THROUGH OUR CONTRACT WITH PUBLIC HEALTH, INITIALLY, WE WERE INSTRUCTED NOT TO, WE WEREN'T ABLE TO USE OUR FUNDS FOR MEDICATION ASSISTED TREATMENT AND THEN THROUGH CONVERSATIONS AND EDUCATION, THAT DECISION WAS CHANGED SO THAT WE WERE ABLE TO PAY BECAUSE WE PAY FOR FOLKS TO GET INTO METHADONE QUICKLY BECAUSE THERE'S SUCH A LONG WAITING LIST. AND MY UNDERSTANDING IS THAT THE CITY MIGHT BE DOING SOME THINGS AROUND BUPRENORPHINE OR SUBOXONE, WHICH IS ONE VERSION OF MEDICATION ASSISTED TREATMENT, BUT METHADONE IS ANOTHER, UM, TYPE OF TREATMENT AND IT'S REGULATED DIFFERENTLY. AND SO IT HAS TO BE DISPENSED THROUGH A OPIOID TREATMENT CENTER. UM, AND SO WE ONLY HAVE A FEW OF THOSE IN, IN AUSTIN. UM, AND MY, I WAS ALSO TOLD THAT, UM, THERE ARE SEPARATIONS, RIGHT, BECAUSE OF LIKE CENTRAL HEALTH, UM, ON WHAT THE CITY CAN FUND. BUT I THINK HAVING A 24 7 MEDICATION ASSISTED TREATMENT PROGRAM, A METHADONE CLINIC IN PARTICULAR WOULD BE A HUGE ASSET TO OUR COMMUNITY. AND I DO THINK THAT'S SOMETHING THAT WE SHOULD TALK TO CENTRAL HEALTH AND THIS, AND Y'ALL SHOULD TALK TO CENTRAL HEALTH ABOUT BECAUSE IT WOULD REQUIRE A PARTNERSHIP. UM, BUT I GUESS THERE'S SOME LIMITATIONS TO LIKE MEDICAL CARE THAT THE CITY CAN CAN, OR CAN'T FINE. AND THAT'S WHY WE WERE TOLD THAT MAT COULD NOT BE USED WITH OUR FUNDS INITIALLY. UM, SO I THINK WE MIGHT NEED TO HAVE A CONVERSATION ABOUT LIKE WHAT THAT LIMITATION IS FOR THE CITY, BECAUSE IT WAS REALLY UNCLEAR FOR US AND WE COULDN'T GET CITY LEGAL TO REALLY CLARIFY EXACTLY WHAT WAS MEDICAL CARE THAT THE CITY COULD FUND AND WHAT YOU KNOW WAS PROHIBITED. UM, SO THAT QUESTION STILL REMAINS FOR US. [01:05:01] OKAY. UM, DO Y'ALL DO Y'ALL WORK WITH DR. S SCOTT? UM, NO, NOT DIRECTLY. OKAY. WELL, THAT'S A FOLLOWUP ITEM. I CAN CHECK WITH MY COLLEAGUES AND OUR, WE HAVE ACCESS TO BUPRENORPHINE, SAME DAY. WE WORK CLOSELY WITH EMS AND OTHER PROVIDERS IN THE COMMUNITY. SO THAT'S NOT AN ISSUE FOR US. IT'S, IT'S REALLY JUST THE METHADONE WAITING ON. YEAH. WHICH IS, WHICH IS AN IMPORTANT TOOL TO HAVE VERY IMPORTANT TOOL TO HAVE. OKAY. THANK YOU VERY MUCH. YES. VICE FANTASY JUST ALSO WANTED TO EXTEND MY GRATITUDE, UM, TO TEXTED HARM REDUCTION ALLIANCE FOR BEING HERE WITH US. I IT'S MY UNDERSTANDING I'LL HAVE TEST KITS FOR US TO LOOK AT, UM, TO SEE WHAT THEY LOOK LIKE AND WHAT THEY INCLUDE, I THINK MIGHT BE HELPFUL FOR THE COMMITTEE TO, UM, TO GET, UH, A LENS FOR, AND, UH, NO FURTHER QUESTIONS ON MY END. JUST WANTED TO THANK OUR PUBLIC HEALTH COMMITTEE FOR JOINING ON AS CO-SPONSORS. AND THANK YOU FOR YOUR PREVIOUS WORK ON, ON OPIOID OVERDOSES AND, AND UNDERSTANDING, UM, AND YOU KNOW, WORKING TOWARDS IMPROVING OUR SYSTEM OF CARE REGARDING SUBSTANCE USE DISORDERS. AND SO I JUST ALSO WANT TO APPRECIATE THE WORK THAT YOU'VE DONE. THANK YOU. UM, WHAT I WOULD SUGGEST IF WE HAVE THE OPPORTUNITY TO DO THIS, UM, IF DO WE HAVE THE OPPORTUNITY TO SEE THOSE TEST KITS ON THAT LITTLE SCREEN OVER THERE? I'M SURE, BUT I'M GOING TO FIRST RECOGNIZE MY COLLEAGUE COUNCIL MEMBER HARPER, MADISON, WHO I BELIEVE HAS A QUESTION. SO MAYBE WHILE WE'RE GETTING SET UP FOR THAT, WHICH WOULD IS, UM, THANK YOU FOR BRINGING THOSE. THAT'S GOING TO BE REALLY INTERESTING. I'LL RECOGNIZE YOU, UH, COUNCIL MEMBER, HARPER MEDICINE FOR QUESTIONS. THANK YOU, TERRY. I APPRECIATE IT. UM, I HAD THE OPPORTUNITY TO LISTEN IN, UH, ON THE WAY IN AND, AND REALLY APPRECIATE THE CONVERSATION AND COUNCIL MEMBER FOR THIS REALLY, REALLY APPRECIATE YOU RESURFACING THE ISSUE. I'M GLAD THAT WE'RE TAKING THIS STEP FORWARD. I DON'T HAVE QUESTIONS SO MUCH AS I'D LIKE TO CHAIR BOTH EXPRESS ITEMS FOR FUTURE CONSIDERATION, AND THEN JUST SORT OF LET THE BODY KNOW THE COMMITTEE KNOW AT LARGE, THAT I ALSO INTEND TO BRING FORWARD SOME ITEMS. UM, AND IT'S, MULTI-TIERED, IT'S, YOU KNOW, WE HAD A WORK SESSION YESTERDAY WHERE WE TALKED ABOUT EVERYTHING FROM, UM, LABOR SHORTAGE AS THE DIRECT RESULT OF STAGNANT WAGES, TO HOUSING SHORTAGE, TO HOMELESSNESS CRISIS, TO, YOU KNOW, UH, UH, EVERYTHING IN BETWEEN. AND I THINK ONE OF THE THINGS THAT WAS REPEATED YESTERDAY OVER AND OVER, REGARDLESS OF WHAT WE WERE TALKING ABOUT WAS, I DON'T KNOW THAT WE, AS A COMMUNITY HAVE TRULY SEEN THE MANIFESTATION OF COVID LIKE THE BY-PRODUCT OF HOW IT TRULY AFFECTED OUR COMMUNITY AT LARGE. AND I MEAN, ALL OF US UNIVERSALLY, UM, THAT SAID, I'M FINDING ANECDOTALLY A MAJOR UPTAKE IN SUBSTANCE USE DISORDER. UM, IT BEING PUBLICLY PRESENTED OR PROBLEMATICALLY PRESENTED, UM, AND, UH, MENTAL HEALTH AND WELLNESS ISSUES, BOTH IN ADOLESCENTS AND IN THEIR CAREGIVERS. AND SO THOSE ARE SOME ITEMS THAT I REALLY LOOK FORWARD TO US AS A BODY BEING ABLE TO TAKE INTO CONSIDERATION MOVING FORWARD. BUT THE CONVERSATION THAT YOU ALL WERE HAVING ABOUT CRIME REDUCTION, UM, SUBSTANCE USE DISORDER AND ITS CONNECTION TO HOMELESSNESS, UM, SORT OF THE, MY BRAIN WORKS CAUSE I LIKE TO FIGURE OUT HOW ALL THE THINGS ARE CONNECTED. SO WE DON'T MISS ANY OPPORTUNITIES WITH RESOURCES. SO WE'RE NOT, YOU KNOW, SAME TEAM, BUT FIGHTING OVER LIMITED RESOURCES. AND SO I'D LIKE MOVING FORWARD TO JUST HOPE THAT WE CAN ALL FIGURE OUT HOW THESE THINGS ARE CONNECTED BECAUSE THE CRIMINALIZATION OF POVERTY, HOMELESSNESS NOW, OR PEOPLE ON THE VERGE OF HOMELESSNESS, PEOPLE WHO ARE SO DEPRESSED BY WAY OF THE LOSS OF INCOME THAT THEY JUST CAN'T, YOU KNOW, AND THEY'RE ABOUT TO LOSE THEIR HOUSING. AND THEY'RE, YOU KNOW, INTERACTING WITH CPS THEY'RE IN THE REARS ON PAYING THEIR, UM, PAROLE OFFICERS AND PROBATION, UH, LIKE ALL THE THINGS THAT ARE CONNECTED. AND I THINK TO SOME DEGREE, WE'RE ALL CONCERNED ABOUT ALL THE THINGS, BUT WE'RE TRYING TO TRIAGE THEM AS OPPOSED TO DIRECTLY CONNECTING THEM AND FIGURING OUT HOW WE CAN ADDRESS IT ALL. AT THE SAME TIME, I READ SOME DATA RECENTLY ABOUT SUBSTANCE USE DISORDER AND JUST HOW LIKE 40 MILLION PLUS AMERICANS FACING, UM, SUBSTANCE USE ISSUES ON A REGULAR DAY. BUT AFTER TWO YEARS OF A GLOBAL PANDEMIC AND LOSS OF INCOME AND WEIGHT WEIGHED SHORTAGES AND STAGNATION AND ALL THE OTHER IMPLICATIONS, I THINK NOW IS THE TIME IN WATCHING OUR CRITICAL INFRASTRUCTURE JUST CRUMBLE. I THINK THIS MIGHT BE THE PERFECT TIME FOR US TO REALLY START TALKING ABOUT GETTING AT IT FROM THE ROOT INSTEAD OF TRYING TO COME, YOU KNOW, REPEATEDLY TRIAGED, LET'S GET TO THE SYMPTOMS THAT SYMPTOMS ARE POVERTY. THE SYMPTOMS ARE MENTAL HEALTH. THE SYMPTOMS ARE SUBSTANCE USE DISORDER. AND I THINK IF WE START THERE, WE DON'T HAVE TO KEEP HAVING THESE CONVERSATIONS ABOUT, UM, SHORTAGES, YOU KNOW, SCARCITY WHEN IT COMES TO ADDRESSING THE MANIFESTATION OF THE ROOTS. AND SO I REALLY JUST LOOK FORWARD TO US DIVING INTO THE ROOTS, UM, US, OUR COLLECTIVELY AS PARTNERS, UM, AND GETTING AT THE ROOT. SO I REALLY LOOK FORWARD TO WORKING [01:10:01] MORE TOGETHER, MOVING FORWARD. I APPRECIATED YOUR PRESENTATION AND LOOK FORWARD TO MORE SUPPORTIVE ALL MY COLLEAGUES AND ANYTHING THAT WE CAN DO MOVING FORWARD TO REALLY GET AT WHAT'S MAKING PEOPLE HURT SO BAD, REALLY, REALLY APPRECIATE THAT. UM, WE WERE REALLY EXCITED THAT THIS IS KIND OF LIKE AN IMMEDIATE RESPONSE, BUT DEFINITELY HAVE BEEN THINKING A LOT ABOUT THE PUBLIC HEALTH COMMISSION ROLE OF THAT BODY WITH THE COUNTY'S HELP INVOLVED INTO INVOLVED IN IT AS WELL. UM, BECAUSE OF COURSE THERE'S, THERE ARE WE TEXAS HARM REDUCTION DEALS WITH LIKE A VERY AT RISK POPULATION, BUT THERE'S MANY OTHERS THAT NEED TO BE A PART OF THE CONVERSATION. MANY OTHER ISSUES THAT WE DIDN'T MENTION TODAY. SO AGREE FOR SURE. UM, ONE OTHER THING, COUNCIL MEMBER WENT AS WE WERE GOING TO, UM, JUST RAISE THAT THERE ARE A FEW, UM, DATA SUGGESTIONS THAT WE WERE THINKING COULD BE HELPFUL, UM, IN THE RESOLUTION AROUND JUST, UH, DATA AROUND HOMELESSNESS THAT MAYBE WE COULD LOOK AT TO ADD. AND I THINK IT WOULD HELP FOR FUTURE CONVERSATIONS TOO, AROUND FUTURE SOLUTIONS. YES, ABSOLUTELY. WHAT'S HUDDLE ON THAT WE HAVE UNTIL NEXT WEEK BEFORE COUNCIL TAKES A VOTE ON IT. OKAY, COOL. THANK YOU. THANK YOU. AND SO I THINK AS OUR LAST, UH, AS OUR LAST ITEM, KATE OR PALLETTE, IF YOU WOULD LIKE TO JUST WALK US THROUGH WHAT WE'RE SEEING AND THEN, UM, IF THERE ARE NO, UNLESS THERE ARE ANY OTHER COMMENTS FROM MY COLLEAGUES OR OUR STAFF, WE'LL WE'LL WRAP FOR THE DAY. OKAY, THANK YOU YET. SO WE JUST WANTED TO BRING A FEW THINGS TO BRING TO LIFE, KIND OF WHAT HARM REDUCTION LOOKS LIKE. OFTEN YOU CAN SEE THERE'S A FENTANYL TESTING STRIP THERE. UH, WE HAVE YOU AND, UH, SH MAYBE POINT TO THINGS. AND SO, UM, UH, WE, UM, THAT'S ONE OF THE TOOLS THAT WE MENTIONED, NOT, NOT THE MOST IMPORTANT TOOL, BUT A TOOL, UM, TO HELP PEOPLE UNDERSTAND WHAT IS IN THE DRUGS THEY'RE USING AND PREVENT OVERDOSE. YOU CAN SEE NARCAN, THE NASAL SPRAY IS THERE. THERE'S A COUPLE OF THEM. AND THEN THERE'S ALSO A VIRAL OF THE NALOXONE, WHICH IS, UM, UH, THE SAME MEDICATION, BUT IS INJECTED IT'S, IT'S THERE WITH THE ORANGE TOP. UM, YEAH. AND SO WE GIVE OUT THOSE, UM, PEOPLE HAVE DIFFERENT PREFERENCES FOR HOW THEY LIKE TO, HOW THEY FEEL COMFORTABLE ADMINISTERING NARCAN OR NALOXONE. UM, YOU CAN SEE, WE HAVE STERILE SYRINGES. UM, OUR SMOKING KITS, WE HAVE HYGIENE KITS, WE HAVE WOUND CARE KITS. UM, YEAH. AND SO THESE ARE THE LIFESAVING TOOLS THAT WE GIVE OUT, UM, ON A DAILY BASIS TO KEEP PEOPLE ALIVE AND CREATE RELATIONSHIPS SO THAT THEY COME BACK AND TALK TO US MORE AND SEE IF WE CAN WALK TOGETHER ON THEIR PATH TO RECOVERY, HOWEVER THEY DEFINE RECOVERY. UM, AND SO THESE ARE VITAL TO STARTING THAT CONVERSATION, RIGHT. WE CAN'T JUST GO OUT IN THE COMMUNITY AND SAY, HERE'S SOME NARCAN AND THEY'LL BE LIKE, COOL, THANK YOU SO MUCH, THROW IT OUT. RIGHT. IT HAS TO START WITH LIKE, WHAT DO YOU NEED TODAY? AND SOMETIMES IT'S NOT NARCAN, RIGHT. THAT SOMETIMES IT'S A SHOWER, SOMETIMES IT'S WOUND CARE. SO THAT'S HOW WE START THE CONVERSATION AND BUILD A RELATIONSHIP. SO WE NEED, YOU KNOW, THESE TOOLS TO MEET PEOPLE WHERE THEY'RE AT WITH WHATEVER THEY'RE FACING THAT DAY, HOPING THAT THEY'LL COME BACK THE NEXT DAY AND THE NEXT DAY. UM, THANK YOU. YEAH. THANK YOU SO VERY, VERY MUCH. THIS HAS BEEN REALLY INFORMATIVE. THANK YOU FOR THE WORK YOU DO. AND THANK YOU FOR BRINGING ALONG THESE REALLY VISIBLE ILLUSTRATIONS OF THE KINDS OF RESOURCES, UM, THAT YOU'RE ABLE TO OFFER. IT'S MY UNDERSTANDING. AND I WOULD INVITE OUR STAFF TO CONFIRM THAT, THAT THE FARM THAT IN AUSTIN, UM, ANYONE CAN GO INTO A PHARMACY AND PURCHASE NARCAN AND NALOXONE, IS THAT ACCURATE THAT THERE IS KIND OF A CITYWIDE PRESCRIPTION OR THERE'S A STATEWIDE STANDING ORDER, UH, THAT WAS PASSED IN 2015. AND SO TECHNICALLY YES, BUT SOME PHARMACIES DO DISCRIMINATE AND THEY WILL PUT UP BARRIERS AND SAY, WHAT DO YOU NEED IT FOR? UM, NO, YOU NEED A PRESCRIPTION. THEY'RE NOT, THEY MIGHT NOT BE EDUCATED OR BECAUSE OF STIGMA AROUND PEOPLE WHO USE DRUGS, THEY DON'T MAKE IT READILY AVAILABLE, BUT IT'S ALSO EXPENSIVE SO THAT FOLKS CAN TECHNICALLY PURCHASE IT. AND IF, YOU KNOW, TO ADVOCATE FOR YOURSELF, EVEN IF THEY MAKE IT DIFFICULT, YOU CAN GET THERE WITH THEM. UM, BUT IT'S NOT AS EASY TO, TO GET AS IT SHOULD BE. UM, THAT'S WHY, YOU KNOW, WE LIKE TO GIVE IT OUT. AND THAT'S WHY, UM, AS PAULA WAS MENTIONING, IT SHOULD BE AVAILABLE KIND OF FOR FREE AND IN AS MANY PLACES AS LIKE THE PLACES WHERE A LOT OF FOLKS ARE COMING THROUGH AND WE CAN CONNECT WITH THEM. SO LIKE THE LIBRARIES AND PARKS AND EVERYTHING. UM, THE OTHER THING WE'VE HEARD IS THAT FOR SOME PROGRAMS, AND SO LIKE NARCAN HELPS WITH AN OPIOID OVERDOSE, RIGHT? WE KNOW THAT FENTANYL IS NOW IN PRETTY MUCH ALL OF OUR SUBSTANCES OR LESS AT SUBSTANCES, RIGHT? SO EVEN IF YOU DON'T IDENTIFY AS AN OPIOD USER, YOU'RE STILL AT RISK OF AN OPIATE OVERDOSE. AND SO YOU STILL NEED NARCAN RIGHT NOW, BUT THAT'S A CONVERSATION YOU HAVE TO HAVE [01:15:01] WITH FOLKS. AND A LOT OF PROGRAMS, THEY DO THIS AT THE JAIL, THEY DO THIS AT INTEGRAL CARE. YOU HAVE TO BE FLAGGED AS HAVING AN OPIATE USE DISORDER FOR THEM TO GIVE YOU NARCAN. UM, BUT WE KNOW THAT PEOPLE ARE DYING, WHO ARE NOT IDENTIFYING THAT WAY. MAYBE THEY DON'T WANT TO SAY THAT THEY'RE USING AT ALL, BUT ALSO, MAYBE THEY'RE USING SOMETHING ELSE. THEY'RE NOT USING IT. THEY'RE NOT A HEROIN USER AND THEY ALSO NEED NARCAN. SO THAT'S LIKE A SMALL BARRIER THAT EXISTS TO ACCESSING NARCAN THAT WE COULD EASILY FIX IF WE HAD THE CONVERSATION AND SORT OF LIKE DUG INTO THE ISSUE A LITTLE BIT MORE. AND THAT'S THE EVOLVING NATURE OF THE CRISIS THAT COUNCILMEMBER KITCHEN WAS TALKING ABOUT. RIGHT. UM, SO WE, YEAH, WE, WE, THE FIRST STEP I THINK, IS REALLY GETTING NARCAN OUT IN THE COMMUNITY FREE FOR EVERYBODY, BUT IT'S, THAT'S JUST ONE SMALL STEP. UM, AND WE REALLY, WE SHOULD HAVE BEEN DOING IT YEARS AGO. SO, UM, WE HAVE LOTS OF IDEAS OBVIOUSLY, AND WE'D BE HAPPY TO TALK MORE ABOUT IT. YEAH. WELL, THANK YOU ALL SO VERY MUCH. THANK YOU AGAIN FOR BEING HERE TODAY. THANK YOU TO OUR STAFF FOR PARTICIPATING AND FOR HELPING US BUILD THE CONTEXT OF, OF THE WORK THAT YOU'D BEEN ENGAGED IN. AND THANK YOU, COUNCIL MEMBER FONTUS OR FOR YOUR LEADERSHIP. AND WE LOOK FORWARD TO THE, THE CONTINUED CONVERSATION AND CONTINUED WORK. UM, WITHOUT FURTHER ADO, WE STAND ADJOURNED AT 10 50. THANK YOU ALL. BUT YOU MUST BE SMOKING SOME GRASS. IF YOU TAKE A TICKET BACK SOME TOGA, THIS IS MY LAST GOODBYE. IT'S FUNNY HOW YOU THINK YOU CAN JUST CALL ME UP WHEN ALL YOU EVER DO WAS LEAD ME THIS TERM. I WON'T BE COMING BACK AROUND. * This transcript was created by voice-to-text technology. The transcript has not been edited for errors or omissions, it is for reference only and is not the official minutes of the meeting.