Aug 09, 2023 Public Health Committee

[00:00:06]

EVERYONE.

IT IS

[CALL TO ORDER]

WE ARE HERE AT THE CITY HALL COUNCIL CHAMBERS, I'M PROUD TO CONVENE THE AUSTIN CITY COUNCIL PUBLIC HEALTH COMMITTEE.

WELCOME EVERYONE.

I'M JOINED HERE BY OUR VICE CHAIR VELASQUEZ OF THE COMMITTEE, MAYOR WATSON AND COUNCIL MEMBER REVELLA.

COUNCIL MEMBER KELLY IS NOT WITH US TODAY.

TODAY WE HAVE SIX ITEMS IN OUR COMMITTEE AGENDA, SO WE HAVE A LOT TO GET THROUGH.

WE'LL START WITH PUBLIC COMMUNICATIONS, THEN WE'LL TAKE A LOOK AT APPROVING MINUTES FROM OUR PAST COMMITTEE MEETING.

FROM THERE, WE'LL HAVE A DISCUSSION AND POSSIBLE ACTION REGARDING THE REAPPOINTMENTS OF TWO MEMBERS OF THE SOBERING CENTER BOARD.

WE ALSO HAVE AN APPOINTMENT FOR THE COMMUNITY DEVELOPMENT COMMISSION.

THEN WE WILL HAVE A BRIEFING FROM THE TEXAS HEALTH ACTION AND KIND KIND CLINIC REGARDING S T I TESTING AND DATA TRENDS.

WE'LL ALSO THEN HAVE A PRESENTATION FROM DIANA GRAY WITH OUR HOMELESSNESS STRATEGY OFFICE FOR AN UPDATE.

AND THEN, UH, COLLEAGUES, WE DO HAVE ON OUR AGENDA, UH, TIME AND SPACE FOR AN EXECUTIVE SESSION IF NEEDED, SINCE WE DO HAVE, UH, COM APPOINTMENTS TO THE SOBERING CENTER BOARD AND THE COMMUNITY DEVELOPMENT COMMISSION.

IF WE NEED TO DISCUSS EITHER OF THOSE, WE CAN GO INTO AN EXECUTIVE SESSION, UH, THE MATERIAL ON THE CANDIDATES BEING PROPOSED OR IN YOUR PACKET IF YOU'D LIKE TO REVIEW THOSE IN THE MEANTIME.

ALL RIGHT, NOW WE'LL WELCOME SPEAKERS FROM THE COMMUNITY.

MAY THE CLERK'S OFFICE PLEASE CONFIRM WHETHER WE HAVE ANY SPEAKERS.

MADAM CHAIR, NO SPEAKERS HAVE SIGNED UP FOR TODAY.

ALRIGHT, THANK YOU.

[1. Approve the minutes of the Public Health Committee meeting on June 14, 2023.]

CAN I HAVE A MOTION? THANK YOU.

COUNCILOR REVELLA.

SECONDED BY MAYOR WATSON.

ANY OBJECTION TO APPROVING THE MEETING MINUTES FROM JUNE 14TH, 2023? SEEING NONE, NO DISCUSSION.

THOSE ARE APPROVED UNANIMOUSLY.

[2. Discussion and possible action regarding the re-appointment of Dr. Chris Ziebell and Chad Hooten to the Sobering Center Board of Directors.]

CHRIS ZOBEL AND CHAD HOOTEN TO THE SOBERING CENTER BOARD.

SO WE HAVE MATERIALS ON, ON THEIR, UM, RESUMES.

I KNOW WE HAVE JANA ORGA WITH THE SOBERING CENTER BOARD AVAILABLE, UH, TO ANSWER ANY QUESTIONS IF NEEDED WITHOUT, UH, SO CAN I HAVE A MOTION TO APPROVE? THANK YOU.

MAYOR WATSON MAKES A MOTION.

SECONDED BY COUNCILMAN RIVERA.

ANY DISCUSSION ON THE REAPPOINTMENTS? JUST, UH, I, I'M ON THE SOBERING CENTER BOARD AND I HAVE VERY MUCH ENJOYED, UH, WORKING WITH, UH, DR.

Z.

HE'S A TREMENDOUS RESOURCE TO THE SOBERING CENTER AND HAS BEEN, YOU KNOW, PART OF IT SINCE DAY ONE.

UH, GREAT PERSPECTIVE.

UH, HE'S AN EMERGENCY ROOM DOCTOR, SO HE DEALS WITH THIS KIND OF STUFF ALL THE TIME.

JUST, UH, UH, VERY GLAD HE'S STAYING ON THE BOARD.

I'LL JUST SAY THAT.

WONDERFUL.

THANK YOU.

ALL RIGHT.

ANY OBJECTION TO THOSE REAPPOINTMENTS? OKAY.

SEEING NONE, THOSE REAPPOINTMENTS ARE APPROVED.

[3. Discussion and possible action regarding the appointment of Jenny Achilles to the Community Development Commission.]

DID I SAY THAT RIGHT? CANES.

DO THE COMMUNITY DEVELOPMENT COMMISSION.

I APOLOGIZE FOR BUTCHERING YOUR NAME.

UM, THIS IS A RECOMMENDATION THAT HAS COME FROM THE COMMUNITY DEVELOPMENT COMMISSION AND AS WELL AS MY OFFICE.

UH, MILLI COSTA IS MY OFFICE, ALSO MET WITH THIS NOMINEE, AND WE HAVE HER BACK, HER RESUME AND APPLICATION MATERIALS FOR Y'ALL'S CONSIDERATION.

CAN I HAVE A MOTION TO APPROVE? THANK YOU.

VICE CHAIR VELASQUEZ, SECONDED BY COUNCIL MEMBER REVELLA.

ANY OBJECTION TO THE APPOINTMENT OF JENNY ACHILLES TO THE COMMUNITY DEVELOPMENT COMMISSIONER? OKAY.

SEEING NONE THAT STANDS APPROVED.

WONDERFUL.

THANK YOU FOR HELPING US GET THROUGH OUR ADMINISTRATIVE ITEMS. NOW WE'LL MOVE TO

[4. Briefing from Texas Health Action and Kind Clinic staff regarding the Sexually Transmitted Infection (STI) Testing Program and STI data trends..]

AND FIRST UP WE'LL HAVE THE TEXAS HEALTH ACTION AND KIND CLINIC STAFF, AND THEY WILL PROVIDE US AN UPDATE ON S T I TESTING PROGRAM AND DATA TRENDS.

AND WILL YOU, UM, IF YOU COULD INTRODUCE YOURSELVES AS YOU START YOUR PRESENTATION? GOOD MORNING.

GOOD MORNING.

MY NAME IS CHRISTOPHER HAMILTON.

I'M THE CHIEF EXECUTIVE OFFICER OF TEXAS HEALTH ACTION.

I AM JOINED BY OUR CHIEF MEDICAL OFFICER, DR.

SANDRA GUERRA.

THANK YOU FOR HAVING US THIS MORNING.

MAYOR WATSON, UH, AND COUNCIL MEMBERS.

UM, WE'RE EXCITED AND GRATEFUL FOR THIS OPPORTUNITY TO TALK ABOUT TRENDS IN S T I TESTING AND TREATMENT IN OUR COMMUNITY.

UM, KIND CLINIC FOCUSES ON SEXUAL HEALTH IN OUR COMMUNITY THROUGH S T I TESTING TREATMENT, AS WELL AS H I V PREVENTION AND TREATMENT AND GENDER AFFIRMING CARE IN OUR COMMUNITIES.

PINE CLINIC WAS FOUNDED IN 2015, AND IN THAT TIME, WE HAVE

[00:05:01]

OF COURSE, AUSTIN IS OUR HOME.

UM, THAT SEXUAL WELLNESS COMPONENT THAT WE PROVIDE, WE VIEW AS PART OF A QUALITY OF LIFE.

UH, FOR MANY PEOPLE, HEALTHY SEXUAL ACTIVITY IS PART OF THEIR QUALITY OF LIFE, AND I KNOW THAT AUSTIN IS PROUD OF ITS QUALITY OF LIFE COMPONENTS.

SO WHEN WE SEE TRENDS, UH, AND THREATS TO THAT, WE WANT TO RAISE ATTENTION.

WHAT WE WANNA TALK ABOUT THIS MORNING IS ONE SPECIFIC COMPONENT OF OUR KIND CLINIC PROGRAMS, OUR COMMUNITY HEALTH PROGRAM.

WE OFFER A WALK-IN TESTING SPACE AT OUR CLINIC ON CANA LANE.

THIS WALK-IN SPACE MEANS PEOPLE CAN ACCESS SS T I TESTING AND TREATMENT WITHOUT AN APPOINTMENT.

AND IF YOU'VE EVER HAD TO ACCESS HEALTHCARE, AND YOU KNOW THAT SOMETIMES IF YOU'RE WORRIED AND YOU WANT TO GET IN RIGHT NOW, APPOINTMENTS AREN'T ALWAYS AVAILABLE.

SO HAVING A SPACE DEDICATED TO PEOPLE BEING ABLE TO WALK IN AND ACCESS SS T I TESTING AND TREATMENT HAS BEEN PARAMOUNT, UH, IN ADDRESSING SEXUAL HEALTH FOR PEOPLE.

ONE OF THE COMPONENTS OF THIS PROGRAM ALLOWS US TO ALSO WORK ON H I V PREVENTION.

MANY TIMES PEOPLE DO NOT UNDERSTAND OR MAY NOT BELIEVE THAT THEY HAVE A RISK FOR H I V ACQUISITION THROUGH SEXUAL ACTIVITY BY INCLUDING H I V TESTING.

IN THIS SS T I TESTING SPACE, WE'RE ALSO ABLE TO DETECT NEW H I V INFECTION THAT MAY OTHERWISE GO UNDIAGNOSED IN OUR COMMUNITY.

AND I'LL, UH, IN A MOMENT, DR.

GARRA WILL SHARE SOME OF THE STATISTICS, UH, ABOUT WHAT WE HAVE SEEN IN THAT SPACE AS WELL.

SO BY PUTTING THESE THINGS TOGETHER, WE'RE ABLE TO CREATE A CONTINUUM OF CARE.

IT IS NOT GET A TEST AND THEN FIGURE OUT WHAT TO DO ON YOUR OWN.

WE'RE ABLE TO PROVIDE TREATMENT FOR THAT S T I IN THAT MOMENT.

WE'RE ABLE TO SCHEDULE TREATMENT LATER IF THAT IS WHAT IS CLINICALLY INDICATED.

IF WE FIND SOMEBODY THAT MAY BE ELIGIBLE FOR PREP, A ONCE DAILY ORAL MEDICATION THAT IS UP TO 99% EFFECTIVE AT PREVENTING H I V ACQUISITION, SOMEBODY CAN START PREP.

UH, IF THEY'RE LIVING WITH H I V THAT HAS BEEN UNDIAGNOSED, WE'RE THEN ABLE TO LINK THEM INTO CARE.

UH, THE VAST MAJORITY OF PEOPLE STARTING CARE WITHIN 72 HOURS.

AND ACTUALLY 24 HOURS IS THE STANDARD THAT WE LOOK AT.

MEANING SAME DAY YOU WALK INTO THE CLINIC, YOU MEET WITH A PROVIDER, YOU LEAVE WITH MEDICATION.

AND THIS IS A GAME CHANGER IN TERMS OF H I V IN OUR COMMUNITY AS WELL.

UNFORTUNATELY, WE HAVE SOME CHALLENGES.

UH, AND I KNOW THAT YOU WERE IN BUDGET SEASON AND YOU WERE HEARING ABOUT A LOT OF CHALLENGES, ONE OF WHICH IS OUR HEALTH INFRASTRUCTURE.

A PUBLIC HEALTH INFRASTRUCTURE STATE AND FEDERAL RESOURCES HAVE BEEN LIMITED.

THE C D C HAS SENT OUT A LETTER SAYING, SORRY, OUR FUNDING OVER THE NEXT TWO YEARS IS GONE FOR SS T I PROGRAMS. THAT'S A BIG BLOW TO PUBLIC HEALTH DEPARTMENTS AND OTHER ORGANIZATIONS ACROSS THE COUNTRY THAT ARE PROVIDING S T I TESTING AND TREATMENT.

WE HAD A GRANT FROM THE C D C, BUT THEY SAID, WELL, WE'RE OUT OF MONEY.

SO THERE'S NO FUNDING TO GO WITH IT.

THERE'S ALSO BUDGET PROPOSALS AT THE FEDERAL LEVEL THAT ARE LOOKING AT ELIMINATING THE ENDING, THE H I V EPIDEMIC THAT WOULD ELIMINATE MILLIONS OF DOLLARS IN RESOURCES TO AUSTIN.

WE ALSO SEE THAT TEXAS JUST RANKED WORST FOR LIFE HEALTH AND INCLUSION.

NOW, SOME OF THESE THINGS I THINK, ARE SOLVABLE IN OUR COMMUNITY.

WE HAVE THIS POWER TO CHANGE THIS COURSE AND DIRECTION.

WE ALSO KNOW THAT STIS AND H I V DISPROPORTIONATELY IMPACT MEMBERS OF OUR COMMUNITY, INCLUDING OUR LGBTQIA PLUS COMMUNITY.

IN FACT, THE CITY OF AUSTIN AND ITS L G B T Q, QUALITY OF LIFE COMMISSION COMMISSIONED A STUDY TO LOOK AT QUALITY OF LIFE IN OUR CITY.

MANY OF THOSE QUESTIONS FOCUSED ON HEALTH, HEALTHCARE, ACCESS AND SERVICE.

AND THE ONE THAT I THINK FIND, I FIND MOST SHOCKING IS MAYBE THIS LAST BULLET POINT THAT ABOUT A QUARTER OF THE RESPONDENTS SAID THEY NEVER TALKED TO THEIR PRIMARY CARE PROVIDER ABOUT THEIR SEXUAL HEALTH.

AND THERE ARE A LOT OF REASONS FOR THAT, A LOT OF REASONS FOR THAT.

BUT WHEN WE LOOK AT THE GROWTH IN THE PROGRAM THAT WE HAVE HAD IN THE INCREASE IN DEMAND FOR OUR SERVICES, INCLUDING S T I TESTING AND TREATMENT, WE BELIEVE THAT WE ARE ADDRESSING SOME OF THOSE REASONS OF PROVIDING A SAFE, SUPPORTIVE AND AFFIRMING SPACE WHERE PEOPLE CAN TRUST THEIR MEDICAL PROVIDER TO TALK ABOUT THEIR SEXUAL HEALTH.

SO I'M GONNA ASK DR.

GARRA TO, UH, PROVIDE A LITTLE MORE SPECIFIC INFORMATION ON WHAT WE HAVE SEEN IN TRENDS IN OUR TESTING PROGRAM.

HELLO EVERYONE.

THANK YOU

[00:10:01]

MY NAME IS DR.

SANDRA GARRA.

I'M A PREVENTIVE MEDICINE BOARD CERTIFIED PHYSICIAN, AND I AM THE CHIEF MEDICAL OFFICER FOR TEXAS HEALTH ACTION AND KIND SERVICES THAT WE PROVIDE.

THIS IS THE FIRST OF ITS KIND, WHICH IS LOOKING AT A SNAPSHOT ON HOW WE ARE DOING FROM A SEXUAL HEALTH PERSPECTIVE WITH REGARD TO THE PERSONS THAT WE SEE THROUGH OUR WALK-IN TESTING AREA.

AND WE CALL THIS OUR COMMUNITY HEALTH REPORT.

SO IN THE NEXT COUPLE OF SLIDES, YOU'RE GONNA SEE A FEW PIE CHARTS, AND WE'RE GONNA TALK A LITTLE BIT ABOUT WHAT THAT MEANS CLINICALLY.

WELL, FIRST OFF, WHAT WE SEE THROUGH THIS WALK-IN TESTING AREA IS THAT WE ARE SEEING A SUBSTANTIAL AMOUNT OF NEED IN OUR COMMUNITY TO HAVE SAME DAY, JUST IN TIME TESTING FOR SS T I EXPOSURES SYMPTOMS AND THE NEED FOR TREATMENT.

AND HERE IS A GOOD EXAMPLE OF THIS.

YOU CAN SEE THAT WE HAD OVER 11,000 VISITS THAT OCCURRED.

IT JUST IN OUR WALK-IN TESTING AREA, WHICH IS ONLY A SEGMENT OF THE PERSONS THAT WE SERVE WITHIN THE AUSTIN COMMUNITY.

AND UNFORTUNATELY, OR FORTUNATELY, WHICHEVER WAY YOU WANNA LOOK AT IT, WE WERE ABLE TO PICK UP ABOUT A QUARTER.

ABOUT 20% OF THOSE PERSONS ACTUALLY CAME BACK POSITIVE FOR SOMETHING.

THIS IS A PHENOMENAL NUMBER.

YOU WOULD THINK 20%, EH, THAT'S NOT THE MAJORITY.

IT SHOULDN'T BE THIS HIGH.

WHAT WE KNOW FROM A COMMUNITY THAT ONCE YOU HAVE EXCEEDED A CERTAIN THRESHOLD, AND IT'S USUALLY AROUND SEVEN TO 8% OF THE PEOPLE THAT ARE BEING TESTED, COMING BACK POSITIVE, IT IS ONLY SHOWING YOU THAT THERE IS WAY MORE DISEASE BURDEN OUT THERE THAN WHAT WE ARE CAPTURING.

SO THIS IS TELLING YOU THAT WE HAVE A VERY HIGH RATE OF NEED IN OUR COMMUNITY.

WE ALSO ARE FINDING QUITE A FEW NEW H I V DIAGNOSES.

THIS IS ALSO CONCERNING.

WE KNOW THAT ONCE YOU TEST POSITIVE FOR A SINGULAR SS T I, LET'S SAY CHLAMYDIA OR GONORRHEA, SOME THAT ARE RE FAIRLY TREATABLE WITH ANTIBIOTICS, IT'S STILL, IF YOU ARE OUT THERE WITHOUT TREATMENT OR HAVE THE INFECTION FOR A GIVEN PERIOD OF TIME, YOU ARE AT INCREASED RISK OF ACQUIRING OTHER INFECTIONS SUCH AS H I V, JUST BECAUSE OF THE BIOLOGY OF AN INFECTION AND HOW IT MAKES YOU MORE SUSCEPTIBLE TO OTHER INFECTIONS.

SO WHAT HERE IS A BREAKDOWN OF THE TYPES OF INFECTIONS THAT WE ARE SEEING.

AND I'M NOT GONNA TALK TO YOU ABOUT WHICH ONE IS MORE SCARY.

BECAUSE IF YOU ARE THE PERSON WHO IS INFECTED WITH ANY ONE OF THESE, IT IS IMPACTFUL TO YOUR LIFE AND OF COURSE YOUR FUTURE HEALTH GOING FORWARD.

AND IT'S A SYSTEMIC ISSUE.

PLEASE DO NOT LOOK AT THESE INFECTIONS AS SOMETHING THAT IS HAPPENING AND LIMITED TO ONE BODY AREA.

THESE ARE INFECTIONS THAT THE ENTIRE BODY EITHER IS AT RISK FOR, SUCH AS SYPHILIS OR, UH, THE AREA IS STILL VERY SUSCEPTIBLE TO HAVING TO FIGHT THIS INFECTION AND HAVING LIFELONG CONSEQUENCES.

SO THE I ILLNESSES THAT WE SEE HERE, SYPHILIS, GONORRHEA, CHLAMYDIA, H I V, UH, AND HEPATITIS C JUST TO NAME A FEW OF THE THINGS THAT WE SEE JUST THROUGH OUR WALK-IN AREA.

SO APPROXIMATELY ONE IN FIVE PATIENTS THAT VISIT OUR LOCATION FOR WALK-IN TESTING ARE COMING BACK POSITIVE FOR SOMETHING.

SO HERE ARE THE PRIORITY POPULATIONS THAT WE HAVE BEEN ASKED AS A PUBLIC HEALTH COMMUNITY, AND WE DO SEE OURSELVES AS AN EXTENSION OF THAT PUBLIC HEALTH COMMUNITY THAT WE SHOULD BE FOCUSING ON BECAUSE THESE ARE THE PERSONS WHO ARE AT INCREASED RISK OF GETTING ONE OF THESE INFECTIONS.

AND SO WE SEE HERE A LIST OF BLACK MEN WHO HAVE SEX WITH MEN, LATIN MEN WHO HAVE SEX WITH MEN, WHITE MEN WHO HAVE SEX WITH MEN, TRANS, TRANS WOMEN, UH, NON-BINARY AND GENDER NON-CONFORMING.

AND EVEN THOUGH THOSE ARE THE PRIORITY POPULATIONS, WHAT YOU CAN SEE ON THE RIGHT HAND SIDE OF THIS SLIDE ARE ALL THE OTHER INDIVIDUALS THAT WE ALSO PROVIDE CARE FOR AND WE CONTINUE TO OFFER THAT TESTING FOR.

SO IT IS BASICALLY, YOU CAN CAPITALIZE THIS SLIDE OF SAYING WE TEST HUMANS DOES.

SO WHAT WE DO SEE IN OUR RESULTS THOUGH, IS A DISPARITY IN WHO IS GETTING THEIR H HI, UH, GETTING DIAGNOSED WITH AN S T I.

AND SO PROBABLY WON'T COME AS A, AS A HUGE SURPRISE TO FOLKS, BUT UNFORTUNATELY, THE YOUNGER COHORT IS HAVING MORE POSITIVE

[00:15:01]

IT IS NOT BECAUSE OF ANYTHING OF THEIR OWN DOING, BUT IT IS ACTUALLY BECAUSE OF THE PERSONS THAT THEY ARE INTERACTING WITH.

THERE IS MORE INFECTIONS IN THAT COMMUNITY, AND SO THEREFORE YOU'RE GOING TO SEE CHLAMYDIA GONORRHEA.

WHAT WE ARE SEEING IS A YOUNGER AGE COHORT IS MORE LIKELY TO HAVE IT, BUT YOU CAN SEE WE STILL RUN THE GAMUT.

WE HAVE PEOPLE WHO ARE TESTING POSITIVE ACROSS ALL AGE SPECTRUMS. WE ALSO SEE A DISPARITY IN THE POPULATIONS THAT ARE GETTING INFECTED, WHICH IS VERY CONSISTENT WITH THE PRIORITY POPULATIONS THAT WE WERE ASKED TO LOOK AT FROM A PUBLIC HEALTH PERSPECTIVE.

SO BLACK AND LATINO MEN HAVING SEX WITH MEN MAKE UP ABOUT 27% OF THOSE WHO WERE DIAGNOSED WITH CHLAMYDIA AND 37% OF GONORRHEA DIAGNOSE DISEASE.

THIS IS SOMETHING THAT SHOULD BE OF CONCERN TO ALL OF US AND A NEED TO INTERVENE.

WE ALSO SEE SOME MORE SERIOUS AND LIFELONG INFECTIONS THAT WE CAN SEE HAPPENING IN THESE POPULATIONS AS WELL.

SYPHILIS IS AN INFECTION THAT CAN BE SEXUALLY TRANSMITTED, IS MOST LIKELY SEXUALLY TRANSMITTED, BUT IF NOT TREATED, IT CAN ACTUALLY CAUSE PROBLEMS IN EVERY SINGLE PART OF THE BODY.

EVERYTHING FROM HAVING ISSUES WITH YOUR NERVOUS SYSTEM THAT MAKES YOU SEEM LIKE YOU'RE HAVING STROKES AT A YOUNG AGE TO HEART AND OTHER AREAS.

AND OF COURSE, IF SOMEONE IS PREGNANT AND IS EXPOSED TO SYPHILIS, YOU CAN HAVE A CONGENITAL SYPHILIS OUTCOME, WHICH YOU HAVE SEEN IN THE NEWS IS THAT ACROSS TEXAS IN SEVERAL OF OUR COMMUNITIES, WE'RE SEEING A VERY SCARY NUMBER OF CONGENITAL SYPHILIS, UH, PREGNANCIES AND DELIVERIES.

SYPHILIS IS VERY IMPORTANT.

OF COURSE, HEPATITIS C IS AS WELL.

WE HAVE HEARD OF THIS AND HOW IT CAN HAVE LIFELONG CONSEQUENCES TO YOUR OWN LIVER HEALTH AND THE ABILITY TO MANAGE THAT OVER TIME.

AND AGAIN, WE'RE SEEING THE DISPARITIES IN THE PRIORITY POPULATIONS THAT WE DISCUSSED BEFORE.

BLACK RESIDENTS OF TRAVIS COUNTY ARE APPROXIMATELY 9% OF THE POPULATION, BUT BLACK MEN WHO HAVE SEX WITH MEN MAKE UP 16% OF KIND CLINIC SYPHILIS DIAGNOSES, FURTHER HIGHLIGHTING THE DISPARITIES THAT PERSIST.

SO WE NEED TO MAKE SURE THAT WE ARE ADDRESSING THESE IN A TIMELY FASHION, IN A FULL FASHION.

NOT JUST TESTING, NOT JUST GIVING YOU THE RESULT, BUT ACTUALLY TREATING YOU FOR IT AND CONTINUING TO SUPPORT YOU GOING FORWARD TO PREVENT A REINFECTION, A NEW INFECTION, AND TO GET YOU ON PREVENTIVE MEDICATIONS SUCH AS PREP TO PREVENT YOU FROM ACQUIRING H I V.

IN SUMMARY, OUR WALK-IN TESTING AREA IS A VITAL AND COMPONENT PART OF OUR COMMUNITY.

WE ARE PROUD TO BE PARTNERED WITH AUSTIN PUBLIC HEALTH AND OTHER ORGANIZATIONS THAT ARE DOING SIMILAR WORK, BUT THE VOLUME THAT WE ARE SEEING JUST THROUGH OUR WALK-IN TESTING AREA IS DEFINITELY DEMONSTRATED IT BEING IMPACTFUL TO OUR COMMUNITY AND HELPING OUR COMMUNITY STAY HEALTHY IN ORDER FOR THEM TO LIVE PRODUCTIVE LIVES IN OUR AUSTIN COMMUNITY.

IT IS IMPORTANT FOR US TO ELIMINATE HEALTH DISPARITIES AND WE NEED TO FOCUS IN HEALTHCARE THAT ON THOSE AREAS THAT WE REALLY CAN BE IMPACTFUL.

AND THIS INCLUDES THE LGBTQIA A PLUS INDIVIDUALS IN OUR COMMUNITY.

WE ARE A CRITICAL PARTNER IN THIS PUBLIC HEALTH INFRASTRUCTURE.

WE ARE WORKING HAND IN HAND WITH AUSTIN PUBLIC HEALTH AND OTHER PUBLIC HEALTH ORGANIZATIONS, D S H S AND C D C TO ADDRESS THESE VITAL COMPONENTS.

AND WE WILL NEED SUSTAINED FINANCIAL SUPPORT IN ORDER TO CONTINUE TO PROVIDE THESE CRITICAL SERVICES THAT WE HAVE PROVIDED TO DATE.

THANK YOU.

THANK YOU SO MUCH.

I, OH, DID YOU HAVE ANY? I WAS GONNA SAY THANK YOU.

WE'RE HAPPY TO ANSWER ANY QUESTIONS YOU HAVE.

THANK YOU.

THANK YOU DR.

GARRA AND MR. CHRISTOPHER HAMILTON FOR JOINING US TODAY TO PROVIDE THIS REALLY IMPORTANT INFORMATION.

I THINK IT WAS REALLY HELPFUL FOR US TO LEARN MORE ABOUT THE DATA TRENDS AND ALSO WELCOME TO COUNCIL MEMBER RYAN TER FOR JOINING US TODAY.

UM, YOU KNOW, I'M WITH YOU ON ACKNOWLEDGING AND WANTING TO DO MORE ON REDUCING HEALTH DISPARITIES IN OUR CITY, AND I WANNA THANK OUR VICE CHAIR OF VELASQUEZ FOR, HE HAS AN AMENDMENT UP, UH, FOR COUNCIL CONSIDERATION, UH, REGARDING OUR, YOU KNOW, THE CITY SUPPORTING AND DOING MORE ON S T I TESTING.

SO I APPRECIATE YOUR LEADERSHIP ON THIS ISSUE.

COLLEAGUES, ANY QUESTIONS OR COMMENTS? YES, VICE CHAIR, THANK Y'ALL FOR BEING HERE WITH US.

UH, AND THANK YOU, UH, MS. HAMILTON

[00:20:01]

I CAME AND TOURED THE KIND CLINIC RECENTLY AND THEY'RE DOING AMAZING WORK OVER THERE.

I HAD A FEW QUESTIONS.

YOU WERE TALKING ABOUT THE RISE IN S T I DO YOU HAVE THE YEAR TO YEAR NUMBERS ON THAT FROM LAST YEAR TO THIS YEAR? GO AHEAD, GO AHEAD.

I WAS GONNA SAY, UM, BUG IN THE MOST COMPREHENSIVE DATA THAT WE HAVE IS FROM THE DEPARTMENT OF STATE HEALTH SERVICES, WHICH JUST PUBLISHED ITS 2020 DATA AND GIVES THE MOST FULL PICTURE OF WHAT IS HAPPENING IN TRAVIS COUNTY.

WE SEE THAT SS T I RATES IN TRAVIS COUNTY ARE STILL ABOVE THOSE OF OTHER CITIES LIKE SAN ANTONIO, UH, AND HOUSTON.

THE NUMBER, TOTAL NUMBER OF INFECTIONS HAS MORE THAN DOUBLED.

AND IF WE LOOK AT 2018, I BELIEVE IT ALMOST QUADRUPLED FROM 2018 TO 2020.

I DON'T SEE THAT TREND REVERSING, UH, AGAIN, IT'S A LITTLE TOO EARLY TO KNOW THE FULL PICTURE OF TRAVIS COUNTY UNTIL WE HAVE THAT FROM DEPARTMENT OF STATE HEALTH SERVICES.

THANK YOU.

UH, YOU MENTIONED THAT Y'ALL HAD A GRANT FROM THE C D C.

HOW MUCH WAS THAT FUNDING UNTIL IT WAS CUT? $0.

I MEAN, NOW THEY, THEY RAN OUT OF MONEY.

THEY SAID WE WROTE A GREAT APPLICATION AND THEY WOULD LOVE TO FUND IT IF THEY HAD THE MONEY.

SO THE GRANT IS AWARDED BUT NOT FUNDED.

.

UH, AND YOU, Y'ALL MENTIONED THAT, UH, WHILE THERE ARE OTHER PROVIDERS THAT OFFER THESE SAME TYPE OF TESTING AND SERVICES, UM, Y'ALL PUT A FOCUS ON, ON THE L G B T Q I A COMMUNITY, HOW MANY OTHER FOLKS ARE HAVE THAT SAME FOCUS? UH, I DON'T WANNA SPEAK FOR OTHERS.

I KNOW THAT OUR FOUNDATION AND CORE AND PART OF OUR MISSION HAS REALLY BEEN TO PROVIDE AN EXPERTISE IN SERVING THIS COMMUNITY.

MEANING WE UNDERSTAND AND PROVIDE AN ENVIRONMENT THAT IS NOT SHAMING, THAT IS NOT, OR NOT STIGMATIZING ABOUT SEXUAL ACTIVITY OR SEXUAL BEHAVIORS THAT ANYBODY ENTERING OUR CLINICS, UH, ENGAGES IN.

UM, AND AS A CITY, HOW MUCH OF AN INVESTMENT ARE WE MAKING RIGHT NOW IN THE KIND CLINIC? UH, WE ONLY HAVE FEDERAL DOLLARS THAT ARE PASSED THROUGH FROM, UH, CITY OF AUSTIN FOR H I V TREATMENT.

THANK YOU, SIR.

YES, MAYOR, I WANNA FOLLOW UP ON THAT.

WAS THAT AN ANSWER JUST ABOUT THE CITY ASPECT OF IT? BUT WHEN YOU SAY YOU ONLY HAVE FEDERAL DOLLARS, HELP ME.

IS THAT ALL, ALL THE FINANCING YOU HAVE IS FEDERAL PASS THROUGH DOLLARS? UH, NO.

THE PRIMARY MECHANISM OF FUNDING OUR ORGANIZATION IS THROUGH THE THREE 40 B MEDICATION SAVINGS PROGRAM.

UH, SO IT IS PRESCRIPTION MEDICATION THAT RESULTS IN SAVINGS BACK TO OUR ORGANIZATION.

UM, WE SUFFERED ABOUT A $9 MILLION LOSS LAST YEAR, ABOUT A 53% REDUCTION BECAUSE OF A CHANGE FROM A MANUFACTURER IN THAT PROGRAM.

SO THAT HAS LEFT US, UH, AT A HARD SPOT, UH, IN FIGURING OUT HOW WE CAN CONTINUE TO SERVE OUR COMMUNITY.

SO, UM, HAVE, HAVE YOU TALKED TO THE, TO CENTRAL HEALTH BOARD OF MANAGERS? WE ARE DISCUSSING WITH CENTRAL HEALTH A WAY THAT THEY COULD PROVIDE CARE FOR PEOPLE THAT WE ARE TAKING CARE OF IN WHAT I WOULD CALL MORE LONGITUDINAL SERVICES.

WHAT DOES THAT MEAN? LIKE, UH, PEOPLE THAT ARE GONNA COME BACK TO US OVER AND OVER, SO PEOPLE THAT ARE ACCESSING H I V, MEDICAL CARE, PREP CARE, UH, ANY OTHER OF THOSE SERVICES WHERE THERE'S A LONGER TERM RELATIONSHIP VERSUS SS T I TESTING AND TREATMENT, WHICH MAY BE ONE TO TWO ENCOUNTERS.

SO WHAT IF, IF THE POPULATION YOU SERVE WOULD OTHERWISE QUALIFY UNDER THE CENTRAL HEALTH PARAMETERS, WHY WOULD YOU DRAW THAT DISTINCTION? IF TESTING WOULD BE A WAY TO PREVENT FUTURE HARM, WHY WOULD THAT, WHY, WHY WOULD THERE BE A DISTINCTION THERE WHERE IT'S MORE LONGITUDINAL, AS YOU SAY? YEAH, SO THERE WE DO HAVE A DISTINCTION IN THE TYPES OF SERVICES THAT PEOPLE NEED AND MEETING THEM WHEN THEY NEED THEM.

SO PEOPLE COMING INTO OUR WALK-IN AREA, IT'S USUALLY AN ACUTE, THEY'RE STARTING THEIR HEALTHCARE JOURNEY FOR SOME REASON, SYMPTOMATOLOGY, EXPOSURES, OTHER THINGS.

SOMETIMES WHAT WE FIND IS THAT THEY HAVE AN ACUTE INFECTION.

WE SPEAK TO THEM ABOUT THE OPPORTUNITY TO BE ABLE TO EITHER TREAT THE CURRENT INFECTION AS WELL AS BEING ABLE TO PREVENT FUTURE INFECTION.

IF THEY ARE INTERESTED, LET'S SAY IN PREP, THEN WE ARE ABLE TO QUICKLY MOVE THEM INTO A MORE LONG-TERM RELATIONSHIP AS OUR PATIENT THAT WILL THEN ACCESS PREP.

PREP IS SOMETHING THAT REQUIRES PEOPLE TO HAVE LABORATORY TESTING DONE EVERY THREE MONTHS.

UM, IT NEEDS A CLINICAL VISIT TO MAKE SURE YOU'RE NOT HAVING ANY SIDE EFFECTS OR ISSUES.

AND HOPEFULLY THAT BECOMES A LONG-TERM HEALTHY RELATIONSHIP, MEANING WE'RE ABLE TO KEEP PEOPLE HEALTHY FROM NOT ACQUIRING INFECTION.

OTHER INFECTIONS SUCH AS H I V OR HEPATITIS REQUIRE A MORE LONG-TERM BECAUSE OF THEIR, THE NATURE OF THE INFECTION.

IT IS NOT SOMETHING THAT CAN BE CURED, BUT IT CAN BE MANAGED TO A HEALTHY STATE.

[00:25:01]

SO THAT'S, THAT'S THE MAIN DIFFERENCE.

WELL, I, I, AND I GET, I GET THE DIFFERENCE OKAY.

BETWEEN, UH, THE CATEGORIES OF CARE.

OKAY.

YEAH.

WHAT I, I'M NOT UNDERSTANDING IS WHY THERE WOULD BE A DISTINCTION BETWEEN THE FINANCING OF THE DIFFERENT CATEGORIES OF CARE, UH, PARTICULARLY IF YOU COULD PROVIDE TESTING AND, AND ACUTE CARE THAT MAYBE TAKES YOU OUT OF THE NEED FOR LONGITUDINAL CARE.

RIGHT.

GO AHEAD.

UM, I THINK THE, THAT WHY, WHY CITY OF AUSTIN, WHY NOT CENTRAL HEALTH QUESTION, UM, COMES DOWN TO WHERE THE AUTHORITY IS FOR COMMUNICABLE DISEASE CONTROL, THAT THE STATE OF TEXAS DELEGATES TO A PUBLIC HEALTH DEPARTMENT IN ITS COMMUNITY, COMMUNICABLE DISEASE CONTROL.

AND THAT IS PART OF S T I TESTING AND TREATMENT.

AND SO THIS SPLIT OF FUNDING FOR AUSTIN PUBLIC HEALTH AND ITS FUNCTIONS TO PROVIDE S T I TESTING VERSUS CENTRAL HEALTH THAT HAS FOCUSED ON LONGER, UH, RELATIONSHIP BASED CARE, I DON'T, DOES THAT HELP CLARIFY? A LITTLE BIT? DOES.

IT DOES.

AND WHAT IT TELLS ME IS SOMETHING ELSE WE PROBABLY OUGHT TO BE UNIVERSALLY AND GLOBALLY ADDRESSING IN THIS COMMUNITY.

AND THAT IS THAT WE DON'T NEED THOSE SILOS BECAUSE THERE MAY BE, THERE MAY BE FUNDING THAT OUGHT TO BE GOING TO THIS SORT OF THING, BUT WE'RE NOT DOING IT BECAUSE WE'VE, WE'VE GROWN INTO A TRADITION OF, AND THAT'S NOT, THAT'S NOT A CRITICISM OF, OF YOUR PRESENTATION OR WHAT THE ANSWER TO THE QUESTION.

IT IS HOW, AS WE GO FORWARD AND TRY TO ACHIEVE MULTIPLE GOALS, UH, HOW, HOW WE BREAK DOWN THOSE SILOS OR THOSE TRADITIONS BECAUSE THERE MAY BE FUNDING THAT OUGHT TO BE AVAILABLE.

SO THANK YOU.

I DIDN'T MEAN TO TAKE SO MUCH TIME, BUT I APPRECIATE THAT.

THANK YOU, MAYOR.

YES.

COUNCIL MEMBER ALTER, I JUST WANTED TO PICK UP ON THAT JUST A LITTLE BIT.

WHAT PORTION OF YOUR POPULATION THAT YOU SERVE IS UNINSURED? ABOUT 50%.

OKAY.

AND SO ARE MOST OF YOUR SERVICES FOR THE INSURED PORTION OR MOST OF YOUR SERVICES COVERED BY EITHER MEDICAID OR WHATEVER PRIVATE INSURANCE THEY HAVE? UH, OUR CLINICAL SERVICES ARE PROVIDED TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY.

UH, PATIENTS WILL USE THEIR INSURANCE WHEN FILLING A PRESCRIPTION.

FOR EXAMPLE, IF THEY DON'T HAVE INSURANCE TO FILL THAT PRESCRIPTION, THEN WE WORK TO FIND OTHER MEANS TO COVER THAT, INCLUDING OUR OWN FUNDING TO EITHER PAY FOR NO COST OR LOW COST MEDICATION TO ACCESS.

DO Y'ALL, ARE, ARE Y'ALL ABLE TO OR ELIGIBLE FOR ANY OF THE UC POOL MONEY FROM THE STATE SINCE YOU'RE PROVIDING UNCOMPENSATED CARE? WE HAVE NOT LOOKED INTO THAT PART YET.

UM, BUT WE'RE ON A JOURNEY AND EXPLORATION OF MANY DIFFERENT SOURCES OF FUNDING.

UM, IF SOMEBODY WANTS TO OFFER UNIVERSAL COVERAGE FOR EVERYBODY, THAT WOULD BE WONDERFUL.

SURE.

UM, SO WE'RE STUCK APPLYING FOR DIFFERENT POTS OF MONEY IN THE MEANTIME.

I THINK YOU MAY HAVE JUST GONE TO MEDLING ON THAT PART OF IT.

SO , UH, OKAY.

UH, THAT HELPS.

THANK YOU VERY MUCH.

ANY FURTHER QUESTIONS? GOOD DEAL.

THANK YOU SO MUCH FOR JOINING US.

THANK YOU.

THANK YOU VERY MUCH.

GREAT PRESENTATION.

THANK YOU.

THANK YOU.

ALRIGHT, NOW

[5. Briefing on issues related to homelessness from Dianna Grey, Homeless Strategy Officer.]

WANNA WELCOME DIANA GRAY, OUR HOMELESSNESS STRATEGY OFFICER FOR A BRIEFING ON ISSUES RELATED TO HOMELESSNESS.

GOOD MORNING CHAIR, UH, VICE CHAIR AND MEMBERS.

WE'LL HAVE A BRIEF BRIEFING THIS MORNING.

UH, AS YOU RECALL, WE SPENT SOME TIME TOGETHER ON THE JULY 20TH COUNCIL MEETING, UH, AT WHICH TIME, UH, THE COUNCIL APPROVED, UH, UH, OR AUTHORIZED THE NEGOTIATION AND EXECUTION OF OUR, UH, CONTRACT, UH, WITH OUR VENDOR FOR THE MARSHALING YARD.

UM, SO WE CAN GO ONTO THE AGENDA HERE, THE NEXT SLIDE.

SO I'LL GIVE A BRIEF UPDATE ON THE STATUS OF THE MARSHALING YARD ON THE EIGHTH STREET STREET SHELTER, WHICH IS THE FORMER, UH, SALVATION ARMY FACILITY ON THE EXPANSION OF CAPACITY AT OUR BRIDGE SHELTERS AND ON THE HEAL INITIATIVE.

UM, WE ARE CURRENTLY NEGOTIATING THE CONTRACT, UH, WITH ENDEAVORS FOR THE MARSHALING YARD OPERATION.

EXPECT TO HAVE OUR DOCUMENTS, UH, READY TO, UH, ROUTE FOR SIGNATURE PROBABLY NEXT WEEK.

UH, SO THAT IS MOVING A PACE, A FEW DETAILS TO BE WORKED OUT, BUT, UM, PROGRESSING AS IN, UH, ANTICIPATED.

UH, WE IN THE R F P ASKED THEM TO BE READY TO STAND UP WITH AT LEAST PARTIAL OCCUPANCY BY THE END OF AUGUST, AND WE ANTICIPATE ACHIEVING THAT AIM.

UM, IN TERMS OF AMENITIES AND SERVICES, I THINK WE WANTED TO, UH, TALK A LITTLE BIT ABOUT

[00:30:01]

SO, FOR EXAMPLE, UH, THE SHUTTLE SERVICE, UH, ENDEAVORS HAS MULTIPLE 15 PASSENGER VANS.

AND WHAT THEY ARE CONTEMPLATING AT PRESENT IS USING SEVERAL OF THOSE AT A TIME, HAVING A ROUTE TO BUS STOPS, PROBABLY EVERY 15 TO 20 MINUTES TO REALLY DIMINISH THE NEED FOR PEOPLE TO GO ON FOOT THROUGH THE NEIGHBORHOOD TO GET TO BUS STOPS.

UM, AND ALSO UTILIZING THOSE FANS TO SOME DEGREE ON AN AD HOC BASIS.

IF SOMEONE HAS A, AN APPOINTMENT THAT THEY NEED TO MAKE, UH, ET CETERA, OR THEY NEED TO BRING SOMEONE INTO SHELTER, UM, WE ARE WORKING THROUGH THE REFERRAL PATHWAYS AND WE'LL BE MEET MEETING, UM, REGULARLY WITH ENDEAVORS, UNDERSTANDING WHAT THEY ANTICIPATE THEIR BED CAPACITY TO BE AT ANY GIVEN TIME.

AND THEN WORKING WITH OUR VARIOUS OUTREACH TEAMS TO BRING PEOPLE INTO SHELTER.

AND SO THAT WILL INCLUDE HOST, UH, WHO WILL BE WORKING CLOSELY, UH, WITH A P D AS WELL AS OUR OTHER STREET OUTREACH TEAMS THAT THE CITY FUNDS.

UM, IN PARTNERSHIP WITH OUR NONPROFITS, UH, BOTH THE CHAIR AND THE VICE CHAIR WERE ABLE TO JOIN, UH, A, A WALKTHROUGH OF, UH, THE FACILITY ON MONDAY, ALONG WITH STAFF FROM, UH, THE MAYOR'S OFFICE AND OTHER, UH, ELECTED OFFICIALS FROM THE NEIGHBORHOOD.

SO WE DID THAT MONDAY MORNING.

AND AS SOON AS WE HAVE OUR, UH, CONTRACT IN PLACE WITH ENDEAVORS, WE WILL ALSO, UM, PLAN ANOTHER COMMUNITY MEETING SO THAT WE CAN ANSWER SOME OF THE MORE SPECIFIC QUESTIONS THAT WE KNOW NEIGHBORS MAY HAVE.

THE, UM, DOWNTOWN SHELTER, UH, THE UH, FACILITY AT AT 5 0 1 EAST EIGHTH STREET, THE FORMER SALVATION ARMY DOWNTOWN SHELTER, UH, REAL ESTATE AND LAW ARE IN THE PROCESS OF NEGOTIATING THE LEASE FOR THAT IT IS PENDING EXECUTION.

UH, YOU MAY RECALL THAT THERE WERE SOME ANTICIPATED, UH, REPAIRS OF THE BUILDING TO GET IT READY FOR OCCUPANCY.

UH, THAT IS EXPECTED TO TAKE AT LEAST SIX WEEKS.

AND SO WE ARE PROBABLY LOOKING AT A SEPTEMBER OCTOBER LAUNCH.

UH, BUT THE, UH, AMENDMENT TO THE URBAN ALCHEMY CONTRACT, UH, IS READY, HAS BEEN EXECUTED BY URBAN ALCHEMY.

WE HAVE A FEW DETAILS, UH, TO NAIL DOWN BEFORE THE CITY EXECUTES.

AS A REMINDER THAT WILL BE 150 BEDS, UH, WITH SUPPORTIVE SERVICES ON SITE.

UM, UH, ACHIEVE SOME ECONOMIES OF SCALE BECAUSE OF COURSE, URBAN ALCHEMIES ALREADY OPERATING, UH, NEXT DOOR.

AND WE DO ANTICIPATE THAT THE LEASE WITH THE SALVATION ARMY WILL BE A YEAR FROM THE TIME, UH, WE EXECUTE.

AND SO WOULD BE LOOKING TO DEMOBILIZE THAT FACILITY A YEAR.

FROM THE TIME WE INK THE CONTRACT.

WE HAVE COMPLETED OUR EXPANSION OF THE TWO BRIDGE SHELTERS TO DOUBLE OCCUPANCY IN EACH ROOM.

YOU MAY RECALL THAT IN JUNE WE HAD, UM, A HEEL SITE, UH, UH, IN, AT GAINES CREEK, UH, WHERE WE FILLED ALL OF THE ROOMS AT NORTH BRIDGE SHELTER.

UH, WE ARE ACTUALLY CARRYING OUT A HEAL INITIATIVE, UH, RELOCATION THIS WEEK AS WE SPEAK.

AND SOUTH BRIDGE SHELTER IS NOW READY AND IS IS BEING OCCUPIED.

I'LL TALK A LITTLE BIT MORE ABOUT THAT IN A MOMENT.

SO THE HEAL INITIATIVE NOW WITH THE CURRENT EFFORT WE WILL, WILL BE ON THE 14TH ENCAMPMENT THAT WE HAVE SERVED.

THE IMAGES THAT ARE SHARED WITH YOU HERE ARE OF THE GAINES CREEK GREENBELT, UH, RELOCATION, UH, FROM LAST MONTH, OR EXCUSE ME, FROM JUNE.

UH, AND SO, UH, CLEANUP CREWS DID A GREAT JOB OF RESTORING THAT SPACE.

UH, WE UNDERSTAND THAT PARD WILL BE ERECTING SOME FENCING AROUND THE AREA TO ALLOW FOR, UH, UH, FURTHER REGENERATION OF THE NATURAL SPACE.

UM, AND THE 14TH SITE, WHICH IS UNDERWAY NOW IS ALSO ON WEST BELT BOLDEN CREEK, BUT NORTH OF THE SITE THAT WAS DONE, UH, FOR HEEL SITE SEVEN, UM, THAT HAS BEEN, THAT AREA HAS BEEN THE SITE OF MULTIPLE ENCAMPMENTS OVER TIME.

AND SO WE'RE, UM, NOW ADDRESSING A, AN ENCAMPMENT THAT WAS FURTHER NORTH, UH, THAN THE ORIGINAL SITE THAT WE ADDRESSED.

AND JUST A REM A REMINDER THAT WE'RE SORT OF TRACKING AS WE MOVE ALONG.

WE ARE STILL SEEING VERY HIGH RATES OF ACCEPTANCE INTO BRIDGE SHELTER.

UH, WE ARE CURRENTLY RUNNING AT ABOUT 85% OF PEOPLE WHO ARE OFFERED TRANSFER INTO BRIDGE SHELTER ARE ACCEPTING.

UH, SO WE DON'T HAVE ALL OF THE NUMBERS FOR SITE 14 YET.

I WILL TELL YOU THAT YESTERDAY WE RELOCATED 28 PEOPLE FROM, UH, THE, THE BOLD CREEK SITE AND, UM, OUR CONTINUING WORK TODAY AND PROBABLY TOMORROW, BUT OF THE 13 ENCAMPMENTS

[00:35:01]

UM, AND THEN HAD HOUSED, UH, A 200 OF THOSE, MANY OF THEM STILL IN SHELTER AND, UM, IN CASE MANAGEMENT.

AND OF THOSE 200 WHO RECEIVED PERMANENT HOUSING, 42 HAVE GRADUATED THE PROGRAM.

UH, RAPID REHOUSING IS TIME LIMITED.

SO THESE ARE INDIVIDUALS THAT WOULD HAVE, UM, RECEIVED THEIR YEAR, UM, OR SO OF RENTAL ASSISTANCE AND CASE MANAGEMENT.

AND THEN, UM, UH, TRANSITIONED OFF OF THAT, UH, THAT HOUSING SUBSIDY AND ACTIVE CASE MANAGEMENT, WE ARE TRACKING, UM, THE TIME IT TAKES FROM THE TIME SOMEONE ENTERS SHELTER INTO, UH, TO GET INTO PERMANENT HOUSING.

AND THAT HAS BEEN STEADILY INCREASING OVER TIME.

UH, JUST AS A POINT OF REFERENCE, DURING THE PANDEMIC WHEN WE WERE RUNNING THE PROTECTIVE LODGES, WHICH WERE A VERY SIMILAR MODEL, WE WERE HAVING LUCK GETTING FOLKS INTO HOUSING IN 90 TO 120 DAYS.

SO THREE TO FOUR MONTHS AND WE ARE NOW AT ABOUT SIX AND A HALF MONTHS ON AVERAGE.

UM, AND SO CONTINUING THAT WORK AND CONTINUING WORK WITH OUR PARTNERS AT ECHO TO OPEN UP, UH, AVAILABILITY OF UNITS IN THE COMMUNITY.

BUT THAT DOES CONTINUE TO BE, UH, A CHALLENGE FOR US AND FOR OUR PARTNER SERVICE PROVIDERS.

WITH THAT, I WILL TAKE ANY QUESTIONS YOU MIGHT HAVE.

THANK YOU COLLEAGUES.

YES.

COUNCIL MEMBER ALTER, I'M GONNA STEP IN FRONT OF THE VICE CHAIR HERE.

.

UH, I WANTED TO ASK YOU ABOUT THAT LAST SLIDE THAT YOU JUST HAD ABOUT THE, THE TIMELINE AS IT RELATES TO THE CASE MANAGERS WHOSE, WHOSE CASE MANAGERS ARE THOSE WHOSE EMPLOYMENT? SURE.

SO WE HAVE DEDICATED RAPID REHOUSING PROGRAMS FOR THE HEAL INITIATIVE AND THOSE, UM, CONTRACTS ARE WITH ENDEAVORS, SAME VENDOR THAT'S RUNNING, UM, THE MARSHALING YARD, FAMILY ELDER CARE AND ALSO WITH AUSTIN AREA URBAN LEAGUE.

AND SO IT, IT IS SOMETIMES PEOPLE WILL COME INTO THE SHELTER AND THEY ACTUALLY ARE ALREADY WORKING WITH A LONG-TERM CASE MANAGEMENT ALREADY IN A RAPID REHOUSING PROGRAM AND, AND HAVE A CASE MANAGER.

BUT THOSE ARE THE THREE PRIMARY DEDICATED PROGRAMS THAT WE'RE UTILIZING TO GET PEOPLE, UH, INTO PROGRAMS. SO IF SOMEONE ALREADY HAS A CASE MANAGER, WOULD THEY NOT BE INCLUDED IN THE THREE 40 ASSIGNED OR, I'M TRYING TO FIGURE OUT WHAT HAPPENS.

THE 200 PEOPLE, I BELIEVE THOSE WOULD BE LIKELY BE ASSIGNED, UH, INCLUDED IN THAT NUMBER.

OKAY.

SO THE THING THAT WE'RE TRACKING IS, UH, ONE OF THE THINGS WE'RE TRACKING IS HOW LONG IT TAKES US TO GET FOLKS A CASE MANAGER.

IN THE EARLY DAYS, WE HAD, UM, AS WE RAMPED UP THESE CONTRACTS BECAUSE WE SORT OF WERE JUST STARTING, WE HAD A SIGNIFICANT LAG FROM ENTRY INTO SHELTER UNTIL THEY GOT THEIR CASE MANAGER AND ACCESS TO THAT RENTAL SUBSIDY.

UM, UH, BEFORE WE WENT TO DOUBLE OCCUPANCY, I'LL TELL YOU, WE HAD FINALLY GOTTEN TO THE POINT WHERE AS SOON AS SOMEONE CAME IN, WE HAD THEIR CASE MANAGER, UH, HAD CAPACITY FOR THEM.

UH, BY VERY RAPIDLY INCREASING THE SIZE OF THE PROGRAM.

WE NOW ARE HAVING A BIT OF A WEIGHT AGAIN, BUT WE'RE WORKING ON THE BACKEND TO LOOK AT THOSE CONTRACTS AND SEE HOW WE NEED TO ADJUST THE SIZE TO CREATE THE CAPACITY.

WHEN DID THEY DO THE COORDINATED ASSESSMENT? IS THAT BEFORE, DURING, SO AGAIN, WHEN UH, FOLKS COME IN AT INTAKE, WE ASSESS WHETHER THEY HAVE HAD, ARE ALREADY IN THE COORDINATED ENTRY SYSTEM.

AND OUR GOAL IS TO GET THEM THAT COORDINATED ASSESSMENT WITHIN A WEEK OR SO OF ENTERING IF THEY'RE NOT ALREADY IN THE SYSTEM.

SO THAT'S NOT SO MUCH A BOTTLENECK, IT'S THEN GETTING THEM THE CASE MANAGER.

THAT'S CORRECT.

AND IN LOOKING AT THE CONTINUUM, YOU KNOW, I THINK ABOUT, WELL, IF WE PLUG IN A BUNCH OF RESOURCES TO ONE PIECE, THAT COULD TYPICALLY JUST MOVE THE BOTTLENECK TO ANOTHER SPOT, RIGHT? SO IF WE INVESTED IN MORE CASE MANAGERS IN ORDER TO GET PEOPLE THAT COORDINATION QUICKER, IS IT LIKELY THAT THEY WOULD RECEIVE A HOUSING OUTCOME FASTER OR IS IT THAT THEN WE WOULD JUST HAVE A MORE PEOPLE WAITING FOR UNITS TO BECOME AVAILABLE? RIGHT.

SO I WOULD OFFER A SLIGHTLY DIFFERENT FRAME FOR THAT CONVERSATION COUNCIL MEMBER, WHICH IS THAT WE DON'T TYPICALLY FUND JUST CASE MANAGERS.

WE HAVE TO FUND THE WHOLE PROGRAM.

'CAUSE YOU COULD ADD CASE MANAGERS, IF YOU DON'T ADD THE, UH, CORRESPONDING CAPACITY TO PROVIDE RENTAL ASSISTANCE, THEN YOU CAN'T GET THAT PERSON INTO HOUSING.

SO WE REALLY HAVE TO LOOK AT THE WHOLE PROGRAM AND UM, THAT IN THAT PROGRAM DESIGN, OUR NONPROFIT PARTNERS WILL, YOU KNOW, HAVE VARYING STRATEGIES FOR MAKING SURE THAT THEY CAN ACTUALLY GET THE UNITS RIGHT.

AND SO THEY MAY HAVE STAFF THAT ARE ONLY DOING LANDLORD OUTREACH, FOR EXAMPLE.

SO WE REALLY NEED TO THINK ABOUT THE PROGRAM

[00:40:01]

I THINK, UM, THE, AGAIN, THE, THE WAIT TIME ISN'T SO MUCH WAIT FOR A CASE MANAGER, BUT IT'S, YOU KNOW, IT'S, IT'S FOR THAT OVERALL PROGRAM CAPACITY.

AND YES, UNDERSTANDING WHERE WE ARE IN TERMS OF CASELOADS, ET CETERA, IS A GOOD BAROMETER FOR IT, BUT IT'S NOT THE ONLY ONE.

AND TYPICALLY ARE HOUSING VOUCHERS, IS THAT WHAT INDIVIDUALS HAVE TO GET INTO HOUSING? SO FOR RAPID REHOUSING, IT IS AKIN TO WHAT WE THINK OF AS A HOUSING VOUCHER, BUT IT'S NOT COMING THROUGH THE HOUSING AUTHORITY.

IT'S SORT OF NOT THAT PARTICULAR.

IT IS A FUND, IT IS A, A BASICALLY A LINE ITEM IN THE NONPROFITS BUDGET THAT THEY HAVE THAT IS AVAILABLE TO SUPPORT THE RENT OF THAT INDIVIDUAL AS THEY MOVE INTO HOUSING.

THE EXPECTATION FOR THE CASE MANAGER IS THAT THEY'RE ASSESSING WHERE THAT INDIVIDUAL IS.

WE DO HAVE QUITE A FEW FOLKS COME IN WHO DO HAVE EARNED INCOME.

THEY JUST MAY NOT HAVE ENOUGH TO PAY MARKET RENT.

AND SO THEY'RE ADJUSTING THAT, UM, UH, APPROPRIATELY AND THEN LIKELY KIND OF DECREASING IT OVER TIME SO THAT PEOPLE HAVE TIME TO STABILIZE TO INCREASE THEIR INCOME.

AND THEN, UM, AS THIS PROGRAM ENDS BECOME, UH, REMAIN STABLE.

ALRIGHT, THANK YOU VERY MUCH.

VICE CHAIR OF ALASKA.

THANK YOU FOR THE TOUR THE OTHER DAY.

OF COURSE.

UM, WILL THE, UH, THE SHUTTLE BE RUNNING, UM, OR CO-OCCURRING AT THE SAME TIME AS UM, CITY BUS HOURS ONLY? THE ONLY REASON I'M ASKING IS, UM, HOW ARE WE ENSURING, AND THIS CAN, I MEAN IF YOU DON'T HAVE IT RIGHT NOW, YOU CAN ALWAYS GET IT BACK TO ME.

HOW ARE WE ENSURING THAT WE'RE MAKE, WE'RE, UH, PROVIDING SERVICE TO OUR FOLKS THAT MAY WORK IN THE SERVICE INDUSTRY THAT MAY BE WORKING OVERNIGHT OR WORKING TILL TWO OR THREE IN THE MORNING? YEAH, SO, UM, I, I DON'T KNOW FOR CERTAIN THERE WILL BE LIKELY A GENERAL CURFEW FOR THE, THE PROPERTY AT TIME AT WHICH IN THE EVENING PEOPLE NEED TO BE IN.

BUT IT IS TYPICAL IN OUR SHELTER FACILITIES THAT HAVE THOSE TYPES OF HOURS THAT IF SOMEONE HAS A JOB THAT IS IN THE EVENING HOURS, THAT YOU KNOW, AS LONG AS THEY CAN, UM, ESTABLISH THAT THEN THEY WORK WITH THE INDIVIDUAL.

SO I DON'T KNOW WHETHER THOSE SHUTTLES ARE NOT SO MUCH SORT OF TO TAKE PEOPLE BACK AND FORTH TO THEIR JOBS, UM, BUT MORE TO THE, THE PUBLIC TRANSPORTATION.

SO THERE ARE A COUPLE QUESTIONS HERE.

I THINK ONE IS ABOUT THE HOURS OF THE TRANSPORTATION AND THEN B, WHAT IS THE ACCOMMODATION THAT THAT ENDEAVORS WOULD BE, UH, PREPARED TO MAKE FOR PEOPLE WHO MIGHT HAVE OTHER WORKING HOURS? AND WE CAN CERTAINLY FOLLOW UP WITH YOU ON THAT.

THANK YOU MA'AM.

COLLEAGUES, ANY FURTHER QUESTIONS? THANK YOU.

THANK YOU.

UM, THANK YOU MS. GRAY.

THE QUESTIONS I HAVE ARE AROUND ACKNOWLEDGING THAT WE HAVE THE MARSHALING YARD THAT WE'RE OPENING UP AS AN EMERGENCY SHELTER.

WE, THAT WILL OPEN UP LATER THIS MONTH.

AND WE ALSO HAVE THE DOWNTOWN SHELTER, UM, THE ARCH OPERATED BY URBAN ALCHEMY THAT WILL ALSO OPEN UP.

AND YOU'VE MENTIONED THAT THAT WILL OPEN EITHER NEXT MONTH, SEPTEMBER, OR OCTOBER.

SO WE WILL HAVE, THE CITY WILL HAVE TWO EMERGENCY SHELTERS THAT WE ARE OPERATING AND RUNNING FOR A YEAR.

CAN YOU SPEAK TO THE REFERRAL PROCESS AND HOW THAT WILL WORK? SO THAT CAME, YOU SHARED WITH US A RECOMMENDATION ON HOW THAT PIECE NEEDS TO BE WORKED OUT.

ANY UPDATES ON THE REFERRAL PROCESS AND KNOWING THAT WE'RE GONNA HAVE TWO SHELTERS STOOD UP WITHIN THE NEXT SIX TO EIGHT WEEKS.

HOW DOES THAT WORK? HOW DOES THAT LOOK LIKE MOVING FORWARD? SURE.

AND THESE CONVERSATIONS ARE ONGOING AS WE MOVE TOWARD CONTRACT EXECUTION, BUT I THINK IN, UM, IN CONCEPT WHAT HAS BEEN AGREED IS THAT WE WILL BE MEETING REGULARLY WITH THE ENDEAVORS STAFF WHO WILL BE PROJECTING THEIR NUMBER OF AVAILABLE BEDS OVER THE COURSE OF SAY A WEEK.

UM, IF WE NEED TO DO IT DAILY, WE WILL, BUT WE'RE GONNA START LOOKING AT, UM, SAY A A WEEK AS AN OPERATIONAL PERIOD AND THEN, UH, ESSENTIALLY SAYING TO OUR DIFFERENT REFERRAL PARTNERS, WE BELIEVE WE HAVE THIS MANY REFERRALS FOR YOU THIS WEEK.

WE HAVE THIS MANY BEDS AVAILABLE FOR YOU.

UM, AND THEN MAINTAINING CONTACT WITH THEM SO THAT IF THERE'S ADDITIONAL CAPACITY, WE CAN EXTEND THAT TO THOSE FOLKS.

BUT THEY THEN ARE WORKING DIRECTLY WITH ENDEAVORS TO BRING THOSE FOLKS INTO SHELTER.

AND HOW ABOUT THE, UM, YOU TOUCHED ON THE PUBLIC TRANSPORTATION PIECE.

FAMILY ENDEAVORS HAS SOME VANS AVAILABLE WHERE THEY CAN, UM, ASSIST THE REFERRAL AGENCIES IN PICKING UP INDIVIDUALS WHO ARE VOLUNTARY, VOLUNTARILY DECIDING TO JOIN TO ENTER INTO ONE OF OUR SHELTERS.

IF SOMEONE SURROUNDING THE MARSHALING YARD DECIDES TO WALK UP, IT IS 8:01 PM ON A TUESDAY NIGHT, WILL THEY BE ADMITTED INTO THE EMERGENCY SHELTER IF THERE IS SPACE,

[00:45:01]

AND THAT IS IN PART BECAUSE WE DON'T WANT THERE TO GENERATE A TON OF FOOT TRAFFIC IN THE NEIGHBORHOOD.

BUT WHAT WE WILL BE DOING, I THINK IS OF COURSE ENDEAVORS WILL SPEAK TO THAT PERSON, UH, TALK ABOUT, YOU KNOW, WHAT THE OUTLOOK IS AND CONNECT THEM WHETHER IT'S DIRECTLY TO AN ENDEAVOR STAFF PERSON OR ONE OF THE OTHER REFERRAL POINTS.

SO WE'LL MAKE SURE THAT THAT ISN'T, UM, SIGNIFICANT SORT OF CHURN FOR THOSE INDIVIDUALS.

BUT WE DON'T ANTICIPATE THAT AN INDIVIDUAL WOULD TYPICALLY BE ABLE TO JUST WALK UP AND GAIN ACCESS THAT NIGHT UNLESS IT'S A CASE OF, YOU KNOW, SERIOUS HEALTH AND SAFETY IN THAT MOMENT.

YEAH, I JUST WOULDN'T WANT ANYONE TURNED AWAY, YOU KNOW, ESPECIALLY IF THERE IS SPACE AVAILABLE.

SURE.

I THINK, UM, IT IS MY EXPECTATION THAT WE WILL BE UTILIZING THESE BEDS.

UM, GIVEN WHERE WE ARE AS A COMMUNITY, I THINK THAT PROBABLY EVEN OUR REFERRAL SOURCES WILL HAVE TO BE DOING SOME SORT OF TRIAGING, RIGHT? DETERMINING WHO MOST NEEDS ACCESS TO SHELTER.

UH, BUT WE'RE CERTAINLY DO OUR BEST TO UTILIZE ALL OF THE BEDS THAT WE HAVE AVAILABLE AT ANY GIVEN TIME.

AND, AND IS THE ARCH, ARCH IS ALSO REFERRAL ONLY? NO, NO.

WALKUPS.

SO CURRENTLY THE ARCH, UM, AND THIS IS SOMETHING THAT WE TALKED ABOUT A LITTLE BIT DURING OUR BRIEFING LAST MONTH ON OUR SHELTER SYSTEM.