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[CALL TO ORDER]
ALL RIGHT.SO, UH, I CALL THIS MEETING TO ORDER FOR JUNE 5TH FOR THE AUSTIN TRAVIS COUNTY PUBLIC HEALTH COMMISSION, UH, AT 2:34 PM DO WE HAVE ANY PUBLIC COMMENTS? NO PUBLIC COMMENTS.
[1. Approve the minutes of the Public Health Commission Regular Meeting on May 1, 2024.]
UH, DO I HAVE A MOTION TO APPROVE THE MINUTES OF THE PUBLIC HEALTH COMMISSION REGULAR MEETING ON MAY 1ST, 2024.IT HAS BEEN MOVED BY THE VICE CHAIR.
ANY QUESTIONS TO THE MOTION? QUESTIONS? TO THE MOTION? THERE BEING NONE.
ALL THOSE IN FAVOR? RAISE YOUR HAND.
[2. Discuss the follow-up on potential recommendations regarding Community Health Worker programming and funding.]
MOVING ON TO DISCUSSION.WE HAVE, UH, DISCUSSED A FOLLOW UP ON POTENTIAL RECOMMENDATIONS REGARDING COMMUNITY HEALTH WORKER PROGRAMMING AND FUNDING.
SO WE HAD THE PRESENTATIONS, WE HAD THE BRIEF REGARDING, UH, COMMUNITY HEALTH WORKERS.
WHAT, WHAT, WHAT THEY MEAN, WHAT THE ROLE, UH, FUNCTIONALITY IS.
I KNOW WE HAD, UH, I KNOW AT LEAST I HAD SOME QUESTIONS.
I CAN'T RECALL ALL OF THEM, BUT IT WAS AN ASPECT OF, UH, WHAT LEVEL OF UTILIZATION ARE THEY, UH, WITHIN EACH OF THE AGENCIES, UM, BASED UPON THAT UTILIZATION.
ARE THEY BEING FULLY MAXIMIZED WITH THE ROLE? IS THERE ARE, ARE THERE ANY RESTRICTIONS WITHIN THE POLICIES THAT POTENTIALLY NEED TO BE RE-LOOKED AT TO GIVE GREATER, UH, UTILIZATION? UM, I THINK THE OTHER ASPECT WAS WHAT CURRENT FUNDING IS, IS OCCURRING.
UH, AND ALSO THE ASPECT OF WHAT TYPE OF TRAINING TO BE ABLE TO INCREASE, UH, CAPACITY THAT WAS OCCURRING, NOT JUST WITHIN ORGANIZATIONS, BUT WITHIN THE COMMUNITY TO BE ABLE TO HELP SUPPORT AS WELL IN, IN TANDEM.
UH, AND I THINK THE O ONE OF THE OTHER QUESTIONS WAS, UH, WHERE IS PEER SUPPORT BEING COUPLED IN, UH, WITH THIS AS WELL AS ANOTHER, UH, BODY OF INDIVIDUALS THAT ARE HELPING TO NAVIGATE AND CONNECT, UH, INDIVIDUALS TO SERVICES AND SO FORTH.
WAS THERE ANYTHING ELSE THAT NEEDS TO BE ADDED TO THAT LIST? 'CAUSE I REALLY WANT TO GO FROM THE PRESENTATION.
US HAVING IDENTIFIED SOME AREA ADDITIONAL AREAS OF MORE POLICY AND, AND CAPACITY TO REALLY HAVING MORE INFORMATION BEING PROVIDED AND DISCUSSION BACK AND FORTH WITH OUR AGENCY REPS ON WHAT ARE THOSE POLICIES THAT ARE CURRENTLY IN PLACE, WHERE ARE POTENTIALLY, WHERE, WHERE RECOMMENDATIONS PROBABLY CAN BE MADE, UH, WHERE RECOMMENDATIONS IN ADDITIONAL FUNDING COULD BE MADE AND HOW THAT COULD POTENTIALLY HAVE MULTIPLE IMPACTS TO IT.
UH, WHAT PARTNERSHIPS AND COLLABORATIONS THROUGH EITHER CURRENT FUNDING THAT'S COMING FROM THOSE AGENCIES TO OTHER ORGANIZATIONS OR ONES THAT ARE NOT BEING FUNDED, THAT ARE OUT THERE DOING GREAT WORK TO, TO BE ABLE TO HELP EXPAND AND BE ABLE TO FILL THIS GAP KNOWING THAT THERE'S STILL THE EQUITY PLAN THAT'S OCCURRING.
THERE'S STILL OTHER EFFORTS THAT ARE OCCURRING, BUT IT'S GONNA TAKE A WHILE FOR A LOT OF THOSE NEW RESOURCES THAT, UH, UH, TO REALLY BE ACTIVATED.
ANY, ANY ADDITIONAL THOUGHTS THERE? JUST ONE? YEAH, I WAS, AND MAYBE IT'S RELATED TO FUNDING, BUT I REMEMBER THEY SAID THAT I THINK THERE WAS, IN THE AUSTIN PUBLIC HEALTH, MAYBE THERE WAS 24 COMMUNITY HEALTH WORKERS, AND WE THOUGHT THERE PROBABLY WAS NEED FOR JUST A BACK OF THE ENVELOPE, MAYBE 240.
SO IT SOUNDS LIKE IT'S, IT'S LIKE VASTLY UNDERUTILIZED.
AND I, I DIDN'T KNOW HOW TO THINK ABOUT THAT.
MAYBE THAT'S KIND OF IN USE AND FUNDING, BUT I WOULD JUST CALL OUT THAT IT SEEMED LIKE, AND IT MAY NOT, THAT THE CITY OR AUSTIN PUBLIC HEALTH DOESN'T EMPLOY THOSE PARTICULARLY, BUT MAYBE THERE'S OTHER AGENCIES IN THE CITY THAT, OR THE COUNTY THAT WOULD, YOU KNOW, BE SUPPLEMENTING THAT.
BUT IT JUST SEEMED LIKE THE, THE CURRENT WORKFORCE WAS POTENTIALLY VASTLY UNDER, UNDER, UM, UNDER A MAN, UNDER WOMAN, UNDER UNDERSTAFFED.
I, I THINK TWO OF THE KEY THINGS THAT REALLY CAME OUT OF THAT PRESENTATION AS, AS YOU JUST HIGHLIGHTED, AND THEY HAD AN UPDATED PRESENTATION THIS MORNING TO THE PUBLIC HEALTH, UH, COMMITTEE, WHICH WAS OUT OF THE 24 11, 11 OF THEM WERE, UH, GRANT FUNDED.
UH, THE OTHER ASPECT WAS, UM, AND THE INDIVIDUAL SAID IT NOT WITH THE, NOT ONLY WITH US, BUT IN THIS MORNING, IN NAME, RIGHT? AND ANYTIME SOMEONE, YOU KNOW, THOSE ARE KEY WORDS, THAT MEANS SOMETHING.
IN NAME MEANS THAT THE FUNCTIONALITY OF THE ROLE AND
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THE POSITION IN ACTUAL UTILIZATION ARE TWO DIFFERENT THINGS.SO WHAT DOES THAT MEAN? WHAT DOES THE POLICY SAY VERSUS WHAT THE ACTUAL GENERAL, GENERAL ASSUMPTION OF THE ROLE? RIGHT.
AND IS THE, IS THE UTILIZATION OF THE ROLE VERSUS WHAT THE COMMUNITY EXPECTS A WIDE GAP? OR DOES THE NAME JUST NEED TO BE MODIFIED OR TWEAKED TO BE SOMETHING ELSE THAT'S MORE REPRESENTATIVE OF THE ACTUAL, UH, PAID ROLE AND RESPONSIBILITY OF THAT INDIVIDUAL? YOU WERE GONNA SAY SOMETHING? WELL, I THOUGHT YOU WERE GOING, WAS THAT I WONDERED HOW MANY OF THE 24 OR ACTUALLY IN FRONTLINE COMMUNITY HEALTH WORKER WORK VERSUS MORE ADMINISTRATIVE AND NOT ON THE FRONTLINE.
YEAH, THAT'S WHAT I WAS SAYING.
THAT'S WHAT, TO ME, THAT LINES WITH IN NAME.
UM, AND, AND A GOOD EXAMPLE, YOU KNOW, WE ALL HAVE AN ASSUMPTION OF WHAT A TERM OR A LABEL MEANS, WHICH MAY NOT BE ACTUALLY REPRESENTATIVE OF THE ACTUAL FUNCTIONALITY.
AND SO WHEN I HEAR THAT WORD TWICE NOW, IN NAME TO ME SAYS, WHAT DOES A POLICY SAY THAT THE ORGANIZATIONS ARE USING FOR COMMUNITY HEALTH WORKER COMPARE TO WHAT'S ACTUALLY NEEDED BY A COMMUNITY HEALTH WORKER? AND WHERE SHOULD THERE BE RECOMMENDATIONS IN THOSE POLICIES TO EITHER, UH, GET IT CLOSER TO WHAT THE COMMUNITY'S NEEDING OR WHAT THE COMMUNITY VIEWS OR MODIFICATIONS AND TWEAKS IN TITLES AND STUFF LIKE THAT.
SO, UH, EVERYTHING'S BETTER ALIGNED.
AND WE'RE NOT SAYING THAT FOR AUSTIN PUBLIC HEALTH, YOU HAVE 24 COMMUNITY HEALTH WORKERS, BUT YOU MIGHT ACTUALLY HAVE FIVE REALLY DOING COMMUNITY HEALTH WORK IN THE OVERALL DEFINITION OF COMMUNITY HEALTH WORKER.
ANY THOUGHTS, QUESTIONS, REMARKS? ANYTHING, ANYTHING ONLINE FROM ONLINE FOLKS? NO.
HOW ARE YA? I HAVE A LOT TO SAY ABOUT COMMUNITY HEALTH WORKERS SINCE I AM MYSELF, A COMMUNITY HEALTH WORKER, UH, INSTRUCTOR, MYSELF.
AND I THINK THAT THERE'S NO MORE POLICIES TO BE DONE.
UM, FIRST BECAUSE COMMUNITY HEALTH WORKERS WERE CREATED.
AND THIS ALL STARTED BY, UH, INDIVIDUALS IN THE COMMUNITY.
UH, AND SO YOU GET TO TEXAS IN PARTICULAR STATES, THERE'S POLICIES WHEN WE TALK ABOUT SYSTEMATIC, UM, OPPRESSION, UM, THIS, WHERE YOU START HAVING POLICIES TO START PUTTING PEOPLE IN A LITTLE BOX, RIGHT.
SO I DON'T THINK THAT WHATEVER IS RIGHT NOW IS THAT YOU HAVE TO TAKE A TRAINING TO BECOME A COMMUNITY HEALTH WORKER.
UH, YOU HAVE TO HAVE SO MANY HOURS.
YOU HAVE THE COURT COM, UH, COM, COURT COM.
YOU HAVE SOME COURT COM, LIKE, UM MM-HMM.
THEN YOU'RE GONNA GO AHEAD AND SUBMIT THAT.
YOU SUBMIT, UM, UM, YOUR HOURS, YOUR CERTIFICATE OF CLASS TIME, AND THEN YOU GET YOURSELF A STATE CERTIFICATION.
THE SAME THING HAPPENS ALSO AS A PEER SUPPORT.
I ALSO HAVE A MENTAL HEALTH CARE SUPPORTMENT, UH, CERTIFICATION.
THAT ONE HAS A LITTLE BIT MORE.
THAT ONE HAS, UM, A BACKGROUND CHECK THAT NEEDS TO BE DONE THROUGH THE FBI.
AND THEN ALSO YOU HAVE TO TAKE EVERY YEAR AN ETHICS CLA, UH, WORKSHOP, UM, AND GET YOUR, YOUR CONTINUING EDUCATION TO GET IT, TO RENEW IT.
THE SAME THING HAPPENS WITH THE COMMUNITY HEALTH WORKER.
YOU HAVE TO GET 20 PER YEAR, EVERY TWO YEARS, I'M SORRY, EVERY TWO YEARS.
YOU HAVE TO DO CONTINUED UNIT, UM, UNITS TO BE ABLE TO, TO RE RECERTIFY, UM, THE TRAINING.
I THINK RIGHT NOW, BASED ON WHAT I'VE SEEN ON MY FIRST TRAINING FIVE YEARS AGO, TO THE TRAINING THAT I JUST RECEIVED WITH, UH, UMBA UMBA WITH, UH, FOR MY INSTRUCTOR, I THINK THAT THE TRAINING IS AMAZING.
THEY'RE HITTING EVERY SPOT THAT WE NEED TO, UM, ON THE FUNDING, YES, SOME OF THEM ARE GRANTS, BUT THEY ALSO HAVE TURNED INTO FEDERAL.
SO THERE'S A FEDERAL GRANT THAT HAPPENED FOR MEDICAID, I THINK IT WAS THAT THE INSURANCES WERE GOING TO BE, UH, REIMBURSED.
GIMME A WE'RE GONNA BE REIMBURSED.
UH, SO YOU HAVE FOR BOTH, SINCE YOU HAD A LITTLE BIT OF PEER SUPPORT AND YOU HAVE A LITTLE BIT OF CH HW, BUT ON THE CHW, THERE WAS GONNA BE A REIMBURSEMENT OF INSURANCES, IF ANY, OF, UM, I'M ASSUMING BASED ON WHAT I READ ON IT WAS GONNA BE MORE ON THE CLINICAL SIDE.
SO IF YOU HAD A CLINIC THAT THE CLIENT NEEDED TO KNOW ADDITIONAL INFORMATION ON DIABETES, IF THAT'S WHAT THEIR DOCTOR HAD JUST DIAGNOSED THEM,
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AND THEY WERE BE PULLED ASIDE TO GIVE MORE INFORMATION, MORE RESOURCES, THAT PARTICULAR, UM, I GUESS I DON'T KNOW HOW THEY WERE GONNA BE CHARGING OR THEY WERE GONNA PUT IT AS A BILL.THEY WERE GONNA BE REIMBURSED.
SO THAT WAS ONE FOR THE FEDERAL.
THAT'S WITH THE MEDICAID ON THE GRANT BASIS.
A LOT OF THESE, UM, THE, THE, THE STARTING CHWS HAVE ALL BEEN BASED ON GRANTS.
UM, BUT I ALSO, SOMETHING THAT YOU SAID THAT WAS IMPORTANT ABOUT WHEN YOU SAID ABOUT TITLE, YOU KNOW, THE COMMUNITY HEALTH WORKER IS STILL YET NOT SEEN AS A PROFESSIONAL, EVEN THOUGH THE COMMUNITY HEALTH WORKER IS LITERALLY BOOTS ON THE GROUND, DIRECT SERVICES, IT ALL STARTED, YOU HAVE HIM FROM AFRICA, FROM EL SALVADOR, FROM HONDURAS, FROM EVERY PART OF THE COUNTRY.
YOU HAVE COMMUNITY HEALTH WORKERS.
THAT'S, THAT'S SOME OF THE HISTORY UNTIL YOU GET TO THE UNITED STATES.
AND NOW EVERYTHING HAS TO BE BASED ON POLICY.
UM, AND THIS IS BECAUSE WE AS PEOPLE OF THE COMMUNITY REACH OUT FOR THE NEXT PERSON.
SO WE KNOW WHAT THE COMMUNITY NEEDS.
THIS IS WHY COMMUNITY HEALTH WORKERS ARE VERY ESSENTIAL, BECAUSE WHEN IT IS SOMETHING THAT IS URGENT, AND I SEE EVERYTHING AS URGENCY, WHENEVER YOU SEE SOMETHING THAT IS A SITUATION THAT NEEDS URGENCY, WE DON'T HAVE TIME FOR AN ASSESSMENT.
THIS IS WHY YOU TURN OVER TO A COMMUNITY HEALTH WORKER AND YOU CAN EASILY TELL, ASK THEM WHAT'S GOING ON IN THIS COMMUNITY.
AND BECAUSE THAT COMMUNITY HEALTH WORKER OR THAT GROUP OF COMMUNITY HEALTH WORKERS HAS BEEN WORKING VERY CLOSELY WITH A PARTICULAR COMMUNITY, THEY'RE ABLE TO COME AND TELL YOU, THIS IS WHAT WE'RE NEEDING.
IF, IF ANYTHING, IF THERE'S A DISASTER THAT WOULD HAPPEN HERE IN DELL VALLEY, AND YOU WOULD SAY, WHAT DO WE NEED IN DELL VALLEY? I CAN EASILY TELL YOU, THIS IS WHAT YOU'RE GONNA BE NEEDING.
ELDERLY IS GONNA BE OUR PRIORITY BECAUSE THERE'S A LOT OF ELDERLY IN THIS AREA.
THERE'S NO TRANSPORTATION, AND NOT, WE ARE NOT GONNA WAIT TWO, THREE WEEKS, SIX WEEKS FOR SOMEBODY TO COME AND DO AN ASSESSMENT, COME AND ASK PEOPLE, COME AND DO GROUPS.
SO THIS IS, THIS IS WHERE, UM, COMMUNITY HEALTH WORKERS ARE UNDERVALUED AND THEY'RE NOT BEING UTILIZED TO THEIR FULL POTENTIAL.
AND I WAS GONNA SAY, I'M SOMETHING ELSE ON THE OPPORTUNITIES.
SO WE HAVE A LOT OF POTENTIAL.
UM, BUT IT'S, UH, VICE CHAIR SAID IT, WE'RE NOT BEING UTILIZED TO THE CAPACITY BECAUSE THERE, WE'RE NOT SEEN AS A PROFESSIONAL.
EVEN THOUGH WE CAN, I'VE IMPLEMENTED A PROGRAM.
WE CAN TEACH, WE CAN, WE CAN BE VERY EMPATHETIC.
WE CAN REACH, WE CAN, UH, DO COMMUNITY EVENTS QUICKLY BECAUSE WE HAVE, UH, WE NETWORK WITH EVERYBODY.
ANY OUTREACH YOU'LL SEE, YOU KNOW, YOU'LL SEE US UP THERE BECAUSE WE LOVE DOING SOME OF THAT STUFF.
AND IT KIND OF COORDINATES A LITTLE BIT WITH OUTREACH, BUT COMMUNITY HEALTH WORKERS ARE UNDERVALUED, UNDERPAID, EVEN IN BIG ORGANIZATIONS EXCEPT FOR ONE THAT I KNOW THAT I WAS PART OF AT ONE POINT.
AND ALSO, UM, NOT GIVEN ENOUGH OF THE RESPONSIBILITY.
LIKE I, I DON'T SEE A LOT OF COMMUNITY HEALTH WORKERS BEING UTILIZED, HOW THEY NEED TO BE UTILIZED, UM, TO REALLY IMPACT OUR CLIENTS, OUR PATIENTS' LIVES.
HOW THEY, YOU WOULD HAVE A LOT, AND, AND YOU COULD SEE A LOT OF IMPACTS ON A LOT OF REPORTS WHEN IT COMES TO ORGANIC, JUST AS PEER SUPPORT.
UM, BUT I THINK I, THAT'S ALL I HAVE TO SAY ON THAT.
AND I THINK, AGAIN, THAT REALLY TIES INTO THAT, THAT KEY WORD OR PHRASE, WHICH IS, UH, IN NAME, RIGHT? A LOT OF WHAT YOU EXPRESSED IS THE TRUE ESSENCE, THE TRUE BACKGROUND, THE TRUE GRASSROOTS DEVELOPMENT AND, AND UPBRINGING OF THIS COMMUNITY HEALTH WORKER ROLE, RIGHT? AND I THINK FOR US AS A COMMISSION NOW, IT'S KIND OF FOR, ESPECIALLY FOR A, A GOVERNMENT AGENCY WORKING WITH TAX DOLLARS, EVERYTHING HAS TO BE SPELLED OUT IN A ROLE, A JOB DESCRIPTION THAT'S POSTED, THIS IS WHAT YOU'RE GETTING FUNDED FOR, THIS IS WHAT THE
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KPIS, RIGHT? THE KEY PERFORMANCE INDICATORS, THE OUTCOME, THE IMPACT.AND I THINK THE, THE KEY WORD THAT YOU SHED THAT, THAT, THAT, YOU KNOW, I DO HAVE A QUESTION ON AS YOU'RE SAYING, IT'S NOT POLICIES OR NOT NEEDED TO FOCUS ON POLICIES, BUT IT SOUNDS IN A SENSE, IT, IT, IT IS POLICIES FROM A GOVERNMENTAL STANDPOINT, BECAUSE THAT'S HOW THEY DETERMINE HOW FUNDING IS GONNA GO AND THE EXPECTATIONS OF IT.
SO WHERE IS THE HEART, THE INTENT, THE COMMUNITY REP REPRESENTATIVE IMPACT THAT A COMMUNITY HEALTH WORKER'S SUPPOSED TO BE? AND IT'S SUPPOSED TO BE SOMEONE THAT IS ACTUALLY FROM THE COMMUNITY AND RESPECTED FROM THE COMMUNITY, AND OFTENTIMES IS HIRING A PERSON TO THEN GO INTO THE COMMUNITY AND, AND BUILD THEIR OWN REPUTATION AND CONNECTION, UH, WHICH IS THE ADVERSE OF THE, OF THE ORIGINAL INTENT OF THAT POSITION, HIRING PEOPLE FROM THE COMMUNITY AND GETTING THEM MORE KNOWLEDGEABLE WITHIN HEALTH SPACE TO NAVIGATE THAT COMMUNITY THROUGH THE, THROUGH, THROUGH THE HEALTH SPACE.
SO AGAIN, BEING ABLE TO LOOK AT EVERY AGENCY'S POLICY WHEN IT COMES TO, THIS IS THE ROLE, THIS IS THE DUTIES, THIS IS, UH, THE VETTING PROCESS.
THIS IS OUR STIPULATIONS THAT WE'VE PUT IN PLACE AS AN ORGANIZATION, NOT WHAT THE STATE PUT IN PLACE, NOT WHAT FEDERAL PUT IN PLACE, BUT THIS IS WHAT WE PUT IN PLACE AS A ORGANIZATION THAT WE WANT THE COMMISSION TO TAKE A LOOK AT AND SEE WHERE THERE CAN BE POTENTIAL RECOMMENDATIONS MADE TO ENSURE THAT THE ORGANIZ, THESE AGENCIES ARE NOT, ARE NOT TAKING THE INTENT OF THIS NEW, THIS NEW LEVEL OF WORKFORCE THAT'S REALLY COMMUNITY, COMMUNITY BUILT TO SUPPORT THE COMMUNITY AND UNINTENTIONALLY KIND OF MORPHING IT TO A REGULAR ROLE AND POSITION OF CLINICAL IN A, I DON'T KNOW IF THAT MAKES ANY SENSE WHAT I'M SAYING RIGHT THERE.
LIKE I SAID IT, BUT I DON'T KNOW.
UM, ANY THOUGHTS FROM, FROM THE TEAM HERE? WHAT I, WHAT I THINK I'M HEARING YOU SAY, AND I'M JUST TRYING TO UNDERSTAND IT, AND THANK YOU SO MUCH FOR, YOU KNOW, TEACHING US THIS, UM, IS THAT THERE MAY BE COMMUNITY HEALTH WORKER POSITIONS SOMEPLACE IN DIFFERENT AGENCIES ACROSS THE CITY AND THE COUNTY.
THE QUESTION IS HOW ARE THEY WORKING? AND I'M STILL STUCK ON IT'D BE, YOU KNOW, UM, HOW, HOW ARE THEY WORKING RELATIVE TO THE COMMUNITY HEALTH WORKER ROLE OR SOMETHING ELSE? AND I GUESS I'M STILL STUCK ON THE IDEA OF HOW MANY OF THOSE COMMUNITY HEALTH WORKERS ARE EMPLOYED IN, IN OFF PUBLIC HEALTH AND IN TRAVIS COUNTY TO SAY LIKE, HERE'S OUR GOAL TO, I'M JUST MAKING THIS UP.
YOU KNOW, UM, VACCINATE ALL PREGNANT WOMEN.
MAYBE THERE'S A COMMUNITY HEALTH WORKER ROLE FOR THAT WHOLE THING.
AND THE QUESTION IS, DO WE USE THAT IN ANY WAY IN TRAVIS COUNTY, OR YOU MIGHT SAY HYPERTENSION, OR YOU MIGHT SAY, I DON'T KNOW WHAT ELSE, EARLY CHILD DEVELOPMENT OR SOMETHING.
AND, YOU KNOW, WE HAVE A PROBLEM WITH X AND WE HAVE AN AGENCY AND OTHER AGENCIES COMMUNITY, UH, UM, YOU KNOW, TRAVIS COUNTY AND, AND CITY.
AND WE'RE, WE'RE JUST SAYING WE THINK THAT COMMUNITY HEALTH WORKERS ARE AN EFFECTIVE, YOU KNOW, TOOL IN THAT ARMAMENTARIUM.
AND REALLY, THEY'RE THE TOOL THAT GETS ALL THE WAY, ALL THE WAY, ALL THE WAY OUT TO THE FRONT LINE.
AND DO WE HAVE THEM, AND THEN, AND HOW MANY DO WE HAVE? AND THEN THEY, ARE THEY FUNCTIONING IN THE WAY THEY SHOULD? AND THAT'S, I I'M REINTERPRETING WHAT YOU SAID.
AND I THINK WHAT I WAS HEARING YOU SAY, BUT, BUT I JUST THROW THAT OUT THERE.
UH, MY, MY RECOMMENDATION, GO AHEAD.
UH, I THINK WHAT REALLY STUCK WITH ME FROM WHAT YOU WERE TALKING ABOUT WAS THE UNDERUTILIZED ASPECT, AND THEN IN TERMS OF KIND OF MORE ACTIONABLE ITEMS, COULD WE IDENTIFY WHAT ARE THOSE RESTRICTIONS THAT DON'T ALLOW COMMUNITY HEALTH WORKERS TO BE UTILIZED, UM, FOR EXAMPLE, FROM A PH OR CENTRAL HEALTH, ARE THERE NECESSARY TRAININGS THAT COMMUNITY HEALTH WORKERS COULD DO TO THEN BE ABLE TO PERFORM SOME OF THE NEEDS AND KIND OF EXPAND, UM, BOTH THE RESPONSIBILITIES OF THE COMMUNITY HEALTH CARE WORKERS, BUT ALSO THE SERVICES THAT A PH AND CENTRAL HEALTH CAN PROVIDE? AND IF WE COULD IDENTIFY THOSE, THEN WE COULD, UM, PUT FORWARD A RECOMMENDATION IN TERMS OF, THESE ARE THE TRAININGS THAT WE SHOULD PUSH FORWARD FOR THE COMMUNITY HEALTHCARE WORKERS.
THIS IS THE BUDGET THAT THAT COSTS.
AND THAT WOULD BE KIND OF A MORE ACTIONABLE THING.
SO I'M JUST, UH, CURIOUS ABOUT FOR THE PROGRAMMING RECOMMENDATIONS, SINCE CHWS AND THEIR TRAININGS ARE STATE REGULATED, I DON'T, I'M CURIOUS HOW WE WOULD MAKE RECOMMENDATIONS ON HOW TO ALTER THAT PROGRAMMING, OR IF THAT'S NOT THE INTENT OF OUR RECOMMENDATIONS TOWARDS THE PROGRAMMING.
THAT'S MORE OF A CLARIFYING QUESTION.
UM, BUT FROM THE FUNDING SIDE OF IT, I'VE WORKED IN PUBLIC HEALTH, I'VE BUILT CHW PROGRAMS FOR ORGANIZATIONS.
THERE ISN'T A TRUE INCENTIVE OF BECOMING A COMMUNITY HEALTH WORKER BECAUSE OF THE TYPICAL CO LIKE
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THE, UM, SALARY THAT'S GIVEN.SO IF SOMEONE WANTS TO BECOME A COMMUNITY HEALTH WORKER, AND THEY ALSO HAVE AN OPPORTUNITY TO BE A PROGRAM COORDINATOR, THAT'S A FIVE $7 DIFFERENCE.
SO THE, I WOULD SAY IF WE ARE MAKING RECOMMENDATIONS OF INCREASING WHAT THE SALARIES ARE FOR COMMUNITY HEALTH WORKERS SO THAT WE CAN ACTUALLY KEEP THEM IN THAT ROLE, I KNOW, UH, COMMISSIONER LUHAN MENTIONED LAST TIME THAT WHEN ANOTHER OPPORTUNITY COMES UP, YOU GET PROMOTED, YOU LEAVE THE COMMUNITY HEALTH WORKER ROLE, NOW THAT ROLE IS GONE, THAT TIE TO THE COMMUNITY IS GONE, AND NOW YOU HAVE TO GO FIND ANOTHER PERSON WHO HAS THE SAME TIES TO THE COMMUNITY.
SO IF THE, IF THERE'S A OPPORTUNITY FOR LIKE THE APS OF THE WORLD OF OUR SPACE TO MAKE THE RECOMMENDATIONS TO SAY, HERE'S LIKE AN INTERMEDIATE ROLE.
LIKE HERE'S A MENTOR ROLE WHERE YOU'RE NOW SUPPORTING THE TRAINING.
YOU'RE NOT AN INSTRUCTOR BECAUSE THAT'S A WHOLE SEPARATE PROCESS, BUT YOU CAN BECOME A COMMUNITY HEALTH WORKER, WE CAN GET YOU INTO THE SYSTEM.
A PH IS A GREAT PLACE TO WORK.
SO GETTING PEOPLE INTO A CITY ROLE THAT THEY MIGHT NOT HAVE TYPICALLY BEEN ABLE TO GET INTO.
BUT THEN NOW WE HAVE TO TALK ABOUT FUNDING AGAIN.
SO I'M JUST LIKE, IS THERE A, I KNOW, AND VICE CHAIR, YOU'VE MENTIONED BEFORE DOING CAMPAIGNS AROUND A VARIETY OF DIFFERENT THINGS, UM, SPECIFICALLY HEART HEALTH.
LIKE, IS THIS A WAY THAT WE COULD THEN, AS A COMMISSION SAY, ONE OF THE INCENTIVES OF BECOMING COMMUNITY HEALTH WORKER IS LEADING THIS INITIATIVE ON HEART HEALTH FOR AUSTIN, TRAVIS COUNTY, UM, AND WE ARE GONNA HAVE OUR, OUR COMMUNITY HEALTH WORKERS TALK ABOUT THE EDUCATION, TALK ABOUT THE ACCESS, UM, AND MOVE THAT INITIATIVE OF HERE'S WHERE WE COULD PUT A POT OF FUNDING THAT WE DON'T YET HAVE OR KNOW WHAT TO DO WITH.
BUT THEN MY OTHER QUESTION IS, COULD WE HAVE, AND THIS IS PROBABLY LIKE A COUNTY CENTRAL HEALTH, LARGER QUESTION OF COULD WE HAVE LIKE COMMUNITY HEALTH WORKERS WHO ARE SHARED ACROSS SYSTEMS TO THEN INCREASE THEIR SALARY OR MAKE IT NOT WHOLLY ON THE CITY DEPARTMENTS WHOLLY ON THE, YOU KNOW, SOLELY ON THE, THE HEALTH, UH, THE HOSPITAL SYSTEMS WHERE WE CAN SAY, HEY, YOU HAVE PART-TIME FUNDING FROM CENTRAL HEALTH.
YOU HAVE PART-TIME FUNDING FROM THE COUNTY, AND YOU SUPPORT ALL OF OUR PROGRAMS. UM, I SAID A LOT, BUT I'M JUST CURIOUS, CAN WE MAKE THOSE TYPES OF RECOMMENDATIONS AS OPPORTUNITIES TO IMPROVE THIS PROCESS? I BELIEVE WE COULD, RIGHT? BECAUSE AS FAR AS I RECALL, THERE ARE INDIVIDUALS THAT WORK FOR SETON AND WORK FOR DELL MEDICAL OR WORK FOR, UH, COMMUNITY CARE AND WORK WITH DELL MEDICAL OR A PH AND SO FORTH.
SO I'M NOT SURE HOW THAT FUNDING KIND OF WORKS OUT WHEN THEY'RE REPRESENTING TWO DIFFERENT ORGANIZATIONS.
I THINK THAT'S AN INTERESTING PROPOSAL.
I'M NOT SURE HOW LOGISTICALLY THAT WOULD WORK.
I KNOW AT THE CENTRAL HEALTH, IN THE CENTRAL HEALTH FAMILY, INCLUDING COMMUNITY CARE IN SANDERO, WE HAVE ABOUT 40 COMMUNITY HEALTH WORKERS.
AND I JUST LOOKED AT OUR, UH, CAREERS WEBSITE AND I SEE A POSTING FOR TWO MORE, UM, TO WORK AT CENTRAL HEALTH.
AND THEY ARE FOC THEY ARE IN THE COMMUNITY.
AND, UM, WE HAVE COMMUNITY HEALTH WORKERS THAT ARE IN THE COMMUNITY DOING OUTREACH AND ENGAGEMENT, HELPING PEOPLE NAVIGATE.
BUT WE ALSO HAVE COMMUNITY HEALTH WORKERS THAT ARE IN THE CLINICAL SPACES HELPING, UH, PEOPLE WITH TRANSITIONS OF CARE.
UM, AND I, I CAN'T SAY I, UM, IF SOME ARE PART-TIME, BUT I, I THINK THEY'RE ALL FULL-TIME POSITIONS AND THERE'S LOTS OF WORK
UM, BUT, UM, SO I GUESS I'D BE INTERESTED TO KNOW, YOU KNOW, UM, I GUESS JUST TO HEAR MORE, YOU KNOW, WE DIDN'T HAVE A PRESENTATION FROM CENTRAL HEALTH ABOUT COMMUNITY HEALTH WORKERS.
IT, IT LOOKS LIKE YOU'RE READY TO MAKE A RECOMMENDATION TODAY.
UM, WE HAVE OUR OWN SEPARATE BUDGET PROCESS.
UM, WE'RE GOING THROUGH THAT PROCESS NOW.
I KNOW THERE ARE CONVERSATIONS ABOUT HOW DO WE, UH, IMPROVE OR BUILD ON OUR COMMUNITY HEALTH WORKER PROGRAM.
I, I WILL SAY WHAT I'VE HEARD, THERE'S JUST A, IS A GREATER NEED.
AND YOU'RE PROBABLY GOING TO SEE MORE COMMUNITY HEALTH WORKERS HIRED BY CENTRAL HEALTH.
OBVIOUSLY WE ALREADY HAVE SOME POSTINGS.
SO, UM, YOU KNOW, I ALSO INVITE COMMISSIONERS TO COME TO OUR, YOU KNOW, PARTICIPATE IN OUR BUDGET PROCESS, UM, AND ENCOURAGE, UM, INVESTMENTS IN, IN THIS AREA.
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DOES ANYBODY HAVE A, A, A DISAGREEMENT WITH, UM, GETTING A PRESENTATION ON CHWS FROM CENTRAL HEALTH? SO, CAN, I WOULD JUST LIKE TO ADD THAT WE, THERE WAS A LOT OF DISCUSSION ABOUT OUR A TH CHWS, AND WE HAVE A STRONG CONTINGENCY AT A PH.THEY ARE OUT IN COMMUNITY WORKING.
UM, AND AS WAS MENTIONED, 11 OF THEM ARE GRANT FUNDED POSITIONS, WHICH MEANS THAT WHEN THE FISCAL CLIFF ARRIVES, THEN WE ARE LOOKING FOR FUNDING TO CONTINUE THEIR WORK.
AND WE NEED NOT ONLY TO, UM, PRESERVE THOSE 11 INDIVIDUALS POSITIONS, BUT TO EXPAND ON THE POSITIONS THAT WE, UM, WOULD NEED FOR OUR COMMUNITY, AS WAS POINTED OUT WITH THE, BY THE DEPUTY COMMISSIONER, UM, VICE COMMISSIONER, I, I JUST FEEL LIKE THE, THE FUNDING QUESTION IS ALWAYS FRONT AND CENTER AND SALARIES, UM, ARE IMPORTANT WITH REGARDS TO TRYING TO BE PRESCRIPTIVE ABOUT WHAT COMMUNITY HEALTH WORKERS DO.
I THINK THAT WE, THAT'S, WE SHOULD CAUTION OURSELVES, UM, AS WE LOOK AT THAT BECAUSE AS, UM, COMMISSIONER POINDEXTER SAID, UM, THEIR CURRICULUM IS, IS MANDATED BY THE STATE.
UM, WE, IN OUR VARIOUS, UM, UM, UM, AREAS IN CENTRAL HEALTH AND A PH IN THE COUNTY, WHEREVER THOSE, THOSE COUNTY COM COUNTY COMMUNITY HEALTH WORKERS ARE WORKING, THEY RECEIVE, UM, TRAINING THAT MAY BE SPECIFIC TO THE ISSUE THAT THEY'RE ADDRESSING.
AND WE HAVE PLANS TO, FOR INSTANCE, INCREASE OUR, UM, COMMUNITY HEALTH WORKERS STRIKE FORCE TEAM IN OUR PREPAREDNESS, UM, SECTION OF OUR DEPARTMENT.
AND SO THEY'LL RECEIVE TRAINING IN THAT, AND WE'RE LOOKING TO EXPAND, UM, LEARNING AND TRAINING AND, UM, CLIMATE HEALTH RESILIENCE.
SO, UM, I, I WOULD SAY THAT IN EVERY ORGANIZATION WHERE THERE IS A CONTINGENCY OF COMMUNITY HEALTH WORKERS, THEY HAVE THAT BASE TRAINING AND THEN THEY'RE RECEIVING TRAINING THAT IS SPECIFIC TO WHATEVER THAT ORGANIZATION HAS IDENTIFIED.
AND SO I THINK WHAT IS UNIVERSALLY NEEDED IS FUNDING, UM, AND A RECOGNITION OF THE PROFESSIONALISM AND, UM, LOOKING AT, UM, SALARIES THAT ARE COMMENSURATE WITH THE LEVEL OF, OF, UM, IMPACT THAT THEY HAVE IN OUR COMMUNITIES.
I I WOULD PROBABLY THINK, AND, AND DEFINITELY I UNDERSTAND YOUR, YOUR, YOUR AREA OF THE FINE LINE, RIGHT? UM, I, I THINK IN THIS ASPECT, SOME OF THE PIECES I WOULD PROBABLY SAY IS LIKE, ARE THE ONES THAT ARE HIRED OR LABELED COMMUNITY HEALTH WORKERS, ARE THEY MORE IN A OFFICE THAN ACTUALLY OUT IN A COMMUNITY? IN SOME ASPECTS THEY ARE, RIGHT? BUT SAYING THAT ACROSS THE BOARD FOR EVERY AGENCY, LIKE, OKAY, ARE THEY REALLY IN THE COMMUNITY AND ARE THEY ONLY IN A COMMUNITY EIGHT TO FIVE MONDAY THROUGH FRIDAY WHEN THAT COMMUNITY PROBABLY DOES MORE EVENING STUFF AND WEEKEND STUFF, RIGHT? SO LIKE, IS THE ROLE IN THE PERSON ACTUALLY BEING UTILIZED BASED OFF OF THE ACTIVITIES IN THE NEEDS, IN, IN THE THINGS THAT ARE GOING ON WITH THE COMMUNITY OR THE AREA OF THE COMMUNITY THAT THEY'RE BEING, UH, BROUGHT ON TO ENGAGE WITH? AND AND THAT'S WHERE I SAY SOME ASPECTS I'VE EVEN SEEN WHERE THEY'RE A COMMUNITY HEALTH WORKER, BUT THEY REALLY CAN'T EVEN GET OUT INTO THE COMMUNITY UNLESS THEY GET APPROVAL.
WELL, UM, OUR EXPERIENCE WITH OUR, UM, TEAM IS THAT THEY, UM, ARE FLEXIBLE AND, UM, IN SOME INSTANCES THEY'RE WORKING AFTER HOURS A LOT BECAUSE OF THE NATURE OF THEIR DUTIES, UM, PARTICULARLY IN THE MATERNAL HEALTH SPACE.
SO AGAIN, I THINK YOU MAY SEE CHWS THAT ARE IN CENTRAL HEALTH'S, UM, UM, CLINICS, BUT THEY ARE WORKING WITH COMMUNITY IN THE CLINIC SPACE.
UM, SO AGAIN, IT, IT REALLY DEPENDS ON WHAT THE JOB REQUIREMENTS ARE FOR THAT PARTICULAR POSITION.
IN THE END, IT'S NAVIGATING PEOPLE THROUGH OUR HEALTHCARE SYSTEM SO THAT THEY HAVE THE BEST OUTCOMES.
SO I WOULD SAY DEFINITELY AGREE, BUT THERE'S, THE PIECE WHERE I THINK WE'RE TALKING ABOUT IS MORE COMMUNITY HEALTH WORKERS PHYSICALLY IN THE COMMUNITY DOING THE NAVIGATION.
AND SO BASED OFF OF UNDERSTANDING THAT THERE ARE SPECIFIC CRITERIA
[00:30:01]
AT THE STATE LEVEL TO BECOME CERTIFIED AS A CHW, EVERY ORGANIZATION THEN PROVIDES ADDITIONAL STIPULATION ON THE, THE ROLE, THE FUNCTIONALITY, WHAT HOURS THE PLACES APPROVALS TO GO DO THINGS.SO I THINK JUST BETTER UNDERSTANDING FROM A POLICY-WISE, WHAT EVERY AGENCY, HOW THEY JUST VIEW IT AND, UH, MAKE DETERMINATIONS ON HOW THOSE CHWS ARE UTILIZED.
I THINK THE PIECE HERE IS NOT NECESSARILY HAVING CHWS AT A CLINIC OR IN A HOSPITAL SETTING, OR, UH, AVAILABLE BY EMAIL OR PHONE TO HELP NAVIGATE AND COORDINATE SOMEONE.
IT SOUNDS LIKE IT'S MORE PEOPLE PHYSICALLY IN THE COMMUNITY ENGAGED WITH THE COMMUNITY, EMBEDDED WITH THAT COMMUNITY THAT'S ABLE TO MAKE THE PHONE CALLS, THE EMAILS TO WHOEVER IT IS IN THE CLINIC, IN THE HOSPITAL.
SO I THINK IN A TIME OF SCARCE RESOURCES, IDENTIFYING WHERE WE CAN IMPACT THE COMMUNITY MEMBERS OF OUR COMMUNITY THE MOST IS WHERE WE SIT RIGHT NOW.
AND WE ARE, WE HAVE CHWS THAT ARE DEPLOYED, DOING JUST WHAT YOU'RE DESCRIBING, AND THEN WE HAVE OTHERS AT POINTS OF CARE WHERE NAVIGATION IS NECESSARY BECAUSE THERE ARE, UM, SOCIAL DETERMINANTS OF HEALTH THAT NEED TO BE OBTAINED, ADDRESSED, IDENTIFIED, CONNECTIONS NEED TO BE MADE, REFERRAL LOOPS NEED TO BE CLOSED, AND WE NEED THAT LEVEL OF PROFESSIONAL TO ACHIEVE THAT.
AND SO WHEN WE EXPAND OUR NUMBERS, THEN WE WILL, WE CAN HAVE MORE PEOPLE OUT IN COMMUNITY.
BUT RIGHT NOW WE'RE USING A SCARCE RESOURCE TO TRY TO ACHIEVE WHAT WE NEED TO FOR THE COMMUNITY AT LARGE.
AND, UM, THEY'VE PROVEN TO BE INVALUABLE.
UM, WE ARE RE JUST TO GO BACK TO COVID, UM, OUR MORTALITY RATE IN THIS COUNTY WAS HALF THAT OF THE REST OF THE COUNTRY.
AND THAT WAS BECAUSE, LARGELY BECAUSE WE WERE ABLE TO CONNECT PEOPLE WITH THE RESOURCES THAT THEY NEED NEEDED SO THAT THEY COULD, UM, ADHERE TO THE GUIDANCES THAT WAS BEING PROVIDED AT THE TIME THROUGHOUT THE PANDEMIC.
AND THAT STILL IS TRUE NOW, AS WE ARE IN RESPONSE, WE HAVE MANY PEOPLE WITH MANY NEEDS, AND THOSE INDIVIDUALS ARE THE HEARTBEAT OF WHAT WE'RE TRYING TO DO TO GET PEOPLE BACK TO WHERE THEY WERE PRE PANDEMIC.
AND SO WE NEED MORE MONEY TO HAVE MORE PEOPLE, AND WE NEED, UM, TO RECOGNIZE THE LEVEL OF PROFESSIONALISM, THE LEVEL OF WORK, THE IMPACT THAT THEY HAVE IN HEALTH OUTCOMES AND RAISE THEIR SALARIES.
AND THAT'S WHERE THE DATA POINT, I, I BELIEVE EVERYBODY'S KIND OF IN A GENERAL SENSE ASKING IS, WE KNOW WE NEED MORE PEOPLE IN THE COMMUNITY, BUT IF OUT OF 24 FROM A PH AND 40 FROM CENTRAL HEALTH, IF THERE'S EVEN 50% OF THE TIME THAT THEY'RE IN THE COMMUNITY VERSUS 50% OF THE TIME THEY'RE NOT IN THE COMMUNITY.
RIGHT? WE NEED THOSE DATA POINTS TO BE ABLE TO COME BACK AND SHOW THE LEVEL OF IMPACT IN THE COMMUNITY THAT WE, THAT WE WOULD NEED THEM TO BE INVOLVED MORE WITH.
UM, BECAUSE YES, YOU'RE RIGHT, MORE MONEY'S NEEDED, MORE DOLLARS IS NEEDED FOR THE WORK THAT IS GOING ON, BUT TO BE ABLE TO MAKE A RECOMMENDATION TO BOTH COUNTY AND THE, THE THE COUNCIL MEMBERS, WE HAVE TO BE ABLE TO SHOW WHAT IS ACTUALLY OCCURRING WITH THE CURRENT POPULATION WHERE A MAJORITY OF THE HOURS ARE, ARE BEING DONE AT.
IS IT BECAUSE MORE IN CLINIC, BECAUSE THERE'S MORE OF A CASE MANAGEMENT ASPECT THAT'S, THAT'S GOING ON MORE OF A, UH, COORDINATION WHEN THE PERSON SHOWS UP.
SO THAT'S TAKING THEM AWAY FROM BEING MORE IN THE COMMUNITY, SO OTHER PEOPLE ARE NOT AWARE OF THE SERVICES OR BEING INFORMED THAT THERE ARE, YOU KNOW, THIS, THIS ASPECT.
SO THEN WE CAN SAY, YOU KNOW, YES, YOU GOT THIS MANY PEOPLE, BUT WE NEED MORE BECAUSE THEY'RE, THEY'RE BOGGED UP SPENDING MOST OF THEIR TIME DOING THIS.
AND I THINK THAT THEN COMES TO POTENTIALLY AS YOU'RE SAYING TOO, THAT YOU'RE FOLLOWING THE MANDATE OF THE STATE AND NOT ADDING ANY ADDITIONAL RESTRICTIONS.
IT JUST HAPPENS TO BE THE CLIENTELE AND WHAT THEY'RE NEEDING TO DO BASED UPON WHO THEY ALREADY ARE ENGAGING WITH.
THEY'RE NOT ABLE TO DO EVERYTHING AS A COMMUNITY HEALTH WORKER.
THAT'S WHY WE NEED MORE COMMUNITY HEALTH WORKERS SO THAT EVERYBODY CAN ACTUALLY DO THE FULL ROLE AND RESPONSIBILITY.
I THINK WE JUST DON'T HAVE THAT PIECE OF THE INFORMATION OUTSIDE OF, UH, OUTSIDE OF HOW MANY HAVE, HOW MANY ARE ON GRANTS.
SO WE STILL NEED ADDITIONAL FUNDING TO BE ABLE TO SECURE THOSE POSITIONS.
[00:35:01]
IN THE COMMUNITY DOING COMMUNITY HEALTH WORKER ROLES AND RESPONSIBILITIES.UH, AND THERE IS ALSO FEELINGS THAT COMMUNITY HEALTH WORKERS ARE NOT ABLE TO FULLY DO THE ROLE OF A COMMUNITY HEALTH WORKER.
SO I THINK BEING ABLE TO HAVE SOME OF THAT INFORMATION ABOUT WHAT'S ACTUALLY GOING ON AND WHY CAN HELP US TO BE ABLE TO PRODUCE, UH, RECOMMENDATIONS BASED OFF OF THE ACTUAL TRENDS AND, UH, HOW TO BE ABLE TO EITHER BRING ON ADDITIONAL FUNDING TO SECURE WHAT'S ALREADY THERE THAT MAY BE LOST, BUT THEN ALSO ADVOCATE FOR HOPEFULLY MORE FUNDING TO BE CARVED OUT TO BE ABLE TO MEET THE FULL INTENT OF THE WHOLE CHW PROGRAMS ACROSS ALL THE AGENCIES.
THE, THE THE LAST PIECE I WANTED TO ADD BEFORE, YOU KNOW, DEFINITELY ASKING ANY OTHER QUESTIONS IS, UM, YOU KNOW, WHAT ASPECTS OF CREATING CHW CERTIFIED CHWS CAN OCCUR, UM, THROUGH THE PROCESS.
IT DOESN'T NECESSARILY REQUIRE SOMEONE, UM, HAVING TO APPLY FOR A JOB, RIGHT? HOW CAN WE MAKE THAT PROCESS OF GETTING APPROVAL AT THE STATE LEVEL EASIER? BECAUSE I, I KNOW SOME INDIVIDUALS THAT HAVE SUBMITTED THEIR PAPERWORK BECAUSE THEY'VE DONE A THOUSAND HOURS, RIGHT? THEY, THEY'VE DONE THOSE THINGS AND THEY COULD BECOME CHW CERTIFIED.
HOW CAN THE AGENCIES HELP AND HELP THOSE COMMUNITY INDIVIDUALS THAT HAVE THOSE HOURS? AND I KNOW YOU HAVE THE, THE, THE, UH, THE CHAMPIONS PROGRAM.
HOW CAN THOSE INDIVIDUALS BECOME FUTURE CHWS AND THEY'RE MORE VOLUNTEER AMBASSADORS, CHWS, KIND OF WHAT YOU'RE TALKING ABOUT, DIFFERENT KIND OF CLASSIFICATIONS AND SO FORTH TO START BUILDING THIS REAL PROFESSION THAT HAS DIFFERENT LEVELS, LEVELS WHERE PEOPLE THAT ARE WANTING TO POTENTIALLY GET INTO HEALTH, BUT THEY MAY NOT HAVE THE CREDENTIALS TO BE ABLE TO APPLY FOR A JOB YET WITHIN THE HEALTH AGENCY.
BUT IT GIVES US MORE EXPOSURE AND MORE OPPORTUNITIES OF PEOPLE THAT ARE CERTIFIED AT CHWS.
UH, ANY OTHER THOUGHTS, REMARKS? GO AHEAD.
WA, UM, IS THERE A WEBSITE BOARD VISUAL THING THAT WE CAN SEE, UM, THE IMPACT THAT CHWS ARE MAKING SPECIFICALLY WITH A PH? I DO NOT HAVE THAT WITH ME RIGHT NOW, BUT I CAN CERTAINLY GO BACK TO THE DEPARTMENT AND, AND ASK FOR THAT TO BE PROVIDED TO THE COMMISSIONERS.
I WAS JUST CURIOUS, LIKE IF THAT EXISTS THEN MAYBE THAT MIGHT ANSWER A LOT OF THE QUESTIONS THAT YOU HAVE, BUT THEN ALSO, UM, HELP EXPAND UPON WHY THE FUNDING IS NECESSARY TO SHOW THOSE DISPARITIES.
AND THEN ALSO TO ADD, AND I'M, I'M CURIOUS, I DON'T KNOW IF WE HAVE THIS ABILITY EITHER, UM, CONNECTING MORE OPPORTUNITIES WITH HEALTHCARE SYSTEMS, UH, ESPECIALLY FOR THAT WRAPAROUND SERVICES ASPECT OF THINGS.
SO ONCE THEY'RE DISCHARGED OR ONCE THEY'RE READY TO GO AND SEE A PRIMARY CARE PHYSICIAN THAT MAY NOT EXIST IN THEIR LIFE, UM, COULD THAT ALSO BE A PLACE AND SPACE THAT WE COULD SEE LIKE WHAT SYSTEMS HAVE WRAPAROUND SERVICES AND HOW MANY CHWS ARE CONNECTED TO THOSE SERVICES? SO THAT PRETENDING DR. RICE IS NOW THEIR NEW PCP, THEY HAVE THIS OPPORTUNITY TO SAY, HEY, THIS IS EXACTLY WHO YOU GO TO.
HERE'S THE INFORMATION THAT YOU NEED.
THIS IS HOW YOU SCHEDULE, BUT THEY'RE ACTUALLY CONNECTED TO THE HOSPITAL SYSTEM AND NOT JUST WITH THE CITY, OR NOT JUST WITH THE COUNTY OR NOT JUST WITH CENTRAL HEALTH.
LIKE WE HAVE THIS MUCH BRIGHTER VIEW.
SO I DON'T KNOW IF WE HAVE THE ABILITY TO REQUEST THAT OF LIKE A DASHBOARD, LIKE A RESOURCE MAP.
YOU KNOW, IT'S A WONDERFUL CONVERSATION.
AND, AND, UM, COMMISSIONER ILLUSION, THANK YOU AGAIN FOR YOUR, YOU KNOW, PERSONAL EXPERIENCE AS I SIT HERE.
I MEAN, THERE'S SO MANY WAYS TO LOOK AT THIS.
RUBIK'S CUBE DEPENDS ON WHICH SIDE YOU LOOK AT.
YOU GOT A BUNCH OF DIFFERENT, YOU KNOW, PARTS TO IT AND DIFFERENT THINGS.
AND SO AS I LISTENED TO YOU, I WAS THINKING, YOU KNOW, UM, I'M KIND OF JUST STUCK IN, IN A VERY SIMPLE WORLD, AND MAYBE I'M A LITTLE BIT HOSPITALIST HOSPITAL CENTRIC, BUT YOU KNOW, IT'D BE INTERESTING TO KNOW LIKE HOW MANY PATIENTS A YEAR ARE, ARE CENTRAL HEALTH PATIENTS THAT GO TO THE HOSPITAL AND GET DISCHARGED OR MAYBE GO TO THE EMERGENCY ROOM, THAT'S A MUCH BIGGER NUMBER, BUT GO TO THE HOSPITAL AND GET DISCHARGED.
AND THEN THE QUESTION IS, HOW MANY OF THOSE PATIENTS HAVE A COMMUNITY HEALTH WORKER THAT, THAT MAKES AT LEAST ONE CONTACT WITH THEM? AND THEN YOU COULD BEGIN TO SIZE OF, WELL, WE NEED X NUMBER TO SOLVE THIS PROBLEM ALONE.
WHICH IS TO SAY, WE THINK EVERY PERSON THAT LEAVES, THAT'S A COMMUNITY HEALTH.
I MEAN, A CENTRAL HEALTH PATIENT THAT LEAVES THE HOSPITAL, UM, SHOULD HAVE A COMMUNITY HEALTH WORKER CONTACT IN CASE THEY NEED SOMETHING AND SOMEONE WHO CAN TAKE, YOU KNOW, BE
[00:40:01]
IN TOUCH WITH THEM.AND THEN YOU'D HAVE SOME MODEL SAY, WELL, WE, WE ADMIT AND DISCHARGE, YOU KNOW, 4,000 PATIENTS A YEAR.
HOW WOULD WE DO THAT? AND THEN YOU'D NOW HAVE A QUANTIFIABLE THING THAT SAYS, CENTRAL HEALTH, YOU NEED THIS MANY MORE.
IF THAT'S GONNA BE THE MODEL WE'RE GONNA TRY TO USE.
AND YOU COULD SORT OF USE THAT KIND OF A MODEL FOR, YOU KNOW, I DON'T KNOW, WOMEN'S HEALTH OR OTHER KINDS OF THINGS TO BEGIN TO QUANTIFY A BUNCH OF DIFFERENT, YOU KNOW, STEPPING STONES THAT MAKE THE WHOLE PICTURE OF COMMUNITY HEALTH IN, IN THE COMMUNITY.
AND YOU MIGHT SAY, WELL, GEEZ, FOR THIS OVER HERE, THERE'S THAT NONPROFIT AND THERE'S THAT NONPROFIT AND THEY'VE GOT 150 COMMUNITY HEALTH WORKERS, SO CHECK THE BOX.
BUT, BUT YOU KNOW, YOU WOULD JUST MARCH THROUGH MAYBE A BUNCH OF, YOU KNOW, CORE KIND OF PRIMARY NEEDS FOR, FOR, UM, YOU KNOW, A DIFFERENT PATTERN OF PATIENT GROUPS.
I THINK OUR COMMISSIONER MARTA TALKED A LITTLE BIT ABOUT DIFFERENT PROGRAMS PROVIDING DIFFERENT SALARIES AND SOME OF THEM BEING MORE FAIR THAN OTHERS.
SO TRYING TO UNDERSTAND THAT BETTER AND HOW WE COULD THEN, WELL, WE NEED THOSE NUMBERS IN ORDER TO REALLY PUSH FOR BETTER SALARIES.
I JUST SAW, SORRY, IT IS REALLY HARD TO LIKE WAVE DOWN WHEN YOU'RE VIRTUAL.
UM, I HAVE A THOUGHT THAT I'VE BEEN HOLDING ONTO FROM WHERE I, LIKE THIS TOPIC KIND OF STARTED IN MY MIND, IT'S LIKE A THREE-PRONGED ISSUE.
YOU HAVE COMMUNITY HEALTH WORKERS THAT ARE NOT BEING USED TO THEIR FULL CAPACITY.
THERE'S NO INCENTIVE FOR COMMUNITY HEALTH WORKERS TO STAND THEIR CURRENT POSITION.
AND I GUESS THERE'S NOT A BIG DRAW FOR FOLKS TO BECOME COMMUNITY HEALTH WORKERS.
AND SO I'M KIND OF CURIOUS, AND COMMISSIONER LU HAHN MIGHT BE ABLE TO LIKE, PROVIDE MORE INSIGHT INTO THIS ABOUT SPECIALIZATION, BECAUSE IN MY MIND, USING THE FULL CAPACITY, SO LIKE, AGAIN, LIKE SPECIALIZING IN MATERNAL HEALTH OR LIKE GETTING ADDITIONAL TRAINING, IS THERE ANY INCENTIVE AS A WORKER, LIKE SALARY WISE IN DOING SO? BECAUSE I FEEL LIKE MAYBE THAT COULD BE LIKE AN OVERSIMPLIFIED VERSION OF IT, BUT MAYBE THAT ADDITIONAL TRAINING AND THAT SPECIALIZATION BEING A WAY TO INCENTIVIZE THE EXISTING COMMUNITY HEALTH WORKERS AND THEN THE ACTUAL FOLKS THAT THEY'RE SERVING.
ANY THOUGHTS OR FEELINGS ON THAT? IF YOU MIND IF I SUMMARIZE AND MAKE SURE I, I KIND OF GOT THIS CORRECT AND I PROBABLY GOT IT WRONG, BUT, UM, LET ME SEE.
UM, IN THE EDUCATION SPACE, TEACHERS GET AN ADDITIONAL STIPEND FOR TAKING ON LIKE THE, THE CHAIR ROLE OF THEIR DEPARTMENT OR, UH, CERTAIN OTHER TYPES OF TRAININGS OR, OR, OR LEADING SOMETHING.
IS THAT SOMETHING SIMILAR, WHAT YOU'RE TALKING ABOUT FOR LIKE, CAN CHW BE A, UH, ADDITIONAL PAID INCENTIVE TO GROW MORE ACROSS THIS IN GENERAL? YEAH.
'CAUSE I THINK COMMISSIONER LUHAN, YOU WERE SAYING YOU SPECIALIZED IN MENTAL HEALTH, I BELIEVE IS WHAT YOU SAID.
LIKE IS THERE AN INCENTIVE FOR COMMUNITY HEALTH WORKERS TO SPECIALIZE IN A PARTICULAR AREA WITH ADDITIONAL TRAINING? MAY I ANSWER THAT? UM, IT ALL DEPENDS ON THE ORGANIZATION AND THE AGENCY THAT YOU'RE WORKING WITH AND, UH, BEING PART OF THE, UM, BEING PART OF THIS BOARD.
UM, I'M ACTUALLY, LIKE WHAT I'M SAYING IS IT, UM, BEING A A COMMUNITY HEALTH WORKER COMES WITH, WITH A LOT OF HATS, RIGHT? SO I THINK THE INCENTIVE IS BEING THERE FOR THE COMMUNITY.
THAT'S THE INCENTIVE, HONESTLY, BECAUSE IF I GET ANY ADDITIONAL TRAINING, IT IS FOR ME TO HAVE THE CAPACITY OF ANY CLIENT THAT COMES THROUGH THIS DOOR, I'M ABLE TO GIVE HIM WHAT, UM, COMMISSIONER POINDEXTER SAID, IT'S THE WRAPAROUND.
SO IT'S ALMOST LIKE CASE MANAGEMENT.
AND THAT'S WHY, AND OF COURSE EVERY PERSON IS DIFFERENT.
UM, YOU, WE ARE NOT TRYING TO POLICE THE POLICY OF BECOMING A, A COMMUNITY HEALTH WORKER, THAT THAT IS IT IN IN STONE PRETTY MUCH FOR THE STATE, RIGHT? SO THAT'S NOT EVEN SOMETHING TO CHANGE ABOUT.
BUT I THINK HAVING OPPORTUNITIES TO DO DIFFERENT TRAININGS FOR US TO BE ABLE TO, WHATEVER ROLE WE ARE AND WHEREVER WE ARE, BE ABLE TO HAVE THE CAPACITY TO REALLY IMPACT THAT INDIVIDUAL THAT COMES IN.
THAT'S THE ONE, AGAIN, THAT'S ON THE INDIVIDUAL BASIS RIGHT NOW, IF WE'RE TALKING ABOUT SOME OF THESE BIGGER PROGRAMS THAT UTILIZE A LOT OF COMMUNITY HEALTH WORKERS, LIKE CENTRAL HEALTH IS GREAT.
UM, A PH IS GREAT, UH, BUT HAVING THAT OPPORTUNITY TO HAVE ADDITIONAL TRAININGS, UM, AND I KNOW THAT THEY DO VALUE, I'VE SEEN SOME OF THEIR SALARIES.
VAL, YOU COULD SEE THAT THERE'S A VALUE THERE OF, OF THE PRACTICE OF CHWS, BUT DEPENDING ON WHAT AGENCY OR ORGANIZATION THAT YOU'RE IN, IT'S PRETTY MUCH AS AN INDIVIDUAL TRYING TO HAVE, UM, THE CAPACITY TO BE ABLE
[00:45:01]
TO HELP SOMEBODY.YOU KNOW, IT'S NOT SO MUCH THAT'S THE INCENTIVE BECAUSE I CAN GET AS MUCH TRAINING AS FIRST AID, UM, OPEN, YOU KNOW, HAVE THE, WHAT IS THIS THING, UH, OVERDOSE TRAINING, ALL OF THESE THINGS, UM, IS WITH, I HAVE A CLIENT THAT IS UNHOUSED THAT HAS HAPPENED, GOES IN THE RESTROOM.
THAT'S FOR ME TO HAVE THAT CAPACITY, RIGHT? AND MY, IS MY AGENCY GONNA GIVE ME AN INCENTIVE FOR HAVE, YOU KNOW, HAVING THAT MOMENT WITH INDIVIDUAL IF, IF THERE WAS A LIFE THREATENING SITUATION? NO.
SO THAT'S JUST FOR ME TO BUILD THAT PROFESSIONAL.
AND THAT'S WHERE I TALK ABOUT HAVING THE CAPACITY, HAVING MORE PROGRAMS, UM, ALSO MAYBE HAVING A GROUP OF CHWS THAT ARE ABLE TO BE USED AS CLINICAL, I MEAN AS VACCINES IN CASE OF ANOTHER OUTBREAK OF ANY KIND.
YOU KNOW, HAVE THAT SPECIFIC WHERE YOU CAN CALL THEM TO DUTY AND SAY LIKE, HEY, WE NEED 10 THAT HAVE BEEN TRAINED IN THIS, WE'RE GONNA NEED YOU.
UM, BUT HONESTLY THE, UM, GETTING THE ADDITIONAL TRAINING IS PRETTY MUCH FOR THAT INDIVIDUAL, UH, DEPENDING ON THE AGENCY.
I WASN'T HERE FOR MY LAST ONE.
I WAS, I WAS SICK, BUT I DON'T KNOW IF RICARDO, THAT I CAME AND GAVE A PRESENTATION AND, UM, I KNOW THAT HE HAD BEEN WORKING WHILE AND HE WAS IN, IN HIS ORGANIZATION, IN HIS, UM, I THINK IT WAS WITH DELL.
I'M NOT SURE THE, WHAT HE WAS WITH BEFORE HE WAS WITH, UH, WHERE HE IS NOW.
HE HAS INFORMATION OF THE STIPEND, LIKE CH HW ONE, CHW TWO, CHW THREE, AND THEN THE LEVELS AND THE RESPONSIBILITIES AND DUTIES OF EACH INDIVIDUAL OF COMMUNITY HEALTH WORKER.
AND I KNOW THAT HE ALSO HAD WORKED ON THE, UH, INCENTIVE ON THERE ALL OUR, THE SALARIES ON THEM.
SO I DO SEE THAT THERE'S PEOPLE OUT THERE ADVOCATING.
UH, BUT AGAIN, IT'S ALWAYS GONNA DEPEND ON THE, ON THE ORGANIZATION.
I WAS LIKE HOPING, I WAS LIKE, ADDITIONAL TRAINING COULD BE A WIN-WIN AGAIN FOR THE COMMUNITY, FOR THE INDIVIDUAL TO INCENTIVIZE THEM IN SOME WAY.
SO I THINK THAT JUST KIND OF HELPS FILL THE PICTURE A LITTLE BIT MORE.
YOU WANNA SAY SOMETHING? UH, WELL I GUESS JUST PIGGYBACKING OFF OF THAT, I KNOW AT A PH OUR COMMUNITY HEALTH WORKERS DO WORK TOGETHER.
THEY DO SHARE RESOURCES, INFORMATION.
THAT WAY WHEN ONE GOES OUT, THEY CAN TALK ABOUT LOTS OF DIFFERENT THINGS THAT A PH DOES AND NOT JUST ONE SPECIFIC AREA.
UH, SO I DO FIND, I WOULD AGREE THAT THERE'S LOTS OF VALUE IN THAT, AND I DO LIKE THE INCENTIVE IDEA, BUT I, I, I GET WHAT YOU'RE SAYING AS WELL.
UM, AND THEN ALSO JUST FROM THE BUDGET SUBCOMMITTEE POINT OF VIEW, I AM TRYING TO SCHEDULE A MEETING WITH A PH RIGHT NOW TO TALK ABOUT COMMUNITY HEALTH WORKERS AND, YOU KNOW, GET MORE OF THEIR PERSPECTIVE.
AND THEN THEY ALSO PROVIDED A LIST OF OTHER ORGANIZATIONS THAT USE COMMUNITY HEALTH WORKERS.
SO I'M TRYING TO COORDINATE A MEETING RIGHT NOW WITH THEM SO THAT WE CAN GET MORE INFORMATION.
ANY OTHER REMARKS ON THIS PARTICULAR TOPIC? ANY, ANY THOUGHTS FROM OUR AGENCIES REGARDING THIS? ANY RECOMMENDED NEXT STEPS BASED UPON THIS DISCUSSION TO CONTINUE TO CONTINUE TO MOVE THIS ITEM FORWARD TO A FORMAL RECOMMENDATION FROM THE COMMISSION? WHAT WOULD THE, SORRY, GO AHEAD.
WHAT WOULD THE FORMAL RECOMMENDATION BE? THAT'S WHAT WE NEED TO FIND OUT.
RIGHT? UM, I THINK WE TALKED IN A LOT OF DIFFERENT AREAS OF, YOU KNOW, THINGS THAT CAN PROBABLY BE JUST LOW HANGING FRUIT TO LOOK INTO AND THEN BE ABLE TO PROPOSE SOME RECOMMENDATIONS.
UH, SOME PROBABLY LESS POLICY THAN THAN OTHERS, BUT I THINK IT COMES DOWN TO, RIGHT, FOR, FOR ME RECOMMENDATION IS I WOULD LIKE FOR US TO DO ALL THE LOW HANGING FRUIT BEFORE SETTING A POLICY AND THEN THEY COME BACK, WELL, YOU COULD HAVE DID THIS LOW HANGING FRUIT FIRST, RIGHT? UM, SO WE'RE REALLY MAXIMIZING THE EFFORT.
SO I THINK WITH THE WHOLE DISCUSSION JUST ACROSS THE BOARD, WHAT DOES THE GROUP THINK AS FAR AS POTENTIAL NEXT STEPS TO CONTINUE TO MOVE THIS TO SOMETHING FORMALIZED? SORRY, I NEVER EXPECT THIS WAY.
UM, I KNOW BEFORE WE HAD A, A SHEET, UM, THAT WE WENT AND TALLIED WHAT OUR LEVELS OF IMPORTANCE WERE WITHIN OUR COMMISSION FOR US TO LOOK AT.
COULD WE POTENTIALLY, NOT TO PUT MORE WORK ON OUR LIAISONS, WHICH ARE ABSOLUTELY AMAZING, BUT COULD WE POTENTIALLY PUT OUR IDEAS OF WHAT LOW HANGING FRUIT ARE BASED, UH, OFF OF THIS CONVERSATION,
[00:50:01]
GET THOSE COMPILED AND THEN SAY, OKAY, HERE'S, WE HAVE 15 OF THEM MM-HMM,AND THEN MAYBE THEN WE WOULD BE ABLE TO SAY, OH, THESE ARE MORE POLICY FOCUS.
LET'S MOVE THOSE TO THE BACK END BECAUSE WE NEED TO GET COMMISSIONER CROOKHAM TO GET THE BUDGET PIECES BEFORE WE CAN TALK ABOUT THAT.
SO WE'LL PUT THE BUDGET AT THE SECOND, AND THOSE MAY BE INCENTIVE CONVERSATIONS OR THE GAPS IN EMPLOYMENT OR THE GAPS OF OPPORTUNITY, OR THE ONES THAT HAVE DONE THEIR A THOUSAND HOURS.
MAYBE THEN WE CAN START TO COLLECT SOME DATA TO SEE, AND I, I DON'T KNOW HOW WE WOULD COLLECT DATA AS A COMMISSION, BUT MAYBE WE CAN ASK SOMEBODY TO COLLECT SOME DATA FOR US.
UH, BUT THAT WOULD BE MY RECOMMENDATION FOR US TO MOVE FORWARD OF, CAN WE COMPILE ALL OF OUR IDEAS OF LOW HANGING FRUIT, COME BACK TOGETHER AND SAY THIS MAKES SENSE FOR THE FIRST ROUND, SECOND ROUND, THIRD ROUND.
ANY ANY THOUGHTS, ADDITIONAL REMARKS OR ANYTHING OF DIFFERENT RECOMMENDATION? I, I WAS JUST, SORRY.
UM, LOVE ALL THAT I WAS, UM, HAVING THE ACTION.
THAT WOULD BE NICE TO STILL LEARN SOME MORE.
WE'VE GOT MUCH, MUCH TO THINK ABOUT SUBSTANTIVE TODAY.
UM, IT MAY BE A TERRIBLE IDEA, BUT I'M GONNA GO BACK TO WHAT I HAD SAID EARLIER, MAYBE THE SICKEST PATIENTS THIS MONTH IN CENTRAL HEALTH, AND I'M JUST USING CENTRAL HEALTH 'CAUSE YOU KNOW, WE'RE TALKING ABOUT THAT.
UM, ARE THE ONES THAT JUST GOT OUTTA THE HOSPITAL, THE ONES THAT ARE IN THE HOSPITAL, THE HOSPITAL THAT JUST GOT OUT.
AND THE QUESTION WAS, I WONDERED IF THAT'S A WORTHY THING TO THINK ABOUT, WHICH I'M NOT SAYING IT IS, I'M JUST LAYING IT OUT THERE.
WOULD IT BE INTERESTING TO KNOW HOW MANY DISCHARGES DO WE HAVE OVER THE LAST 12 MONTHS FROM CENTRAL HEALTH, FROM ANY OF THE HOSPITALS ACROSS THE CITY? AND AND YOU MIGHT ASK THE QUESTION, DID ANY OF THOSE PATIENTS GET A CONTACT WITH A COMMUNITY HEALTH WORKER AFTER DISCHARGE? I DON'T KNOW HOW YOU'D KNOW THAT.
YOU MIGHT KNOW ABOUT THE CENTRAL HEALTH.
BUT ANYWAY, I'M JUST WONDERING, AND THAT MAY BE A WORTHLESS TIME, YOU KNOW, IDEA, BUT I WAS JUST TRYING TO THINK ABOUT HOW TO QUANTIFY AT LEAST IN THAT PATIENT POPULATION, IT'S ONE POPULATION THAT WE HAVE SOMEBODY IN THE ROOM THAT KNOWS ABOUT AND COULD GET TO AND UM, AND, AND, AND THEN ASK THE QUESTION FURTHER.
MAYBE THEY'D SAY, WELL, WE DON'T THINK THAT'S THE, THE RIGHT IDEA.
MAYBE THE PHYSICIANS IN THE MANAGEMENT TEAM, THE CLINICAL MANAGEMENT TEAM AT CENTRAL HEALTH WOULD SAY, THAT'S A TERRIBLE IDEA BECAUSE YOU WOULDN'T DO THAT FOR X, Y, Z REASONS.
BUT I'M SAYING IF SOMEONE SAID, NO, I THINK THAT MAKES SENSE TO HAVE COMMUNITY HEALTH WORKERS AS A STRATEGY FOR PEOPLE THAT ARE IN THE HOSPITAL WHEN THEY COME OUT OF THE HOSPITAL, THEN YOU'D SAY, WELL, HOW MANY OF THOSE GOT CALLED OR NOT? THE WHOLE THING I TALKED ABOUT, ABOUT TRYING TO DECIDE WHETHER THAT WAS, YOU KNOW, HOW MUCH WOULD IT TAKE TO DO IF YOU SAID EVERY PERSON SHOULD HAVE ONE? HOW MANY, YOU KNOW, HOW MANY COMMUNITY HEALTH WORKERS WOULD THAT BE? JUST TRYING TO BUILD SOMETHING THAT'S A MODEL I'M JUST THROWING OUT AS AN IDEA TO THINK ABOUT, TO GIVE US SOME KIND OF A STRUCTURE, YOU KNOW, NUMERATOR, DENOMINATOR ON SOMETHING THAT COULD BE IMPORTANT.
ANY THOUGHTS ON, 'CAUSE TO ME THIS, THAT'S ALMOST AN ASPECT OF SAYING WHERE IS NATURAL FOOT TRAFFIC OCCURRING THAT CHW CHWS CAN BE INTENTIONALLY PLACED AS AN ENGAGEMENT, BUT I KNOW YOU ALSO HAVE, UM, UH, UH, INDIVIDUALS THAT ARE PART OF, I CAN'T THINK OF THE WORD, THE INDIVIDUALS, WHEN THEY'RE DISCHARGED, THEY'RE PART OF THE DISCHARGE PROCESS.
SO IS THAT KIND OF OVERLAPPING INTO ANOTHER ROLE AND RESPONSIBILITY THAT'S ALREADY BEING FUNDED? I THINK THE ASK IS FOR STUDY, AND I THINK THAT MIGHT BE SOMETHING THAT YOU COULD PUT TOGETHER A WITH A LOT MORE, UM, CLARITY ONCE YOU FINISH THE PROCESS OF INFORMATION GATHERING.
BECAUSE RIGHT NOW, UM, I SUSPECT THAT WHAT YOU'RE ASKING FOR WOULD BE VERY DIFFICULT TO GATHER FROM DATA.
I'M NOT SURE THAT THERE'S EVEN A DATA POINT IN AN EMR THAT ADDRESSES THAT.
SO, UM, I THINK THERE ARE SOME OTHER THINGS THAT YOU CAN GLEAN ONCE YOU, COMMISSIONER KIRKHAM GETS THE INFORMATION FROM HIS INVESTIGATIONS AND THE OTHER COMMITTEE MEMBERS THAT ARE WORKING ON THIS CAN PULL TOGETHER THINGS THAT WE CAN ADDRESS.
BUT I'M, I, I DOUBT THAT WE'RE GOING TO BE ABLE TO PUT THAT THE, THAT A A BC TOGETHER RIGHT NOW, BUT MAYBE BASED ON WHAT YOU FIND FROM THE INVESTIGATIONS THAT YOU'RE DOING AS A COMMITTEE, THAT COULD BE A RECOMMENDATION THAT WE TRY TO PUT THAT TOGETHER SO WE CAN ASSESS IMPACT AND THEN LOOK AT THE ECONOMICS OF EXPANSION OF CAPACITY.
YEAH, THOSE, THOSE, THE ONLY KIND OF THOUGHT
[00:55:01]
WHEN YOU WERE MENTIONING IT IS, YOU KNOW, YOU ALREADY HAVE INDIVIDUALS WHEN A PERSON COMES IN TO A CLINIC OR TO A HOSPITAL THAT THEY'RE SEEING, AND THEN YOU HAVE THE DISCHARGE PROCESS, RIGHT? SO HOW DO WE MAKE SURE THAT WE'RE NOT DUPLICATING EFFORTS THAT ARE BEING FUNDED BY DIFFERENT ENTITIES? PERFECT.BUT I THINK I ALSO HEAR, HEAR FROM OUR COMMISSIONER TOO IS, YOU KNOW, CREATING THIS MORE ROBUST PROFESSIONAL CAREER PATH FOR CHWS THAT THEY HAVE THEIR OWN DISTINCTIVE LANE AND PLACE AND MM-HMM.
UM, ANY OTHER THOUGHTS OR RECOMMENDATIONS? YES, I JUST WANTED TO FOLLOW UP WITH, UM, WHAT COMMISSIONER NATALIE WENT OVER ABOUT COMPILING IDEAS.
UM, I WANTED TO CLARIFY, COMMISSIONERS WILL BE EMAILING STAFF ABOUT LOAN, LOW HANGING FRUIT IDEAS.
WE WILL COMPILE SOMETHING AND SEND IT BACK OUT AS, UM, FOR YOU GUYS TO LIKE RANK OUT.
CAN WE JUST SET A TIMELINE FOR THAT, UM, BEFORE NEXT MEETING? SO, UM, OUR NEXT MEETING IS NOT GONNA BE THE FIRST OF LIKE DIFFERENCE WEDNESDAY BECAUSE IT'S UH, 4TH OF JULY WEEK.
UM, CAN WE POTENTIALLY SET IT AS TWO WEEKS FROM TODAY? SO THE 19TH, IS THAT ENOUGH TIME FOR YOU GUYS TO GET INFORMA, LIKE, YOU KNOW, GO OVER EVERYTHING AND SEND INFORMATION OVER TO ME OR US? YEAH.
ANY ISSUES WITH THAT 19TH? SOUNDS LIKE IT'S A GO.
UM, ANYTHING ELSE TO ADD REGARDING, UH, UH, COMMISSIONER'S RECOMMENDATION OF THIS PROCESS? SOUNDS LIKE WE GOOD TO GO THERE TOO.
[3. Discussion of the City of Austin’s Special Operations Plan – Heat Emergencies.]
ON TO ITEM NUMBER THREE, DISCUSSION OF THE CITY OF AUSTIN'S SPECIAL OPERATIONS PLAN, HEAT EMERGENCIES, UH, REQUESTED.UM, THIS TO BE ON THE AGENDA AGAIN, GOING IN THE SUMMER.
WE KNOW THE HOT DAYS THAT HAVE BEEN OCCURRING.
UH, AGAIN, THIS WAS SOMETHING THAT WAS PRESENTED IN THIS MORNING'S, UH, CITY COUNCIL'S, UM, HEALTH COMMITTEE.
UH, ANY, ANY THOUGHTS BASED UPON IF YOU HAD A CHANCE TO BE ABLE TO READ THE DOCUMENT, UM, THAT, THAT KIND OF STUCK OUT THAT YOU WOULD LIKE TO HIGHLIGHT, MAYBE DISCUSS OR EVEN, UH, ASK OUR AGENCIES, UM, ABOUT GO AHEAD.
ANYBODY? I JUST HAD A QUESTION I DIDN'T SEE, I SAW A LOT OF INFORMATION IN THERE.
SO THIS IS ME QUICKLY REGURGITATING.
UM, ARE THERE ANY PROCESSES IN PLACE AS LOOKING AT THE, THE FOLKS WHO HAVE LOW INCOME THINGS? RIGHT, WE'RE, I SAW A LOT ABOUT OUR HOUSELESS, UM, OUR UNHOUSED COMMUNITY.
I SAW A LOT ABOUT OUR ELDERLY COMMUNITY, BUT I DIDN'T SEE ANYTHING SPECIFICALLY ABOUT OUR LOW INCOME COMMUNITIES WHO ARE NOW GOING TO BE, THEY'RE NOT AT THAT RATE WHERE THEY CAN GET ASSISTANCE, BUT THEY'RE AT THE PLACE AND SPACE WHERE IF THEIR AIR CONDITIONING HAS TO BE TURNED OFF BECAUSE THEY NEED TO SAVE ON MONEY, UM, WHAT, WHAT SUPPORT IS OFFERED FOR THEM.
IT ALMOST SEEMED LIKE THERE WAS THIS GROUP OF FOLKS WHO DIDN'T HAVE A PLAN OR A PART IN THE PLAN IS, I DON'T KNOW IF ANYBODY ELSE SAW THAT OR FELT THAT, BUT IT, IT SEEMED AGAIN, LIKE THE UNHOUSED, UH, THE ELDERLY HAD PLANS PUT TOGETHER, BUT THOSE THAT ARE IN BETWEEN WEEN DID NOT, DID NOT HAVE A VOICE, UM, OR A, A PROCESS IN PLACE, THE ASSET LIMITED INCOME CONSTRAINED EMPLOYED WHO DON'T HAVE ENOUGH MONEY.
WHICH PAGE WAS THAT? UH, I'M JUST THINKING ABOUT OH, YES, THE DEFINITIONS.
THAT IS A BEAUTIFUL DEFINITION.
WE THOUGHT HE WAS READING, SO I WAS LIKE, DID I MISS THE PAGE, GIRL? TELL ME PLEASE.
AND WHAT WAS THAT TERM THAT THE, THE PHRASE YOU SAID, IT'S, IT'S THE TERM IS ALICE AND IT'S ASSET LIMITED, INCOME CONSTRAINED, EMPLOYED.
SO WOULD YOUR, WOULD YOUR QUESTION THEN BE BASED OFF OF THIS, THIS TERM, IS THERE SOME OTHER PLANS THAT ARE ALREADY OUT THERE THAT MAY BE ALREADY, UH, SUPPORT, UH, THIS PARTICULAR POPULATION? AND IF SO, UH, COULD THOSE BE SHARED WITH US IN, YOU KNOW, HOW EASILY COULD SOME OF THOSE COMPONENTS BE ADDED INTO, UH, THE EMERGENCY,
[01:00:02]
UH, SUPPORT ASPECTS TO, TO HELP FILL THAT GAP? THAT WAS IT.I, I WILL SAY THAT, UH, TRAVIS COUNTY PROVIDES ASSISTANCE FOR UTILITY BILLS AND THEY PRIORITIZE PEOPLE WHO ARE GETTING DISCONNECTED.
UM, SO PEOPLE CAN, CAN REACH OUT TO OUR COMMUNITY CENTERS, SUBMIT AN APPLICATION, LET 'EM KNOW THAT THEY'RE IN, UH, YOU KNOW, ON THEIR WAY TO GET DISCONNECTED AND THEY CAN BE PRIORITIZED FOR UTILITY ASSISTANCE.
THE, THE, THE ONE, UH, PIECE I WOULD, I WOULD ADD TO THAT TOO, WHICH I SAW WASN'T NECESSARILY A, A PIECE HIGHLIGHTED IN HERE WERE WHAT ARE THE, THE DEPARTMENTS OR ENTITIES FOR THE OTHER CITIES THAT THE COUNTY'S CONNECTING TO WHEN THERE IS AN EMERGENCY OR SOMETHING GOING ON, RIGHT? I SEE ALL THESE ENTITIES LISTED FOR THE CITY OF AUSTIN, BUT I DON'T SEE ANY LISTED FOR ANY OF THE OTHER CITIES.
SO WHO IS THE COUNTY REACHING OUT TO CONTACTING AND SAYING, DO YOU HAVE ANYBODY THAT THAT NEEDS TO APPLY FOR THESE PROGRAMS OR THIS PROGRAM? HAVE YOU PUSHED THIS STUFF OUT TO THEM AND SO FORTH? SO, UH, THAT WAS PROBABLY THE, THE PIECE THAT I DIDN'T SEE IN HERE, WHICH WAS WHO'S THE GO TO FOR LAKEWAY AND FOR, YOU KNOW, THOSE OTHER AREAS.
UM, BECAUSE MOST OF THEM DON'T HAVE THE TEXT PROCESS.
UH, THEY DON'T HAVE FORMAL, UH, NEWSLETTERS AND, AND, AND, AND THOSE THINGS LIKE THE BIG CITY HAS.
SO, UH, AND MOST PEOPLE ARE NOT GOING TO THE COUNTY.
THEY'RE, THEY'RE USUALLY GOING TO THE CITY FIRST AND THE CITY DOESN'T HAVE THOSE PROGRAMS AND SERVICES.
SO WHERE WITHIN THE PLAN IS THERE THAT IS SPECIFICALLY SAYING TO SOMEONE, AND IT'S UPDATING TOO AS THINGS CHANGE THAT THE COUNTY WILL BE CONNECTING WITH THE CITIES AND MAKING SURE THAT THEY DON'T HAVE NEEDS, UH, THAT HAVE THEY ASKED THEIR POPULATION TO SEE WHO NEEDS SUPPORT OR WHO NEEDS ACCESS TO PROGRAMS AND SO FORTH.
SO THAT WAS THE KIND OF PIECE THAT WAS MISSING THAT, THAT IN, IN THIS PLAN AS WELL.
I THINK WHAT YOU RECEIVED WAS THE CITY OF AUSTIN PLAN? NO, IT SAYS, UH, AUSTIN, TRAVIS COUNTY.
UM, WE CAN ASK, WE, WE CAN ASK IF WE CAN HAVE THAT AND, AND UPDATE IT.
I WILL TELL YOU THAT, UM, MOST OF THE PEOPLE IN, IN THE OUTER AREAS OF THE CITY KNOW WHERE TO, WHERE TO GO WHEN THEY NEED ASSISTANCE.
WE GET THOUSANDS AND THOUSANDS OF APPLICATIONS FOR UTILITY ASSISTANCE, RENT ASSISTANCE, FOOD PANTRY AT OUR COMMUNITY CENTERS.
AND, UM, SO WE'LL, WE'LL NEED TO UPDATE THAT TO MAKE SURE THAT, THAT, THAT INFORMATION IS IN THERE.
WE PUSH OUT INFORMATION ON SOCIAL MEDIA, ON FLYERS, UM, ABOUT THE COOLING CENTERS OUT IN OUR, UM, THE COUNTY OUTSIDE OF THE CITY.
UM, OUR COMMUNITY CENTERS ARE OPEN TO ANYONE.
AS LONG AS THE COMMUNITY CENTER IS OPEN, PEOPLE CAN WALK IN TO COOL DOWN.
UM, SO, UM, WE'LL, WE'LL TAKE A LOOK AT WHAT ELSE WE CAN DO AND UPDATE THIS.
I MEAN, HAVING SAT ON THE OTHER SIDE, I DEFINITELY KNOW THAT Y'ALL ARE DOING EVERYTHING YOU NEED TO DO.
UH, I THINK IT'S JUST A PIECE OF THE, THE REALITY AS, AS HUMANS, RIGHT? NOBODY'S REALLY, YOU HAVE PEOPLE FOLLOWING THE, THE, THE GOVERNMENT'S SITES AND SOCIAL MEDIA, BUT THERE'S SO MANY THAT DON'T.
RIGHT? AND THE FIRST PLACE THEY GO TO IS NOT GONNA BE THE LARGER GOVERNMENT ENTITY IS GONNA BE THE LOCAL ONE.
AND SO THAT'S JUST THAT PIECE OF, WITH SO MANY PEOPLE THAT ARE REACHING OUT, THERE'S PROBABLY DOUBLE OR TRIPLE THAT HAVE NO CLUE.
UM, SO THAT'S WHERE I WAS JUST HOPING WHERE, WHERE, WHERE IS THAT KIND OF HAPPENING? SO EVEN THAT PHONE CALL BLAST EMAIL TO THE POINTS OF CONTACTS WITHIN THE OTHER CITIES, HOPEFULLY THAT JUST HELPS PUSH THAT INFORMATION A LITTLE BIT OUT TO THOSE THAT OTHERWISE DON'T HAVE A CLUE.
YEAH, THERE'S KINDA LIKE THE ECHO THAT I KNOW THAT I USED TO WORK IN PUBLIC HEALTH EMERGENCY PREPAREDNESS AND BACK THERE WAS A FLOODING, I THINK IN LAKEWAY SEVERAL YEARS AGO.
AND IT WAS NEWS TO ME THAT THEY HAD THEIR OWN EMERGENCY MANAGEMENT COORDINATOR.
I THOUGHT, YOU KNOW, ERIC WAS THE COORDINATOR FOR THE ENTIRE COUNTY.
UH, BUT IT TURNS OUT SEVERAL CITIES HAVE THEIR OWN EMERGENCY MANAGEMENT COORDINATORS.
AND SO I AGREE THAT PIECE IS MISSING IN HERE.
AND IF EACH ENTITY OR SEVERAL ENTITIES DO HAVE THEIR OWN MCS, THEN WHY AREN'T THEY INVOLVED IN THIS? WHY AREN'T THEY PART OF THE PROCESS? UM, AND I REMEMBER SPEAKING WITH THAT PERSON BACK WHEN THIS WAS HAPPENING AND HOW THERE WAS A LACK OF COMMUNICATION AND COORDINATION BETWEEN LAKEWAY AND THE COUNTY.
UM, AND SO THEY FELT LIKE THEY WEREN'T BEING VERY SUPPORTED AND THEY WERE SURPRISED THAT WE WERE OUT THERE, YOU KNOW, BLAH, BLAH, BLAH.
[01:05:01]
YOU.THAT PIECE IS MISSING AND, AND HONESTLY, YOU BRING IT UP EVERY TIME HOW IT'S AUSTIN AND TRAVIS COUNTY, AND I'M STARTING TO NOTICE THAT AS WELL.
WHERE'S MAINOR? WHERE'S, YOU KNOW, EVERYTHING ELSE AS WELL.
SO, UH, I JUST WANNA ECHO THAT.
ANY OTHER, ANY OTHER THOUGHTS ON YOUR REVIEWS OF THE, THE, THE PACKAGE? ANY, I THOUGHT GO AHEAD.
I CAN'T SEE WHOSE MOUTH IS MOVING.
UM, I HAVE A QUESTION SLASH CONCERN ABOUT THE CAP ME, LIKE GENERAL ACCESSIBILITY TO THE COOLING, UM, AREAS BECAUSE THEY HAVE A TENDENCY TO BE MORE OR LESS LIKE DOWNTOWN.
AND I BELIEVE IT WAS LAST SUMMER OR THE SUMMER BEFORE WHERE CAP METRO MADE IT FREE TO RIDE IF YOU WERE GOING TO A COOLING CENTER.
I DON'T KNOW IF THAT WAS LIKE A ONE TIME DEAL, IF THAT'S GONNA BE CONTINUAL OR NOT.
I KNOW THAT THEY HAVE A SYSTEM FOR BUS PASSES, BUT THEN YOU HAVE TO GET IT EITHER THROUGH A PROVIDER OR THROUGH AN ORGANIZATION.
AND THAT'S JUST LIKE AN ADDITIONAL BARRIER.
'CAUSE YOU HAVE TO GO TO ONE PERSON TO GET THE OTHER ITEM.
SO I DIDN'T SEE ANYTHING ABOUT THAT KIND OF ACCESSIBILITY IN THE DOCUMENT, BUT I'M JUST CURIOUS IF THERE'S, IF THAT'S GONNA BE A CONTINUOUS THING DURING THE SUMMERTIME OR IF THAT'S SOMETHING THAT NEEDS TO BE DISCUSSED AS A CONCERN.
THAT WAS MENTIONED YESTERDAY IN THE PRESS CONFERENCE THAT THEY WOULD BE OFFERING THAT SERVICE AGAIN THIS SUMMER.
UM, AND IF IT'S NOT IN THE DOCUMENT, THAT'S ANOTHER THING THAT WE NEED TO, UM, TALK TO EMERGENCY MANAGEMENT ABOUT PUTTING IN THERE.
I HAD ONE COMMENT AND ACTUALLY DISCUSSED THIS WITH MEGAN CERMAK, UM, BEFORE COMING OVER, BUT DURING THE PANDEMIC, UM, CENTRAL HEALTH WAS, UH, ACTIVE IN AMPLIFYING THE CITY AND THE COUNTY'S EFFORTS THROUGH SOCIAL MEDIA, WORD OF MOUTH THROUGH OUR COMMUNITY HEALTH WORKERS.
AND SO, UM, YOU KNOW, I'D ALSO LOVE TO SEE CENTRAL HEALTH IS, YOU KNOW, ONE OF THE PARTNERS IN HERE THAT CAN HELP BECAUSE WE DO HAVE MANY VULNERABLE, UM, COMMUNITY MEMBERS THAT ARE PATIENTS OF OURS.
AND SO I THINK WE CAN ALSO AMPLIFY TO THOSE INDIVIDUALS EITHER THROUGH OUR TEXT PLATFORM OR, YOU KNOW, THROUGH FLYERS AT THE CLINICS OR PHONE CALLS.
UM, SO I WANTED TO ALSO BRING THAT UP.
NO, IT DEFINITELY MAKES SENSE.
AND I THINK TOO, YOU KNOW, UH, YOU KNOW, LOVE THE WHOLE REBRANDING PIECE THAT YOU HAVE GOING ON IN, UH, SHOWING THAT GREATER INTER INTERCONNECTIVITY INTERCONNECTEDNESS BETWEEN SENDERO AND COMMUNITY CARE AND CENTRAL HEALTH THAT OFTENTIMES THE COMMUNITY DOESN'T KNOW THE THREE ARE REALLY MARRIED TOGETHER, SO APPRECIATE BEING ABLE TO HAVE Y'ALL BETTER INCLUDED INTO THESE EFFORTS.
ESPECIALLY AS, YOU KNOW, GOING WITH THE ORIGINAL NAME THAT, THAT TRAVIS COUNTY HEALTHCARE DISTRICT,
UM, ANY OTHER THOUGHTS, COMMENTS, REMARKS ON THIS ONE? YES.
UH, COMMISSIONER LUHAN HERE AGAIN ON THE CAPITAL METRO, AND NOW THAT Y'ALL BRINGING IT UP THERE IS, UM, THERE IS A GOOD AREA WHICH IS BETWEEN, UH, ELROY ROAD AND, UH, ROSS ROAD.
THE SECOND HALF, NOT THE ONE THAT'S IN FRONT OF THE HIGH SCHOOL, BUT THERE'S ANOTHER LITTLE PIECE BETWEEN PIERCE AND ELROY.
THEY ARE BUILDING THREE ADDITIONAL, UM, APARTMENT CONFERENCES.
AND WHEN I'M COMING WITH THIS IS FOR THE, IF ANY, WHEN WE TALK ABOUT CAPITAL METRO, THERE'S NO ACCESS TO CAPITAL METRO OVER THERE FOR, IN CASE OF ANY SITUATION LIKE THIS, THAT IF ANY FAMILIES IN THAT AREA DON'T HAVE POWER AND THEY NEED TO GO TO A COIN PLACE, THERE IS NO WAY TO BE ABLE TO GET AHOLD OF SOME OF THE PEOPLE THERE AND BRING 'EM EVEN CLOSE TO PEERS, WHICH IS THE LAST BUS STOP THAT THERE IS.
SO I'M NOT SURE WE WOULD BE ABLE TO, UH, BRING THAT UP TO ANYBODY WHEN THEY COME TO THIS DISASTER, UH, PIECE, ESPECIALLY FOR THE HEAT, BECAUSE THERE'S NO WAY FOR SOME OF THOSE INDIVIDUALS TO BE ABLE TO EVEN, THERE'S NO SIDEWALK FOR THEM TO WALK TO PI, WHICH IS THE, AGAIN, THE LAST BUS STOP.
AND THERE'S A, A BIG AREA IN THAT, NOT NOT ONLY THE DELL VALLEY THAT'S BEEN THERE DEVELOPED BEFORE, UM, BUT NOT, BUT THIS IS INCLUDING NOW THE NEW APARTMENT, THE DEVELOPMENT.
AND, UM, SO THAT'S ANOTHER CONCERN THAT I'VE BEEN SEEING, UM, FOR A COUPLE OF MONTHS.
BUT, UM, IN THIS CASE, WHEN WE TALK ABOUT HAVING TO, YOU KNOW, WITH ALL OF THIS CRAZY WEATHER, HOW WOULD WE BE ABLE TO ACT HOW THESE PEOPLE HAVE ACCESS TO TRANSPORTATION?
[01:10:02]
GO AHEAD.IT'S, IT'S SO INTERESTING COMMISSIONER ILLUSION BECAUSE YOU HAVE THAT EXPERIENCE AND KNOWLEDGE, AND I WONDER IF THERE'S A HUNDRED TIMES AS MUCH KNOWLEDGE THAT'S NOT BEING SURFACED TO THE SYSTEM TO KNOW WHERE THOSE KINDS OF NEEDS ARE NOT BEING MET.
I HAVE A JURISDICTIONAL, UH, I DUNNO HOW I WANNA PHRASE IT, SO I'M JUST GONNA SAY IT, IT'S GONNA COME OUT WRONG, BUT IT'S OKAY.
UH, I DIDN'T NECESSARILY SEE IT ADDRESSED HERE.
WE PROBABLY WILL NOT BE ABLE TO ADDRESS IT ANYTIME SOON, SO I'LL PUT IT OUT THERE.
BUT I WOULD LOVE TO BE ABLE TO SEE IN Y'ALL'S RECOMMENDATION OF HOW TO WORK THROUGH THIS, WHERE THERE'S IMMEDIATE NEED NOW, BUT SOMETIMES GOING TO THE AGENCY IS A DELAYED RESPONSE.
AND SO THE CITIES ARE USUALLY LIKE THE TAX DOLLARS THAT WE GET ARE FOR THE CITY, AND IT CREATES THIS UNINTENTIONAL, THE DOLLARS NEED TO BE USED FOR OUR RESIDENTS.
YOU'RE IN MY CITY, BUT YOU'RE NOT PART OF THE CITY.
BUT THERE'S DOLLARS ALLOCATED BY THE AGENCIES THAT SUPPORT YOU, BUT THEIR SUPPORT IS MORE DISTANT THAN WHAT WE CAN DO RIGHT NOW.
AND I'VE NEVER REALLY SEEN IN ANY OF THE EMERGENCY MANAGEMENT DOCUMENTS OR PAPERWORK AND SO FORTH WHERE THERE'S THIS AGREEMENT OF, YES, CITY, GO AHEAD AND PAY FOR THAT.
WE'LL REIMBURSE YOU BECAUSE IT NEEDS TO HAPPEN NOW AND IT CAN'T WAIT UNTIL WE HAVE RESOURCES, ALLOCATABLE, IT CAN'T HAPPEN UNTIL WE CAN, UH, UH, UH, YOU KNOW, VET THROUGH THIS PROCESS.
THE ONLY TIME I SAW THAT THERE WAS A FLATTENING OF IT WAS WITH THE THRIVE, UH, FUNDING THAT THE COUNTY DID FOR SMALL BUSINESSES DURING COVID, WHERE THEY MADE A DECISION THAT SAID, WE'LL GO OFF OF THE CITY'S RECOMMENDATION AND WON'T HAVE THEM HAVE TO GO THROUGH THE WHOLE PROCESS WITH US JUST TO GET 'EM IN AND MAKE SURE THAT THAT SMALL BUSINESS IS TAKEN CARE OF.
BUT FOR EMERGENCY MANAGEMENT, WHEN WE'RE TALKING ABOUT WATER THAT PROBABLY NEEDS TO BE PURCHASED OR UH, UH, ACS AND ALL THAT TYPE OF STUFF, RIGHT.
WHEN THAT PROCESS MAY BE TOO LONG TO GO THROUGH THE COUNTY AS THE ETJ AREA TO GO THROUGH, UH, YOU KNOW, UM, WHATEVER IT MAY BE, IS THERE A WAY THAT THE CITY CAN BE ABLE TO FILL THAT GAP AND GET, FILL THAT GAP ON THAT AGENCY'S BEHALF AND THEN BE REIMBURSED FOR IT AS WELL? I, NO CONVOLUTED QUESTION.
AND THAT'S USUALLY WHERE YOU SEE THE BREAKDOWNS WITHIN THE CITIES OF ITS OWN RESIDENCE AND ITS OWN INDIVIDUALS WHEN IT'S, BUT YOU'RE THE CITY.
I DON'T CARE IF I'M IN THE ETJ
I GUESS, UM, MAYBE COMMISSIONER KIRKHAM CAN SPEAK TO THIS BETTER THAN I, BUT THAT'S WHERE PLANNING AHEAD AND HAVING THOSE, UM, AGREEMENTS SET IN PLACE BEFORE THE EMERGENCY HAPPENS, UM, IS REALLY HELPFUL.
BUT IN ADDITION TO THAT, IN, UM, JURISDICTIONS THAT HAVE THEIR OWN BOUNDARIES, IF THEY HAVE AN EMERGENCY MANAGEMENT TEAM, UM, THEY'RE TRAINED IN HOW TO, AS IT WERE, ONCE THEY'VE EXPENDED OR REACHED THEIR, UM, CAPACITY, THEY'RE ABLE TO MAKE, UM, REQUEST IF THERE'S AN EMERGENCY ONGOING, UM, TO THE STATE FOR THROUGH STAR REQUEST.
CORRECT ME IF I'M GOING OFF SCRIPT HERE, UM, SO THAT THEY COULD GET THOSE THINGS, UM, THAT THEY NEED FOR THAT ASSISTANCE.
UM, WITHOUT HAVING AN IDEA ABOUT SPECIFIC EXAMPLES, MAYBE WE CAN TALK OFFLINE AND MAYBE WE SHOULD ACTUALLY REACH OUT TO OUR EM PARTNERS.
UM, BUT I MEAN, I THINK THAT'S SOMETHING THAT CAN BE ADDRESSED BY PLANNING AHEAD.
BUT THEN ALSO I JUST WANNA POINT OUT THAT THANKFULLY WITH AUSTIN PUBLIC HEALTH, WE HAVE AN INTER-LOCAL AGREEMENT WITH TRAVIS COUNTY.
SO WE ACTUALLY PROVIDE PUBLIC HEALTH SERVICES FOR ALL OF TRAVIS COUNTY AND ALL OF CITY OF AUSTIN, EVEN AS PART OF THE CITY THAT GOES IN WILLIAMSON COUNTY.
WE COVER THAT AND THEN WE COVER ALL OF TRAVIS COUNTY.
[01:15:01]
AND SO FOR AT LEAST PUBLIC HEALTH, THAT'S OUR CONTRACT AND WE HAVE A LOT OF FLEXIBILITY AND IT'S A LOT EASIER TO RESPOND IN THOSE REGARDS.YOU KNOW, OBVIOUSLY WE HAVE CITY HOMELAND SECURITY, AND THEN WE HAVE THE COUNTY OFFICE OF EMERGENCY MANAGEMENT.
SO I'M SURE THOSE DON'T WORK AS SEAMLESSLY AS WE DO.
BUT I DO WANNA POINT OUT THAT OUT, AT LEAST IN TERMS OF PUBLIC HEALTH, WE ARE ABLE TO COVER THE ENTIRE COUNTY.
AND THIS MAY JUST BE, AGAIN, LIKE A COMMUNICATION PIECE, RIGHT? UM, OR SOMETHING THAT NEEDS TO BE EVEN ADDED INTO, UH, UH, THE CITIES, CITIES ON THE COUNTY SIDE, THE CITIES OWN BASIC EMERGENCY PLANS BECAUSE THERE'S USUALLY A NORM OF, WELL, IT'S NOT CITY LIMITS, SO THERE'S NOTHING WE CAN DO MM-HMM.
AND SO DEFINITELY LOVE TO TALK MORE OFFLINE ABOUT IT AND JUST SOME OF THE EXAMPLES THAT HAVE HAPPENED OVER BETWEEN 2019 AND 22 OF, OF THOSE SITUATIONS WHERE CITY GOVERNMENT FOR THE SMALLER RURAL COMMUNITIES, SOMETIMES THEIR PERSPECTIVE IS MORE CITY LIMITS, NON-CITY LIMITS.
AND THAT'S NOT OUR SPACE FOR NON-CITY LIMITS.
I, I WOULD LOVE TO TALK OFFLINE TO GET VERY SPECIFIC SCENARIOS BECAUSE MY UNDERSTANDING, AND I'VE BEEN IN MANY CALLS, BUT THERE IS A LOT OF COORDINATION WITH THE CITIES OUTSIDE OF THE CITY OF AUSTIN AND THE COUNTY DURING A DISASTER.
UM, THERE ARE, THERE ARE SOMETIMES THERE'S TWO OR THREE CALLS A DAY, UM, WITH THE CITIES, WITH EMERGENCY MANAGEMENT, WITH THE EMS SYSTEMS IN THOSE CITIES, AND EVERYBODY'S ASKING, WHAT ARE YOUR NEEDS? AND, UM, THE CITY'S REPORT WHAT THEIR NEEDS ARE, AND THEN THE, THOSE, THOSE NEEDS ARE SUPPOSED TO BE MET.
SO, UM, YEAH, IF WE CAN GET SPECIFIC EXAMPLES TO SO THAT WE DON'T REPEAT THOSE, THAT WOULD BE GREAT.
BUT I, I'VE SEEN A LOT OF COORDINATION DURING THE DISASTER.
I, I JUST WONDERED AS I LISTENED THAT I THINK, DID WE MORPH FROM A HEAT, THE HEAT CONVERSATION TO A DISASTER CONVERSATION IN THE SUMMERTIME IS, IS A, IS A 90 DAY HEAT DISASTER, I SUPPOSE, IS THAT THE SAME CONVERSATION? I'M JUST TRYING TO, SO OVERARCHING, RIGHT? THE, THE, THE EMERGENCY MANAGEMENT PLAN IS, IS SUPPOSED TO BE THE OVERARCHING WHICH YOU EXECUTE FOR WINTER STORM VERSUS COVID VERSUS HEAT VERSUS A BIG SIGNIFICANT EVENT HAPPENING IN THE CITY.
IT KIND OF DETAILS OUT WHO'S SUPPOSED TO BE ACTIVATED, WHO'S SUPPOSED TO BE ENGAGED, WHO WITHIN THE COMMUNITY IS CONSIDERED THE SUBJECT MATTER EXPERT TO HELP SUPPORT IN THOSE ASPECTS.
AND THEN YOU HAVE THESE MORE PEELED OFF, THIS IS WHAT NEEDS TO HAPPEN FOR HEAT SITUATIONS, AND THESE ARE THE PARTNERS AND YADA, YADA, YADA.
SO EVERY CITY MAY NOT NECESSARILY HAVE, ESPECIALLY WHEN YOU'RE TALKING ABOUT THE LAKEWAY, AND I CAN'T, I ALWAYS SAY LIKE B CAVE AND ALL THE OTHER, THEY MAY NOT HAVE LIKE BIG AUSTIN, THE SPECIFIC PILL OUT.
I SEE POLICIES, THEY JUST GO OFF OF THE BASIC EMERGENCY PLAN NINE TIMES OUTTA 10.
THEY'RE BASIC EMERGENCY PLAN IS NO MORE OR LESS THAN THE COUNTY'S EMERGENCY PLAN.
SO WHEN THERE'S CONFLICT IN THE SENSE OF IMMEDIATE NEED, THE COUNTY MAY NOT BE ABLE TO REACT AND SO FORTH BECAUSE IT'S NOT SUPPOSED TO OPERATE LIKE A LOCAL GOVERNMENT.
THEN THERE BECOMES THE ISSUE ON THE RES RESIDENT SIDE, WHICH IS YOU, THE CITY SHOULD BE HAVING SOME THINGS IN PLACE AND BEING ABLE TO DO SOME THINGS AND NOT HAVE TO WAIT ON THE COUNTY.
JUST TYING THIS TO DISCUSSION ITEM TWO, I THINK THIS MIGHT BE A PLACE WHERE COMMUNITY HEALTH WORKERS WOULD BE VERY VALUABLE AS WELL IN TERMS OF CONNECTING RESIDENTS WITH RESOURCES DURING AN EMERGENCY, UH, REGARDLESS OF THE EMERGENCY.
UM, IS IT POSSIBLE TO HAVE CAT METRO COME AND TALK TO US ABOUT WHAT THEIR PLANS ARE FOR AREAS THAT THEY DO NOT SERVE? OR WOULD THAT BE, OBVIOUSLY THEY DON'T SERVE THEM AND WHEN WE'RE THINKING ABOUT THE DOLL VALLEY AREA, LIKE THERE IS NO TRANSPORTATION.
SO EVEN IF WE WANTED TO GET TO THE DOLL VALLEY COMMUNITY CENTER TO A COOLING STATION, YOU HAVE TO HAVE A CAR, OR YOU HAVE TO BE WILLING TO WALK ON THE SIDE OF THE ROAD TO GET TO THAT PLACE TO THEN WALK ON THE SIDE OF THE ROAD TO GET BACK.
SO ARE THERE A WAY, IS THERE A WAY THAT WE CAN EITHER HAVE CAP METRO OR A SYSTEM STARTING WITH CAP METRO THAT'S GONNA TALK ABOUT TRANSPORTATION AND WHAT THEIR PLANS ARE FOR FOLKS WHO DO NOT HAVE CARS AND THAT THEY DO NOT SERVE? MY INITIAL THOUGHT IS GONNA BE A VERY THIN LINE.
AND HOW DO WE HAVE THAT CONVERSATION WITHOUT IT TURNING
[01:20:01]
INTO NON-HEALTH? I THINK IT IS THE SOCIAL DETERMINANT OF HEALTH.TRANSPORTATION, ENVIRONMENTAL CHANGE.
THAT IS A, THAT IS SOMETHING THAT THEY ACT, IT, IT IS PHYSICAL DETERMINANTS OF HEALTH.
WHEN WE TALK TO THE RETREAT, TRANSPORTATION FALLS INTO THAT SPACE.
SO HOW WOULD WE, I'M JUST THINKING THROUGH HERE AND BRAINSTORMING WITH YOU ALL.
SO THE REASON I SAID IS BECAUSE YOU NECESSARILY WANT TO TALK TO 'EM ABOUT THIS PARTICULAR TOPIC.
AND SO IF WE GO OUTSIDE THIS PARTICULAR TOPIC, THEN WE NEED TO BE ASKING THEM TO COME IN FOR MORE OF A SOCIAL DETERMINANT OF HEALTH BRIEF WITH A FOCUS ON EMERGENCY MANAGEMENT, IS WHAT YOU'RE ASKING.
I WOULD JUST BE CURIOUS WHAT THEIR EMERGENCY MANAGEMENT PLAN IS AS A WHOLE.
WELL, AND I'M, IF THEY, IF THEY ARE NOT ALREADY INCLUDED IN THE CITY OR COUNTY'S CONVERSATION MM-HMM.
AND IF CAF METRO'S, LIKE KNOWS, GOES, IT'S NOT US.
NOW WE'RE TALKING ABOUT A TRUE PUBLIC HEALTH CRISIS OF THOUSANDS OF PEOPLE WHO ARE IN AREAS THAT DO NOT HAVE TRANSPORTATION.
I, I WOULD RECOMMEND BROADENING THAT IF WE CAN, INVITING THEM TO COME HERE TO JUST TALK ABOUT THEIR OVERALL TRANSPORTATION PLANS FOR THE COUNTY.
UM, YOU KNOW, IF THEY'VE GOT A PLAN 3, 4, 5 YEARS OUT TO HELP US IDENTIFY WHERE THERE MAY BE, YOU KNOW, HOLES IN ACCESS TO CARE.
I THINK JUST HEARING ABOUT WHAT THEY'RE PLANNING ON IN GENERAL WOULD BE VERY HELPFUL FOR US.
AND NOT NECESSARILY JUST RELATED TO HEAT.
THAT, THAT WAS WHAT I WAS SAYING TOO, BECAUSE IF WE WANTED TO GO AND TALK ABOUT SOMETHING ELSE, WE WOULDN'T BE ABLE TO IF WE'RE ONLY ASKING THEM TO TALK ABOUT THIS.
BUT, BUT I WOULD, BUT I WOULD, YOU KNOW, RECOMMEND THAT THEY ADDRESS THE DELL VALLEY QUESTION.
YOU KNOW, OTHER CITIES IN THE COUNTY HAVE TO BUY INTO THE CAPITAL METRO SYSTEM, BUT DE VALLEY'S NOT A CITY.
SO THAT'S WHY WE NEED TO HEAR FROM CAPITAL METRO AS TO WHAT IS, IF THEY COULD SHOW US WHAT THEIR BUS LINES ARE IN DELL VALLEY, AND THEN IF THEY HAVE ANY PLANS ON EXPANDING THOSE NOW THAT DELL VALLEY IS GROWING, UM, BECAUSE THAT'S PART OF THE COUNTY.
YOU KNOW, COMMISSIONER, OH, GO AHEAD.
I ACTUALLY WAS ABLE TO ASK THIS QUESTION, AND IT SEEMS THAT THEY ARE NOT, UH, DELL VALLEY HAS ONLY ONE BUS ROUTE.
LITERALLY IT'S ONLY ONE BUS ROUTE, AND IT ONLY GETS TO PEERS AND THEN IT GOES BACK INTO US.
UM, I DID ASK, UM, I HAD ASKED IN THIS, UM, VANESSA FUENTES PUT A FACEBOOK ON SOME QUESTIONS, AND I DID ASK ABOUT THAT.
WHAT IS IT? UM, THE RESPONSE WAS THAT IT'S NOT IN THE BUDGET AND THAT IF CAPITAL METRO NEEDS TO COME AND MAKE AN ADDITIONAL ROUTE, THE, THE COUNTY WOULD HAVE TO TAKE THAT.
UH, I GUESS THEY WOULD HAVE TO PAY FOR IT.
UM, SO THAT MEANS THAT IF IT'S, IF IT, IF CAPITAL METRO DOESN'T HAVE A FUTURE IN DELL VALLEY WITH AN ADDITIONAL ROUTE, THAT MEANS THAT THE COUNTY WOULD HAVE TO PICK IT UP SO IT COULD HAPPEN TO GET IMPLEMENTED.
IT'S NOT ON THE BUDGET FOR 2025, SO THAT WOULD GIVE ANOTHER TWO YEARS.
BUT IN THIS CASE, WE UNDERSTAND THAT YOU HAVE THREE COMPLEXES, AND I'M JUST GONNA ROUND NUMBER, LET'S SAY 2000 FAM, UH, INDIVIDUALS IN EACH COMPLEX.
THAT'S 6,000 PEOPLE JUST IN THAT STREET ALONE, WHICH IS THE ROSS ROAD BEFORE BETWEEN PIERCE.
THIS IS NOT COUNTING THE HOUSES THAT ARE ALREADY THERE, THE COMMUNITY THAT'S ALREADY ON ELROY, I FEEL THAT FOR US TO BE ABLE TO TALK ABOUT AND OKAY.
AND THAT'S THE, THE GENERAL ONE.
BUT WHEN WE'RE GONNA TALK ABOUT THE, UH, HEATING, UH, WITH THE SUMMER COMING UP, IF THEY DO HAVE AN EMERGENCY PLAN FOR AREAS LIKE MAGNER AND DELL VALLEY ONE, I THINK THAT CENTRAL HEALTH, CENTRAL HEALTH WOULD BE ESSENTIAL TO HELP US START THIS CONVERSATION.
BECAUSE YOU DO HAVE COMMUNITY CARE RIGHT THERE ON ELROY AND ROSS THAT IS BEING BUILT.
AND WHEN WE TALK ABOUT SOCIAL DETERMINANTS OF HEALTH, WE WOULD BE ABLE TO SAY SOME OF OUR PATIENTS, SOME OF OUR CLIENTS WILL NOT BE ABLE TO GET SOME, WELL AS, AS NOT AS MANY PEOPLE IN THIS COMMUNITY WILL BE ABLE TO BE SERVED.
BECAUSE IF THEY DON'T HAVE A VEHICLE, HOW ARE THEY GONNA GET TO THAT AREA? BECAUSE PEOPLE LITERALLY THAT LIVE IN THIS AREA WHERE THE BUS ROUTE IS, WOULD HAVE TO WALK ALL THE WAY TO THE ROSS ROAD, ALL THE WAY TO ELROY TO GO TO A DOCTOR'S APPOINTMENT.
SO I FEEL THAT MAYBE, AND THIS IS JUST A SUGGESTION, OBVIOUSLY, UM, HELP US BREAK THAT CONVERSATION
[01:25:01]
WHEN WE TALK ABOUT SOCIAL DETERMINANTS OF HEALTH, AND IF THAT'S SOMETHING THAT HAS TO BE DEFINITELY SEEN IN A TWO, THREE YEAR BASED ON POLITICS, KIND OF WHAT IT IS.UM, WELL, DOES, UH, CAPITAL METRO HAVE AN EMERGENCY PLAN FOR SOME OF THESE AREAS? AN IMMEDIATE EMERGENCY PLAN FOR SOME OF THESE AREAS? UH, INSTEAD OF WAITING TILL IT HAPPENS AND THEN YOU HEAR THE COMMUNITY UPSET OR POSTING AND SAYING, HEY, WHERE ARE YOU WHEN SOMETHING HAPPENS, WHEN WE CAN ACTUALLY HAVE SOMETHING PREVENTIVE? NOW OBVIOUSLY WE'RE NOT TELLING THEM WHAT TO DO, BUT WE'RE DEFINITELY PUTTING IT ON THEIR RADAR BECAUSE THEY ARE THE ONLY TRANSPORTATION COMPANY IN THIS AREA, AND YOU HAVE CODA, WHICH I'M SURE THAT THEY COULD, SOME OF THOSE TAX DOLLARS THAT THEY'RE BEING EXEMPT CAN GO TOWARDS CAPITAL METRO, WHICH IT WOULD BENEFIT THEM TOO, YOU KNOW, FOR SOME OTHER CONCERTS PEOPLE WOULD HAVE TRANSPORTATION, YOU KNOW.
SO I THINK IT'S A WAY, BUT I, I, THAT'S HOW I'M VISUALIZING IT.
UM, AGAIN, THIS ISN'T, POLITICS IS NOT MY STRONGEST, BUT THAT'S WHAT I, I, UM, I WAS TOLD, UH, CAPITOL METRO WILL NOT BRING A ROUTE OVER HERE UNLESS THEY HAVE IT IN THEIR FUTURE PLANS.
AND IF IT'S NOT, THE COUNTY WOULD HAVE TO PICK UP THE, I GUESS THE, THE EXPENSE.
AND, UM, BUT WE DO HAVE A LOT OF THINGS HAPPENING IN THIS AREA THAT WOULD AFFECT A LOT OF FAMILIES.
THE MAIN, I THINK, I'M SORRY, I WAS GONNA SAY THE MAIN, THE MAIN THING, I'M TRYING TO THINK, THINK THROUGH HERE BECAUSE DEFINITELY BELIEVE IS A CONVERSATION THAT THAT NEEDS TO BE HAD, BUT ALSO KEEPING IT AWAY FROM TRANSPORTATION INFRASTRUCTURE IS, THERE'S A VERY THIN LINE ON ON THAT THIS CONVERSATION COULD GO TO.
AND IT ALMOST SOUNDS IN A SENSE HERE, WHAT YOU'RE SAYING HERE TOO, COMMISSIONER AND, AND, AND, AND COMMENTS HERE IS ALMOST BECAUSE CAPITAL METRO IS FUNDED THROUGH TAX DOLLARS, THE CITIES THAT IT'S INVOLVED WITH, RIGHT? HOW ARE THEY INTENTIONALLY MAKING THESE LOCATIONS A PART OF THE BUS ROUTES OR, OR SOME ASPECT, RIGHT? AND I THINK JUST BEING ABLE TO FLESH OUT WHAT IS THE ASK WHEN IT COMES TO SOCIAL DETERMINANTS OF HEALTH, UM, WITH PUBLIC HEALTH, THAT FOCUS, RIGHT? SO WE DON'T GET OFF INTO ALL THE OTHER TRANSPORTATION CONGESTION ISSUES THAT WILL ARISE UNDER SOCIAL DETERMINANTS OF HEALTH WHEN OUR FOCUS IS MORE PUBLIC HEALTH.
LET ME SEE IF I CAN ASK A QUESTION ON THAT.
COMMISSIONER POINDEXTER AND DR.
WALTZ MADE ME THINK OF THIS IS THAT I WONDER IF THE WAY TO NARROW THAT, AND I'M JUST THROWING OUT AN IDEA, IS TO SAY, LET'S LOOK AT, UM, COUNTYWIDE EMS, UH, HEAT EMERGENCY RUNS THAT HAPPENED BETWEEN JUNE 1ST AND, AND AUGUST 31ST.
THAT'S AN EASY NUMBER TO GET BY LOCATION AND THEN MAP THAT TO PLACES NOT SERVED BY, UM, BY, BY E BY, UM, WHATEVER THAT IS, BY, BY, UM, UM, CAPITAL METRO.
AND THEN YOU MIGHT HAVE A MAP THAT EITHER OVERLAPS OR DOESN'T OVERLAPS AND YOU'D HAVE SOME REAL DATA.
ANY OTHER THOUGHTS, COMMENTS? SURE.
YEAH, I, I THINK IT'S, UH, IT SOUNDS LIKE A REALLY GOOD RECOMMENDATION THAT THERE BE, UH, AN EMERGENCY PLAN OF FROM CAPITAL METRO AS TO WHAT THEY WOULD DO IN AN EMERGENCY IN THOSE AREAS.
UM, DELL VALLEY SPECIFICALLY IS WHERE THEY CAN START.
UM, AND ALSO A, A PLAN FOR, UM, EXTENDING TO THOSE AREAS AND, AND A GOOD RECOMMENDATION FOR THE CITY FOR, UH, FOR THE COUNTY TO KICK IN IF THAT'S WHAT'S NECESSARY.
I MEAN, I, I THINK, I THINK I HEARD THROUGH REALLY GOOD RECOMMENDATIONS THERE.
AND ALSO AS WE ARE TALKING, UM, ABOUT PUBLIC HEALTH, IF WE ARE ABLE TO HAVE A BUS LINE OR EXPAND THE PUBLIC TRANSPORTATION OUT INTO THAT AREA WITH, UM, USE OF CAP METRO LINES, UM, WE HOPEFULLY WOULD BE ABLE TO THEN DECREASE CAR TRAFFIC IN THAT AREA.
AND THAT WOULD FAVORABLY IMPACT THE ENVIRONMENT AS WELL.
ANYBODY DISAGREE WITH, UH, HAVING THAT AS A FUTURE PRESENTATION? SO CAN WE HAVE THAT ADDED AS A FUTURE PRESENTATION AND HOPEFULLY CAPTURE THE UNIQUENESS OF THAT PRESENTATION
UM, WITH THAT BEING SAID, LET'S
[4. Update from Infrastructure & Access work group.]
MOVE OVER TO WORKING GROUP UPDATES.UH, UPDATE FROM THE INFRASTRUCTURE AND ACCESS WORK GROUP.
YEAH, SO WE HAD OUR FIRST MEETING.
UM, I CAN, I'M HAPPY TO SHARE OUT OUR MEETING MINUTES WITH ALL THE REST OF THE COMMISSION.
UH, AND OUR EX OFFICIOS, UM, WE ENDED, I HAVE TO FOLLOW UP WITH OUR STAFF LIAISONS TO MAKE SURE WE CAN DO CERTAIN THINGS, BUT ONCE WE HAVE DONE THAT, WE CAN SCHEDULE OUR NEXT MEETING TO START OUR PLANNING PROCESS.
[01:30:01]
ON DEVELOPING A LOGIC MODEL THAT WILL BE HOPEFULLY AVAILABLE BY THE NEXT MEETING THAT I CAN, I'M HAPPY TO SHARE EITHER VIA EMAIL OR JUST IN A REFERENCE MATERIAL, UM, SO THAT WE CAN ACTUALLY PUT TOGETHER OUR, OUR GOALS, OUR OUTCOMES, OUR LONG TERM SHORT TERM GOALS, UH, AS WELL AS OUR IMPACT AND EVALUATION PLAN FOR THE INFRASTRUCTURE AND ACCESS GROUP.AND THAT WAY WHEN WE ARE HAVING A CONVERSATION AROUND WHAT'S IMPORTANT TO US, WE HAVE THIS LOGIC MODEL, UM, TO GUIDE OUR PROCESSES.
SO, UH, I WILL GET THOSE TO YOU GUYS SHORTLY.
APPRECIATE ANY, ANY QUESTIONS, UH, FOR THIS WORK GROUP? ALL RIGHT, MOVING ON TO THE ADVOCACY
[5. Update from Advocacy & Partnership work group.]
AND PARTNERSHIP WORK GROUP.UH, SO WE WILL MEET ONCE A MONTH.
INITIALLY, UH, WE MET ALREADY ONCE, WE STILL NEED TO DEFINE THE SCOPE OF OUR SUBCOMMITTEE AND HOW IT FITS WITHIN THE MANDATES AND BYLAWS OF THE PUBLIC HEALTH COMMITTEE.
BUT ONE OF THE THINGS THAT, UH, COMMISSIONER LUHAN PROPOSED, WHICH WE ALL AGREED WA WITH, WAS COMMUNITY MEETINGS UP TO 10 PEOPLE TO KIND OF START GATHERING INSIGHTS INTO PARTICULAR TOPICS.
BUT OUR UNDERSTAND HOW THE EXISTING PROGRAMS ARE WORKING AND WHERE THEY NEED IMPROVEMENT.
AND THEN IN TERMS OF SOCIAL DETERMINANTS OF HEALTH, WHERE WE WANNA START, OUR FOCUS IS WITH HOUSING.
UH, AND THIS IS REALLY IN LINE WITH CITY MANAGERS PRIORITIES, HOUSING AND SOCIAL SERVICES.
UM, AND YEAH, WE'RE TRYING TO BRIDGE AND GIVE VOICE TO OUR COMMUNITIES AND CONNECT THEIR NEEDS TO CONCRETE PROPOSALS FOR ORGANIZATIONS THAT SERVE THEM.
UH, SO REALLY WE JUST ARE STILL IN THE PROCESS OF FINDING MORE CONCRETE GOALS.
ANY QUESTIONS FOR THIS WORK GROUP? ALRIGHT, THE LAST WORK GROUP, THE BUDGET
[6. Update from Budget work group.]
WORK WORK GROUP, ANY UPDATES? WE, I ARRANGED A MEETING AND THEN FAILED TO ATTEND IT.UM, BUT I KNOW YOU ATTENDED, SO IF YOU WANT TO SHARE ANY INFORMATION.
I WASN'T GONNA SAY NOTHING, MAN.
UH, THEY WERE GONNA PROVIDE US, UH, MORE DETAILS ON THEIR SECTION NINE THAT HAD TO DEAL WITH COMMUNITY HEALTH WORKERS AS WELL AS SECTION SIX.
UM, WE DID DISCUSS IN, IN THE ASPECT OF REALLY WORKING COLLABORATIVELY, UM, YOU KNOW, WITH SOME OF THE RECOMMENDATIONS AND SO FORTH, HOW CAN WE, UH, HELP TO, UM, SU MAYBE EVEN AS A COMMISSION, MAKE A RECOMMENDATION TO COUNSEL TO APPROVE THE PLAN.
YOU KNOW, THOSE TYPES OF ASPECTS.
SO HOW CAN WE BE MORE INTENTIONALLY INVOLVED WITH WHAT THEY HAVE GOING ON TO, TO HELP BE ABLE TO GIVE THAT VOICE? HOW CAN WE HELP IN EVEN IDENTIFYING AMONGST THE AGENCIES, UH, WHAT TYPE OF FUNDING, WHAT TYPE OF PROGRAMS WITHIN THE HEALTH FOOD ASPECTS ARE OCCURRING.
UM, SO IN THAT WAY THEY CAN REALLY MAKE SURE THEY'RE FOCUSING ON WHERE THEY NEED TO FILL THE GAP OR RECOMMENDATIONS ON, YES, WE KNOW ABOUT THIS PROGRAM, BUT IT'S NOT HITTING THIS, OR WE WOULD LIKE IT TO BE ABLE TO DO MORE OF THAT TO, TO BETTER CONNECT IT IN THAT ASPECT.
ANYTHING THAT YOU WANTED TO ADD? NO.
UH, ANY QUESTIONS ON THE BUDGET WORK GROUP? WELL, JUST THAT, SO AS I MENTIONED EARLIER, WE ARE ALSO WORKING ON SCHEDULING A MEETING WITH CHW STAKEHOLDERS TO LEARN MORE INFORMATION ABOUT THAT.
UM, DO, I DIDN'T SEE THE LIST OF THE, UH, CONTACTS FOR, UM, THE WORK GROUPS TO BE ABLE TO REACH OUT TO, I'LL BE RIGHT BACK.
SO YOU'LL GET AN EMAIL POINT OF CONTACTS WITH SOME ORGANIZATIONS THAT SAID THEY WOULD LOVE TO BE INVOLVED WITH THE EFFORTS OF THE WORK GROUPS AS WELL AS UT WALKER, UH, UM, MENTORSHIP ORGANIZATION THAT IS INTERESTED IN SUPPORTING THE WORK GROUPS WHEN IT COMES TO POLICIES, ANALYZATION, CREATION, CRAFTING AND SO FORTH, THAT THEY HIT ME UP PROBABLY ABOUT THREE DIFFERENT EMAILS.
I WAS LIKE, WE'RE NOT THERE YET.
SO, UH, I THINK WE WILL DEFINITELY BE ABLE TO HOPEFULLY HAVE DIFFERENT SUPPORT AND RESOURCES IN, IN THE EFFORT, UM, ESPECIALLY WHEN IT COMES TO POLICY CRAFTING AND PROPOSING RECOMMENDATIONS THROUGH THE OVERALL COMMISSION.
UM, HAS THERE BEEN ANY CONVERSATION ABOUT, UM, CFAM, THE GROUP THAT, UM, HELPED PROVIDE MEALS DURING THE PANDEMIC TO THOUSANDS OF PEOPLE THAT THAT'S GONNA GO AWAY AND THEY WERE SERVING, UM, A NICHE THAT IS NOT TYPICALLY LOOKED AT, UM, AT RISK UNHOUSED YOUTH, UM, A LARGE LIST OF PEOPLE, SO MIGHT WANT TO, AS A GROUP, CONSIDER, UM, TALKING TO THEM.
I DON'T THINK THAT HAS COME UP, UH, HERE.
SO WOULD YOUR RECOMMENDATION BE, IS IT
[01:35:01]
A PRESENTATION OR SEEING IF THEY COULD BE INCLUDED INTO THE WORK GROUPS? I, I GUESS IN, IN WHAT I ASKING, I THINK WE'RE TRYING TO UNDERSTAND WHETHER WE CAN HAVE PRESENTATIONS FROM GROUPS.SO I, I, WE CAN TALK OFFLINE, BUT, AND I'LL GIVE YOU THE CONTACT INFORMATION.
'CAUSE I'M NOT, I THINK THAT'S WHAT WE WERE GONNA FIND.
THAT'S WHAT COMMISSIONER POINDEXTER WAS WORKING ON.
[FUTURE AGENDA ITEMS]
ADDITIONAL FUTURE AGENDA ITEM RECOMMENDATIONS OUT OF THE TWO THAT WE ALREADY DID? YES, SIR.I HAVE TO RUN INTO, WHERE'D THAT COME FROM? UM, I HAPPEN TO RUN INTO THE DEAN OF THE PHARMACY SCHOOL AT UT SAM POLLAK, AND HE WAS INTERESTED IN A CONVERSATION ABOUT HOW COMMUNITY PHARMACIES CAN REALLY HAVE A BETTER ROLE OR LARGER ROLE IN THE CARE, CHRONIC DISEASE, SPECIFICALLY HYPERTENSION, DIABETES WITHIN THEIR LICENSES, WITHIN THEIR PURVIEW, WITHIN THEIR INTEREST.
AND SO HE EXPRESSED AN INTEREST TO MAYBE COME SHARE SOME OF THAT VISION AND, YOU KNOW, WAS WANTED TO OFFER THAT TO THE GROUP AS AN INTEREST PERSON WHO WANTS TO COME AND MAYBE THINK ABOUT MAYBE, UH, ANOTHER DELIVERY SYSTEM, SO TO SPEAK, QUOTE UNQUOTE OF CARE AND CARE COORDINATION POTENTIALLY THAT WOULD, UM, YOU KNOW, WOULD WANNA COME TO TALK TO US.
THEY'RE, WE'RE UTILIZING PHARMACISTS IN THE SUBSTANCE USE DISORDER, UM, REALM AND DOING EDUCATION AND, UM, OUTREACH AND WHEN THEY'RE FILLING PRESCRIPTIONS AND DURING IMMUNIZATIONS.
ANY DISAGREEMENT ON ADDING THAT AS ANGEN? CAN YOU PLEASE ADD THAT? I THINK WE GOT THREE.
CAN I HAVE ONE MORE
WELL, YOU KNOW, THERE WAS THE, UM, NOTIFICATION SOME WEEKS AGO ABOUT THE, UM, OPIOID, UM, EVENT WHERE THERE WAS I THINK 71 PEOPLE AND UM, MAYBE EIGHT OR NINE DEATHS AND MAYBE EIGHT OR NINE SAVES WITH NARCAN.
AND I, I WONDERED IF IT WOULD BE OF INTEREST TO BRING SOMEBODY TO TALK TO US ABOUT OPIOIDS.
WE ALL KNOW ABOUT THE PROBLEM, BUT I WONDERED IF THERE'S A LARGER CONVERSATION THAT COULD HAPPEN IN THE COMMUNITY AND A LARGER CONVERSATION THAT WOULD PUT NARCAN ON EVERY WALL THAT'S IN A CITY PUBLIC PLACE IN ADDITION TO JUST HAVING, AND I DON'T KNOW WHERE EVERY PLACE POSSIBLE, BUT, YOU KNOW, WE HAVE THE, UM, CARDIO DEFIBRILLATORS IN A LOT OF PUBLIC BUILDINGS AND A LOT OF PRIVATE BUILDINGS AND ALL THIS AS AN INFRASTRUCTURE.
AND I WONDER IF IN AUSTIN, AGAIN, IT'S NOT QUITE THE SAME, OBVIOUSLY, BUT IF IT'D BE GOOD TO HAVE A LOT MORE NARCAN AROUND IN GENERAL.
SO THERE WERE, THERE WAS AN 80% RESUSCITATION RATE PRIOR TO EMS ARRIVING ON THE SCENE DURING THAT PERIOD OF TIME, WHICH IS LARGELY DUE TO THE WORK THAT'S HAPPENED WITH THE COLLABORATION THAT'S GONE ON BETWEEN, UM, A PH, THE COUNTY CENTRAL HEALTH, UM, EMS AND A MYRIAD OF PROVIDERS, UT SCHOOL OF PHARMACY.
UM, AND WE ARE CURRENTLY PUTTING NALOXONE INTO ALL OF THE COUNTY BUILDINGS, ALL OF OUR CITY BUILDINGS AND TRAINING COUNTY AND CITY EMPLOYEES.
UM, BUT YES, THERE THAT CONVERSATION WOULD MAYBE OF INTEREST TO THIS GROUP.
UM, I THINK WE'RE, IF I'M, IF I WERE ASKED, I, I'M VERY CONCERNED ABOUT FOOD INSECURITY, VERY CONCERNED ABOUT THE LOSS OF THAT FUNDING AND VERY CONCERNED ABOUT PEOPLE BEING HUNGRY WHEN THE FUNDING GOES AWAY.
AND IS THAT FUNDING, WHAT IS IT EARMARKED TO GO AWAY SEPTEMBER? SO WE PROBABLY NEED TO BUMP THAT HIGHER ON THE, THE, THE LIST OF FUTURE DISCUSSIONS.
SO PROBABLY, UH, YOUR PRESENTATION ALONG WITH THE, THE FOOD DISCUSSION THAT YOU'RE TALKING ABOUT THERE, DR.
WALKS, IF POSSIBLE FOR THE NEXT, THE NEXT MEETING.
UM, ANY QUICK REMARKS? UH, I KNOW THAT AS YOU JUST STATED, A PH IN THE COUNTY, THERE'S UH, OPIOID PROGRAMS THAT Y'ALL ARE, THAT Y'ALL HAVE IMPLEMENTED RIGHT NOW IN PARTNERING WITH DIFFERENT ORGANIZATIONS AND ENTITIES TO BE ABLE TO HAVE SOME OF THOSE RESOURCES ON HAND.
UM, SHOULD THAT BE PROBABLY A PRESENTATION TO THE COMMISSION? IS THAT SOMETHING THAT JDI WANNA GO AHEAD AND SPEAK ABOUT RIGHT NOW? UH, ABOUT THOSE PROGRAMS THAT ARE A LITTLE BIT MORE COMMUNITY FOCUSED TO GET MORE RESOURCES OUT INTO THE COMMUNITY? UM, I WAS REMISS IN NOT MENTIONING INTEGRAL CARE IN MY LONG LIST OF COLLABORATIVE, UM, COLLABORATIVE PARTNERS, BUT, UM, WE'VE GIVEN A PRE, UM, A PRESENTATION TO COUNTY COMMISSIONER'S COURT AND HAD HOW MANY, ABOUT 10 PEOPLE,
[01:40:01]
UM, THAT PRESENTED.UM, AND IT TOOK ABOUT TWO HOURS.
SO, UM, I'LL LEAVE IT TO YOU CHAIR WALLACE, JUST, DO YOU HAVE A RECORDING OF IT? IS THERE A RECORDING OF IT? MAYBE THAT CAN BE A PREFACE AND THEN WE CAN REVIEW IT, WATCH IT, AND THEN NOT NEXT MEETING, BUT MAYBE THE FOLLOWING MEETING MORE OF A CLIFF NOTES DISCUSSION ABOUT IT.
AND SO AT LEAST THAT WAY, YOU KNOW, FOR SAKE OF TIME, SINCE IT IS MATERIAL THAT'S ALREADY OUT THERE, WHY DON'T WE LEVERAGE THAT TO BE MORE INFORMED ON THE OPIOID AND SOME OF THE PROGRAMS THAT THE CITY AND THE COUNTY AND AND, AND SO FORTH HAVE.
AND THEN WHAT CAN POTENTIALLY BE OUR ROLE IN THIS EFFORT THAT'S GOING ON.
ANY, ANY LAST REMARKS? GO AHEAD.
I JUST WANNA THROW AN IDEA OUT THERE.
I DON'T KNOW IF WE REALLY HAVE ANY JURISDICTION SO TO SPEAK, BUT WITH THE I 35, YOU KNOW, RECONSTRUCTION GOING TO BEGIN AND THEN THIS CAP AND STITCH AND THE CITY'S TALKING ABOUT WHETHER THEY WANNA PUT BUSINESSES ON THERE OR PARKS OR WHATEVER ELSE.
I WONDER IF OUR COMMISSION HAS ANY ROOM TO, TO MAKE RECOMMENDATIONS FOR THE CAPTAIN STITCH AND WHAT SHOULD BE THERE, WHAT YOU KNOW WOULD HELP BE HEALTHY OR WHATEVER.
WE KNOW THAT 35, YOU KNOW, HAS BEEN A RACIAL DISCRIMINATION LINE ESSENTIALLY.
RIGHT? SO, YOU KNOW, THERE HAVE BEEN A LOT OF NEGATIVE PUBLIC HEALTH EFFECTS BECAUSE OF 35 MM-HMM.
SO I WONDER WITH US REIMAGINING 35 SO TO SPEAK, ARE THERE THINGS THAT WE COULD PUT IN PLACE TO ENSURE PUBLIC HEALTH DOES NOT CONTINUE TO DECLINE? YOU KNOW, ON THE EAST SIDE, I'M NOT SURE IF THAT'S ANYTHING WE SHOULD BE TALKING ABOUT, BUT I WANTED TO THROW IT OUT THERE.
ANY, ANY, UH, ME PERSONALLY, I'M LAYING ON THE RR AGENCIES ON THIS ONE.
'CAUSE THIS IS PARTICULARLY A TOPIC I HAVE LIKE LITTLE TO NO REAL KNOWLEDGE ON TO EVEN PROVIDE ANY TYPE OF RECOMMENDATIONS.
SO TO THE, TO THE COMMISSIONERS AS WELL AS THE AGENCY, UH, REPS, YOU KNOW, WHAT, WHAT ARE YOUR THOUGHTS ON THIS AND WHERE IS THERE POTENTIALLY THAT, THAT SEGUE TO, TO, TO BE INVOLVED AND WE'RE NOT OUTSIDE OF OUR LANE.
ANY THOUGHTS? I'LL JUST SAY IF YOU UM, WANT TO EXPLORE IT, LOOK AT HOW IT APPLIES TO YOUR GENERAL GOVERNANCE, UM, AND HOW IT, HOW YOU CAN STRATEGIZE YOUR TOPIC AROUND THAT.
SO IN THE ESSENCE OF WHAT, UM, COMMISSIONER CROOKHAM JUST MENTIONED IS WORKING TO INFORM STRATEGIES THAT ADDRESS HEALTH DISPARITIES THAT IMPACT HEALTH OUTCOMES.
SO IF YOU'RE TALKING ABOUT THAT PARTICULAR AREA, THAT WOULD BE ONE OF THOSE PINPOINT GOVERNANCE THAT YOU WOULD LOOK AT.
AND THEN DEVELOP YOUR PLAN AROUND HOW THIS BODY COULD ADVOCATE FOR THAT.
AND THEN PROVIDE, UM, THE ADVICE TO COUNCIL, UM, ON WHAT YOUR FINDINGS WOULD BE FOR THAT EFFORT.
AND IF WE HAD SOME STATEMENT ABOUT ENVIRONMENTAL IMPACT, I THINK THAT WOULD THEN FALL INTO OUR PURVIEW AS PUBLIC HEALTH COMMISSION.
SO DOES ANYBODY HAVE ANY OPPOSITION TO ENTERTAINING THAT TOPIC? DO YOU MIND TAKING THE LEAD? 'CAUSE YOU'LL PROBABLY BE THE BEST ONE TO THREAD THE NEEDLE ON THAT.
I THINK IT WOULD BE A QUESTION OF WHICH ONE OF YOUR WORKING GROUPS THAT FALLS UNDER.
SO YOU KNOW, IF IT'S INFRASTRUCTURE, IF IT'S BUDGET, UM, THEN YOU, YOUR WORK GROUPS MIGHT NEED TO DECIDE WHERE THAT ITEM WOULD FALL BEST.
SHE JUST CLARIFIED MY COMMENT.
ANYTHING ADDITIONAL THERE BEING NONE.
I CALL THIS MEETING ADJOURNED AT FOUR 17.
I'VE HAD MY MAN, I'VE BEEN EVERYWHERE.
I'VE BEEN TO LOUISVILLE, NASHVILLE, KNOXVILLE ON BABA, CHEV HILL, JACKSONVILLE, WATERVILLE COAST TO RIMA.
PITTSFIELD, SPRINGFIELD, BAKERSFIELD.
THREE PORT HACKENSACK, CADILLAC, FOND LAC, DAVENPORT, IDAHO.
SHELBYVILLE, ARGENTINA, DIAMOND, DINA PASADENA, CATALINA SEA.
WHAT? I MEAN I'VE BEEN EVERYWHERE MAN.
I BREATHE THE MOUNTAIN AIR MAN.
A TRAVEL I'VE HAD IN MY SHARE, MAN.
I'VE BEEN TO PITTSBURGH, PARKERSBURG, GRAVEL BURG, COLORADO, ELLENSBURG, REXBURG, VICKSBURG, EL DORADO.