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[00:00:04]

GET STARTED.

[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.

ALL RIGHT.

[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.

SO MOVED.

IT HAS BEEN MOVED BY THE VICE CHAIR.

DO I HAVE A SECOND? I SECOND.

AND SECONDED.

ANY QUESTIONS TO THE MOTION? QUESTIONS? TO THE MOTION? THERE BEING NONE.

ALL THOSE IN FAVOR? RAISE YOUR HAND.

ALL RIGHT.

NON OPPOSING MOTION PASSES.

[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.

ALL RIGHT.

OH, IS THIS US? THIS? OKAY.

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.

YEAH.

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.

SO, MM-HMM.

LONGEVITY CONCERN, RIGHT? MM-HMM.

.

MM-HMM.

.

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

[00:05:01]

THE POSITION IN ACTUAL UTILIZATION ARE TWO DIFFERENT THINGS.

MM-HMM.

.

RIGHT.

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.

MM-HMM.

, I WASN'T SURE IF THAT WAS WHERE YOU WERE GOING, BUT THAT TO ME, TO ME, THAT LINES WITH IN NAME.

YEAH, THAT'S WHAT I WAS SAYING.

YEAH.

THAT'S WHAT, TO ME, THAT LINES WITH IN NAME.

YEAH.

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.

YES, I HAVE A LOT TO SAY.

GO AHEAD.

I'M A COMMUNITY.

YES.

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.

THEY'RE ALL OVER THE WORLD.

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.

TO BE ABLE TO MANEUVER THEM.

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.

COMPONENTS.

GOTCHA.

GOTCHA.

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,

[00:10:01]

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.

THIS IS HOW IT ALL STARTED.

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.

NOW, IT GIVES, OH, SORRY.

GO AHEAD.

AND I WAS GONNA SAY, I'M SOMETHING ELSE ON THE OPPORTUNITIES.

MM-HMM.

OPPORTUNITY WHERE, UM, ADDITIONAL TRAINING FOR CLINICAL, FOR VACCINES WHERE WE CAN ACTUALLY COME IN WITH A PH IN A DISASTER OR IN A SITUATION LIKE COVID THAT HAPPENED, BE ABLE TO, I WAS ABLE TO BE DOING THAT WHEN I WAS AT ABU WITH, WHEN A PH CAME OVERWHELMING OF HAVING TO VACCINATE SO MANY PEOPLE THAT CAME, UH, THERE WAS A POINT THAT I JUMPED IN AND HELPED SOME OF THE, NOT, NOT TO GIVE THE VACCINE, BUT TO SUPPORT THEM WITH THE PAPERWORK THAT THEY HAD TO FILL IN TO THEIR LITTLE CARDS.

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, WE ALL HAVE THE CAPACITY.

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.

NOT NOW, NOT NOW.

I TELL YOU THAT MUCH.

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.

NO PROBLEM.

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

[00:15:01]

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.

, HOPEFULLY IT MAKES SENSE.

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.

I'M JUST MAKING IT UP.

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.

THEY'RE DOING CERTAIN THINGS.

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.

YEAH.

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.

CHAIR HAVE A, JUST, YEAH.

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.

TOTALLY FINE.

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

[00:20:01]

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.

I MEAN, I'D BE HAPPY.

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.

[00:25:01]

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.

NO, ABSOLUTELY.

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.

GOT IT.

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.

RIGHT.

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.

YEAH.

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.

RIGHT.

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.

RIGHT.

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.

UH, WE NEED MORE PEOPLE

[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.

I JUST HAD A QUESTION.

DR.

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.

THANK YOU.

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.

THESE ARE HIS OFFICE HOURS.

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.

YEAH.

THANK YOU.

ANY OTHER? GO AHEAD.

YOU KNOW, IT'S A WONDERFUL CONVERSATION.

THANK YOU SO MUCH.

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.

MM-HMM.

, UH, I THINK THE LAST THING FROM ME, AND THIS IS MORE FROM THE BUDGET SUBCOMMITTEE, IS, UM, TRYING TO UNDERSTAND A LITTLE BIT BETTER, KIND OF THOSE SALARY LEVELS, HOW THE SALARIES DETERMINED AND THEN HOW THAT LOOKS LIKE AT A NATIONAL LEVEL.

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.

THERE'S BARRIERS.

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.

THEY DO.

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.

UM, I DON'T KNOW.

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.

OKAY.

THANK YOU.

THAT'S HELPFUL.

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 MEET REGULARLY.

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.

YES.

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.

CHRIS.

WHAT WOULD THE FORMAL RECOMMENDATION BE? THAT'S WHAT WE NEED TO FIND OUT.

, WE JUST STATED A LOT OF DIFFERENT POTENTIALITIES ASPECTS OF, UM, TRAINING INCENTIVES ASPECTS TO, UH, INCENTIVE TO BECOME A CHW ASPECTS TO, UM, YOU KNOW, HOW TO, UH, MAYBE LEVERAGE OUR AGENCIES TO GET PEOPLE CERTIFIED IN THE COMMUNITY QUICKER THAT MEET THE CRITERIA ALREADY.

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.

SORRY.

NO WORRIES.

NO WORRIES.

I'M WITH YOU.

I'M WITH YOU.

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, , UM, WE ALL RECOMMENDED THAT SCORING MATRIX THAT WAS DONE AND SAY, OKAY, HOW CAN WE NOW ESTABLISH A PROCESS FOR THE, THE TOP ONE, THE TOP TWO, THE TOP THREE, THE TOP FOUR, UH, AND THEN LIKE CHUNK THOSE OUT.

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.

NO, I LOVE THE IDEA.

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.

OF COURSE.

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.

AREA OF OWNERSHIP AND SO FORTH TOO, RIGHT? UM, YEAH, I, I DEFINITELY UNDERSTAND WHERE YOU'RE COMING FROM, BUT I THINK SAME THING AS WHAT YOU'RE SAYING TOO, IS THERE'S PROBABLY SOME OTHER MORE LOW HANGING FRUIT THAT WE CAN KNOCK OUT, SOME INFORMATION WE CAN PROBABLY GATHER AND, AND, AND THAT MAY KIND OF ENLIGHTEN BEFORE TRYING TO ASK FOR THAT REPORT TO BE PUT TOGETHER.

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.

OKAY, THANKS.

APPRECIATE IT.

UM, ANYTHING ELSE TO ADD REGARDING, UH, UH, COMMISSIONER'S RECOMMENDATION OF THIS PROCESS? SOUNDS LIKE WE GOOD TO GO THERE TOO.

ALRIGHT, UH, MOVING

[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