Sep 04, 2024 Public Health Commission

[CALL TO ORDER]

[00:00:07]

I CALL THIS PUBLIC HEALTH COMMISSION MEETING FOR SEPTEMBER 4TH TO ORDER AT 2:33 PM UH, DO WE HAVE ANY PUBLIC

[PUBLIC COMMUNICATION: GENERAL]

WE HAVE ONE PUBLIC COMMENT.

IF YOU CAN PLEASE COME UP TO ONE OF THE MICS AND, UH, YOU'LL ROUGHLY HAVE, UM, THREE MINUTES.

THREE, YEAH, SORRY, IT SAID FIVE.

WHERE DOES IT SAY, WHERE IS IT AT? WHERE'S IT AT? HERE SAY FIVE, BUT I DON'T REALLY CARE.

, RIGHT, NO PROBLEM.

IF YOU CAN STATE YOUR NAME, UH, IF THERE'S ANY ORGANIZATIONAL AFFILIATION THAT YOU HAVE.

AND, UH, THE FLOOR IS YOURS.

HI, MY NAME'S AT THE PRESTON MIC.

APOLOGIES ON ME.

OKAY.

CAN YOU HEAR ME? DO I NEED TO, YOU SHOULD BE GOOD.

OKAY.

IS ANYBODY WATCHING? BUT CAN THEY HEAR ME? YES, THEY SHOULD BE ABLE TO.

THAT'S, THAT'S THE PURPOSE OF, UH, HIGHLIGHTING THE MIC.

RIGHT, RIGHT.

OKAY.

HI, I AM SONJA BURNS.

I'M A MENTAL HEALTH ADVOCATE, AND I SPECIFICALLY FOCUS ON PEOPLE WITH THE MOST COMPLEX NEEDS WHO ARE CYCLING THROUGH THE JAILS AND THE STREETS AND THE HOSPITALS.

AND WE HAVE NO ANSWER FOR THEM.

SO I WANT TO BRING ATTENTION.

THERE IS A PUBLIC HEALTH CRISIS.

WE HAVE A NEW STATE HOSPITAL, HAS NO ADDITIONAL BEDS.

I THINK THAT WE ALL KNOW THAT, UM, IT USED TO BE THE THE LAST RESORT, RIGHT? BUT THAT'S NOT TRUE ANYMORE.

SO LAST RESORT WOULD BE JAIL.

AND IF I CAN FIGURE OUT A WAY TO GET YOU TO TDCJ, THAT'S THE LAST RESORT.

BUT FOR THE POPULATION I'M TALKING ABOUT, IF I'M AN ETHICAL ATTORNEY, I CAN'T DO THAT BECAUSE THIS POPULATION GOES INTO THE JAIL.

I'M INCOMPETENT TO STAND TRIAL AND I'M UNLIKELY TO RESTORE.

SO I CANNOT MOVE FORWARD WITH THIS CASE.

AND I HAVE NOTHING OUT IN THE COMMUNITY.

THIS POPULATION IS TOO ACUTE, TOO ENGAGE MEANINGFULLY INVOLUNTARY SERVICES, BUT NOT ACUTE ENOUGH FOR INPATIENT, BECAUSE I AM AT BASELINE.

AND THAT WORD I WANT EVERYBODY TO PAY ATTENTION TO, BECAUSE YOU HEAR ABOUT THIS ALL THE TIME AT THE HOSPITALS AND YOUR LAW ENFORCEMENT AND YOUR EMS, AND EVERYONE'S GONNA TELL YOU HOW THEY DROPPED SOMEONE OFF IN CRISIS AND THE HOSPITAL KICKED THEM OUT BECAUSE THEY'RE AT BASELINE.

AND SO, WHEN I'M AT BASELINE, I DON'T GET TO GO INPATIENT ANYMORE BECAUSE I DO NOT BENEFIT FROM TREATMENT.

SO TO DRIVE THIS HOME, I HAVE SOMEONE WHO IS SITTING IN JAIL RIGHT NOW.

YOU CAN LOOK HIM UP.

HIS NAME IS ROBERT DANIEL CUMMINS.

AND WHEN YOU DO LOOK HIM UP, YOU'LL SEE WHEN HE BURNED DOWN HIS H BROTHER'S HOUSE TO THE GROUND, I THINK 12 YEARS AGO, FOR OVER 10 YEARS, HE'S BEEN ON THE HIGHEST LEVEL OF CARE IN THE COMMUNITY.

WHEN HE WAS ARRESTED THIS LAST TIME, HE WAS ON OUR LATEST, GREATEST, HIGHEST LEVEL OF CARE, WHICH IS A OT ASSISTED OUTPATIENT TREATMENT.

AND THIS IS WHERE NOW THE CIVIL COURT HAS ENTERED INTO THE PICTURE TO HOLD THE PERSON AND ALL THE PROVIDERS ACCOUNTABLE TO AN AGREED UPON TREATMENT PLAN.

THE TEETH OF A OT IS THE PERSON IS DETERIORATING, AND I AM GOING TO BRING THEM BACK INTO THE HOSPITAL SYSTEM.

THAT IS NOT HOW WE'VE BEEN DOING IT HERE.

AND HE IS NOT THE FIRST PERSON ON A OT TO BE ARRESTED.

WHEN ROBERT MUNGIA DIED IN OUR JAIL IN MAY, THIS WAS ANOTHER PERSON, INCOMPETENT TO STAND TRIAL, UNLIKELY TO REGAIN, BEEN CYCLING FOR DECADES, DIED ALONE IN HIS JAIL CELL, ARRESTED FROM YVETTE MCKINNEY'S PLACE.

YOU COULD LOOK THAT UP IN THE NEWS TOO.

ZOE'S PLACE.

IT'S BEEN YEARS AND YEARS.

SHE'S ALREADY BEEN ARRESTED FOR EXPLOITATION, ABUSE, NEGLECT OF HER CLIENTS.

I LOOKED HIM UP.

I SAW THE ARTICLE INCOMPETENCE STAND TRIAL PERSON DIES IN THE JAIL.

I SEE PREVIOUS ARTICLES.

OH, HE'S BEEN AT YVETTE'S.

I CALL THE TRAVIS COUNTY CLERK.

THEY READ ME THE PROBABLE CAUSE AFFIDAVIT AND HE'S BEEN ARRESTED FROM YVETTE MCKINNEY'S PLACE.

SO THIS WAS LATE ON A FRIDAY.

I DROVE STRAIGHT OVER THERE.

IT'S RIGHT BY THE IN AND OUT AT 45TH IN BETWEEN I 35 AND 45TH WHEN I GOT THERE.

THE MAN IS STILL THERE.

THERE'S THE FIRST PERSON I GOT TO TALK TO, DOES NOT KNOW HIS OWN NAME.

I DO WANNA CONTINUE QUICKLY.

THIS IS A SERIOUS PUBLIC HEALTH CRISIS.

AND WE HAVE THROWN SO MUCH MONEY AT HOMELESSNESS AT THE NEW STATE HOSPITAL.

THE COUNTY AND THE CITY HAVE DONE THIS MENTAL HEALTH, UH, DIVERSION PILOT.

I HAPPENED TO BE THERE ON THE FIRST MEETING WHEN IT WAS PRESENTED AND NOBODY IN THE ROOM AGREED TO IT.

WE WERE ALL SHOCKED.

THIS WAS NOT ANYTHING WE HAD DISCUSSED.

WE'RE TALKING ABOUT A DIVERSION FACILITY AND NOTHING WE'RE DOING IS TOUCHING THIS POPUL .

NOTHING ELSE ID, HE ASKED ME THAT EVERY TIME.

AND MOST OF THE OTHER PEOPLE, IF THEY WEREN'T IN ACTIVE PSYCHOSIS, ASKED ME IF I WAS WITH FACT OR ACT OR THEY DO ALWAYS.

'CAUSE I GO BY FREQUENTLY.

NOW, THAT'S THE HIGHEST LEVEL OF CARE IN THE COMMUNITY.

ASSERTIVE COMMUNITY, ASSERTIVE COMMUNITY TREATMENT OR FORENSIC ASSERTIVE COMMUNITY TREATMENT.

SO I'VE PULLED YOU FROM THE JAIL.

WE HAVE PEOPLE DYING IN OUR STREETS AND IN OUR JAILS.

AND THIS HAS HAS

[00:05:01]

WE HAVE NOTHING.

WE NEED TO HAVE A SECURE OPTION UNDER REGULATORY, A NEW LICENSING FOR SOME KIND OF FACILITY THAT'S NOT A NURSING HOME, A JAIL OR A PRISON OR PSYCHIATRIC, INPATIENT PSYCHIATRIC FACILITY.

CALIFORNIA HAS IT, ARIZONA HAS IT.

UM, YOU HAVE TO HAVE INTENTIONAL COMMUNITIES, RIGHT? AND BUILD SOMETHING AT THE ASH CAMPUS.

AND I KNOW YOU NEED TO STOP ME, BUT I DO WANNA SAY I GO TO THESE MEETINGS.

I WORK AT THE LOCAL, STATE, AND FEDERAL LEVEL.

AND THIS IS AN ISSUE BECAUSE NOBODY'S TALKING ABOUT THIS.

AND FOR YOUR DATA, START LOOKING AT HOW MANY PEOPLE WERE SO SICK ON MEDICAID THAT NOW THEY GOT MEDICARE, AGE 25.

SO SICK.

AND MEDICARE HAS A LIFETIME LIMIT OF, SO UNFORTUNATELY.

ONE SECOND.

UNFORTUNATELY, I HAVE TO CUT YOU OFF NOW.

90 DAYS.

I HAVE TO CUT YOU OFF NOW.

I APOLOGIZE.

SO, SO, SO WHAT I CAN SAY, AND I CAN'T TALK DIRECTLY TO YOU SINCE IT'S PUBLIC COMMENTS.

I'VE ADDED THIS AS A QUESTION OF DISCUSSION WHEN WE TALK ABOUT FUTURE AGENDA ITEMS. 'CAUSE I'M INTERESTED TO SEE WHERE THERE IS, UH, CONNECTIVE TISSUE BETWEEN THE PUBLIC AGENCIES OR NOT.

SO JUST KNOW THAT'LL BE TOWARDS THE END OF OUR MEETING TODAY.

THANK YOU.

CONNECTIVE TISSUE IS A UNIVERSAL SHRUG ON THIS POPULATION.

ALRIGHT, TALK UP ALL THE, SO MOVING ON TO

[1. Approve the minutes of the Public Health Commission Regular Meeting on August 7, 2024.]

UH, DO I HAVE A MOTION TO APPROVE THE MINUTES OF THE PUBLIC HEALTH COMMISSION REGULAR MEETING ON AUGUST 7TH, 2024.

SO MOVED.

SO MOVED.

DO I HAVE A SECOND? AND SECONDED? ANY QUESTIONS TO THE MOTION QUESTIONS? TO THE MOTION? THERE BEING NONE.

ALL THOSE IN FAVOR, RAISE YOUR HAND.

NONE OPPOSING MOTION PASSES.

MOVING ON TO DISCUSSION

[2. Presentation from Central Health on organizations Community Health Worker program.]

ALRIGHT, OVER TO YOU ALL.

THANK YOU, COMMISSIONERS.

UM, GOOD AFTERNOON.

MY NAME IS SHEIK ALZ AND I'M HERE WITH DR.

UH, AUDREY KWAN WITH THE, UM, UH, HIGH RISK HEALTH POPULATIONS.

UH, SHE IS THE DIRECTOR.

UM, OH, I HAVE THE, THE CLICKER.

AND SO I WANNA MAKE THIS PRESENTATION VERY INTERACTIVE, SO I WON'T REALLY TOUCH ON ALL OF THE, UH, THE DIFFERENT POINTS.

SO IF YOU HAVE QUESTIONS DURING THE PRESENTATION, PLEASE STOP ME.

I LIKE TO, AGAIN, MAKE IT VERY ACTIVE.

SO JUST KIND OF SOME HIGHLIGHTS OF THE CHWS AS YOU'RE FAMILIAR.

SO, SO THE VALUE OF CHWS HAS BEEN RECOGNIZED AS PROVIDING, UM, CONNECTIONS TO COMMUNITY SERVICES, BOTH HISTORICALLY TO UNDER, UM, MARGINALIZED POPULATIONS.

SO IT'S IMPORTANT TO KNOW THAT CHWS ARE NOT MEANT TO PROVIDE DIRECT HEALTHCARE TO THE POPULATION.

UM, BUT THEY ARE THERE TO PLAY A KEY ROLE IN INCREASING ACCESS TO PREVENTATIVE CARE, UH, FOR TREATMENT, BOTH WITH ACUTE AND CHRONIC NEEDS TO IMPROVE THE, THE HEALTH AND WELLNESS NEEDS OF OUR PATIENTS.

LASTLY, SO CHWS ADDRESS THE, THE SDOH AS AS YOU'RE AWARE AND HELPING TO PREVENT PATIENTS FROM RECEIVING OR TO HELP PATIENTS, UH, RECEIVE ACCESS TO CARE, UH, HEALTH EDUCATION, SERVICES AND RESOURCES, AGAIN, THAT THEY NEED TO IMPROVE THEIR QUALITY OF LIFE AND, UH, HEALTH AND WELLNESS.

SO HERE'S A BRIEF HISTORY OF THE CHW, UM, EXISTENCE OR ORIGIN, IF YOU'RE NOT FAMILIAR.

SO IT FIRST BEGAN IN THE 1930S, UH, IN CHINA.

THEY WERE FIRST KNOWN AS FARM SCHOLARS IN CHINA.

AND SO SHORTLY THEREAFTER, IN THE FIFTIES AND SIXTIES, THAT MODEL KIND OF PROGRESSED OVER TO SOUTH AMERICA, WHERE THEY WERE, UH, INFLUENTIAL IN SUPPORTING HEALTH AND WELLNESS AS WELL.

MOVING FORWARD TO 1980S, UH, THE STATE OF TEXAS BECAME THE FIRST STATE TO ADOPT LEGISLATION TO PROVIDE, UM, STATEWIDE TRAINING AND CREDENTIALS STANDARDS FOR CHWS.

BUT THE PROFESSION REALLY BLEW UP, UH, IF I CAN SAY THAT, IN 2010, WITH THE ADOPTION AND PASSING INTO LAW OF THE AFFORDABLE CARE ACT, SHORTLY THEREAFTER IN 2016, CENTRAL HEALTH BEGAN UTILIZING, UM, CASE MANAGEMENT FOR COMPLEX PATIENTS.

AND THEN SHORTLY AFTER THAT, UM, CHWS WERE VERY INSTRUMENTAL IN SUPPORTING, UH, COVID EFFORTS, RIGHT? VACCINE EDUCATION, CONNECTING PEOPLE TO RESOURCES AND SO ON AND SO FORTH, AS WELL AS EDUCATION AROUND, UH, YOU KNOW, WHAT THEY NEED TO DO TO BE HEALTHY.

IN 2021, CHWS ASSISTED PATIENTS WITH TRANSPORTATION NEEDS, UM, UH, PATIENT, UH, COMMUNICATION, HEALTH EDUCATION OR HEALTH LITERACY AS WELL AS ALWAYS, YOU KNOW, BEING INVOLVED WITH COMMUNITY ENGAGEMENT AS WELL.

SO YOU MAY BE FAMILIAR WITH CHWS IN ORDER TO BECOME ONE, IT'S 160 HOUR, UH, CREDIT OR, OR COURSEWORK THAT'S REQUIRED OF THE EIGHT CORE COMPETENCIES THAT ARE LISTED ON THE SCREEN.

SO I JUST WANT TO POINT OUT THAT EACH OF THE CORE COMPETENCIES REQUIRES A MINIMUM OF EIGHT HOURS OF DIDACTIC TRAINING FOR THAT CHW UH, TRAINING TO KIND OF GO THROUGH.

SO ON THE SCREEN, THAT'S COMMUNICATIONS, INTERPERSONAL SKILLS, SERVICE COORDINATION, CAPACITY BUILDING, ADVOCACY, TEACHING, ORGANIZATIONAL SKILLS, AND THEN LASTLY, KNOWLEDGE BASED OF GENERAL, LOCAL AND STATEWIDE HEALTH, UH, CONDITIONS.

AND ARE THERE ANY QUESTIONS BEFORE I CONTINUE? OKAY.

SO JUST THE CURRENT ARRANGEMENT OF THE CHWS AS IT EXISTS, UH, WITH CENTRAL HEALTH, RIGHT NOW, I BELIEVE WE HAVE EITHER BETWEEN 24 AND 25

[00:10:01]

AND SO THEY'RE PLACED WITHIN OUR SPECIALTY CLINICS TRANSITION OF CARE CASE MANAGEMENT, COMMUNITY OUTREACH AND COMMUNITY ENGAGEMENT.

AND THE CENTRAL FOCUS OF OUR CHWS, AS ALWAYS, IS AROUND THE S DHS, THE SOCIAL DETERMINANTS OF HEALTH, PROMOTING HEALTH EDUCATION, WHILE CONSTANTLY ADVOCATING FOR EQUITY AND CARE, UH, WITH HISTORICALLY MARGINALIZED POPULATIONS.

SO HERE'S THE MEAT AND THE POTATOES OF THE PROJECT AND THE PRESENTATION.

SO WE ARE WANTING TO, WE'RE PREPARING TO BEEF UP OUR CHW, UM, UM, WORKFORCE, UM, BY LAUNCHING THE ALIGNMENT PROJECT THAT STARTED IN 2023.

AND SO I WON'T GO THROUGH ALL OF THE POINTS ON THE SCREEN, BUT I DO WANT TO POINT OUT SOME OF THE MOST HIGHLIGHTED OR MOST IMPORTANT, UH, FACTORS.

SO THE RECRUITMENT PROGRAM, OR THE RECRUITMENT PROCESS WILL INCLUDE US RECRUITING, UH, LOCAL FOLKS FROM THE AUSTIN TRAVIS COUNTY COMMUNITY TO REPRESENT AND APPLY FOR THIS PROGRAM.

SO THE PROGRAM WILL BE, UH, SOMETHING THAT FOLKS WILL NEED TO APPLY FOR THROUGH THE CENTRAL HEALTH WEBSITE.

THERE WILL BE AN INTERVIEW PROCESS FOR FOLKS TO BE INTERVIEWED AND SELECTED FOR THE TRAINING PROGRAM, BUT IN EXCHANGE FOR THEIR EFFORTS IN APPLYING WITH US, THEY WILL RECEIVE, UH, PAY, IT'D BE A PAY TRAINING, WHICH IS SOMETHING THAT'S VERY UNUSUAL, RIGHT? AND A GREAT BENEFIT.

THEY'LL RECEIVE HEALTH BENEFITS AS WELL.

UM, THE PAY RATE, IF YOU'RE CURIOUS, UM, COMMISSIONERS WILL BE $17 AN HOUR, UH, DURING THE 12 WEEK TRAINING PROGRAM.

SO, OTHER THINGS I WANNA HIGHLIGHT ON THE SCREEN IS THE PROJECT WILL SUPPORT A SUSTAINABLE WORKFORCE.

WE PLAN ON HAVING TWO, UM, TRAINING COHORTS EACH YEAR WITH, UM, THE TRAINING CAPACITY TO, TO SUPPORT 10 CHWS.

SO WE'LL HAVE A FALL COHORT AND A SPRING COHORT, UH, EVERY YEAR TO SUPPORT, UM, OUR, OUR WORKFORCE.

AND THEN, UM, LASTLY, WANNA POINT OUT TOWARDS THE END HERE THAT THE PROJECT, UM, YOU KNOW, WE'LL WORK ON STANDARDIZING ALL OF OUR WORKFLOWS, BOTH OUR SOPS AND, UM, OUR INTERNAL PROCESSES AND SYSTEMS TO MAKE SURE THAT PATIENTS HAVE THE VERY BEST SERVICE FROM US AND THE BEST EXPERIENCE FROM THAT CENTRAL HEALTH CAN, CAN OFFER EACH OF OUR PATIENTS.

ANY QUESTIONS? THE, THE, THE ONE QUESTION I HAVE, AND I, I'LL, I'LL, I'LL WAIT FOR THE OTHERS.

WHEN YOU, WHEN YOU GET DONE, UM, HAUSER INCORPORATION, OR IS THERE GONNA BE INCORPORATION FOR THOSE THAT MEET THE EXPERIENCE REQUIREMENTS TO NOT HAVE TO GO THROUGH THE PROGRAM? GOOD QUESTION.

TO GET MORE PEOPLE WITH THE CERTIFICATION, GOOD QUESTION.

TO THEN BE ABLE TO REALLY EXERCISE AND OPERATE IN THAT ASPECT.

THERE'S ALREADY THE BACKLOG AND STUFF MM-HMM.

WHERE PEOPLE HAVE SUBMITTED TO HHS S AND HAVE NOT RECEIVED ANYTHING BACK.

SO WHERE'S THE SUPPORT INTO THAT ASPECT TO GET MORE PEOPLE CERTIFIED AND TRAINED OKAY.

AND SO FORTH.

AND THEN THE OTHER ONE IS, HOW IS THIS GONNA BE DIFFERENT FROM THE TRAINING AND CERTIFICATION THAT A PH AND LWIN ARE DOING? GOOD QUESTION.

YEAH.

SO ONCE WE OPEN UP OUR, UM, YOU KNOW, THE PROJECT FULLY LAUNCHES, SO THE PEOPLE THAT HAVE EXPERIENCE AND GO THROUGH THAT ROUTE TO BECOME CERTIFIED, THEY CAN APPLY IMMEDIATELY TO THOSE VACANCIES AS THEY EXIST ON THE CENTRAL HEALTH WEBSITE.

SO CURRENTLY, I BELIEVE WE HAVE TWO NOW.

AND IF THEY HAVE THAT CERTIFICATION, WHETHER IT'S EXPERIENCE OR THEY'VE GONE THROUGH THE DIDACTIC TRAINING, THEY'RE ELIGIBLE TO APPLY.

UM, REMIND ME OF THE SECOND PART OF YOUR QUESTION.

SO, OH, IT DIFFERENT, RIGHT? BUT I'LL SAY IF THEY DON'T HAVE CERTIFICATION, BUT THEY HAVE THE EXPERIENCE IN HOW CAN CENTRAL HEALTH BE TIED INTO HSS AS A WAY TO BE ABLE TO GET THAT CERTIFICATION, SO THEN THEY CAN APPLY IF THAT CERTIFICATION IS A REQUIREMENT FOR THE JOB.

UM, IF THEY, IF THEY'RE PUT IN CONTACT WITH ME, I CAN SUPPORT THEIR EFFORTS TO GET THAT CERTIFICATION.

IN FACT, I'VE, UH, MET PEOPLE AT DIFFERENT SOCIAL EVENTS FOR CHWS AND I, I REGULARLY DO, UM, TOURS OF CENTRAL HEALTH SO THEY CAN UNDERSTAND ABOUT THE ORGANIZATION, KNOW HOW TO APPLY, KNOW ABOUT OUR RESOURCES AND THINGS.

SO AS SOON AS THINGS COME ONLINE, THEY HAVE ME AS A DIRECT CONTACT WITH MY CELL NUMBER AND THROUGH LINKEDIN.

AND SO THAT'S BEEN PRETTY EFFECTIVE IN KEEPING PEOPLE, UH, IN THE KNOW.

IN REGARDS TO YOUR SECOND QUESTION THOUGH, UM, OUR PROGRAM HOPES PLANS TO BE THE FLAGSHIP OF CH HW TRAINING AND DIFFERENT FROM OTHER ORGANIZATIONS BECAUSE IN ADDITION TO THE 160 HOURS THAT WE PLAN ON OFFERING, THERE'LL BE 320 ADDITIONAL, UM, UM, ADDITIONAL TRAINING OPPORTUNITIES WITH HANDS-ON EXPERIENCE THAT WILL SUPPORT, UM, THE UNIQUENESSES OF OUR CLINICS AND OUR ORGANIZATION.

SO THEY'LL HAVE THE, THE, THE ONE 60 PLUS THE THREE 20.

AND IN ADDITION TO THAT, THERE'LL BE EXPERIENTIAL TRAINING OPPORTUNITY FOR THEM TO WORK WITH A SENIOR CHW STAFF PERSON.

SO THEY GET DIRECT HANDS-ON EXPERIENCE AS WELL.

SO THE PROGRAM TOTAL, UH, IT'LL BE 12 WEEKS, SO THERE'LL BE FOUR WEEKS OF THE TRADITIONAL TRAINING AND THEN ANOTHER EIGHT WEEKS OF THE SPECIALIZED ESSENTIAL TRAINING THAT CENTRAL HEALTH IS DEVELOPING FOR THE TRAINEES OR APPRENTICES.

[00:15:02]

UM, UH, YEAH, YOU POINTED OUT THAT THEY HAVE TO APPLY ONLINE.

IS THERE ALSO A PAPER APPLICATION OR ANY PARTICULAR REASON WHY IT'S ONLY ONLINE? JUST FROM AN EQUITY STANDPOINT, NOT EVERYBODY, YOU KNOW, MAY HAVE THAT ABILITY AND THAT MAY BE MISSING A IMPORTANT POPULATION OF PEOPLE YOU'D WANT TO BE CHWS.

THAT'S A GOOD QUESTION.

UM, THERE, I DON'T REALLY HAVE AN ANSWER FOR IT, TO BE HONEST WITH YOU.

THAT'S SOMETHING THAT WE NEED TO, UM, INCORPORATE INTO OUR, OUR MARKETING AND PROMOTIONAL PLAN FOR THE PROGRAM.

VICE CHAIR.

AND THEN GO AHEAD.

YOU WERE NEXT.

GOOD AFTERNOON.

THANK YOU SO MUCH FOR BEING HERE.

YES, SIR.

UM, WE'RE, WE'RE VERY INTERESTED IN THIS TOPIC AND WE'RE STILL LEARNING A LOT.

AND THANK YOU DR.

WALKS.

LAST TIME WE MET FOR YOUR TEACHING AND HELPING ME SEE SOME THINGS, I WONDERED ABOUT THE, UM, COUPLE OF THINGS, PROFESSIONAL DEVELOPMENT.

SO YOU'RE A COMMUNITY HEALTH WORKER NOW THAT'S, YOU'RE, YOU'RE THERE AND YOU'RE MAYBE WORKING IN THAT REALM.

IS THERE, IS THERE A KIND OF A PATH THAT PEOPLE HAVE SO THAT, THAT BECOMES A CAREER? AND I JUST WONDERED IF THERE'S ECHELONS, KINDA LIKE AN EMT AS, YOU KNOW, MOVES TO PARA, YOU KNOW, UH, CAN MOVE TO PARAMEDIC, ET CETERA, ET CETERA, OTHERWISE, DOES THAT APPLY IN THIS KIND OF A REALM? YEAH, THAT'S A GREAT QUESTION.

UH, YES.

UH, WITH THE LAUNCH OF THE PROGRAM, WE HAVE DEVELOPED A CAREER LATTICE.

AND SO THE CAREER LINE IS MADE UP OF FOUR TIERS.

AND THE FIRST TIER IS THE CHW ONE, CHW TWO, CHW SPECIALIST, AND CH HW LEAD.

AND EACH OF THE DIFFERENT TIERS WILL, UH, OFFER A RANGE OF PAY RESPONSIBILITIES AND DUTIES, UM, FOR, FOR STAFF TO DISPLAY THEIR, THEIR LEADERSHIP QUALITIES OR GAIN LEADERSHIP QUALITIES ALONG THE WAY.

SECOND PART.

THANK YOU.

THAT'S FANTASTIC.

UM, JUST BRIEFLY, UM, I THINK YOU SAID THERE WERE 24 25, CORRECT.

AND NOW YOU'RE GONNA HAVE COHORTS OF 10 IN THE SPRING, 10 IN THE FALL, TWO COHORTS A YEAR OF 10, IS THAT RIGHT? THE 20 A YEAR? CORRECT.

SO THAT'S THRILLING.

'CAUSE WE THINK THAT, YOU KNOW, OUR GRAND THEORY, ONE OF OUR GRAND THEORIES IS THAT THAT'S GOOD FOR THE COMMUNITY TO HAVE MORE COMMUNITY HEALTH WORKERS IN GENERAL.

DO YOU SEE CENTRAL HEALTH BEING IN THE BUSINESS OF EXPANDING ITS FOOTPRINT TO MULTIPLES OF 25 TO 50 TO 75 COMMUNITY HEALTH WORKERS THAT ARE PART OF THAT ORGANIZATION? I DO.

UM, I, I BELIEVE THAT IF THE DATA CAN SUPPORT IT, THAT WE'LL, UH, UH, CONTINUE TO ONBOARD ADDITIONAL CHWS TO SUPPORT THE NEEDS OF THE AUSTIN TRAVIS COUNTY COMMUNITY.

AND, AND LASTLY, AND AGAIN, I APOLOGIZE, ARE MOST OF THE CHWS NOW IN CLINICS, AND I THINK YOU SAID KIND OF IN LOCATIONS, ARE MANY OF THEM OUT IN THE COMMUNITY? THAT'S KIND OF WHERE I'VE ENVISIONED THAT MORE OF A PICKUP TO BE.

YEAH.

LET ME SEE HERE IF I CAN SKIP AHEAD.

UH, OH, MY CLICKER'S NOT WORKING HERE.

UH, OH, DID I PASS IT? YEAH, I PASSED IT.

LET ME GO BACK.

THERE WE GO.

YES.

SO WE HAVE CHWS IN OUR SPECIALTY CLINICS, UH, TRANSITION OF CARE, WHICH IS IN OFFICE, UH, CASE MANAGEMENT OFFICE, AND THEN WE HAVE COMMUNITY ENGAGEMENT AND COMMUNITY OUTREACH.

SO THEY'RE, THEY'RE INTERTWINED ALL OVER THE CITY.

OKAY.

WONDERFUL.

THANK YOU.

YEAH.

SORRY.

YES, MA'AM.

HOLD YOU UP.

UM, I KNOW YOU HAVE ADDITIONAL SLIDES TO SHOW US AS WELL, SO I CAN HOLD OFF.

NO, BUT, OKAY.

UH, WE ARE WORKING ON GETTING SOME RECOMMENDATIONS ON HOW CHWS CAN BE INFLUENTIAL ACROSS MULTIPLE INSTITUTIONS AND NOT JUST CENTRAL HEALTH.

SO THINKING ABOUT THIS FROM A PH, THE COUNTY AND CENTRAL HEALTH, ALL ENTITIES THAT ARE A PART OF OUR COMMISSION FROM A LONGEVITY PERSPECTIVE, IT'S BEAUTIFUL THAT YOU'RE BE ABLE TO DO THE 20, BUT THEN THINKING OF THIS, IS IT GOING TO NOW PULL CHWS FROM A PH TO NOW WANT TO COME AND BE A PART OF CENTRAL HEALTH'S PROGRAM SO THAT THEY CAN THEN TEAR UP WITHIN YOUR LATTICE? SO THAT'S MY FIRST QUESTION OF LIKE, IS THIS GOING TO BE SO INTERESTING AND, UH, FINANCIALLY MORE ENTICING YEAH.

FOR CHWS TO COME TO CENTRAL HEALTH AND LEAVE POTENTIALLY THE COUNTY AND THE CITY.

AND THEN MY NEXT QUESTION IS, WHERE IS THE OPPORTUNITY, UH, FROM A COLLABORATIVE PERSPECTIVE OF LOOKING AT IT FROM A HOLISTIC SPACE OF CENTRAL HEALTH, A PH, THE COUNTY AND OTHER ENTITIES THAT ARE ALSO TRAINING THESE CHWS AS YOU'RE CREATING THIS PROGRAM? ARE THERE, THIS IS THE QUESTION.

YEAH.

ARE, ARE THERE, UM, PLANS ON HOW TO SCALE THIS APPROPRIATELY ACROSS OUR COUNTY? YEAH.

YEAH.

THANK YOU FOR THOSE QUESTIONS.

I THINK THE FIRST PART OF YOUR QUESTION IS HYPOTHETICAL.

WE DON'T REALLY KNOW THE IMPACT OF HOW IT MIGHT AFFECT OUR PARTNER ORGANIZATIONS, BUT I CAN TELL YOU THAT WE ARE ACTIVELY COLLABORATING WITH OUR COMMUNITY PARTNERS.

I READ, UM, UH, EXCUSE ME, I MEET REGULARLY WITH, UH, THE CH HW COALITION AT AUSTIN PUBLIC HEALTH, UM, TO GATHER IN, UH, INPUT AND INSIGHT ON, UM, YOU KNOW, TARGETING CHWS.

WE WANT A MORE DIVERSE POOL OF APPLICANTS, UM, DIVERSITY AND AGE DIVERSITY AND, AND, AND ETHNICITY AND SO ON AND

[00:20:01]

AND SO WE MEET REGULARLY TO MAKE SURE THAT THEY'RE, THEY'RE A PART OF THIS PLANNING PROCESS AND CAN ADVISE US ALONG THE WAY.

I, I WANTED TO ASK A FOLLOW UP QUESTION TO, TO, TO BOTH, UH, THE VICE CHAIR AND COMMISSIONER.

UM, WE HEARD A LOT ABOUT CAREER PROGRESSION, RIGHT? YES.

AND BEING ABLE TO HAVE CAREER PROGRESSION AND, AND LONGEVITY WITHIN THE CHWS.

AND THIS IS IN GENERAL, THIS HAPPENS TO BE A THOUGHT THAT CAME UP WITH YOUR PRESENTATION.

OKAY.

BUT I THINK IT'S FOR ALL THE ORGANIZATIONS TO HAVE CHW, WE'VE SEEN CHW 1, 2, 3, 4, I HAVE NO CLUE WHAT ALL THAT MEANS.

OKAY.

WHEN IT COMES TO LEVEL OF ROLE RESPONSIBILITY.

UM, AND SO ARE ANY OF THOSE TRANSITIONING INTO A MANAGERIAL ROLE? UM, AND IF NOT, HOW COME NONE OF THE AGENCIES ARE LOOKING AT THAT? AS FAR AS TAKING SOMEONE FROM THE STREET ENGAGEMENT, WHICH IS, I WOULD SAY IS THE PURE ESSENCE OF THE COMMUNITY HEALTH WORKER.

MM-HMM.

MORE SO THAN BEING A LIAISON WITHIN A CLINIC TO TAKING THAT EXPERIENCE, THAT KNOWLEDGE, THAT RELATIONSHIP BUILDING, AND THEN CREATING A MANAGEMENT PATHWAY MM-HMM.

TO THEN BEGIN TO OVERSEE THE OTHER CHWS AND ENSURE THAT DOES NOT GET MORPHED INTO THE OTHER PROCESSES OF OUTREACH AND ENGAGEMENT MM-HMM.

THAT EACH AGENCY HAS.

YEAH.

THANK YOU FOR THAT.

SO, UH, OUR PROGRAM, ONCE IT'S LAUNCHED, THE, THE LATTER OPTION IN OUR TIER, THE, UM, CHW LEAD WILL, WILL MORE OR LESS FUNCTION IN A MANAGERIAL ROLE.

THEY'LL BE EXPECTED TO, TO, UH, BE A DIRECT CONTACT FOR CHWS ON LOWER TIERS.

THEY'RE EXPECTED TO PROVIDE RESEARCH INFORMATION OR, OR ESTABLISH, GET, GET INVOLVED IN RESEARCH.

UM, IN FACT, WE ARE PREPARING OUR CHWS, UM, HOPEFULLY, UH, TO, TO DO A, UH, THE AP AP, THE, THE CONFERENCE TRAINING, THE PUBLIC HEALTH CONFERENCE TRAINING, OR NOT CONFERENCE, I'M SORRY, WHAT'S IT CALLED? IT'S CALLED THE, UM, THE PUBLIC HEALTH NATIONAL CONFERENCE.

UH, WE PLAN ON EXPLAINING THE WHOLE PROGRAM TO THE, TO THE NATION.

AND SO THIS YEAR WE'RE GOING TO KIND OF GET A FEEL FOR HOW THINGS WORK.

AND THE FOLLOWING YEAR, OUR HOPE IS THAT WE CAN TAKE OUR CHW SENIOR LEADERSHIP, UM, THAT ARE PREPARED FOR THAT TO ALSO BE PART OF OUR PRESENTERS TO SHOWCASE WHAT WE'RE DOING AS WELL AS, YOU KNOW, HOW THEY HAVE EVOLVED THEIR TALENT AND SKILLS FOR THAT MANAGERIAL ROLE, AS YOU MENTIONED, FOR A, A, A THOUGHT FOR THE COMMISSIONERS AND, AND OUR, UH, AGENCIES.

UM, I, I KNOW AT LEAST WHAT I UNDERSTAND FROM THE COMMUNITY CARES CONSTRUCT, I'M NOT SURE HOW SIMILAR IT IS ACROSS THE OTHER AGENCIES, BUT YOU HAVE THE, THE, THE TRIFECTA, RIGHT? YOU HAVE THE BUSINESS OPERATIONS ASPECT THAT OVERSEES THE CLINIC.

YOU HAVE THE NURSING ASPECT THAT OVERSEES THAT PART OF THE CLINIC, AND THEN YOU HAVE THE MEDICAL MM-HMM.

.

IS THERE A NEED FOR CHW FOCUS? BECAUSE THAT'S NOT NECESSARILY FALLING IN WITHIN NURSING, IT'S NOT NECESSARILY FALLING IN WITH MEDICAL.

DOES IT FALL IN SOMEWHERE WITHIN OPERATIONS? AND IF SO, HOW? UM, SO I'D BE INTERESTED IN JUST PUT THAT IN A PARKING THOUGHT FOR POTENTIAL FUTURE CONVERSATIONS.

YES.

SINCE YOU POSED THE QUESTION ABOUT THE CHW LADDER FOR ALL THE ORGANIZATIONS, IF YOU'LL ALLOW ME CHAIR TO ANSWER ON THE PART OF AUSTIN PUBLIC HEALTH.

SO A CHW ONE IS SOMEONE THAT IS INTERESTED IN THE FIELD AND IS WORKING TOWARDS THEIR CERTIFICATION.

A TWO IS WHEN YOU HAVE YOUR CERTIFICATION, AND THEN THE NUMBER OF YEARS OF EXPERIENCE TIED TO IT.

AND A CHW TWO CAN SERVE AS A LEAD, MEANING THAT THEY CAN LEAD THE WORK OF OTHERS, BUT THEY DON'T HAVE THE FULL REIGNS OF SUPERVISORY, UH, RESPONSIBILITIES AT A THREE.

UM, YOU HAVE THE CERTIFICATION FROM THE STATE TO NOT ONLY BE AN INSTRUCTOR, BUT YOU ALSO HAVE THE OPPORTUNITY TO, UH, SUPERVISE AND MANAGE FULL RANGE OF DUTIES.

UM, AUSTIN PUBLIC HEALTH IS LOOKING AT THEIR SUPERVISORY TITLES TO MAKE SURE THAT WE HAVE SUBSTITUTIONS FOR EXPERIENCE RIGHT NOW, UM, AND A DEGREE REQUIREMENT IS IN PLACE.

AND WE RECOGNIZE AS WE'RE BUILDING THIS PIPELINE, WE HAVE TO VALUE ALL LEVELS OF, OR TYPES OF EXPERIENCE AT ALL LEVELS OF ACROSS THE ORGANIZATION.

SO WE'RE, WE'RE TRACKING WITH YOU ON MAKING SURE THOSE OPPORTUNITIES ARE AVAILABLE.

BACK, BACK TO YOU, SIR.

OKAY.

ANY OTHER QUESTIONS? OKAY.

NO.

OKAY.

UM, SO HERE'S AN OVERVIEW OF THE CURRICULUM.

SO, UH, ESSENTIAL HEALTH, WE PURCHASED THE CURRICULUM.

WE HAVE A LICENSING AGREEMENT WITH HEALTH ACADEMY.

THIS IS A, AN APPROVED CURRICULUM BY THE TEXAS DEPARTMENT OF STATE HEALTH SERVICES TO BE ABLE TO PROVIDE THE TRAINING AS WELL AS THE CEUS TO OUR, TO OUR TRAINEES AND, AND, AND OTHERS.

UM, IN ADDITION TO THAT, AS I MENTIONED EARLIER IN THE PRESENTATION, SO CENTRAL HEALTH IS WORKING ON A, AN ESSENTIAL TRAINING COMPONENT THAT'S SEPARATE FROM THE INITIAL TRAINING TO BUILD ON THE FOUNDATIONAL SKILLS AND THE COMPETENCIES TO PROMOTE HEALTH EQUITY AND TO REDUCE DISPARITIES.

[00:25:01]

I MEAN, IT'S BASED AROUND THE 160 DIDACTIC CLASSROOM HOURS IN ADDITION TO THE 300 HOURS.

THAT'S EXPERIENCE-BASED TRAINING THAT'LL HAPPEN, UM, WHILE OUR CHWS WORK WITH, WITH OUR SENIOR CHWS TO, UM, SHADOWING CLINIC TO BECOME MORE CONNECTED TO THE COMMUNITY, TO UNDERSTAND OUR PROCESSES AND PROCEDURES, UH, BEFORE THEY COMPLETE THE, THE PROGRAM.

SO, MORE INFORMATION ON THE PROGRAM HERE.

SO THE APPRENTICE PROGRAM'S GONNA FOCUS ON HEALTH EQUITY, CLINICAL, UM, INTEGRATION, BLENDING LEARNING GROUPS, UH, WITH LIVE SESSIONS AND SELF PAY SESSIONS FOR OUR TRAINEES.

AND THEN THE PROGRAM DELIVERY, UM, IS GONNA BE DIDACTIC, AS I MENTIONED.

SO WITH IN-PERSON GROUP ACTIVITY DEMONSTRATIONS, ROLE PLAYING CASE STUDIES, SIMULATIONS OVER FOUR WEEKS, PLUS THE SUPERVISED EXTERNSHIP THAT I MENTIONED WITH HANDS-ON EXPERIENCE.

IT'LL BE AN ADDITIONAL, UH, EIGHT WEEKS FOR OUR TRAINEES.

SO WE BELIEVE THAT THIS, THIS APPROACH WILL REALLY MAKE, UM, OUR WORKFORCE OR TRAINEES VERY JOB READY, UH, AS SOON AS THEY COMPLETE THE EXAM.

QUESTIONS.

YES, MA'AM.

YEAH.

UM, FROM A FUNDING PERSPECTIVE, UM, , I KNEW THIS WAS COMING.

YEP.

UM, HOW, HOW SUSTAINABLE IS GROWING, LIKE CURRENTLY LAUNCHING THIS PROGRAM AND THEN GROWING THIS PROGRAM FROM NOT ONLY THE 20 PEOPLE THAT YOU HAVE COMING IN PER YEAR? YEAH.

UP TO THE OTHER NUMBERS THAT CHAIR WALLACE MENTIONED, OR, UH, VICE CHAIR.

YEAH.

WHAT I CAN SAY IS THAT OUR FUNDING HAS BEEN APPROVED FOR FY 25.

UH, BEYOND THAT, I, I DON'T HAVE ANY INSIGHT INTO HOW THE FUNDING MIGHT EXIST.

CAN I ASK A FOLLOW UP QUESTION ON THAT PART? YES, MA'AM.

UM, I KNOW WE DON'T REALLY HAVE CONVERSATION ABOUT WHAT YOU DO WITH YOUR FUNDING AND WHERE THE FUNDING COMES FROM, BUT ARE THERE OPPORTUNITIES THAT YOU'RE AWARE OF THAT COULD BE A COMPREHENSIVE OR A COLLABORATIVE FUNDING EFFORT AMONGST EVERYONE WHO HAS CHWS WITHIN OUR CITY AND COUNTY? THAT'S A GOOD QUESTION.

THAT'S SOMETHING THAT'S BEEN TALKED ABOUT, UH, WITH THE CHW MEET, UM, UH, GROUP MEETING THAT I HAVE EVERY TWO WEEKS.

AND SO THAT'S SOMETHING THAT I HAVE TAKEN BACK TO MANAGEMENT FOR THEIR CONSIDERATION.

THANK YOU.

SO, UH, IN CLOSING, OUR CHW UH, GRADUATES WILL BE EXPECTED TO EXIT OUR PROGRAM WITH A SCORE OF 80% OR HIGHER.

AND IF THEY DON'T PASS, THEN THEY'LL HAVE A CHANCE TO, TO RETAKE THE TEST IN A, IN A, I BELIEVE IT'S A WEEK.

UM, AFTER THEY GRADUATE, THE APPRENTICE WILL HAVE THE OPTION TO APPLY FOR A JOB WITH CENTRAL HEALTH AS A PERMANENT EMPLOYEE FOR A HIGHER, UH, RATE OF PAY AND THEIR BENEFITS, OR THEY CAN CHOOSE TO WORK FOR A COMMUNITY PARTNER.

AND THEN LASTLY, THE PROGRAM IS, IS WILL BE LAUNCHING AN FY 25.

I HAVE A COUPLE OVERALL QUESTIONS.

OKAY.

UH, I, I'LL TRY TO CONSOLIDATE DOWN TO TWO.

OKAY.

UM, ONE IS ON SLIDE SEVEN, SLIDE SEVEN, UM, REGARDING THE 160 DIDACTIC CLASSROOM TRAINING, 320 HOURS EXPERIENCE BASED TRAINING.

OKAY.

UM, WHAT ASPECT OR COMPONENT ONE, IT'S KIND OF LIKE, NOT REALLY A, WHAT IS THAT REALLY FROM A CURRICULUM STANDPOINT.

OKAY.

BUT WHAT IS THAT REALLY FROM AN ASPECT OF COMMUNITY HEALTH WORKER BEING ABLE TO ENGAGE APPROPRIATELY AND EFFECTIVELY WITH THE COMMUNITY? YEAH.

WHERE THE HOURS AT IN THIS YEAH.

FOR THAT KEY FUNCTIONAL ROLE.

YEAH, GOOD QUESTION.

SO THE TRAINEES WILL GET SOME OF THAT TRAINING IN THE INITIAL 160 HOURS, BUT THE 120 HOURS WILL REALLY DISSECT, UM, UH, MORE INTO THOSE, UH, COMPETENCIES.

AND I THINK PARTICULARLY ON, UM, COMMUNITY ENGAGEMENT, UH, BEHAVIORAL INTERVIEWING, UM, BEHAVIORAL ASSESSMENT THINGS.

AND, AND SO IT'S, IT'S VERY DETAILED IN, IN THOSE DIFFERENT COMPONENTS.

AND I WISH, I CAN'T RECALL MORE OFF THE TOP OF MY HEAD, BUT, UH, BUT THE CURRICULUM WILL BE WRITTEN IN SUCH A WAY WHERE THEY GET ADDITIONAL, UH, INFORMATION SUPPORTIVE OF THE COMMUNITIES, AND THEY'LL HAVE AN OPPORTUNITY TO KIND OF ROLE PLAY, UH, TO MAKE SURE THAT THEY GET, THEY GAIN THE INFORMATION AS WELL.

YEAH.

BECAUSE I THINK POTENTIAL CONCERN, I DON'T WANNA SPEAK FOR, FOR ANYBODY ELSE, BUT I, I FEEL LIKE ONE OF THE CONCERNS IS WE'RE TAKING INDIVIDUALS THAT ARE NOT FROM THE COMMUNITY, MAKING THEM BECOME COMMUNITY HEALTH WORKERS, AND THEN PUTTING THEM IN THE COMMUNITY, AND THEY DO NOT HAVE ESTABLISHED CREDIBILITY.

I SEE.

VERSUS TAKING COMMUNITY MEMBERS THAT HAVE THE BUY-IN THAT HAVE THE CONNECTIVE TISSUE, THAT HAVE THE, THE, THE, UM, DEFINED OUTCOMES ALREADY, AND THEN HELPING THEM TO BECOME MORE KNOWLEDGEABLE.

MM-HMM.

IN THE PUBLIC HEALTH SPACE AND SECTOR.

MM-HMM.

.

YEAH.

THANKS FOR THAT.

I THINK IT, IT'S GONNA BE UP TO US, UM, TO HAVE A VERY ROBUST RECRUITING EFFORT TO MAKE SURE THAT WE CONNECT WITH THOSE PEOPLE AND

[00:30:01]

YOU JUST MADE ME ADD, ADD ANOTHER QUESTION, SORRY.

UM, AND MAYBE IT MIGHT BE SOMETHING FROM A, I DON'T KNOW IF IT'S A POLICY ASPECT, BUT WHERE WITHIN THE, UH, APPLICATION PROCESS, DOES IT HELP TO IDENTIFY WHERE THAT INDIVIDUAL IS LIVING AND WHAT CONNECTIVE TISSUE THEY ALREADY HAVE IN THAT COMMUNITY AS PART OF THE APPLICATION? YES, SIR.

THAT'S PART OF OUR SCREENING PROCESS.

SO WE ASK THEIR ZIP CODE, WHERE THEY'RE FROM, AND THEN HOW THEY'RE CONNECTED TO THE CITY AS WELL.

THAT, THAT'S PART OF OUR, OUR, UH, SCREENING PROCESS.

I WONDERED IF THERE'S, UM, YOU SAID SOMETHING ABOUT A MONTHLY MEETING, AND I WONDERED IF, IF, UH, IF YOU, IF THERE'S A COMMUNITY OF COM OF CHWS THAT ARE OUT THERE THAT WOULD BE INTERESTING FOR US TO VISIT IF THEY HAD A MONTHLY MEETING OR SOMETHING, OR TO GET TO KNOW, AND I DON'T KNOW IF IT'S DOZENS OF PEOPLE OR, OR HOW MANY, BUT WHAT DID, WHAT DO YOU THINK ABOUT THE COMMUNITY AND HOW WELL COALESCED IT IS AS A, AS A, AS A PLACE TO SEE THAT, THAT RESOURCE? I'M SORRY.

SO WHAT IS THE QUESTION? UH, I WONDERED IF THERE'S LIKE A PROFESSIONAL GROUP OF COMMUNITY HEALTH WORKERS THAT COMES TOGETHER, LIKE, YOU KNOW, LIKE, LIKE THE, THE TECH, LIKE THE TRAVIS COUNTY MEDICAL SOCIETY HAS DOCTORS THAT COME TOGETHER, OR THE NURSING.

YEAH.

UH, I SEE.

SO, YEAH, GOOD QUESTION.

UM, SO I THINK TWOFOLD.

SO, UM, ONE OF THE, THE BIG CONNECTING POINTS THAT WE HAVE TO CONNECT WITH THE PROFESSIONAL COMMUNITY IS THROUGH OUR CHW, UM, SOCIAL THAT HAPPENS EVERY MONTH.

AND SO THAT'S THE OPPORTUNITY FOR ME TO CONNECT WITH FOLKS TO SEE WHO'S OUT THERE IS INTERESTED IN THE PROFESSION, TO PROVIDE MORE INFORMATION ABOUT, UH, WHAT'S HAPPENING AT CENTRAL HEALTH AND GET THEM INSIDE CENTRAL HEALTH, AS I MENTIONED EARLY ON FOR A TOUR OF THE FACILITY, UNDERSTANDING WHO OUR PARTNERS ARE, WHO OUR PROVIDERS ARE.

SO WHEN, WHEN THE PROGRAM FULLY LAUNCHES, THEY'RE ALREADY CONNECTED TO THE INFORMATION AND PEOPLE.

I HAVE A FEW QUESTIONS FOR YOU.

YEAH.

SO YOU MENTIONED DURING THE TRAINING, THEY ARE GONNA GET A $17 AN HOUR FOR THE PRE-TRAINING, CORRECT? YES, MA'AM.

TO THE TRAINING PERIOD FOR 12.

THAT'S A, THAT'S 40 HOURS A WEEK.

CORRECT.

SO THEY'RE GETTING ROUGHLY $1,400 A MONTH.

MM-HMM.

BEFORE TAXES.

MM-HMM.

THINKING ABOUT THIS, THIS, THIS IS THE, IT'S GONNA BE A MULTI-PART QUESTION BECAUSE I WOULD LIKE TO MAKE SURE WE HAVE A BETTER UNDERSTANDING BEFORE WE CAN PUT TOGETHER A RECOMMENDATION ON HOW WE SUPPORT OUR CHWS EQUITABLY ACROSS THIS, THIS COUNTY FROM A, A STANDARD OF LIVING QUALITY OF LIFE.

MM-HMM.

THAT IS HARSH TO EVEN PRETEND TO COME ACROSS AS SUPPORTIVE WHEN WE'RE, WHEN YOU'RE LOOKING AT THAT.

ALSO.

ARE THERE ANY OTHER RESOURCES FROM INSTANCE OF LIKE TRANSPORTATION, TRAVEL, CHILDCARE, ANYTHING THAT'S ALSO SUPPORTING THEM DURING THEIR TRAINING PROCESS? YEAH, THAT'S A GOOD QUESTION.

UH, I DON'T HAVE ANY INFORMATION ON THAT, AND AS IT STANDS RIGHT NOW, IT'S JUST THE $17 AN HOUR.

BUT, UH, I WILL TAKE THAT BACK TO MANAGEMENT FOR THEIR CONSIDERATION.

AND THEN AS THEY, AS THEY TR IT'S OKAY, I WAS LIKE, I WILL MEET MYSELF REAL QUICK.

UM, AS THEY TRANSITION INTO FULL-TIME, EMPLOYEES WITH CENTRAL HEALTH, WHAT'S THE RATE SHIFT? YEAH, SO THE RATE SHIFT RIGHT NOW IS BEING EXAMINED AND IT PLANS ON BEING VERY COMPETITIVE, WHAT THE EXACT NUMBER IS.

I DON'T KNOW.

THAT'S SOMETHING THAT HR AND MANAGEMENT IS WORKING ON.

OKAY.

IS THERE, FROM YOUR PERSPECTIVE, WITH YOUR VAST AMOUNT OF KNOWLEDGE IN CHWS IN THE, THE LATTICE PROGRAM THAT YOU ALL ARE IMPLEMENTING, UM, I'M GONNA CALL IT A PIPELINE PROGRAM JUST FROM A FUNDING PERSPECTIVE.

OKAY.

BECAUSE THAT'S HOW I KNOW IT.

INTEGRATING THIS PIPELINE PROGRAM INTO CENTRAL HEALTH IS OBVIOUSLY GOING TO IMPROVE YOUR CHW SPECIFICALLY.

CORRECT.

BUT WHEN WE'RE LOOKING AT IT FROM LIKE A QUALITY OF LIFE AND ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH OF YOUR ACTUAL EMPLOYEES DOLLARS ALWAYS ARE COMING INTO THAT CONVERSATION.

MM-HMM.

, ARE THERE OTHER HOLISTIC SUPPORTIVE SERVICES ALREADY IN CENTRAL HEALTH THAT ARE OFFERED TO OTHER EMPLOYEES THAT COULD BE ACCESSIBLE TO YOUR CHWS? AND I'M ASKING THAT IN A SEPARATE WAY OF LIKE, IF YOU HAVE, UM, A PROGRAM FOR YOUR NURSES TO GET DIFFERENT SCRUBS AND THEY CAN USE THE CENTRAL HEALTH STORE TO BUY THEM AND GET 'EM AT A DISCOUNT, ARE THERE OTHER THINGS LIKE THAT ALREADY IN THE INSTITUTION THAT COULD POTENTIALLY BE A PART OF YOUR PILOT PROGRAM? YEAH.

SO WE DO HAVE, UM, VENDORS AND THINGS IN PLACE TO SUPPORT THE COST OF, OF CERTAIN THINGS.

YEAH.

IN ADDITION TO CONTINUING EDUCATION FOR OUR CHWS ONCE THEY BECOME, UH, EMPLOYEES OF THE COMPANY.

THE, THE LAST QUESTION THAT I HAVE IS IT'S GONNA CROSS ABOUT THREE DIFFERENT SLIDES.

OKAY.

UH, SLIDE EIGHT.

YOU HAVE FOCUSES ON HEALTH EQUITY AND CLINICAL INTEGRATION.

[00:35:01]

SLIDE FOUR TALKS ABOUT CORE COMPETENCIES AS CAPACITY BUILDING SKILLS, ADVOCACY SKILLS, KNOWLEDGE BASED ON GENERAL HEALTH ISSUES.

AND SLIDE TWO IT SAYS, DOES NOT PROVIDE PATIENT CARE.

MM-HMM.

.

BUT THE KEY ROLE IS INCREASING ACCESS TO PREVENTIVE CARE AND TREATMENT.

WE ALREADY KNOW THERE'S A SHORTAGE OF ACCESS OF DOCTORS AND PHYSICIANS AND SO FORTH.

SO HOW IS INCREASING THE CHW AND THE PILOT PROGRAM WHEN THE CAPACITY MAY NOT FULLY BE THERE IN CLINICS OR NOT IN PARTICULAR PLACES AND SO FORTH? HOW IS THIS ACTUALLY GONNA BE DONE? UM, IT'S GONNA BE DONE BECAUSE WE'LL BE VERY MINIMALLY NIMBLE IN OUR RESPONSE TO SUPPORTING THE PUBLIC.

SO AS THE NEED, UM, GROWS, THEN OUR RESOURCES WILL SHIFT TOWARDS HELPING THE PUBLIC, UH, AS IT'S NEEDED WITH OUR CH HW WORKFORCE.

UH, IN RESPONSE TO YOUR QUESTION, UH, OR I DON'T WANNA GET AHEAD, BUT I THINK YOU WERE ASKING ON ONE OF THE SLIDES ABOUT, UM, THE, SOMETHING ABOUT THE TRAINING MM-HMM.

COHORT.

MM-HMM.

OR SO, SO IF I WASN'T CLEAR ON THAT, YEAH, IT'LL BE 10 10, UM, CH HW TRAINEES TO KIND OF GO THROUGH THAT PROCESS.

BUT THAT NUMBER CAN BE ADJUSTED DEPENDING ON, YOU KNOW, WHAT THE NEED IS FOR THE COMMUNITY.

SO WE COULD ADD MORE, OR MAYBE WE COULD ADD LESS DEPENDING ON WHAT THE NEED IS WITH OUR CLINICS AND JUST WHAT WE'RE SEEING OUT IN THE COMMUNITY.

GOT IT.

AND I, I THINK FOR ME, IT'S ALMOST IN A SENSE HERE, UH, THE MOST VI I THINK THE MOST LOGICAL RESPONSE ABOUT HOW VIABLE IS IT IS EVEN THOUGH THEY'RE BEING FUNDED AND THEY'RE ASSIGNED TO, YEAH.

CENTRAL HEALTH WHERE THE BOTTLENECK IS, THEN HOW ARE THEY ALSO COORDINATING TO A PH TO, UM, ST.

DAVID'S TO WHEREVER IT IS.

SO IT'S NOT ALL TRYING TO GET 'EM INTO ONE DOOR.

MM-HMM.

WHERE THE CAPACITY IS IN THERE, OR THE FACILITIES AND THE LOCATIONS ARE NOT NECESSARILY IN CLOSER TO WHERE THAT INDIVIDUAL IS.

MM-HMM.

TO REDUCE A LOT OF THE HUMANISTIC BARRIERS WE PLACE UPON OURSELVES TO GETTING HELP EVEN WHEN IT IS AFFORDED TO US.

MM-HMM.

WELL, THAT'S WHAT WE'RE HOPING TO COLLABORATE WITH OUR COMMUNITY PARTNERS.

SO AGAIN, SO THE PEOPLE THAT CAN COMPLETE THEIR TRAINING PROGRAM, THEY HAVE THE OPTION TO WORK FOR US OR WORK FOR WITH ONE OF OUR PARTNERS.

BUT WE BELIEVE THAT OUR TRAINING CURRICULUM AND THE EXPERIENCE THEY'LL GET AT, AT, UH, CENTRAL HEALTH WILL BE THE FLAGSHIP OF, UH, AUSTIN, TRAVIS COUNTY.

ANY OTHER QUESTIONS FROM, FROM THE COMMISSIONERS? I APOLOGIZE IF I MISSED IT.

DO YOU HAVE A CHW THAT ALREADY HAS THEIR BASIC CERTIFICATION? CAN THEY JOIN THE PROGRAM TO GET THE ADDITIONAL THREE 20 HOURS OR YOU HAVE TO START ALL OVER AGAIN AND DO THE FULL YES, MA'AM.

NO, THEY DON'T.

IF THEY ALREADY HAVE THEIR CERTIFICATION, THEN THEY CAN IMMEDIATELY APPLY FOR PERMANENT PLACEMENT WITHOUT THE THREE 20 EXTRA.

CORRECT.

AND IS THERE A, I'M SORRY.

IS THERE A WAY TO GET THEM THAT TRAINING? SO THEY'RE ON CALL WITH THEIR COLLEAGUES THAT WILL BE WORKING FOR CENTRAL HEALTH? YES.

UH, WE DO HAVE AN ONBOARDING PERIOD AND THEY COULD PIGGYBACK ON THE ONBOARDING PERIOD FOR THAT ADDITIONAL TRAINING.

YES, MA'AM.

ANY LAST QUESTIONS FOR THIS PRESENTATION? INFORMATION THERE BEING NONE.

THANK YOU.

ALRIGHT.

OH, OH, EXCUSE US.

, DR.

WA, SO IF THEY'RE CERTIFIED, WILL SOMEBODY THAT IS FROM A GIVEN COMMUNITY WITH LIVED EXPERIENCE TAKE PRECEDENCE OVER SOMEBODY WHO HAPPENS TO BE FROM THE ZIP CODE? ABSOLUTELY.

WITH THE CERTIFICATION? YEAH.

IT'S PART OF OUR INTERVIEW AND, AND SCREENING PROCESS.

WE HAVE A SCORING RUBRIC THAT WE USE WITH QUESTIONS BUILT INTO OUR SCORING RUBRIC TO MAKE SURE THAT WE GET PEOPLE THAT ARE MOST CONNECTED AND KNOWLEDGEABLE TO THE COMMUNITY.

ANY LAST QUESTIONS? ALRIGHT.

APPRECIATE IT.

THANK YOU.

THANK YOU.

UH, NEXT UP WE HAVE

[3. Discussion of Community Health Workers advocacy by Ricardo Garay with the City of Austin’s Equity Office. ]

HOPEFULLY I SAID IT CORRECTLY WITH THE CITY OF AUSTIN'S EQUITY OFFICE.

ALRIGHT, Y'ALL, THANK YOU FOR HAVING ME.

UM, JUST, UH, I'LL START WITH JUST, I, I REALLY WANNA JUST ACKNOWLEDGE THE TONE THAT YOU, THAT, SORRY, BEEN SET HERE.

I APPRECIATE THE QUESTIONS THAT WERE LOBBIED TO, TO SEEK THEM, UH, ON SOME OF THIS STUFF BECAUSE I DO FEEL VERY PASSIONATE ABOUT THE ROLE OF COMMUNITY HEALTH WORKERS.

UM, I, MYSELF, UH, I WAS BORN INTO HONDURAS, AND SO I REMEMBER GROWING UP THERE, MY, MY GRANDPA, MY DAD WERE DOCTORS, AND SO I ALWAYS GREW UP AROUND STUFF THAT WAS CLINICAL.

BUT IT WAS IN 1998 WHEN HURRICANE MITCH DESTROYED THE COUNTRY THAT I GOT TO SEE.

UH, AND I, AND WHEN I WAS A TEENAGER, I WOULD DO, UM, INTERPRETATION FOR, FOR MEDICAL BRIGADES IN HONDURAS.

AND SO THAT'S REALLY MY

[00:40:01]

BUT IT WAS IN 1998 WHEN HURRICANE MITCH HIT THE COUNTRY THAT IT WAS DEVASTATED.

AND ALL THESE COUNTRIES WERE SENDING AID, AND CUBA WAS SENDING DOCTORS AND NURSES.

AND THAT'S REALLY WHEN I UNDERSTOOD THAT THESE DOCTORS WERE NOT ACTUALLY WAITING FOR PATIENTS TO COME TO THEM, BUT THEY WERE ACTUALLY GOING TO THE PEOPLE'S HOMES.

THEY WERE TALKING TO THEM DIFFERENTLY.

THEY WERE TALKING TO THEM WITHOUT WANTING, WITHOUT PRESCRIBING THINGS.

THEY WANTED TO KNOW HOW PEOPLE LIVED.

AND THAT'S REALLY WHERE I LEARNED HOW HEALTHCARE SHOULD BE.

IT SHOULDN'T HAPPEN AT CLINICS.

IT, IT HAPPENS IN THE COMMUNITY.

AND THEN WHEN I CAME TO THE US AS A STUDENT IN THE YEAR 2000, I, I HAD AN EAR INFECTION.

I WENT TO A CLINIC AND I FELT HORRIBLE.

I WAS LIKE, THERE'S TECHNOLOGY HERE, BUT THERE'S NO HUMAN CONNECTION.

I FELT UNWANTED, I FELT UNSEEN.

AND I, THAT'S REALLY WHAT MOTIVATED ME TO BE LIKE, THERE HAS TO BE A BETTER MODEL HERE.

THERE HAS TO BE A BETTER WAY TO LOOK AT HEALTHCARE.

AND SO SINCE THEN, I'VE BEEN JUST VERY PASSIONATE ABOUT COMMUNITY HEALTH WORKERS IN THE US.

I WORKED FOR EIGHT YEARS, UH, UH, WITH, UH, AN ORGANIZATION CALLED MIGRANT CLINICIANS NETWORK, DOING A LOT OF PATIENT NAVIGATION GLOBALLY.

AND I ALSO SAW THAT THE BEST FEDERALLY QUALIFIED HEALTH CENTERS WERE THE ONES THAT HAD COMMUNITY HEALTH WORKERS, NOT ONLY WORKING FOR THEM, BUT IN THEIR BOARDS AND HAVE HAD THEIR MICD TERMED UP ON THE BOARD SAYING, THESE ARE FOLKS FROM THE COMMUNITY THAT ARE TELLING US HOW TO PROVIDE BETTER SERVICES.

THESE, THESE BOARD MEMBERS OR COMMUNITY HEALTH WORKERS ARE PUSHING FOR EXTENDED HOURS, LANGUAGE ACCESS, REALLY COMING FROM THE COMMUNITY SAYING, WE KNOW WHAT THE COMMUNITY NEEDS.

WE NEED THESE HEALTHCARE SYSTEMS TO CHANGE.

SO GETTING THAT EXPERIENCE REALLY WAS WHAT SOLIDIFIED MY COMMITMENT TO THE, THE WORK IN, AT, AT THE NATIONAL LEVEL.

UH, I HAVE SINCE BECOME A BOARD MEMBER OF THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH WORKERS, THE TEXAS ASSOCIATION OF COMMUNITY HEALTH WORKERS AND, UM, AND THE TEXAS SOCIETY OF PUBLIC HEALTH EDUCATION.