* This transcript was created by voice-to-text technology. The transcript has not been edited for errors or omissions, it is for reference only and is not the official minutes of the meeting.
          [CALL TO ORDER]
          [00:00:07]
          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]
COMMENTS? YES, WE DO. 
          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]
TO BE ADDRESSED. 
          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.]
THE APPROVAL OF MINUTES. 
          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.]
ITEMS. HAVE A 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]
CHWS, UH, WITHIN OUR ORGANIZATION. 
          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]
YES, SIR. 
          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]
SO FORTH. 
          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]
UM, THAT'S, IT'S LOOSE. 
          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]
THOSE PEOPLE CAN APPLY FOR THE PROGRAM BECAUSE WE WANT THE BEST AND BRIGHTEST TO APPLY AND, UH, BE ACCEPTED TO COMPLETE THE TRAINING, ESPECIALLY IF THEY'RE CONNECTED TO THE AUSTIN TRAVIS COUNTY COMMUNITY. 
          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]
ON SLIDE SIX, IT SAYS, CREATE A SUSTAINABLE LOCAL COMMUNITY HEALTH WORKFORCE, PURSUE PHYSICAL RESPONSIBILITY BY REDUCING INPATIENT READMISSIONS AND PROMOTING EFFICIENT PATIENT NAVIGATION AND ENHANCE PATIENT SERVICES AND PATIENT EXPERIENCE. 
          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. ]
DISCUSSION OF COMMUNITY HEALTH WORKERS ADVOCACY BY RICARDO GORE. 
          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]
FIRST ROLE IN BEING A MIDDLE PERSON FROM THESE MEDICAL BRIGADES TO THE COMMUNITY. 
          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. 
          UH, LOCALLY, I'M A COMMUNITY ORGANIZER. 
          SO THOSE ARE, THAT'S MY BIAS, RIGHT? LIKE, I, I WORK AT THE EQUITY OFFICE NOW, BUT I ALSO WORKED FOR SEVEN YEARS AT THE DELL MEDICAL SCHOOL, REALLY TRYING TO GET A COMMUNITY HEALTH WORKER HUB THERE. 
          I SAY TRYING BECAUSE IT WAS VERY, VERY CHALLENGING TO GET SUPPORT. 
          UM, IT WAS, UH, IT WAS VERY DIFFICULT TO BE, TO BE ABLE TO GET SUSTAINED SUPPORT FOR THE WORK THAT WE DO. 
          THAT CONTINUES TO BE THE BIGGEST CHALLENGE. 
          AND ALSO THIS IDEA THAT I WAS CHANGING A LOT OF PARADIGMS AS TO HOW PEOPLE SEE HEALTHCARE. 
          UH, A LOT OF PEOPLE SEE HEALTHCARE IN THESE, LIKE, CLINICAL TERMS, IN THESE CLINICAL INTERVENTIONS. 
          I DON'T SEE IT LIKE THAT. 
          I SEE IT AS, UH, REALLY FOSTERING A SELF, UH, A SENSE OF WELLBEING AND, AND, AND, AND BELONGINGNESS. 
          AND SO FOR ME, UH, BEING ABLE TO CREATE PROGRAMS THAT JUST PROVIDE CERTAIN INTERVENTIONS FOR A HEALTH CONDITION ARE NOT ENOUGH. 
          NONE OF US ARE ONLY DIABETIC OR A CANCER SURVIVOR. 
          WE'RE MANY THINGS. 
          WE'RE A NEIGHBOR, WE'RE A FATHER, WE'RE SO MANY THINGS. 
          AND SO I THINK BEING ABLE TO REALLY FOCUS THE SHIFT FROM, AGAIN, LOOKING AT PEOPLE FROM A PARTICULAR CONDITION TO, TO THEM AS AS, AS HUMAN BEING, AS AS NEIGHBORS, IS SOMETHING THAT I REALLY WANT TO ADVOCATE FOR WHEN WE'RE TALKING ABOUT COMMUNITY HEALTH WORKERS. 
          UM, AND SO BEING ABLE TO OPEN THOSE THINGS. 
          AND SO AT THE NATIONAL LEVEL, WE HAVE REALLY PUSHED, FOR EXAMPLE, ON, UM, ESTABLISHING OUR VALUES OF COMMUNITY HEALTH WORKERS, UH, THOSE BEING SELF-EMPOWERMENT, SOCIAL JUSTICE AND EQUITY, UH, UNITY, UH, SELF-DETERMINATION, UH, INTEGRITY AND DIGNITY AND RESPECT BEING OUR VALUES OF A COMMUNITY HEALTH WORKER. 
          UM, AND SO WE ALSO, DURING THE PANDEMIC, WERE GETTING A LOT OF QUESTIONS, UH, AS TO HOW OUR ROLE SHOULD BE VIEWED IN THE HEALTHCARE SYSTEM. 
          UH, I THINK IT WAS VERY, VERY CLEAR THAT WE WERE NOW LABELED ESSENTIAL WORKERS, UH, YET WE'RE NOT GETTING ESSENTIAL PAY, YOU KNOW, UH, AS COMMUNITY HEALTH WORKERS. 
          AND SO THAT REALLY PROMPTED US TO COME UP WITH SIX PILLAR, UH, SIX PILLARS FOR COMMUNITY HEALTH WORKERS THAT HIGHLIGHT HOW WE ARE A UNIQUE WORKFORCE. 
          WE ARE COMMUNITY BASED, WE ARE HISTORIC AND DIVERSE. 
          WE ARE CROSS-SECTIONAL, WE ARE PROVEN AND WE ALSO WORK IN VERY PRECARIOUS PO POSITIONS. 
          AND SO I THINK THAT REALLY IS WHY A LOT OF US AFTER THE PANDEMIC HAVE BECOME A LOT LOUDER, UH, IN, IN OUR WORK IN SAYING LIKE THE, THE HEALTHCARE SYSTEM HAS TO SHIFT. 
          WE'VE BEEN DOING IT WRONG. 
          I THINK THAT THERE'S BEEN A LOT OF, LOT OF FOCUS IN THE PAST 10, 15 YEARS ON SOCIAL DETERMINANTS OF HEALTH, BUT STILL NOT DETER NOT CENTERING THE PATIENTS MOST AFFECTED, THE COMMUNITY'S MOST AFFECTED BY HISTORICAL VIOLENCE AND HAVING THEM LEAD. 
          SO THAT'S WHY TO ME, IT WAS VERY EXCITING WHAT YOU WERE ASKING ABOUT LIVED EXPERIENCE TO ME, BECAUSE THE BEST COMMUNITY HEALTH WORKERS ARE THE ONES THAT HAVE A STORY. 
          THAT'S ALSO WHY I STARTED WITH MY STORY, BECAUSE I REALLY 
          [00:45:01]
FEEL THAT THAT'S REALLY WHAT CONNECTS US AND ANCHORS US AND REMINDS US THAT EVEN THOUGH WE WORK AT INSTITUTIONS ARE ACCOUNTABILITY SHOULD ALWAYS BE TO THE COMMUNITIES WHERE WE LIVE. 
          SO I HAVE A GREAT, AH, IT'S NOT THE RIGHT WAY TO START THAT. 
          , I HAVE, UM, NO, I APPRECIATE YOUR REMARKS AND I BELIEVE IT WAS COMMISSIONER LUJAN THAT THAT RECOMMENDED, UH, FOR YOU TO BE ON THE AGENDA. 
          YEAH. 
          SO I DEFINITELY WANNA TURN THE MIC OVER FOR ANYTHING THAT SHE MAY WANT TO ADD, UH, TO THIS, TO THIS CONVERSATION. 
          BUT I WOULD SAY AS, AS IT RELATES TO THE, THE MISSION AND THE MANDATE THAT WE HAVE AS, AS THIS COMMISSION, RIGHT? AND WE HAVE THREE DIFFERENT WORK GROUPS, BUDGET, INFRASTRUCTURE AND PARTNERSHIPS. 
          AND I, I THINK AS A IDENTIFIED SUBJECT MATTER EXPERT AND SOMEONE THAT CAN HELP ASSIST, UM, AS THE WORK GROUPS ARE FLESHING THROUGH, UH, THIS TOPIC OF COMMUNITY HEALTH WORKERS AND WHAT ARE THE POLICY RECOMMENDATIONS TO THE AGENCIES THROUGH THE COUNTY AND THROUGH THE CITY OF AUSTIN, FROM A INFRASTRUCTURE STANDPOINT, BUDGETING, RIGHT? BUT AGAIN, WHEN YOU'RE DEALING WITH MONEY IS EVEN MORE STRINGENT ON HOW ARE YOU TYING THE DOLLAR TO THE DOUBLE, TRIPLE IMPACT, RIGHT? UM, TO BE ABLE TO HAVE THAT ASSISTANCE AND SUPPORT. 
          AND I THINK, YOU KNOW, WHEN WE GET DONE WITH THIS, THIS MEETING, BE ABLE TO IDENTIFY WHO THE LEADS ARE FOR THOSE WORK GROUPS SO WE CAN START MOVING TOWARDS SOME POLICY RECOMMENDATIONS. 
          AND I THINK YOU'VE HEARD EVEN IN THE PREVIOUS, UM, PRESENTATION, AND YOU CAN PROBABLY GO BACK AND LOOK AT THE ONES WITH A PH MM-HMM. 
           AND SO FORTH. 
          MM-HMM. 
           WHERE A LOT OF THE QUESTIONS ARE WHAT IS THE ROLE AND IS THE ROLE TRUE TO THE INTENDED MISSION? OR IS THE ROLE IN TITLE ONLY? IS THE POSITIONS, AS YOU HEARD, IS IT ONLY JUST PUTTING PEOPLE ON THE STREET OR IS IT PUTTING PEOPLE IN THE CLINICS AND, AND SO FORTH? AND HOW DO WE COME UP WITH RECOMMENDATIONS TO SAY, ARE THEY DOING THESE THINGS THAT IT'S SUPPOSED TO BE INTENDED FOR? AND IS IT ACTUALLY ENHANCING? AND IF WE ARE GETTING IN CONTACT WITH MORE INDIVIDUALS TO GET THEM CONNECTED TO HEALTH, WHAT HAPPENS WHEN WE DON'T HAVE THE APPOINTMENTS AVAILABILITY? SO WE'RE LETTING PEOPLE KNOW, RIGHT? WE START GETTING THE FOOT TRAFFIC. 
          AND IF WE DON'T HAVE THE INFRASTRUCTURE TO SUPPORT, THEN WHAT HAPPENS? WE JUST SOLD 'EM A PROMISE THAT WE CAN'T, WE CAN'T DO. 
          I THINK YOUR, YOUR, YOUR, YOUR ASSISTANCE IN THAT CAN HELP US MAKE SOME REAL TANGIBLE RECOMMENDATIONS, UM, UH, ONE HOPEFULLY THAT THE EX OFFICIALS AND THEIR LEADERSHIP CAN DO THEMSELVES AND OTHERS THAT PROBABLY HAVE TO GO TO THE ELECTED OFFICIALS. 
          UM, WITH THAT BEING SAID, IS THERE ANYTHING THAT YOU WANTED TO ADD? COMMISSIONER LUHAN? UH, THERE IS NOTHING I WOULD LIKE TO ADD. 
          UM, RICARDO PRETTY MUCH SPOKE WHERE WE COME FROM, AS YOU KNOW, I ALWAYS KEEP ON ADVOCATING, I'M A COMMUNITY HEALTH WORKER MYSELF, INSTRUCTOR NOW, AND EVERYTHING THAT VEGA HAS SHARED IS TO THE TI AM A LIVING EXPERIENCE. 
          UM, YOU DO HAVE SOME VALID CONCERNS, I THINK, AND THOSE ARE SOME OF THE THINGS THAT I ADVOCATE MYSELF FOR, THAT YOU CANNOT JUST GRAB SOMEBODY JUST SO WE CAN BUILD THESE COMMUNITY HEALTH WORKERS WITHOUT THE LOVE OR THE PASSION FOR THE COMMUNITY, BECAUSE LIKE I'VE SAID BEFORE IS WE CAN ACTUALLY HURT OUR COMMUNITY, RIGHT? SO THIS IS WHY A LOT OF TIMES I TALK ABOUT TRAUMA INFORMED CARE FOR THE SIMPLE FACT THAT IF YOU'RE FROM THE COMMUNITY, YOU DON'T WANNA HURT THE COMMUNITY. 
          SO YOU DEFINITELY DON'T WANNA, SO I'M GLAD THEY HAVE A SCREENING TEST. 
          UM, BUT THAT'S A VALID CONCERN IN, IN THAT ASPECT. 
          BUT I THINK WE CAN'T POLICE, I DON'T FEEL THAT CHWS SHOULD BE POLICED IN THE SENSE OF WHAT, WHAT THEY NEED TO DO, WHAT THEY NEED TO DO, UH, GO OR WHAT, UM, ON THE PROCESS, I FEEL THAT A CHW GETTING THEIR 160 HOURS TRAININGS IS, IS A VERY SIMPLE PROCESS. 
          YOU GO TO YOUR TRAININGS, YOU SEND IN YOUR INFORMATION, AND YOU GET YOURSELF SORT OF STATE CERTIFIED EVERY TWO YEARS. 
          YOU NEED TO CERTIFY AGAIN. 
          YOU NEED TO BE DOING CONTINUED EDUCATION. 
          YOU HAVE TO COME UP WITH 20, UM, CREDIT UNITS FOR THE NEXT TWO YEARS, WHICH IS ALWAYS HELPING YOU EVOLVE AS A COMMUNITY HEALTH WORKER. 
          UM, SO I DON'T EVEN THINK THAT ASPECT SHOULD BE CHANGED BECAUSE FIRST OF ALL, UM, IT IS GONNA BE SIMPLE FOR ANYONE THAT WHEN WE TALK ABOUT COMMUNITY AND LIVED EXPERIENCES, UH, SOMETIMES HIGHER EDUCATION, AND, AND I KNOW THIS BECAUSE OF ME, I SAY IT ALSO BECAUSE OF ME. 
          IT'S SUCH AN EASY PROCESS THAT YOU WANNA HELP THE COMMUNITY. 
          AND WHEN YOU HAVE 
          [00:50:01]
SO MANY BARRIERS, IF WE'RE GONNA START ADDING POLICIES AND WE'RE GONNA START ADDING, YOU NEED TO DO THIS AND ALL OF THESE CHECK MARKS, THIS IS GONNA ACTUALLY MAKE OUR COMMUNITY HURT. 
          OR, AND THAT'S JUST MY THOUGHT PROCESS ON THAT. 
          UM, ON THE $17 PER HOUR, I'M ALSO WITH COMMISSIONER, UH, POINDEXTER. 
          THAT IS NOT A LIVING WAGE FOR SOMEBODY THAT'S TRAINING REGARDLESS IF THEY'RE GONNA HAVE A SECURE JOB COMING IN. 
          UM, I THINK THAT NEEDS TO BE RE-LOOKED AT BECAUSE THAT IS, AGAIN, TAPPING INTO THE RESOURCE OF THE COMMUNITY. 
          IT'S JUST LIKE TAPPING INTO THE DIAMONDS OF THE COMMUNITY TO BRING IN A BUSINESS, BRING IN DOLLARS, AND THEY ARE GIVING $17 A WEEK. 
          AND THAT IS NOT A LIVING CONDITION. 
          WHEN WE TALK ABOUT SOCIAL DETERMINANTS OF HEALTH, WE ARE ACTUALLY HURTING OUR COMMUNITY AGAIN, WHICH OUR COMMUNITY HEALTH WORKS. 
          AND THAT'S ALL I HAVE TO SAY. 
          BUT THANK YOU FOR COMING, RICARDO, AND I APPRECIATE FOR MAKING IT HAPPEN. 
          JUANITA AND DANNY. 
          THANK YOU. 
          MARTHA. 
          I DO WANNA FOLLOW UP ON SOMETHING YOU SAID, UH, UH, LARRY, BECAUSE I DO FEEL THAT, UM, I THINK TRADITIONALLY THE FOCUS HAS BEEN WORRYING ABOUT, UH, ACCESS, RIGHT? BUT I THINK THAT IF YOU WORK IN, IN THE COMMUNITY, I THINK THERE COULD BE APPROACHES WHERE YOU FOCUS ON PREVENTION. 
          AND A LOT OF COUNTRIES AROUND THE WORLD HAVE ACTUALLY FOCUSED ON THAT. 
          YOU LOOK AT THE MODEL IN CUBA, YOU LOOK AT THE MODEL IN COSTA RICA WHERE THE COMMUNITY HEALTH WORKERS HAVE ACTUALLY BEEN INSTRUMENTAL IN FOCUSING ON PREVENTION. 
          AND THAT WAY THERE'S LESS STRAIN ON ACTUAL AND THE CLINICAL SYSTEM. 
          AND SO I THINK THAT'S ALSO WHAT'S EXCITING IN THIS CHANGE IN PARADIGM, THAT INSTEAD OF HAVING TO FOCUS ON THIS HEAVY ROTATION AT CLINICS, YOU ACTUALLY, IF YOU CENTER CARE IN THE COMMUNITY BY FOLKS AFFECTED THE MOST AFFECTED, HAVE THEM COME UP WITH THE SOLUTIONS THROUGH COMMUNITY HELP WORKERS, YOU CAN ACTUALLY PREVENT THAT, THAT, THAT, THAT TENSION THAT IS THERE. 
          SO I DO WANNA ACKNOWLEDGE THAT THERE, BUT I ALSO WANNA BE ABLE TO PRESCRIBE, YOU KNOW, OFFER SOMETHING AS AN ALTERNATIVE. 
          HAVING FOLKS IN THE COMMUNITY CHECK IN WITH YOU AND ALSO ALONG THOSE LINES AND MEASURING THINGS THAT HAVE NOT BEEN TRADITIONALLY MEASURED. 
          I'M TALKING ABOUT PATIENT, YOU KNOW, UH, PROBLEMS, RIGHT? A PATIENT REPORTED OUTCOME MEASURES. 
          I WOULD LOVE TO HAVE SOMEONE MEASURE TRUST DURING THE PANDEMIC. 
          WHY WAS COMMUNICATION SO HORRIBLE? WHY WEREN'T PEOPLE NOT, NOT WHY WAS, WHY WERE MESSAGES NOT LANDING BECAUSE OF TRUST. 
          AND SO IF YOU FOCUS ON MEASURING THINGS THAT ACTUALLY VAL ARE VALUED IN THE COMMUNITY, YOU ACTUALLY HAVE HAVE IMPROVEMENTS IN THE HEALTHCARE SYSTEM IN GENERAL. 
          SO I, AGAIN, I I, I REALLY WANNA SHIFT THIS THINKING FROM LIKE JUST CLINICAL EXERCISES INTO MORE HUMANISTIC PERCEPTION OF, OF WHAT HEALTH SHOULD BE. 
          AND, AND I THINK THAT'S WHERE THE OPPORTUNITY IS. 
          AND, AND I FEEL LIKE, YES, BUILDING PIPELINE IS AMAZING AND I, I, I APPRECIATE THAT AUSTIN PUBLIC HEALTH HAS THAT PIPELINE. 
          CENTRAL HEALTH HAS THAT PIPELINE AND THAT THERE'S AN, AN ACKNOWLEDGEMENT THAT YOU SHOULDN'T JUST BE TRAINING COMMUNITY HEALTH WORKERS. 
          YOU SHOULD BE GIVING THEM JOBS LIKE NOT JUST, YOU KNOW, ANY JOB, BUT THRIVING WAGES, JOBS, SO THAT YOU CAN BE A COMMUNITY HEALTH WORKER FOR THE REST OF YOUR LIFE. 
          ALONG THOSE LINES, I ALSO FEEL LIKE IT'S, WE SHOULD NEVER BE THE STEPPING STONE TO ANY HEALTHCARE CAREER. 
          I'M GONNA BE A COMMUNITY HEALTH WORKER TILL I DIE, AND I WANNA BE VERY PROUD TO SAY THAT I'M GONNA BE A SENIOR COMMUNITY HEALTH WORKER. 
          MM-HMM. 
           IN THAT FIELD. 
          BUT THAT'S A FIELD IN ITSELF, RIGHT? AND SO A LOT OF TIMES THERE'S OTHER SPECIALTIES THAT CAN FOCUS ON CLINICAL, YOU KNOW, DIMENSIONS. 
          I WANNA BE ABLE TO FOCUS ON SOCIAL AND COMMUNITY DIMENSIONS. 
          THAT'S WHERE MY EXPERTISE IS. 
          AND SO THAT'S ALSO WHY IT'S VERY DIFFICULT TO FIND THE RIGHT COMMUNITY HEALTH WORKERS BECAUSE THESE, THESE ARE FOLKS THAT ARE GONNA BE OUT AT COMMUNITY MEETINGS, WHETHER THEIR JOB DEMANDS IT OR NOT, THEY ARE INVOLVED IN THE COMMUNITY BECAUSE THAT'S WHO THEY, THEY ARE. 
          IT'S HARD TO FIND THEM, BUT I THINK IF THEY CAN BE CHANNELED TO TRAINING PROGRAMS AND PLACEMENT AND HAVE JOBS THAT REALLY MAKE THEM THRIVE, I THINK WE'LL THEN SHIFT THE HEALTHCARE SYSTEM INTO THAT PREVENTATIVE FOCUS. 
          APPRECIATE IT. 
          ANY ADDITIONAL QUESTIONS, COMMENTS, REMARKS? UH, YES. 
          VICE CHAIR AND THEN COMMISSIONER ESER, FIRST OF ALL, THANK YOU SO MUCH FOR BEING HERE. 
          IT'S VERY MUCH AN INSPIRATION TO HEAR YOU TALK AND TO HEAR YOUR BACKGROUND AND KIND OF HEAR YOUR PATH AND YOUR, AND YOUR, UM, INTENT TO BE A, UM, A GERIATRIC COMMUNITY, CHW . 
          YES. 
          UM, I'M LOOKING FORWARD TO YOUR HELP. 
          A, A VINTAGE ONE CALL ME THAT. 
          UM, I WAS JUST GONNA MAKE THE POINT. 
          I'M A PHYSICIAN AND, AND PART OF A HEALTHCARE SYSTEM, AND I WOULD SAY THAT FOR MOST CHRONIC DISEASES, FOR INSTANCE, YOU NEED AN APPOINTMENT WITH A DOCTOR MAYBE OR A NURSE PRACTITIONER OR, OR, OR, OR MANY THINGS IN A CLINIC. 
          THE OTHER 95% OF YOUR CARE IS, IS ABSOLUTELY IN THE REALM OF THE COMMUNITY HEALTH WORKER, I THINK TO HELP IF THEY NEED, UM, A WAY TO GET THEIR MEDS, UH, TRANSPORTATION TO SOME OTHER KIND OF A THERAPY, UM, FOOD, NUTRITION, UM, YOU KNOW, EXERCISE, A WHOLE LINE OF THINGS THAT, 
          [00:55:01]
YOU KNOW, THE COMMUNITY HEALTH WORKER, I KIND OF THINK OF AS THIS IS MAYBE, UM, I MEAN, IT'S LIKE A, A SUPER CONCERNED FAMILY MEMBER WHO'S WELL ORGANIZED AND KNOWS HOW TO MAKE A LIST AND, AND CHECK OFF BOXES, RIGHT? AND SO THAT TO ME IS, IS I, I THINK WHAT YOU'RE SAYING, I JUST WANTED TO REFLECT THAT. 
          SO IT'S, TO ME, IT'S MORE THAT THAN HAVING AN APPOINTMENT TO SEE SOME DOCTOR SOMEPLACE TO GET A PRESCRIPTION THAT'S ONE DAY, ONE HOUR, ABSOLUTELY. 
          THE REST OF THE YEAR HE OR SHE NEEDS THE REST OF THAT PART. 
          AND I'LL GIVE YOU A STORY TOO, BECAUSE DURING THE PANDEMIC, WE HAD A COMMUNITY HEALTH WORKER WORKING AT THE HOSPITAL, UM, AND, AND, AND, AND, AND SHE WAS NAVIGATING WITH FOLKS, UH, ON DISCHARGE. 
          AND ONE OF THE THINGS THAT WE THOUGHT WAS, WAS A BEAUTIFUL INSIGHT IS THAT SHE WAS COMING BACK TO THE DOCTORS AND REPORTING WHAT THE OUTCOMES HAD BEEN AND THE, THE GRATIFICATION THAT DOCTORS HAD IN MAKING THAT THEY, MAKING, MAKING THAT CONNECTION. 
          I THINK A LOT OF TIMES CLINICIANS ARE JUST DOING WHAT THEY'RE DOING AT A CLINIC, AND THEN TWO MONTHS LATER, THE SAME PATIENT COMES BACK AND THEY'RE ACTUALLY IN A WOR WORSE PLACE THAT'S HARMFUL FOR SOMEONE ON A, ON A, ON A, AN INTRINSIC LEVEL, RIGHT? THAT, THAT, THAT, THAT IDEA THAT YOU'RE, LIKE, YOU, YOU'RE JUST, YOU'RE JUST THROWN THROUGH THE MOTIONS, BUT YOU DIDN'T BECOME A DOCTOR TO DO THAT. 
          YOU CAN BE A DOCTOR, TO TREAT PEOPLE, TO MAKE THEM FEEL BETTER. 
          AND I THINK SO MANY IN THE CLINICAL FIELD ARE JUST DOING THAT, WHERE THEY'RE, THEY'RE WORKING THIS ROTATING DOOR AND YOU'RE, WE'RE WASTING MONEY. 
          WE'RE WASTING PATIENTS' TIME, AND WE'RE NOT FEELING LIKE WE'RE MAKING A DIFFERENCE. 
          AND SO HAVING A COMMUNITY HEALTH WORKER COME IN AND COME BACK AND SAY, YOU KNOW WHAT? THAT PERSON YOU TREATED TWO MONTHS AGO, THEY DID THIS, AND I GOT THEM FOOD AND I GOT THEM A VOUCHER FOR, FOR TRANSPORTATION. 
          AND NOW THEY'RE ACTUALLY THRIVING AND NOW THEY'RE LESS STRESSED. 
          AND YOU KNOW WHAT? THEIR KIDS ARE HAPPIER. 
          'CAUSE WE GOT THEM A, A CONNECTION AT THE LIBRARY. 
          ALL THOSE THINGS THAT DON'T, THAT WE RIGHT NOW DON'T CLASSIFY AS HEALTH. 
          I WANNA PUSH BACK ON THAT. 
          ALL THOSE THINGS ARE HEALTH. 
          AND THAT'S WHY I JUST FEEL IT'S LUDICROUS THAT WE ARE NOT SPENDING TIME ON PEOPLE THAT ARE ACTUAL CHANGE MAKERS. 
          NOT THE DISCOUNT, THE EXPERTISE AND THE INVESTMENT THAT CLINICIANS HAVE MADE. 
          BUT WE HAVE TO THINK OF HEALTH IN MUCH BROADER TERMS. AND IF WE CONTINUE JUST, AGAIN, LOOKING AT PEOPLE JUST FOR A HEALTH CONDITION, WE'RE MISSING THE POINT OF WHAT HEALTH MEANS. 
          THIS, IT FALLS, UH, DIRECTLY INTO MY QUESTION. 
          SO THANK YOU FOR TAKING US THERE. 
          YEAH. 
          I DON'T WANNA ADD TO THE OFFICE OF EQUITY, UM, OR THE CITY OF AUSTIN'S EQUITY OFFICE. 
          UHHUH, , UM, WORKLOAD. 
          BUT IS THERE ANY CAPACITY TO DO A QUALITATIVE RESEARCH STUDY ON, I'M GONNA NERD OUT FOR A SECOND, BUT I FEEL LIKE WE CAN GO THERE. 
          'CAUSE I THINK YOU KNOW WHERE I'M GOING. 
          UM, THE THINGS YOU WERE MENTIONING, RIGHT, OF THESE ALLOSTATIC STRESSORS, THIS ALLOSTATIC LOAD THAT IS BEING ADDED TO PATIENTS WHO ARE NOT ACTUALLY RECEIVING FULL CARE BY JUST GOING TO A CLINIC. 
          UM, THE AMOUNT THAT, THE AMOUNT OF STRESS THAT CAN ADD TO SOMEBODY'S LIFE FROM NOT HAVING ACCESS TO CHILDCARE NOW HAS INCREASED. 
          SOME BLOOD PRESSURE HAS INCREASED, SOME ANXIETY HAS INCREASED X, Y, Z. 
          AND AFTER YOU'VE STACKED AND STACKED AND STACKED AND STACKED, THEN NOW WE HAVE CHRONIC ILLNESSES THAT HAVE DEVELOPED BECAUSE OF STRESS. 
          SO THINKING ABOUT THIS, AND I'M SURE MY PROFESSORS WOULD LAUGH AT ME, BUT FROM ACTIVATING SOME SORT OF EVIDENCE-BASED MODEL, LIKE A HEALTH BEHAVIOR MODEL OF WHAT HAPPENS WHEN A CHW ACTUALLY GETS ACCESS TO SOMEONE WHO HAS BEEN DISCHARGED, GETS THEM THE APPROPRIATE, UH, LITERACY THAT THEY NEED, GETS THEM ACCESS TO THE PHARMACEUTICALS OR SUPPORTIVE SERVICES MM-HMM. 
           THAT THEY NEED FROM A QUALITATIVE PERSPECTIVE, IS THAT A CAPACITY THAT THE EQUITY OFFICE HAS THE ABILITY TO DO? WHETHER IT'S, IT'S, IT'S A PEOPLE CAPACITY, IT'S A FUNDING CAPACITY, IT'S A, YOU'VE ALREADY DONE IT AND WE JUST DON'T KNOW THAT IT EXISTS. 
          WELL, THAT'S A BEAUTIFUL QUESTION BECAUSE I, I I, COMING FROM THE MEDICAL, THE DELL MEDICAL SCHOOL, THERE WAS A LOT OF INTERESTING RESEARCH HAPPENING THERE. 
          AND SO I, I, I THINK ONE OF THE, THE, THE PROJECTS THAT I WORKED ON THAT KIND OF STARTED DEALING WITH THAT WAS THE HOUSEHOLD LEVEL ASSESSMENT. 
          FOR A COUPLE YEARS, I WAS GOING INTO PEOPLE'S HOMES IN THE BERG AREA AND ASKING THEM ABOUT THEIR SOCIAL NEEDS. 
          AND THIS WAS MORE OF A CONVERSATION THAN JUST A CHECKBOX. 
          YOU KNOW, LIKE WE PRACTICED A LOT TO MAKE SURE THAT I WASN'T JUST LOOKING AT A TABLET, BUT IT WAS LIKE A VERY, AND, AND, AND, AND SO THAT WAS A BEAUTIFUL COLLECTION OF, OF, OF, OF DATA. 
          THE IDEA WAS TO BE ABLE TO PROVIDE THAT DATA TO A LOCAL CLINIC TO SAY, THESE ARE ALL THE, THE THINGS THAT MAYBE YOU SHOULD INCLUDE IN A MEDICAL RECORD AS, AS, AS, AS, AS CONTEXT FOR THAT PARTICULAR PERSON. 
          UH, THAT GRANT, UH, THAT THAT PROJECT DID NOT RECEIVE, UM, MORE FUNDING FOR THAT. 
          BUT I THOUGHT THAT WAS A BEAUTIFUL EXERCISE IN THAT, UM, IN THE SENSE THAT IT ALSO HUMANIZED THE, THE WORK. 
          UM, ALL THOSE FOLKS STILL REMAIN IN TOUCH WITH ME. 
          WHEN THE WINTER STORM HAPPENED, THEY WERE TEXTING 
          [01:00:01]
ME, THEY WERE LIKE, WHAT DID I DO? YOU KNOW? 'CAUSE THESE ARE CONNECTIONS THAT I HAD PAST THE PROJECT. 
          AND SO, UM, I, I DON'T WANNA COMMIT THE EQUITY OFFICE TO, TO, TO, TO THIS, BUT I DO FEEL THAT WHAT WE ARE TRYING TO DO A LOT, UH, IS TO BE ABLE TO LOOK AT THE SYSTEMS AND HOW THESE SYSTEMS ARE ACTUALLY CENTERING PEOPLE. 
          AND I FEEL THAT WE ALSO ARE VERY INTENTIONAL ABOUT RACE EQUITY AND SAYING LIKE, HOW ARE, HOW IS WORK ACTUALLY INCORPORATING RACE EQUITY INTO, INTO THINGS? BECAUSE THAT'S WHEN YOU ALSO LEARN INTO, YOU KNOW, LEANING INTO THE HISTORY, RIGHT. 
          AND THAT THE EPI EPIGENETICS, RIGHT. 
          AND, AND KNOWING THAT, THAT THERE'S COMMUNITIES THAT HAVE BEEN UNDER STRESS FOR MUCH LONGER THAN OTHERS. 
          AND, AND THAT'S BEEN VERY INTENTIONAL. 
          AND SO I THINK BEING ABLE TO UNDERSTAND THOSE HISTORIES AND WORK OFF OF THAT IS REALLY, REALLY IMPORTANT. 
          UM, I WOULD HAVE TO CONSULT WITH THE REST OF MY OFFICE. 
          I MEAN, WE'RE AN OFFICE OF 10 PEOPLE. 
          I'VE JUST BEEN THERE FOR A YEAR TOO, SO I, I DON'T FEEL COMFORTABLE SAYING THE EQUITY OFFICE CAN DO THIS OR THAT. 
          I'M, ONE OF THE PROJECTS THAT I'M WORKING ON RIGHT NOW IS THE EQUITY ASSESSMENT WHERE WE GO TO DIFFERENT DEPARTMENTS ACROSS THE CITY AND DO AN EQUITY ASSESSMENT TO SEE HOW THEY ARE OUR OPERATING OR OPERATIONALIZING SOME OF THESE THINGS. 
          UM, BUT I DO FEEL THAT THAT WOULD BE A VERY INTERESTING OPPORTUNITY TO BE ABLE TO, I MEAN, THE OTHER THING THAT I FEEL IS INTERESTING IN AUSTIN IS THAT THE UNIVERSITY OF TEXAS IS RIGHT THERE. 
          AND I THINK IDEAS LIKE THIS TO BE ABLE TO SAY, CAN WE, CAN WE DO THIS RESEARCH? BUT I WOULD REALLY ADVOCATE TO HAVE COMMUNITY HEALTH WORKERS BE AT THE CENTER OF THE DESIGN IMPLEMENTATION AND EVALUATION OF THAT RESEARCH. 
          UH, BECAUSE I THINK A LOT OF TIMES THAT'S NOT REALLY HOW IT HAPPENS. 
          UM, BEYOND THAT, I WOULD REALLY WANT TO MAKE SURE THAT, UM, IF IF STUDIES LIKE THAT HAPPEN THAT THEY ARE INVESTED LONG TERM. 
          BECAUSE A LOT OF TIMES COMMUNITIES ARE SICK AND TIRED OF GETTING STUDIED ON AND, AND, AND SO IF THERE'S NOT A COMPONENT OF STUDYING THAT TO MAKE SURE THAT THERE'S A COMMITMENT TO FUNDING CHANGE, THEN I WOULD ALSO SAY THAT THAT IS REALLY IMPORTANT. 
          I TOO, LIKE REALLY INTERESTING RESEARCH AND I LIKE TO GET EXCITED WITH HOW THINGS COULD BE, BUT IF THERE'S NOT A COMMITMENT TOWARDS THAT CHANGE, I THINK IT ALSO CAN BE REALLY HARMFUL IN THE COMMUNITY. 
          UM, SO REAL QUICK, YEAH. 
          BECAUSE I KNOW WE'RE GETTING, UH, GETTING TO THE POINT OF FOR, FOR SAKE OF TIME. 
          NO, NO, YOU'RE GOOD. 
          YOU'RE GOOD. 
          UM, TWO THINGS. 
          I THINK ONE THING HIGHLIGHTED WHEN IT CAME TO A COST BENEFIT IMPACT STANDPOINT, UH, WHICH WAS, WHICH I DON'T, I DON'T KNOW IF IT'S BEING EVALUATED OR ASSESSED RIGHT NOW. 
          SO I THINK WHAT IS THE VIABILITY WHEN YOU'RE TALKING ABOUT AS, AS STATED, THE MESSAGING THAT'S COMING BACK. 
          UH, DO CHWS GET A DIFFERENT LEVEL OF INFORMATION ABOUT A PATIENT THAN THE FRONT DESK AND, AND WHOEVER ELSE IS ENGAGING WITH THEM. 
          AND WHEN THAT INFORMATION IS GATHERED AND IS PROVIDED BACK TO THAT CLINICAL TEAM, IS THAT CREATING GREATER COMMITMENT, BUY-IN REDUCING STRESS AND BURNOUT AND SO FORTH BY HAVING THAT MORE HOLISTIC IMPACT OF THE CLINICAL SERVICES TIED TO THE SOCIAL DETERMINANT OF HEALTH SUPPORT. 
          RIGHT. 
          AND SO, I MEAN, THAT MAY BE ANOTHER COMPONENT TO BE ABLE TO LOOK AT WHEN YOU'RE TALKING ABOUT THE MONEY THAT'S GOING OUT. 
          WHAT ARE ALL THE ACTUAL IMPACTS THAT ARE HAPPENING? AND IS THE CHWS NOT JUST HELPING THAT PATIENT, BUT WITH HOW THEY'RE HELPING THE PATIENT, THE OUTCOMES THAT ARE HAPPENING WITH THAT PATIENT AND THE SERVICES THEY RECEIVE FROM THE CLINICAL SECTOR BY PROVIDING THAT INFORMATION BACK TO THAT CLINICAL TEAM. 
          IS IT REVITALIZING? MM-HMM. 
           THEM. 
          AND SO YOU'RE HOPEFULLY GETTING MORE AND GREATER PRODUCTIVITY EVEN FROM THE CLINICAL TEAM. 
          RIGHT? UM, SO THAT, THAT'S THE ONE ASPECT, UH, THERE THAT, THAT I WAS, THAT I WAS THINKING OF THAT WE CAN SEE IF THAT'S SOMETHING OF INTEREST TO KIND OF REALLY DOVETAIL A LITTLE BIT MORE, UH, INTO ANY ADDITIONAL QUESTIONS OR REMARKS, UH, FROM THE COMMISSION. 
          UH, I HAD A QUICK REMARK, UM, SINCE YOU MENTIONED PREVENTION, AND I ACTUALLY, I REALLY APPRECIATE IT. 
          YOU MENTIONED COSTA RICA, SINCE I'M FROM COSTA RICA, AND, UM, THE COMMUNITY HEALTHCARE WORKER SYSTEM THERE IS REALLY ESTABLISHED MM-HMM. 
          . 
          UH, WE HAVE, FOR EXAMPLE, MONTHLY CALLS FOR FOLKS OVER 65 HOUSE VISITS, DISCUSSIONS AROUND NUTRITION, REMINDING THEM ABOUT, UH, KIND OF EARLY SCREENING. 
          UH, AND JUST RECENTLY MY DAD, FOR EXAMPLE, GOT IDENTIFIED WITH A VERY EARLY TUMOR JUST BECAUSE OF THIS, UH, WHOLE SYSTEM THAT WE HAVE. 
          SO KIND OF CURIOUS ABOUT WHAT YOU THINK AROUND, WHEN WE THINK ABOUT PREVENTION, WHAT ARE THE RESOURCES AVAILABLE? WHAT IS THE TRAINING AVAILABLE THERE? AND THEN HOW, UM, IS THERE KIND OF A STRONGER FOCUS AROUND HAVING THE COMMUNITY HEALTHCARE WORKER IN THE CLINIC OR MORE IN THE FIELD? AND THEN, UH, I ALSO LIKE WHAT YOU MENTIONED ABOUT 
          [01:05:01]
UT AND THINKING A LITTLE BIT ABOUT HOW TO USE THOSE RESOURCES MORE SINCE IT IS IN THE CITY. 
          UH, PREVIOUSLY I WAS AT, IN PHILADELPHIA, AND THEN THE UNIVERSITY OF PENNSYLVANIA THERE WITH , UH, KIND OF, UH, HAS A VERY STRONG CLINIC WITH PROMOT AND A LOT OF STUDIES THERE THAT I THINK KIND OF PROVIDE SOME OF THE DATA THAT YOU'RE MENTIONING HERE. 
          SO KIND OF CURIOUS IF THERE'S A WAY FOR US AS A COMM MISSION TO KIND OF PROMPT SOME OF THAT DISCUSSION AND, UH, HELP THAT MOVE ALONG TOO. 
          YEAH. 
          THANK YOU SO MUCH FOR THAT. 
          UM, I, I FEEL LIKE, AND AGAIN, AS A COMMUNITY ORGANIZER, I ALWAYS FEEL THAT THE, THE, THE OPPORTUNITIES ARE OUT IN THE COMMUNITY. 
          SO, UH, SHE CAN MENTION THE, THE, THE, THE, THERE, THERE'S TWO CONVENINGS RIGHT NOW FOR COMMUNITY HEALTH WORKERS. 
          THERE'S AUSTIN PUBLIC HEALTH, CONVENES ONE THROUGH THE HUB, AND THEN I, I GET TO, YOU KNOW, HOST A, A SOCIAL EVERY MONTH WHERE WE HAVE SOCIAL SERVICE PROVIDERS, FOLKS FROM INTEGRAL CARE FOUNDATION COMMITTEES, ALL THESE DIFFERENT AGENCIES TO LEARN REALLY HOW IT IS THAT, THAT WE CAN WORK TOGETHER. 
          AND SO I THINK THAT THAT'S A LOT TOO, WHERE WE ARE LEARNING ORGANICALLY HOW TO PREVENT SOME OF THESE ISSUES FROM, FROM, FROM FROM HAPPENING. 
          I THINK HAVING COMMUNITY HEALTH WORKERS, WORKERS CON FOCUS INTENTIONALLY ON CONTINUOUS EDUCATION, CONTINUOUS COMMUNITY EDUCATION, WHERE YOU'RE, YOU'RE LEARNING WHAT RESOURCES ARE OUT THERE, WHAT IT TAKES, WHAT THE CRITERIA IS, WHAT HOURS OF OPERATION ARE, WHAT THE EXCLUSIONS ARE, IS REALLY, REALLY IMPORTANT. 
          UM, I, I I THINK THAT, THAT, THAT'S, THAT'S, UM, THAT'S A HUGE CHALLENGE. 
          I I, I, I THINK THE, THE BIGGEST CHALLENGE WHEN IT COMES TO ANY HEALTHCARE SYSTEM IS HOW DO YOU FUND THESE POSITIONS THAT A LOT OF TIMES ARE SEEN AS NONCLINICAL WHEN TRADITIONALLY THE US HAS DONE REIMBURSEMENT MODELS AROUND CLINICAL INTERVENTIONS. 
          RIGHT. 
          BUT I DO FEEL THAT THERE ARE WAYS WHERE WE CAN THINK ABOUT DIFFERENT, UH, FEDERAL FUNDING AND, AND, AND, AND, AND, AND MAYBE POT, AND MAYBE PUT IT IN ONE POT TO SAY, THIS IS, THESE ARE, THIS IS A GROUP THAT'S GONNA BE WORKING ON A HOLISTIC LEVEL INSTEAD OF SILOING IT AND SAYING, WELL, TRANSPORTATION OR FOOD AND WHATEVER THEY, THEY, THEY HAVE THEIR SEPARATE STREAMS. HOW WHY NOT HAVE A CENTRAL POOL THAT'S GONNA FUND A CENTRAL TEAM THAT'S GONNA FOCUS ON HEALTH LIKE THAT? AND SO I OFFER THAT AS AN IDEA THAT MIGHT BE VERY RADICAL IN THE SENSE OF LIKE, THIS, THIS IS HEALTHCARE RE REIMAGINED. 
          RIGHT. 
          GO AHEAD, VICE CHAIR. 
          I'LL DO ONE MORE MAYBE QUESTION. 
          AND AGAIN, REALLY THANK YOU. 
          AND MAYBE WE WOULD LOOK FORWARD TO A FOLLOW UP CONVERSATION. 
          SURE. 
          IT'S A LITTLE BIT LOADED QUESTION, SO TAKE IT FOR THAT. 
          SURE. 
          IF ALL OTHER THINGS BEING EQUAL, WHICH IS, AGAIN, NOT THE WORLD, BUT ALL OTHER THINGS BEING EQUAL, DOES A COMMUNITY WORKER, HEALTH WORKER, CHW WHO SPENDS A DAY IN THE COMMUNITY, IS THAT A MORE EFFECTIVE THING FOR COMMUNITY HEALTH WORKER DUKE VERSUS A CLINIC? OOH, THAT'S A REALLY GOOD QUESTION. 
          UH, BECAUSE I, I, WHILE I APPRECIATE HAVING COMMUNITY HEALTH WORKERS, UM, IN THE CLINIC OR IN INSIDE A SYSTEM, I ALWAYS ADVOCATE FOR MAKING SURE THAT, THAT THEY HAVE SOME TIME IN THE COMMUNITY TO MAKE SURE THAT THEY ARE ACTUALLY PAYING ATTENTION TO WHAT'S HAPPENING AT THE COMMUNITY LEVEL. 
          A LOT OF TIMES SOME OF THE VALUES THAT WE HAVE IS THAT WE ARE NOT ONLY EDUCATING PATIENTS, BUT WE'RE ALSO EDUCATING CLINICIANS. 
          RIGHT. 
          THE FOLLOW UP THERE, MAYBE NOT TO YOU, IS TO ASK, AND WE'RE NOT TO ANSWER IT NOW, IS AMONG THE COMMUNITY HEALTH WORKERS THAT ARE EMPLOYED BY AUSTIN PUBLIC HEALTH OR, OR CENTRAL HEALTH, WHAT PORTION OF THEM SPEND HALF OF THEIR TIME IN THE COMMUNITY? AND I THINK THOSE ARE POINTS OF INFORMATION THAT, UH, WE'LL, WE'LL, WE'LL TALK ABOUT WHEN WE GET TO THE, THE WORKING GROUPS, BECAUSE I KNOW THERE'S BEEN SOME ASKS OF INFORMATION, BUT I THINK WE JUST NEED TO REHASH THAT, UH, AND GIVE SOME GREATER CLARITY TO THE AGENCIES ON SOME OF THE POINTS OF INFORMATION WE NEED TO REALLY GET INTO POLICY DISCUSSIONS. 
          OKAY. 
          UM, LAST THING I'LL SAY, AND THEN I APPRECIATE YOUR TIME, UH, IS THE TEXAS CENTER FOR EQUITY PROMOTION OVER AT UT IS A CONSOLIDATION. 
          THEY'RE CREATING A PILOT. 
          THEY'VE ALREADY SELECTED ABOUT FIVE OR SIX AGENCIES OR ORGANIZATIONS. 
          IF THERE'S OF INTEREST, I CAN CONNECT YOU. 
          UM, AND IT'S TO CONNECT COMMUNITY ORGANIZATIONS INTERESTED IN GETTING CONNECTED WITH RESEARCH, UH, CONNECTED TO FACULTY MEMBERS THAT HAVE AN ALIGNING INTEREST, BUT TRYING TO MAKE SURE FACULTY RESEARCH IS MORE COMMUNITY FOCUSED AND OUTCOMES AND IMPACT. 
          YEAH. 
          AND SO WHEN WE'RE TALKING ABOUT, I'VE HEARD IT MULTIPLE TIMES ABOUT, UH, RESEARCH AROUND THE IMPACT OF COMMUNITY HEALTH WORKERS AND SOME OF THESE MORE NUANCED ASPECTS. 
          UM, I, I'M, I'M SURE WITH, WITH AN NAS, THEY WOULDN'T HAVE AN ISSUE OF ADDING THAT JUST NEED ORGANIZATION TO, TO BE THAT REPRESENTATIVE FOR IT. 
          SO, YEAH. 
          AND, AND I WOULD WANNA STRESS, AGAIN, THE IMPORTANCE OF, OF HAVING OUTCOMES AND MEASUREMENTS EVALUATED BY THE COMMUNITY. 
          I THINK A LOT OF TIMES, UH, THINGS ARE MEASURED BY THE INSTITUTIONS, AND I DON'T, I THINK WE'RE 
          [01:10:01]
MISSING A BIG POINT IN HAVING THE COMMUNITY EVALUATE THE WORK AND, AND, AND, AND, AND OUR PERFORMANCE AS COMMUNITY HEALTH WORKERS AS WELL. 
          AND SO I THINK BEING ABLE TO REALLY SHIFT AND SAYING, ARE THERE, THERE, YOU KNOW, PATIENT REPORTED OUTCOME MEASURES, UH, THAT ARE NOT ONLY QUANTITATIVE, BUT QUALITATIVE. 
          AND I REALLY GO DEEP ON, ON QUALITATIVE BECAUSE I FEEL LIKE STORIES ARE THE UNTAPPED RESOURCE IN ANY SYSTEM IN THE US THAT I THINK IF WE WERE LISTENING TO EACH OTHER A LOT MORE, WE WOULD UNDERSTAND THAT WE'RE MUCH RICHER THAN MM-HMM. 
           THAT WE'VE BEEN TELLING OURSELVES. 
          AND THERE'S A LOT MORE OPPORTUNITIES ABSOLUTELY. 
          IN GATHERING THOSE STORIES. 
          NO, APPRECIATE IT. 
          THANK YOU. 
          THANK YOU FOR YOUR TIME. 
          YOU'RE WELCOME. 
          THANK FOR HAVING, OH, GO AHEAD. 
          I'M SORRY. 
          BEFORE WE LOSE YOU, RICARDO, REAL QUICK, UM, ARE YOU AWARE OF ANY POLICIES THAT ARE DIRECTLY AFFECTING THE EXPANSION, THE IMPLEMENTATION AND EXECUTION OF THE WORK CHWS ARE DOING THAT ARE IN EXISTENCE RIGHT NOW AT THE TEXAS LEVEL? I THINK IT WAS A POSITIVE STEP THAT THERE WAS SOME REIMBURSEMENT, UH, YOU KNOW, MOVEMENT FORWARD AROUND MATERNAL HEALTH. 
          I THINK THAT THAT REALLY IS SETTING PRECEDENT TO SAYING, OKAY, LET'S PAY ATTENTION TO THAT AND HOW CAN WE EXPAND THAT AND INCORPORATE SOME OF THAT, UH, SOME OF THAT REIMBURSEMENT FRAMEWORK FOR OTHER THINGS. 
          UH, BUT I DO FEEL THAT THAT'S SOMETHING THAT, THAT, THAT, THAT WE CAN ALL BE PAYING ATTENTION TO, TO SAYING. 
          I THINK ALSO CALIFORNIA AT A NATIONAL LEVEL HAS SOME REALLY ROBUST SUPPORT UNDER MEDI-CAL FOR COMMUNITY HEALTH WORKERS. 
          MM-HMM. 
           THAT I THINK WOULD BE ASPIRATIONAL. 
          BUT I THINK AS WE'RE TALKING ABOUT THESE, THESE ISSUES, I THINK WE'RE ALSO, I MEAN, I'M ALWAYS IN THE ROLE OF LIKE CRITIQUING, BUT ALSO PROPOSING SOMETHING TO SAY, OKAY, THIS IS NOT WORKING. 
          WHAT ELSE COULD WE DO? AND I THINK THAT LOOKING AT THE MEDICAL MODEL IN CALIFORNIA FOR, FOR REIMBURSMENT FOR COMMUNITY HEALTH WORKERS WOULD BE SOMETHING AGAIN, ASPIRATIONAL. 
          THANK YOU. 
          APPRECIATE IT. 
          THANK YOU. 
          THANKS Y'ALL. 
          UM, I'M GONNA TAKE A COUPLE THINGS 
          [6. Update from Infrastructure & Access work group by Commissioner Natalie Poindexter on recommendation drafting progress.]
OUTTA ORDER. 
          UH, LET'S GO TO WORKING GROUPS AND COMMITTEE UPDATES. 
          UPDATE FOR THE INFRASTRUCTURE AND ACCESS WORK GROUP BY COMMISSIONER POINDEXTER ON A RECOMMEND RECOMMENDATION DRAFTING PRO PROGRESS. 
          YEAH. 
          SO, UH, WE WERE ABLE TO MEET LAST MONTH MYSELF, UH, DR. 
          W AND DR. RICE. 
          UM, WE ARE GOING TO BE PUTTING TOGETHER TWO RECOMMENDATIONS. 
          ONE IS GOING TO BE FOR THE FOOD POLICY BOARD, UM, TO ADD AND NOT ONLY SAY LIKE WHAT THEY'RE DOING IS REALLY WONDERFUL, BUT ALSO ADDING IN SOME OF THOSE INFRASTRUCTURE RECOMMENDATIONS AROUND FOOD ACCESS AND FOOD INSECURITIES. 
          UM, LOOKING AT THE RECOMMENDATION ALSO AROUND MULTI-YEAR FUNDING, COMMUNITY PARTNERSHIP ACTIVATIONS AND COMMUNITY CAMPAIGNS AS WELL AS, UH, FOOD REDISTRIBUTION. 
          MM-HMM. 
          SO THAT WAS DEFINITELY SOMETHING THAT WAS MENTIONED DURING OUR FOOD PLAN CONVERSATION, THAT THERE ARE OVER A MILLION POUNDS OF FOOD MM-HMM. 
           LEFT TO WASTE HERE IN AUSTIN, TRAVIS COUNTY. 
          UM, AND SO OUR RECOMMENDATION WILL BE TO THE PO FOOD POLICY BOARD. 
          MM-HMM. 
          . 
          SO WE'LL MAKE IT FOR THE COMMISSION FIRST TO REVIEW AND THEN GO TO SUPPORT THE FOOD POLICY BOARD'S WORK THAT'S ALREADY HAPPENING. 
          AND THEN OUR SECOND RECOMMENDATION WILL TIE IN A LOT OF THE CONVERSATION THAT WE'VE HAD TODAY AROUND COMMUNITY HEALTH WORKERS, WHICH I THINK AFTER THIS CONVERSATION, WE NEED TO MEET A COUPLE MORE TIMES, UM, ON HOW WE CAN, UH, PUT TOGETHER A PUBLIC HEALTH, HEALTH, UH, COMMUNITY HEALTH WORKER EQUITY RECOMMENDATION. 
          UM, LOOKING AT NOT ONLY THE QUALITY OF LICENSE, SOCIAL DETERMINANTS OF HEALTH OF OUR COMMUNITY HEALTH WORKERS, BUT ALSO WHAT THAT LOOKS LIKE FROM A SCALABILITY SUSTAINABILITY. 
          UM, AND THEN HOW DO WE IMPLEMENT AND EXECUTE THAT. 
          SO THAT WOULD BE SOMETHING THAT WOULD COME FROM OUR, UH, OUR ACTUAL COMMISSION TO GO TO WHATEVER NEXT LEVEL IS THERE. 
          OKAY. 
          OKAY. 
          ANY, UH, COMMENTS, REMARKS, OR QUESTIONS REGARDING THE REPORT? THERE BEING NONE? UH, UPDATE FROM THE ADVOCACY 
          [7. Update from Advocacy & Partnership work group by Commissioner Enrique Lin Shiao focusing on Community Health Worker’s.]
AND PARTNERSHIP WORK GROUP BY COMMISSIONER CHAO FOCUSING ON COMMUNITY HEALTH WORKERS. 
          YEAH. 
          SO, UH, WE WERE ALSO ABLE TO MEET LAST MONTH. 
          UH, INITIALLY WE HAD THOUGHT ABOUT A FOCUS AROUND HOUSING, BUT GIVEN, UM, KIND OF THE PRESENT MOMENT AND OUR CURRENT DISCUSSIONS, WE WANTED TO FOCUS ON COMMUNITY HEALTHCARE WORKERS. 
          NOW, UH, TO PROVIDE A LITTLE BIT OF CONTEXT, WE HAD, UH, COMMISSIONER, UH, LUHAN PROVIDE SOME KEY BACKGROUND. 
          UH, ONE OF THE THINGS THAT WE HEARD WAS, IT SEEMS LIKE AUSTIN PUBLIC HEALTH MIGHT BE LETTING GO OF YOU COMMUNITY HEALTHCARE WORKERS IN DECEMBER, UH, ESPECIALLY BECAUSE A LOT OF THEIR SALARIES ARE COVERED BY GRANTS. 
          SO THERE WAS A CONCERN THERE ABOUT HOW DO WE HAVE A MORE SUSTAINABLE WAY OF FUNDING COMMUNITY HEALTHCARE WORKERS, UH, THAT WE ALSO HEARD A LITTLE BIT AROUND HOW THE RURAL COMMUNITY HEALTHCARE WORKERS DURING COVID AND HOW THEY PLAYED A KEY ROLE THERE, UH, AND HOW THEN THERE WAS AN INCREASE OF THEM. 
          AND NOW THAT KIND OF, THAT, UH, IN HEALTHCARE EMERGENCY HAS PASSED, THERE'S A LOSS OF INTEREST, UH, IN SOME OF THOSE POSITIONS. 
          SO, UM, ONE OF THE THINGS THAT WE WANTED TO KIND OF FOLLOW UP ON HERE WITH THE BROADER COMMISSION IS 
          [01:15:01]
WE HAD A COUPLE REQUESTS. 
          ONE OF THEM WAS TO THE BUDGET GROUP TO COLLECT INFORMATION ON, UH, MAYBE WHAT HAPPENED WITH THE A PH BUDGET FOR THE COMMUNITY HEALTHCARE WORKERS THIS YEAR. 
          UH, COLLECT SALARY INFORMATION ACROSS ORGANIZATIONS AND BENCHMARK, UM, TO ALSO UNDERSTAND THE BUDGET OF CENTRAL HEALTH AND OTHERS AROUND COMMUNITY HEALTHCARE WORKERS. 
          AND THEN OUR REQUESTED INFRASTRUCTURE GROUP WAS MORE ON TRYING TO UNDERSTAND GEOGRAPHICALLY WHERE COMMUNITY HEALTHCARE WORKERS ARE LOCATED WITHIN AUSTIN AND TRAVIS COUNTY. 
          AND THEN, UH, ANY BARRIERS, UH, THAT YOU MIGHT SEE IN TERMS OF ACCESS. 
          UH, FROM OUR ADVOCACY, UH, PARTNERSHIP GROUP, WHAT WE'RE THINKING WAS, UH, TO ATTEND A COMMUNITY HEALTHCARE WORKER MONTHLY MEETING AND GATHER, UH, COMMUNITY CONCERNS AND INFORMATION DIRECTLY FROM BOTH COMMUNITY HEALTHCARE WORKERS AS WELL AS THE COMMUNITY. 
          AND THEN CONSIDER ORGANIZING AN ADDITIONAL COMMUNITY EVENT, UH, TO REALLY GET FEEDBACK FROM THE COMMUNITY THAT WE COULD THEN PROVIDE TO THE BROADER, UH, FOUNDATION AS WELL. 
          AND THEN I THINK WE'RE ALSO WAITING ON OUR ROBERT WOOD JOHNSON STUDY ON COMMUNITY HEALTHCARE WORKERS, UH, IN AUSTIN THAT COULD PROVIDE SOME ADDITIONAL DATA, UH, FOR US. 
          UH, OVERALL, I THINK WE ALSO WANTED TO START THINKING A LITTLE BIT ABOUT IF WE WERE TO PUT TOGETHER A RECOMMENDATION, WHAT SHOULD THOSE WHEREAS CLAUSE LOOK LIKE, UM, AND WHAT SHOULD THE RECOMMENDATION OVERALL BE? UH, BUT I THINK, UH, WE SHOULD DEFINITELY COMMUNICATE ACROSS GROUPS AS WE THINK ABOUT THAT. 
          UM, MARTA, UH, COMMISSIONER LUHAN, DID YOU WANNA ADD ANYTHING ADDITIONAL OR, UH, ANYONE ELSE WHO CAME TO THE MEETING? ANY ADDITIONAL QUESTIONS, COMMENTS, REMARKS REGARDING THAT? THAT REPORT? I JUST WANNA ADD, UM, COMMISSIONER THAT, UH, WE PASSED OUT THE SALARIES FOR AUSTIN PUBLIC HEALTH. 
          SO THE, THAT SPREADSHEET THAT DANNY PASSED OUT REPRESENTS THE NUMBER OF COMMUNITY HEALTH OR HEALTH WORKERS WE HAVE ON STAFF BY LEVEL AND WHAT THEIR SALARIES ARE PER HOUR. 
          SO YOU CAN SEE WHAT THE RANGE IS AND I'LL MAKE SURE I GET TO THAT, TO THE REST OF THE COMMISSIONERS, UM, IN THE VIRTUAL SPACE AS WELL. 
          APPRECIATE IT. 
          SURE. 
          YES. 
          COMMISSIONER, YOU MENTIONED YOU HAD SOME QUESTIONS FOR THE BUDGET WORK GROUP. 
          UM, DO YOU MIND SENDING THOSE, I GUESS, TO STAFF TO SEND TO ME, UH, THAT WAY WE CAN LOOK AT THOSE AND GET RESPONSES FOR YOU? YES. 
          THANK YOU. 
          ALRIGHT, UH, MOVING UP 
          [5. Discussions and possible action on food insecurity recommendations to the Austin Health Commission from the PHC Budget and Infrastructure Work Groups.]
TO AGENDA ITEM NUMBER FIVE, DISCUSSION AND POSSIBLE ACTION ON FEW FEUD, FOOD INSECURITY RECOMMENDATIONS TO THE AUSTIN PUBLIC, UH, TO THE AUSTIN HEALTH COMMISSION. 
          I'M MESSING THIS ALL UP FROM THE PUBLIC HEALTH COMMISSION BUDGET AND INFRASTRUCTURE WORK GROUPS. 
          UM, UH, THE, THE INITIAL ASK ON THIS ONE WAS BASICALLY, UH, WHAT TYPE OF, UH, VERBIAGE RECOMMENDATION ARE CAN COME FROM THESE TWO DIFFERENT WORK GROUPS AS IT'S SPECIFIC TO, UH, REQUESTING A FUNDING LINE SPECIFIC TO, UH, SUPPORTING FOOD AND PROVIDING FOOD, UH, THROUGH A NETWORK. 
          UM, SO SOME TYPE OF ORGANIZATION, INSTITUTION, OR ENTITY THAT IS NOT JUST PROVIDING THE FOOD ITSELF OR CREATING THE FOOD ITSELF, BUT IS A PART OF A NETWORK OF DISTRIBUTION ACCESS AND SO FORTH. 
          I THINK Y'ALL KIND OF RECALL HOPEFULLY, UH, UH, HOW THIS KIND OF CAME ABOUT. 
          AND SO I KNOW WE'RE A LITTLE BIT OVERDUE ON JUST KIND OF PUTTING TOGETHER SOME DRAFT VERBIAGE, BUT, UH, ANY UPDATES, IF ANY, IF NOT FULLY UNDERSTOOD. 
          UM, BUT WOULD LIKE TO, UH, AT LEAST NEXT MEETING, BE ABLE TO HAVE SOME DRAFT VERBIAGE FROM BOTH OF THE WORK GROUPS FOR THE COMMISSION TO CONSIDER AND THEN TRY TO CONSOLIDATE THEN FROM THERE INTO AN OVERALL RECOMMENDATION. 
          UH, ANY COMMENTS, QUESTIONS, OR FEEDBACK REGARDING THAT YET? YES. 
          THANK YOU FOR BRINGING THIS BACK TO THE FOREFRONT. 
          UM, AND I DID RECEIVE YOUR EMAIL. 
          I HAVE STARTED TO DRAFT SOME OF THE LANGUAGE, BUT THEN I KNOW COMMISSIONER POINDEXTER HAS SOME QUESTIONS AS WELL. 
          SO I THINK BASED ON TODAY'S DISCUSSION, I HAVE THE ANSWERS I NEED. 
          SO I THINK I'LL ALSO, UM, COLLABORATE WITH COMMISSIONER POINDEXTER SINCE IT MAKES, PROBABLY MAKES MORE, MORE SENSE TO HAVE JUST ONE. 
          UM, SO WE CAN COMBINE THOSE TOGETHER. 
          OKAY. 
          AND THEN ALSO, I'M SORRY, JUST CAN YOU CLARIFY THE FIVE DISCUSSION, POSSIBLE ACTION ON FOOD INSECURITY RECOMMENDATION TO, IS THAT AUSTIN CITY COUNCIL? IS THAT WHAT IT'S SUPPOSED TO SAY? YES, IT'S PROBABLY, YEAH, AUSTIN CITY COUNCIL AND, UH, MOST LIKELY ALSO TO THE COMMISSIONER'S COURT. 
          OKAY. 
          THANK YOU. 
          ANY OTHER COMMENTS, QUESTIONS? ALRIGHT, ON TO 
          [4. Conduct officer elections for the Chair and Vice Chair for the term to expire April 30, 2025.]
THE BIG AGENDA ITEM FOR THE DAY. 
          UH, I, AGENDA ITEM NUMBER FOUR, CONDUCT OFFICER ELECTIONS FOR THE CHAIR AND VICE CHAIR FOR THE TERM TO EXPIRE APRIL 30TH, 2025. 
          UM, DO WE HAVE ANY RULES IN HOW THIS NEEDS TO PROCEED? UM, THANK YOU. 
          UM, CHAIR, THE LAST MEETING, WHICH WAS YOUR LAST ELECTION ON THIS, WE JUST TOOK NOMINATIONS FROM THE FLOOR OF 
          [01:20:01]
WHO WOULD LIKE TO SERVE IN THAT CAPACITY. 
          AND THEN YOU ALL VOTED. 
          OKAY. 
          SO WE WILL USE THAT SAME FORMAT, BUT IT'LL HAVE TO BE A, A VERBAL VOTE OF WHO YOU VOTE FOR. 
          GOT IT. 
          DO WE HAVE ANY NOMINATIONS FOR THE CHAIR? I'LL NOMINATE THE CURRENT CHAIR. 
          HEARD. 
          WHAT'S THAT? I SAID HEARD, NOT NECESSARILY RECEIVED, BUT HEARD . 
          UH, ANYBODY ELSE? UH, YES, I RECOMMEND OR NOMINATE, UH, CHAIRPERSON POINDEXTER. 
          POINDEXTER. 
          OKAY. 
          DO YOU ACCEPT THAT NOMINATION? WHY NOT? OKAY. 
          ALL RIGHT. 
          ANYBODY ELSE? DO WE HAVE A THREE? ALL RIGHT. 
          OKAY, SO NO. 
          ALL RIGHT. 
          UM, I'M GONNA PAUSE FOR A SECOND. 
          'CAUSE I HAVE NOT ACCEPTED OR NOT ACCEPTED. 
          I KNOW, THAT'S WHY I SAID HEARD. 
          I'M ONLY PAUSING BECAUSE I'M ALL ABOUT SUCCESSION, BUT I'M ALSO PAUSING BECAUSE I KNOW WE'RE STILL IN THE INITIAL STARTUP TIME, RIGHT? SO I'M BALANCING THOSE TWO. 
          I WILL ACCEPT, BUT I THINK WE SHOULD BE STATIONARY PASS THIS NEXT YEAR. 
          OKAY? SO WITH THAT BEING SAID, ALL THOSE IN FAVOR OF DR. WALLACE BEING THE CHAIR? RAISE YOUR HAND. 
          SO WE GOT ONE, TWO, GOT IT. 
          SO TWO. 
          ALL RIGHT. 
          ALL THOSE IN FAVOR OF COMMISSIONER POINDEXTER BEING THE CHAIR. 
          RAISE YOUR HAND. 
          WE GOT 1, 2, 3, 4. 
          THERE YOU GO. 
          OH, . 
          ALL RIGHT. 
          AND, AND DOES THAT MEAN THE OTHER TWO PEOPLE ARE ABSTAINING FROM VOTING? WHO ARE THE TWO THAT ABSTAINED? YOU SAID TWO FOR WALLACE AND FOUR. 
          FOUR, RIGHT. 
          SO I DIDN'T VOTE. 
          YOU DIDN'T VOTE? I DIDN'T VOTE FOR YOURSELF. 
          I DIDN'T VOTE EITHER WAY. 
          EITHER WAY. 
          IT WOULD'VE BEEN FOUR. 
          THREE. 
          UM, WHO ELSE DIDN'T VOTE? NATALIE, YOU DIDN'T VOTE? VOTE. 
          SHE DIDN'T VOTE. 
          SUPPOSED TO VOTE. 
          SORRY. 
          SEE? NOT SUPPOSED VOTE. 
          WELL, TECHNICALLY YOU'RE CAN'T YOU VOTE FOR YOURSELF? SO WAIT A MINUTE. 
          SO IT, IT CANCELS EACH OTHER OUT. 
          , OKAY. 
          YOU KNOW, I'M OKAY IF THAT. 
          ALL RIGHT. 
          UM, DO WE HAVE NOMINATIONS FOR VICE CHAIR? SO LET'S CLOSE THIS OUT. 
          ALL ALL IN FAVOR FOR, UM, COMMISSIONER POINTEX SERVING AS YOUR CHAIR FOR THE TERM AP BEGINNING APRIL. 
          SO IT ACTUALLY IS A LITTLE LATE UNTIL 2025. 
          ROLL CALL. 
          ROLL CALL. 
          BOOKS. 
          OKAY. 
          ROLL CALL. 
          HMM. 
          AFTER THIS MEETING? YEAH. 
          YOU AIN'T GOT NO TIME. 
           25. 
          I WAS LIKE, COOL. 
          NO. 
          ENDS ENDS IN 2025 ENDS. 
          SURE. 
          IT'S IN MY NOW. 
          SO, SO, OH, YOU SAID YOU WANNA DO THE ROLL CALL? SHE, ARE YOU DOING IT AGAIN? SHE DID GET THE, THE, IT'S FIVE, IT'S 4, 3 5. 
          IT'S, IT'S FIVE THREE. 
          IF WE BOTH VOTE, THEN IT'S, THEN IT'S FIVE THREE. 
          OKAY, THEN WE DON'T NEED TO DO IT. 
          MM-HMM? . 
          ALRIGHT. 
          DO I HAVE A NOMINATION FOR VICE CHAIR? ANY NOMINATIONS OR VICE CHAIR? I'M GONNA THROW THIS OUT HERE. 
          I DIDN'T ACTUALLY ASK HIM, BUT I'D, I'D LIKE TO RECOMMEND. 
          UH, COMMISSIONER LYNCH CHA. 
          OKAY. 
          FOR VICE CHAIR, DO YOU ACCEPT? OH, I ACCEPT HE ACCEPTS. 
          ALL RIGHT. 
          ANY OTHER NOMINATIONS? ANY OTHER NO OTHER NOMINATIONS. 
          I'M SORRY. 
          POINT OF ORDER. 
          DOES HE HAVE TO BE POINT OF ORDER? DOES THE NOMINATION HAVE TO BE SECONDED OR HE CAN JUST ACCEPT IT? HE, TO ACCEPT THAT'S SO NO SECOND. 
          NO SECOND. 
          HE JUST NEEDS TO ACCEPT THE NOMINATION, RIGHT? NO, WE HAVEN'T GONE TO VOTING YET, SO WE'RE JUST SEEING WHO'S, WHO'S PUTTING THEIR NAME IN THE HAT? ANY ANYBODY ELSE GOING ONCE, GOING TWICE. 
          YOU WIN BY. 
          SO NOMINATION. 
          CONGRATULATIONS. 
          ALL RIGHT, SO YOU ALL START OFFICIALLY AFTER THIS MEETING ENDS. 
          UM, 
          [01:25:01]
OKAY, MOVING ON TO . 
          THERE'S NO TRANSITION PERIOD, SO DO Y'ALL WANT TO RE DO A RECOUNT? ALL RIGHT. 
          UM, FUTURE AGENDA 
          [FUTURE AGENDA ITEMS]
ITEMS. UM, I, I THINK IT'S, UH, VERY, VERY, I DON'T KNOW THE RIGHT WORD FOR THIS, BUT WE HEARD ABOUT THE STATE HOSPITAL. 
          I DON'T KNOW IN WHAT CAPACITY. 
          UH, I DON'T KNOW THAT MUCH ABOUT THE STATE HOSPITAL. 
          I DON'T KNOW HOW MUCH, UH, THE FELLOW TEAM DOES AS WELL. 
          BUT I THINK UNDERSTANDING, UM, ITS RELATIONSHIP AS IT IS TO THE, THE MISSION AND THE FUNCTION OF THIS PUBLIC HEALTH COMMISSION AND THE COLLABORATION AMONGST THE PUBLIC HEALTH AGENCIES. 
          UH, WHAT, WHAT IS Y'ALL'S RELATIONSHIP WITH IT, BOTH FROM A LEGAL STANDPOINT AND A COMMUNITY ENHANCING STANDPOINT. 
          SO THEN WE CAN PROBABLY HAVE MORE OF AN INTENTIONAL, UH, ONE UNDERSTANDING AND COMPREHENSION IN, IN CASE, UH, THIS TOPIC DOES GET BROUGHT UP AGAIN, OR WHEN THE COMMISSIONERS ARE OUT AND ABOUT, BEING ABLE TO SPEAK MORE INTELLIGENTLY ABOUT IT AND GIVE GUIDANCE AND DIRECTION BASED UPON LEGALLY AND COMMUNITY ASPECT OF IT. 
          UM, AND THEN IF THERE IS ANY, UH, INTERCONNECTEDNESS DISCUSSIONS THAT ARE GOING ON, OR THERE IS SOME TYPE OF A LEGAL PUBLIC HEALTH STANDPOINT, UH, AS WELL, THEN LOOKING AT, UH, UH, CHAIR, UH, WHERE THAT APPROPRIATELY SHOULD PROBABLY BE A TOPIC, UH, FOR THE COMMISSION TO TALK ABOUT. 
          UH, ANY THOUGHTS, QUESTIONS, REMARKS, QUESTION? YES. 
          UM, FROM MY END, THE MIC OF THE SPEAKER WAS CUTTING OUT QUITE A BIT. 
          WAS THERE AN ASK OR AN OUTCOME THAT THEY WANTED THAT THEY EXPRESSED? BECAUSE I, IF THERE WAS, I DIDN'T HEAR IT, AND I JUST WANNA KNOW IF Y'ALL IN THE ACTUAL ROOM DID. 
          'CAUSE I THINK THAT WOULD HELP GUIDE MY THOUGHT PROCESS A LITTLE BIT MORE, BUT IT WAS REALLY DIFFICULT TO HEAR VIRTUALLY, WHICH IS LIKE THE DOWNSIDE ALWAYS BEING RIGHT, RIGHT. 
          VIRTUAL, BUT I DON'T KNOW IF THERE WAS LIKE A DESIRED OUTCOME OR CALL TO ACTION THAT WAS EXPRESSED. 
          MM-HMM. 
          . 
          AND IF THERE WAS HEARD IN THE PHYSICAL ROOM, CAN YOU TELL ME WHAT THAT WAS? RIGHT. 
          I'LL TRY TO SUMMARIZE AND I WILL NOT DO IT PROPERLY. 
          JUSTICE. 
          UM, JUST TO LET YOU KNOW, THAT, UH, BASICALLY IT WAS AN ASPECT OF, UM, A, A, A CONCERN OF, UH, NOT JUST BANDWIDTH, BUT CONNECTIVE SERVICES IN RELATION TO TAKING CARE OF THOSE INDIVIDUALS. 
          IT WAS AN ASPECT OF HIGHLIGHTING THIS CONCERN, THIS IMPACT THE NEED. 
          AND ITS SOMEWHAT FALLING ON DEAF EARS. 
          AND THE, THE ASPECT, I THINK TOO, UH, THIS NEW COMMISSION AND ITS ROLE IN WHAT IT'S SUPPOSED TO DO, THAT EVEN THOUGH IT MAY BE PUBLIC HEALTH FOCUSED WITH THE AGENCIES, UH, THAT HAVE EX OFFICIALS HERE, UM, IN, IN, IN WHAT ASPECT OR CAPACITY CAN WE LEVERAGE OUR CONTACTS AND OUR RESOURCES? IF THIS IS NOT A PUBLIC HEALTH, UH, ALIGNED TOPIC, WHO CAN WE ACTUALLY GET IT TO? AND THEY ACTUALLY TAKE HEED AND, AND HOPEFULLY PUT EYES ON IT. 
          OKAY. 
          OKAY. 
          THANK YOU. 
          ABSOLUTELY. 
          ANY OTHER? YEP. 
          SO I WAS, THIS IS ON TRAVIS COUNTY HEALTH AND HUMAN SERVICES. 
          I WAS THINKING IT, IT WOULD BE HELPFUL FOR THE COMMISSION TO RECEIVE A REPORT ON THE WORK THAT, UH, THE CITY CENTRAL HEALTH AND THE COUNTY ARE DOING ON THE MENTAL HEALTH JAIL DIVERSION WORK. 
          NOT REALLY AS A, AS A, AS A CURE FOR THIS ISSUE THAT WAS RAISED, BUT MORE TO UNDERSTAND THE CURRENT PLAN AND SEE WHERE THERE'S STILL MAYBE GAPS THAT NEED TO BE ADDRESSED AS WELL. 
          CAN, CAN Y'ALL ADD THAT? DOES ANYBODY HAVE ANY PUSHBACK ON THAT? ALRIGHT. 
          THANK YOU. 
          AND SO, UH, FEASIBLE FOR THE NEXT MEETING. 
          UM, IT, I THINK, UH, DONNIE AND, AND JUANITA WILL PROBABLY NEED TO CHECK ON AVAILABILITY OF PEOPLE'S TIME. 
          GOT IT. 
          UNDERSTOOD. 
          UH, AND, AND THE LAST TOPIC BEFORE WE CLOSE OUT, UH, A AGAIN, FOR THE NEW, THE NEW LEADERSHIP FOR THE COMMISSION AND, AND AS WELL AS THE TEAM, I HAD, UH, THE OPPORTUNITY TO TALK WITH, UH, UH, COUNCIL MEMBER, UH, FUENTES, UH, REGARDING HER ASK, UH, OF, OF SOME, UH, RECOMMENDATIONS FROM THE COMMISSION REGARDING OPIOID AND REALLY WHERE THAT STAND STEMMING FROM IS, UH, COMMUNITY IN ORGANIZATIONS KIND OF REACHING OUT TO HER OFFICE AND STATING THAT YES, EVEN THOUGH FUNDING AND IN, IN, IN, IN AND THE PATHWAYS OCCURRING, THAT THERE'S, THERE'S STILL THE 
          [01:30:01]
CONCERN OF NOT SEEING THE ACTUAL IMPACT YET. 
          UH, I, I'VE STATED TO HER THAT, UM, WE'VE BEEN CAUTIOUS ON PUTTING TOGETHER A RECOMMENDATION THAT WE HAVE RECEIVED ALL THE PRESENTATIONS, BUT THERE'S STILL SOME SPECIFIC RFIS REQUEST FOR INFORMATIONS AS IT RELATES TO WHAT HAS BEEN THE IMPACT SO FAR FROM THE FUNDING AND THE LOCATIONS AND SO FORTH. 
          AND BASED OFF OF THAT, ARE THERE ANY TWEAKS OR MODIFICATIONS THAT AGENCIES MAY BE LOOKING AT? SO THEN THAT WAY WE CAN COME WITH MORE OF A TANGIBLE, UH, UH, RECOMMENDATION FOR COUNCIL TO PROBABLY ACT ON. 
          UH, SO SHE'S OKAY WITH THAT, BUT I DID, UH, HERE I DID DO THE ONE PROMISE WITHOUT TALKING TO Y'ALL BEFORE I DID STATE THAT WE WOULD PUT AT LEAST SOMETHING TOGETHER HIGHLIGHTING WHAT WE HAVE RECEIVED, WHAT WE STILL NEED INFORMATION ON, AND ONCE WE GET THAT INFORMATION, THAT WE WOULD THEN PROVIDE A FORMAL RECOMMENDATION. 
          AND SO SHE'S OKAY WITH THAT. 
          'CAUSE THAT ALLOWS HER TO AT LEAST TO BE ABLE TO GO BACK AND TALK TO THOSE, REACHING OUT TO HER THAT THERE IS MOVEMENT, THERE IS TRACTION, THERE'S JUST SOME ADDITIONAL PIECES THAT ARE MISSING. 
          UM, AND SO THAT, AGAIN, UH, NEW CHAIR, VICE CHAIR, UH, IF YOU ALL CAN TAKE THAT ON INTENTIONALLY, UH, STARTING WITH WITH THE NEXT MEETING, UH, THAT'D BE GREATLY APPRECIATED. 
          WHAT INFORMATION ARE WE STILL WAITING ON? I KNOW WE HAD THE PRESENTATION, IT KIND OF GAVE A GENERAL OVERVIEW, BUT WHAT OTHER ADDITIONAL INFORMATION WAS REQUESTED AND FROM WHO? AND I THINK THAT'S GONNA BE THE ASPECT WHERE WE NEED TO CREATE AND CONSOLIDATE. 
          WHAT ARE THE QUESTIONS THAT WE STILL HAVE TO BE ABLE TO MAKE A POLICY RECOMMENDATION FROM EITHER A FUNDING CHANGE OR A, UH, POTENTIAL, UH, RE DISBURSEMENT OF RESOURCES TO HAVE A COMMUNITY IMPACT? UM, I THINK RIGHT NOW IT'S JUST IN MY STANDPOINT, FROM SEEING THE PRESENTATIONS AND READING THE PRESENTATIONS, IT TELLS ME WHAT'S OCCURRING, BUT I STILL DON'T KNOW WHAT THE IMPACT IS. 
          I SEE A LOT OF MONEY, I SEE A LOT OF THINGS, I SEE A LOT OF PARTNERS, BUT I DON'T KNOW WHAT IMPACT THERE HAS BEEN YET TO DETERMINE IF THAT COURSE OF ACTION IS DOING WHAT IT NEEDS TO DO WITH SO MUCH MONEY AND PARTNERSHIPS ESTABLISHED. 
          YEAH, I GUESS, 'CAUSE I, WHEN WE HAD THE PRESENTATION, I WASN'T SURE IF THESE THINGS HAVE ACTUALLY STARTED. 
          LIKE, I KNOW I WANNA SAY IT WAS LIKE ARPA FUNDS OR SOMETHING WERE USED PREVIOUSLY FOR LIKE EXPANSION OF LIKE MAP PROGRAMS, THOSE TYPES OF THINGS. 
          BUT WHEN WE GOT THE, THE PRESENTATION, THEY WERE LIKE, GENERALLY THESE ARE WHAT WE ARE DOING. 
          HAVE THESE PROGRAMS ALL STARTED? I GUESS MAYBE THAT IS THE REQUEST OF INFORMATION OF LIKE WHAT HAS AND WHAT HAS NOT STARTED WITH THESE FUNDS, HAVE THEY? YEAH, I GUESS THAT'S THE THING. 
          'CAUSE LIKE WE DID GET INFORMATION ABOUT WHAT IS THE PLAN, BUT I DON'T KNOW WHAT HAS AND HAS NOT BEEN IMPLEMENTED. 
          SO I GUESS THAT'S WHAT WE'RE ASKING FOR. 
          THAT COULD BE ONE OF YOUR RFIS. 
          CORRECT. 
          OKAY. 
          ONE OF THE THINGS THAT I'VE WONDERED ABOUT, AND MAYBE WE'VE GOTTEN IT IN THE PRESENTATIONS THAT I'M JUST NOT RECALLING IT, BUT YOU KNOW, THE QUESTION IS LIKE, TO ME IT'S, IT'S LIKE, WHO NEEDS NALOXONE NOW? AND ALL OF THE PROGRAMMATIC STUFF, UPSTREAM IS ALL IT IS IS OBVIOUSLY IMPORTANT, BUT I DON'T KNOW IF IT'S AN EMS REPORT OR WHO WOULD HAVE THE LOCATION. 
          I'D LIKE TO KNOW IF, UM, YOU KNOW, IF 30% OF OPIOID, UH, OVERDOSES, I DON'T, I'M JUST MAKING THIS UP, IT OCCUR, YOU KNOW, UM, IN BARS THAT'S PROBABLY NOT TRUE. 
          MAYBE IT'S 10%. 
          MAYBE THE, YOU KNOW, THE, IT WOULD BE GREAT TO HAVE, UM, A, UM, YOU KNOW, A COMMUNITY RULE THAT SAYS EVERY BAR SHOULD HAVE THREE DOSES OF N NALOXONE ON HAND. 
          SO THAT WOULD BE POLICY DECISIONS FOCUSED ON TREATING THE EMERGENCY. 
          AND YOU MIGHT SAY, WELL, NO, IT'S ON THE STREET. 
          SO YOU'D SAY, WELL, MAYBE EVERY STREET HAS NEEDS A BOX, LIKE A FIRE ALARM THING WHERE YOU CAN GO UP AND BREAK THE GLASS AND GET IN NALOXONE. 
          AND THAT WOULD BE A WAY TO HAVE SOMETHING. 
          BUT TO ME THAT'S, THAT'S WHAT COMES TO MIND IS WHAT ARE THINGS THAT WE COULD DO TO HAVE AN IMPACT RIGHT ON THE FRONT LINE. 
          MIGHT, YOU KNOW, THE, THE COST OF ALL THOSE THINGS I'M TALKING ABOUT IS, YOU KNOW, IT'S, IT'S VERY SMALL FOR, FOR INDIVIDUAL BARS TO BUY THINGS OR HAVE BOXES ON STREETS, I WOULD THINK. 
          BUT I'M JUST THINKING ABOUT, YOU KNOW, BIG POLICY THINGS ARE HARD TO THINK ABOUT, BUT IF YOU CAN GET DOWN TO THE BOTTOM LINE, IT'S LIKE, WHO'S HAVING AN OVERDOSE AND WHO NEEDS THE NALOXONE NOW? AND TRYING TO ADDRESS THAT SPECIFIC QUESTION MIGHT BE SOMETHING WE COULD THINK ABOUT OR LEARN ABOUT AT LEAST. 
          YEAH. 
          SO EACH ONE OF YOU CAN GO. 
          SO, UM, IF I COULD CHAIR, UM, WE HAVE STARTED MANY OF THE PROGRAMS THAT HAVE BEEN DISCUSSED HERE BEFORE THE, THE COMMISSION. 
          UM, WE ARE DISTRIBUTING NALOXONE THROUGH PARTNERSHIPS WITH OUR HARM, HARM REDUCTION PARTNERS. 
          UM, WE HAVE EMS DISTRIBUTING, UM, NALOXONE, WE HAVE A NALOXONE SITUATED IN COUNTY AND CITY BUILDINGS. 
          WE ALSO HAVE NALOXONE IN BARS AND SCHOOLS. 
          AND AS A RESULT OF THE EFFORTS HAVE BEEN DONE THUS FAR, WHEN WE 
          [01:35:01]
HAD TO RESPOND TO, UM, SOMEWHERE CLOSE TO 90 OVERDOSES IN A PERIOD OF THREE TO FOUR DAYS, WE SURPASSED THE NATIONAL AVERAGE FOR RESUSCITATION OF PEOPLE WHO HAD OVERDOSED, WHICH IS 60, AND OUR RESUSCITATION RATE WAS 80 PLUS. 
          SO OUR EFFORTS HAVE MADE AN IMPACT AND WE'RE NOW LOOKING FOR ADDITIONAL WAYS TO MAKE IMPACT THROUGH DISTRIBUTION IN COMMUNITY. 
          UM, AND WE'RE ALSO LOOKING AT, UM, WAYS TO IMPROVE HANDOFFS, UM, WITH REGARDS TO PEOPLE LEAVING THE, UM, LEGAL SYSTEM BACK INTO COMMUNITY AND THROUGH THE DIVERSION CENTER THAT'S BEEN TALKED ABOUT HERE DURING THIS MEETING. 
          SO WE ARE ALREADY SPENDING THE FUNDS AND WE ARE, UM, LOOKING COLLABORATIVELY, UM, THROUGH A PH, UM, TRAVIS COUNTY, CENTRAL HEALTH, INTEGRAL CARE, AND OUR HARM REDUCTION PARTNERSHIPS, UM, AT WAYS THAT WE CAN IMPROVE, UM, ON WHAT HAS ALREADY BEEN WAY A SUCCESS. 
          WE'RE ALSO USING THE MONEY TO EDUCATE, UM, PROVIDERS IN OUR AREA, UM, BOTH THROUGH ONLINE, UM, CME ACCREDITED PRESENTATIONS AND THROUGH DOING, UM, DOOR TO DOOR DETAILING OR, UM, WE HAVE SOMEONE WHO GOES TO PRACTICES AND DISCUSSES HARM REDUCTION STRATEGIES WITH PROVIDERS BOTH IN CLINICS AND IN OUR EMERGENCY DEPARTMENTS. 
          SO WE ARE ALREADY SPENDING THE FUNDING AND WE HAVE ALREADY SEEN THE BENEFIT OF IT. 
          I APPRECIATE THE, THE, THE, THE DATA POINTS. 
          I THINK AS, AS I, FOR ME, WRITING STATING THAT THOSE DATA POINTS WERE NOWHERE IN THOSE PRESENTATIONS. 
          RIGHT. 
          UM, AND I THINK BEING ABLE TO GET THOSE DATA POINTS FROM THE DIFFERENT AGENCIES THAT CAN HELP US TO EITHER BE ABLE TO COME WITH A RECOMMENDATION THAT SAYS, HEY, SOME ASSESSMENT IS STILL REQUIRED. 
          UM, YOU KNOW, BECAUSE IMPLEMENTATION, WE'RE STARTING TO SEE THIS, THIS IMPACT OR THIS NEEDLE MOVE, SO WE WANT TO GIVE IT SOME MORE TIME AND GET MORE FEEDBACK FROM THE AGENCIES OVER TIME OR VICE VERSA. 
          RIGHT. 
          UM, I THINK THAT'S JUST WHAT THE COUNCIL MEMBERS IS TRYING TO ASKING IS JUST LIKE, ALL RIGHT, HAS THE PUBLIC HEALTH COMMISSION ASSESSED ITSELF OF WHAT THE AGENCIES ARE DOING? WHAT THE IMPACT HAS BEEN, IF ANYTHING SO FAR? AND THEN AT LEAST COMING BACK WITH A, IS THERE A RECOMMENDED CHANGE OR IS THERE A RECOMMENDED CONTI CONTINUE TO EVALUATE FOR SO LONG? OR A NOPE, EVERYTHING'S LOOKING GOOD, YOU KNOW, SO HERE'S THE INFORMATION TO BE ABLE TO SHARE WITH THOSE THAT ARE REACHING OUT TO YOU REGARDING WHAT THEY MAY NOT BE SEEING OR THEY MAY NOT BE, UH, UH, INFORMED ON. 
          SO, UH, ANYTHING ELSE REGARDING THAT? I DO WANNA JUST COMMENT ON JUST THAT BECAUSE YEAH, THINGS ARE HAPPENING ALREADY AND IT'S BEING USED, BUT IT SOUNDS LIKE MAYBE THE BETTER THING TO LOOK AT IS THE PROPORTION OF WHERE THE FUNDING IS GOING. 
          BECAUSE WHEN I THINK ABOUT IT, YOU THINK OF LIKE NALOXONE DISTRIBUTION, THAT'S GREAT, BUT IF YOU DON'T HAVE OUTREACH AND YOU DON'T HAVE OTHER THINGS IN PLACE, HOW USEFUL IS IT IN THAT WAY? LIKE IT IS USEFUL. 
          I'M NOT SAYING IT'S NOT, BUT THERE'S CERTAIN ASPECTS THAT ARE OF HIGHER RANKING THAN OTHERS. 
          SO I THINK IT'S NOT A MATTER OF LIKE WHAT IT SHOULD BE USED, 'CAUSE I THINK WE'VE SOLIDIFIED THAT WHAT HAS BEEN SHARED IS WHERE IT SHOULD BE GOING, BUT MAYBE IT'S MORE OF A PROPORTION OF LIKE WHERE IT SHOULD BE DISTRIBUTED AMONGST ALL THE THINGS THAT WE'RE DOING. 
          I THINK THAT'S PROBABLY A BETTER WAY TO LIKE HONE IN BUDGET WISE BASED ON THE ACTIVITIES THAT ARE ALREADY HAPPENING. 
          I DON'T KNOW. 
          ABSOLUTELY. 
          I THINK EVERYBODY'S GONNA END UP HAVING SOME SIMILAR AND SOME DIFFERENT, YOU KNOW, REQUESTS FOR INFORMATION. 
          AND SO I THINK IF EVERYBODY, YOU KNOW, ESPECIALLY THOSE THAT YOU'VE HIGHLIGHTED AND WE CAN JUST CON CONSOLIDATE 'EM AND THEN WE CAN GET 'EM TO THE AGENCIES. 
          YES. 
          I JUST WANNA, I DON'T KNOW, POINT OF REFERENCE FOR EVERYONE. 
          WE RECEIVED A TRAVIS COUNTY EFFORTS TO ADDRESS THE OPIOID CRISIS AUGUST, 2024 UPDATE FROM THE LAST GROUP THAT WAS HERE. 
          I'M NOT SURE, I'M NOT SURE. 
          IT'S JUST TWO PAGES, BUT IT'S VERY IN DEPTH AND IT ACTUALLY EXPLAINS EVERYTHING THAT THEY'RE ALREADY DOING. 
          THEY'VE ALSO ALREADY IDENTIFIED POTEN FROM THE COMMUNITY, FUTURE INVESTMENT OPPORTUNITIES THAT THE COMMUNITY HAS STATED ARE IMPORTANT TO THEM, AS WELL AS WHERE ALL OF THE GRANT FUNDING IS GOING, HOW IT'S GOING, IF IT'S GOING WELL OR NOT. 
          AND SO I'M JUST CURIOUS, LIKE IF WE REVIEW THESE TWO PAGES, COULD WE NOT HAVE OUR ANSWERS TO SOME OF THE QUESTIONS THAT WE'RE 
          [01:40:01]
SAYING? WE STILL DON'T HAVE ANSWERS TO? POSSIBLY. 
          UH, WHAT, WHAT I'M PROBABLY SAYING IS I KNOW THERE IS PRESENTATIONS, I KNOW THERE IS, THERE ARE HANDOUTS. 
          I WANNA MAKE SURE THAT, I WOULD LIKE TO MAKE SURE THAT EVERY COMMISSIONER, UH, HAS THE OPPORTUNITY TO REQUEST ANY ADDITIONAL INFORMATION, ESPECIALLY, UH, BEFORE WE ATTEMPT TO PUT TOGETHER SOMETHING TO PROVIDE TO, UM, TO THE COUNCIL. 
          UM, SO THEN THAT WAY EVERYBODY CAN BE ABLE TO SAY THEY'VE HAD THEIR OPPORTUNITY TO HAVE ANY PIECE OF QUESTION OR CONCERN ADDRESSED. 
          UM, AND IT'S BEEN INCLUDED INTO THE CONSIDERATION FOR THAT RECOMMENDATION. 
          UM, AND THAT DEFINITELY YOU'RE RIGHT, THAT DOCUMENT TO ME PROVIDED MORE INFORMATION THAN THE, THE BRIEFS THAT WERE UH, CONDUCTED TO THE COUNTY. 
          CAN WE ASK THAT, THAT BE SENT TO US AGAIN? I DON'T SEEM TO HAVE MY FINGERTIPS ON THAT. 
          THANK YOU. 
          COOL. 
          ANYTHING ADDITIONAL? IF NOTHING, I CALL THIS MEETING ADJOURNED. 
          THANK YOU.
* This transcript was created by voice-to-text technology. The transcript has not been edited for errors or omissions, it is for reference only and is not the official minutes of the meeting.