Nov 06, 2024 Public Health Commission

TRAVIS COUNTY AND CITY OF AUSTIN FOR YOUR SUPPORT IN PROVIDING, UH, A RESOURCE THAT HAS BEEN LONG, A LONG-TERM GAP IN OUR COMMUNITY.

UM, IT IS OFFERED TO YOUTH 13 TO 17.

IT CAN BE AN OPPORTUNITY TO AVOID INPATIENT PSYCHIATRIC HO HOSPITALIZATION IN A THERAPEUTIC SUPPORTIVE ENVIRONMENT THAT CAN BE VERY SHORT TERM OR COULD BE UP TO 10 DAYS AND CONNECT FOLKS TO RESOURCES.

FAMILIES ALSO CAN BE INVOLVED IN COUNSELING TO HELP THEIR, IN THEIR YOUTH THAT ARE IN THE CRISIS RESPITE PROGRAM, HUMAN RIGHTS CAMPAIGN.

GOTTA GIVE A SHOUT OUT TO MEGAN CMAC WITH CENTRAL HEALTH FOR SOME OF HER LEADERSHIP.

I UNDERSTAND WE'RE ONE OF THE FEW BEHAVIORAL HEALTH ORGANIZATIONS, UM, THAT HAVE HAD THIS DESIGNATION, UM, TO, AND IT'S QUITE THOROUGH.

UM, IT'S GOT MANY, MANY DIFFERENT MEASURES, BUT OUR TEAM EMBRACED THIS FULLY, UH, TO BE A WELCOMING PLACE TO THE L-G-B-T-Q COMMUNITY, UM, AND BE SUPPORTIVE AND INFUSE THAT KIND OF WELCOMING THERAPEUTIC MESSAGING THROUGHOUT OUR SYSTEM OF CARE.

AND WE HAD MANY PARTNERS IN THAT.

I WILL SAY WE HAD MANY PARTNERS.

UM, AND THEN THERAPEUTIC DIVERSION PROGRAM, UM, KEY TO HELPING FOLKS AVOID JAIL AND GET THE KIND OF TREATMENT THEY NEED FOR THEIR MENTAL HEALTH CONDITION.

AND AGAIN, DON'T DO THIS ALONE.

UH, CITY COUNTY CENTRAL HEALTH, UM, HUGE COLLABORATORS AND SUPPORTERS, UH, FINANCIALLY AND LOGISTICALLY IN MAKING THIS HAPPEN.

AND FINALLY, THE PERMANENT SUPPORTIVE HOUSING.

HOT OFF THE PRESSES.

LAST FRIDAY, WE HAD A RIBBON CUTTING.

UM, THIS IS, WE WERE, IF YOU, IF ANY OF YOU'RE FAMILIAR WITH TERRACE AT OAK SPRINGS, IT WAS OUR FIRST FORAY AS IN CENTRAL TEXAS INTO A SINGLE SITE PERMANENT SUPPORTIVE HOUSING APARTMENT COMPLEX WITH AN ADJACENT CLINIC.

UM, THIS BUILDS UPON THAT MODEL.

IT'S 60 UNITS WE WORK THROUGH AS A COMMUNITY THAT A COORDINATED ENTRY SYSTEM AND IDENTIFY THOSE OF HIGHEST NEED TO, TO, UH, BE ABLE TO LIVE IN A SAFE, SUPPORTIVE ENVIRONMENT, UM, TO GET BACK ON THEIR FEET.

YOU KNOW, THE, THE INDIVIDUALS WE SERVE WITH SEVERE MENTAL ILLNESS, SUBSTANCE USE DISORDERS, AND A MULTITUDE OF OTHER, UM, CONDITIONS HAVE A VERY DIFFICULT TIME.

LIKE ALL OF US WOULD, UH, UH, ACHIEVING ANY RECOVERY IF THEY DON'T HAVE A SAFE AND STABLE PLACE TO LIVE.

SO THOSE WERE THE HIGHLIGHTS OF THE LAST QUARTER AND A VERY BROAD OVERVIEW OF OUR PUBLIC HEALTH INITIATIVES.

AND WE ARE OPEN TO ANY QUESTIONS.

HELPING THOSE WHO ARE IN NEED.

UM, I THINK WE HAD DIFFERENT SLIDES TOWARDS THE END OF OUR PRESENTATION FOR WHAT WE HAVE ACCESS TO.

UM, I'M NOT SURE IF ANYONE HAS QUESTIONS PERTAINING TO THE SLIDES THAT WERE NOT PRESENTED.

UM, I HAVE QUITE A FEW QUESTIONS, UH, AS I'M SURE SOME OF THE OTHER COMMISSIONERS DO AS WELL.

UM, I'LL SAVE MY, MY OPIOID QUESTION FOR, FOR LATER.

YOU MENTIONED IN THE, UH, DIVERSION PROGRAM THAT YOU HAVE SUPPORTIVE SERVICES AND, AND YOU'RE

[00:25:01]

DO YOU ALSO HAVE SUPPORTIVE SERVICES FOR THOSE WHO ARE NEEDING LONG-TERM TREATMENT OR INTERESTED IN, UM, GETTING CLEAN, SO TO SPEAK? DO YOU ALSO SUPPORT IN THAT PROCESS AS WELL? YES.

I MEAN, WE, AGAIN, DEPENDING ON THAT, THE LEVEL OF NEED THAT THAT INDIVIDUAL HAS, I THINK WHAT, UM, WHAT KATHLEEN WAS JUST IDENTIFYING IS THAT PERMANENT SUPPORTED HOUSING IS THAT IT IS PERMANENT.

SO SOMEONE CAN STAY THERE AS LONG AS THEY NEED TO STAY.

UM, WHAT WE ALSO WANTED TO MAKE SURE OF IS THAT WE CREATED ENOUGH ALTERNATIVES TO PEOPLE GOING TO INTENSIVE SETTINGS WHERE THEY WOULD COULD GET STUCK AND NOT BEING ABLE TO ACCESS THAT LEVEL OF CARE.

I THINK WE'RE ALSO WORKING WITH OUR HOUSING PARTNERS BEYOND THE SERVICES WE PROVIDE IS TO MAKE SURE THAT WE CAN FIND PERMANENT HOUSING.

MOST OF THE, THE HOUSING THAT WE'RE ACTUALLY SUPPORTING PEOPLE IN IS NOT OUR OWN PEOPLE ARE IN HOUSING OF THEIR OWN, THAT WE'RE PROVIDING LONG-TERM PERMANENT SUPPORTS TO THEM WHERE THEY ARE.

SO IT IS A CONTINUUM AND IT'S A RANGE BASED ON THAT INDIVIDUAL'S NEEDS.

AND I CAN TELL YOU WE NEED TO DO A HECK OF A LOT MORE OF IT.

UM, I HAVE TWO MORE QUESTIONS THEN I WILL PASS IT OFF TO EVERYONE ELSE.

JUST FOR CLARITY.

UM, KATHLEEN, YOU MENTIONED THAT THERE HAVE BEEN 1,529 INDIVIDUALS TRAINED IN THE FIRST AID MENTAL HEALTH FIRST AID TRAINING.

IS THAT CORRECT? YES.

IN PARTICULAR THE YOUTH MENTAL HEALTH FIRST AID TRAINING.

AND HAVE YOU, DO YOU HAVE ANYTHING WE CAN SEE AS FAR AS LIKE HOW MANY PEOPLE HAVE BEEN TRAINED BOTH FOR THE ADULT AND THE YOUTH, AND THEN MAYBE WHAT IMPACT THAT'S MADE ON THE COMMUNITY FROM HAVING THAT TRAINING? YES, WE CAN ABSOLUTELY SHARE THOSE MATERIALS.

I DON'T HAVE THEM.

NO WORRIES.

COMMITTED TO MEMORY.

UM, YOU KNOW, I MENTIONED THAT WE COLLECTED DATA, FOR EXAMPLE, ON THE IMPACT ON AUSTIN PUBLIC LIBRARY SYSTEM, BUT WE HAVE VERY DETAILED, UH, DATA ON WHO WE'VE TRAINED AND WHERE, UM, RECENTLY THE COUNTY COMMISSIONERS GOT TRAINED.

UH, AND THEN MY, MY, SO NATALIE, IF I COULD ADD, ADD SOMETHING TO THAT TOO.

THIS, THIS ISN'T SOMETHING WE, WE JUST COOKED UP.

THIS IS A NATIONAL STANDARD IN TERMS OF TRAINING, RIGHT? AS OF LAST WEEK, THE THRESHOLD OF 4 MILLION PEOPLE HAVE BEEN TRAINED IN MENTAL HEALTH FIRST AID.

AND, UM, WE CAN CERTAINLY BOTH SHARE OUR INFORMATION, BUT ALSO THERE'S A NUMBER OF RESEARCH STUDIES THAT HAVE SHOWN THAT, AGAIN, PEOPLE WHO ARE NOT NECESSARILY MENTAL HEALTH PROFESSIONALS, MAYBE THE FIRST PEOPLE TO IDENTIFY IF SOMEONE'S STRUGGLING AND IF WE CAN GET PEOPLE ACCESS TO CARE WHEN AND HOW THEY NEED IT, IT REALLY CAN MAKE A REMARKABLE SUCCESS AND OVERALL TREATMENT OUTCOMES.

SO WE'LL HAPPILY SHARE SOME OF THAT DATA AS WELL.

APPRECIATE THAT.

UM, VERY FAMILIAR WITH YOU ALL'S MENTAL HEALTH FIRST AID KIT.

SO, UH, HAPPY THAT PEOPLE ARE TAKING IT AND, AND GETTING ENGAGED WITH IT.

UH, MY LAST QUESTION IS, DO YOU ALL HAVE ANY COMMUNITY HEALTH WORKERS INVOLVED IN YOUR PROGRAMMING OR PROCESSES ALREADY? OR IS THAT SOMETHING YOU ALL ARE PLANNING ON DOING AS WELL? WE DO HAVE COMMUNITY HEALTH WORKERS THAT, UM, WORK IN OUR VARIOUS PUBLIC HEALTH INITIATIVES.

WE'D LIKE TO BUILD THAT OUT MORE.

AND I KNOW WE COLLABORATE WITH OTHER COMMUNITY HEALTH WORKERS IN THE COMMUNITY.

IN ADDITION TO THAT, WE HAVE PEOPLE THAT MAY NOT BE CALLED A COMMUNITY HEALTH WORKER, BUT ARE DOING THOSE FUNCTIONS MM-HMM.

THAT ARE ACROSS ALL OF OUR, OUR TREATMENT TEAMS DOING CARE COORDINATION, HELPING PEOPLE INTEGRATE INTO OTHER SYSTEMS AND ENSURING LONG-TERM FOLLOW UP.

AND WOULD YOU BE ABLE TO, TO MAYBE PROVIDE JUST A ONE PAGER ON WHAT TYPE OF ACTIVITIES AND SUPPORT YOUR COMMUNITY HEALTH WORKERS OFFER? AND I'LL EXPLAIN WHY.

WE ARE ACTIVELY WORKING ON SUPPORTING OUR COMMUNITY HEALTH WORKERS, NOT ONLY WITHIN OUR CITY COUNTY SPACE, BUT ALSO WHAT THEIR QUALITY OF LIFE LOOKS LIKE AT HOME, UM, AND FUTURISTIC EXPERIENCES FOR THEM AS WELL.

SO HAVING MORE CONTENT TO SUPPORT WHAT WE ARE HOPING TO PUSH AS A COMMISSION WOULD BE EXTREMELY VALUABLE.

OH, THAT'S GREAT.

WE'RE HAPPY TO DO THAT.

AND I WILL PASS IT OFF TO WHOEVER ELSE HAS QUESTIONS.

I WAS GONNA TRY NOT TO BE THE NEXT QUESTION OR THE ONE THAT HAD THE MOST QUESTIONS.

, IS THERE ANYONE ELSE WOULD LIKE TO JUMP IN FIRST? I HAVE EIGHT QUESTIONS, BUT I WON'T ASK EIGHT QUESTIONS.

AND I WANTED TO COMMENT TO THE CHAIR THAT I THANK HER SO MUCH BECAUSE MY FIRST QUESTION WAS ABOUT COMMUNITY HEALTH WORKERS.

THAT WE LOOK AT AROUND SYMPTOMS REDUCTION AROUND TREATMENT THAT WE PROVIDE.

SO WE ARE DEFINITELY IN SYNC AND LEARNING AS WE GO IN OUR, IN OUR, UM, EXPERIENCE.

UM, I'LL ASK TWO QUESTIONS IF THAT'S ALL RIGHT.

FIRST IS THE, IS THE BEHAVIORAL HEALTH OR THE MENTAL HEALTH OF THE COMMUNITY GETTING BETTER OR WORSE? AND I WONDER HOW YOU THINK ABOUT THAT AS A, AS A FOUNDATIONAL DEFINITION OF THE CHALLENGE.

YEAH, I THINK THAT THAT THE, IT'S HARD TO SAY THAT IT'S GETTING BETTER.

THERE'S THINGS THAT ARE REFLECTIVE ON THE OVERALL HEALTH.

UM, SOME, MOST OF IT HAS TO DO WITH BOTH MEASURES

[00:30:01]

BUT MORE OF IT IS AROUND QUALITY OF LIFE INDICATORS.

HOW ARE PEOPLE, ARE PEOPLE ABLE TO WORK? ARE THEY ABLE TO MAINTAIN STABLE HOUSING? DO THEY HAVE FRIENDS? ARE THEY IN THE COMMUNITY? ARE THEY EMPLOYED? ARE THEY CONNECTED TO OTHERS? AND WE, WE DO MEASURE THAT, THAT AS WELL.

AND I THINK WHEN WE, WHEN YOU LOOK AT THE OVERALL HEALTH OF OUR COMMUNITY, THERE'S OTHER METRICS THAT WE TALKED ABOUT EARLIER.

THINGS LIKE THE NUMBER OF, UH, DEATHS BY SUICIDE OVERDOSES, UM, UH, DOMESTIC VIOLENCE.

IT ALSO DRIVES A COMMISSIONER INTO OTHER AREAS THAT WE DIDN'T TALK ABOUT, WHICH HAS TO DO WITH OVERALL PUBLIC HEALTH.

UM, IF PEOPLE'S BEHAVIORAL HEALTH SERVICES ARE, ARE PEOPLE ARE GETTING TREATMENT, THEIR OVERALL MEDICAL SERVICES ARE BETTER.

THE STATISTIC REALLY HOLDS RIGHT NOW IS THAT THERE'S ABOUT 50% OF THE COST AND, AND MEDICAID SYSTEMS ARE USUALLY DRIVEN BY A SMALL NUMBER OF PEOPLE WHO AREN'T GETTING NECESSARILY ALL OF THOSE NEEDS MET.

SO ONE OF THE THINGS THAT WE'RE DOING IS WORKING IN A MORE COORDINATED FASHION WITH OUR FEDERAL QUALIFIED HEALTHCARE PARTNERS, BUT ALSO, UH, HAVING CO-LOCATED MEDICAL SERVICES AT OUR SITES.

SO THE, IT IS A BASKET OF INDICATORS AND BY POPULATION IT ALSO VARIES.

UM, SO WE'RE HAPPY TO SHARE SOME OF OUR OUTCOME DATA WITH THIS GROUP AND, AND MORE THAN HAPPY TO COME BACK AND TALK ABOUT THEM IN, IN DETAIL.

LEMME SEE IF I CAN JUST ASK ONE MORE.

FIRST OF ALL, THE, THE, UM, I THINK, I CAN'T REMEMBER THE TERM YOU USED, BUT THE, THE, THE BEHAVIORAL HEALTH FIRST AID PROGRAM SOUNDS VERY, VERY INTERESTING.

AND I WONDERED IF, UM, YOU KNOW, IF THAT IS SOMETHING THAT'S ABLE TO BE AMPLIFIED THROUGH THE WHOLE PUBLIC HEALTH SYSTEM AND IN A NON-PUBLIC HEALTH SYSTEM ACROSS PROVIDER SYSTEMS, OTHER PROVIDER SYSTEMS ACROSS THE HEALTHCARE SPECTRUM AND, AND OTHER SYSTEMS THAT, UM, THAT JUST SOUNDS LIKE A VERY IMPORTANT THING THAT I'M NOT REALLY THAT FAMILIAR WITH.

WELL, IT'S GREAT.

THAT'S A GREAT QUESTION.

I MEAN, I THINK THERE'S A LOT, THE, THE NICE THING ABOUT THIS PROGRAM IS THAT WE DON'T HAVE TO BE THE SOLE OWNERS OF THIS.

THIS IS ONE THAT IF WE CAN TRAIN OTHERS TO BE TRAINERS OF OTHERS, AND THAT'S REALLY THE WORK THAT WE'VE BEEN DOING IN OUR COMMUNITY ALONG WITH TRAINING PEOPLE, IS TRAINING PEOPLE AS TRAINERS.

WE'VE BEEN WORKING WITH, UM, COMMUNITY GROUPS, CHURCHES, UM, UH, MEDICAL PRACTICES, UM, OUR LEGAL SYSTEM, UM, UH, WE'VE HAD REQUESTS FROM BUSINESSES HERE IN TOWN AS WELL, BECAUSE WE'RE ALL SEEING SOMEONE WHO'S STRUGGLING WITH THIS AND FINDING WAYS TO INTERVENE AND ACTUALLY LINK THEM TO CARE.

AND REALLY, IT'S ALSO EVEN MORE BASIC, BEING ABLE TO ASK THE QUESTIONS THAT PEOPLE ARE UNCOMFORTABLE TO ASK, KNOWING WHAT TO DO IF, IF SOMEONE'S STRUGGLING, AND HOW TO, HOW TO APPROACH SOMEONE WHO MAY BE SUICIDAL OR STRUGGLING IN SOME OTHER WAY.

NO, NOBODY HAS TRAINED PEOPLE ON HOW TO DO THIS.

AND IT'S A VERY TRAINABLE SKILL THAT IF WE DO THIS WELL CAN HELP, HELP EXPOSE THOSE NEEDS THAT SOMEONE HAS AND IF THEY NEED MORE INTENSIVE NEEDS, LINKING THEM TO THE RIGHT SET OF SERVICES WHERE AND WHEN THEY NEED THEM.

AND IT IS A TRUE PUBLIC HEALTH INITIATIVE IN A, IN A WAY THAT IT ALSO CAN GENERATE ITS OWN WAKE IF WE DO THIS.

WELL, LAST I MEAN, IS ARE THERE COMMUNITIES THAT DO THAT EXQUISITELY WELL AROUND THE COUNTRY? THAT WOULD BE AN EXAMPLE FOR US, OR ARE WE IN THE POSITION TO TRY TO LEAD OR, UM, WE DO IT EXQUISITELY WELL, RIGHT.

BUT THERE, THERE ARE OTHER PLACES THAT HAVE DONE THIS.

UM, BUT I, I THINK ONE OF THE THINGS THAT WE AS AN ORGANIZATION CONTINUE TO HAVE MADE THIS A COMMITMENT BECAUSE PART, PART OF THE WORK IN HEALTHCARE FOR US IS WHATEVER, NOT EVERYTHING HAS TO BE DONE BY A THERAPIST OR A SOCIAL WORKER OR A PSYCHIATRIST.

IF WE CAN PROVIDE, UH, PREVENTATIVE SERVICES WHERE PEOPLE NEED THEM, IT ALSO REDUCES THE NEED FOR MORE INTENSIVE SERVICES.

UM, WE'RE ALSO SEEING THIS IN THE SCHOOLS.

WE'RE SEEING IT EVERYWHERE.

SO IT'S AN IMPORTANT TOOL THAT, THAT WE NEED TO, TO MAKE SURE THAT EVERYONE HAS IT WIDELY AVAILABLE.

BUT THERE ARE EXAMPLES OF OTHER COMMUNITIES THAT HAVE DONE IT DIFFERENTLY.

BUT I THINK WE'RE, BECAUSE OF THE COMMITMENT OF THE, THE CITY AND OTHER PARTNERS, WE'VE BEEN ABLE TO WIDELY PROMOTE THIS IN A WAY THAT REALLY WE HAVEN'T SEEN THAT PICKUP IN OTHER PLACES.

PSYCHIATRIC MENTAL HEALTH SERVICES FOR CHILDREN, UM, AND HAVING SUFFICIENT CHILD PSYCHIATRY AND MENTAL HEALTH PROFESSIONALS, THERE HAS BEEN A GAP, NOT UNIQUE TO OUR COMMUNITY HERE, BUT NATIONWIDE.

UM, I HAVE ONE QUESTION.

SO MHAS TYPICALLY HAVE REALLY LONG WAIT LISTS.

UM, IT'S NOT UNIQUE TO INTEGRAL CARE BLUE BONNET TRAILS VERY SIMILARLY, I'M FAMILIAR WITH IT IN THE SCOPE OF LIKE CHILD AND ADOLESCENT MENTAL HEALTH, ARE THERE ORGANIZATIONS THAT YOU ARE WORKING WITH OR WAYS IN WHICH YOU'RE TRIAGING FOLKS THAT ARE IN THAT WAIT LIST BECAUSE THERE'S A HIGH NEED HERE, THERE ARE PEOPLE WHO MAY NEVER GET THE SERVICES AT INTEGRAL CARE BECAUSE THEY FALL INTO THIS LITTLE GAP.

IS THERE A CURRENT STRATEGY TO CAPTURE THOSE PEOPLE OR ORGANIZATIONS THAT YOU ARE SENDING THEM TO? AND IF SO, WHO, WHAT ARE THEY? WE, WE COULD TAG TEAM THIS, BUT I, I'LL START BY SAYING THERE'S, I, I'VE WORKED ON THIS NATIONALLY AND WHERE THE ORGANIZATION I CAME FROM, UM, CHILD AND

[00:35:01]

SO DEPENDING ON THE SERVICES THAT THAT INDIVIDUAL NEEDS, I THINK WE ARE LOOKING VERY SERIOUSLY ABOUT HOW DO WE EXPAND ALL OF THEM AND EXPAND THOSE WITH EXISTING PARTNERS.

UH, ONE OF THE AREAS THAT I THINK WE'VE TALKED ABOUT EARLIER, MORE IN THE ADULT SIDE, BUT IT ALSO WORKS WITH CHILDREN, IS HOW DO WE WORK WITH PEDIATRICIANS MORE SPECIFICALLY, HOW DO WE ACCESS PRIMARY CARE POINTS OF EN ENCOUNTERS FOR CHILDREN AND THEIR FAMILIES? AND PART OF WHAT WE'RE, WE'RE ALSO LOOKING AT IS HOW DO WE WORK MORE CLOSELY WITH THE SCHOOL SYSTEM TO BE ABLE TO AGAIN, INTERVENE, UH, WHERE PEOPLE NEED THEM IN TERMS OF WAIT LISTS? UH, YOU KNOW, UH, KATHLEEN, I'M WONDERING IF YOU WANT TO TALK TO HOW WE MANAGE THAT RIGHT NOW.

BUT, BUT IT IS SOMETHING THAT, THAT WE HAVE EVERY INTENTION ON EXPANDING.

UM, BUT WE CAN ONLY DO IT WHEN WE CAN RECRUIT AND RETAIN THE, THE, THE PSYCHIATRY AND TREATMENT SERVICES AVAILABLE TO DO THAT.

AND THAT'S SOMETHING THAT, UM, I'M VERY EAGER TO DO.

SO OVER THE PAST 24 MONTHS, WE'VE IMPLEMENTED A BEST PRACTICE CALLED JUST IN TIME SCHEDULING.

WE HAD NOHO, A NO-SHOW RATE THAT FAR EXCEEDED 30, 40% WITH JUST IN TIME SCHEDULING THAT HAS GONE PRECIPITOUSLY DOWN, YOU KNOW, IN THE SINGLE DIGITS WE HAVE AT ALL OUR MAJOR CLINICS WALK-IN APPOINTMENTS SAME DAY, UM, WHERE FOLKS CAN GET CONNECTED RIGHT AWAY.

UM, SO THAT'S BEEN A STRATEGY THAT'S BEEN HIGHLY EFFECTIVE.

IT DOESN'T SOLVE THE WHOLE PROBLEM, BUT AT LEAST IT IS, UH, AN OPPORTUNITY FOR SOMEBODY IN SIGNIFICANT NEED TO BE ABLE, THAT WOULDN'T MEET THE CRITERIA FOR CRISIS, FOR PSYCHIATRIC EMERGENCY SERVICE, URGENT CARE, BUT REALLY NEEDS THEIR MEDS REFILLED, REALLY NEEDS TO GET IN AND SEE SOMEONE THAT'S BEEN VERY SUCCESSFUL.

THE THE OTHER THING I WOULD ADD TO THAT, THIS IS NOT AS INTERESTING, BUT HAS A LOT MORE, UH, SUCCESS IN TERMS OF MAKING SURE THERE'S CAPACITY.

WE'VE BEEN UPDATING A LOT OF OUR TECHNOLOGY ABOUT HOW SOMEONE HAS TO DOCUMENT WHAT THEY DO IN TERMS OF AN ENCOUNTER TO REDUCE THE BURDEN OF PAPERWORK WHEN SOMEBODY IS SEEING SOMEONE.

AND YOU GO, WELL, SO WHAT? BUT THAT OPENS UP MORE CAPACITY OF CARE WHEN WE RE WE FIND MORE EFFICIENT WAYS THAT PEOPLE CAN MANAGE, UH, TO COMPLETE THEIR DOCUMENTATION.

WE'RE ALSO ALSO PILOTING WITH A, A NATIONAL PARTNER TO DO SOME, UM, WORK TO IMPROVE EVEN THAT EVEN FURTHER WITH THE USE OF AI TO REDUCE THE DOCUMENTATION BURDEN ON OUR CLINICIANS.

UM, SO THEY CAN DO WHAT THEY'RE WELL-TRAINED AT, WHICH IS SERVING PEOPLE AND NOT FILLING OUT PAPERWORK.

GREAT.

FAMILY CONFERENCE THAT WE'RE PUTTING ON IN FEBRUARY.

THANK YOU FOR YOUR PRESENTATION.

I'M CURIOUS ON ONE, ONE OF THE SLIDES WE DIDN'T SEE, UM, YOU HAVE LINGUISTICALLY APPROPRIATE AND MULTILINGUAL, UH, APPROACHES TO YOUR, YOUR CLIENTELE.

I'M WONDERING HOW, HOW MANY NON-ENGLISH SPEAKERS AND NON-SPANISH SPEAKERS DO Y'ALL SEE? AND HOW DO Y'ALL ADDRESS THOSE SITUATIONS? I DON'T HAVE THE DATA OF OF, OF HOW MANY WE CAN EASILY GET THAT FOR YOU OF, OF NON-ENGLISH SPEAKERS.

UM, I DO KNOW THAT WE HAVE A NUMBER OF STAFF WHO ARE FLUENT IN THE MAIN LANGUAGES, AND WE ALSO HAVE THE LANGUAGE LINE, WHICH IS ACCESSIBLE, NOT IDEAL.

YOU WANT A LIVE PERSON, WE ALL WOULD WANT THAT.

BUT WE DO HAVE, UH, A MECHANISM BY WHICH TO CONVERSE WITH SOMEBODY AND FOLLOWING UP ON THAT, GIVEN THAT IT'S NOT IDEAL.

AND I KNOW THAT FROM MY WORK AS WELL.

RIGHT.

DO YOU SEE ANY CHANCE THAT PERHAPS THAT POPULATION WON'T SEEK SERVICES AND SO FIVE, 10 YEARS DOWN THE ROAD WE'LL HAVE A HIGHER RATE OF MENTAL HEALTH ILLNESS IN THAT POPULATION, IF THAT MAKES SENSE? I THINK RIGHT NOW WE'RE ALREADY SEEING THAT, UM, NON-ENGLISH SPEAKING POPULATIONS IN OUR COMMUNITY AND ACROSS THE COUNTRY ARE NOT ASKING, NOT JUST BECAUSE OF THE TRANSLATIONAL PIECE, BECAUSE FRANKLY, THERE ARE NOT ENOUGH PEOPLE THAT WE'VE RE WE'VE RECRUITED ASSERTIVELY TO BE, TO REFLECT THE PEOPLE WHO ARE GETTING THEIR CARE.

SO NOT EVERYONE WANTS TO MEET A CHUBBY, MIDDLE AGED WHITE GUY FOR THERAPY.

UM, HOW DO WE HAVE PEOPLE THAT REFLECT THE PEOPLE THAT NEED THOSE SERVICES? SO PART OF THE WORK THAT WE'RE DOING IS WORKING WITH OUR, OUR, UH, SCHOOLS OF, AND, AND TO BE ABLE TO BUILD CAPACITY FOR PEOPLE TO GET INTO THIS WORK TO KNOW THAT THIS IS HOW, HOW IMPORTANT IT IS, AND DOING RECRUITMENT AND VERY EARLY ON SO THAT WE, WE CAN DO THAT.

IT'S ALSO WHERE PEOPLE ARE GETTING CARE MAY NOT ALWAYS TRADITIONALLY BEEN WILLING TO COME INTO A CLINIC TO GET THOSE SERVICES.

SO WE'VE DONE A LOT OF WORK AND, UM, SOME OF, YOU KNOW, WE, WE, WE HAVE A, A CENTRAL AFRICAN AMERICAN

[00:40:01]

AND ONE OF THE REASONS WE HAVE THAT IS A WAY FOR PEOPLE TO ALSO FIND OTHER MECHANISMS TO ACCESS CARE, HELP US DO A BETTER JOB ABOUT CONNECTING WITH THAT COMMUNITY TO BE ABLE TO REACH SERVICES.

UM, WE ALSO HAVE AN ENORMOUS AMOUNT OF WORK TO DO.

UM, AND, AND THE WE, I DON'T WANT TO BEAT THE DRUM ON MENTAL HEALTH FIRST AID, BUT PART OF THE UPTICK WE'VE GOTTEN IS FROM A LOT OF COMMUNITY GROUPS OF NON-ENGLISH SPEAKING FOLKS FOR THAT SERVICE.

UH, AND THAT'S, THAT'S AGAIN, TALKING ABOUT OTHER WAYS THAT PEOPLE CAN GET CARE BECAUSE THERE, THERE HASN'T ALWAYS BEEN SUCCESSFUL WAYS FOR PEOPLE TO SEE THAT PEOPLE THAT, THAT YOU CAN RECOVER AND THESE TREATMENT SERVICES ARE EFFECTIVE.

SO IT IS A MULTI-PRONGED APPROACH TO MAKE IT WORK.

THAT'S GREAT TO HEAR.

UH, FINAL QUESTION IS, I'M CURIOUS WHAT THE BURDEN ON YOUR SYSTEM IS OF PEOPLE OUTSIDE AUSTIN, TRAVIS COUNTY.

WE KNOW WITH HOSPITAL SYSTEMS, YOU KNOW, A LOT OF PEOPLE COME IN FROM OTHER COUNTIES AND THEN BURDEN OUR SYSTEM, SO TO SPEAK.

DO YOU HAVE THAT SAME ISSUE OR, UH, AND IF SO, HOW ARE YOU ADDRESSING THAT? SO WE, AS, AS JEFF SAID AT THE OUTSET, WE ARE ONE OF 39 LOCAL MENTAL HEALTH AUTHORITIES.

SO IF SOMEBODY IS FROM ANOTHER PART OF TEXAS, WE COORDINATE IN A VERY STRATEGIC WAY WITH THE, WE, WE TREAT ANYBODY IN CRISIS AND STABILIZE THEM.

AND WE DON'T ASK WHERE THEY LIVE OR ANY OTHER QUESTIONS OTHER THAN, UH, TRYING TO DETERMINE WHAT THEIR NEEDS ARE AND HOW WE CAN MEET THEM ONCE WE IDENTIFY SOMEBODY IS NOT A RESIDENT OF TRAVIS COUNTY, BUT RESIDES SOMEWHERE ELSE IN TEXAS, WE WORK WITH THE OTHER LOCAL MENTAL HEALTH AUTHORITIES TO TRANSITION THEM TO CARE.

UM, NATIONAL, I MEAN, WE HAVE, WE'RE A BIG FESTIVAL TOWN, RIGHT? SO WE'VE GOT A LOT OF FOLKS THAT COME IN, UM, FOR AS TOURISTS FOR FESTIVALS.

UM, AND TYPICALLY THEY, UH, WE ENCOUNTER THEM IN THEIR CRISIS, STABILIZE THEM, AND THEN HELP WITH WHATEVER MEANS, UH, NEEDED TO REUNITE THEM TO CONTACT FAMILY.

WE, OF COURSE, WE WORK WITH OUR HOSPITALS AND OUR OTHER, UM, PROVIDE HEALTHCARE PROVIDERS TO TRY TO STRATEGIZE AROUND HOW TO, UM, CONNECT SOMEBODY TO LONG-TERM CARE IN THEIR PLACE OF RESIDENCE.

AND MOST OF THE FOLKS, I WILL SAY, I THINK YOU WERE KIND OF POINTING MORE TOWARDS MONETIZING LIKE THE HOSPITALS DO, WHO'S OUTSIDE OF OUR SYSTEM.

SO MANY OF THE INDIVIDUALS THAT WE SERVE HAVE NO SOURCE OF FUNDING.

SO IT'S, UM, IT'S CHALLENGING OFTEN AND ESPECIALLY IF THEY PRESENT IN CRISIS TO BE ABLE TO COLLECT THAT DATA IN A VERY SYSTEMATIC WAY.

AND THAT'S NOT WHAT I MEANT.

I'M KIND OF ANTI PROFIT, SO OKAY.

I'M VERY AGAINST THE HOSPITAL SYSTEM.

UM, WHAT I'M WONDERING THOUGH IS JUST, YOU KNOW, IT DOESN'T SOUND LIKE Y'ALL ARE IN A BUDGET CRUNCH OR ANYTHING.

I HAVEN'T HEARD ANY CONCERNS ABOUT BUDGET, BUT I'M CURIOUS, YOU KNOW, IF THERE IS AN OUTSIZED, OUTSIZED BURDEN OUTSIDE THE COUNTY ON YOUR SYSTEM, I WONDER IF THERE ARE CHANGES TO THE FORMULA, THE FUNDING FORMULA AT THE STATE LEVEL THAT COULD TAKE THAT INTO ACCOUNT THAT YOU ARE HAVING TO SEE MORE OUTSIDE YOUR COUNTY, EVEN THOUGH YOU THEN PUSH THEM BACK OUT TO THEIR HOMES.

YOU KNOW, THAT IS A COST, OBVIOUSLY, AND I, I JUST WONDER IF PERHAPS AT SOME POINT THAT'S SOMETHING WE COULD ADVOCATE FOR OR SHOULD ADVOCATE FOR, IS A CHANGE IN THE FUNDING ALGORITHM? SO, CHRIS, WE DID, I, I WILL NEVER SAY THAT WE'RE COMPLETELY SUFFICIENTLY FUNDED TO DO WHAT WE NEED TO DO.

I, I THINK WE SHOULD BE THE TWICE THE SIZE THAT WE ARE NOW TO BE ABLE TO MEET THE NEED, BUT WE LIVE WITHIN THE MEANS THAT WE HAVE, BECAUSE THAT'S HOW WE DO IT HERE.

BUT I DO THINK THE ABILITY FOR US TO GROW TO MEET THIS NEED IN FOLKS IN THIS POPULATION THAT WE'RE, THAT'S HERE NOW IS GROWING.

WE DO SHARE DATA WITH THE STATE ON THE VOLUME OF, OF SERVICES WE PROVIDE AND, UM, ANY OF THE DATA ON, ON WHO'S ACCESSING CARE.

ONE OF THE AREAS OF CONCERN THAT I KNOW YOU GUYS HAVE, HAVE, AND WE HAVE TOO AS WELL, IS A NUMBER OF PEOPLE THAT WE'RE, WE'RE DIS-ENROLLED ON UNDER MEDICAID.

AND BEING ABLE TO ACCESS MEDICAID AND GET PEOPLE ENROLLED WHERE THEY NEEDED TO HAVE THOSE SERVICES.

AND I THINK WE'VE SEEN, WE, WE, WE COULD, WE WOULD TREASURE ANY ADVOCACY TO BE ABLE TO ENSURE THAT PEOPLE ARE GETTING ALL THE RESOURCES THAT THEY NEED AND WHEN AND HOW THEY NEED THEM.

UM, BUT WE DEFINITELY FEEL THAT WHAT WE'RE DOING NOW IS THE, THE ORGANIZATION HAS GROWN BECAUSE OF THE GROWTH IN OUR COMMUNITY.

IT NEEDS TO GROW EVEN FASTER TO KEEP UP.

SO PART OF THE WORK THAT WE'RE TRYING TO LOOK AT IS WHERE ARE WE SEEING THE MOST SIGNIFICANT GAPS, UM, RIGHT NOW ACROSS THE BOARD IN EVERYTHING THAT WE DO, I THINK WE, WE COULD GROW, BUT I WANNA MAKE SURE WE'RE DELIVERING THE RIGHT SET OF SERVICES TO MATCH THAT GROWTH.

DO YOU HAVE ANY, UH, PROJECTIONS BASED UPON WHAT WE ARE SEEING OR PROJECTING THE POPULATION GROWTH IS GOING TO BE ABOUT WHAT YOUR NEED IS GONNA BE? FROM THE FISCAL PERSPECTIVE? ONE OF THE THINGS THAT WE'RE, WE'RE, WE'RE CHALLENGING OURSELVES AND WE COULD USE ALL THE HELP WE CAN.

UM, AND IN FACT, UH, YOU KNOW, WE, WE WANNA BE ABLE TO MAKE SURE THAT WE'RE NOT JUST GROWING, BUT WE'RE GROWING IN THE RIGHT SET OF SERVICES.

[00:45:01]

SO, YOU KNOW, UH, ONE FUNDING DOESN'T ALWAYS MATCH NECESSARILY WHERE THE SERVICES ARE.

UH, WE WANT TO BE ABLE TO BE MORE INTENTIONAL ABOUT WHAT WE, WHAT WE NEED IN THIS COMMUNITY.

I THINK IT WOULD BE HELPFUL FOR THIS COMMISSION TO HAVE WHENEVER YOU HAVE IT AVAILABLE, THAT INFORMATION SO THAT WE CAN SUPPORT YOUR REQUESTS.

WE CAN ALSO SHARE WHAT WE DO ANNUALLY ALREADY, WHICH IS WE DO AN ANNUAL PLAN THAT REFLECTS WHERE WE SEE THE GAPS RIGHT NOW.

AND, UM, IT'S ACTUALLY UP IN OUR WEBSITE RIGHT NOW.

WHAT, WHAT I'M SPEAKING TO IS I WANT TO BE EVEN MORE DETAILED AROUND THAT AND USING, YOU KNOW, EPIDEMIOLOGICAL DATA AND REALLY LOOKING AT THE SET OF SERVICES THAT, WHERE WE FEEL THERE'S THE MOST SIGNIFICANT GAP IN CARE, BUT WE, WE ALREADY ARE DOING THAT AND ARE REQUIRED BY LAW TO DO THAT EVERY YEAR.

I, I WANNA MAKE IT EVEN MORE SUBSTANTIAL.

ANY QUESTIONS FROM OUR FOLKS ONLINE? YES.

HI.

UM, I WOULD LIKE TO ASK YOU A LITTLE BIT MORE ON THE YOUTH CRISIS RESPITE PROGRAM.

WHAT IS THE PROCESS STEP BY STEP TO BE ABLE TO HAVE A YOUTH, UM, BE ABLE TO RECEIVE THE SERVICES AT THE RESPITE? THE REFERRAL SOURCES, UM, ARE PARENTS, SCHOOL PROFESSIONALS, UM, UH, HOSPITALS, UH, A VARIETY.

IT, IT'S NO DIFFERENT FROM HOW SOMEBODY ELSE ENTERS OUR SYSTEM.

WE HAVE AN EVALUATION, AN ASSESSMENT.

UH, MANY REFERRALS CAN COME THROUGH DIRECTLY THROUGH THE HELPLINE, AND A DETERMINATION CAN BE MADE THAT, UH, THIS YOUTH IS IN NEED OF SERVICES CLINICALLY AND COULD BENEFIT FROM THIS.

UH, IT'S IMPORTANT TO UNDERSTAND IF SOMEBODY, IF A, IF A CHILD OR YOUNG PERSON, YOUNG ADULT IS SO IS HAVING SYMPTOMS THAT ARE SO SIGNIFICANT THAT THEY REALLY REQUIRE HOSPITALIZATION, THAT WE MAKE SURE THAT HAPPENS.

UM, SO IF THEY'RE ACTIVELY SUICIDAL, UM, HAVE HAD, UM, SOME VIOLENT BEHAVIORS THAT WOULD EXCEED OUR CAPACITY TO KEEP THEM SAFE AND OTHERS THEY WOULDN'T BE APPROPRIATE FOR, FOR THAT YOUTH RESPITE.

BUT, UM, MANY, MANY YOUTH END UP GOING TO THE HOSPITAL OR NOT GETTING CARE BECAUSE OF, UH, A PROGRAM LIKE THAT, NOT EXISTING.

SO IT'S, UM, IT'S AN IN INCREDIBLE RESOURCE AND THE REFERRALS SOURCES ACROSS THE SPECTRUM.

BUT CALL US, WE, WE WILL HELP YOU PROBLEM SOLVE IT.

HAVE ENOUGH THERE.

I KNOW I, GO AHEAD.

I'M WRITING A LIST, A BUNCH OF STUFF I OWE NATALIE AND, AND THE BOARD, AND WE'VE GOT A, A SUMMARY OF THE YOUTH CRISIS RESPITE PROGRAM THAT WE CAN SHARE WITH THE BOARD.

AND ASSISTANCE, ESPECIALLY WHEN THEY ARE AND ON THE STREETS.

AND THEN I HAVE ANOTHER, UM, THIS WILL BE MORE OF A LIVED EXPERIENCE.

MY, MY NAME IS MARTHA AND I'M A COMMUNITY HEALTH WORKER.

AND I HAVE BEEN DEVELOP, I DEVELOPED A PROGRAM IN DELL VALLEY, AND I AM A, DEFINITELY THE VOICE OF THE COMMUNITY.

AND AS MUCH AS BEAUTIFUL AS THE PRESENTATION IS, THERE IS A LOT OF AREAS THAT NEED, UM, SOME WORK TO DO.

I'M GONNA TAKE IT TO A PERSONAL LI LIVED EXPERIENCE WITH MY OWN CHILD.

WHEN MY CHILD, WELL, HE'S NOT MY CHILD, HE'S NOT A BABY.

HE'S 32 YEARS OLD AND HE IS ON METH, WAS UNHOUSED, SHOWED UP IN MY HOUSE, DID SOME HARM REDUCTION, UM, HERE WITH HIM AND THE MOMENT THAT THEY MENTIONED OF TRYING TO GET SUPPORT, WE HAVE HEARD A LOT OF THINGS ABOUT INTEGRAL CARE AND SAID, LET'S GO.

WENT AHEAD AND WALKED INTO YOUR INTEGRAL CARE ON AIRPORT.

THE FIRST PERSON THAT ADDRESSED GIGI WAS YOUR SECURITY GUARD.

YOUR SECURITY GUARD ASKED, HOW CAN WE HELP YOU? WE SHARED WHY WE WERE THERE, AND HIS RESPONSE WAS, UM, I CAN'T HELP YOU, BUT SHE CAN, WHICH WAS THE FRONT DESK RECEPTIONIST.

AT THAT POINT, GIGI DID NOT FEEL COMFORTABLE ANYMORE.

AND AS YOU KNOW, BEING IN THIS, UH, WHEN WE TALK ABOUT, UM, IT, YOU HAVE A VERY SMALL WINDOW, RIGHT? WHEN SOMEBODY NEEDS ASSISTANCE AND WHEN THEY WANT THE HELP, RIGHT? SO I'M ALWAYS ABOUT RESOURCES BEING PART OF THE COMMUNITY.

I'M ALWAYS HAVE A LIST OF RESOURCES FOR ANYBODY.

BUT WHEN IT COMES TO MENTAL HEALTH, BECAUSE I'M ALSO A, A MENTAL HEALTH PEER SUPPORT SPECIALIST, I KNOW THAT THERE'S A VERY SMALL WINDOW WHEN SOMEBODY WANTS SUPPORT

[00:50:01]

SO, UM, AT THAT POINT, GIGI DECIDES THAT DOESN'T WANNA PARTICIPATE ANYMORE, PARTICIPATE ANYMORE, BECAUSE WE HAVE ACTUALLY, HE PRETTY MUCH WHAT SHE PRETTY MUCH SUPPORT HER HEART OUT OF WHY SHE WAS THERE, WAS ASKED FRONT, WHAT KIND OF, UM, SUBSTANCE DO YOU USE? AND VERY SHAMEFUL, GIGI ASKED, THAT MEANS RESPONDED WITH METH.

THIS IS ALL BEING AT THE FRONT, RIGHT? AND THIS IS ALL TO THE SECURITY GUARD.

SO BY THAT TIME, SHANE KICKS IN, GIGI WANTS TO LEAVE, AND YOUR RECEPTIONIST STEPS IN AND PROVIDES GIGI BEFORE WE LEAVE.

AND A BIG HANDBOOK OF ALL THE RESOURCES AVAILABLE.

AT THAT POINT, GIGI IS NOT GONNA READ ANY OF THOSE RESOURCES AS WE KNOW.

AND I THINK THAT THERE'S A LOT OF, UH, ROOM FOR IMPROVEMENT.

NOW, MIND YOU, IT'S NOT YOUR FAULT.

IT IS NOT YOUR, UM, RESPONSIBILITY OF THE CHOICES THAT GIGI HAS MADE IN LIFE THAT HAS PLA THAT HAS PLACED THEM WHERE THEY ARE NOW.

RIGHT? BUT I CAN TELL YOU THAT WITHIN, THAT HAPPENED WITHIN SEVEN YEARS AGO, THAT WAS, THAT HAPPENED SEVEN YEARS AGO.

AND I DECIDED, BECAUSE I KNEW YOU WERE GONNA BE HERE TO DO THE, TO DO A WALKTHROUGH ON ONE OF YOUR FACILITIES.

AND IT SEEMS IT'S STILL THE SAME PROCESS.

SO SEVEN YEARS LATER, THE PROCESS IS THE SAME.

AND AS MUCH AS, UM, YOU HAVE SO MUCH DATA AND SO MANY PEOPLE THAT YOU ARE HELPING, WHICH THERE IS NO DOUBT ABOUT BECAUSE THERE IS A NEED.

I CAN JUST IMAGINE HOW MANY OTHER PEOPLE HAVE JUST DECIDED TO NOT PURSUE ANY RESOURCES BECAUSE OF THAT FIRST ENCOUNTER.

WITHIN THE SEVEN YEARS OF THAT ENCOUNTER, GIGI WAS ASSAULTED THREE TIMES BEING ON THE STREET.

AGAIN, IT'S NOT YOUR FAULT, I JUST WANNA GO AHEAD AND PAINT THE BIG PICTURE OF WHEN WE ARE AS PROFESSIONALS HAVE THE OPPORTUNITY TO SUPPORT AN INDIVIDUAL, WE HAVE TO HAVE THOSE RESOURCES IN MIND.

AND WHEN WE TALK ABOUT DIGNITY AND RESPECT, RIGHT? THIS IS WHERE IT COMES IN.

WITHIN THOSE SEVEN YEARS, GIGI WAS ASSAULTED THREE TIMES, TWO PHYSICAL AND ONE SEXUAL WHILE BEING ON THE STREETS.

UM, IF IT WASN'T FOR SUNRISE, GIGI HAS DECIDED, YOU KNOW, AFTER THE THIRD ASSAULT THAT THEY HAD TO WIRE HER MOUTH SHUT.

UM, I THINK THERE WAS A TIME WHERE GIGI DECIDED THAT NEEDED TO REALLY FOCUS A LOT MORE ON HAVING A PLACE TO LIVE.

SO I SHARE THIS WITH YOU BECAUSE AGAIN, IT IS NOT, YOUR RESPONSIBILITY OF THE CHOICES ISN'T, YOU'RE NOT ACCOUNTABLE FOR THE CHOICES THAT GIGI HAS MADE.

AS GIGI HAS MADE IT CLEAR TO ME THAT, HEY, MOM, I'VE MADE THESE CHOICES AND I'M ACCOUNTABLE FOR THEM.

BUT I DO WANNA SH I DO WANNA PAINT THE PICTURE OF HOW THE RIPPLING EFFECTS OF THE FIRST POINT OF CONTACT CAN AFFECT AN INDIVIDUAL.

AND IN THIS CASE, I FEEL THAT THAT'S A, UM, I THINK THERE IS ROOM FOR IMPROVEMENT WHEN IT COMES TO SOME OF THE CLIENTS THAT ARE VERY VULNERABLE THAT DECIDE TO ASK FOR RESOURCES OR ASK FOR SOME HELP, UH, TO ALSO SEE SOMETIME ON THIS RUN THROUGH THAT I DID SEE ONE, A CLIENT ON THE FLOOR JUST LAYING THERE LIKE, UM, JUST LAYING THERE WITH NOBODY TRYING TO SUPPORT AND SEE WHAT THEY'RE NEEDING.

UM, AND I JUST OVERHEARD THE SECURITY SAY, I'VE ALREADY CALLED A PD, THIS INDIVIDUAL IS LITERALLY FAINTED OR ASLEEP OR RESTING IN, IN YOUR FRONT, IN YOUR AREA.

UM, AGAIN, THAT WAS JUST MY LIKE, QUALITY.

'CAUSE OF COURSE, I WASN'T GONNA COME AND SAY ALL OF THIS WITH SAYING THAT MAYBE THERE WAS A RESTRUCTURE OF THE FRONT DESK.

UM, ALSO, UM, THAT IS JUST THE LIVED EXPERIENCE.

AND AS A COMMUNITY HEALTH WORKER, I CAN TELL YOU THAT I HAVE HEARD MANY STORIES ABOUT INTEGRAL CARE HAVING A LITTLE BIT OF A, AND I'M ASSUMING THAT IT'S GONNA BE BECAUSE OF THAT, BECAUSE OF LANGUAGE AND BECAUSE OF THE FIRST POINT OF CONTACT.

NOW, I ALSO WOULD LIKE TO SUGGEST, OR PROPOSE OR GIVE AN IDEA OF HOW THE IMPORTANCE OF CROSS TRAINING, PEER SUPPORT, UM, AND COMMUNITY HEALTH WORKERS WORK TOGETHER, COMMUNITY HEALTH WORKERS, YOU KNOW, WE, WE FOCUS A LOT ON SOCIAL DETERMINANTS OF HEALTH AND PEER.

WE SUPPORT MENTAL HEALTH.

AND I THINK THAT WHEN AN INDIVIDUAL IS NOT GONNA CONTINUE GOING TO THEIR DOCTOR'S APPOINTMENTS, THEY'RE NOT GONNA CONTINUE TRYING TO GET ANY KIND OF SUPPORT IF THEIR BASIC NEEDS ARE NOT BEING MET.

SO THAT WOULD JUST BE SOMETHING THAT I WOULD LIKE JUST THROW OUT THERE IF THERE'S AN OPPORTUNITY WHERE I KNOW THAT INTEGRAL CARE IS VERY STRONG ON, UH, PEER

[00:55:01]

SUPPORT.

UM, AND I THINK THAT WITH COMMUNITY HEALTH WORKERS RIGHT NOW THAT WE'RE PUSHING IN THIS INITIATIVE WOULD MAYBE SUPPORT EVEN MORE.

UM, OF COURSE THAT WOULD COME WITH, ONE THING I DO BELIEVE IS THAT YOU PAY, YOU, YOU, UM, VALUE WHAT COMES TO THE TABLE AND, YOU KNOW, MAKE SURE LIKE, YOU KNOW, PEER SUPPORT IS, IS WHEN IT COMES TO MENTAL HEALTH.

YOU KNOW, GETTING VALUED PRETTY MUCH JUST A WAGES, IN OTHER WORDS, WITH A COMMUNITY HEALTH WORKER.

UM, BECAUSE YOU WOULD BE ABLE TO REALLY, UM, MAKE A MAJOR IMPACT ON AN INDIVIDUAL THAT IS ACTUALLY BEING ABLE TO BE SUPPORTED BY PEER SUPPORT AND COMMUNITY HEALTH WORKER.

BECAUSE I AM BOTH, I, I HAVE BEEN ABLE TO UTILIZE BOTH OF THOSE EXPERIENCES TO BE ABLE TO SUPPORT A LOT OF FAMILIES IN DE VALLEY AND ALSO BE ABLE TO PUSH HIM TO GET SOME MENTAL HEALTH OR IF I KNOW THAT THEY HAVE MEDICAID, BE ABLE TO LIKE, HELP THEM AND SUPPORT AND MAKE AN APPOINTMENT WITH LONG SOURCE CIRCLE CARE WHO HAVE BEHAVIORAL HEALTH.

UM, BUT YES, SO I JUST WOULD LIKE TO, I WANTED TO SHARE THAT WITH YOU AND, UM, THANK YOU FOR BRINGING THAT PRESENTATION TO US TODAY.

THANK YOU FOR SHARING YOUR EXPERIENCE AND, UH, YOU KNOW, NOT, I AM NOT ONLY SOMEONE WHO'S, UH, LEADING THIS ORGANIZATION.

I HAVE A CHILD WHO'S MENTALLY ILL AND I KNOW WHAT THAT FIRST POINT OF EXPERIENCE CAN BE AND CAN BE SUCCESSFUL OR FAIL.

SO I THANK YOU FOR SHARING THAT.

AND WE DO TAKE THAT VERY SERIOUSLY.

UH, AND I APPRECIATE YOUR FEEDBACK AND ANY FEEDBACK, GOOD, BAD OR OTHERWISE WE WANT TO HEAR IT.

SO THANK YOU FOR SHARING THAT.

ANY OTHER COMMENTS FROM OUR FOLKS ONLINE? WONDERFUL.

I HAVE ONE FOLLOW UP QUESTION THAT WE'LL, WE'LL SEE HOW IT GOES.

UM, YOU MENTIONED PREVIOUSLY THAT IN 2022, UM, TRAVIS COUNTY HAD A HUNDRED PERCENT OVER A HUNDRED PERCENT INCREASE IN OPIOID DEATHS.

DO YOU HAVE ANY DATA TO LOOK AT, UM, THAT HISTORY, RIGHT? I, I'M PREVIOUS EMS PERSON, SO I'M, I'M TAKING THIS FROM NINE ONE ONE CALL OR HOWEVER THAT WAS CAPTURED TO.

WHAT WAS THEIR PREVIOUS HISTORY? WERE THEY TREATED AT CIRCLE CARE? THEY WERE A PART OF THE HOUSING PROGRAM, RIGHT? LIKE THEY WERE NOT, THEY WERE HERE AT A PH, THEY WENT INTO WHATEVER THEIR STORY WAS LOOKING AT SERVICES PROVIDED AND THEN IN RELATION TO THEIR MENTAL HEALTH DISORDERS AND THEN THEIR DEATH.

DO YOU HAVE THAT CONTENT OR THAT DATA OR THAT SOME SORT OF INFORMATION? WE HAVE, WE HAVE CONTENT IF THEY WERE TREATED WITHIN OUR SYSTEM AND THAT HAPPENED.

I MEAN, PART OF THE WORK THAT YOU HEARD KATHLEEN TALK ABOUT EARLIER, WHICH IS HOW ARE WE, HOW CAN WE ALL, EVERY PROVIDER IN THIS COMMUNITY MORE EFFECTIVELY USE, UM, THE REGIONAL HEALTH EXCHANGE CONEXUS AS WELL AS OTHER MEANS TO SHARE INFORMATION, TO BE, TO BE ABLE TO CAPTURE ALL OF THAT DATA.

UH, BECAUSE THAT IS A PROBLEM THAT WE HAVE ORGAN, NOT ORGANIZATIONALLY, BUT IN ANY COMMUNITY.

HOW DO WE ENSURE THAT WE GET, UH, PEOPLE'S EXPERIENCE CAPTURED? UM, THERE'S SOME INFORMATION BY LAW WE CAN'T, BUT MOST THERE, THERE'S A LOT MORE INFORMATION WE CAN.

AND SO THERE'S SOME WAYS THAT WE'RE LOOKING AT SOME TECHNOLOGICAL FIXES SO WE CAN SHARE THAT INFORMATION.

BUT IF SOMEONE HAS, UM, DIED OF AN OVERDOSE AND WE, WE ARE TREATING THEM AT THE TIME, WE DO CAPTURE THAT INFORMATION.

BUT WE, UNLESS WE'RE ABLE TO SHARE THAT INFORMATION COLLECTIVELY, THE, I THINK SOME OF THE TECHNOLOGY AND SOME OF THE AGREEMENTS THAT WE'RE WORKING ON IN THIS COMMUNITY NOW, I THINK WILL HELP.

UM, BUT THAT, THAT HAS ALWAYS BEEN A CHALLENGE.

RIGHT.

UM, WHEN THAT'S WHERE WE OBVIOUSLY WE'RE DISCUSSING THAT, THAT LATER ON IN OUR AGENDA, UM, BUT WOULD LOVE TO HAVE THAT SHARED BACK WITH THE COMMISSION IF POSSIBLE.

UH, OF COURSE, THE APPROPRIATE CONTENT THAT IS FOR THE PUBLIC TO SEE, UH, ON, ON HOW THAT'S LOOKING AND WHAT'S BEEN AFFECTED WITHIN INTEGRAL CARE, RIGHT.

INDIVIDUALS THAT YOU ARE TREATING.

UM, THAT'D BE REALLY WONDERFUL IF WE COULD GET THAT BACK.

I THINK THAT'S A REALLY INTERESTING AND, AND, UM, WONDERFUL, UM, LINE OF QUESTIONING AND RESEARCH AND THOUGHT THAT WE SHOULD BE, UM, CONSIDERING AS A COMMUNITY, YOU KNOW, SO WE'RE WORKING CLOSELY.

CHAIR.

YES, I WAS JUST GONNA ECHO IF I'M NOT INTERRUPTING YOUR SEQUENCE, DID YOU HAVE MORE QUESTIONS? I WE, WE GONNA WRAP THIS UP.

I KNOW WE GOTTA WRAP IT UP, BUT I THINK IN THE STUDY I HAVE AND MAYBE THE PAPERS THAT I CITED, I THINK 32% OF PATIENTS THAT HAVE AN AN OPIOID OVERDOSE DEATH HAD A PRIOR, UM, OVERDOSE IN THE, IN THAT SAME, UM, CALENDAR YEAR.

SO IT, THAT WHOLE QUESTION IS A VERY INTERESTING QUESTION TO WONDER IF ALL OF OUR SYSTEMS COULDN'T PLAY BETTER TOGETHER TO SEE ONCE YOU HAVE THAT FIRST SIGNAL, YOU'VE GOT A VERY HIGH, UM, YOU KNOW, IMPORTANT SIGNAL FOR SOME SUBSEQUENT EVENT IN THE NEXT 30 12 MONTHS OF THOSE KINDS OF THINGS.

AND SO, UM, YOU KNOW, UM,

[01:00:01]

HAVE YOU ALL BEEN INVOLVED WITH DR. CASEY CLAYBORNE AND TEX COPE, THE TEXAS OVERDOSE TRACKING SYSTEM SO RECENT? SO, SO SOME OF THAT DATA WAS DERIVED FROM AUSTIN PUBLIC HEALTH AND THE COUNTY NOT INTEGRAL CARES PATIENT DATA, IT'S COMMUNITY-WIDE.

UM, IT'S VERY DIFFICULT FOR OBVIOUS REASONS TO TRACK INDIVIDUALS, BUT THE, THE TEXT COPE SYSTEM WAS HIGHLY IMPACTFUL WITH THE BAD BATCH THAT HAPPENED SEVERAL, UM, MONTHS AGO NOW, IN BEING ABLE TO ALERT EVERYBODY AND INTEGRAL CARE WAS PART OF THAT IN DISTRIBUTION OF NALOXONE.

SO IDEALLY YOU WANNA GET WAY UPSTREAM, BUT FAILING, GETTING SOMEBODY INTO, YOU KNOW, ONGOING TREATMENT AND UM, UH, YOU KNOW, HARM REDUCTION, YOU WANNA HAVE THE ABILITY IN REAL TIME TO BE ABLE TO DISTRIBUTE IN PARTNERSHIP WITH EMS AND OTHERS OUTREACH WORKERS TO GET PEOPLE, UH, THE LIFESAVING INTERVENTIONS THAT THEY NEED.

THE COROLLARY TO THAT, I'LL MAKE THAT FORM IS ONE OF THE THINGS THAT I READ ABOUT IS DON'T USE ALONE.

ONCE YOU HAVE AN OVERDOSE, THAT'S A VERY IMPORTANT COMMENTARY TO HAVE IN TEACHING AND EVERYBODY SHOULD BE TEACHING AND TALKING ABOUT THAT THROUGHOUT THE HAIR, THE CARE SYSTEM, IT TOUCHES, YOU KNOW, THOSE KINDS OF PATIENTS.

WONDERFUL.

THANK YOU SO MUCH FOR YOUR TIME, FOR YOUR PRESENTATION.

UM, I KNOW YOU WROTE NOTES.

HOPEFULLY DANNY CAPTURED ALL OF OUR FOLLOW UP REQUESTS, BUT, UH, HOPEFULLY WE'LL SEE YOU AGAIN TO HAVE A UPDATE ON DIFFERENT ASPECTS OF YOUR PROGRAMMING AND THE SUCCESS THAT YOU'RE HAVING.

APPRECIATE IT.

THREE, UH, PRESENTATION BY JULIE WEEKS FROM AUSTIN, VOICES FOR EDUCATION AND YOUTH, AND MICHELLE MURKY FROM AUSTIN PUBLIC HEALTH ON VACCINE EQUITY COALITION.

OKAY, MOVING ON TO ITEM

[3. Presentation by Julie Weeks from Austin Voices for Education and Youth, and Michelle Mirsky from Austin Public Health on vaccine equity coalition.]

WELCOME.

GOOD AFTERNOON, COMMISSIONERS.

PLEASE MAKE SURE YOU USE YOUR MICROPHONE.

THERE WE GO.

OH, HI.

THANK YOU SO MUCH FOR HAVING US.

I'M JULIE WEEKS.

I'M THE DIRECTOR OF FAMILY RESOURCE CENTERS WITH AUSTIN VOICES FOR EDUCATION AND YOUTH.

AND I'LL TALK MORE ABOUT WHAT WE DO LATER.

MICHELLE.

I'M MICHELLE MURKY, AND I'M A SUPERVISOR IN THE AUSTIN PUBLIC HEALTH IMMUNIZATIONS PROGRAM.

UM, HEALTH DISPARITIES REDUCTION IS MY TEAM.

UM, AND WE ARE REPRESENTING THE, UH, VAX ACT, WHICH IS THE VACCINE EQUITY COALITION OF AUSTIN AND TRAVIS COUNTY, UM, WHICH IS NOT JUST US.

IT HAS REPRESENTATIVES FROM ORGANIZATIONS AROUND, UM, AUSTIN AND TRAVIS COUNTY, BUT NOT EVERYONE WHO NEEDS TO JOIN.

SO WE'LL HAVE SOME, SOME ASKS FOR YOU GUYS LATER.

UM, BUT THANKS.

UM, FIRST I WANNA GIVE YOU SOME CONTEXT OF WHY WE'RE HERE.

UM, FIRST, ALTHOUGH I DIDN'T WRITE IT ON THE SLIDE, WE ARE NOT HERE TO ASK FOR MONEY.

UM, IT, IT IS MY OPINION AND MY ASSESSMENT, UM, AS A SUBJECT MATTER EXPERT IN THIS WORK, THAT THERE ARE MANY, MANY RESOURCES AVAILABLE THAT ARE NOT BEING USED EFFICIENTLY.

UM, SO THE, THE STATE OF OUR WHOLE VACCINE SAFETY NET, WHICH IS NOT JUST PUBLIC HEALTH, BUT ALL OF THE VACCINES FOR CHILDREN, PROVIDERS, AND ADULT SAFETY NET PROVIDERS, IT'S NOT MEETING THE CURRENT DEMAND, PARTICULARLY IN, UM, SCHOOL VACCINES, BUT ALSO NOT ADULT VACCINES AT ALL.

UM, JUST MY OWN PERSONAL, UH, REASON FOR GETTING THE COALITION TOGETHER WAS TO TRY AND GET MORE RESOURCES TOWARD ADULT VACCINES.

AND WE WERE IMMEDIATELY STOPPED IN OUR TRACKS, REALIZING THAT THE SUR FIT OF RESOURCES THAT WE HAVE FOR PEDIATRIC VACCINES WAS NOT MEETING THE NEED.

UM, AND, AND THEN WE HAVE THIS UNDERSTANDING THAT AS WE CONTINUE TO DO VACCINE EQUITY WORK, WHICH IS A LOT OF VACCINE EDUCATION, UM, THAT WE ARE ACTUALLY ONLY OPENING UP MORE DEMAND AND IT'S ALREADY NOT ABLE TO BE MET.

SO WE WANTED TO STEP IN AND REQUEST SOME SUPPORT FROM PUBLIC HEALTH COMMISSION ON MEETING THIS DEMAND.

WE'RE, WE'RE IN A CRISIS POINT, BUT IT, IT IS A CHRONIC PROBLEM.

UM, AND, AND WE'RE GONNA USE SCHOOL IMMUNIZATIONS TO KIND OF TRY AND, AND JUST GROUND US, BUT JUST KNOW THAT THIS IS LIKE A STONE SKIP OVER THE WATER .

WE'RE NOT DOING A DEEP DATA DIVE TODAY.

UM, SO WE'RE GONNA START WITH WHO, WHO DOES VACCINATE UNDERSERVED CHILDREN? SO WE HAVE OVER 70 TVFC TEXAS VACCINES FOR CHILDREN PROVIDERS, UM, AND THEY OFFER VACCINES AT LOW OR NO COST, UH, TO CHILDREN INFANTS UP TO AGE 19.

UM, THE ELIGIBILITY REQUIREMENTS ARE UNINSURED, UH, MEDICAID OR INSURANCE THAT DOESN'T COVER VACCINES.

UM, AND WE, WE HAVE

[01:05:01]

ALL DIFFERENT PROVIDERS UNDER THAT UMBRELLA.

OBVIOUSLY, SEVEN D PLUS PROVIDERS IS A LOT.

UM, WE HAVE OUR OWN IN AUSTIN PUBLIC HEALTH.

WE HAVE TWO SHOTS FOR TOTS LOCATIONS, UM, BRAND NEW DOVE SPRINGS LOCATION TO REPLACE OUR FORMER, UH, FAR SOUTH LOCATION, BRIGHT AND SHINY AND LOVELY.

UM, AND WE ALSO HAVE THE A PH MOBILE VACCINE PROGRAM, WHICH WAS FORMERLY ADULT OUTREACH DURING COVID, BECAME OUTREACH FOR EVERYONE AND WILL SUNSET AS A PEDIATRIC OUTREACH PROGRAM IN MARCH OF 2025.

AND WE WILL NOT HAVE A PEDIATRIC VACCINE OUTREACH PROGRAM THROUGH AUSTIN PUBLIC HEALTH.

UM, AND THEN WE ALSO AS VACCINE FOR CHILDREN PROVIDER HAVE THE REFUGEE HEALTH SERVICES CLINIC, BUT THEY ARE LIMITED TO REFUGEES, UM, WHO ARE UNDER CERTAIN PROGRAMS, AND SO THEY'RE NOT OPEN TO THE PUBLIC.

UM, IN ADDITION AND, AND SORT OF THE LION'S SHARE OF THE PROVIDERS WHO ARE IN THIS SAFETY NET ARE FQHCS.

UM, AND EACH HAS THEIR OWN GRANT FUNDING AND MANDATES AND DIFFERENT CRITERIA, UM, AND DIFFERENT STAFFING.

AND AS A RESULT, THE CAPACITIES DIFFER.

UM, AND IT, THE, THERE'S NOT A TREMENDOUS AMOUNT OF TRANSPARENCY FROM ONE TO THE OTHER OR TO US ABOUT WHAT THE CAPACITY IS.

UM, WE ALSO HAVE AUSTIN REGIONAL CLINIC, AUSTIN DIAGNOSTIC CLINIC, TEXAS CHILDREN'S CLINICS, ASCENSION CLINICS, UM, BUT THEY, UH, ARE MOSTLY IN THE TVFC BUSINESS FOR THE MEDICAID CLIENTS.

UM, AND THEY'RE, THEY'RE NOT NECESSARILY PREPARED TO TAKE UNINSURED CLIENTS, ALTHOUGH THEY, THEY HAVE TO VACCINATE THEM IF THEY GET THROUGH THE DOOR.

THERE'S, THERE'S A LOT OF DIFFERENT, ALL THE ELIGIBILITY IS THE SAME, BUT THERE'S A LOT OF DIFFERENT HOOPS TO JUMP THROUGH.

UM, I'M GONNA TURN IT OVER TO JULIE FOR A FEW SLIDES, AND THEN I'LL DO SOME, SOME MORE.

TALKING ABOUT SCHOOL VACCINES.

THANK YOU, MICHELLE.

SO, MY, UH, ORGANIZATION, AUSTIN VOICES.

UM, WE DO WHAT'S CALLED COMMUNITY SCHOOLS.

SO WE ARE A NONPROFIT HERE IN AUSTIN, AND WE ARE IN SEVEN, UH, TITLE ONE SCHOOLS, MOSTLY MIDDLE SCHOOLS, SEVERAL HIGH SCHOOLS, AND ONE ELEMENTARY SCHOOL.

WE SERVE 20 SCHOOLS IN THE EASTERN CRESCENT, THE LOW INCOME AREAS OF THE CITY, UM, PROVIDING SOCIAL SERVICES, UM, SUPPORTS TO FAMILIES BECAUSE WE KNOW IT KIND OF TAKES A VILLAGE TO EDUCATE A CHILD.

THERE'S A LOT OF THINGS THAT AFFECT STUDENTS BEING IN SCHOOL EVERY DAY READY TO LEARN, THAT HAS ABSOLUTELY NOTHING TO DO WITH CURRICULUM AND INSTRUCTION, AND WHAT HAPPENS IN THE SCHOOL BUILDING IF THEY CAN'T MAKE IT TO THE SCHOOL, IF THEY'RE NOT COMING IN A STATE WHERE THEY'RE READY TO LEARN, OR IF THEY'RE BEING PREVENTED FROM COMING TO SCHOOL, SUCH AS NOT HAVING VACCINES.

WE REFER TO THOSE THINGS AS BARRIERS TO LEARNING AND BARRIERS TO LEARNING HAVE A REAL EFFECT ON KIDS BEING ABLE TO GRADUATE AND MAKING IT ALL THE WAY THROUGH.

AND SO, THE SLIDE HERE, UM, THERE'S OVER 112,000 STUDENTS ATTENDING PUBLIC SCHOOLS IN, IN AUSTIN, TRAVIS COUNTY.

UH, YOU CAN SEE A ISD IS MORE THAN HALF.

UH, VILLE IS NUMBER TWO.

DEL VALLEY IS NUMBER THREE, AND MAINOR IS NUMBER FOUR.

AND THERE'S A CONCERNING TREND.

AS MICHELLE SAID.

WE'RE HERE TO TALK ABOUT A CHRONIC TREND AS WELL AS AN IMMEDIATE CRISIS.

AND WE WANT Y'ALL'S HELP FIGURING OUT HOW AS A HEALTHCARE SYSTEM IN THE COMMUNITY THAT IS MADE UP OF PRIMARY CARE, PUBLIC HEALTH, AND HOW IT INTERFACES WITH THE SOCIAL SERVICE SECTOR, WITH THE EDUCATION SYSTEM, HOW WE CAN DO BETTER.

SO ON THE STATE WEBSITE FOR TEXAS, UH, DEPARTMENT OF STATE HEALTH SERVICES, I FOUND THAT THE, THE SCHOOLS HAVE TO REPORT, UM, VACCINE COMPLIANCE, UM, WITH TWO INDICATORS, KINDERGARTEN READINESS FOR VACCINES IN SEVENTH GRADE.

AND IN 19 2019 AND 20, THAT WAS THE, THE OLDEST DATA THAT WAS ONLINE.

UM, WE WERE PRETTY MUCH KEEPING STEP WITH THE 95% COMPLIANCE LEVEL THAT'S MANDATED BY THE STATE.

STATE SAYS SCHOOLS MUST BE 95% FOR KIDS TO ATTEND SCHOOL.

AND, UM, LOOKING BACK AT LAST YEAR'S DATA, IT'S CONCERNING, UM, BECAUSE THE, THE SECOND AND FOURTH COLUMNS, THERE'S MORE RED THERE.

THAT MEANS THEY'RE NOT HITTING THE 95%.

THERE'S A, THERE'S A SIGNIFICANT DECREASE IN KINDERGARTEN READINESS.

AND WITHIN A IC ESPECIALLY, 58% OF SEVENTH GRADERS ARE COMPLIANT WITH THEIR VACCINES.

IT'S SUPPOSED TO BE 95%.

SO FOUR OF MY FAMILY RESOURCE CENTERS THAT I MANAGE ARE IN EASTERN CRESCENT MIDDLE SCHOOLS, WEBBED, OB BURNETT, AND MARTIN MIDDLE SCHOOLS.

THAT'S THE STORY.

THAT'S WHERE I BROUGHT THIS CONCERN UP WITH OUR COALITION AND WITH MEGAN CERMACK, WHO'S ONE OF OUR PARTNERS.

AND WITH

[01:10:01]

DR. LYNN CHAO, YOU KNOW, WE ARE CONCERNED THAT SO MANY KIDS ARE NOT GETTING VACCINATED.

UM, THE NEXT SLIDE SHOWS, UM, A LITTLE BIT MORE DETAIL.

SO I DUG IN THIS YEAR, ASKED AD'S, UM, DIRECTOR OF, OF STUDENT HEALTH SERVICES, HOW MANY STUDENTS WERE NOT COMPLIANT WITH VACCINES? FIRST DAY OF SCHOOL, AUGUST 20TH, 14,854 STUDENTS, 22.6% OF THE STUDENTS ENROLLED IN A ISD WERE NOT YET COMPLIANT WITH THEIR VACCINES.

FIRST DAY OF SCHOOL.

THEN I ASKED FOR ANOTHER DATA POINT, OCTOBER 1ST, THAT'S JUST A MONTH AGO.

THE ENROLLMENT FOR A ISC HAS INCREASED TO 72,000.

THEY'VE ENROLLED MORE STUDENTS, BUT 13,443 STUDENTS, 18.5% OF A ISD STUDENTS ARE STILL NOT COMPLIANT WITH THEIR VACCINES.

THIS IS A REAL CONCERN BECAUSE THE GOAL REMEMBERS 95%.

SO, UM, FROM MY PERSPECTIVE, AUSTIN VOICES, WE HAVE BEEN WORKING AT THIS FOR A LONG TIME.

AND THROUGH OUR FAMILY RESOURCE CENTERS, WE HAVE COMMUNITY HEALTH WORKERS.

WE CALL THEM PRO.

WE HAVE A SMALL ARMY, BUT OUR SOCIAL WORKERS, OUR DIRECTORS, AND OUR FAMILY RESOURCE CENTERS, WE CREATED A CAMPAIGN.

WE CALL IT THE HEALTHY FAMILIES HEALTHY COMMUNITIES CAMPAIGN.

AND THERE'S BASICALLY FOUR STEPS.

NEXT SLIDE.

THERE'S BASICALLY FOUR STEPS THAT, UM, FAMILIES HAVE TO GO THROUGH TO GET TO VACCINES.

IT'S COVER, CONNECT, PREPARE, PROTECT, INSURANCE COVERAGE.

THAT'S THE FIRST CHALLENGE IN ORDER TO THEN CONNECT TO A MEDICAL HOME AND, AND, AND ACCESS A CLINIC.

AND THEN PREPARE.

THAT MEANS GET YOUR CHILD SCHEDULED FOR THEIR WELL CHECKS WHERE THEY YES, GET PROTECTED, THEY GET THEIR VACCINES.

SO YOU'VE GOT CHALLENGES, BARRIERS, LIMITATIONS AT EACH STEP ALONG THE WAY.

AND IT PROMPTED US AS AUSTIN VOICES.

WE WORK WITH CENTRAL HEALTH.

WE DO MAP ENROLLMENTS, WE DO STATE BENEFITS, ENROLLMENTS.

WE TRY TO HELP PEOPLE THEN LEARN HOW TO CONNECT TO A CLINIC, ENCOURAGE THEM TO GET THEIR WELL CHILD CHECKS SCHEDULED.

SO JUST THIS MORNING BEFORE I CAME HERE, I THOUGHT, YOU KNOW, I'M GONNA CALL, I'M GONNA LOOK ON COMMUNITY CARE.

LOOK THROUGH MY CHART, LOOK ON THE WEBSITE, SEE WHEN IS THE NEXT APPOINTMENT FOR ELIGIBILITY AVAILABLE.

DOES ANYONE WANNA GUESS? DECEMBER 19TH, I'M A PARENT.

I'M GETTING LETTERS FROM MY SCHOOL.

I NEED TO GET MY CHILD VACCINATED.

THEY'RE PART OF THAT 18%, THAT 13,433 STUDENTS THAT STILL NEED SHOTS.

I'M GONNA CALL CENTRAL HEALTH TODAY, AND I DON'T HAVE COVERAGE.

THE FIRST APPOINTMENT AVAILABLE IS A MONTH AND A HALF, NINE THE 19TH OF DECEMBER.

THAT'S THE END OF THE FALL SEMESTER.

NOW, IF MY SCHOOL, IF MY CHILD DECIDES TO FOLLOW THE LAW, THEY WILL EXCLUDE MY CHILD UNTIL MY CHILD, THEY CANNOT ATTEND SCHOOL UNTIL MY CHILD IS VACCINATED.

NOW, SOME SCHOOLS DO THAT, SOME SCHOOLS DON'T, BUT THE RISK IS STILL THERE.

AND IF A ISD IS GONNA FOLLOW THE LAW, THEY'RE GONNA EXCLUDE 13,343 STUDENTS FROM SCHOOL.

AND SO, UM, THERE'S BARRIERS ALONG THE WAY.

SO THANK GOODNESS FOR THE SAFETY NET.

THE SAFETY NET CONSISTS OF NEXT SLIDE, PLEASE.

UM, WHEN YOU, THERE'S BASICALLY THREE STEPS TO GET SHOTS, RIGHT? THE FIRST ONE IS YOU CONTACT YOUR CLINIC.

I JUST TALKED ABOUT WHAT THAT LOOKS LIKE.

IF YOU CAN'T DO THAT, YOUR NEXT STEP IS SHOTS FOR TOTS.

IT'S OPEN TWO LOCATIONS.

IT, MICHELLE SAID, YOU CAN CALL, BUT YOU KNOW WHAT, THAT'S EVEN CHALLENGING BECAUSE WHEN YOU CALL, YOU GET PUT ON HOLD BECAUSE THEY'RE SCHEDULING FOR ONE WEEK FROM THAT DAY, I CALL TODAY, I AM A MOM, I'VE GOT A JOB, I'M AT WORK.

I CALL AT EIGHT O'CLOCK IN THE MORNING.

I GET PUT ON HOLD.

IT'S ACTUALLY A GOOD THING I'M ON HOLD, BUT I DON'T KNOW THAT.

AND I'M LIKE, NOBODY'S ANSWERING MY CALL.

I HANG UP.

I HAVE JUST LOST MY PLACE IN LINE.

I WAS IN THE QUEUE TO BE ABLE TO GET AN APPOINTMENT FOR A WEEK FROM THAT DAY.

AND SO WHAT HAPPENS IS, AFTER THAT QUEUE IS FULL, IT GOES TO VOICEMAIL, SAYS, CALL BACK TOMORROW.

YOU CAN IMAGINE THE FRUSTRATION OF A MOM.

I'M, I'M A I'M A HOURLY WORKER.

I'M AT WORK ALREADY.

I'M TRYING TO GET MY CHILD APPOINTMENT.

GUESS WHAT? I HAVE MORE THAN ONE CHILD THAT NEEDS VACCINES.

I'M IN SERIES.

I'M A NEW PERSON.

I'VE LOST MY SHOT RECORDS.

I HAVE FOUR CHILDREN.

LAST WEEK I TALKED TO A MOM THAT HAD FOUR KIDS THAT NEEDED VACCINES.

AND SHE HAS TO DO THAT FOR EACH INDIVIDUAL CHILD BECAUSE YOU CANNOT MAKE MULTIPLE APPOINTMENTS FOR MULTIPLE CHILDREN AT THE SAME TIME.

AND SO THERE'S JUST CHALLENGES.

THE THIRD BOX, THE YELLOW BOX THERE, THAT'S THE MOBILE VACCINE PROGRAM.

AND WE, DURING, DURING CID AS MICHELLE SAID, THEY SHIFTED THE ADULTS OVER TO, TO VACCINATING KIDS.

THEY, THEY DID A HEROIC THING, UM, TO BE ABLE TO CROSS TRAIN THOSE NURSES

[01:15:01]

AND TRAIN THEM HOW TO DO PEDIATRIC VACCINES.

WE WORKED WITH THEM.

WE BROUGHT THEM WEEKLY.

EVERY WEEK WE DID VACCINE CLINICS IN SCHOOLS IN A ISD.

AND THE SAD THING IS, THOSE NUMBERS YOU SAW, THAT'S IN SPITE OF US DOING WEEKLY VACCINES IN AUSTIN, ISD SCHOOLS.

SO WHAT WE'VE BEEN DOING, THE THE CHRONIC TREND IS CONCERNING.

AND THE IMMEDIATE SITUATION IS ALSO CONCERNING.

SO I'M GONNA TURN IT BACK OVER TO MICHELLE.

UM, SO I'M GONNA TALK A LITTLE BIT MORE ABOUT THE VACCINATION RESOURCES THAT THE COMMUNITY HAS.

AND THIS, AGAIN, IS A STONE SKIP THAT WE WE'RE ABLE TO COLLECT, UH, BY ASKING PROVIDERS.

SOME OF THEM GAVE US ANSWERS, SOME OF THEM DIDN'T.

AND ALSO GOING THROUGH PROVIDER BY PROVIDER ON THE WEBSITE AND COUNTING UP THE NUMBER OF PEDIATRIC AND FAMILY MEDICINE PROVIDERS.

SO THESE, THIS IS BY NO MEANS A COMPREHENSIVE LIST, BUT, UM, ONE OF THE THINGS I DID WANNA TOUCH ON IS THAT PRE COVID, THE LANDSCAPE LOOKED VERY DIFFERENT.

THERE WERE MANY DIFFERENT PARTNERS WORKING DIRECTLY WITH THE SCHOOLS, DIFFERENT COMMUNITY-BASED ORGANIZATIONS THAT WERE RESPONSIBLE FOR CATCHING KIDS UP ON THEIR VACCINATIONS.

SHOTS FOR TOTS HAD A SMALL OUTREACH PRESENCE.

UM, BUT IT REALLY, IT WASN'T THE, THE BULK OF WHAT THEY DID.

AND THEY WORKED DIRECTLY WITH, WITH SCHOOLS TO GO IN AND DO THOSE IMMUNIZATIONS.

AND THEY WOULD GET CONSENT BEFORE, GET THE SHOT RECORDS REVIEWED BEFORE THEY WOULD KNOW WHICH CLIENTS THEY WERE SEEING.

AND IT WAS A VERY LABOR INTENSIVE AND HANDS-ON DURING THE SCHOOL DAY.

YES, DURING THE SCHOOL DAY VACCINES.

UM, AND SO THE, THE MOBILE VACCINE PROGRAM WAS NOT ABLE TO, TO DO THAT LEVEL OF SERVICE.

UM, THEY WERE MUCH MORE ABOUT UTILIZING OUR SURGE CAPACITY, UTILIZING OUR PUBLIC HEALTH PREPAREDNESS INFRASTRUCTURE, UM, INCIDENT COMMAND SYSTEM TO GET IN, BRING A WHOLE OPERATION, DO THE JOB, AND GET OUT.

UM, AND THEY'RE, THEY'RE SCHEDULED AS IT IS ALL, THEY'RE ALREADY SCHEDULED THROUGH FEBRUARY AND MARCH WHEN THE CLINIC WILL SUNSET.

UM, SO THERE'S NOT A LOT OF CAPACITY THERE THAT'S NOT BEING SUCKED UP RIGHT AWAY IN ADVANCE.

SO IF JULIE WERE TO IDENTIFY A NEED, THERE'S, THERE'S NOT A PLACE TO FILL THAT NEED.

UM, AND WHAT WE HAVE DISCOVERED IN OUR WORK, UM, IN EQUITY IS THAT NO ONE ELSE IS DOING VACCINE OUTREACH FOR PEDIATRICS RIGHT NOW.

NONE OF THE OTHER PROVIDERS.

SO WHAT WE FOUND WHEN WE DID OUR ARITHMETIC WAS, UM, AUSTIN PUBLIC HEALTH HAS EIGHT PEDIATRIC VACCINATORS, AND THAT, UM, INCLUDES REFUGEE, UM, TWO FAMILY MEDICINE PROVIDERS, ONE OF WHOM IS DR.

WA, AND THE OTHER ONE IS THE DOCTOR AT THE REFUGEE CLINIC.

UM, AND WE WORK UNDER A SYSTEM OF STANDING DELEGATION ORDERS.

SO LVNS AND RNS PROVIDE ALL OF OUR VACCINES AT, AT AUSTIN PUBLIC HEALTH.

UM, AND WE HAVE THREE BRICK AND MORTAR SITES, INCLUDING THE REFUGEE CLINIC, COMMUNITY CARE.

THEY HAVE, UM, 81 PROVIDERS ACROSS THEIR MANY LOCATIONS.

AND THEY, UH, MAS AND NURSES VACCINATE AS WELL AS PHYSICIANS.

AND THEY HAVE OVER 300 VACCINE PROVIDERS THAT ARE ABLE TO VACCINATE, UM, AND 24 BRICK AND MORTAR SITES.

UM, LONE STAR CIRCLE OF CARE HAS, THIS HAS ABOUT 21 PROVIDERS, UM, 10 ADDITIONAL VACCINATORS AND 18 SITES.

UM, AND THEN PEOPLE'S HAS, THIS IS, I COUNTED, AND IT'S VERY LOOSE COUNT, 14 PLUS PEDIATRIC AND FAMILY MEDICINE PROVIDERS COULDN'T GET ANYONE TO ANSWER MY QUESTIONS ABOUT HOW MANY NURSES AND OTHER VACCINATORS THEY HAD.

AND THEY HAVE THREE TOTAL BRICK AND MORTAR SITES.

UM, SO HERE'S WHERE THE OPPORTUNITIES COME INTO PLAY LOOKING.

THIS IS A NUMBER THAT WE SOURCED FROM OUR OWN, UM, MEDICAL, UH, RECORD SYSTEM AND FROM MT A C BECAUSE AS AUSTIN PUBLIC HEALTH, WE ARE THE, UM, RESPONSIBLE ENTITIES FOR THE TEXAS IMMUNIZATION REGISTRY FOR AUSTIN TRAVIS COUNTY.

SO WE'RE RESPONSIBLE FOR MAKING SURE THAT ALL OF THESE PROVIDERS REPORT IN AND MAINTAIN THE STANDARDS OF AMTRAK.

SO WE ACTUALLY HAVE ACCESS TO THAT RAW DATA, AND IT'S VERY GOOD DATA.

UM, AND WE ANALYZED IT PRETTY THOROUGHLY.

UM, MY TEAM WAS UPSET THAT I ONLY WOULD GIVE YOU THESE SMALL NUMBERS, UM, BECAUSE THEY DID A LOT OF WORK TO GET TO THESE LITTLE TINY BOXES.

BUT AUSTIN PUBLIC HEALTH VACCINATED 883 CHILDREN IN JULY OF TWENTY TWENTY FOUR, SEVENTEEN HUNDRED AND FORTY ONE CHILDREN IN AUGUST OF 2024 FOR A TOTAL OF TWENTY SIX HUNDRED AND TWENTY FOUR CHILDREN.

COMMUNITY CARE VACCINATED 1,246 IN JULY, 2032 IN AUGUST FOR A TOTAL OF 32 78.

[01:20:02]

UM, AND IF YOU REMEMBER, THE, THE NUMBERS OF VACCINATORS THAT THEY HAVE VERSUS THE NUMBERS OF VACCINATORS THAT WE HAVE IS OUTRAGEOUSLY OUT OF SYNC.

UM, WE KNOW THAT THEY DO FAR MORE THAN VACCINATE.

I'M NOT MEANING TO CRITICIZE COMMUNITY CARE HERE OR SAY THAT THEY HAVE TO PICK UP THE SLACK.

I'M JUST SAYING, I THINK WE GOT OUT OF SYNC, ALL OF US AS A SYSTEM, AND EVERYBODY JUST SAYS WE DON'T HAVE ANY APPOINTMENTS, GO SOMEWHERE ELSE.

WE SAY WE DON'T HAVE ANY APPOINTMENTS, GO TO COMMUNITY CARE.

COMMUNITY CARE SAYS WE DON'T HAVE ANY APPOINTMENTS, GO TO SHOTS FOR TOTS.

SO EVERYBODY'S JUST POINTING THEIR FINGERS SOMEWHERE ELSE, AND EVERYONE'S ASSUMING WHAT RESOURCES ARE AVAILABLE IN OTHER, OTHER PLACES.

AND YEAH, WE DO A REALLY GOOD JOB AT AUSTIN PUBLIC HEALTH VACCINATING, BUT THIS IS MAXING OUT, AND THIS IS DOING WHAT PUBLIC HEALTH DOES BEST, WHICH IS SURGING.

SO WE UNDERSTAND THAT THIS IS A CHRONIC PROBLEM, AND THAT IT BECOMES A CRISIS EVERY YEAR, AND WE SURGE TO MEET IT.

SO WE PIVOT AWAY FROM ADULT IMMUNIZATIONS AWAY FROM A LOT OF OUR OTHER EFFORTS.

WE EVEN PULL STAFF AWAY FROM OTHER JOBS TO HELP WITH DATA ENTRY AND TO HELP WITH THE CASHIERING AND TO HELP WITH ALL OF THE SUPPORT OF THIS PROCESS.

SO WE KNOW THAT IT'S POSSIBLE AND WE KNOW HOW TO DO IT.

SO WE WILL OFFER, UM, OUR SUBJECT MATTER EXPERTISE TO HELP ANYONE ELSE DO IT.

AND WE DID ACTUALLY DO THIS SOMEWHAT BEFORE COVID, BUT IT'S LIKE A FULL, LIKE REGIME CHANGE AT EVERY SINGLE PLACE NOW.

AND WE DON'T EVEN HAVE THE SAME CONTACTS THAT WE HAD BEFORE, UM, AT THE TOP OR IN THE MIDDLE.

AND SO WE, YOU KNOW, I, I WOULD HAVE DR.

WS MAKE A CALL, BUT IT JUST DOESN'T TRANSLATE TO WHERE THE RUBBER MEETS THE ROAD.

UM, SO THIS BRINGS US TO OUR CONCLUSIONS.

UH, VACCINE SAFETY NET PROVIDERS WITH A PARTICULAR EMPHASIS ON FQHCS AND PUBLIC HEALTH PROVIDERS.

WE HAVE A VESTED INTEREST IN, IN MAKING SURE THAT OUR UNDERSERVED POPULATIONS, UM, ARE SERVED WITH VACCINES WITH EDUCATION.

AND WE UNDERSTAND THAT THERE'S A NEED TO DO MORE OUTREACH TO BREAK DOWN BARRIERS OF ACCESS AND TRUST.

SO WHEN WE BREAK DOWN THOSE BARRIERS, WHERE WILL THOSE PEOPLE GO? I DON'T WANNA EARN SOMEONE'S TRUST WITH SEVERAL VISITS TO THEIR CHURCH AND TELL THEM, YES, WE, WE, WE ARE PREPARED TO HELP YOU.

AND THEN NO ONE WILL HELP THEM.

THAT'S ACTUALLY, AS OUR MENTAL HEALTH COLLEAGUES WE'RE SHARING IT, IT'S, IT'S NOT THE BEST WAY TO KEEP SOMEBODY, UM, TRUSTING THE SYSTEM.

SO FOCUSING ON BOTH THE CHRONIC ISSUES AND THAT CRISIS POINT OF 13,000 KIDS WHO DON'T HAVE THEIR VACCINES.

UM, WE, WE WANT TO FOSTER, UM, MORE COLLABORATIVE COMMUNICATION BETWEEN PUBLIC HEALTH AND THE PROVIDERS, UM, SO THAT ALL OF THE, THE DIFFERENT ARMS OF THE SAFETY NET, UM, CAN WORK TOGETHER TO TAKE THAT RESOURCE, SURF IT THAT WE HAVE, AND DEPLOY IT IN A WAY THAT CAN ACTUALLY SERVE ALL OF THE CHILDREN.

BECAUSE I DON'T THINK ANYONE'S TRYING TO STEP OUT, YOU KNOW, AND SAY, NOT IT, I THINK EVERYONE IS DOING WHAT THEY BELIEVE TO BE THEIR BEST.

UM, BUT EVERYONE ALSO IS ASSUMING THAT SOMEONE ELSE HAS THE CAPACITY TO PICK UP WHAT THEY CAN'T DO.

UM, SO WE WOULD LIKE A DEEPER EXPLORATION.

WE WOULD LIKE FOR THE PUBLIC HEALTH COMMISSION TO RECOMMEND THIS AND REQUEST THIS DATA SO THAT WE CAN ACTUALLY SHOW YOU THE REAL DEEP DIVE ON WHAT THIS LOOKS LIKE ACROSS THE CITY.

UM, AND AS I WAS NOT DOING THIS FOR ANY HIGHER AUTHORITY, I DID NOT WANT TO ASK COMMUNITY CARE AND PEOPLE'S COMMUNITY CLINIC AND LONE STAR CIRCLE OF CARE FOR A LOT OF DATA ABOUT WHAT THEY'RE DOING AS, AS THE, THE VACCINE EQUITY COALITION, RIGHT? I MEAN, IN MY, I'M NOSY IN MY JOB, I WOULD TOTALLY ASK THEM.

BUT IF THEY SAY NO, THEY SAY NO.

SO I WOULD LIKE FOR THERE TO BE SOME MOTIVATION FOR THEM TO ACTUALLY SHARE THE DATA.

I, I WILL VOLUNTEER.

I HAVE A DATA ANALYSIS TEAM OF FIVE PEOPLE.

UM, I WILL VOLUNTEER TO CRUNCH ALL OF THAT DATA IF WE CAN HAVE ACCESS TO IT.

UM, AND I ALSO, WE WANNA RECOMMEND A, A FORMAL COLLABORATION BETWEEN A PH AND THOSE PARTNERS IN THE VACCINE EQUITY SPACE AND IN THE RESPONSIBLE ENTITY SPACE, WHICH IS WHERE WE ALREADY WORK WITH THEM REALLY CLOSELY, UM, AND HAVE CONNECTIONS TO THEIR BACKEND SYSTEMS AND REALLY A LOT OF, A LOT OF CONNECTION, UM, THAT CAN BE EXPLOITED FOR THIS PURPOSE AND FOR THIS PROJECT.

UM, AND I THINK IF WE, IF WE ARE DELIBERATELY COLLABORATIVE AND WE SHARE INFORMATION THAT WE CAN BETTER MEET THE COMMUNITY NEED, LIKE, IT, IT WON'T EVEN BE HARD TO MAKE AN IMPACT ON THIS.

WE HAVE ENOUGH TIME TO PREPARE FOR NEXT YEARS

[01:25:01]

BACK TO SCHOOL THAT EVEN IF WE JUST DECIDE TO DO A PILOT PROJECT OF COLLABORATION FOR NEXT YEARS BACK TO SCHOOL, WE COULD CONCEIVABLY IMPACT THIS, UM, WITH OUR EXISTING RESOURCES WITHOUT SPENDING ANY MORE MONEY, WHICH I THINK IS REALLY IMPORTANT.

UM, AND THEN WE ALSO REALLY, REALLY WANNA INCREASED COLLABORATION BETWEEN THE SCHOOL DISTRICTS A PH AND FQHCS.

'CAUSE AS JULIE POINTED OUT, IF THE SCHOOL DISTRICTS ARE NOT TRANSPARENT ABOUT THEIR NEED OR ARE NOT ENGAGED IN THE PROCESS OF GETTING THESE STUDENTS VACCINATED, THEN WE'RE LOST BECAUSE WE END UP FINDING OUT ABOUT IT, PARENT BY PARENT CALL BY CALL.

AND THAT'S, IF, IF WE COULD ALL COORDINATE, HEY, WE, THE NUMBER'S 18,000, HOW DO WE COORDINATE TO GET THESE KIDS VACCINATED? AND WE ALL PITCH IN, IN A TRANSPARENT WAY, I THINK THAT, AGAIN, WE CAN EASILY MAKE AN IMPACT.

UM, I, LIKE I SAID, I'M NOSY.

I'M LOUD.

I'LL ASK ANYONE TO DO ANYTHING.

BUT IF THEY SAY, NO, I, I DON'T HAVE ANY POWER .

SO WE'RE HERE TO ASK YOU TO REQUEST SOME DATA TO REQUEST COLLABORATION TO, UH, FROM WHERE THE PLACES WHERE YOU ALL SIT TO SEE WHAT YOU CAN DO TO MOVE THE NEEDLE FORWARD.

AND IT, AND IN A WEIRD WAY, WE ACTUALLY NEED TO MOVE THE NEEDLE BACK BECAUSE WE DID THIS A LOT BETTER PRE COVID.

MY SECOND QUESTION WOULD BE, IS THERE A DASHBOARD OF ANY SORT IN DEVELOPMENT, LOOKING AT THE AVAILABILITY OF VACCINES, LOOKING AT THE APPOINTMENTS THAT ARE AVAILABLE EVERY DAY, UH, EVEN A HEAT MAP, UM, SO THAT FOLKS CAN UNDERSTAND, HEY, WE KNOW THAT THIS IS A TRENDY HOTSPOT SPACE, UM, FOR PEOPLE TO GO GET THEIR KIDDOS VACCINATED.

AND, AND LIKE, IRONICALLY, WE ALL KNOW MUCH MORE ABOUT SURGING TO MEET DEMAND BECAUSE OF SURGING, TO MEET COVID DEMAND.

UM, WE HAVE A LOT BETTER TOOLS.

WE HAVE A LOT BETTER UNDERSTANDING AT, JUST AT A SOCIETAL LEVEL ABOUT THE NEED FOR VACCINES.

UM, SO WE, WE HAVE SOME REALLY GREAT RESOURCES AT OUR DISPOSAL.

UM, I THINK WE JUST NEED TO SORT OF PULL THE VEIL OFF AND HELP EVERYONE UNDERSTAND THE CHRONIC PROBLEM AND THE CRISIS.

UM, THE LAST SLIDE IS JUST RESOURCES FOR YOU GUYS.

UM, BUT IT, IT, WE DO HAVE A LOT OF, UM, WE, WE HAVE A LOT OF SOURCES THAT WE GO TO FOR PUBLICLY AVAILABLE DATA.

AND SO ANYONE TAKING A CURSORY LOOK CAN SEE THAT, THAT EVERYTHING IS JUST COME TOGETHER TO, UM, REALLY MAKE IT DIFFICULT.

UH, AND AUSTIN'S GROWN.

WE ALL KNOW THAT.

UM, AND ALTHOUGH THE SYSTEM HAS GROWN A LITTLE BIT, UM, IT HASN'T GROWN.

PUBLIC HEALTH HAS NOT GROWN, UM, SIGNIFICANTLY.

WE STILL HAVE THE SAME TWO SITES.

WE STILL HAVE THE SAME NUMBER OF FULL-TIME NURSES, AND, UM, WE JUST, WE'RE DOING EVERYTHING WE CAN.

AND WE, WE WELCOME ALL PARTNERSHIP.

AND I, I WILL ALSO SAY THAT MICHELLE'S TEAM HAS THE EXPERTISE OF KNOWING HOW TO MANAGE THE VACCINE PROGRAM AND TO SERVE CHILDREN.

AND WITH THEM FALLING OFF THE GRID AT THE END OF MARCH, I MEAN, THERE'S EVEN LESS CAPACITY.

AND NOT ONLY THAT, THE NUMBER IS GONNA GROW.

SO IF THIS DOESN'T GET RESOLVED, UM, THERE'S GONNA BE MORE KIDS ADDED IN THE SPRING BECAUSE ALL THOSE ENTERING SCHOOL, ALL THOSE SIXTH GRADERS THAT ARE GONNA BECOME SEVENTH GRADERS, THAT THE TREND IS GOING TO GET WORSE.

SO IT'S, IT'S, IT'S AN URGENT NEED AND IT'S A SYSTEMS CHANGE.

SO HOW CAN WE QUICKLY WORK ON A WAY TO IMPLEMENT SOMETHING, GET IT STARTED AS A PILOT THAT WILL HAVE THE LONG TERM EFFECT, BUT WILL ALSO HELP WITH THIS IMMEDIATE NEED.

BECAUSE AN ORGANIZATION LIKE MINE, AND THERE'S LOTS OF NONPROFITS THAT ARE SUPPORTING KIDS, SUPPORTING FAMILIES, SUPPORTING IMMIGRANTS, SUPPORTING, YOU KNOW, AP ASIAN FAMILIES.

I MEAN, YOU NAME IT, WE ARE JUST AMPLIFYING WHAT THE HEALTHCARE SYSTEM HAS TO OFFER, BUT WE CAN'T AMPLIFY WHAT DOESN'T WORK AND WHERE THERE'S NO CAPACITY.

OUR VOICE, IT'S LIKE, TURN OFF THE MIC.

WE DON'T KNOW WHAT TO DO.

AND SO THAT'S WHY WE'RE HERE.

Y'ALL ARE ALL REALLY SMART AND YOU'RE IN ALL THESE DIFFERENT AREAS.

SO WHAT THOUGHTS, QUESTIONS, IDEAS, DO YOU ALL HAVE? UH, THANK YOU SO MUCH FOR THE PRESENTATION.

AND, UM, I DO HAVE A FEW QUESTIONS.

I WOULD BE BRIEF JUST BECAUSE OF WHERE WE ARE AT WITH TIME.

UH, I'LL BRING THIS UP LATER, BUT FOR A FUTURE CONVERSATION, UH, INVITING A ISD TO SHARE WITH THE COMMISSION WOULD BE WONDERFUL.

UM, SO WE'LL, WE'LL TALK ABOUT THAT LATER.

BUT I AM VERY CON, VERY CONCERNED AND CURIOUS AT THE ASK, UNDERSTANDING THAT YOUR CAPACITY IS GREATLY GETTING READY TO REDUCE OF HOW YOU WOULD TAKE ON WHAT'S SEEMINGLY LIKE A LARGE PROJECT WITHIN THE NEXT, LESS THAN SIX MONTHS WITH, WITH FOLKS LEAVING.

SO THAT'S MY FIRST QUESTION.

AND THEN

[01:30:01]

DON'T HIT THAT ONE.

UM, BUT THEN ALSO, UH, AND I KNOW THIS IS POSSIBLE IN, IN A VARIETY OF EHRS, A DIVERSION STATEMENT SO THAT PEOPLE UNDERSTAND WHEN THEY'RE CALLING OR THEY'RE LOOKING ONLINE, THERE IS IN FACT ALREADY A DIVERSION STATEMENT ON THERE, LETTING THEM KNOW, DON'T COME HERE.

WE WILL NOT BE ABLE TO HELP YOU TODAY.

UH, WE ARE OVERWHELMED AND, UH, AND, AND DON'T HAVE CAPACITY.

DOES THAT EXIST? UM, WE AT A PH HAVE, WE, WE DON'T NEED TO DO THAT BECAUSE WE ACTUALLY TRY TO GET EVERYONE, WE'RE, WE'RE THE FASTEST.

WE GET EVERYONE IN WITHIN A WEEK.

UM, WE, WE DO LET THEM KNOW THAT THEY'RE LONG HOLD TIMES.

UM, WE DON'T WANT TO DIVERT THEM BECAUSE AT THIS POINT, WHEN THEY'RE COMING TO US, THEY HAVE TRIED EVERYWHERE ELSE.

SO THAT WOULD BE A QUESTION FOR SOME OF OUR OTHER PARTNERS.

UM, COMMUNITY CARE IN PARTICULAR WITH THE, THEIR PROCESSES THAT HAVE A TENDENCY TO TURN INTO BARRIERS.

UM, IN THIS CASE, THE PERFECT IS THE ENEMY OF THE GOOD.

WE WANT EVERY CHILD TO HAVE A WELL CHECK, WE WANT THE DOCTOR TO LOOK AT THEIR RECORD AND, AND PRESCRIBE THE CORRECT VACCINES, BUT THAT'S NOT NECESSARY FOR THEM TO GO TO SCHOOL.

THEY NEED SOMEONE TO LOOK AT THAT RECORD, ANALYZE IT, SAY WHAT VACCINES THEY NEED, AND SOMEONE TO PROVIDE THOSE VACCINES.

AND WE ARE DEPUTIZED BY DR.

WA TO DO THAT.

UM, SO THE SYSTEM EXISTS FOR THIS PROCESS TO WORK.

UM, YOUR QUESTION, NATALIE, ABOUT THE, UH, ACTUAL CAPACITY.

SO THE TEAM THAT I LEAD, THE VACCINE EQUITY TEAM, UM, I'M, I'M ACTUALLY GOING TO LOSE A LOT OF MY CAPACITY TO VACCINATE.

UM, WE'VE HAD TWO NURSES.

WE'RE DOWN TO ONE NURSE.

UM, AND I WILL BE DOWN TO A PROGRAM COORDINATOR, UM, POTENTIALLY ONE DATA ANALYST AND A COMMUNITY HEALTH WORKER.

BUT THAT IS ACTUALLY, AND MYSELF ENOUGH TO PROJECT MANAGE THIS PROCESS BECAUSE THE MAIN CONTACT WITH ALL OF THE VFC PROVIDERS IS ALREADY IN PLACE.

THAT'S OUR MANAGER OF A SUPERVISOR OF THAT PROGRAM, EDGAR HERTADO.

UM, SO WE DON'T NEED TO MAKE NEW CONTACTS.

WE JUST NEED TO HAVE EVERYONE MOTIVATED TO COME TOGETHER.

AND THEN THE VACCINE EQUITY COALITION IS ALREADY AN EXISTING SPACE, UM, WHERE WE COULD COME TOGETHER TO PROJECT MANAGE IN THAT SPACE AS WELL.

UM, AND SO THERE ARE SUBJECT MATTER EXPERTS BOTH AT A PH AND IN THE VACCINE EQUITY COALITION.

UM, AND WE DO FEEL THAT WE HAVE THE RESOURCES TO MANAGE THIS PROJECT.

IRONICALLY, BECAUSE SO MANY OF MY OTHER PROJECTS ARE SUN SETTING, I'M LOOKING FOR WHERE'S THE VACCINE EQUITY PROJECT THAT ACTUALLY IT CAN TAKE THIS TIME AND I SEE THIS OPPORTUNITY AND BEFORE SOMEBODY BOOKS ME TO DO SOMETHING ELSE, I WOULD REALLY LIKE TO DO THIS.

SURE, THANK YOU.

AND I JUST WANNA CLARIFY THERE, THE DASHBOARD WASN'T NECESSARILY FOR A PH THAT WAS JUST, DOES ONE EXIST IN GENERAL? YOU KNOW, I DON'T THINK ONE DOES OKAY, ACTUALLY, BUT WE HAVE TALKED ABOUT WITH OUR GIS FOLKS, THERE IS A MAP THAT YOU CAN GO TO PUBLIC MAP THAT HAS ALL THE VFC PROVIDERS, THEIR LOCATIONS, THEIR PHONE NUMBERS, UM, AND THAT DOES EXIST.

SO WE TALKED ABOUT ADDING LAYERS TO THAT MAP, UM, TO HELP THE PUBLIC BE ABLE TO DETERMINE WHERE TO GO.

UM, BUT WE, NO ONE'S ASKED US TO DO IT.

WE DON'T KNOW WHERE WE'LL PUT IT.

SO IT'S ONE OF THOSE, PICK YOUR THING THAT'S MOST ON FIRE.

BUT I WILL SAY THAT THE, THE COMMISSIONER POINDEXTER SAID TO DO IT, AND WE'LL MAKE IT HAPPEN, , , ASHA, THAT WILL GET YOU.

BUT, UM, BY ALL MEANS, GO FOR IT.

UH, ANY QUESTIONS FROM OTHER COMMISSIONERS, EITHER ONLINE OR, UH, SHALL PLEASE GO AHEAD.

COURSE.

UH, SO BEYOND WHO ADMINISTERS THE VACCINES, CAN YOU TALK A LITTLE BIT ABOUT MAYBE LOGISTICAL BARRIERS AROUND THE NUMBER OF VACCINES THEMSELVES OR DIFFERENT INSTITUTIONS LIKE A PH ALLOCATED, A SPECIFIC AMOUNT OF VACCINES THAT THEY CAN THEN ADMINISTER? OR IS IT NOT CONNECTED TO INSTITUTION? AND YOU CAN KIND OF SHARE VACCINES ACROSS DIFFERENT GROUPS? WE, WE CAN'T SHARE VACCINES, BUT WE ARE NOT SPECIAL AS A P IN TERMS OF THE SHOTS FOR TOTS CLINICS.

THEY OPERATE EXACTLY LIKE ANY OF THE OTHER VFC PROVIDERS.

WE DON'T GET, WE, WE HAVE TO TELL THEM WHAT OUR MAXIMUM STOCK LEVEL OF VACCINES, LIKE HOW MANY WE PATIENTS WE'LL SEE.

AND

[01:35:01]

THEY GIVE US THREE MONTHS, MORE MONTHS THAN THAT.

AND THAT'S TRUE ACROSS THE BOARD.

SO WE, WE CAN'T DO ANYTHING THAT EVERYONE ELSE CAN'T ALSO DO.

WHAT WE CAN DO IS CALL THE, THE RESPONSIBLE ENTITY FOR THE REGION AND SAY, HEY, THIS CLINIC NEEDS TO SURGE.

CAN WE HELP THEM SURGE FOR THIS PERIOD OF TIME SO THAT WE DO HAVE THAT TEAM, THE VFC RESPONSIBLE ENTITY TEAM THAT CAN ASSIST IN SURGING.

AND WE USED TO DO THAT PRE COVID WITH COMMUNITY CARE FOR BACK TO SCHOOL EVENTS WHERE WE WOULD, UH, FIGURE OUT HOW MANY VA VACCINES THEY NEEDED THAT WERE THE SEVEN SERIES BACK TO SCHOOL VACCINES AND, UM, WORK TO MAKE SURE THEY HAD ENOUGH.

SO IT'S NOT ACTUALLY A QUESTION OF, OF INVENTORY.

UM, THESE ARE FEDERAL VACCINES, FEDERALLY FUNDED VACCINES, AND THEY ARE VERY MUCH AVAILABLE.

UM, IT'S MORE ABOUT THE COMPLEXITY OF READING THOSE RECORDS.

UM, AND I DIDN'T MENTION BEFORE, BUT I AM SURE WE'RE ALL AWARE THAT MANY OF THE FOLKS COMING INTO AUSTIN ARE NOT LOCAL.

THEY'RE COMING IN FROM OTHER COUNTRIES.

THEY'RE COMING IN FROM OTHER JURISDICTIONS.

AND SO THOSE RECORDS HAVE TO BE FRESHLY ANALYZED.

UM, WE HAVE SUBJECT MATTER EXPERTS AND WE'VE ACTUALLY HAD THIS TRAINING.

WE'VE PROVIDED THIS TRAINING FOR COMMUNITY CARE IN THE PAST RECORDS READING TRAINING TO HELP THE FRONTLINE STAFF BE, USE THE SAME TOOLS THAT WE USE TO, TO READ THESE RECORDS.

UM, AUSTIN PUBLIC HEALTH BECAME SUBJECT MATTER EXPERTS OUT OF NEED BECAUSE WE WERE THE FINAL PIECE OF THE SAFETY NET.

BUT IT'S NOT SOMETHING THAT WE WERE GIFTED ANY SPECIAL RESOURCES TO DO.

SO WE ARE WILLING TO PROVIDE THAT SUBJECT MATTER EXPERTISE AS WELL, UM, TO BOTH TRAIN AND SUPPORT IN REAL TIME.

IF SOMEONE NEEDS ONE OF OUR EXPERT VACCINE READERS TO COME TO THEIR EVENT, WE COULD POTENTIALLY DO THAT.

BUT AGAIN, WE, WE NEED FOR PEOPLE TO KNOW WHAT RESOURCES ARE AVAILABLE AND HOW TO DEPLOY THEM.

OUR SUBJECT MATTER EXPERTISE IS ABSOLUTELY ONE OF THOSE RESOURCES THAT WE COULD DEPLOY DIFFERENTLY IF, IF WE NEEDED TO.

UM, IN THE BEGINNING YOU HAD ASKED WHAT WE MIGHT RECOMMEND TO HELP OR WHATEVER.

UH, ONE QUESTION I HAVE IS, WHAT IS PFLUGERVILLE ISD DOING SO WELL IN DOING? RIGHT.

LET'S FIND THAT OUT AND EXTRAPOLATE THAT.

NO.

, THEY ACTUALLY HAVE A REALLY, UM, INTERESTING PROGRAM FOR THEIR INTERNATIONAL, UH, MIGRANT STUDENTS WHERE THEY HAVE ONE ELEMENTARY SCHOOL, ONE MIDDLE SCHOOL, AND ONE HIGH SCHOOL WHERE THERE'S A RESOURCE CENTER FOR INCOMING FAMILIES.

AND THEY GET A LOT OF SERVICES, UH, THERE TO HELP THEM INTEGRATE INTO THE SCHOOL SYSTEM.

UM, AND THEIR VACCINE RECORDS ARE READ THERE AND THEY'RE, UH, THAT SOMEONE CALLS TO HELP THEM GET AN APPOINTMENT.

AND SO THEY DO HAVE A, A DIFFERENT LEVEL OF, UM, OF RESOURCES, UH, IN PFLUGERVILLE, BUT THEY, UM, THEY'RE, THEY'VE BEEN ASKING US FOR HELP, UM, JUST TO TRANSLATE BETWEEN ALL OF THE HELP THEY CAN OFFER.

AND ACTUALLY THE OTHER SIDE OF THE HELP, LIKE JULIE MENTIONED, WHERE IF WE CAN BUILD ALL OF THE INFRASTRUCTURE TO HELP PEOPLE, BUT IF THE END PRODUCT IS NOT AVAILABLE, THERE'S NO VACCINE APPOINTMENTS AVAILABLE.

IT DOESN'T MATTER HOW MUCH HELP WE PROVIDE, UM, BUT THEY DO, THEY DO A TREMENDOUS AMOUNT OF WORK, UM, ON THE GROUND TO GET THEIR STUDENTS VACCINATED.

UM, AND THEN GOING, KIND OF TOUCHING ON THE LOGISTICS QUESTION FROM EARLIER, UH, I KNOW FROM HAVING WORKED IN THE FIELD BEFORE THAT ONE ISSUE IS THAT PARENTS AND FAMILIES LOVE TO WAIT UNTIL SCHOOL STARTS TO MAKE APPOINTMENTS TO GET VACCINATED.

WHEN THEY HAVE DECEMBER, JANUARY, FEBRUARY, MARCH, SO THE WHOLE REST OF THE YEAR TO GET VACCINATED.

A PH, WE KNOW, WE KNOW WE HAVE TO SURGE AND WE PUSH ALL OUR RESOURCES TOWARD THIS ONE IMPORTANT THING.

IS THERE ANYTHING THE COALITION IS DOING TO HELP EDUCATE FAMILIES ON THAT AND SCHOOLS ON THAT, THAT THERE ARE APPOINTMENTS AVAILABLE THROUGHOUT THE YEAR? YOU DON'T HAVE TO WAIT UNTIL SCHOOL STARTS.

UM, IT'S KIND OF LIKE VOTING ON ELECTION DAY, RIGHT? SOME PEOPLE JUST LOVE THE CEREMONY OF IT, UM, NO MATTER HOW MUCH EASIER EARLY VOTING CAN BE.

SO I THINK THAT WE, THERE WILL ALWAYS BE ALSO PEOPLE WHO JUST GOT HERE, LIKE JUST GOT TO TOWN AND NEED TO ENROLL IN SCHOOL.

UM, BECAUSE A LOT OF PEOPLE DO MOVE WITH THE START OF THE SCHOOL YEAR AS, AS A, A GUIDEPOST.

SO, UM, WE'VE TRIED ACTUALLY TO DO THIS OVER THE YEARS.

THE COALITION HASN'T DONE ANYTHING SPECIFIC YET FOR THIS WORK.

BUT A PH HAS TRIED HAVING BIG CLINICS IN MAY AT THE END OF THE SCHOOL YEAR TO LIKE, GET PEOPLE TO COME.

BUT, UM, I THINK ONE THING THAT WE HAVEN'T IMPLEMENTED, UM, IS REALLY JUST HELPING THE OTHER, UH, VACCINE SAFETY NET PROVIDERS TO UNDERSTAND HOW TO SURGE.

BECAUSE AT

[01:40:01]

FOR TWO MONTHS, WE EXHAUST OURSELVES AND THEN WE STEP BACK AND WE'VE DONE ALL WE CAN DO.

WE HAVE TO GO BACK TO THE REGULAR OPERATIONS.

BUT IF EVERYBODY IN THE CITY, EVERY SAFETY NET PROVIDER DID THAT, WE ACTUALLY COULD EASILY MEET THE NEED.

SO I THINK IF WE, UM, IF WE CAN LOOK AT WHAT THAT WOULD LOOK LIKE TO DO VACCINE ONLY PROVISION, UM, AT A, AT A LARGER SCALE THROUGHOUT THE CITY, UM, USING OUR PHEP SKILLS AND OUR VACCINE RESPONSE SKILLS, I, I ACTUALLY DON'T THINK THIS IS AS BIG A LIFT MM-HMM.

AS IT MIGHT BE.

AND ALSO, IF I COULD JUST ADD, IF THEY WOULD USE THOSE, THOSE AS ENROLLMENT EVENTS INTO THE CLINIC SYSTEM, YOU'RE ACHIEVING BOTH THE IMMEDIATE AND THE LONG-TERM GOAL.

RIGHT? BECAUSE THEN THE NEXT TIME THEY NEED THEIR SHOTS, GUESS WHAT? THEY'RE ESTABLISHED AT COMMUNITY CARE PEOPLES OR WHEREVER AND THEY CAN GET THEIR APPOINTMENT AND THEY'VE ALREADY BEEN THERE.

SO I THINK IT'S, IT'S THAT CONVERSATION THAT MICHELLE'S SAYING THAT THE PRIMARY CARE PROVIDERS, IF THEY WOULD BE WILLING TO SOMEHOW ALTER THEIR DELIVERY MODEL TO BE ABLE TO ALLOW PEOPLE TO WALK IN TO BE ABLE TO, AND THEY DO THAT WITH BACK TO SCHOOL COMMUNITY CARE DOES BOTH NORTH AND SOUTH.

THEY DO, YOU KNOW, THEIR BACKPACK GIVEAWAY AND THEIR VACCINE EVENT, BUT IT'S A LIMITED SEVERAL HUNDRED KIDS.

BUT, AND IT'S ONCE, IT'S ONE TIME.

SO OBVIOUSLY WE'VE GOT A GREATER NEED THAN ONCE IN AUGUST, UH, NORTH, ONCE SOUTH.

AND AGAIN, WE DON'T HAVE ANY POWER TO COMPEL A ISC TO DO ANYTHING.

AND THEN JUST ONE LAST THING, UH, MORE JUST A SUGGESTION TO THINK ABOUT IN TERMS OF AI AND PERHAPS LEVERAGING THAT TO HELP VAC RECORDS AND TO, YOU KNOW, EXPEDITE A LOT OF THE PAPERWORK PROCESS.

I KNOW THERE'S PHI AND PII ISSUES WITH THAT, BUT PERHAPS AI COULD BE USED IN THE FUTURE.

THAT IS AN INTERESTING SUGGESTION.

I'LL ASK JEFF KHAN IF THAT IS SOMETHING THAT A PH CAN DO.

UM, BUT I DO THINK THAT'S A GREAT IDEA IN TERMS OF IF WE CAN FIGURE IT OUT THEN TO TRAIN OTHERS.

WE ARE, WE'RE ALWAYS HAPPY TO SHARE WHATEVER OUR EXPERTISE IS AT A PH.

WE'RE SCRAPPY.

UM, BUT I DON'T, I DON'T NECESSARILY THINK THAT, AGAIN, THE RESOURCE, THE RESOURCES ARE UNDERSTOOD.

EVERYONE UNDERSTANDS THE CRISIS, BUT EVERYONE, WHEN IT'S EVERYONE'S RESPONSIBILITY, IT'S NO ONE'S RESPONSIBILITY.

AND SO WE ALL JUST DO WHAT WE CAN AND THEN THROW UP OUR HANDS.

UM, AND AS THE VACCINE EQUITY SUPERVISOR IN AUSTIN PUBLIC HEALTH, I SELF-IDENTIFIED TO TRY AND MAKE A DIFFERENCE IN THIS SPACE AND REALIZING THAT THE MORE PEOPLE WE CONVINCED TO GET VACCINATED, THE HARDER THIS JOB GETS.

WONDERFUL.

ANY FINAL QUESTIONS? YES.

I JUST MAKE THE ONE COMMENT JUST TO ECHO DOC, UH, COMMISSIONER HAM'S OBSERVATION, IF YOU GO BACK TO THAT PAGE, IT'S NOT NUMBERED, BUT, YOU KNOW, AT THE SEVENTH GRADE, DELL VALLEY, MAYNARD AND PFLUGERVILLE HAVE 96, 97, 90 9% SUCCESS RATE IN AUSTIN, ISD HAS A 57%.

SO I DON'T KNOW IF THERE'S A SCALE ISSUE OR SOME COMPLEXITY IN AUSTIN, ISD THAT'S DIFFERENT, BUT IN A WAY IT'S NOT A COMMUNITY WIDE PROBLEM, IT'S AN A-S-I-A-A-S-I-D PROBLEM 'CAUSE THEY'RE, YOU KNOW, THE DIFFERENCE BETWEEN 57 AND 97 IS MASSIVE.

SO I'M JUST STRUCK BY THE CONVERSATION, WANTING TO ORGANIZE THE WHOLE COMMUNITY, BUT REALLY IT LOOKS LIKE A ISD NEEDS TO CALL THE OTHER THREE TO SAY, WHAT ARE YOU GUYS DOING? RIGHT? THE, UM, THE CAPACITY ISSUES IN AUSTIN, UH, I MEAN, AUSTIN, ALL THESE SAME PROVIDERS ARE SERVING FLUER AND MAYNARD IN DEL VALLEY AS WELL.

AND MAYNARD HAS A CLINIC ON SITE.

THEY HAVE MAYER MUSTANG, AND THERE ARE SOME THINGS, AND OBVIOUSLY THEY'RE MUCH SMALLER MAYNARD IN, IN DELL VALLEY, SO THERE'S NOT, THEY, THEY DON'T HAVE 13,000 KIDS IN SCHOOL.

SO IT IS A SCALE QUESTION AS WELL AS A A PERCENTAGE QUESTION, RIGHT.

WHEN THE NUMBERS GET HIGHER, IF YOU ONLY HAVE 30 APPOINTMENTS IN A DAY, UM, IN A DISTRICT THAT HAS 5,000 KIDS, IT MAKES MUCH BIGGER IMPACT THAN IN A DISTRICT THAT HAS 70,000 KIDS.

RIGHT? BUT AS I LOOK AT THIS, OF COURSE, THERE'S 112,000 THAT WE'RE TALKING ABOUT, AND AIC IS ONLY 68,000.

SO AGAIN, THERE MAY BE SOME OTHER FACTORS, BUT THE OTHER, THE OTHER 60,000, IF YOU WILL, OR JUST 50,000, I MEAN, IT'S ALMOST 50% ALMOST IS IN NON A-S-I-A-I-S-D AND THEY'RE DOING FABULOUSLY.

SO THAT'S WHAT, SO I DON'T KNOW IF IT'S SCALE OR WHATEVER, BUT ALMOST, LET'S SAY 45% OF THE KIDS ARE IN, UM, THE NON A ISD AND, AND THEY'RE THE 97% ANYWAY.

SO MY QUESTION'S NOT, NOT TO BE ANSWERED TODAY, BUT IT'S, YOU KNOW, WHY IS THAT SO DIFFERENT? SEEMS STARKLY DIFFERENT.

WE DO NEED TO ASK A ISD SOME QUESTIONS, BUT, UM, THAT'S, WE, WE DON'T KNOW THE ANSWERS TO THOSE QUESTIONS.

[01:45:01]

WE WERE LUCKY WE GOT THE DATA THAT WE GOT.

BUT, UM, I THINK THOSE ARE REALLY GREAT QUESTIONS AND I WOULD ALSO LOVE TO KNOW THE ANSWERS.

WELL, HOPEFULLY WE WILL, WE WILL KNOW THAT SOONER RATHER THAN LATER.

UM, APPRECIATE YOU ALL FOR COMING OUT AND SHARING THAT INFORMATION WITH US.

JOHN HAS A QUESTION.

COMMISSIONER LUHAN, DO YOU HAVE A QUESTION? I JUST WANTED TO MAKE A COMMENT 'CAUSE SHE, THE, THE FIRST WAS THAT THEY'RE TRYING TO FIND PILOT PROGRAMS, RIGHT? SOME INITIATIVES, WE TALK ABOUT DATA, WE, WE WANNA, WE HAVE ALL THESE QUESTIONS.

SO ON THE NATIONAL LIBRARY OF MEDICINE, ON THE GLOBAL GLOBAL LANDSCAPE OF 2000 TO 2021, THERE IS AN ARTICLE THAT TALKS ABOUT COMMUNITY HEALTH WORKERS ACTUALLY PROVIDING ADMINISTRATING VACCINES THAT HAVE BEEN CRITICAL TO REACHING UNDER IN MY, OH MY GOD, ZERO DOSE COMMUNITIES, UH, CHWS IN PAKISTAN ADMINISTERED THE ORAL POLIO VACCINE.

IN OTHER WORDS, WHAT I'M SAYING IS THERE IS SOME DATA, I MEAN, OR AT LEAST AN ARTICLE THAT SAYS THAT COMMUNITY HEALTH WORKERS, AND I'VE SAID THIS BEFORE, THAT CAN HAVE THAT, UH, CAPACITY IF, YOU KNOW, I'M NOT SURE HOW IT IS HERE, IT JUST SEEMS, BASED ON WHAT I'M READING, IT SEEMS THAT IT'S OTHER COUNTRIES THAT HAVE BEEN ABLE TO UTILIZE COMMUNITY HEALTH WORKERS TO ACTUALLY PROVIDE VACCINES.

I'M NOT SURE WHAT IS, UH, THE PROCESS HERE IN THE UNITED STATES OR JUST IN TEXAS OR IN TRAVIS COUNTY THAT WHEN YOU'RE LOOKING FOR MAYBE A PILOT PROGRAM, UH, UTILIZING COMMUNITY HEALTH WORKERS IN EACH OF THESE ORGANIZATIONS, LONE STAR COMMUNITY CARE, UM, THAT THEY CAN ACTUALLY DO HOME VISITS, DO THE INTAKE, AND THEY ACTUALLY WOULD GO INTO THEIR SYSTEM AND BECOME A PATIENT OF THAT CLINIC.

AND AT THAT POINT, THEY'RE ALREADY, YOU KNOW, A PATIENT.

AND IF YOU DO A HOME VISIT, YOU HAVE ALL YOUR KIDS THERE.

YEP.

AND JUST MAKE AN APPOINTMENT, COME HOME AND BE ABLE TO ADMINISTER.

THAT'S JUST MY IDEA WHEN, WHEN YOU SAID YOU WANTED A SOLUTION, I UNDERSTAND NUMBERS AND EVERYTHING ELSE AND ALL THE QUESTIONS PEOPLE WANNA HAVE, BUT I'M ABOUT SOLUTIONS.

SO THAT'S MY LITTLE, I THINK THAT'S ACTUALLY AN EXCELLENT POINT.

UM, WE DO, THEY, THE COMMUNITY ORGANIZATIONS AND PROVIDERS THAT WE'VE TALKED ABOUT ACTUALLY HAVE MORE PROMOTOR AND C COMMUNITY HEALTH WORKERS THAN A PH.

SO TO BE ABLE TO DEPUTIZE THEM, MAYBE NOT TO GIVE VACCINES, BUT TO READ THE RECORDS, TO WRITE UP WHAT'S UH, NEEDED, AND THEN THE NURSES CAN REVIEW IT AND THE PHYSICIANS CAN REVIEW IT TO INTAKE THE PATIENTS.

ALL OF THAT IS VERY TIME CONSUMING AND COULD BE OUTSOURCED EASILY TO COMMUNITY HEALTH WORKERS, UH, WHO, WHO WOULD HAVE AN EASIER TIME CONNECTING WITH THEM SOMETIMES IN THEIR HOME LANGUAGE AS WELL.

SO THAT'S A GREAT IDEA.

UM, AND I, WELL, ABSOLUTELY.

I CAN WORK ON THAT IN MY OWN TEAM.

SO THANK YOU.

ALRIGHT.

I KNOW WE ARE SHIFTING THINGS A LITTLE BIT WITH OUR PUBLIC COMMENT FOLKS TO ITEM FOUR.

UM, STILL, STILL THE TWO MINUTES, THREE MINUTES, THREE MINUTES JUST TO LIKE, KEEP THAT IN FRONT OF EVERYBODY'S MIND.

IT IS THREE MINUTES.

PLEASE BE MINDFUL THAT IT IS THREE MINUTES.

I CAN'T SAY ENOUGH TIMES THAT IT IS THREE MINUTES.

MANY OVERDOSES ARE GOING UNREPORTED.

UM, AND PLEASE COME UP, TELL US WHO YOU ARE.

YOU'LL HEAR A LITTLE TONE WHEN IT'S TIME TO SWITCH OFF.

UM, HEY Y'ALL, MY NAME IS ALEXANDRA WHITE.

I'M THE DIRECTOR OF SERVICES WITH TEXAS HARM REDUCTION ALLIANCE.

UM, WE ARE A HARM REDUCTION PROGRAM THAT WORKS WITH PEOPLE WHO USE DRUGS TO HELP KEEP THEM ALIVE AND CONNECTED TO COMMUNITY.

UM, WE WANT TO BE INVOLVED IN THE CONVERSATION AROUND, UM, THE OPIOID CRISIS, OF COURSE, AND HOW TO COMBAT IT HERE IN TRAVIS COUNTY.

AND, UM, WE WANNA PROMOTE THE IDEA THAT PEOPLE WITH LIVED EXPERIENCE SHOULD BE FRONT AND CENTER IN THIS CONVERSATION.

TO GIVE A LITTLE BACKGROUND ABOUT THRA, EVERY SINGLE PERSON WHO WORKS AT THA HAS LIVED EXPERIENCE PRINCIPALLY WITH DRUG USE, BUT ALSO WITH SEX WORK, INCARCERATION AND OR HOMELESSNESS HERE IN TRAVIS COUNTY.

AND THAT IS WHAT ALLOWS US TO MAKE THE IMPACT THAT WE DO EVERY DAY.

BETWEEN OUR DROP-IN AND OUR, UH, STREET OUTREACH TEAM, WE HAVE A REACH OF OVER 2300 PEOPLE WHO USE DRUGS IN TRAVIS COUNTY.

THAT'S 2300 PEOPLE WHO ARE AT RISK OF AN OPIOID OVERDOSE.

UM, IN 2023, THERE WERE 486 OVERDOSE DEATHS IN TRAVIS COUNTY.

IN THE LAST YEAR, OUR PARTICIPANTS HAVE REVERSED OVER 370 OVERDOSES.

SO THAT IS SIGNIFICANT.

UM, WHEN WE THINK ABOUT HOW

[01:50:01]

AND THE THING THAT WE KNOW IS THAT THE PERSON WHO IS MOST LIKELY TO RESPOND TO AN OVERDOSE AND SAVE A LIFE IS A PERSON WHO USES DRUGS.

SO WE WANT TO ADVOCATE, UM, FOR RESOURCES AND FUNDING TO GO TOWARDS, UM, ORGANIZATIONS THAT ARE ADEPT AND AGILE AND DOING TARGETED OUTREACH TO PEOPLE WHO ARE MOST AT RISK, UM, AND TO THE PEOPLE WHO ARE COUNTING ON TO KEEP OUR LOVED ONES ALIVE.

UH, MY NAME IS, UH, JIMENA DIAZ PRONOUNS.

SHE, THEY IS, CAN YOU GET YOUR MICROPHONE PLEASE? SORRY.

MY NAME IS JIMENA DI PRONOUNS.

SHE, IT, AND, UH, I'M THE PEER SERVICES COORDINATOR AT TEXAS HARM REDUCTION ALLIANCE.

I AM A, UH, QUEER PERSON WITH LIVED EXPERIENCE, AND WHAT I'M HERE IS TO TALK ABOUT, UM, HOW PEOPLE WHO USE DRUGS SHOULD BE ABLE TO, UM, MAKE DECISIONS ON HOW, UM, THESE, UH, OPIOID ABATEMENT FUNDS SHOULD BE USED IN TRAVIS COUNTY AND HOW THRA ARE THE ONES THAT ARE ABLE TO, TO MITIGATE THAT BECAUSE WE ARE THE ONES THAT WORK DIRECTLY WITH THESE FOLKS, THE ONES THAT ARE, ARE MARGINALIZED AND EXPERIENCING, UM, HOUSELESSNESS AND, UM, MENTAL HEALTH ISSUES.

UM, WE ALSO WANT TO TALK ABOUT HOW WE CAN EXPAND OUR OUTREACH EFFORT EFFORTS TO, UH, NORTH AUSTIN AS WELL AS THERE IS, THERE IS A HIGH DEMAND OUT THERE.

AND, UM, YOU KNOW, WITH, WITH THE HELP OF, UM, THESE, UH, ABATEMENT FUNDS, UH, WE'RE, WE'RE VERY WELL EQUIPPED TO, UH, MEET THAT, THAT NEED OUT THERE.

IN THAT PART OF, UH, AUSTIN, WE ALSO WANNA TALK ABOUT EXPANDING OUR DROP-IN HOURS AS WELL.

UM, WE ARE ABLE TO LINK SERVICES, UH, FOR EXAMPLE, LEGAL AID, MEDICATION ASSISTED TREATMENT, UH, TREATMENT IN GENERAL.

WE DO PEER SUPPORT, UH, CONNECTION TO HOUSING AND EMPLOYMENT.

UH, THE NEED IS GREAT.

WE'RE ABLE TO RISE TO THE TASK WITH THE COUNTY'S HELP.

UH, WE SEE ANYWHERE UP TO ABOUT 190 TO 200 FOLKS A DAY.

THAT'S BETWEEN THE DROP IN AND OUTREACH TEAM WITH, WITH ONLY EIGHT STAFF MEMBERS.

UM, SO IF OVERDOSE PREVENTION IS THE PRIORITY IN TRAVIS COUNTY, UM, WE'RE THE ONES THAT ARE ABLE TO, UH, MITIGATE THIS SITUATION BY BEING THAT GATEWAY FOR INDIVIDUALS TO LINKAGES, UH, TO PROGRAMS, TO TREATMENT, TO WELLNESS IN TRAVIS COUNTY.

SO, UM, ALSO AS WELL AS PEOPLE, UM, LIVING WITH HEPATITIS CHIV OR THAT HAVE LIVED WITH HEPATITIS C AND HIV, UM, WE'RE ALSO ABLE TO, TO HELP THESE FOLKS, UM, UM, LINK TO THOSE SERVICES AND THOSE CARE AND TO, UH, EMPOWER THEM SO, UH, WE CAN CARRY OUT THEIR DEMANDS AND, UH, YOU KNOW, HELP FIND A SOLUTION.

AND ONE MORE THING, AND I'LL WRAP IT UP, IS, UH, I ALSO AM THE LIAISON FOR OUR PARTICIPANT ADVISORY BOARD AT TEXAS HARM REDUCTION ALLIANCE.

THESE ARE, UH, FOLKS THAT ARE LIVE, THEY HAVE THE LIVING EXPERIENCE, THEY'RE PEOPLE OF COLOR, AND THEY BEST REFLECT THE COMMUNITY WE SERVE.

AND, AND THESE ARE, UH, DISCUSSIONS THAT WE HAVE AND THESE ARE ISSUES, UM, THAT I'M HERE TO BRING TO Y'ALL.

WHICH IS TO DISCUSS HOW TO ADDRESS THE OPIOID CRISIS FROM THE PRESENTATION BY TRAVIS COUNTY, WHICH IS REFERRING TO, UH, THE REPORT THAT WE RECEIVED FROM TRAVIS COUNTY.

THANK YOU ALSO VERY MUCH APPRECIATE YOU ALSO BEING AWARE OF TIME AS THAT AS IT GOES .

I WILL CONTINUE TO IMPRESS THAT.

DO WE HAVE MORE FOLKS FOR PUBLIC SPEAKING? BEAUTIFUL.

UM, WELL THAT LEADS US INTO DISCUSSION ITEM NUMBER FOUR,

[4. Discuss how to address the opioid crisis from the presentation by Travis County.]

THAT ALSO IS WHERE WE WERE ASKING FOR QUESTIONS LAST MONTH.

UM, THERE ARE, IF YOU DON'T REMEMBER WHAT THE PORT IS, PLEASE GO AND CHECK YOUR EMAILS.

BUT THERE ARE, UH, THERE WAS A REQUEST FOR ADDITIONAL QUESTIONS WHEN WE WERE INITIALLY HAVING THIS CONVERSATION AROUND WHAT DO WE WANT TO DO WITH THE OPIOID CRISIS AS A COMMISSION.

UH, COMMISSIONERS STATED, WE STILL HAD OPEN QUESTIONS, WE STILL HAD QUESTIONS THAT WERE NOT ANSWERED.

UH, THUS FAR WE HAVE RECEIVED THREE, UM, RESPONSES FROM COMMISSIONERS WITH ADDITIONAL QUESTIONS.

YOU SHOULD HAVE THOSE EITHER AS AN ATTACHMENT OR PRINTED OFF.

UM, MY HOPE TODAY WITH THESE IS NOT TO PUT THESE IN FRONT OF OUR, OUR SUPPORTIVE

[01:55:01]

SERV, OUR SUPPORTIVE ENTITIES IN FRONT OF THE CITY, COUNTY, AND CENTRAL HEALTH OR OTHER INSTITUTIONS BEFORE WE HAVE THE CONVERSATION AS A COMMISSION ON WHAT IT IS THAT WE ARE CAPABLE OF DOING AND WHAT OUR CAPACITY IS.

UNDERSTANDING THAT WE DO NOT HAVE A CLINICAL CAPACITY, HOW DO WE WANT TO APPROACH SUPPORTING THE OPIOID CRISIS HERE IN AUSTIN, TRAVIS COUNTY? UM, I WOULD LIKE TO HAVE THIS AS A DISCUSSION.

I UNDERSTAND THAT WE ARE AT LIMITED TIME.

WE ARE ACTUALLY OVER OUR TIME.

UM, SO MY REQUEST WOULD BE THAT WE WOULD REVIEW THESE QUESTIONS AGAIN, THE DEADLINE TO SUBMIT QUESTIONS HAS CLOSED, SO YOU WILL HAVE TO WAIT UNTIL QUARTER ONE TO SUBMIT ADDITIONAL QUESTIONS TO DANNY.

THOSE GO TO DIRECTLY JUST TO DANNY AND JUANITA, UH, NOT ADDITIONAL PEOPLE.

THEY WILL THEN DISPERSE THOSE OUT TO THE COMMISSIONERS IF YOU HAVE ADDITIONAL QUESTIONS.

FOR QUARTER ONE.

CURRENTLY, WE ARE GOING TO REVIEW THE QUESTIONS THAT YOU DO HAVE PRINTED OUT OR AS AN ATTACHMENT TO SEE ONE, WHAT CAN WE DO AS A COMMISSION? IS IT SOMETHING TO SUPPORT THE CONVERSATION AND HOW THE FUNDS ARE BEING USED? IS IT TO MOVE THE NEEDLE AND MOVING HOW THOSE FUNDS ARE BEING USED? UM, AND THEN WHAT CAN WE ASK OF OUR INSTITUTIONS THAT ARE ALSO SUPPORTING US OF A PH OF TRAVIS, COUNTY OF CENTRAL HEALTH IN WHAT THEY'RE DOING WITH THEIR FUNDING, HOW IT'S PROGRESSING, WHAT THAT IMPACT LOOKS LIKE I SAID, A WHOLE LOT, JUST AGAIN, BECAUSE WE ARE OVER OUR TIME AND I WANNA BE MINDFUL OF EVERYONE AND THEIR TIME AS WELL.

ANY QUESTIONS ON OUR NEXT STEPS, WHICH I WILL REITERATE REAL QUICK.

YOU HAVE A PRINTOUT WITH CURRENT QUESTIONS FROM COMMISSIONERS BASED OFF OF OUR FORENSIC REPORT, AS WELL AS OUR ABATEMENT REPORT, UM, THAT WAS PROVIDED TO US.

AND WE ARE NOW GOING TO GO THROUGH THIS INFORMATION INDIVIDUALLY AND FIGURE OUT WHAT IS IT THAT WE CAN ACTUALLY DO.

IS IT SENDING THESE QUESTIONS TO THESE INSTITUTIONS TO ASK FOR FOLLOW UP? IS IT SOMETHING THAT WE WOULD LIKE TO SUBMIT TO OUR WORKING GROUPS AND OUR WORKING COMMITTEES TO, UM, RESEARCH FARTHER OR INVESTIGATE FARTHER? AND THEN WHAT IS A, AS A COMMISSION DO WE WANT TO DO AS A WHOLE WITH REGARDS TO THE RESPONSE AS ITSELF, NOT ABOUT THE ABATEMENT FUNDS, BUT AS A RESPONSE ITSELF.

ANY QUESTIONS OR ANYONE THAT'S LIKE, WE JUST WANNA STAY AND CONTINUE THIS CONVERSATION UNTIL WE ARE DONE, DONE FOR THE DAY.

LET'S KEEP IT GOING.

FIVE, WHICH IS ALSO AN ACTION ITEM.

OKAY, WE HAVE OUR HOMEWORK AND OUR MARCHING ORDERS.

UH, QUICK ROLLING INTO DISCUSSION ITEM NUMBER

[5. Discuss and take action on changing regular meeting in December 2024 to a working retreat.]

UM, I WOULD LOVE TO DO THIS.

SO YOU ALL SAY YES OR NO, UH, DISCUSSION AND TAKE ACTION ON CHANGING OUR REGULAR MEETING, WHICH IS HAPPENING IN DECEMBER, 2024.

SO NEXT MONTH'S MEETING AND TURNING THAT INTO A WORKING RETREAT.

I FEEL LIKE I TEED UP OUR HOMEWORK VERY WELL TO HAVE THAT DONE TOGETHER, UM, NEXT MONTH INSTEAD OF HAVING OUR SPACE LIKE THIS.

ANYONE? UH, YES FOR THAT? CAN YOU RESTATE WHAT THAT WAS? SURE.

SO THE QUESTION IS, UM, HOW DO, CAN WE, OR IS THIS A, UH, A APPROVED IDEA THAT WE TRANSITION OUR REGULAR WORKING MEETING, A REGULAR MEETING HERE INTO A WORKING RETREAT? OKAY, JUST A QUESTION.

WERE YOU THINKING ABOUT USING THE SAME HOURS OR DIFFERENT HOURS? SAME LOCATION, DIFFERENT LOCATION OR HALF A DAY OR, I JUST DIDN'T KNOW WHAT THAT MEANT.

SAME LOCATION, LONGER TIME.

IT MAYBE I THOUGHT THAT.

JUST KIDDING.

TWO HOURS.

SAME PLACE, SAME TIME.

WORKING RETREAT INSTEAD OF A MEETING.

AND THAT WOULD BE ON DECEMBER 4TH, SORRY.

DECEMBER 4TH.

SO IF YOU'RE ALREADY PLANNING TO BE HERE, NOTHING HAS TO CHANGE .

IT'S JUST THE, THE FORMALITY OF THE EXPERIENCE.

QUESTIONS WILL BE DISCUSSED AHEAD OF TIME AND WE CAN THEN DETERMINE HOW WE'RE GOING TO LIKE, PUT THAT OUT.

WOULD IT BE JUST ON THIS ONE TOPIC? UH, NO.

SO OUR WORKING RETREAT WOULD BE AROUND A VARIETY PACK OF TOPICS.

UH, IT WOULD NOT JUST BE ON THE OPIOID ABATEMENT PLAN, WHICH I HOPE WE WOULD NOT SPEND TWO HOURS ON, BUT, UH, THIS IS GONNA BE A, A MULTI-PACK.

THIS IS GONNA BE LOOKING AT OUR 2025 GOALS.

UM, THAT IS DEFINITELY SOMETHING I WOULD LIKE THIS COMMISSION TO HAVE IN PLACE SO THAT WE KNOW JANUARY, 2025, THIS IS WHY WE'RE HAVING THESE PRESENTATIONS.

IT'S GOING TO NOW LINK TO X, Y, Z.

UH, THIS IS WHY WE ARE GOING TO INVITE FOLKS TO COME IN TO HAVE THIS CONVERSATION.

IT'S GOING TO LEAD TO DAH, DAH, DAH.

THAT WOULD ALSO BE A PART OF OUR WORKING RETREAT.

UM, HOPEFULLY THESE, THESE

[02:00:01]

UM, I KNOW WE HAVE OTHER CONVERSATIONS AROUND A VARIETY PACK OF DIFFERENT THINGS THAT WE'VE ALREADY TALKED ABOUT AND WHAT DOES THAT MEAN RIGHT NOW? WHAT DO WE WANT TO DO WITH REGARDS TO OUR MENTAL HEALTH, UH, CRISIS THAT WE'RE, WE'RE NAVIGATING? WHAT DOES THAT LOOK LIKE FOR THE COMMISSION? WE'VE HAD SUCH AMAZING INFORMATION.

YES MA'AM.

MADAM CHAIR.

WE JUST WANTED TO, UM, POINT OUT THAT WE HAVE, UM, ASKED FOR EXTENDED TIME FOR THE MEETING.

SO IF WE'RE ABLE TO GET THAT APPROVED, UM, WE WILL LET YOU ALL KNOW AND WE'LL SEND OUT A MESSAGE TO THE COMMISSIONERS SO THAT YOU HAVE IT ON YOUR AGENDA.

UM, BUT AS A POINT OF GOOD PRACTICE FOR A RETREAT, IT WOULD BE GOOD IF EVERYONE IS PRESENT SO THAT IT IS MORE ENGAGING AND INTENTIONAL IN HOW WE ADDRESS THE OUTCOMES OF THE MEETING.

UM, SO JUST WANTED TO MAKE THAT A LITTLE NOTE.

SO THEN THE QUESTION SHOULD BE, IF YOU ARE PLANNING, IF YOU ARE HERE DECEMBER 4TH AND YOU PLAN TO PHYSICALLY BE HERE, THAT WOULD BE WONDERFUL AND THAT WOULD THEN MAKE OUR WORKING RETREAT EVEN BETTER.

BACK TO THE QUESTION.

I'M SORRY TO SAY I WILL NOT BE HERE FOR THE DECEMBER MEETING, , BUT YOU CAN MEET WITHOUT ME.

JUST COMMISSIONER CROOKHAM.

ANYONE ELSE THAT IS ALREADY AWARE OF THEIR ABSENCE? JUST POTENTIALLY CROOKHAM.

JUST, OKAY.

SO HOW DO WE FEEL ABOUT CHANGING A REGULAR MEETING IN DECEMBER TO A WORKING RETREAT? RAISE OF HANDS.

DO WE HAVE SOMEONE TO SECOND? SECOND.

I APPRECIATE YOU ALL.

AYE AND OH, I'M SORRY.

NOW VOTE ON THIS AGAIN.

DONE.

AYE.

WE'RE GONNA FIGURE IT OUT.

ALL IN FAVOR? AYE.

UNANIMOUS MINUS, UH, LARRY, WHO'S NOT HERE.

GOT IT.

IS A QUICK UPDATE, UH, FROM OUR INFRASTRUCTURE AND ACCESS WORKING GROUP.

UM, BEAUTIFUL.

SO WE WILL MAKE THAT A WORKING RETREAT.

DECEMBER 4TH.

UM, LAST ITEM

[6. Update from Infrastructure & Access work group by Chair Natalie Poindexter on groups recommendation timeline and progress, and update on Texas Center for Equity Promotion Partner Coalition meeting.]

WE HAVE DRAFTED A COMMUNITY HEALTH WORKER, UM, SUPPORTIVE SERVICES AND QUALITY OF LIFE IMPROVEMENT IDEA RECOMMENDATION.

I DON'T KNOW HOW TO SAY THAT QUICKLY.

UM, BUT THAT HAS BEEN SENT OUT TO THE REST OF THE WORKING GROUP WITH REQUESTS FOR EDITS AND CLARIFICATION.

ONCE THAT IS DONE, WE WILL THEN CIRCULATE THAT TO THE REST OF THE COMMISSION, UM, FOR INPUT AND FEEDBACK.

UM, AND I DID HAVE A WONDERFUL OPPORTUNITY TO MEET WITH THE TEXAS CENTER FOR EQUITY AND PROMOTION PARTNERING COALITION.

UH, THEY ARE GOING TO PROVIDE HT PROFESSORS TO SUPPORT US.

I'M SO SORRY, UH, WRONG SCHOOL UT PROFESSORS TO SUPPORT US IN OUR, UH, COMMISSION WORK, WHETHER THAT'S RESEARCH, UM, OR OTHER PARTNERSHIP ENGAGEMENT IN ACTIVATION.

I WILL REALLY QUICK RUN

[FUTURE AGENDA ITEMS]

TO FUTURE AGENDA ITEMS AND IF ANYONE ELSE HAS FUTURE AGENDA ITEMS, PLEASE UH, SHOUT THESE OUT.

MY FIRST AGENDA ITEM WOULD BE FROM, UM, A IST WOULD LOVE TO HEAR WHAT THEY HAVE GOING ON, UH, WITH THEIR STUDENTS AND THEIR VACCINE PROGRAM.

I'M NOT SURE IF WE CAN, WE ALREADY HAVE OUR, OUR DECEMBER PLAN, SO WE ARE LOOKING AT MAYBE JANUARY OR FEBRUARY FOR THEM TO COME IN.

I KNOW JANUARY HAS A AT LEAST ONE PRESENTATION ON IT ALREADY.

UM, AND THAT'LL GIVE THEM SOME TIME.

BLESS, UH, WOULD LOVE TO INVITE BACK.

DO I NEED TO ASK FOR SECONDED ON THOSE? OKAY, GREAT.

UM, FOR THE TEXAS HARM REDUCTION ALLIANCE WHO STAYED SO PATIENTLY AND WAITED TO SHARE THEIR INFORMATION, UM, I WOULD LOVE TO HAVE A PRESENTATION FROM THEM, UM, ON THE WORK THAT THEY'RE DOING.

UM, I CAN GET SOMEONE, UH, THE EXECUTIVE DIRECTOR, I HAVE CONTACT WITH HER.

I CAN ASK AND SHE CAN DO A PRESENTATION FOR Y'ALL.

BUT I DO WANNA NOTE, LIKE, WE'RE GONNA BE DOING THE WORKING GROUP IN DECEMBER, BUT THE OPEN ABATEMENT FUNDS, I DON'T WANT IT TO BE A CAN KICKING DOWN THE ROAD.

SO LIKE, IN MY MIND IT IS A PRIORITY, ESPECIALLY GIVEN WHAT WE HEARD TODAY.

CAN YOU, CAN YOU WORK WITH OUR TEAM TO GET THAT TAKEN CARE OF? BEAUTIFUL.

UH, AND MAYBE, MAYBE THAT COULD BE A JANUARY CONVERSATION AND LIKE, I KNOW WE WANNA GET SO MANY THINGS DONE, BUT, UH, OVERWHELMING INFORMATION CAN, CAN SLACK UP THINGS AS WELL.

UM, THANK YOU.

AND THEN ANYTHING ELSE FOR FUTURE AGENDA ITEMS? YES, CHAIR.

I HAVE A QUESTION AND IT'S NOT ABOUT FUTURE AGENDA

[02:05:01]

ITEMS. OKAY.

FOR THE FUTURE, FOR THE DECEMBER MEETING, UH, THERE HAD BEEN DISCUSSION THAT CENTRAL HEALTH, UH, THE COUNTY AND THE CITY WOULD BE PROVIDING, UH, MORE PRESENTATION ON OPIOID ABATEMENT DOLLARS.

AND I KNOW THAT YOU SAID THAT FIRST YOU'RE GONNA KICK OFF THE QUESTIONS BY EMAIL.

DO YOU STILL WANT THE STAFF TO BE THERE AT THE, AT THE RETREAT? YOU DON'T HAVE TO DECIDE NOW.

CAN I, CAN I FOLLOW UP WITH YOU ON THAT ONE? ABSOLUTELY, ANNA.

ANY OTHER QUESTIONS FOLLOW UP? YES.

JUST WANNA POINT OUT THAT I PROVIDED TO THE COMMISSIONERS HERE, AND I'LL SEND AN EMAIL TO, UH, DANNY AND JUANITA SENT OUT TO EVERYBODY ELSE, BUT A PH RECENTLY, UH, TODAY PRODUCED A HEAT RELATED ILLNESS, MORBIDITY AND MORTALITY REPORT, UH, FOR SUMMER 2024.

I HIGHLY RECOMMEND LOOKING AT THAT SINCE WE'VE BEEN INTERESTED IN HEAT.

AND THEN ALSO A PH JUST RELEASED THE 2024 COMMUNITY HEALTH IMPROVEMENT PLAN AND COINCIDENTALLY THE MANAGER OF THAT PROGRAM IS HERE.

UH, KOJO JUST GIVING YOU A SHOUT OUT.

UM, SO THIS IS OBVIOUSLY A VERY IMPORTANT DOCUMENT THAT, YOU KNOW, COMMUNITY INPUT HAS BEEN GIVEN FOR IT.

SO I HIGHLY RECOMMEND PERUSING THROUGH THIS AS WELL TO GET A BETTER IDEA OF THIS SITUATION IN OUR COMMUNITY.