Dec 04, 2024 Public Health Committee

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PERFECT.

[CALL TO ORDER ]

GOOD MORNING.

I CALLED TO ORDER THIS MEETING OF THE AUSTIN CITY COUNCIL PUBLIC HEALTH COMMITTEE.

THE TIME IS 10:02 AM ON WEDNESDAY, DECEMBER 4TH, 2024, AND WE ARE IN THE CITY HALL CHAMBERS.

WELCOME EVERYONE TO OUR DECEMBER PUBLIC HEALTH COMMITTEE MEETING.

THIS IS OUR LAST MEETING OF THE YEAR, IF YOU CAN BELIEVE IT.

IT'S JUST GONE BY SO FAST.

UH, WE ARE JOINED TODAY BY OUR VICE CHAIR COUNCIL MEMBER JOSE VELASQUEZ, AS WELL AS COUNCIL MEMBER RYAN ALTER, WHO ARE MEMBERS OF THE COMMITTEE.

UH, SO WE HAVE A FEW ITEMS ON OUR AGENDA AND OUR GOAL IS TO, UH, WRAP UP BY NOON.

UH, SO WE'LL START WITH PUBLIC COMMUNICATIONS, THEN WE WILL MOVE TO APPROVING THE MEETING MINUTES FROM NOVEMBER 6TH.

AND FROM THERE, THE COMMITTEE WILL THEN HEAD INTO EXECUTIVE SESSION AND TAKE UP PERSONNEL MATTERS RELATED TO THE CENTRAL HEALTH BOARD OF DIRECTORS.

WHEN WE RETURN, WE WILL DISCUSS THE APPOINTMENT RECOMMENDATIONS TO OF THE CENTRAL HEALTH BOARD OF MANAGERS, AND THEN WE WILL DISCUSS AND TAKE POSSIBLE ACTION AND RECOMMENDATIONS REGARDING THE ECHO STATE OF THE HOMELESSNESS RESPONSE SYSTEM REPORT AND GAPS IN INVESTMENTS TO IMPROVE THE SYSTEM.

FINALLY, WE'LL MOVE INTO OUR BRIEFINGS.

UH, FROM THERE, THE FIRST BRIEFING WE'LL HAVE WILL BE ON CENTRAL HEALTH AND ITS HOUSING FOR HEALTH PARTNERSHIP, PROVIDING RESPITE CARE AND SERVICES PROGRAM FOR UNHOUSED COMMUNITY MEMBERS.

AND LAST BUT NOT LEAST, WE WILL HEAR FROM OUR HOMELESSNESS STRATEGY OFFICE FOR AN UPDATE ON THE CITY'S MARSHALING YARD, WHICH IS SERVING AS EMERGENCY SHELTER RIGHT NOW.

UH, ARE THERE ANY QUESTIONS OR COMMENTS ON THE AGENDA? OKAY, THANK YOU.

UH, WE'LL NOW MOVE TO SPEAKERS FROM THE COMMUNITY.

DO WE HAVE ANY REGISTERED GOOD MORNING CHAIR.

NO, THERE ARE NO SPEAKERS THIS MORNING.

ALRIGHT, THANK YOU.

AND NOW WE'LL MOVE TO

[1. Approve the minutes of the Public Health Committee meeting on November 6, 2024. ]

CAN I HAVE A MOTION MOVED BY VICE CHAIR VELASQUEZ? SECONDED BY COUNCIL MEMBER RYAN ALTER ANY OBJECTION TO APPROVING THE MEETING MINUTES FROM NOVEMBER? SEEING NONE, THOSE STAND APPROVED.

AND NOW WE'LL MOVE

[2. Discussion and consideration of appointments to the Central Health Board of Managers. (Part 1 of 2)]

I'D LIKE TO PAUSE ON THIS ITEM AND TAKE IT INTO EXECUTIVE SESSION.

AND SO THE COMMITTEE WILL NOW

[Executive Session]

THE COMMITTEE WILL DISCUSS PERSONNEL MATTERS RELATED TO ITEM NUMBER SIX, DISCUSS THE SELECTION OF MEMBERS TO THE CENTRAL HEALTH BOARD OF MANAGERS.

IS THERE ANY OBJECTION TO US GOING INTO EXECUTIVE SESSION ON THE ITEM ANNOUNCED? HEARING NONE, THE COMMITTEE WILL NOW GO INTO EXECUTIVE SESSION.

WE ARE OUT OF CLOSED SESSION AND CLOSED SESSION.

WE DISCUSS PERSONNEL MATTERS RELATED TO ITEM NUMBER SIX.

AND BELIEVE NOW

[2. Discussion and consideration of appointments to the Central Health Board of Managers. (Part 2 of 2)]

CYNTHIA BRINSON TO THE CENTRAL HEALTH BOARD OF MANAGERS.

SECONDED BY COUNCIL MEMBER RYAN ALTER ANY OBJECTION? SEEING NONE, WE, UH, WILL NOW MOVE FORWARD THOSE RECOMMENDATIONS TO THE FULL COUNSEL AT OUR NEXT COUNCIL MEETING.

AND, UH, AND AGAIN, THAT IS FOR THE REAPPOINTMENTS OF CYNTHIA BRINSON AND AMIT ANI TO THE CENTRAL HEALTH BOARD OF MANAGERS.

THANK YOU.

[3. Discussion and possible action regarding ECHO’s State of the Homelessness Response System report and recommendations, and additional investments to fill comprehensive gaps and needs to improve the Homelessness Response System. ]

COLLEAGUES.

LAST MONTH WE RECEIVED A PRESENTATION FROM ECHO AROUND THE CURRENT STATE OF HOMELESSNESS RESPONSE, AND THE PRESENTATION HIGHLIGHTED A NUMBER OF NEEDS THAT WE HAVE, INCLUDING APPROXIMATELY 350 MILLION NEEDED TO SUFFICIENTLY ADDRESS OUR HOMELESSNESS RESPONSE SYSTEM OVER THE NEXT 10 YEARS.

UM, AS A COMMITTEE, WE ARE TASKED WITH MAKING POLICY RECOMMENDATIONS AND DECISIONS REGARDING HOMELESSNESS.

AND SO I'M BRINGING FORWARD A COMMITTEE RECOMMENDATION TO PRIORITIZE INVESTMENTS IN OUR HOMELESSNESS RESPONSE SYSTEM.

WE SHOULD HAVE A YELLOW COPY OF THAT POLICY RECOMMENDATION BEFORE YOU.

UH, ESSENTIALLY THIS RECOMMENDATION ADOPTS ECHO'S REPORT AS A MODEL TO INFORM INVESTMENTS IN THE HOMELESSNESS RESPONSE SYSTEM AND, UH, MAKES ADJUSTMENTS IN IN RESPONSE TO THE UPDATED DATA.

IT ALSO DIRECTS THE CITY MANAGER TO EXPLORE ADDITIONAL FUNDING OPPORTUNITIES, UM, FOR US AND TO PRIORITIZE THOSE ONGOING INVESTMENTS IN THE HOMELESSNESS RESPONSE SYSTEM, STARTING WITH FISCAL YEAR 25, 26.

AND THIS IS KEY HERE.

WE REALLY WANNA ENSURE THAT WE MAKE OUR HOMELESSNESS RESPONSE SYSTEM, UH, ONE OF OUR TOP BUDGET PRIORITIES GOING INTO NEXT FISCAL YEAR.

IT ALSO DIRECTS THE CITY MANAGER TO IDENTIFY POLICY AND ADMINISTRATIVE CHANGES NECESSARY TO

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AND WELL, I THINK THAT IS PART OF THE AMENDMENT THAT COUNCIL MEMBER RYAN ALTER HAS BEFORE US.

UM, AND THIS INCLUDES A REPORT BACK DATE.

AND SO WE HAVE THAT, WE HAVE MY RECOMMENDATION.

UM, I MOVE MY RECOMMENDATION IF I CAN HAVE A SECOND COUNCIL, VICE CHAIR ALASKA SECONDED.

SECOND THE RECOMMENDATION.

AND THEN, UH, COUNCILMAN RYAN ALTER.

I BELIEVE WE HAVE AN AMENDMENT TO THE RECOMMENDATION.

I DO.

THANK YOU VERY MUCH.

AND YEAH, THIS, THIS IS, UH, TO BUILD ON WHAT, UH, THE CHAIR IS TALKING ABOUT.

ADDING A COUPLE THINGS TO IDENTIFY FIRST AND FOREMOST, UM, THE ARPA CLIFF THAT IS COMING AND REALLY UNDERSTANDING WHAT PROGRAMS THAT WE HAVE BEEN OPERATING VIA ARPA DOLLARS, DO WE THINK WE SHOULD CONTINUE TO OPERATE? AND IF SO, HOW ARE WE'RE GOING TO FUND THOSE IN THE UPCOMING BUDGET? UH, AS WELL AS ONE OF THE BIG, UH, COST DRIVERS IN THE ECHO REPORT IS THE NEED FOR, UH, OVER 4,000 UNITS OF PERMANENT SUPPORTIVE HOUSING.

AND IF THAT IS SOMETHING THAT WE ARE GOING TO PROVIDE AS A COMMUNITY, AS A CITY AND, AND HOPEFULLY WITH PARTNERS, WE ARE GOING TO NEED A LARGE AMOUNT OF CAPITAL AND A LARGE AMOUNT OF ONGOING FUNDING FOR THOSE SERVICES.

AND SO THESE PROJECTS TAKE A LONG TIME.

THEY'RE NOT SOMETHING THAT, YOU KNOW, IN 2027, WE CAN SAY, WE WANNA START THE PROCESS TO GET UNITS IN 2028.

WE NEED TO START THE PROCESS TODAY.

IF WE'RE GOING TO BE BUILDING THE OVER 600 UNITS IN SOME OF THESE YEARS, THAT IS CALLED FOR IN THIS PLAN.

AND SO THE HOPE IS FOR, UM, THE MANAGER, HOMELESS STRATEGY OFFICE, THE HOUSING DEPARTMENT, TO PUT FORWARD A, HERE'S HOW WE WOULD ACCOMPLISH THAT GOAL TYPE PLAN.

YOU KNOW, HERE ARE THE CAPITAL DOLLARS WE WOULD NEED.

HERE'S THE TIMELINE, HERE ARE THE OPERATIONAL DOLLARS WE NEED, AND THIS IS HOW WE WOULD DO IT IF THAT, UH, IS THE GOAL.

SO I JUST WANNA MAKE SURE WE GET, UM, WE HAVE ENOUGH LEAD TIME TO ACCOMPLISH THE GOALS WITHIN THIS MODEL THAT ARE SO IMPORTANT.

UM, AND SO I THINK THAT'S A, A, A REALLY CRITICAL ADD.

THE FINAL THING THAT WANT TO EXPLORE IS, YOU KNOW, WHEN WE TALK ABOUT IN THE REPORT, CAPACITY EXPANSION CAPACITY ISN'T ALWAYS JUST ADDING ADDITIONAL BEDS, RIGHT? AND WHEN IT COMES TO SHELTER OR OTHER INTERVENTIONS, YOU CAN BRING ANOTHER BED ONLINE OR YOU CAN GET THE PERSON WHO'S IN THE BED INTO HOUSING.

AND THAT HAS THE SAME EFFECT.

AND SO HOW CAN WE, UH, FIGURE OUT WAYS TO INCREASE TURNOVER, INCREASE MOVES TO HOUSING THAT HAS THE EFFECT OF, OF ADDING CAPACITY, BUT DOESN'T REQUIRE THAT ADDITIONAL CAPITAL EXPENSE AND, AND HAS THE OUTCOME THAT WE'RE TRYING TO GET.

SO THAT IS WHAT MY AMENDMENT ADDS ON TO, UH, THE CHAIR'S ITEM.

AND I REALLY APPRECIATE HER BRINGING THIS FORWARD TO, TO MAKE THIS A PRIORITY.

YOU KNOW, WE'VE SEEN THE, YOU PRIORITIZE IT IN THE LAST BUDGET AND APPRECIATED THAT WORK.

AND SO NOW LOOK FORWARD TO CONTINUE TO DO THAT IN THE UPCOMING BUDGET.

THANK YOU.

ANY OBJECTION TO INCORPORATING COUNCIL MEMBER RYAN AL ALTER'S AMENDMENT? SEEING NONE, THE MOTION STANDS AMENDED AND, UH, ANY DISCUSSION ON THE MOTION TO MOVE FORWARD THIS RECOMMENDATION? OKAY.

ANY OBJECTION TO MOVING FORWARD THE RECOMMENDATION? ALL RIGHT.

SEEING NONE, THE RECOMMENDATION STANDS ADOPTED COLLEAGUES, THIS, UH, RECOMMENDATION WILL GO TO THE FULL COUNCIL FOR CONSIDERATION.

UH, I WANNA THANK YOU FOR YOUR SUPPORT ON THIS.

I THINK IT, IT MEANS A LOT THAT OUR PUBLIC HEALTH COMMITTEE HAS TAKEN A DEEP DIVE INTO OUR HOMELESSNESS RESPONSE SYSTEM.

UH, AND SO I APPRECIATE ALL THE WORK AND SUPPORT FROM OUR CITY STAFF, UH, ESPECIALLY FROM THE LEADERSHIP FROM DAVID GRAY, OUR, UH, CHIEF HOMELESSNESS STRATEGY OFFICER.

UM, AND, UH, AND WE'LL HAVE THIS DISCUSSION AS A COUNCIL.

MY, UH, MY SUGGESTION TO THE CITY MANAGER WOULD BE THAT WE CONSIDER THIS AT THE JANUARY COUNCIL MEETING AND IT CAN BE, UH, ONE OF OUR TOP FOCUS AS WE BEGIN 2025.

ALRIGHT, THANK YOU.

[4. Update from Central Health on its Housing for Health Partnership, providing respite care, and services program for individuals experiencing homelessness. ]

THIS IS, UH, RECEIVE AN UPDATE FROM CENTRAL HEALTH ON ITS HOUSING FOR HEALTH PARTNERSHIP, PROVIDING RESPITE CARE AND SERVICES PROGRAM FOR UNHOUSED COMMUNITY MEMBERS.

I WANNA WELCOME DR.

PAT LEE, PERLA CAVASSO, MONICA CROWLEY, DR.

CYNTHIA BRINSON, AND AMANI FROM CENTRAL HEALTH FOR AN UPDATE

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UH, THANK YOU ALL FOR BEING HERE.

GOOD MORNING COUNCIL MEMBERS.

THANK YOU, CHAIR.

UH, MY NAME IS PERLA VASO.

I'M THE DEPUTY ADMINISTRATOR AT CENTRAL HEALTH, AND I'M GONNA KICK OFF OUR PRESENTATION TODAY.

UM, I WANNA, AGAIN, THANK YOU FOR THE OPPORTUNITY TO GIVE YOU SOME UPDATES ABOUT CENTRAL HEALTH, INCLUDING OUR SERVICES AND INITIATIVES AROUND SERVING PEOPLE, EXPERIENCING HOMELESSNESS.

UM, OUR PRESENTATION TODAY, WHAT WE'RE GONNA DO, UM, JUST TO GIVE YOU AN OVERVIEW, IS WE'RE GONNA TALK A, UM, A LITTLE ABOUT OUR ACCOMPLISHMENTS IN FISCAL YEAR 20 24 4.

WE'RE, UM, NOW IN FISCAL YEAR 2025.

SO WE'RE GONNA SHARE A LITTLE BIT ABOUT OUR PRIORITIES FOR THE UPCOMING YEAR.

AND THEN WE ALSO WANT TO GIVE YOU AN OVERVIEW OF SOME OF OUR, UM, PROGRAMS AND INITIATIVES SERVING PEOPLE, EXPERIENCING HOMELESSNESS.

UM, I WANNA RECOGNIZE OUR, UM, BOARD OF MANAGERS THAT ARE HERE TODAY.

UM, OF COURSE, DR.

CYNTHIA BRINSON.

UM, AMIT WAN IS ALSO HERE.

I WANNA ACKNOWLEDGE A MANAGER, CYNTHIA VALADE, WHO'S HERE.

AND I ALSO WANT TO RECOGNIZE OTHER CITY APPOINTED BOARD MANAGERS WHO ARE ELISA MAY, DR.

MANUEL MARTIN AND MARAM, THANK YOU FOR, UM, APPOINTING THESE LEADERS TO OUR BOARD OF MANAGERS.

I'M GONNA HAND IT OVER TO, UM, AMEE, ANI AND, UM, CYNTHIA BRINSON TO SAY A FEW WORDS BEFORE WE HAND IT OVER TO DR.

PAT LEE TO BEGIN THE FORMAL PRESENTATION.

THANK YOU FOR HAVING ME, CHAIR AND COUNCIL MEMBERS.

UH, MY NAME IS AMIT WANNI, AND I'VE SERVED ON THE CENTRAL HEALTH BOARD OF MANAGERS FOR THE LAST FOUR YEARS.

AND, UH, I HAVE A BACKGROUND IN NONPROFIT HEALTH AND HUMAN SERVICES, UH, FOR ABOUT THE LAST 20, 25 YEARS HERE AT THE AUSTIN AREA.

AND A STRONG, IN MY OPINION, UNDERSTANDING OF HOW THE HEALTH SYSTEM AFFECTS FOLKS UNIQUELY THROUGH THE LENS OF SOCIAL HEALTH DETERMINANTS OR NON-MEDICAL DRIVERS OF HEALTH.

UH, ONE OF THOSE OF COURSE, BEING INCOME AND HOW POVERTY AFFECTS POVERTY AND STRESSORS.

UH, UH, AND OF COURSE, SOCIOCULTURAL AND RACIAL ISSUES CAN AFFECT HEALTH OUTCOMES IN OUR COMMUNITY.

AND THAT'S WHAT DRIVES ME TO BE ON THIS BOARD.

I'M A FORMER MAP MEMBER, UH, AND A FORMER COMMUNITY CARE PATIENT, UH, MYSELF.

AND SO IT IS VERY PERSONAL TO ME, UH, THIS MISSION, UH, THAT WE SHARE TO ENSURE THAT ALL FOLKS IN AUSTIN HAVE ACCESS TO HIGH QUALITY HEALTHCARE, UH, AND ACCESS TO THE SAME PROBABILITY OF POSITIVE HEALTH OUTCOMES, WHICH HAS NOT BEEN HISTORICALLY THE CASE.

ONE OF THE THINGS, UH, THAT HAS BEEN UNIQUELY HEARTENING FOR ME, UH, RECENTLY IS TO SEE THE ENTERPRISE, THE CENTRAL HEALTH ENTERPRISE'S PROGRESS WHEN IT COMES TO STANDING UP RESPITE CARE SERVICES IN JUST A VERY SHORT PERIOD OF TIME.

AND I'M BRINGING THIS UP BECAUSE THIS IS REPRESENTATIVE, AND I'M EMBLEMATIC, I SHOULD SAY, OF THE COLLABORATION, UH, OF THE CITY AND THE COUNTY AND THE HEALTHCARE DISTRICT, THE HOSPITAL DISTRICT AROUND PROVIDING CARE FOR THOSE WHO NEED IT MOST, BOTH BY MEANS OF A MORAL, UH, IMPERATIVE, BUT ALSO BY MEANS OF PRAGMATIC IMPERATIVE.

AND SO, FOLKS WHO ARE EXPERIENCING HOMELESSNESS NEED THE TIME AND SPACE TO BE ABLE TO HEAL.

NOT ONLY DO THEY NEED THE ACCESS TO CARE, WHICH IS OF COURSE, WHAT WE TIRELESSLY WORK TO PROVIDE, BUT THE TIME AND SPACE TO BE ABLE TO HEAL OFF THE STREETS.

UH, AND FOR ONE THING THAT'S UNIQUELY NOTABLE, UH, I THINK IS THAT WE WERE JUST, UH, RECENTLY REPORTED BACK TO FROM OUR CEO THAT WE'VE DOUBLED EFFECTIVELY, UH, OUR GOAL, OUR BASE GOAL OF, UH, AROUND 3,400, UH, RESPITE, UH, BED DAYS.

UH, AND IT'S, UH, I BELIEVE OVER 6,700, UH, IN THE LAST YEAR.

AND, AND SO THAT'S SOMETHING THAT I'M EXTREMELY PROUD, UH, TO SHARE AS A BOARD MANAGER, UH, IN, IN THE, UH, THE BENEFIT AND HARD WORK, UH, THAT OUR CEO AND STAFF, UH, HAVE BEEN GUIDING.

SO, UH, IN THE INTEREST OF TIME, UH, I'M GOING TO SPARE YOU ALL THE OTHER 15 THINGS THAT REALLY INSPIRE ME ABOUT THIS WORK.

AND I THANK YOU ALL FOR YOUR SUPPORT, UH, ATTENTION AND, AND HARD WORK.

AND OF COURSE, UH, THE SUPPORT AND RE APPOINTMENT.

UH, THANK YOU YOU, PERLA AND MANWANI FOR THAT, UH, LOVELY, UH, UH, OPENING AND COLLEAGUES, IT'S AN HONOR TO BE HERE.

UM, FRIENDS, THANK YOU SO MUCH FOR THE, UM, OPPORTUNITY TO ADDRESS YOU.

[00:15:01]

IT'S REALLY AN HONOR TO TO BE HERE WITH ALL OF YOU.

SO, UM, UH, WHAT I'D LIKE TO BEGIN IS, UH, IS, IS REALLY THE PLACE THAT WE BEGIN WITH EVERY NEW EMPLOYEE ORIENTATION.

UM, AND MANY OF THE, UM, ALL EMPLOYEE, UH, GATHERINGS THAT WE HAVE, WHICH IS WITH THE STATEMENT OF BELIEF THAT WE BELIEVE AT CENTRAL HEALTH, THAT WE ARE STRONGEST WHEN WE ARE ONE TRUNK, MANY BRANCHES.

WHEN WE ARE CLEAR ABOUT THE TRUNK, UH, WHY ARE WE HERE? WHAT IS OUR PURPOSE? WHAT ARE OUR CORE VALUES? AND WE LIFT UP THE MANY BRANCHES.

WHAT IS THE DIVERSITY THAT NOURISHES, UH, THIS TRUNK? UH, AND IT'S HELD UP BY THE TRUNK.

SO ON THE RIGHT, YOU SEE THAT OUR TRUNK BEGINS WITH TRUST.

WE BELIEVE THAT, UH, OUR WORK IS TO EARN TRUST, PERIOD.

AND THROUGH TRUST, WE THEN CAN HAVE A REAL CONVERSATION ABOUT WHOLE PERSON CARE.

WHAT IS IT THAT A PERSON BEFORE US NEEDS TO THRIVE? ALL OF IT, MEDICAL CARE, SURGICAL CARE, BEHAVIORAL HEALTH, SUBSTITUTES CARE, NUTRITION, TRANSPORTATION, HOUSING, UH, EDUCATION, AND SO ON.

UH, WHAT DOES THAT LOOK LIKE FOR YOU TODAY AND TOMORROW? BECAUSE THE WORK AND THE JOINT DOESN'T STOP WHEN WE LEAVE THIS CONVERSATION, WE WANNA DO THE AT SCALE FOR EVERYONE WHO NEEDS US IN OUR COMMUNITY.

NOT ONE SIZE FITS ALL, BUT ONE SIZE FITS.

ONE, BECAUSE IT'S LIKELY DIFFERENT FOR EACH OF US, AND IT'D BE DIFFERENT FOR US AT DIFFERENT POINTS IN TIME.

AND IF WE CAN DO THAT, OF COURSE, EASIER SET THAN DONE, THEN WE BELIEVE THAT LEADS TO THE OUTCOMES THAT MATTER, WHICH IS HOW WE THINK ABOUT HEALTH EQUITY.

THESE ARE THE QUADRUPLE AIM OUTCOMES.

AIM NUMBER ONE IS THE CARE KIND AND COMPASSIONATE AS WE'D WANT FOR OUR OWN MOTHERS AND SISTERS AND LOVED ONES.

NUMBER TWO, IS THE CARE HIGH QUALITY? DOES IT DIRECTLY ADDRESS THE REASONS WHY PEOPLE ARE DYING 10 TO 20 YEARS BEFORE THEIR NATURAL TIME, PREDOMINANTLY BLACK AND BROWN NEIGHBORS, PREDOMINANTLY IN THE EAST SIDE? ARE WE GETTING RIGHT AT THE ROOT OF THAT AND IMPACTING THAT UNJUST LIFE EXPECTANCY GAP? AND NUMBER THREE, IS IT HIGH VALUE CARE? WHAT BENEFIT ARE WE GETTING FOR, UH, THE PUBLIC DOLLARS THAT WE ARE INVESTING, UH, INTO THIS SPACE? ARE WE INVESTING IN THE RIGHT THINGS? ARE WE MAKING BOTH NEAR TERM AND LONG TERM, UH, INVESTMENTS HERE? VERY MUCH APPRECIATE, UH, COUNCIL MEMBER AL ALTER'S, UH, COMMENTARY ABOUT THE, THE FORESIGHT THAT'S REQUIRED TO REALLY BUILD TO THE GAPS THAT EXIST IN THE SPACE.

AND IN NUMBER FOUR, IS THIS WORK THAT IS THRIVING, THIS, THIS HARD WORK.

WE'VE ALWAYS KNOWN THAT WE LEARNED THAT MORE THROUGH COVID.

SO CAN WE SUSTAIN A SENSE OF FAMILY, A SENSE OF FULFILLMENT, A SENSE OF THRIVING FOR OUR CURRENT WORKFORCE AND THE FUTURE WORKFORCE.

FOLKS ARE COMING UP THROUGH THE AUSTIN COMMUNITY COLLEGE OR A ISD, UH, SO THAT THERE ARE GOOD JOBS WITH GOOD BENEFITS IN OUR COMMUNITY IMPACTING THE ECONOMICS OF OUR COMMUNITY AND THROUGH ALL THE CIRCLES AND COMMUNITIES THAT THOSE INDIVIDUALS, UM, UH, AND, UH, UH, LIVE IN THE BRANCHES THAT NOURISH THIS TRUNK.

UH, THE FIRST BRANCH IS THE PEOPLE AND CULTURE, WHICH WILL ALWAYS BE THE FIRST BRANCH AS LONG AS I HAVE THE PRIVILEGE OF SERVING IN THIS ROLE.

THE SECOND IS COMMUNITY HEALTH, DNA.

WE ARE THE ONLY HOSPITAL DISTRICT IN A MAJOR PUBLIC, UH, URBAN AREA IN TEXAS THAT DOES NOT CURRENTLY OWN AND OPERATE THE HOSPITAL.

AND FOR 20 YEARS, WE HAVE WORKED IN COMMUNITY, WE'VE WORKED THROUGH PARTNERSHIPS, WE'VE WORKED THROUGH, UH, HUNDREDS OF CONTRACTS WITH HUNDREDS OF PARTNERS.

AND THAT I THINK IS A FEATURE AND NOT A DEFECT IN MY VIEW, THAT ENABLES US TO SEE THE WHOLE CARE CONTINUUM TO SEE, UH, UH, THE ENTIRE SPACE THAT PATIENTS MOVE THROUGH ACROSS THESE, UH, OFTEN COMPLICATED AND FRAGMENTED JOURNEYS.

AND WE THINK THAT IS NECESSARY ACTUALLY TO BUILD A HEALTH SYSTEM IN THE FUTURE THAT OUR COMMUNITY DESERVES AND THAT OUR COUNTRY DESERVES.

UH, UH, BRANCH NUMBER THREE IS THE FINANCIAL STRENGTH AND FLEXIBILITY, THE PRIVILEGE AND THE TRUST OF THE PEOPLE OF TRAVIS COUNTY TO ALLOW US TO HAVE A REVENUE SOURCE THAT, UH, GROWS AS THE PROSPERITY OF OUR COMMUNITY GROWS, AND ALLOW US TO CHANNEL THAT PROSPERITY INTO THE FULL BREADTH OF WHOLE PERSON CARE THAT OUR COMMUNITY AND OUR PATIENTS NEED.

THAT IS A REMARKABLE, UH, UM, LEGISLATIVE, UH, UM, UH, UM, UH, UH, STRUCTURE THAT IS NOT REPLICATED AROUND THE COUNTRY AND IS PART OF, UH, THE SECRET SAUCE THAT ALLOWS OUR HEALTH SYSTEMS TO BE AS EFFECTIVE AS THEY ARE.

THE NORTH STAR FOR US IS THE SEVEN YEAR HEALTHCARE EQUITY PLAN.

THIS, AS YOU KNOW, IS A SEVEN YEAR OVER $700 MILLION INVESTMENT TO CLOSE, UH, DIRECTLY DEFINED AND MEASURED GAPS THAT WE HAVE IDENTIFIED THAT IF YOU IMAGINE THERE ARE ISLANDS OF CARE, THERE'S ISLANDS OF GOOD CARE IN OUR COMMUNITY,

[00:20:01]

AND THEY'RE NOT EQUIPPED TO SWIM THOSE DEEP CHANNELS ON THEIR OWN.

THEY WASH UP AGAIN ON THE SHORES OF THIS ISLAND THAT THEY HAVE BEEN ON IN THE EMERGENCY DEPARTMENT, PICKED UP FOR A MISDEMEANOR IN JAIL, MAYBE INCOMPETENT STAND TRIAL, AND ON OUR STREETS, UH, AND UN UNTIL THEY, UH, UNTIL THEY DROWN, UNTIL THEY DIE, 10 TO 20 OR EVEN 25 YEARS EARLIER THAN THEIR NATURAL TIME.

UH, WE CAN'T EXPECT THE PRIVATE SECTOR TO BUILD THE BRIDGES BETWEEN THOSE ISLANDS.

WE CAN'T EXPECT A NONPROFIT TO INVEST $700 MILLION OVER SEVEN YEARS.

THIS IS THE ROLE OF LOCAL GOVERNMENT.

IT IS OUR PRIVILEGE, IT IS OUR RESPONSIBILITY, UM, AND WE ARE HONORED TO BE ON THAT JOURNEY.

UM, THE NEXT BRANCH IS OUR CENTRAL HEALTH FAMILY, OUR CENTRAL HEALTH SYSTEM, CENTRAL HEALTH COMMUNITY CARE CERA.

WE HAVE THE HONOR OF BEING PART OF THE PUBLIC HEALTH SYSTEM OF TRAVIS COUNTY.

EACH COMPONENT OF THIS SYSTEM PLAYS A UNIQUE ROLE.

CENTRAL HEALTH PROVIDES THE UMBRELLA, THE REVENUE SOURCE, THE CONNECTIVE TISSUE, THE SPECIALTY CARE, THE TRANSITIONS OF CARE, THE ABILITY TO MAKE THESE DEEPER STRUCTURAL INVESTMENTS.

COMMUNITY CARE IS THE PRIMARY CARE HEARTBEAT OF THIS SYSTEM.

PRIMARY CARE IS CENTRAL TO ANY PATIENT JOURNEY, UH, UH, THROUGH THE POPULATION THAT MUST BE STRONG.

SENDERO PROVIDES THE ABILITY FOR US TO FLEXIBLY AND INNOVATIVELY, UM, ALIGN THE INCENTIVES, THE FINANCIAL INCENTIVES FOR HOW UH, PAYERS CARE IS PROVIDED, AND ALSO DRAW DOWN, UM, INNOVATIVE FUNDING THROUGH THE NATIONAL, UM, UH, A CA MARKETPLACE.

PARTNERSHIPS, UM, ARE ABSOLUTELY REQUIRED TO MAKE THIS GO.

THE CITY IS CENTRAL TO IT.

WE THANK YOU FOR YOUR LEADERSHIP AND YOUR VISION AND YOUR FOCUS AND DEDICATION ON, UM, HOUSING FOR HEALTH.

UM, UH, AMONGST OTHER, UH, VITAL PRIORITIES.

THE COUNTY INTEGRAL CARE, UT OUR COMMUNITY AND MANY OTHERS ARE ABSOLUTELY CENTRAL.

THIS, THIS, THIS WORKS WITH MANY HANDS, UH, NOT WITH ONE.

AND ULTIMATELY, WE WANNA MAKE SURE THAT WE'RE SPEAKING TO THE HEART, WE'RE TALKING ABOUT PEOPLE AND THE IMPACT OF OUR WORK IN TERMS THAT REALLY MATTER AND RESONATE.

DOLLARS AND DATA ARE VALUE, VALUABLE AND IMPORTANT, BUT ULTIMATELY, UH, WE NEED TO, UH, SPEAK TO THE HEART.

SO I WANNA BRIEFLY, UH, JUST DESCRIBE SOME OF THE, UH, UH, KEY POINTS FROM LAST FISCAL YEAR.

UH, I'LL START HERE WITH ACCESS AND ENROLLMENT.

THESE ARE NUMBERS ACROSS, UH, MAP AND MAP BASIC.

FROM FISCAL YEAR 2020 TO THE MOST RECENT YEAR IN 2024, THERE WAS A, A BIT OF A, UM, A DECLINATION DURING THE EARLY PART OF THE PANDEMIC, BUT YOU CAN SEE THAT OVERALL WE'VE RISEN BY ABOUT 36% OR ABOUT 22,600 INDIVIDUALS, UH, DURING THAT PERIOD OF TIME.

MOST OF IT THROUGH THE MAP BASIC, UH, PART OF OUR, UH, WORK.

UM, THE MAP AS YOU, AS YOU ARE AWARE, REQUIRES, UM, UH, ALIGNMENT ACROSS OUR PARTNERS, INCLUDING ASCENSION DECEDENT.

UM, BUT MAP BASIC, WE ARE ABLE TO TO MOVE MORE, UH, INDEPENDENTLY AND MEET PEOPLE WHERE THEY ARE.

THIS IS A BUSY SLIDE, BUT IT IS A, UM, WHAT WE USE IS SORT OF A, UH, A RED, YELLOW, GREEN DASHBOARD OF THE KEY WORK IN YEAR ONE OF THAT HEALTHCARE EQUITY PLAN FROM LAST YEAR.

WHAT I'LL SHARE WITH YOU IS THAT PRIOR TO LAST FISCAL YEAR, THIS ENTIRE SLIDE WOULD HAVE BEEN RED.

AND NOW YOU CAN SEE THAT IT'S NOT ENTIRELY GREEN, BUT THERE IS A TREMENDOUS AMOUNT OF WORK ON THIS PAGE.

UH, WE ARE NOT THE CENTRAL HEALTH THAT WE WERE 20 YEARS AGO, WE'RE NOT THE CENTRAL HEALTH THAT WE WERE THREE YEARS AGO.

WE ARE DIRECTLY, UH, FOLLOWING THE LEAD OF OUR HOSPITAL DISTRICT COLLEAGUES IN DALLAS AND HOUSTON AND SAN ANTONIO AND ELSEWHERE TO STAND UP AND BUILD THE CH NET SYSTEM THAT, UH, CLOSES THE GAPS BETWEEN THOSE ISLANDS OF CARE.

UM, WE HAVEN'T SEEN ANY OTHER WAY REALLY TO PROVIDE THAT CARE CONTINUUM IF WE DON'T STEP FORWARD AND, UH, AND BUILD TO THE GAPS THAT EXIST ON THE LEFT, UH, UH, HAND SIDE, YOU SEE AT THE TOP, UH, THREE NEW FACILITIES.

AND I'LL SHOW THAT GEOGRAPHICALLY, UM, IN A MOMENT, UM, THAT WERE STOOD UP.

AND TWO MORE THAT ARE IN PROCESS.

UM, A LARGE NAVIGATION CENTER TO CONNECT SOME OF THESE DOTS THAT MAP ELIGIBILITY TO MAKE IT EASIER, WHICH WE CANNOT MOVE WITHOUT ASCENSION'S AGREEMENT.

UM, COMPLETING THE MASAR PERFORMANCE REVIEW AND A GREAT DEAL OF CONNECTIVE TISSUE WORK, WORKING WITH THE JAIL, UH, COLLEAGUES ON THE STREETS TO BE MORE DETAILS TO COME.

TRANSITIONS OF CARE, SKILLED NURSING FACILITIES, HOME-BASED SERVICES, RESPITE SERVICES, CANCER SCREENING, WORKING WITH THE INTEGRAL CARE PARTNERS, UM, AND, UH, AND WITH THE COUNTY'S DIVERSION, UH, MENTAL HEALTH PILOT.

AND ON THE RIGHT YOU SEE A WHOLE SUITE OF MEDICAL SPECIALTIES AND DIAGNOSTIC SERVICES.

UH, STANDING UP A COUPLE OR THREE OF THESE IN A YEAR IS ALREADY FAIRLY SIGNIFICANT FOR TYPICAL HEALTH SYSTEM TO STAND THIS ENTIRE AMOUNT,

[00:25:01]

UM, I WANNA GIVE YOU, UH, JUST ONE BRIEF SENSE OF WHAT THIS MEANS.

SO IN THIS LIST OF SERVICES, YOU SEE PODIATRY AND X-RAY.

THERE WAS A WEEK IN MARCH WHERE BOTH SERVICES WENT LIVE TOGETHER.

UH, AND AT THE, UH, END OF THAT WEEK, ON A FRIDAY AFTERNOON, AN 86-YEAR-OLD EL SALVADORIAN WOMAN PRESENTED FOR CARE WITH SEVERE FOOT PAIN.

AND THE PODIATRIST SAW HER.

DR.

BRETT VESSEL WAS WORRIED ABOUT A SERIOUS INFECTION, WAS ABLE TO TAKE AN X-RAY IMMEDIATELY ON SITE THAT X-RAY DEMONSTRATED GAS BUBBLES IN THE SOFT TISSUE OF HER FOOT.

UH, THAT CLINICALLY SIGNIFIES A POTENTIALLY LIFE-THREATENING GANGRENE INFECTION.

THIS IS A FRIDAY AFTERNOON.

BUT BECAUSE WE WERE ABLE TO CONTROL THIS CARE CONTINUUM, WE COULD IMMEDIATELY ESCALATE TO DEFINITIVE CARE IN THE END.

THAT WOMAN HAD ONE TOE AMPUTATED AND THE APPROPRIATE ANTIBIOTICS.

WE SAVED HER FOOT, WE SAVED HER LIFE.

HAD THAT, UH, NOT HAPPENED ON THAT FRIDAY AFTERNOON, WE HAD TO MONDAY, SHE ALMOST CERTAINLY WOULD'VE LOST THAT LIMB.

IF IT WAITED TO WEDNESDAY, THAT INFECTION MIGHT HAVE GONE TO THE BLOOD WITH OVERWHELMING STEPS.

SHE MIGHT HAVE LOST HER LIFE.

HOW MANY PEOPLE IN OUR COMMUNITY HAVE LOST THEIR LIMBS WITHOUT ACCESS TO THAT CARE? HOW MANY HAVE LOST THEIR LIVES, LET ACCESS TO THAT CARE? UM, WE ARE BEGINNING DOWN THAT JOURNEY.

INTERESTINGLY, FOLLOWING THE REQUEST AND AND VISION OF OUR COUNTY COLLEAGUES, WE BEGAN TO WORK WITH OUR, UH, JAIL HEALTH COLLEAGUES TO PROVIDE THESE SERVICES.

UM, THE VERY FIRST SERVICE THAT WAS REQUESTED WAS PODIATRY.

AND INTERESTINGLY, THE VERY FIRST PATIENT WHO CAME OVER FROM THE JAIL TO OUR EAST, UH, CLINIC, HAD A THREATENED LIMB AND NOT ENOUGH BLOOD SUPPLY IN LO UH, IN RISK OF LOSING THEIR FOOT, WE IMMEDIATELY BROUGHT THAT PERSON TO THE RIGHT VASCULAR INTERVENTION SERVICE, UH, AND SAVED THAT PERSON'S LIMB.

SO THIS IS, UH, JUST ONE STORY TO, UH, PUT INTO PERSPECTIVE WHAT IT MEANS TO CREATE ACCESS WHERE THAT ACCESS HAS BEEN MISSING FOR MANY YEARS.

SO, UH, TURNING FORWARD, UH, JUST A VERY BRIEF OVERVIEW OF THE 2025 BUDGET HIGHLIGHTS AND PRIORITIES.

AGAIN, I APOLOGIZE FOR THE BUSY SLIDE.

THERE'S A LOT ON THIS SLIDE.

UM, WE WANNA REALLY MAKE SURE THAT WE ARE, UM, ACCELERATING IN A YEAR TWO, UM, TO CONTINUE TO CLOSE THOSE GAPS.

AND, AND THE FIRST POINT THAT I WANNA MAKE HERE IS A POINT OF GRATITUDE FOR THE DEEP COLLABORATION IN OUR COMMUNITY.

MANY OF THE INDIVIDUALS ON THE DIETS AND IN THE AUDIENCE, UM, BUT MORE, UH, WE HAVE, UH, COME TOGETHER IN A WAY THAT REALLY WARMS MY HEART, UH, AND GIVES US HOPE, UH, TO CREATE A CONTINUUM OF HOUSING AND HEALTH.

UH, FOR OUR MOST VULNERABLE, REQUIRES ALL SECTORS TO WORK AS ONE AND PROVIDE HOUSING AND SERVICES TOGETHER.

AND THAT IS WHAT WE ARE LEANING IN TO DO.

UH, AMONGST THE HIGHLIGHTS, WE ARE, UH, TAKING THE GROUND FLOOR OF THE OLD CHILDREN'S HOSPITAL CLINICAL EDUCATION CENTER, UM, AND, UH, BUILDING OUT APPROXIMATELY 40 BEDS OF RESPITE CARE THAT WE WILL OWN AND OPERATE AND BE ABLE TO PLACE THE ADJACENT SERVICES NEXT TO YOU THAT PEOPLE WILL NEED, IN ADDITION TO THE MEDICAL CARE, UM, SOCIAL CARE, UH, UM, APPLYING FOR DISABILITY, HOUSING, UH, CLINICAL CARE, AND SO ON.

UM, WE ARE ALSO INVESTING SIGNIFICANTLY IN TRANSITIONS OF CARE SERVICES, UH, MILLIONS OF DOLLARS TO ENSURE THAT WE CAN CONNECT THE DOTS BETWEEN THE HOSPITAL, THE SKILLED NURSING FACILITY, AND THE HOME.

WE ARE CREATING BRIDGE TEAMS, WHICH YOU'LL HEAR MORE ABOUT FROM MY COLLEAGUE IN A MOMENT, UM, THAT PROVIDE A CONNECTION BETWEEN, UM, THE, THE STREET AND OUR CLINICAL SERVICES.

ALSO OUR AUSTIN TRAVIS COUNTY EMS SERVICES, UH, REALLY FILLING IN A KEY NEED THERE.

UH, WE ARE PROVIDING, UH, MAP AND DISABILITY APPLICATION ASSISTANCE, UH, MOST RECENTLY REALLY SCALING UP SERVICES, SUNRISE CHURCH, UH, AND MORE.

UM, WE ANTICIPATE, UH, SIX TIMES INCREASE IN THE VOLUME OF DIRECT SPECIALTY CARE VISITS THAT WILL BE PROVIDED BY OUR CENTRAL HEALTH CLINICAL TEAMS IN THE COMING YEAR.

OVER LAST YEAR, UH, WE ARE INCREASING INVESTMENT IN COLLABORATION IN MANY WAYS WITH COMMUNITY CARE AND SENDERO.

WE ARE MAKING A MAJOR INVESTMENT IN INTEGRAL CARE AND MENTAL HEALTH SERVICES, OUTPATIENT PSYCHIATRIC EMERGENCY SERVICES.

WE BELIEVE IN THE WORK THAT RI COLLEAGUES ARE DOING, AND WE KNOW THAT WE ARE DOING THE SAME MISSION BASED WORK, OFTEN FOR THE SAME INDIVIDUALS AND POPULATIONS.

AND OUR INTENT IS TO CREATE A SHARED VISION OF WHAT THAT PHYSICAL AND MENTAL HEALTH CARE CONTINUUM LOOKS LIKE AND WORK TOGETHER TO ACHIEVE THAT VISION.

WE ARE MAKING MAJOR BRICK AND MORTARS INVESTMENTS IN EASTERN TRAVIS COUNTY.

WE ANTICIPATE DELL VALLEY HEALTH AND WELLNESS CENTER TO OPEN THE SPRING OF THIS COMING YEAR.

WHILE CONSTRUCTION AT THE CAMERON CENTER IN COLONY PARK IS ONGOING, WE ARE CONTINUING TO COLLABORATE

[00:30:01]

AND WE'RE PARTNERING WITH MANY COMMUNITY BASED ORGANIZATIONS, MANY COMMUNITY BASED ORGANIZATIONS OF COLOR TO BROADEN OUR REACH AND ADDRESS FOOD INSECURITY, HOUSING, HOMELESSNESS, MENTAL HEALTH TRAUMA, AND MORE VISUAL VISUALLY.

THIS IS ONE WAY OF SEEING THE, UH, THE INVESTMENT AND THE VOLUME OF CARE ACROSS MANY DIFFERENT SPECIALTY LINES, ALL OF WHICH WERE SIGNIFICANTLY GAPPED PRIOR TO OUR BEGINNING.

THIS DIRECT INVESTMENT BETWEEN LAST YEAR AND THE COMING FISCAL YEAR.

VISUALLY, THESE ARE THE THREE LOCATIONS THAT, UH, CAME ONLINE IN THE LAST FISCAL YEAR.

ROADS AT OSA, EAST AUSTIN SPECIALTY CLINIC IN CAPITAL PLAZA.

AND THEN THESE ARE THE FOUR THAT ARE, UH, IN PROCESS IN THE COMING YEAR.

CAMERON CENTER IN THE NORTH, THE HANCOCK CENTER, IN THE CENTER, THE CLINICAL EDUCATION CENTER, UH, AND THEN THE COLONY PARK HEALTH AND WELLNESS CENTER, UM, AND THE EASTERN CRESCENT.

AND SO I'M GONNA ADDRESS, UH, JUST THE OPENING SLIDE HERE IN THIS IMPORTANT SEGMENT ABOUT ADDRESSING HOUSING FOR HEALTH THROUGH PARTNERSHIP.

AND THEN INVITE MY COLLEAGUE, UH, CHIEF STRATEGY OFFICER MONICA CROWLEY TO, UM, TO, UH, TO GO DEEPER INTO THIS TOPIC.

MANY OF YOU HAVE SEEN THIS DESIGN SLIDE, A HOUSING FOR HEALTH PARTNERSHIP SLIDE, UNDERLINE ON THE PARTNERSHIP, AND, UH, UNDERLINE ON THE GOAL TO BRING SERVICES OR CARE AND HOUSING TOGETHER.

I HAD THE PRIVILEGE OF ATTENDING THE SCREENING OF THE BEYOND THE BRIDGE FILM THAT PERHAPS, UH, YOU WERE AWARE OF AS WELL.

AND MY COLLEAGUE, DAVID GRAY WAS, UH, PART OF A PANEL, UM, UH, THAT DISCUSSED, UH, THIS KEY LESSON THAT ACROSS THE COUNTRY AS WE REFLECT ON WHAT WORKS, HOUSING PLUS SERVICES WITH ALL SECTORS COLLABORATING TO A COMMON GOAL IS WHAT WORKS.

SO ON THIS SLIDE, YOU SEE RESPITE CARE ON THE LEFT HAND SIDE, A PLACE TO HEAL.

IF YOU ARE COMING OUTTA THE HOSPITAL, YOU NEED TO HEAL A SURGICAL WOUND.

YOU DON'T HAVE ANTIBIOTICS FOR SEVERAL WEEKS, YOU HAVE TO HAVE A PLACE TO HEAL.

BUT IF YOU GO BACK TO THE STREET AFTER THAT, WE HAVEN'T CHANGED UNDERLYING CONDITION.

SO OUR COMMITMENT OF CENTRAL HEALTH IS TO STAY WITH YOU FOR THAT FIRST YEAR.

WE KNOW THE JOURNEY IS MORE THAN A YEAR, BUT AT LEAST THAT FIRST YEAR, IF YOU COME INTO OUR RESPITE ENVIRONMENT, WE WILL ACCOMPANY YOU FOR THAT FIRST YEAR AND TRY TO ENSURE THAT YOU HAVE THE CARE THAT YOU NEED AND THE HOUSING THAT YOU NEED WHILE WORKING WITH OUR MANY PARTNERS AND NAVIGATING THAT ROAD IN THE MIDDLE TO STAY ALONGSIDE YOU AND NEVER LET YOU GO.

WORK WITH OUR EMS COLLEAGUES IF YOU POP UP WITH THE 9 1 1 GRID TO GET YOU BACK TO OUR BRIDGE CLINIC AND SO FORTH.

I WON'T GO INTO, UH, DEEPER DETAIL HERE BECAUSE I KNOW MONICA CROWLEY PROVIDE FOR THE DETAILS AND THE SLIDES TO FOLLOW.

SO LET ME INVITE MY COLLEAGUE, UH, MONICA CROWLEY UP TO, TO TAKE US FORWARD HERE.

MONICA.

THANK YOU.

I'M MONICA CROWLEY, CENTRAL HOST, CHIEF STRATEGY OFFICER, AND THANK YOU FOR, UM, LETTING US, UH, PROVIDE THIS INFORMATION, UM, TO YOU TODAY.

UH, AND I ALSO AM GONNA APOLOGIZE FOR THIS VERY, VERY BUSY SLIDE.

UM, CENTRAL HEALTH'S UPCOMING DEMOGRAPHIC REPORT CONTINUES TO SHOW THAT, UH, WHAT WE ALL KNOW, THAT EXPERIENCING HOMELESSNESS MAKES IT MORE LIKELY THAT YOU WILL, UM, ALSO BE DIAGNOSED WITH ONE OR MORE CHRONIC ILLNESSES, AND ALSO IN ANY NUMBER OF CHRONIC ILLNESSES, UM, MEDICAL AND, UH, MENTAL AND BEHAVIORAL.

IT ALSO MAKES YOU, UM, 20 TO 27% MORE LIKELY THAT FOR ANY OF THOSE INDIVIDUAL ILLNESSES, THAT YOU'RE MORE LIKELY THAN ANYONE ELSE IN THE POPULATION TO BE DIAGNOSED WITH THOSE ILLNESSES.

UH, WHICH IS ONE OF THE REASONS THAT CENTRAL HEALTH IS INVESTING IN CLOSING THIS HEALTHCARE EQUITY GAP, UM, THROUGH INVESTMENTS IN SERVICE EXPANSIONS ACROSS ALMOST EVERY AREA OF THE HEALTHCARE CONTINUUM.

AND THIS SLIDE IS, UH, KIND OF A PREVIEW OF COLLABORATIVE WORK THAT WE ARE DOING WITH ASSISTANT CITY MANAGER HAYDEN HOWARD, THANK YOU FOR CONVENING THIS.

AND, UH, DAVID GRAY AND, UH, ECHO AND INTEGRAL CARE AND THE COUNTY IN REALLY LOOKING AT ALL OF THE INVESTMENTS THAT EACH OF OUR ORGANIZATIONS OR INSTITUTIONS IS MAKING, UM, IN, UH, SERVICES FOR PEOPLE EXPERIENCING HOMELESSNESS, UH, SO THAT WE CAN ALIGN OUR WORK BETTER AND ALSO SO THAT WE CAN VALUE, UM, THE TOTAL INVESTMENT THAT'S BEING MADE ACROSS ALL OF THESE DIFFERENT AREAS.

UM, WE ARE PRESENTING TO OUR INTERNAL WORKING GROUP NEXT MONDAY ON DECEMBER 9TH.

AND THERE WILL BE, IN EACH OF THE DROPDOWN BULLETS, THERE'S GOING TO BE A EVALUATION AND A LIST OF DIFFERENT PROJECTS AND PROGRAMS, UM, THAT, UH, ACCOMPANY EACH OF THOSE BULLETS IN COMPREHENSIVE PRIMARY AND SPECIALTY CARE, INTEGRATED OUTPATIENT AND POST-ACUTE CARE, UH, INVESTMENTS IN SERVICE COORDINATION AND SUPPORT,

[00:35:01]

SO THIS IS KIND OF A PREVIEW SLIDE, AND WE WILL HAVE, UM, MORE DETAIL TO COME THAT GOES ALONG WITH THIS.

UM, I KNOW THAT DR. LEE MENTIONED, UM, THAT INCREASE IN RESPITE CARE SERVICES.

UM, HERE'S A LITTLE BIT MORE DETAIL IN THIS INCREASE IN, UH, RESPITE CARE SERVICES.

UM, AND THIS IS A LOOK AT THE NUMBER OF BED DAYS, WHICH BED DAYS MEANS THE TOTAL NUMBER OF AVAILABLE BEDS MULTIPLIED BY THE NUMBER OF DAYS EACH BED WAS USED TO PROVIDE CARE IN A YEAR.

UM, THIS SLIDE REPRESENTS OUR INCREASE IN SERVICES OVER THIS PROGRAM STARTED IN 2023 FOR CENTRAL HEALTH.

UM, IT'S CONTRACTING WITH COMMUNITY PROVIDERS, WHICH ARE, UH, AND HAVE BEEN VERY LIMITED.

AND SO IF YOU LOOKED AT OUR THRESHOLD THAT WE STARTED WITH, THAT WAS THE 3,200 BED DAYS, WHICH REFLECTS THAT WE WERE CONTRACTING AT THE BEGINNING OF FISCAL YEAR 2024 FOR ABOUT 10 BEDS ACROSS THE COMMUNITY.

UM, WE HAD THE INTENTION OF EXPANDING THE BEDS THAT WE WERE ABLE TO CONTRACT FOR.

UM, BUT WE SET OUR GOAL AT 3,600 BED DAYS BECAUSE WE DIDN'T KNOW HOW MANY ADDITIONAL BEDS WOULD BE AVAILABLE.

AND, YOU KNOW, WE ALSO WOULD LIKE TO THANK, UM, THE CITY FOR MAKING BEDS, UH, AVAILABLE IN, UM, DIFFERENT LOCATIONS IN THE MARSHALING YARD.

THEN WE HADN'T KNOWN IF THAT WOULD HAPPEN.

AND SO THE REASON THAT WE WERE ABLE TO ACTUALLY INCREASE THE BED DAYS FROM THIS BASELINE OF 3,200 TO ALMOST, YOU KNOW, 60, 67 OVER 6,700, IS THAT WE WENT FROM CONTRACTING FOR 10 BEDS TO CONTRACTING FOR 25 BEDS OVER THE COURSE OF THE YEAR.

UM, AND SO WE WERE ABLE TO, UM, SIGNIFICANTLY INCREASE, UM, THE BED DAYS.

AND NEXT YEAR AS WE ACTUALLY OPEN OUR OWN FACILITY WITH BETWEEN, UH, STANDING IT UP, IT'LL WILL EVENTUALLY HAVE 40 ADDITIONAL BEDS ON TOP OF THIS.

UH, NEXT YEAR WE'RE HOPING TO ACTUALLY OPEN UP, UM, O OPERATE, STARTING WITH 30 BEDS, UM, AND THEN IT WILL EXPAND TO 40 BEDS OVER THE COURSE OF THE YEAR.

UM, ONE OF THE THINGS THAT DR. LEE MENTIONED IS THAT WHEN YOU HAVE THE ADDITIONAL HEALTHCARE SERVICES AND WRAPAROUND SERVICES, UM, THAT'S SOMETHING THAT REALLY IMPROVES THE OUTCOMES.

HOWEVER, IN A RESPITE SETTING, UM, BECAUSE OF LICENSING REQUIREMENTS AND REGULATIONS, YOU CAN'T PROVIDE COMPREHENSIVE MEDICAL SERVICES IN A RESPITE FACILITY BECAUSE THEN IT WOULD HAVE TO BE LICENSED AS A SKILLED NURSING FACILITY.

AND SO THIS HAS, UH, NECESSITATED THE DEVELOPMENT OF THE BRIDGE CLINICS, UH, THAT DR. LEE WAS TALKING ABOUT.

AND WE STARTED THE BRIDGE CLINIC, UH, LAST AT, TOWARDS THE END OF THE LAST FISCAL YEAR, UH, AT CAPITAL PLAZA.

AND THE BRIDGE CLINIC IS A TRANSITIONAL CLINIC THAT ALLOWS CENTRAL HEALTH TO PROVIDE COMPREHENSIVE COORDINATED MEDICAL AND BEHAVIORAL HEALTH AND COUNSELING AND PSYCHIATRY AND SPECIALTY CARE SERVICES, UM, TO PATIENTS THAT WE STARTED WITH PATIENTS THAT WERE IN OUR RESPITE CARE FACILITIES, AND WE WOULD BRING THE PATIENTS FROM THE RESPITE CARE FACILITIES TO THE BRIDGE CLINIC SO PEOPLE COULD GET THIS COMPREHENSIVE HIGHER LEVEL OF CARE.

AND ONE OF THE THINGS THAT WE'VE HEARD IS IT'S NOT JUST, UM, GETTING THAT HIGHER LEVEL OF CARE, IT'S RECEIVING CARE FROM THE DOCTORS, THE NURSES THAT VISIT YOU WHEN YOU ARE IN THE RESPITE CENTER.

AND SO, UM, YOU KNOW, THEY HAVE THIS TRUSTED FACE OF THE PERSON THAT THEY'RE WORKING WITH AND THAT THEY'VE WORKED WITH IN RESPITE.

AND SOMETIMES EVEN, UH, DOCTORS THAT HAVE WORKED IN MOBILE CLINICS ON, UH, YOU KNOW, WHEN PEOPLE WERE UNHOUSED OR BEFORE THEY WENT INTO RESPITE.

AND SO THEY FEEL LIKE THEY'VE GOT THIS MEDICAL HOME WHERE PEOPLE KNOW THEIR STORY, PEOPLE KNOW WHO THEY ARE, THEY HAVE THIS KIND OF TRUSTED, UH, RELATIONSHIP.

THE SECOND PHASE OF THE BRIDGE CLINIC, WHICH, UH, RECENTLY STARTED WAS WORKING WITH, UH, EMS, WHERE THE EMS PROVIDERS, UM, BRING LOWER ACUITY EMS PATIENTS DIRECTLY TO

[00:40:01]

IF THEY'RE PATIENTS THAT DON'T NEED TO BE TREATED AT A HOSPITAL FACILITY, THEY CAN BRING THEM DIRECTLY TO THE BRIDGE CLINIC WHERE THEY CAN RECEIVE CARE AND BE TRIAGED IN REAL TIME AND RECEIVE THIS HIGHER LEVEL OF SPECIALTY CARE.

THINGS LIKE X-RAYS INSTEAD OF HAVING TO BE TRANSPORTED, UH, TO THE HOSPITAL.

AND IT ALSO CREATES THIS BRIDGE TO THESE PATIENTS TO BE TRANSITIONED INTO A MEDICAL HOME, UH, AT COMMUNITY CARE DOWN THE ROAD WHEN THEY ARE MORE STABLE AND WHEN THEY'RE ABLE TO, UM, TRANSITION INTO A PRIMARY CARE MEDICAL HOME.

THE NEXT PHASE OF THE BRIDGE CLINIC IS GOING TO BE AN ACTUAL MOBILE BRIDGE CLINIC.

UM, AND SO FAR WE'VE HOSTED THREE KIND OF MOBILE OUTREACH EVENTS IN THE COMMUNITY.

ONE WAS AT HUNGRY HILL, AND THEN THERE WERE OTHER ONES AT THE ARCH.

UM, AND WE INTEND IN JANUARY TO EXPAND THESE MOBILE SERVICES, UM, WITH A FULL MOBILE TEAM THAT'S GOING TO BE ABLE TO PROVIDE THESE COMPREHENSIVE AND COORDINATED SERVICES, UM, IN COMMUNITY-BASED SETTINGS ON, ON SITE.

SO THAT WILL START IN JANUARY, UM, HAVING THAT KIND OF MOBILE TRANSITION.

AND THE PHYSICAL BRIDGE CLINIC ALSO PROVIDES, UM, UH, A WAY FOR PROVIDERS, UH, AND SUPPORT PERSONNEL AND STAFF WHO ARE WORKING WITH THIS VERY VULNERABLE POPULATION.

SOMETIMES WHEN YOU'RE WORKING DIRECTLY, UM, WITH, UH, PATIENTS IN A STREET-BASED SETTING, THAT CAN BE VERY STRESSFUL.

IT CAN BE TRAUMATIC FOR THE PROVIDERS IN MANY WAYS.

AND SO BEING ABLE TO HAVE A TRANSITION WHERE YOU'RE WORKING IN THAT PHYSICAL CLINICAL SETTING SOMETIMES, AND THEN WHERE YOU'RE ALSO WORKING IN THAT MOBILE SETTING IS SOMETHING THAT ALSO PROVIDES A BETTER QUALITY OF LIFE FOR THE PEOPLE WHO ARE DIRECTLY PROVIDING THE CARE, WHICH ALSO MAKES THE CARE BETTER FOR THE PATIENTS.

UM, AND IT WOULDN'T BE A CENTRAL HEALTH PRESENTATION IF WE DIDN'T HAVE, UH, ANOTHER PATIENT STORY.

AND, UH, THIS PATIENT STORY, THESE PICTURES ARE ALL, UM, PATIENTS WHO HAVE BEEN CARED FOR IN THE BRIDGE CLINIC BY DR.

AUDREY KWANG, WHO YOU ARE ALL FAMILIAR WITH, UM, AND WHO WANTED TO SHARE THEIR STORIES.

AND THIS STORY REALLY IS ABOUT OUR FIRST BRIDGE PATIENT WHO WAS NAMED GLENDA, BUT WHO PREFERS TO GO BY GIGI.

UH, SHE CAME TO OUR RESPITE CARE, UM, SETTING AFTER THREE WEEKS INPATIENT AT DELL SETON, AND THEN ANOTHER TWO WEEKS, UH, IN A SKILLED NURSING FACILITY STAY.

UH, WHEN SHE WAS INITIALLY HOSPITALIZED, SHE WAS FOUND UNCONSCIOUS AND SHE WAS IN SHOCK WITH HEART FAILURE AND WITH KIDNEY FAILURE, AND SHE REQUIRED SHORT-TERM DIALYSIS, AND SHE ALSO REQUIRED A NUMBER OF, UM, HEART MEDICATIONS IN ORDER TO, UM, STABILIZE HERSELF.

AND WHEN SHE CAME INTO THE RESPITE, UH, SETTING, THERE WAS A HIGH LEVEL OF NEED TO REALLY COORDINATE CARE, INCLUDING, UM, SPECIAL BLOOD THINNERS BECAUSE SHE HAD A BLOOD CLOT IN HER NECK.

UH, THEY NEEDED ADDITIONAL, UH, ONGOING KIND OF HANDS-ON CARDIOLOGY CARE TO TREAT HER HEART FAILURE.

SHE NEEDED NEPHROLOGISTS THAT WERE AVAILABLE TO TREAT HER ONGOING KIDNEY FAILURE.

UH, SHE WAS DIAGNOSED WITH BIPOLAR DISORDER AND SHE NEEDED PSYCHIATRIC CARE.

AND THEN SHE HAD A LONG HISTORY OF, UM, SELF MEDICATION AND NEEDED ACCESS TO THE MEDICATION ASSISTED THERAPY CLINIC IN ORDER TO ADDRESS HER, UM, LONG HISTORY OF SUBSTANCE USE DISORDER.

UM, AND BEING ABLE TO COME INTO THE CENTRAL HEALTH BRIDGE CLINIC SETTING, SHE'S ABLE TO GET HER LABS DONE ON SITE.

SHE WAS ABLE TO SEE THE SPECIALIST ON SITE.

SHE WAS ABLE TO MEET WITH A NUTRITIONIST ON SITE.

UH, SHE WAS ABLE TO GET A WELL WOMAN CHECK FOR THE FIRST TIME IN OVER 20 YEARS.

AND SHE SHARED WITH DR.

KWANG THAT SHE FELT SO LUCKY TO BE ALIVE, THAT SHE REALLY, UM, FELT LIKE SHE HAD A SAFE TEAM THAT ALSO WAS INVESTED IN HER IN TRYING TO, UM, SUPPORT HER BOTH PHYSICALLY AND EMOTIONALLY SO THAT SHE COULD, UM, COULD REMAIN HEALTHY.

AND THEN SINCE SHE WAS ONE OF THE FIRST RESPITE CARE PATIENTS TO BE SEEN IN THE BRIDGE CLINIC, AS OTHER PATIENTS STARTED TO COME INTO THE RESPITE FACILITY WHERE SHE WAS THAT NEEDED TO GO TO BRIDGE, SHE WAS KIND OF A COACH THAT WOULD SERVE AS, AS A COACH TO BRING IN, UH, HER PEERS,

[00:45:01]

AND THEN FINALLY, WE JUST DIDN'T WANT TO, UH, NOT MENTION THE PERMANENT SUPPORTIVE, UH, HEALTHCARE COLLAB, PERMANENT SUPPORTIVE HOUSING, HEALTHCARE COLLABORATIVE, THAT CENTRAL HEALTH.

UH, IT WAS CONVENED BY, UH, DR.

TIM MERCER AND DR. ASHLEY TRUST AT THE, UH, UNIVERSITY OF TEXAS.

AND THIS WAS A COMMUNITY, UH, TRUE COMMUNITY COLLABORATION THAT DEVELOPED A MODEL FOR PROVIDING INTEGRATED MENTAL AND BEHAVIORAL HEALTH SERVICES, UH, THROUGH MOBILE TEAMS IN THE NEW PERMANENT SUPPORTIVE HOUSING, UH, SITES THAT ARE COMING ONLINE, UH, OVER THE COMING YEAR.

AND, UH, CENTRAL HEALTH HAS CONTINUED WORKING WITH ECHO, UH, IN A ROLE COORDINATING THE CARE PROVISION AND, UH, THE PAYMENT OF COMMUNITY CARE AND INTEGRAL CARE AND, UH, MANAGING FIDELITY TO THE P-S-H-H-C-C MODEL THAT WAS DEVELOPED BY THE COMMUNITY SO THAT THERE IS A STANDARD MODEL OF HOW SERVICES ARE GOING TO BE PROVIDED TO THE NEWLY HOUSED, UH, POPULATIONS IN THE, UH, HOUSING THAT IS COMING ONLINE SO THAT PEOPLE CAN BOTH STAY HEALTHY AND STAY, UM, STABLY, UH, IN THE NEW HOUSING.

AND OUR FIRST, UM, HOUSING, UH, SITE THAT THE P-S-H-H-C-C IS GOING TO BE SUPPORTING ARE THE TWO NEW, UM, INTEGRAL CARE PSH SITES THAT HAVE, UM, RECENTLY COME ONLINE.

THANK YOU.

THANK YOU, MONICA.

I CAN'T HELP BUT TAKE THE OPPORTUNITY TO THANK OUR COLLEAGUES AT UT DELL MED SCHOOL.

UH, I BELIEVE WE GET TREMENDOUS VALUE FROM THE PRESENCE OF THE MEDICAL SCHOOL, FROM OUR, UH, LEADER DEAN CLAUDIA TI THERE, AND THE MANY, UH, TOUCH POINTS IN COLLABORATION FROM RECRUITING THE HEALTH PROVIDERS THAT OUR COMMUNITY NEEDS TO INNOVATIVELY DESIGNING, UH, SERVICE LINES LIKE YOU JUST HEARD WITH THE HEALTHCARE COLLABORATIVE.

SO, JUST WANTED TO SAY THAT IN THIS FINAL SLIDE HERE, I'M ACTUALLY, UH, CHANNELING, UH, SOMETHING THAT DR.

STANAL PATEL, UH, SHARED WITH OUR BOARD.

DR. PATEL WAS A HOSPITALIST AT DEL SEED MEDICAL SCHOOL, UH, DEL SEED MEDICAL CENTER, EXCUSE ME.