Sep 03, 2025 Public Health Commission

PRESENTATION BY MICHELLE MURKY, PROGRAM SUPERVISOR AT AUSTIN PUBLIC HEALTH ON THE IMMUNIZATION PILOT PROGRAM.

I SECOND THANK YOU.

ANY QUESTIONS TO THE ORDER? WONDERFUL.

ALL OF THOSE IN FAVOR FOR APPROVING THE QUESTIONS.

RAISE YOUR HAND OR SAY, AYE.

YOU GOT EVERYBODY, JUANITA? YES.

BEAUTIFUL.

THANK YOU SO MUCH, EVERYONE.

UH, MOVING ON TO OUR DISCUSSION ITEMS. I BELIEVE WE HAVE A SPECIAL APPEARANCE BY ONE OF OUR, OUR VERY OWN, UH, IN PLACE OF THE

[2. Presentation by Michelle Mirsky, Program Supervisor with Austin Public Health, on immunization pilot program. ]

SO I WILL PASS THE MIC TO COMMISSIONER ROCOM.

GOOD AFTERNOON.

A LITTLE UNCONVENTIONAL, CONVENTIONAL, BUT OUR SUPERVISOR, MICHELLE MURKY, UNFORTUNATELY HAD AN UNEXPECTED, UH, ISSUE AND NOT, WAS NOT ABLE TO ATTEND.

BUT BEING SEMPER GUMBY, WE WILL PIVOT AND I WILL PRESENT, UH, NOT AS BEAUTIFULLY, BUT WITH THE SAME INFORMATION.

UM, ALRIGHT, SO AGAIN, UM, I WILL BE PRESENTING ON THE AV, WHICH IS AUSTIN VOICES FOR EDUCATION, AUSTIN INDEPENDENT SCHOOL DISTRICT AND AUSTIN PUBLIC HEALTH, UH, SUMMER PILOT THAT WE DID AND DISAPPEARED.

NO WORRIES.

YOU'RE BUYING ME TIME .

PERFECT.

AND THEN STUDENTS ENROLLED IN AUSTIN, ISD SCHOOLS SERVED BY AV FAMILY RESOURCE CENTERS.

UM, THIS IS A PRELIMINARY REPORT.

I'LL POINT OUT JUST AS WE ARE STILL COLLECTING THE FINAL DATA AND F UH, FINESSING THE FINAL REPORT.

UH, BUT THE INFORMATION SHOULD NOT CHANGE, UH, A WHOLE LOT.

UM, SO SOME CONTEXT.

SO AVAC, VACCINE AVAILABILITY AND SCHOOL COMPLIANCE.

YOU MIGHT REMEMBER LAST YEAR COMMISSIONERS THAT, UM, MICHELLE AND JULIE WEEKS FROM AV PRESENTED TO US LAST YEAR AND DISCUSSED SPECIFICALLY, UH, VACCINATION RATES WITH EL ISD.

WE LOOKED AT PFLUGERVILLE, WE LOOKED AT MAINOR.

WE HAD POINTED OUT THAT THE OTHER SCHOOL DISTRICT SEEMED TO BE DOING VERY WELL IN THEIR COMPLIANCE RATES, WHEREAS A SD NOT SO MUCH.

UM, SO THIS COLLABORATIVE PILOT PROJECT WAS BETWEEN AV AND A PH, AND IT GREW OUT OF A DISCUSSION OF THE OFFICER TRAVIS COUNTY VACCINE EQUITY COALITION.

SO WE HAVE A VACCINE COALITION.

UM, AV IS PART OF THAT, A PH IS PART OF THAT.

IN THOSE CONVERSATIONS, UM, THEY BROUGHT TO US THEN THE PRESENTATION ABOUT THE COMPLIANCE RATES.

AND THEN FROM THERE THEY BRAINSTORMED WITHIN THE COALITION TO FIGURE OUT HOW WE COULD ADDRESS AD'S, COMPLIANCE RATES, AND HELP THEM OUT.

UM, OUR MOBILE VACCINATION PROGRAM WAS ALREADY ENGAGED WITH AV AND A ISD, BUT WERE LIMITED IN THEIR SCOPE BY THE CONSTRAINTS OF STAFFING AND OUTREACH SETTING, WHICH MEANS WE WERE REALLY CAPPING OUR EVENTS AT 20 PEOPLE ONLY, UM, BECAUSE OF ALL THE PAPERWORK THAT'S INVOLVED, AND THEN ALL THE BACKEND AND THE DATA ENTRY OF THE MEDICAL RECORDS AND ALL THAT STUFF.

UM, HOWEVER, UM, WELL I'LL STOP THERE.

SO THAT WAS WHAT WE WERE DOING WITH AV IN TERMS OF MVP.

UM, AND SO AGAIN, UH, THESE ARE SOME VACCINE RATES FOR A ISD FROM 20 19 20 20 SCHOOL YEAR, AND THEN THE 2324 SCHOOL YEAR, WHICH IS THE MOST, UH, RECENT DATA WE SHOULD GET TO 24 25 DATA SOON.

UM, BUT YOU CAN SEE THAT FROM 1920 TO 20 THROUGH 24, UM, COMPLIANCE RATES DID SEEM TO GO UP, I BELIEVE MM-HMM .

IS THAT RIGHT ON MOST OF THEM, IF I'M LOOKING AT THAT CORRECTLY, OR NO, I'M SORRY.

THEY DID.

THEY DECREASED SLIGHTLY.

THEY ALL DECREASED SLIGHTLY, WHICH IS NOT, UH, UNEXPECTED.

WE KNEW THAT THERE WAS MORE VACCINE HESITANCY AND MORE, UM, ACCESS ISSUES TO GETTING VACCINATED DURING THE PANDEMIC.

SO VACCINE AVAILABILITY AND SCHOOL COMPLIANCE.

SO AGAIN, UM, OUR COALITION MEMBERS, INCLUDING IMMUNIZATION STAFF, BRAINSTORMED IDEAS TO BRING COMMUNITIES, VACCINE PROVIDERS, AND OTHER AGENCIES TOGETHER TO ADDRESS THIS PUBLIC HEALTH CONCERN.

UM, PREVIOUSLY THE VACCINE COALITION PRESENTATION, THE PUBLIC HEALTH COMMISSION IN OCTOBER, 2024, AS I JUST MENTIONED, POSITED OPPORTUNITY FOR COLLABORATION BETWEEN AGENCIES.

AND THEN FINALLY WE IDENTIFIED AS PART OF THE SOLUTION USING OUR PRN OR AS NEEDED NURSES AS A POSSIBLE UNTAPPED RESOURCE FOR ADDITIONAL VACCINE CLINICS.

[00:05:01]

WE GOOD? YES.

SO HERE WAS THE OPPORTUNITY, A SUMMER VACCINE CATCH UP.

SO EVERY YEAR DURING SUMMER, WE PROMOTE AND PUSH THAT PEOPLE, THAT PARENTS GET THEIR KIDS VACCINATED PRIOR TO BACK TO SCHOOL, BECAUSE THERE'S ALWAYS A BACK TO SCHOOL RUSH.

SO THE MORE WE CAN DO TO GET KIDS CAUGHT UP ON THEIR VACCINES PRIOR TO THE SCHOOL START, THE BETTER.

WE'LL, WE'LL ALL WE'LL ALL BE.

SO DURING JUNE AND JULY THIS YEAR, UM, AUSTIN PUBLIC HEALTH SHOTS FOR TOTS VACCINE CLINICS TYPICALLY EXPERIENCE REDUCED REQUESTS FOR APPOINTMENTS.

AGAIN, NOBODY'S REALLY IN A HURRY OR BOTHERED TO GET VACCINATED DURING THE SUMMER, SO OUR CLINICS DO TEND TO, UH, BE A LITTLE BIT SLOWER.

SO WE WANTED TO USE THIS TIME AS AN OPPORTUNITY TO IDENTIFY AND VACCINATE STUDENTS STILL NEEDING TO CATCH UP ON VACCINES BEFORE THE NEXT SCHOOL YEAR BEGINS.

SO THE OPPORTUNITY WAS WITH AV AND A ISD, AUSTIN VOICES FOR EDUCATION AND YOUTH, A ISD, SCHOOL-BASED FAMILY RESOURCE CENTERS, HOST VACCINE TEAMS, PROMOT, AND OTHER RESOURCES.

SO AV HAS, UH, LOCATIONS WITHIN SEVERAL SCHOOLS.

THEY HAVE A DATING A DATA SHARING AGREEMENT WITH A ISD, UM, INCLUDING ACCESS TO UPDATED VACCINE DELINQUENCY REPORTS BY SCHOOL.

AND THEN A PH WAS ABLE TO IDENTIFY BANDWIDTH, AGAIN USING OUR PR AND NURSES TO OFFER ADDITIONAL VACCINE CLINIC HOURS IN THE BRICK AND MORTAR SPACE SHOTS FOR TO AT ST.

JOHN'S DURING THE EVENINGS AND ON WEEKENDS, TIME'S TRADITIONALLY, UH, MORE CONVENIENT FOR WORKING FAMILIES.

SO NOT ONLY DID WE PARTNER WITH AV AND A ISD, WE ALSO CREATED SPECIFIC VACCINE CLINICS FOR THIS PROJECT.

SO WE RESERVED TIME ON WEDNESDAY EVENINGS, AND WE RESERVE TIME ON SATURDAY MORNINGS SPECIFICALLY FOR THESE STUDENTS TO COME IN, UM, TO GET VACCINATED AND CAUGHT UP FOR SCHOOL.

SO THE PROPOSED PILOT WAS THAT, UM, OUR PARTNER, AUSTIN A SD, WOULD PROVIDE AV WITH UPDATED LIST OF STUDENTS WHO NEED REQUIRED SCHOOL VACCINES ARE ENROLLED IN PILOT TARGET SCHOOLS.

THEN AV USING THE LISTS, WOULD USE THEIR PROMOTOR TO REACH OUT TO THE FAMILIES AND STUDENTS NEEDING REQUIRED VACCINES.

THEY WOULD SCHEDULE TIME BY PHONE OR IN PERSON TO PRE-REGISTER STUDENTS AND COMPLETE ALL THE PAPERWORK FOR THE CLINICS AND PROVIDE THE PAPERWORK.

A PH FOR ADVANCED REVIEW.

YOU, EXCUSE ME, THIS IS ONE WHERE ONE OF THE TIME SAVINGS, UM, COMES IN FOR US.

THE PAPERWORK TAKES A LONG TIME.

UM, AND OFTENTIMES IF YOU DON'T SPEAK ENGLISH, THEN WE HAVE AN INTERPRETER OR SOMEBODY ELSE WITH YOU TRYING TO HELP YOU COMPLETE THE PAPERWORK.

UM, WHAT WAS NICE WITH WORKING WITH AV THOUGH, IS THAT THEY USED THEIR PROMOTOR TO COMPLETE ALL THE PAPERWORK.

SO THEY MET WITH THE PARENTS AND WITH THE STUDENTS.

THEY COLLECTED THE STUDENT SHOT RECORDS, THEY HELPED THEM COMPLETE THE, UH, PAPERWORK, AND THEN THEY SENT IT TO US AHEAD OF TIME.

THAT WAY WE COULD THEN REVIEW THE RECORDS, ENSURE THAT THEY DID NEED VACCINES, AND WE COULD ALREADY KNOW WHICH VACCINES THEY WOULD NEED.

AND SO THAT WAS NICE BECAUSE AT THE CLINICS, WE WERE THEN ABLE TO PROJECT OR GUESSTIMATE HOW MANY VACCINES WE WOULD BE GIVING, HOW MANY PEOPLE WE WOULD NEED, ET CETERA.

WHEREAS IN A NORMAL CLINIC, YOU KNOW, THERE MAY BE NO SHOWS CANCELLATIONS, AND YOU'RE NOT REALLY SURE WHAT YOU'RE GONNA GET.

AND THAT'S A DOWNFALL.

UM, OF THAT IS THAT WHEN THERE'S A NO-SHOW, WE DON'T NECESSARILY HAVE THE CAPABILITY TO IMMEDIATELY REPLACE THAT APPOINTMENT WITH SOMEBODY ELSE, SO WE LOSE AN APPOINTMENT.

UM, SO THIS WAS ONE OF THE BIG, UH, SAVINGS FOR US.

FINALLY, THE DAY OF THE CLINIC, AV PROMOTOR WOULD PROVIDE CHECK-IN AND SUPPORT NAVIGATION FOR STUDENTS AND FAMILIES IN OUR LOBBIES.

SO THE PROMOTORS WERE IN OUR CLINIC THERE, GREETING THE PARENTS AND THE STUDENTS, MAKING THEM FEEL WELCOME.

THEY HAVE THOSE ESTABLISHED RELATIONSHIPS ANSWERING ANY ADDITIONAL QUESTIONS THEY MAY HAVE, AND THEN THE NURSE WOULD COME OUT AND GET THEM.

SO THEN OUR UNIT, WE SCHEDULED A SERIES OF SIX OFF HOUR CLINICS, AGAIN SATURDAY MORNINGS AND WEDNESDAY EVENINGS AT OUR ST.

JOHN'S LOCATION, WITH THE GOAL OF BRINGING IDENTIFIED STUDENTS UP TO DATE ON VACCINES REQUIRED FOR SCHOOL.

UM, OUR TEAM REVIEWED THE PAPERWORK AND VACCINE RECORDS ASSOCIATED WITH THE APPOINTMENTS AND CREATED OR UPDATED CLIENT RECORDS IN OUR EHR.

SO THAT'S ANOTHER ISSUE, UM, THAT WE HAVE AS WELL, IS WHEN YOU CALL TO MAKE AN APPOINTMENT, IF YOU DON'T ALREADY HAVE AN ACCOUNT CREATED, WE HAVE TO SIT ON THE PHONE WITH YOU AND CREATE THAT APPOINTMENT AND CREATE THE ACCOUNT.

UM, WHICH CAN OFTEN BE DIFFICULT, ESPECIALLY WHEN YOU'RE SPEAKING TO SOMEONE WHO'S NOT A NATIVE ENGLISH SPEAKER, UNDERSTANDING, YOU KNOW, THEIR PRONUNCIATIONS OF HOW TO SPELL THEIR NAME.

OFTENTIMES THEY DON'T KNOW HOW TO SPELL THEIR NAMES OR DON'T KNOW WHAT THEIR ADDRESS IS.

SO THAT'S SOMETHING THAT, YOU KNOW, SLOWS THINGS DOWN FOR US AS WELL.

SO ANOTHER BENEFIT OF HAVING A PROMOTOR IS THE NAVY THERE WAS THAT THEY WERE ABLE TO SPEAK THE LANGUAGE.

THEY WERE ABLE TO REVIEW DOCUMENTATION OR IDS TO BE SURE TO GET THE CORRECT INFORMATION.

UM, STUDENTS WERE THEN SEEN FOR VACCINATION BY OUR NURSES.

THEY WERE BROUGHT UP TO DATE AND PROVIDED A COPY OF THEIR UPTODATE RECORD.

TEXAS IMMUNIZATION REGISTRY, UH, WAS ALSO UPDATED.

SO ANYTIME WE PROVIDE VACCINATION, WE UPDATE MTAC.

SO THE STRATEGY WAS TO PARK, UH, TARGET POPULATION MIDDLE SCHOOL STUDENTS SHOWING UP ON AD'S LIST OF, UH, NOT BEING COMPLIANT.

WE FOCUSED SPECIFICALLY ON ADOBE WEB AND BURNETT MIDDLE SCHOOLS, WHERE AV HAS PRESENCE.

[00:10:01]

SO WE ALSO SAW NORTHEAST, UH, EARLY COLLEGE HIGH SCHOOL, INTERNATIONAL HIGH SCHOOL, AND NAVARRO HIGH SCHOOL.

AND THEN WE HAD A FAMILY FOCUS, UH, WHERE WE WANTED TO BETTER SERVE THE COMMUNITY.

UH, APPOINTMENTS WERE ALSO MADE AVAILABLE TO OLDER OR YOUNGER SIBLINGS OF THESE STUDENTS WHO WERE ALSO ENROLLED IN US AND ISD SCHOOLS.

SO NOT ONLY DID WE IDENTIFY THIS CHILD WHO NEEDED TO BE CAUGHT UP ON THEIR VACCINES, IF THEY CAME IN THAT DAY WITH THEIR OLDER SIBLINGS OR YOUNGER SIBLINGS, WE WOULD ALSO VACCINATE THOSE INDIVIDUALS TOO.

THEY WEREN'T PART OF THE INITIAL PROCESS WHERE THE PROMOTOR HAS REVIEWED ALL THE PAPERWORK, BUT IF IT'S ONE OR TWO PEOPLE, WE CAN EASILY MANAGE THAT AND IT ALLOWS US TO VACCINATE THE WHOLE FAMILY, WHICH OF COURSE IS BETTER FOR EVERYBODY.

SO, UM, AWESOME VOICES FOR EDUCATION.

THEY HAD A TOTAL OF EIGHT STAFF, SIX PROMOTORAS, UH, DIRECTOR, AND THEN A PROGRAM COORDINATOR.

AND THEN A ISD HAD THEIR SCHOOL NURSE TEAM AND SUPPORT STAFF THAT EMAILED UPDATED LIST OF STUDENTS IN NEED OF VACCINES, UH, THAT THEY SHARED WITH AV THAT THEN WE, UH, THAT THEN SHARED WITH US.

AND THEN ALSO PUBLIC HEALTH, UH, SPECIFICALLY FROM OUR HEALTH DISPARITIES REDUCTION PROGRAM, WHICH IS WHERE THIS PILOT WAS BORN.

UM, WE HAD THREE STAFF, OUR SUPERVISOR, OUR QUALITY IMPROVEMENT SPECIALIST, AND OUR HEALTH EDUCATOR.

UM, A NOTE ON THERE, THIS WAS A GREAT EQUITY PROJECT TO BEGIN WITH, BUT THEN WITHIN THIS PROJECT, THERE WERE EVEN MORE EQUITABLE THINGS WE COULD DO.

SO, FOR EXAMPLE, WE HAD SEVERAL FAMILIES THAT SPOKE P PTO.

AND SO ONE DAY WHEN AV WAS MEETING WITH THOSE FAMILIES TO COMPLETE ALL THE PAPERWORK, WE SHOWED UP AS WELL WITH OUR HEALTH EDUCATOR AND WITH AN INTERPRETER WHO SPOKE PTO TO HELP THOSE FAMILIES COMPLETE ALL THE PAPERWORK.

AND THEN THE DAY OF THE CLINIC, WE SCHEDULED ALL THOSE PTO SPEAKING FAMILIES AT THE, UH, AROUND THE SAME TIME.

THAT WAY WE COULD BRING OUR INTERPRETER IN AGAIN AND BE ABLE TO SERVE ALL THOSE FAMILIES AND STUDENTS, UH, TO THE BEST OF OUR ABILITIES.

AND THEN FOR ST.

JOHN'S, OUR, UM, SPOTS WERE TAUGHT STAFF.

WE HAD 12 STAFF, INCLUDING OUR RN SUPERVISOR, SEVEN VACCINATORS, AND FOUR PATIENT REPRESENTATIVES.

JUST TO GIVE YOU AN IDEA, YOU KNOW, OF HOW MUCH PEOPLE, THIS, THIS TAKES ALL THIS PROCESS.

UM, BUT IT REALLY DOES PAY OFF.

SO JUST SOME NUMBERS.

PLANNED APPOINTMENTS, WE HAD TOTAL 122, WE OFFERED 186, BROUGHT UP 104 STUDENTS, UH, ON THEIR RECORDS.

UH, WE HAD PLANNED SIX VACCINE CLINICS ONLY DID FIVE.

UM, THE PRO PROMOTORY INTAKE APPOINTMENTS, THEY DID 96 OF THOSE.

WE ADMINISTERED 266 VACCINES.

WE SERVED 19 ADDITIONAL SIBLINGS.

UM, WE SERVED 15 DIFFERENT SCHOOLS AND WE SERVED NINE DIFFERENT ZIP CODES.

SOMETHING NOT REFLECTED IN THIS THAT I DO WANNA POINT OUT IS SOME OF THE STUDENTS THAT WERE IDENTIFIED AS NEEDING VACCINES DIDN'T ACTUALLY NEED VACCINES.

SO THERE WERE, YOU KNOW, A HANDFUL THAT DID NOT NEED TO COME.

AND THAT'S ONE REASON WHY WE REVIEW THE RECORDS PRIOR TO MAKING THE APPOINTMENT, BECAUSE WE OFTEN GET THESE, UM, WHICH IS A NOTE OF PERHAPS, UM, SOMETHING WE NEED TO FURTHER EDUCATE WITH THE SCHOOLS.

'CAUSE THE SCHOOLS ARE IDENTIFYING THESE STUDENTS AND NOT BEING UP TO DATE, BUT THEN THEY ARE UP TO DATE.

SO THAT'S SOMETHING THAT WE WILL BE LOOKING INTO AS WELL, SO THAT, YOU KNOW, SCHOOLS AREN'T MISSING OUT ON STUDENTS BEING IN CLASS, MEANING THEY'RE NOT GETTING THE MONEY FOR THOSE STUDENTS BECAUSE THEY THINK THEY'RE NOT COMPLIANT WITH VACCINES WHEN IN ACTUALITY THEY ARE.

UM, I WON'T GO THROUGH ALL THESE, BUT THIS IS JUST SOME, YOU KNOW, ADDITIONAL INFORMATION ABOUT EACH SCHOOL.

HOW MANY STUDENTS? UM, LET'S SEE.

OH, ACTUALLY, STUDENTS ALREADY HAD SHOTS.

SO YOU CAN SEE 67, 67 OF THE STUDENTS ALREADY HAD SHOTS AND WERE UP TO DATE.

UM, SO THAT WAS GREAT THAT THEY DIDN'T MAKE A REGULAR APPOINTMENT WITH THEIR REGULAR PROVIDER AND THEN GET THERE AND NOT HAVE TO GET ANY VACCINES AT ALL.

SO OBVIOUSLY WE'RE ABLE TO SAVE OUR TIME.

WE'RE ABLE TO SAVE THE FAMILY'S TIME.

UM, AND WE'RE NOT OVER VACCINATING, YOU KNOW, UNNECESSARILY.

UH, SOME DEMOGRAPHICS, SO THESE ARE THE ZIP CODES THAT WE SERVED.

YOU CAN SEE THAT, UH, 29 ARE FROM 7 8, 7 5 3, AND THEN 29 ARE FROM 7 8, 7 5 8.

UM, THOSE ZIP CODES DO GENERALLY LINE UP WITH THE SCHOOLS THAT WE FOCUSED ON.

UM, BUT THEN OF COURSE THERE ARE OTHER SIBLINGS FROM OTHER SCHOOLS THAT MAY NOT, UM, BE SPECIFICALLY WITHIN THOSE ZIP CODES.

UH, THE AGE RANGE OF OUR CLINICS, UH, WE DID STUDENTS ONLY.

SO THEY WERE ALL, UH, MINORS.

UM, 74% WERE 10 AND UNDER, I'M SORRY, YEAH, 74% WERE 10 AND UNDER 16% WERE 11 TO 13 OR 10% RATHER THAN 16.

WERE 14, 18 YEARS OLD.

SO YOU CAN TELL THE MAJORITY OF THEM WERE 10 AND OLDER.

UM, AND THEN 11 TO 13, WHICH IS AROUND THE ELEMENTARY MIDDLE SCHOOL AGE.

AND THEN WE HAVE SOME DEMOGRAPHICS HERE.

UH, THIS IS RACE.

UM, SO YOU CAN SEE 96, UH, WERE WHITE.

WE HAD ABOUT 103 ASIAN, ONE OTHER AND TWO DECLINED TO SPECIFY.

UM, SO FOR A TOTAL OF 104 CLIENTS.

[00:15:01]

AND THEN FOR ETHNICITY, YOU CAN SEE THAT 97 OF THEM WERE HISPANIC OR LATINO, FIVE WERE NOT.

AND THEN TWO DECLINED TO SPECIFY.

SO, UM, MAJORITY WHITE HISPANIC ARE THE INDIVIDUALS WE SAW, WHICH ALIGNS WITH THOSE SCHOOLS AND THE POPULATIONS WE WERE WORKING WITH.

AND THEN, UH, INSURANCE STATUS, MOST OF THEM DID NOT HAVE INSURANCE.

SO IN CONCLUSION, OUR COLLABORATIVE MODEL SHOWED ANECDOTAL BENEFIT TO ALL PARTNERS AND THE COMMUNITY.

OUR HEALTH DISPARITIES REDUCTION PROGRAM TEAM WILL PERFORM MORE DETAILED DATA ANALYSIS FOR STATISTICAL SIGNIFICANCE WHEN DISHES AND A ISD RELEASE UPDATED VACCINE COVERAGE DATA LATER IN 2025.

SO AGAIN, WHEN THE 20 24, 20 25 SCHOOL DATA COMES OUT, UH, WE'LL BE ABLE TO, WE'LL SEE WHAT THE COMPLIANCE RATE IS.

IT WON'T NEC IT WON'T BE AFFECTED BY WHAT WE DID THIS SUMMER.

WE WILL BE ABLE TO SEE IF WE HAD ANY REAL EFFECT NEXT YEAR WHEN WE LOOK AT 25, 26.

UM, SO UNFORTUNATELY THERE IS A LAG TO PREVENTION, WHICH WE'RE ALL AWARE OF, BUT, UH, IT IS PREVENTION.

AND WE DO THINK THIS WAS A VERY SUCCESSFUL, UM, UH, PILOT.

AND IN FACT, WE ARE GOING TO NOW EXPAND IT TO OUR MOBILE VACCINATION PROGRAM.

SO AS I MENTIONED EARLIER, WE'RE REALLY LIMITED TO ABOUT 20 PEOPLE WE CAN SEE AT OUR MOBILE CLINIC.

THAT'S BECAUSE WE HAVE NO IDEA WHO'S GONNA BE THERE, HOW MANY PEOPLE THEY NEED TO DO THEIR PAPERWORK, ET CETERA.

SO WE'RE ONLY ABLE TO SEE ABOUT 20.

BUT NOW WITH THIS NEW PROCESS, ALL THAT PAPERWORK WILL BE DONE AHEAD OF TIME.

SO NOW WE'LL BE ABLE TO SEE BETWEEN 30 AND 40 PEOPLE.

SO ALMOST DOUBLING THE NUMBER OF PEOPLE WE CAN DO WITH THE ASSISTANCE FROM OUR PARTNER, AV AND A ISD.

UM, WE WILL CONTINUE THE, THE WORK.

IT'S NO LONGER PILOT, IT'S AN OFFICIAL PROGRAM.

UM, WE WILL CONTINUE THAT AT OUR SHOTS FOR TOTS CLINIC WITH AB AND WE ALREADY HAVE DATES SCHEDULED FOR OCTOBER AND NOVEMBER.

AND THEN WE ARE EXPLORING COLLABORATIVE REGISTRATION AND SCREENING MODEL FOR ADULT SAFETY NET COMMUNITY VACCINATION CLINICS.

SO WE WANT TO TAKE THE SAME MODEL, WORKING WITH PARTNERS, GETTING THEM TO DO A LOT OF THE LEGWORK.

UM, WE WANNA DO THAT WITH OUR ADULT SAFETY NET PRO PROVIDER PARTNERS AS WELL.

SO THAT IS THE END OF THAT PRESENTATION.

AGAIN, THIS KIND OF WAS BORN OUT OF THE COALITION TALKING ABOUT RATES.

THEY CAME HERE, PRESENTED IT TO US, AND THEN I ASKED THE TEAM TO COME BACK, UM, JOKES ON ME TO PRESENT AN UPDATE ON WHAT WE DID.

SO WE'RE VERY PROUD OF IT, WE'RE VERY EXCITED ABOUT IT, AND WE THINK IT WENT REALLY WELL.

UM, OUR PARTNERS ARE VERY HAPPY ABOUT IT, AND SO WE CAN, WE WILL CONTINUE TO STRIVE TO, TO DO THIS.

COMMISSIONER CROOKHAM.

UM, I THINK WE ALL MIGHT HAVE A FEW QUESTIONS FOR YOU.

UH, I'M JUST CURIOUS, WITH EVERYTHING THAT'S HAPPENING WITH FUNDING RIGHT NOW, UM, I KNOW THERE'S, THIS IS AN OFFICIAL PROGRAM AND LOOKING AT THE OCTOBER AND NOVEMBER OPPORTUNITIES, IS THIS, IS THIS SOMETHING THAT CAN STILL HAPPEN? OR IS DO WE THINK THERE'S GONNA BE SOME CONCERNS ABOUT FUNDING TO KEEP IT GOING? THAT'S A GREAT QUESTION.

AND ACTUALLY ONE REASON I LIKE THIS MODEL SO MUCH IS BECAUSE AS WE CONTINUE TO LOSE FUNDING AND AS WE CONTINUE TO GET SMALLER, WE'RE GONNA, A PH IS GONNA HAVE EVEN LESS CAPACITY TO VACCINATE.

SO IF WE'RE ABLE TO PARTNER WITH ORGANIZATIONS THAT CAN DO A LOT OF THAT PAPERWORK AND FRONT END WORK, THAT HELPS US VACCINATE A LOT MORE, RIGHT? SO WE'RE AT MEP DOING 20 NOW, BUT THE NAVY DOES ALL THE PAPERWORK.

WE CAN SEE 40.

AND SO WE DIDN'T CHANGE THE NUMBER OF RESOURCES WE HAD NECESSARILY.

WE JUST CHANGED WHERE THE WORK WAS BEING DONE.

AND SO THAT ALLOWS US TO, TO SEE MORE WITHOUT ANY REALLY MORE RESOURCES IN-HOUSE.

BEAUTIFUL.

AND THEN MY LAST QUESTION, UM, IS THERE ANYTHING, DO YOU KNOW IN THE WORKS FOR LIKE THE COLD AND FLU SEASON THAT'S COMING UP, UH, COVID SLASH FLU SLASH NEXT THINGS, IS THAT ALSO SOMETHING THAT'LL, THAT'LL HAPPEN WITH THE SHOTS FOR TOTS GROUP, OR IS THAT NOT IN THE WORKS YET? LIKE A SPECIFIC PROJECT OR, YEAH, UH, JUST SO THE ABILITY TO MAYBE EVEN EXPAND THIS BEYOND, UM, THE REGULAR VACCINATIONS THAT ARE NEEDED.

OH, YEAH.

ANY VACCINE THAT'S AVAILABLE AND RECOMMENDED, WE, WE, WE OFFER AND PROVIDE.

SO YEAH, NOW THE FLU IS AVAILABLE, WE'LL START OFFERING FLU AT ALL OF THESE CLINICS.

UM, WE ALREADY OFFER HPV, WHICH ISN'T REQUIRED, BUT RECOMMENDED, UM, COVID, ALL OF THOSE.

AWESOME.

UH, BUT THERE WILL, I BELIEVE THERE IS A CAMPAIGN COMING OUT FROM OUR DEPARTMENT SOON ABOUT RESPIRATORY ISSUES.

COMMISSIONER RICE, PLEASE.

UM, THANK YOU COMMISSIONERS QUESTIONS.

I WAS JUST WONDERING, FIRST OF ALL, THANK YOU FOR SHARING THAT.

UM, I WAS WONDERING ABOUT OTHER ORGANIZATIONS THAT ARE ALSO, UH, SEEING CHILDREN AND WHAT COMES TO MIND IN, IN MY WORLD WOULD BE ST.

DAVID'S FOUNDATION WHO HAS A DENTAL PROGRAM, WHICH SEES LITERALLY HUNDREDS, MAYBE THOUSANDS OF CHILDREN EACH YEAR ACROSS THE COMMUNITY.

AND

[00:20:01]

I WONDER IF, UM, IMMUNIZATION AS A MEDICAL, YOU KNOW, INTERVENTION COULD BE COUPLED WITH DENTAL CARE AS A, AS A MEDICAL, OR, YOU KNOW, AS AN INTERVENTION, A DENTAL INTERVENTION.

AND, UM, AND THERE, THERE WAS SYNERGIES AND THAT KIND OF THING.

AND IF WE'VE EVER TRIED TO SORT OF FIND OUT IF HOW TO EXPLORE THOSE KIND OF SYNERGIES.

NOT, NOT THAT I'M AWARE OF.

UH, I THINK THAT'S A GREAT IDEA THOUGH.

AND WE CAN DEFINITELY LOOK INTO THAT.

UH, I APPRECIATE THAT IDEA.

IF YOU HAVE OTHER IDEAS OR ANYBODY ELSE, PLEASE LET ME KNOW.

'CAUSE WE ARE LOOKING FOR OTHER PARTNERS.

UM, YOU KNOW, AB IS WONDERFUL.

THEY WORK IN SEVERAL DIFFERENT A ISD SCHOOLS, SO THAT GETS US DEFINITELY IN A ISD AND ASSISTING THOSE SCHOOLS.

UM, BUT THERE'S OTHER SCHOOLS, OBVIOUSLY, OTHER SCHOOL DISTRICTS THAT COULD USE THIS TOO.

SO WE'RE TRYING TO EXPLORE WHETHER THEY HAVE GROUPS LIKE AV, RIGHT? SOMETHING LIKE A PARENT GROUP OR SOMETHING THAT'S HEAVILY INVOLVED IN WHAT THEY'RE DOING ALREADY THAT WE COULD TIE INTO WITH, OR IF THERE'S MAYBE OTHER CLINICS IN THE AREA THAT WE COULD PUSH, YOU KNOW, MORE PATIENTS TO IF WE'RE NOT ABLE TO SEE THEM OR, UM, YEAH, WHATEVER.

WE'RE OPEN TO ALL KINDS OF, UH, PARTNERSHIPS.

SO YEAH, I'LL LOOK INTO THAT.

ANY OTHER QUESTIONS OR, UH, COMMENTS FROM COMMISSIONERS ONLINE? I SEE A FEW HEAD SHAKES.

TO DISCUSSION ITEM THREE, WHICH IS TO DISCUSS THE DRAFT RECOMMENDATION ON HARM REDUCTION AND HEAT RELATED ILLNESS PREVENTION WITH, UH, COMMISSIONER DOHA.

AWESOME.

UM, THANK YOU SO MUCH AGAIN, CHRIS, UH, COMMISSIONER COMB, UH, FOR GIVING US AN UPDATE ON WHAT IS HAPPENING.

IT'S AMAZING WHAT HAPPENS WHEN PARTNERSHIPS AND COLLABORATION WORK WELL.

UH, SO WE ARE GRATEFUL FOR YOU TO GIVE US THAT UPDATE AND MAYBE WE CAN GET ANOTHER ONE AS IT CONTINUES ON OR EVEN JUST A SMALL REPORT.

UM, WONDERFUL.

LET'S MOVE ON

[3. Discuss draft recommendation on harm reduction and heat-related illness prevention]

UM, I HAVEN'T RE I HAVEN'T, UM, MADE ANY CHANGES TO IT.

ANNA, I SENT OVER TO VERSIONS OF IT TO YOU VIA EMAIL, UM, BOTH TO TAKE A LOOK.

'CAUSE I THINK WHERE WE LANDED LAST TIME IS WE HAD ONE VERSION THAT WAS VERY SPECIFIC AND ONE VERSION THAT WAS VERY BROAD.

AND SO WE HAD CONFLICTING THOUGHTS AND FEELINGS ON WHICH ONE TO USE AND HOW TO GO FORWARD WITH IT.

UM, SO I'M JUST WAITING ON THAT FEEDBACK, BUT THAT'S WHERE I AM AT RIGHT NOW WITH IT.

THANK YOU, COMMISSIONER DOHA, IS THERE ANY ADDITIONAL SUPPORT THAT YOU NEED IN ORDER TO GET THAT TO A FINAL DRAFT? UM, I WOULD JUST SAY THE FEEDBACK FROM ANA, PLEASE IF YOU COULD RESPOND TO THAT, UM, 'CAUSE I KNOW IT'S BEEN KIND OF STUCK WHERE IT'S AT RIGHT NOW.

BUT I SEEN, OH, GO AHEAD.

SORRY.

SORRY, I COULDN'T UNMUTE.

UM, YES, UH, STAFF DID REVIEW IT AND, UM, I DIDN'T RECEIVE THEIR FINAL COPY OF THE REVIEW, SO I'LL FOLLOW UP WITH THEM AND THEN FOLLOW UP WITH YOU.

TO DISCUSSION ITEM FOUR, WHICH IS TO DISCUSS PUBLIC HEALTH RELATED TOPICS COVERED IN THE TRAVIS COUNTY COMMISSIONER'S COURT, UH, PRESENTATION, WHICH WE ALL HAVE RECEIVED.

'CAUSE I KNOW, AGAIN, TWO VERSIONS ON LIKE WHICH TO USE AND WHAT TO DO WITH IT.

UM, SO I LOOK FORWARD TO THAT RESPONSE.

[4. Discuss public health related topics covered in Travis County Commissioners Court. ]

JUANITA IS, I TOO, WE'RE JUST OPEN DISCUSSION.

I THOUGHT WE WERE GONNA GET A FULL PRESENTATION.

I WAS VERY EXCITED ABOUT THIS.

WONDERFUL.

UH, ANY, UM, FOR THOSE WHO HAVEN'T REVIEWED OR HAVE REVIEWED, HOPEFULLY YOU HAVE, UH, ANY QUESTIONS, COMMENTS, IDEAS ON HOW WE CAN, UH, TAKE INFORMATION THAT WE ARE RECEIVING FROM THIS, UH, PRESENTATION AND HAVING MORE CONVERSATIONS? I KNOW I'M SURE THAT THERE ARE MANY QUESTIONS AROUND THE OPIOID ABATEMENT FUNDS, UH, BUT I WOULD LOVE TO HAVE A TRUE CONVERSATION AROUND WHAT IT IS THAT WE CAN DO.

UM, WHETHER IT'S HAVING FURTHER CONVERSATIONS AND DISCUSSIONS, UH, WITH ENTITIES SUCH AS A PH OR IT'S OUTSIDE OF THAT, AND LEARNING HOW WE CAN, UM, START TO MAKE A BIGGER IMPACT OR ASK BETTER QUESTIONS.

SO I WILL OPEN UP THE FLOOR FOR FOLKS WHO HAVE, LET'S HAVE A REAL DISCUSSION.

I WOULD LOVE TO WALK AWAY FROM THIS WITH IDEAS ON WHAT WE COULD DO NEXT.

UM, I THINK BASED OFF OF EARLIER THIS YEAR AND LAST YEAR, WE HAD LOTS OF CONVERSATIONS AROUND THE OPIOID ABATEMENT FUNDS AND WHAT'S HAPPENING NEXT WITH THOSE FUNDS.

UM, NOT TO PUT DR WALKS ON THE, ON THE, ON THE SPOT, BUT SINCE SHE IS HERE WITH US, MAYBE MAYBE

[00:25:01]

YOU CAN EVEN GIVE US JUST A QUICK SYNOPSIS AND UPDATE ON, ON WAYS THAT WE CAN MOVE THE NEEDLE AS WELL AND, AND HOW THINGS ARE GOING.

UM, FIRST OF ALL, I APOLOGIZE FOR BEING LATE.

UM, THE, AS WE SPEAK, WE HAVE TWO INTERNS THAT, UM, ARE WORKING IN THE TEXAS HARM REDUCTION SPACE.

UM, AND THEY HAVE BEEN SINCE MAY, MAY, UM, ACTUALLY WORKING AT THE LOCATION, UM, AND INTERVIEWING, UM, AND WORKING WITH, UM, HARM REDUCTION SPECIALIST AND CLIENTS ALIKE.

AND THEY WILL BE PREPARING A REPORT.

SO I DON'T HAVE THE FINDINGS AS OF YET, BUT I'M, I'M CURIOUS TO FIND OUT WHAT THEY'RE GOING TO TELL US.

UM, THEY'VE BEEN DOING A LOT OF OBSERVATIONAL, UM, DATA COLLECTION, AND IT WAS, UM, AN IDEA THAT ACTUALLY WAS GENERATED FROM ONE OF OUR MEETINGS EARLIER THIS YEAR WHEN, UM, THE DIRECTOR OF TEXAS HARM REDUCTION, MAGGIE LUNA WAS HERE AND SAID THAT SHE HAD LOTS OF DATA AND, AND NO TIME NOR CAPACITY TO LOOK AT IT.

UM, THEY'VE NOT BEEN LOOKING SPECIFICALLY AT DATA PER SE, BUT ACTUALLY, UM, COLLECTING INFORMATION FROM REAL WORLD, WORLD OBSERVATIONS AND PEOPLE.

SO, UM, IF THAT'S OKAY WITH THE CHAIR, UM, WHEN THAT'S AVAILABLE, UM, I'LL LET EVERYONE KNOW AND WE CAN SEE IF THAT'S SOMETHING YOU THE COMMISSION WOULD LIKE TO HEAR.

ABSOLUTELY.

UM, IT'S GOOD TO KNOW THAT FROM THAT CONVERSATION, SOMETHING HAS, UH, POSITIVELY PROGRESSED.

UM, I THINK WE, AS A COMMISSION LOVE TO HEAR THINGS LIKE THAT, THAT, YOU KNOW, THIS IS A SPACE THAT NOT ONLY THE COMMUNITY IS, IS ABLE TO VOICE, BUT ALSO WE'RE ABLE TO ACTIVATE EVEN IF IT'S BY WAY OF PRESENTATIONS AND EXPERIENCES.

SO, UM, I, YEAH, WE WOULD LOVE TO HEAR ABOUT THAT.

AND I KNOW THAT, UM, DIRECTOR STIR WENT THROUGH SOME OF THIS WITH US, WITH US LAST MONTH AS WELL.

SO SOME OF THIS MIGHT BE REOCCURRING INFORMATION, ESPECIALLY AROUND LIKE, UM, THE REVENUE LOSS FOR, UM, THE MOBILE FOOD VENDING PROGRAM, WHICH WE DID HEAR ABOUT THAT, AS WELL AS THE IMPACT OF EMPLOYEES.

UM, I, I WOULD BE VERY CURIOUS IF THERE'S, WHAT HAPPENS NEXT, I GUESS I SHOULD SAY, FROM SOME OF THE BILLS, THE LEGISLATIVE BILLS THAT HAVE PASSED AND THEIR IMMEDIATE EFFECTS.

I DON'T KNOW IF THERE'S ALREADY PREVENTION IN DATA COLLECTION HAPPENING, OR OR TRACKING THE IMPACT.

I THINK WE'RE ALL VERY CURIOUS TO WHAT HAPPENS WITH PUBLIC HEALTH AS THIS CONTINUES TO HAPPEN.

UM, DO YOU KNOW, I DON'T KNOW IF THIS IS LIKE A DR WALK'S QUESTION OR NOT, BUT DO YOU KNOW IF THERE'S ANYONE IN THE A PH REALM, AND I WILL SAY THIS ALSO WITH THE COUNTY AND CENTRAL HEALTH SINCE THEY'RE ALL HERE TODAY.

UM, WHO IS CAPTURING KIND OF WHAT'S HAPPENING WITH PUBLIC HEALTH AS THESE FUNDING CUTS ARE, ARE ACTIVE? LIKE, UM, WE'RE LOOKING AT PEOPLE LOSING THEIR EMPLOYMENT, WE'RE LOOKING AT INDIVIDUALS LOSING ACCESS TO SERVICES.

IS THERE ANYONE, LIKE IN THE BACKGROUND JUST TICKING A BOX OF WE, WE SEE THE PROBLEMS AND WE'RE CAPTURING THOSE PROBLEMS? I, I DON'T KNOW THAT WE'RE DOING IT TO THE DEGREE, UM, THAT YOU'RE MAYBE LOOKING FOR, BUT WE ARE, UM, WE HAVE CREATED A DASHBOARD, UM, AND I THINK THAT WAS SHARED WITH THE COMMISSIONERS THAT LOOKS AT WHERE OUR FUNDS, UM, COME FROM AND WHAT SERVICES ARE BEING PROVIDED WITH THE RECEIPT OF THOSE FUNDS.

AND SO, UM, THAT MAY BE A WAY THAT WE CAN LOOK BACKWARD RETROSPECTIVELY ONCE WE DO HAVE FINAL DECISIONS MADE ON WHERE THINGS ARE NOT BEING PROVIDED BECAUSE OF THE LACK OF FUNDING RESOURCES.

UM, SO THAT, THAT MAY BE INFORMATIVE LATER ON DOWN THE LINE.

UM, THINGS ARE STILL VERY MUCH IN A STATE OF FLUX AND UNCERTAINTY, HOWEVER, AND DR.

WS, WHICH DASHBOARD WAS THAT? IT'S THE DASHBOARD ON WHAT HAPPENS TO PUBLIC HEALTH.

THAT I THINK WE GOT IN OUR EMAIL.

YESTERDAY.

[00:30:01]

TOUCH MY BREATH THERE.

OH NO, YOU'RE, YOU'RE GOOD.

TAKE YOUR TIME.

WE HAVE, WE HAVE TIME AND, UM, WE ARE, OH, SORRY ABOUT THAT.

WE'RE, UH, CENTRAL HEALTH.

WE ARE MONITORING, UM, OBVIOUSLY THE LEGISLATURE AND, UM, CONGRESS FOR POLICY AND FUNDING CHANGES.

WE ARE NOT CLOSELY MONITORING PUBLIC HEALTH.

I THINK WE RELY ON OUR PUBLIC HEALTH FRIENDS FOR THAT.

BUT WE ARE MONITORING, UM, BECAUSE OF OUR FQHC COMMUNITY CARE, UM, MEDICAID IMPACTS TO MEDICAID, UH, FUNDING, UM, THREE 40 B, WHICH IS A PHARMACEUTICAL DISCOUNT PROGRAM.

UM, ON THE HEALTH PLAN SIDE, BECAUSE WE HAVE A COMMUNITY HEALTH PLAN SEND HEALTH PLANS, WE'RE MONITORING CHANGES TO THE AFFORDABLE CARE ACT, WHICH INCLUDES, UM, SOME, UM, ENHANCED, UH, PREMIUM TAX CREDITS THAT ARE GOING TO EXPIRE AT THE END OF THE YEAR UNLESS CONGRESS, UM, ACTS TO EXTEND THOSE.

UM, IF THEY DO EXPIRE, I THINK WE'RE, WE'RE GONNA FIND A LOT MORE PEOPLE WHO ARE NOT LIKELY TO GET COVERAGE ON THE A CA EXCHANGE.

UM, WE'RE ALSO MONITORING SOME TAX LIABILITY STUFF RELATED TO THOSE PREMIUM TAX CREDITS.

UM, AND THOSE ARE SOME OF THE KEY ISSUES.

THERE'S, THERE'S A FEW OTHER, YOU KNOW, CHANGES TO, UM, CERTAIN POPULATIONS AND STUFF.

SNAP PROGRAM OBVIOUSLY.

UM, SOCIAL DETERMINANTS OF HEALTH IMPACTS, UM, HEALTH OUTCOMES.

SO THOSE ARE SOME OF THE, UM, ISSUES WE'RE MONITORING.

THIS IS ON OUR, FROM, UM, TRAVIS COUNTY HEALTH HUMAN SERVICES.

SO WE ARE MONITORING AS WELL.

AND, AND I THINK THAT IT'S CORRECT TO SAY WE'RE IN A STATE OF FLUX 'CAUSE THERE'S SO MUCH UNKNOWN, UM, THAT IT'S DIFFICULT TO PREDICT, UH, WHAT NEXT TWO OR THREE MONTHS WILL LOOK LIKE.

UM, WE DO KNOW THAT, UH, A A RP GRANT THAT WAS CUT, UM, IS IMPACTED OUR, UH, PANTRIES, OUR FOOD PANTRIES.

UH, WE USE THOSE VOLUNTEERS THROUGH THE A RP PROGRAM TO HELP WITH, UM, SCHEDULING AND ASSISTING CLIENTS.

AND SO WE'VE ASKED FOR, UH, FUNDING FROM THE COURT TO, TO, UM, BASICALLY SHORE UP THAT FUNDING SO THAT WE CAN CONTINUE TO PROVIDE SERVICES TO OUR COMMUNITY.

AND, UM, AS I SAID, WE'RE, WE'RE ALSO MONITORING IT ON A, YOU KNOW, EVERY TWO WEEKS WE MEET INTERNALLY AND DISCUSS ANNA, UM, I WONDERED, YOU SAID A-A-R-P-I THINK, AND I WONDERED IF THAT, UH, WOULD BE A NON-GOVERNMENTAL, ARE YOU, ARE YOU SEEING NON-GOVERNMENTAL SUPPORT GRANTS ALSO CONTRACTING IN THIS ENVIRONMENT? SO THE A RP WAS A, UM, PART OF THE, A AGING SERVICES CUTS.

SOME OF THE CUTS WERE, WERE THROUGH THE FEDERAL GOVERNMENT AND CONDUIT.

FOR THOSE WHO ARE ARE UNDER THEIR UNDERINSURED OR UNINSURED.

OH, THANK YOU.

YOU'RE WELCOME.

I WOULD IF I MAY OH, SORRY.

I'M SORRY.

PLEASE, PLEASE.

SO THANK YOU DR.

WALKS FOR, UM, TAKING THAT, THAT FIRST QUESTION.

SO WE ARE MONITORING ON A BUNCH OF DIFFERENT FUNDS.

SO THE FIRST THING WE'RE LOOKING AT IS FUNDING AND STABILITY.

ONE, THE IMPACT THAT IT'S HAVING DIRECTLY ON STAFF.

TWO, THE IMPACT THAT IT'S HAVING ON, UH, PROGRAMS AND SERVICES.

AND SO ASIDE FROM THE PRESENTATIONS THAT WE'VE MADE IN THIS SPACE AND OTHER SPACES, HAVING CONVERSATIONS WITH PARTNERS LIKE FOUNDATIONS OR CENTRAL HEALTH OR COMMUNITY CARE, OR EVEN THE COUNTY ABOUT WHAT KIND OF SAFETY NET WE CAN PUT IN PLACE FOR THE SAFETY NET.

UM, THE OTHER THING THAT WE'RE MONITORING, UM, REALLY CLOSELY IS, UH, THE POLICY DIRECTIONS THAT ARE COMING OUT OF THE FEDERAL GOVERNMENT AND THE IMPACTS THAT IT'LL HAVE ON OUR SERVICES.

UM, OVER THE WEEKEND WHEN WE GOT THE UPDATED RECOMMENDATIONS ABOUT THE COVID-19 VACCINE, I IMMEDIATELY PINGED, UH, DEPUTY DIRECTOR DELEON AND DR.

WA TO TALK ABOUT WHAT THAT MEANS FOR OUR SERVICES AND WHAT ARE THE WAYS THAT WE COULD PERHAPS STAND IN THE GAP AND MAKE SURE THAT THERE'S STILL AN AVAILABILITY OF VACCINE OF COVID-19 VACCINES PARTICULARLY, UM,

[00:35:01]

UM, THE OTHER THING THAT WE'RE WATCHING RELATED TO POLICY OR ALL THE EXECUTIVE ORDERS THAT ARE COMING OUT AND, UM, ASKING US TO STRUCTURE THE WAY OR RESTRUCTURE THE WAY WE THINK ABOUT PROGRAMS AND DO OUR BUSINESS.

SO BEING VERY DILIGENT ABOUT WORKING WITH ALL OF OUR PROJECT OFFICERS, UH, TO MAKE SURE THAT WE'RE, UM, ON THE SAME PAGE ABOUT WHAT COMPLIANCE LOOKS LIKE, AND AT THE SAME TIME, MAKING SURE THAT WE'RE PRESERVING WHAT IS AT THE HEART OF PUBLIC HEALTH, AND THAT IS LOOKING AT HEALTH DISPARITIES.

AND THAT MEANS THAT YOU HAVE TO HAVE FOCUS INTENTIONAL WORK IN, IN DIFFERENT COMMUNITIES.

UM, THE OTHER THING THAT WE'RE LOOKING AT IS, UM, YOU KNOW, WHAT'S GOING ON WITH THE AGENCY THAT, THAT GOVERNS OUR, OUR PRACTICE PRETTY MUCH LIKE, SO TRYING TO GUESS AS THE CDC CHANGES, WHAT ARE THE IMPACTS GOING TO BE AT A STATE LEVEL AND AT A LOCAL LEVEL.

AND THEN IN MY MIND, I FEEL OUR JOB AS A DEPARTMENT IS TO PREPARE VERY SPECIFIC RECOMMENDATIONS FOR COUNCIL ABOUT LOCAL ACTIONS, SHOULD WE DECIDE A DIFFERENT PATH FOR AUSTIN AND TRAVIS COUNTY.

UM, AND THEN TO YOUR POINT ABOUT FUNDING, UM, I REPRESENT THE CITY IN, UH, AND I, UH, PILAR IS A PART OF IT AS WELL.

WE'RE WORKING WITH ONE, ONE VOICE CENTRAL TEXAS TO KIND OF ASSESS, UM, WHAT THE FEDERAL FUNDING INSTABILITY IS DOING IN THE NONPROFIT SPACE.

UM, THE ONE THING THAT WE'RE NOTICING IS THAT USUALLY IN TIMES WHERE THERE'S FEDERAL INSTABILITY, WE SEE OUR PHILANTHROPIC PART PARTNERS KIND OF STAND UP.

UM, WE'RE NOT SEEING THAT QUITE YET.

AND SO WE'RE WORKING ON A SURVEY TO KIND OF GET A GOOD LANDSCAPE OF WHAT THE FULL PICTURE LOOKS LIKE, UM, SO THAT WE COULD PRESENT THAT INFORMATION TO THE COUNTY, CITY COUNCIL BODIES SUCH AS YOURSELF, UM, AND AGAIN, HAVE THAT GROUP GIVE INDEPENDENT RECOMMENDATIONS ABOUT, UM, WHAT SERVICES WE NEED TO REALLY PROTECT AS A COMMUNITY WHILE WE'RE TRYING TO, YOU KNOW, RIDE THIS OUT.

SO THOSE, THOSE ARE ALL THE, THE OTHER THINGS THAT WE'RE TRACKING AS THIS UNFOLDS.

, COMMISSIONER WALLACE, PLEASE.

YEAH, I, I THINK ALSO HIGHLIGHTING SOME OTHER POTENTIAL REALITIES THAT, THAT ALL ARISE AS WELL.

UM, YOU KNOW, AS FUNDING IS NOT BEING PERMITTED FOR IMMIGRANTS, FUNDING IS GONNA GET RESTRICTED IN OTHER AREAS AS WELL.

AND I THINK SAME THING THAT, UH, DIRECTOR STR HIGHLIGHTED PHILANTHROPIC FUNDERS ARE REDUCING, AND A LOT OF THAT IS POTENTIALLY FEAR AND HESITATION, UH, REPERCUSSIONS OF GETTING INTO THAT SPACE AND SUPPORTING WHERE FEDERAL HAS, UH, SHIFTED.

SO I THINK THAT'S A REALITY YOU TAKE INTO CONSIDERATION.

AND THEN ALSO, AS COMMUNITY CARES AND DARROW AND OTHERS START TO POTENTIALLY LOSE FUNDING FROM THE FEDERAL, THEN THAT MEANS WHAT IS THE IMPACT ON RESERVE FUNDING AND FUNDING FROM CENTRAL HEALTH? THAT IS, AND HAS BEEN OVER THE LAST YEAR OR SO, BEEN SHIFTING TO DO MORE COLLABORATIONS AND PARTNERSHIPS WITH ORGANIZATIONS WITHIN THE COMMUNITY.

SO, YOU KNOW, I I WOULD SAY THAT THAT'S THE FULL KIND OF LIKE, REALITY OF THE IMPACT THAT WE'RE SEEING IT RIGHT NOW WITH A PH, BUT THERE POTENTIALLY COULD BE ANOTHER SIGNIFICANT RIPPLE, UH, THROUGH OUR CENTRAL HEALTH AND ITS ENTERPRISE.

EXPOSURES FROM PEOPLE THAT HAD, UM, BEEN IN AREAS WHERE THEY'D BEEN EXPOSED TO MEASLES, BUT ONLY TWO TRAVEL RELATED CASES.

UH, ANY OTHER COMMENTS, QUESTIONS FROM OUR FRIENDS ONLINE? OKAY.

I WANNA SHIFT BACK JUST REAL QUICK BECAUSE I DIDN'T, I DON'T THINK WE GAVE THIS ENOUGH ATTENTION, UH, THE MEASLES OUTBREAK, SO THAT'S INTERESTING.

UM, IS THERE ANY, I MEAN, I'M, I'M LOOKING HIGH LEVEL OVERALL OF THIS, AND I KNOW WITH YOU HERE, DR.

WALKS, WE CAN ASK THESE QUESTIONS.

UM, ARE CAN YOU GIVE US LIKE A QUICK HIGH LEVEL OF, AND THEN I'D BE CURIOUS, ARE THERE WAYS THAT WE CAN BE ACTIVATED AS A COMMISSION, WHETHER THAT'S AND WHAT THAT MEANS.

I DON'T KNOW IF THAT'S EVEN A, A WAY THAT WE CAN BE ACTIVATED TO SUPPORT IN THIS CURRENT CRISIS THAT WE'RE HAVING.

SO, UM, AS OF, UM, AUGUST 18TH, THE COMMISSIONER OF HEALTH, UH, DR.

SHUFORD FROM THE DEPARTMENT OF STATE HEALTH SERVICES DECLARED THAT THE OUTBREAK IN TEXAS WAS OVER.

UM, AND AT THAT POINT IN TIME, TRAVIS AUSTIN, TRAVIS COUNTY HAD REPORTED TWO TRAVEL RELATED CASES OF MEASLES.

UM, SEVERAL

[00:40:01]

UM, AND SO THAT'S GOOD NEWS, AND THAT'S, THAT'S THE WORK THAT'S, UM, BEEN THE GOOD WORK OF PUBLIC HEALTH, UM, IN TEXAS.

UM, AND IN AUSTIN, TRAVIS COUNTY, I, YAY, YAY, RAH RAH.

UM, OUR, OUR CLINICAL PARTNERS AND OUR PUBLIC HEALTH PROFESSIONALS HERE DID AN OUTSTANDING JOB.

UM, AND SO THAT'S WHAT HAPPENED.

THAT'S WHAT'S THE STATUSES FOR TAXES.

HOWEVER, UM, THERE'S STILL SEVERAL OUTBREAKS THAT ARE ONGOING IN THE COUNTRY IN THE US UM, AND I BELIEVE IT'S IN SIX JURISDICTIONS AT THIS POINT THAT ARE, HAVE ONGOING OUTBREAKS.

UM, AND WE HAVE OUTBREAKS IN MEXICO AND IN CANADA THAT ARE STILL ONGOING.

AND THOSE TWO COUNTRIES HAD, HAD DECLARED A ERADICATION OR AS OF 19 98, 96, UM, TIMEFRAMES A LITTLE BIT EARLIER THAN WE DID IN 2000.

UM, AND SO WE STILL HAVE THINGS TO DO HERE.

WE STILL HAVE TO, UM, GET OUR VACCINATION COVERAGE RATES UP, UM, BY CONTINUING THE PROGRAMS THAT COMMISSIONER KIRKHAM JUST SPOKE OF, AND CONTINUING TO ENCOURAGE OUR, UM, CLINICAL PROVIDERS TO TAKE EVERY OPPORTUNITY TO OFFER VACCINATIONS OF THEIR VACCINE PROVIDERS AND, AND OR, UM, URGING PEOPLE TO GET THEIR CHILDREN VACCINATED AND, AND CONGRATULATING THOSE WHO HAVE HAD THEIR CHILDREN VACCINATED SO THEY CAN BECOME, UM, ADVOCATES AND AMBASSADORS FOR OTHERS IN OUR COMMUNITY WHO MAY STILL BE HESITANT, BUT ARE THE MOVABLE MIDDLE.

UM, SO MEASLES IS NOT OVER BY ANY MEANS.

UM, BUT THE OUTBREAK IS OVER IN TEXAS, AND WE STILL HAVE TO BE VERY COGNIZANT OF THE FACT THAT WE LIVE IN A GLOBAL SOCIETY WHERE PEOPLE ARE TRAVELING.

AND SO WHEN PEOPLE ARE TRAVELING, THEY NEED TO ESPECIALLY BE READY BY GETTING VACCINATED AND PROTECTED BEFORE THEY LEAVE TO GO TO PLACES WHERE MEASLES IS ENDEMIC.

AND OUR NEIGHBORS TO THE NORTH AND THE SOUTH HAVE MEASLES OUTBREAKS.

SO, UM, AND IN CERTAIN PARTS OF OUR COUNTRY AS WELL.

AND DO YOU KNOW IF THERE ARE, UM, CAMPAIGNS, I, I MEAN, I KNOW WE'RE, WE'RE OUT OF THE SUMMERTIME, SO MAYBE FOLKS AREN'T TRAVELING AS MUCH SCHOOL HAS STARTED, BUT THINKING OF THE HOLIDAY SEASON COMING UP, ARE THERE GOING TO BE MAYBE LIKE AWARENESS CAMPAIGNS THAT COME OUT? SO A PH HAS HAD, UM, SEVERAL VACCINE CAMPAIGNS ONGOING.

UM, THE TRAVIS COUNTY MEDICAL SOCIETY, UM, PUBLIC HEALTH COMMITTEE, AND SOME, UM, EXOFFICIO MEMBERS, DR.

HELLER STEP BEING ONE OF THEM.

AND DR.

ARI BROWN, WHO'S THE SPOKESPERSON FOR THE AMERICAN ACADEMY OF PEDIATRICS, JOINED US AT A MEETING LAST MONTH.

AND WE'RE PUTTING TOGETHER A CAMPAIGN TO HELP CONTINUE THE DRUM ROLL FOR OUR CLINICAL PROVIDERS TO HAVE THOSE CONVERSATIONS EVERY TIME SOMEBODY COMES TO THE OFFICE, SO THAT THEY LEAVE WITH INFORMATION ARMED AND READY TO GET VACCINATED OR, OR GET THAT VACCINATION THAT THEY NEED WHEN THEY'RE IN THE OFFICE.

JUST TO ADD ON TO THAT, THERE ARE A FEW, UH, SIGNATURE EVENTS THAT HAPPENED DURING THIS TIME OF YEAR.

UM, ONE OF THEM HAS PASSED IS TAKE A LOVED ONE FOR A CHECKUP WHERE WE, WE LIKE TO HAVE A PRESENCE FROM THE IMMUNIZATIONS TEAM TO INVITE FAMILIES TO GET, UM, VACCINATED IN A FUN ENVIRONMENT COMING UP IN SEPTEMBER AS FIESTA DE SALUD, WHICH IS ANOTHER OPPORTUNITY, UM, WHERE IMMUNIZATIONS HAS A REALLY BIG PRESENCE.

UM, I DON'T KNOW IF IT'S HAPPENED YET, AND THE NAME IS ESCAPING ME.

IT HAPPENS IN THE ST.

JOHN'S AREA WITH AV.

YOU MIGHT HAVE TALKED ABOUT IT IN YOUR PRESENTATION, BUT I MISSED IT.

THEIR BIG THING THAT THEY DO, HOPE FEST, UM, IS ANOTHER ONE WHERE WE HAVE A BIG PRESENCE AND THEN BOO THE FLU.

AND SO IN ADDITION TO ALL OF THESE INFORMATION CAMPAIGNS, WE HAVE, UM, SOME SIGNATURE EVENTS THAT REALLY HELP PEOPLE GET READY FOR THIS SEASON OF RESPIRATORY VIRUS FUND.

ANY OTHER, PLEASE GO AHEAD.

UH, I HAD A QUESTION, DIRECTOR STIR, UH, YOU MENTIONED ONE VOICE LAST, UM, MEETING, AND I WAS CURIOUS IF THAT CONTINUES WHERE IT'S AT, UH, HOW WE COULD KIND OF CONNECT WITH THEM FOR SERVICE AND YEAH, I, I CAN DEFINITELY MAKE A CONNECTION, UM, WITH THE EXECUTIVE BOARD FOR, FOR YOU GUYS.

WE'LL DO THAT.

[00:45:01]

ANY OTHER QUESTIONS, COMMENTS REGARDING, UM, ANY OF THE CONTENT THAT'S IN OUR UPDATE FROM COMMISSIONER FROM THE, UH, TRAVIS COUNTY COMMISSIONER'S COURT? I GUESS I HAD A QUICK QUESTION AROUND, UM, WASTEWATER SURVEILLANCE AND IF, UH, FUNDING IS MAINTAINED FOR THAT, UM, OR IF THAT'S BEING CUT TO DATE.

UM, THERE IS FUNDING THAT'S AVAILABLE.

UM, THAT'S ALL I CAN SAY, .

UM, AND WE'RE HOPEFUL THAT THAT WILL CONTINUE BECAUSE IT CONTINUES TO BE THE CANARY IN THE COAL MINE.

UM, WE GET A LOT OF INFORMATION ABOUT WHAT'S HAPPENING, UM, FROM WASTEWATER.

UM, USUALLY ABOUT 10 TO 14 DAYS BEFORE WE MAY HAVE A REPORTED CASE OF, UH, SOME OF THE THINGS THAT WE'RE CONCERNED ABOUT.

SO I THINK WE'RE VERY HELPFUL ABOUT THAT.

MAYBE DIRECTOR STIR HAS MORE INTEL ON THAT, BUT I HAVEN'T HEARD OF ANY CUTS AS YET.

I JUST WANTED TO ADD A LITTLE BIT MORE ABOUT, UM, SOME THINGS THAT HAVE OCCURRED SINCE THIS PRESENTATION, SPECIFICALLY FROM THE, OUR IMMUNIZATIONS UNIT, AUSTIN PUBLIC HEALTH, UM, SINCE I'M ALREADY TALKING, UM, IN ADDITION TO THE AV PROJECT WE MENTIONED, UM, PART OF THAT I WOULD LIKE TO TRY TO MEET WITH COMMUNITY CARE TO SEE HOW THE COMMUNITY CARE CLINICS THAT ARE, ARE IN SCHOOLS, HOW THEY MIGHT BE ABLE TO USE THAT MODEL AND BE ABLE TO SEE THE STUDENTS THAT ARE IN THAT SCHOOL SO THAT WE DON'T HAVE TO THEN GO ALSO TO THAT SCHOOL.

UM, I'M ALSO, OR WE ARE ALSO WORKING INTERNALLY WITH A PH, UH, WITH OUR ENVIRONMENTAL HEALTH SERVICES.

SO OUR FOOD PERMIT BOARD MEETING PEOPLE, UM, EVERY TUESDAY AND THURSDAY, THEY INSPECT AND PERMIT MOBILE FOOD VENDORS AT THEIR LOCATION OFFER RUTHFORD LANE.

AND SO WE ARE GOING TO SET UP ON TUESDAYS, WHICH ARE BUSIER OUR VACCINE CLINIC OR MOBILE VACCINE CLINIC SO THAT WE CAN VACCINATE THE FOOD WORKERS WHO ARE LESS LIKELY TO HAVE INSURANCE.

UM, AND WE WILL, YOU KNOW, WE'LL ADVERTISE AND OFFER IT TO THEIR EMPLOYEES AS WELL IF THEY WANT TO COME AND THEN GET VACCINATED, UH, WHILE THEY'RE ALREADY THERE GETTING PERMITTED.

UM, AND THEN FINALLY THIS SUMMER WE DID A SEPARATE PROJECT WHERE WE WORKED WITH, AGAIN, A PH, OUR EARLY CHILDCARE PROGRAM.

UM, AND WE SET OUR AUDIT TEAM, THE ONES WHO AUDIT THE SCHOOLS AND THE DAYCARES, UM, PER OUR STATE CONTRACT, UM, DURING THE SUMMER.

THEY DON'T HAVE THOSE AUDITS GOING ON.

SO WE DECIDED TO USE OUR TEAM THIS YEAR TO GO INTO SELECT CHILDCARE FACILITIES TO DO A COMPLIMENTARY, UM, RECORD REVIEW JUST TO HELP THEM UNDERSTAND WHERE THEY ARE IN THEIR COMPLIANCE RATES AND THEIR DOCUMENTATION AND, UM, TO HELP THEM PREPARE FOR WHEN THEY DO, UH, GET AUDITED.

IF THEY DO, UM, WE CAN PRESENT ON THAT IF Y'ALL LIKE.

UH, IT WAS A REALLY GREAT PROJECT AND WORKED REALLY, REALLY WELL.

SOMETHING THAT REALLY STOOD OUT WAS THE CHILDCARE FACILITIES.

WE LOOKED AT THE VALID RECORDS AND WE LOOKED AT THE INVALID RECORDS AS WELL.

IF WE ONLY LOOKED AT THE VALID RECORDS, THE COMPLIANCE RATES WEREN'T THAT GREAT, BUT IF WE LOOKED AT THE INVALID RECORDS, THEY HAD VERY GOOD RATES.

AND SO THAT'S ANOTHER EDUCATION PIECE ON OUR PART IS WHAT IS A VALID RECORD AND HOW DO YOU AS A PARENT ENSURE YOU GET THE RIGHT RECORD? HOW AS A PROVIDER ARE YOU GIVING THE RIGHT RECORD THAT'S VALID BECAUSE, YOU KNOW, IT'S A SIMPLE PIECE OF PAPER, BUT IT COULD, YOU KNOW, YOU COULD, YOU COULD FAIL JUST BECAUSE YOU DON'T HAVE THE RIGHT PIECE OF PAPER.

SO, UM, THOSE ARE JUST SOME PROJECTS THAT WE'RE WORKING ON AND THAT WE'RE GONNA CONTINUE TO WORK ON.

UM, JUST TO TRY AGAIN, KIND OF WHAT THE AV THING, YOU KNOW, BETTER USE OF OUR RESOURCES, BETTER TARGETED, UH, FOCUS OF OUR RESOURCES SO THAT, UH, THEY CAN GO FURTHER WITH, YOU KNOW, LESS.

SO JUST WANTED TO ADD THOSE.

IT IT'S, IT'S GOING OFF, IT'S GOING OFF OF WHAT YOU'RE SAYING.

COMMISSIONER COOK IN MY NEXT COMMENT, BUT IF DIRECTOR STIR, IF WHAT YOU WERE GONNA MENTION IS A LINE.

MAYBE FROM A PH CAN'T BE, OR THE PEOPLE CAN'T BE CONTINUED , I'M, I'M SMILING BECAUSE, UM, I FOOLISHLY MADE THAT STATEMENT TO A GROUP OF NONPROFIT LEADERS AND, UH, IT WAS NOT WELL RECEIVED.

UM, THINKING ABOUT COLLABORATIONS, THINKING ABOUT WAYS TO WORK WITH WHAT WE HAVE, UM, LOOKING AT THE EMERGING ISSUE SLIDE OF THE IMMEDIATE LOSS OF FUNDING, UH, THERE ARE FOUR GRANTS THAT WERE RESCINDED BEFORE THEIR END DATE.

ONE WAS THE IMMUNIZATIONS COVID-19, THE COVID-19 HEALTH DISPARITIES REACH AND REACH OUT THE IDCU COVID-19, AND THEN THE TEXAS TOBACCO CONTROL GRANT.

ARE THERE PARTNERS THAT CAN BE ACTIVATED TO CONTINUE THIS WORK? I UNDERSTANDING IT'S A $2 MILLION LOSS, BUT IS THERE A WAY, AND, AND I DON'T, I'M NOT SURE IF THIS IS THE SPACE THAT WE COULD COLLECTIVELY SHARE THIS CONVERSATION, OR IF THIS IS NOT THE RIGHT SPACE OF TAB TACK TAP, YOU KNOW, TAPPING IN PARTNERS WHO CAN CONTINUE TO DO THE WORK WHERE THEIR FUNDING

[00:50:01]

KNOW, REALLY LOOKING AT YOUR, YOUR SPHERES OF IN INFLUENCE, THINKING ABOUT WHAT THE WM PRINCIPLE IS FOR THAT PARTICULAR ORGANIZATION.

UM, YOU KNOW, BECAUSE THEY'RE ALSO EXPERIENCING LOSSES.

SO IN THE SAME WAY, IT WAS KIND OF LIKE, WE'RE NOT GONNA ABSORB YOUR BUSINESS WHILE WE'RE LOSING MONEY.

UM, TO, BUT THEN A AFTER THAT ROUGH POINT, IT WAS KIND OF LIKE, WELL, WE, WE PROBABLY NEED TO DECIDE TO TOGETHER WHAT WE'RE GOING TO MAINTAIN AND WHO'S GOING TO DO WHAT TO CREATE EFFICIENCIES AND MINIMIZE DUPLICATION.

UM, AND SO I, I DO THINK THAT THERE'S A LOT OF OPPORTUNITY FOR THAT TO STILL HAPPEN.

UM, ONE EXAMPLE IS THAT WE LOST FUNDING FOR, AND THERE'S AN, AN UPDATE THAT WE GAVE TO THE PUBLIC HEALTH COMMITTEE.

SO NOTE TO MYSELF, EVERY TIME THE DEPARTMENT GIVES A PRESENTATION TO THE COURT OR TO PUBLIC HEALTH COMMITTEE, WE WILL MAKE SURE THAT WE, WE ASK IF THIS BODY WOULD LIKE TO HAVE THOSE PRESENTATIONS AS WELL.

BECAUSE I, I HEARD YOU SAY, UM, WHILE I WAS LISTENING, LISTENING ON THE PHONE, THAT YOU WERE EXPECTING A, A PRESENTATION TODAY.

AND I APOLOGIZE THAT THAT MISSED MY UNDERSTANDING.

UM, AND WE CAN DEFINITELY COME BACK AND TALK ABOUT MORE OF THESE ISSUES, UM, TO THE COMMISSIONER'S LIKING.

UM, BUT THAT BEING SAID, ONE EXAMPLE WAS WHEN WE LOST OUR FUNDING FOR, UM, HIV PREVENTION, SPECIFICALLY FOR THE MOV TEAM, THE CONSOLATION WAS THAT WE KNOW THERE ARE OTHER PARTNERS IN THE COMMUNITY THAT ARE ALSO DOING THAT WORK.

AND SO WHERE WE'RE TRYING TO LIVE IS WHERE ARE THE THINGS THAT PUBLIC HEALTH HAS TO DO? UM, AND THAT IN THE HIV SPACE IS THE FOLLOW UP, RIGHT? WE ARE THE PERSONS WHO ARE GONNA GET THE, THE PERSONS, WE'RE THE PEOPLE WHO ARE GONNA GET THE INFORMATION ABOUT THE PARTNERS AND, AND DO THAT WORK AND DO THE CONNECTIONS TO CARE.

WE'RE THE, WE'RE THE PEOPLE WHO ARE GOING TO BE THE STEWARDS OF THE DATA, UM, TO THE DEPARTMENT OF STATE HEALTH SERVICES.

AND SO, YOU KNOW, SHOULD FUNDING BECOME AVAILABLE, WE JUST, WE, WE SLIDE BACK AND LET ANOTHER ORGANIZATION DO THAT KNOWING THAT WE ARE GONNA DO THE FOLLOW-UP WORK AND BEING VERY INTENTIONAL ABOUT STRUCTURING AGREEMENTS WITH THEM, THAT WE CAN MAKE SURE THAT ANY CLIENT THEY SEE IS GETTING CONNECTED TO A PH FOR THAT FOLLOW-UP IMMEDIATELY.

UM, ANOTHER GOOD EXAMPLE OF THAT IS, YOU KNOW, WE USED TO, UH, RUN THE RYAN WHITE PART C GRANT AND COMMUNITY CARE APPROACHED US ABOUT TAKING IT OVER.

AND THEY, I MEAN, THEY HAVE AN EHR, THEY COVER A FIVE COUNTY AREA.

THEY WERE WILLING TO GIVE THE FUNDED PARTIES ACCESS TO THEIR EHR FOR BETTER INFORMATION FLOW AND SHARING.

I WAS LIKE, OH, OKAY.

LIKE, YOU, YOU CAN DO THIS BETTER THAN WE CAN.

LIKE, WE DON'T HAVE TO BE THE BIG DOG IN EVERY SPACE.

AND SO, UM, YOU KNOW, FOR, FOR OUR POSTURE, IT'S LIKE, WHERE DO WE HAVE TO STAND 10 TOES DOWN BECAUSE THIS IS WHAT WE'RE REQUIRED TO DO AS A HEALTH DEPARTMENT.

AND THEN HAVING THE AWARENESS TO SAY, HEY, FOR THESE OTHER THINGS, THERE MIGHT BE AN AGENCY THAT'S BETTER POSITIONED TO DO THIS WORK.

AND NOT THAT WE CAN GIVE YOU ANY MONEY, BUT MAYBE LIKE, IN THE CASE OF COMMUNITY CARE, WE SIGNED OFF AND WE SENT THE LETTER OF SUPPORT FOR THEIR APPLICATION.

UM, AND SO THAT'S, THAT'S HOW WE'RE THINKING ABOUT IT AT THE DEPARTMENT.

BUT IF THIS BODY WOULD LOVE TO MEET WITH FOLKS AND TALK ABOUT PARTNERSHIP AND THE NEED TO STAND TOGETHER AND NOT, YOU KNOW, BE CRABS IN THE BARREL ISH, BUT REALLY BE LIKE THE WAKANDANS AND SHARE, SHARE THE WEALTH AND THE INFORMATION, RIGHT.

SO WE CAN ALL PROSPER.

UM, THAT'S, THAT'S WHAT WE NEED RIGHT NOW.

WELL, SINCE YOU OFFERED, UH, HOW DO WE ACTIVATE THAT? I MEAN, I, I FEEL LIKE WE ARE LOOKING FOR THE MOST RIGHT NEXT STEPS AS, AND I SAY WE, THE COMMISSION BODY TO SUPPORT THE ACTIVE CRISIS THAT WE'RE DEALING WITH, RIGHT? WHERE WE'RE ALL JUST LIKE WE, WHAT DO WE DO? HOW DO WE, HOW DO WE, HOW DO WE FILL IN THIS GAP? UM, WHAT CAN WE ACTIVATE? WHAT, WHAT STEPS SHOULD WE TAKE TO BE ABLE TO HAVE THOSE CONVERSATIONS, UM, AND GET THAT BALL ROLLING? I MEAN, WE'RE, I THINK WE'RE ALL LOOKING TO MOVE THE IMPACT, I WOULD SAY.

UM, ONE GOOD FIRST STEP IS LOOKING AT YOUR OWN SPIRITS OF INFLUENCE TO SEE WHERE YOU CAN INITIATE THOSE CONVERSATIONS.

WHO, WHO DO YOU HAVE CONNECTIONS TO WITH THAT NEED TO BE AT THE TABLE HAVING THIS CONVERSATION? UM, HOSPITAL PARTNERS, DEFINITELY.

I KNOW THEY HAVE A VESTED INTEREST.

'CAUSE IF PUBLIC HEALTH BREAKS DOWN, WOE IS ME RIGHT ON THE EMERGENCY ROOM.

AND SO, YOU

[00:55:01]

UH, WHAT'S IN IT FOR ME? UM, AND AGAIN, NOT PICKING ON YOU, BUT IT'S THE EASIEST.

HOSPITAL PARTNERS LOVE PUBLIC HEALTH BECAUSE WE, WHEN WE'RE WORKING RIGHT, THERE'S PRESSURE OFF OF THE, THE EMERGENCY ROOM MM-HMM .

UM, AND SO STARTING THERE, UM, BEING WILLING TO MEET WITH OTHER ORGANIZATIONS, I THINK IT'S WONDERFUL THAT YOU WANNA CONNECT WITH ONE VOICE, CENTRAL TEXAS, THE SURVEY THAT WE'RE WORKING ON IS ALMOST FINISHED.

UM, YOU KNOW, SHARING THAT OUT WITH YOUR GROUP, UM, INVITING THEM TO COME AND GIVE A PRESENTATION ON THE RESULTS AND COMMITTING TO WORKING WITH THEM ON SOME RECOMMENDATIONS.

I, I THINK IS ANOTHER GREAT STEP.

DR.

WALKS, I'M LOOKING AT YOU.

WHAT ELSE? WHAT, WHAT ELSE CAN WE, OR SOME ACTIONABLE THINGS TO SUGGEST TO THE COMMISSIONERS? I THINK THAT, UM, THE, FROM THE, IN THE AREA OF FOOD INSECURITY, WHICH I KNOW IS NOT NECESSARILY ONE OF THE MAJOR PURVIEWS, ALTHOUGH IT IS A NON-MEDICAL DRIVER, THERE IS, THERE WAS SOME REALLY GOOD WORK THAT'S HAPPENING IN THAT SPACE.

UM, THERE WAS A FOOD SUMMIT TODAY THAT LOOKED AT THINGS ON A REGIONAL LEVEL AND, UM, FROM, FROM THE STANDPOINT OF PUBLIC HEALTH, UM, WE'RE, WE'RE VERY, UM, WHAT'S THE RIGHT WORD? WE'RE ONE OF THE LARGER JURISDICTIONS IN THE AREA.

SO, UM, I DON'T KNOW IF THERE'S ANY, IF YOU'VE CONTEMPLATED DOING ANYTHING THAT LOOKS AT HOW WE CAN REGIONALLY ATTACK SOME OF THESE PROBLEMS, BECAUSE WE DEFINITELY CARE FOR PEOPLE FROM A MULTI-COUNTY, UM, AT PERSPECTIVE.

AND SO IS THAT SOMETHING THAT WOULD BE WORTHWHILE THINKING ABOUT? ARE THERE PARTICULAR ORGANIZATIONS, UH, I DON'T KNOW THAT WE NEED TO CALL THEM OUT TODAY, BUT THAT HAVE BEEN RESISTANT TO PARTNERSHIP OR EVEN COMING TO THE TABLE, UH, WHERE MAYBE WE CAN PUSH A LITTLE BIT AS WELL? I DON'T THINK ANYONE'S BEEN RESISTANT.

IT'S JUST BEEN SO DIFFICULT TO PLAN IN HIGH LEVEL OF UNCERTAINTY.

UM, AND I, I WON'T SPEAK FOR MY PARTNERS, BUT I'LL, I'LL SPEAK FOR, FOR ME, AND I THINK THEIR EXPERIENCES WERE PROBABLY THE SAME.

UM, CHANGING INFORMATION, NOT BEING ABLE TO PROVIDE SOLID COMFORT IN LEADERSHIP TO YOUR STAFF, , TRYING TO JUGGLE, UH, MULTIPLE PRIORITIES AND VIEWPOINTS.

UM, AND, YOU KNOW, USUALLY THE FEDERAL GOVERNMENT WAS THE, THE PLACE WHERE THE SANITY LIKE LIVED , AND IN THAT, THAT'S MISSING NOW.

UM, AND SO I, I THINK EVERYONE IS JUST TRYING TO COME TO TERMS WITH WHAT THIS NEW REALITY IS AND, AND WHAT IT, WHAT IT MEANS.

AND, YOU KNOW, I LIKEN IT TO COVID.

WE WERE ALL, WE WERE ALL SCARED AND UNSURE AT FIRST, BUT THEN AFTERWARDS WE, WE, LIKE, WE GOT IT RIGHT? LIKE WE GOT OURSELVES TOGETHER, WE GOT IN ROOMS, WE HAD CONVERSATIONS, WE, WE PROBLEM SOLVED AND WE WERE CREATIVE ABOUT PROTECTING THIS COMMUNITY.

AND I, I MEAN, I THINK, I THINK WE'RE, WE'RE AT THAT POINT WHERE WE NEED TO, TO START HAVING THOSE CONVERSATIONS BECAUSE WHEN I LISTEN TO EACH OF THE AGENCIES TALK ABOUT THE NUMBER OF PEOPLE THAT THEY HAD TO LAY OFF JUST IN A THREE MONTH PERIOD, IT'S, IT'S ALARMING.

AND IT, IT'S ABOUT TO BE AN ECONOMIC PROBLEM.

ALL RIGHT? SO WE, IF WE CAN START PUTTING THE FRAMEWORK IN PLACE WHEN OTHER PEOPLE START GETTING THEIR FEET WET AS THE WATERS RISE, YOU KNOW, WE'LL, WE'LL HAVE A PLACE FOR THEM TO COME AND, UM, SAY, HEY BABY, IT'S ALL RIGHT.

SIT DOWN, REST A LITTLE BIT AND LET'S, LET'S FIGURE THIS OUT.

BUT IT, IT JUST HASN'T BEEN A LOT OF UNCERTAINTY AND AND CONFUSION FOR PEOPLE TO WORK THROUGH.

I WOULDN'T YOU SAY.

YEAH, THAT'S TRUE.

AND SOMETHING THAT YOU MENTIONED LAST MEETING THAT I THINK IS IMPORTANT TO THINK ABOUT IS AS WE LOSE STAFF AND CAPACITY, SUSTAINABILITY OF ANYTHING BECOMES QUESTIONED, RIGHT? AND SO EVEN IF WE HAVE A PARTNER THAT MAY HAVE GRANT FUNDING AVAILABLE, UM, YOU HAVE TO STOP AND THINK ABOUT THE UNINTENDED CONSEQUENCES OF WHAT ARE YOU GONNA DO WHEN THE MONEY RUNS OUT.

AND SO THAT THERE'S, THAT'S REALLY A BIGGER PROBLEM NOW THAN IT HAS BEEN, I THINK HERE TWO FOR

[01:00:05]

UM, AGREE.

AND I KNOW WE TALKED ABOUT LOCAL FUNDERS, BUT WE'VE ALSO SEEN A SHIFT IN THE PRIORITIES.

I'VE ALSO, UH, REGARDING LOCAL FUNDERS AND, UM, HAVE SEEN A SHIFT WHO OFTENTIMES MIGHT FUND A PILOT PROJECT, BUT, UM, WE'VE SEEN A SHIFT IN, UM, PRIORITIES AND, UM, IN SOME INSTANCES, CENTRAL HEALTH HAS PICKED UP FUNDING FOR SOME OF THESE, FOR SOME OF THESE, UM, UH, FUNDING SHIFTS.

, IT WILL SAY, AND I, I THINK THIS IS, I'M GONNA, I'VE GOTTA PUT THIS PLUG IN.

WE NEED DATA CARE COORDINATION SHARING REALLY BADLY IN THIS SETTING BECAUSE WHEN RESOURCES ARE SCARCE, YOU REALLY NEED TO KNOW WHERE THEY NEED TO GO AND HAVING, UH, A GOOD PICTURE OF WHAT IS HAPPENING IS ALL THE MORE IMPORTANT.

SO THE IMPLEMENTATION OF THE CARE COORDINATION PLATFORM THAT'S ONGOING AS WE SPEAK, NEEDS TO CONTINUE.

AND I WOULD SAY ACCELERATE SO THAT AS WE ARE MOVING INTO THESE UNCHARTED WATERS DIRECTORS, LIKE DIRECTOR STIRRUP AND UM, DR. LEE AND OTHERS CAN REALLY UNDERSTAND WHAT IT IS THAT THEY NEED TO DO AS THE NEXT RIGHT MOVE.

AND THEN YOU MENTIONED THE RE REGIONAL OUTREACH, WHICH I THOUGHT WAS A GOOD IDEA.

IS THERE, WOULD IT BE HELPFUL TO DO THINGS AT THE STATE LEVEL AS WELL AS THE PROBLEMS ARE AFFECTING US KIND OF STATE AND THEN FEDERAL TOO, OR DEFINITELY.

I WANTED TO GO BACK JUST REAL QUICK, AND I DON'T KNOW IF THIS IS SOMETHING, SINCE WE HAVE BOTH ST.

DAVID'S AND CENTRAL HEALTH AT THE TABLE, UM, ARE YOU ALL SEEING ANY INCREASING TRENDS IN YOUR ERS WITH THESE CUTS ALL? I DON'T KNOW IF IT'S, IT MIGHT BE TOO EARLY TO ASK THIS, SO IF THAT'S NOT THERE, THEN TOTALLY FINE, BUT IF PEOPLE AREN'T HAVING ACCESS RIGHT, AND RESOURCES, UH, YOU'RE GONNA GO TO THE ONLY THING THAT YOU KNOW, WHICH IS THE EMERGENCY ROOM.

SO I WAS JUST CURIOUS, IS THAT ALREADY SOMETHING THAT YOU ALL ARE SEEING AS LIKE AN EMERGENT CRISIS IN YOUR FACILITIES, OR IS IT A LITTLE TOO EARLY TO TO KNOW? I'M NOT, UM, AWARE, BUT I THINK THERE'S AN EXPECTATION THAT THAT MIGHT HAPPEN.

UM, BUT PERHAPS, UH, INDIVIDUALS WHO WORK FOR HOSPITALS, UH, CAN PROVIDE SHED SOME MORE LIGHT.

YOU KNOW, EMERGENCY DEPARTMENTS HAVE BEEN UNDER STRESS AND STRAIN FOR A LONG TIME AND, AND SO I DON'T KNOW THAT WE'VE SEEN ANY PARTICULAR BLIP IN THE LAST FEW MONTHS, PER SE, UNLESS YOU SAY IT'S A LITTLE EARLY.

AN ANNUAL PICTURE WILL TELL US VERY SPECIFICALLY WHAT'S EKING UP THAT MAYBE LOOKS LIKE A NORMAL VARIATION, BUT IT'S A TENDENCY TO MOVE INTO A HIGHER VOLUME KIND OF SITUATION.

SO I DON'T THINK WE HAVE GOOD, UM, SENSE OF THAT YET.

SURE.

BUT THAT'S SOMETHING WE ALL THE SYSTEMS COULD COME TOGETHER AND TALK ABOUT AND WONDER ABOUT AND MAYBE HAVE EVIDENCE OF, YOU KNOW, I THINK, I THINK IT'S TOO, YEAH, WE'RE, OH, I DON'T THINK WE'RE GONNA SEE THE EFFECTS OF, OF THAT RIGHT AWAY, BUT WHEN, WHEN IT STARTS, I FEEL LIKE IT'S GONNA BE SNOWBALL.

I WONDER IF THERE'S ANY ROOM FOR US TO LOOK AT WHAT IDEALLY SHOULD BE THE PERCENT OF A BUDGET THAT'S ALLOCATED FOR PUBLIC HEALTH, AND THEN GARNER THE SUPPORT OF THIS BODY TO PUT THAT FORWARD IS SOMETHING TO CONTEMPLATE IN THE FUTURE.

WHEN, LIKE IN JANUARY, I THINK WE HAVE SOME GOOD, PLEASE GO AHEAD, COMMISSIONER GRIFFIN.

SO, AS AN ADD, I THINK, I DON'T KNOW THAT WE'VE EXPLORED THIS YET AS A COMMISSION, BUT MAYBE SOMETHING WE CAN DO IS TO LOOK AT CITYWIDE COUNTYWIDE REGIONAL PLANS AND SEE HOW PUBLIC HEALTH IS OR ISN'T IN THERE, AND HOW WE MAY BE ABLE TO LEVERAGE THOSE AS OPPOSED TO CREATING A WHOLE NEW PLAN OF SOMETHING, YOU KNOW, JUST INSERTING PUBLIC HEALTH INTO THE DIFFERENT THINGS.

WHAT COMES TO MIND IS THE FOOD PLAN, UM, AND THEN THE PILOT THAT WE'RE DOING WITH THE ENVIRONMENTAL HEALTH SERVICES.

YOU KNOW, IS THERE ANYTHING IN THE FOOD PLAN ABOUT WORKERS' SAFETY, YOU KNOW, AND HEALTH AND ACCESS TO VACCINES AND WHATEVER ELSE THEY MAY NEED.

AND IF NOT, THEN MAYBE THAT'S SOMETHING WE COULD ADD TO THAT TO ENSURE THAT IT'S CONSIDERED IN THE HOLISTIC FOOD PLAN.

AND MAYBE WE CAN GET SOME MONEY FOR THAT TOO.

UM, OR, YOU KNOW, IMAGINE AUSTIN OR WHATEVER ELSE THAT THERE ARE ALREADY EXISTS.

YOU KNOW, I THINK THAT MIGHT BE A GOOD, UM, USE OF RESOURCES.

[01:05:02]

SINCE WE KNOW THAT FOR THE FORESEEABLE FUTURE, WE CANNOT LOOK TO, UM, OUR USUAL SOURCES FOR GRANT FUNDING AND, AND SUSTAINED FUNDING.

I'M HAPPILY LOOKING AT COMMISSIONER RICE BECAUSE I KNOW THIS WAS SOMETHING THAT WAS BROUGHT UP DURING OUR PRESENTATION MONTHS AGO OF WE'VE BEEN STUCK AT THIS PERCENT AND HAVE NOT SHIFTED IN WHAT WOULD BE THE, UH, BENEFITS OF SHIFTING.

UM, AND THEN WHO HAS SHIFTED IN THEIR OWN CITIES, REGION, STATES, AND THE IMPACTS THAT THAT HAS MADE WITH A SIMPLE, I THINK, I THINK THE IDEA WAS 5%, NO, 3%, 3% WAS THE FIRST IDEA.

TRYING TO KEEP MY SAAS TO A MINIMUM, AS I SAY THESE THINGS, BECAUSE IT'S A LONG TIME TO SIT AT 1.6%.

IT'S A LONG TIME.

UM, AND I, I THINK THAT, YOU KNOW, IF WE, IF WE COULD PUT THAT INTO WORDS THAT, UH, THE COMMUNITY CAN UNDERSTAND, I THINK THERE WOULD BE A LOT OF, UH, IMPACT THAT COULD BE MADE FROM VOICES AMONGST OUR COMMUNITY MEMBERS TO SAY, HEY, MAYBE THREE PERCENT'S NOT TOO BAD.

UM, HAPPY TO JUMP IN AND SEE HOW WE CAN GET SOME CONTENT, SOME INFORMATION TO SHARE.

SOME, UH, I KNOW I, I THINK, I CAN'T REMEMBER WHERE TULSA MIGHT HAVE BEEN THE CITY THAT YOU USED AS THE EXAMPLE, BUT, UM, THEY DID SOMETHING SMALL, WHICH WAS JUST MOVING THE NEEDLE IN THAT CITY BUDGET.

UM, I SAY WE DUSTED OFF AND KEEP IT GOING.

WHY NOT? I GUESS THE OTHER THING THAT COMES TO MIND IS WE'RE TALKING ABOUT INCREASE, BUT CAN WE LOOK AT EXAMPLES WHERE THE BUDGET WAS DECREASED AND WHAT EFFECTS IT HAD TO KIND OF MAYBE LOOK AT WHAT'S HAPPENING NOW.

UH, AND THEN I KNOW UT THE POLICY SCHOOL WAS INTERESTED IN WORKING WITH US, OR I WONDER IF THEY WOULD BE OPEN TO THIS.

I DON'T KNOW WHAT'S HAPPENED.

OH, I DON'T KNOW.

UH, YOU KNOW, UT WENT THROUGH SOME CHANGES WITH CERTAIN THINGS THAT THEY WERE ALLOWED TO DO, TALK ABOUT AND ADDRESS.

UM, THAT PARTICULAR PROFESSOR HAS NOT GOTTEN BACK TO ME.

UH, SHE WAS SPECIFICALLY WORKING ON THE OPIOID CRISIS AND, UH, LOOKING AT HOW TO REMOVE FENTANYL TESTING STRIPS FROM BEING CONSIDERED, UH, CONTRABAND, SO TO SPEAK, UM, IN PREVENTATIVE ACTIONS.

SO I, I CAN REACH BACK OUT AGAIN.

HAPPY TO, HAPPY TO.

UM, YEAH.

ALRIGHT.

I'M HAPPY TO ALSO LOOK AND SEE IF THERE'S OTHER PUBLIC HEALTH PROFESSORS THERE WHO MIGHT BE INTERESTED IN THIS.

AND THIS IS, SOUNDS A LITTLE BIT LESS CONTROVERSIAL MAYBE.

I DO THINK THERE'S LIKE SOME MAYBE WAYS THAT WE CAN TAP INTO STUDENTS.

I KNOW DATA SCIENCE IS A VERY BIG THING RIGHT NOW, AND IT, IT IS, IT IS LIKE SWITZERLAND, SO TO SPEAK.

IT'S JUST LOOKING AT THE DATA MM-HMM .

UM, AND I'M, I AM, I WROTE DOWN A QUESTION OF, YOU KNOW, CAN WE FIND, UH, A DATA, YOU KNOW, DATA SCIENTIST STUDENT WHO IT EVEN CAN WORK ON SOME OF THIS FOR US, OF LOOKING AT THE PERSPECTIVE DOWNFALLS OF THIS LIKE ECONOMIC ASPECT THAT'S HAPPENING TO US WITH THESE LAYOFFS, WITH WHAT THAT COULD DO TO AUSTIN AS A CITY, TO TRAVIS COUNTY.

WE'RE ALREADY SEEING PEOPLE NOT MOVING IN AS FREQUENTLY.

UM, DOES THAT MEAN THE POPULATION IS NOW GOING TO BE AFFECTED BECAUSE FOLKS ARE LEAVING? I MEAN, I THINK THERE'S SO MANY DIFFERENT DIRECTIONS THAT THIS COULD GO, UM, WHICH COULD HAVE A LARGER IMPACT ON OUR CITY.

SO, UM, HAPPY TO HELP SUPPORT, FIND, LOOK FOR SOME STUDENTS WHO I'M SURE NEED SOME PROJECTS TO WORK ON.

YOU KNOW WHAT I'M SAYING? THAT THESIS.

TALKED ABOUT, HOW MANY PEOPLE NOW AREN'T WORKING THAT USED TO WORK IN PUBLIC HEALTH AND ALL THESE KINDS OF VERY, YOU KNOW, BIG QUESTIONS THAT, UM, COULD BE WORKED ON.

PLEASE.

HOW WOULD IT WORK IF WE WERE TO WANT TO ENGAGE A STUDENT WHO MIGHT BE FROM THE UNIVERSITY OF TEXAS TO COME, YOU KNOW, MAYBE WORKING THROUGH THE AUSTIN PUBLIC HEALTH, AUSTIN, TRAVIS COUNTY PUBLIC HEALTH, BE, YOU KNOW, UM, WORKING ON SOME PROJECTS FOR US MM-HMM .

THAT WOULD ANSWER SPECIFIC QUESTIONS THAT MIGHT COME MONTHLY TO US TO, UM, REPORT.

UM, IT COULD BE ONE OR MORE PROJECTS THINKING IN TERMS OF OUR RELATIVE FUNDING AND HOW WE COMPARE ACROSS THE COUNTRY, THOSE ISSUES, THE LOCAL ISSUES YOU JUST

[01:10:01]

THAT'S DEFINITELY DOABLE.

AND THAT'S WHAT WE DID WITH OUR OMD INTERN PROJECT WHEN WE STARTED LOOKING AT HARM REDUCTION BASED UPON SOME COMMENTS THAT WERE MADE HERE AT THIS COMMITTEE, AT THIS COMMISSION.

UM, SO WE COULD DEFINITELY DO THAT.

IT, THE QUESTIONS THAT ARE ASKED THOUGH, TAKE LONGER THAN A COUPLE OF WEEKS TO ANSWER.

SO I, I JUST, I WANNA CAVEAT MY STATEMENT BY SAYING YOU'RE ASKING BIG QUESTIONS, .

OH YEAH.

WE NEED SEMESTER LEVEL WORK HERE.

I MAY GET PHD THESIS OR RIGHT.

BUT STUDENTS NEED DATA.

SO I THINK IF WE CAN PROVIDE 'EM WITH ACCESS TO DATA, THERE MIGHT BE INTEREST.

AND JUANITA, IS THIS SOME, LIKE, AS THE, AS THE COMMISSION, DO WE APPROACH UT OR AN A CC OF SORTS TO ON OUR OWN INDIVIDUALLY? DO WE NEED TO HAVE WE CAN JUST DO IT.

YOU, YOU CAN DO IT.

OR IF IT'S EASIER TO COORDINATE, THE DEPARTMENT CAN DO THAT.

I'M SORRY, I JUST WANTED YOU TO WALK AROUND MY MICROPHONE.

, UM, THROUGH THE DEPARTMENT, I BELIEVE, UM, UNDER DR.

W'S INTERNSHIP PROGRAM, WE, WE CAN ASSIGN A STUDENT, UM, OF COURSE, THERE'LL HAVE TO BE SOME PARAMETERS.

IT, IT CAN'T BE GRUNT WORK.

IT HAS TO MATCH UP WITH, UM, WHAT WE AGREED TO SUPPORT THEM ON.

BUT THESE DEFINITELY SOUND LIKE PROJECTS THAT SOME OF HER STUDENTS HAVE BEEN UNDERTAKING.

AND IF YOU WOULD LIKE, WE, WE COULD COORDINATE THAT ON YOUR BEHALF, IF THAT'S PLEASE.

WELL, UM, I THINK WE CAN ALSO REACH OUT DIRECTLY.

'CAUSE WE KNOW THAT MM-HMM .

WE DON'T WANNA PUT MORE WORK ON, YOU KNOW, SO I THINK WE CAN TRY TO REACH OUT DIRECTLY TO A FEW AND THEN, UH, ONCE WE HAVE SOME INFORMATION, WE CAN ALSO COME BACK AND SHARE AND COORDINATE TOGETHER.

THE REASON WHY I THINK THE DIRECTOR'S, UM, ADVOCATING FOR GOING THROUGH THE DEPARTMENT, THANK YOU FOR THINKING OF US, UM, IS THAT THERE NEED TO BE DATA USE AGREEMENTS AND THAT SORT OF THING.

SO IF THEY'RE COMING THROUGH THE DEPARTMENT, THEN WE CAN NAVIGATE THAT CONFIDENTIALITY AND HIPAA AND ALL THAT SORT OF THING.

BUT HA, HAPPY TO TAKE THE, YOU KNOW, IF YOU REACH OUT AND YOU GET SOMEBODY, SEND THEM OUR WAY AND WE'LL GET 'EM ALL UP.

DID WE MISS ANYONE ONLINE? I WANNA MAKE SURE WE'RE KEEPING EVERYBODY TAPPED IN.

SINCE, UH, THANK YOU FOR THAT.

I THINK THESE ARE, I, I FEEL LIKE WE HAVE SOME REALLY GREAT ACTION ITEMS TO MOVE FORWARD, UM, AND START TO LAUNCH DIFFERENT PROJECTS INTERNALLY AS THE COMMISSION.

UM, BUT THEN ALSO TAKE IDEAS IN PROJECTS THAT WE HAVE BEEN HAVING SIDE CONVERSATIONS ON, UM, AND START TO MOVE THOSE IN A DIFFERENT, IN, IN, IN A POSITIVE DIRECTION OF ACTION.

UH, ANY FINAL COMMENTS, IDEAS, CONCERNS, UH, RELEVANCE, UM, REGARDING OUR UPDATES AND, UH, OVER THE COMMISSIONER'S COURT, PLEASE.

I WOULD SAY IN YOUR, IN YOUR PLANNING, IF YOU HAVE A CLEAR TIMELINE THAT LINES UP WITH THE CITY'S BUDGET PROCESS.

UM, SO SOME THINGS TO WATCH FOR ARE THE RESULTS OF THE TRE ELECTION ON NOVEMBER 5TH, AND THEN ANY SUBSEQUENT AMENDMENTS THAT ARE MADE TO THE 26TH BUDGET AS ADOPTED.

UM, BECAUSE A LOT OF THAT IS DEPENDENT ON THE TRE PASSING.

AND THEN, UM, THE OUTCOME OF THAT ELECTION WILL DETAIL HOW CRITICAL 27 WILL BE FROM A LOCAL LEVEL.

AND THEN THE OTHER THING THAT, YOU KNOW, I'M WATCHING FOR, AND I WOULD MAKE THE SUGGESTION TO COMMISSIONERS IS THE OUTCOME OF THE FEDERAL BUDGET.

AND BECAUSE THAT IS GOING TO HAVE, UM, A CLEAR EFFECT ON WHAT HAPPENS HERE LOCALLY.

AND IF YOU WORK BACKWARDS FROM, I BELIEVE IT'S MARCH 31ST, WHERE COMMISSIONS HAVE TO AROUND, IT'S SOME SOMEWHERE IN MARCH THAT YOU HAVE TO PUT FORTH YOUR BUDGET RECOMMENDATIONS MM-HMM .

SO WORKING BACKWARDS FROM THERE, WHATEVER PROJECT YOU UNDER UNDERTAKE, UM, BEING READY TO HAVE SOME CLEAR RECOMMENDATIONS FOR THE BUDGET PROCESS

[01:15:02]

DIRECTOR STIR.

UM, I WOULD SAY COMMISSIONERS, AS WE ARE SPENDING THESE NEXT COUPLE OF WEEKS, UH, BETWEEN NOW AND OCTOBER, UH, IF WE CAN COME BACK WITH A PLAN, I CAN HELP WITH THE TIMELINE COORDINATION.

WE CAN PUT IN SOME ACTION ITEMS. UM, YOU ALL KNOW I LOVE LOGIC MODELS, UH, AND STRUCTURE.

SO IF WE CAN , UH, EVEN BUILD THAT OUT AS A LOGIC MODEL PERSPECTIVE, RIGHT? UM, WAYS THAT WE CAN LOOK AT OUR OUTPUTS, WE CAN LOOK AT OUR TIMELINE USING THAT MARCH 31ST, TICK BACKWARDS, UM, WITH THAT.

UH, AND NOW PUT THIS IN OUR FUTURE AGENDA ITEMS TO MAKE SURE WE HAVE A REMINDER FOR THE TRE ELECTION, UM, IN OCTOBER AS WELL.

UH, AS I THINK THAT, IS THAT GONNA BE OUR EXACT DATE OF OUR, IT IS OCTO, UH, OF OUR NOVEMBER.

SO NOVEMBER FIVE IS OUR NEXT UHHUH, SO WE WON'T KNOW.

WELL, WE COULD BY THE END OF THE DAY, RIGHT? WE'LL WAIT TILL DECEMBER.

WE'LL PUT THAT AS A HAIL MARY FULL OF GRACE ON THERE, UM, FOR OUR DECEMBER OR DECEMBER CONVERSATIONS.

UM, AND THEN, UH, WE CAN, JUST TO KEEP OURSELVES HONEST, UM, BY NOVEMBER, HAVE A TIMELINE PUT TOGETHER MM-HMM .

SO THAT WE AREN'T MISSING THAT MARCH 31ST DEADLINE FOR 27, EVEN FOR NEXT YEAR.

I KNOW WE HAVE TWO COMING UP WITH COMMISSIONER DOHA, UH, HIS RECOMMENDATIONS.

UM, AND THEN WHATEVER WE WANT TO PUT IN PLACE, IT'S NOT NECESSARILY A BUDGET RECOMMENDATION, BUT IT IS IN FACT A THING WE NEED TO WORK ON.

OUR WASTEWATER SURVEILLANCE.

UH, LET'S HOLD OURSELVES ACCOUNTABLE BY GETTING THAT READY FOR, UH, PRESENTATION OR ACTIVATION IN NOVEMBER.

UM, I THINK WE HAVE A LOT OF THINGS THAT WE CAN ACTIVELY BE WORKING ON.

AND, UH, WHY, AS I'M SAYING ALL OF THIS, JUANITA, IS THERE A POSSIBILITY TO HAVE THE FOOD PLAN COMMITTEE BOARD PO, UH, WHAT IS IT? FOOD POLICY BOARD.

FOOD POLICY BOARD, UM, PROVIDE AN UPDATE ON HOW THINGS ARE GOING WITH THEIR FOOD PLAN PROCESS? IT'S BEEN A WHILE SINCE WE'VE HEARD FROM THEM.

UM, I THINK THAT WOULD ALSO HELP US IF, IF THEY'RE AVAILABLE IN OCTOBER, WOULD BE BEAUTIFUL.

UH, I THINK THAT WOULD ALSO HELP US WITH OUR TIMELINE.

YES, MA'AM.

UM, IS, IS THERE SOME FLEXIBILITY IF A MEMBER OF THE POLICY BOARD IS NOT AVAILABLE, WOULD YOU TAKE A PROFESSIONAL STAFF FROM THE, OKAY, SO THE BOARD, OR THIS IS A LATENT RESPONSE, BUT FOOD, THE, UH, THE WASTEWATER CONVERSATION, WOULD THAT BE SOMETHING THAT OUR ENVI, LIKE ONE OF OUR ENVIRONMENTAL BOARDS MIGHT ALSO BE LOOKING INTO? UH, MM-HMM .

I KNOW IT'S PRIMARILY LIVES UNDER THE PUBLIC HEALTH ARM, BUT WOULD THAT MAYBE BE SOMETHING THAT OUR, UH, WHAT'S THE ONE WE ACCIDENTALLY JOINED? NO, IT'S, IT'S UNDER US.

IT'S ALL UNDER US.

WE HAVE, WE HAVE PEOPLE THAT ARE WORKING WITH US TO GET THOSE SAMPLES COLLECTED, BUT IT'S ALL MANAGED BY THE DEPARTMENT.

UM, SO DO WE HAVE A PRIORITIZATION OF THE THINGS THAT WE WANT TO ADDRESS? BECAUSE THAT WOULD BE, THERE'S SO MANY THINGS.

OH YEAH, FOR SURE.

UM, I THINK THAT NO DIRECT ANSWER.

NO.

UM, OKAY.

COMMISSIONERS.

SO, OCTOBER, JUANITA, DO WE KNOW WHAT WE HAVE FOR OCTOBER? I'M JUMPING AHEAD AND I KNOW WE'RE GONNA GET UPDATE, ACTUALLY.

NO, THAT'S FINE.

WE'RE ALREADY ON IT.

UM, DO WE ALREADY KNOW WHAT WE HAVE COMING IN OCTOBER? I I DON'T HAVE YOUR FULL BACKUP.

UM, OF WHAT? SO WHAT'S PENDING? UM, I CAN CHECK WITH DANNY WHEN SHE RETURNS.

AND IF, IF THAT IS OUR MOVE, HOW THEN DO WE SHOW UP AND SUPPORT THEM? IF IT, IF IT'S NOT WITH THAT, WHAT ARE THE OTHER WAYS WE'RE GONNA SUPPORT THAT COMMUNITY? BECAUSE THE WORK THEY DO IS STILL VERY IMPORTANT.

ONCE HERE'S, THIS IS, I WILL, SINCE THIS IS ON RECORD, I WILL HOLD MYSELF ACCOUNTABLE TO THESE THINGS.

UH, I WILL CONNECT WITH DANNY ONCE SHE COMES BACK.

UM, COMMISSIONERS, IF YOU ALL CAN, UH, CAPTURE YOUR GREATEST DESIRES OF WHAT WE DO AS ACTION ITEMS NEXT AND HAVE THOSE INTO DANNY

[01:20:01]

WITHIN TWO WEEKS.

UM, THAT'S, THAT'S THE STUDENTS.

IT'S THE REPORTING, IT'S THE, WHATEVER WE'VE HAD THIS CONVERSATION ON, UM, SO THAT WE CAN PRI PUT THOSE INTO AND KIND OF GO BACK LIKE WHAT WE DID BEFORE, WHICH WAS PRIORITIZING OUR CONVERSATIONS.

UH, WE CAN DO A VOTING, UM, THROUGH DANNY SO THAT WE ARE NOT A WALKING QUORUM.

UH, AND THEN WE CAN PUT INTO A REAL STRATEGY WHAT THAT TIMELINE LOOKS LIKE BASED OFF OF THE PRIORITIZATION OF ALL OF OUR TOPICS THAT HAVE BEEN COVERED TODAY AND RECENTLY.

COMMISSIONER WALLACE, DID I SEE YOU WITH A HAND? YEAH, I DID HAVE A HANDOFF.

PLEASE.

UM, I'M TRYING TO FIGURE MY WORDS OUT, BUT THE SUM SYNOPSIS ON IT IS WE, WE HAD A CONVERSATION ON PROBABLY ONE OF THE MOST SIGNIFICANT IN DESTITUTE SITUATIONS THAT ALL THE ENTITIES ARE GOING THROUGH AS WELL AS THE COMMUNITY WHEN IT COMES TO THE FUNDING.

ALTHOUGH IT'S LIKE COVID, IT'S NOT LIKE COVID BECAUSE COVID, THERE WAS FUNDING COMING TO IT WAS JUST TRYING TO GET ACCESS TO WHERE HERE WE'RE TALKING ABOUT FUNDING GOING AWAY, WHICH THEN ALSO MEANS NO ACCESS TO, AND I MEAN, I GET IT.

FOOD PLAN, I GET IT.

WATER STUFF.

BUT, YOU KNOW, I, I DON'T EVEN HAVE A GRASP OF, AS DR.

UH, DIRECTOR STR STATED, ONE PUSHBACK IS ALWAYS GONNA HAPPEN BECAUSE THE AGENCIES RECEIVE TAX DOLLARS THAT NONPROFITS DON'T RECEIVE.

SO COLLABORATION AND COORDINATION AND SO FORTH IS GONNA ALWAYS BE PROBLEMATIC BECAUSE THAT IS ALWAYS GONNA BE SOMETHING THAT'S ON THE TABLE.

THE SECOND PIECE IS THEN BASED OFF OF THE TAX DOLLARS THEY RECEIVE AND THE STATE AND FEDERAL, UH, AUTHORITIES THAT CREATED THE DEPARTMENTS AND SO FORTH AS DIRECTOR STR STATED, EXACTLY WHAT ARE THEY REQUIRED TO DO, OBLIGATED TO DO.

I DON'T THINK THEY EVEN HAVE THAT UNDERSTANDING ACROSS ALL THE DIFFERENT AGENCIES, UH, TO THEN SAY, HOW MANY PEOPLE DO THEY NEED TO BE ABLE TO PROVIDE THAT SERVICE ADEQUATELY AND WITH QUALITY, UH, BASED UPON THEIR OBLIGATIONS OF RECEIVING TAX DOLLARS AND WHATEVER FEDERAL DOLLARS THEY'RE GONNA RECEIVE TO PROVIDE THAT IN THE COMMUNITY.

WHEN A NONPROFIT OR ANY OTHER AGENCY CAN SAY, WELL, THAT'S NOT MY JOB TO DO.

AND THEN FROM THERE, I THINK THAT ALLOWS US TO THEN BE ABLE TO SAY, BASED OFF OF WHAT IS MANDATED THAT NOBODY ELSE HAS THE OBLIGATION TO BE ABLE TO DO, OR REQUIREMENT TO DO, AND BASED OFF OF POPULATION AND QUALITY AND SO FORTH, THIS AMOUNT OF INDIVIDUALS ARE NEEDED PER SERVICE, PER PROGRAM, PER EXECUTION, THEN THIS IS THE MINIMAL, MINIMAL VIABILITY THAT IS NEEDED BUDGET-WISE TO BE ABLE TO EXECUTE TO THE MANDATE OF THAT AGENCY OR DEPARTMENT.

I, I, I, I THINK YOU SAID IN A, IN A PROBABLY A BETTER WAY, WHAT I WAS THINKING OF ASKING THIS BODY, AND I WAS JUST GONNA ASK THE CHAIR PRIVATELY, BUT HERE WE ARE WITH THE MIC ON, ARE WE PRIORITIZING PUBLIC HEALTH? ARE WE PROVI, ARE WE TRYING TO PRIORITIZE HUMAN SERVICES? 'CAUSE THERE'S A, THERE'S A DISTINCT DIFFERENCE.

AND I THINK SOME OF WHAT, UH, COMMISSIONER WALLACE SAID LINES UP WITH THAT QUESTION IN MY MIND.

UM, AT THE CITY, WE, THE TWO ARE INTERCHANGEABLE AND IT'S NOT ALWAYS SO, AND SO I WAS CURIOUS, I WAS GONNA WAIT TO SEE DURING WHAT THIS BODY IS GOING TO PRIORITIZE.

UM, WILL IT BE CORE PUBLIC HEALTH SERVICES, THE THINGS THAT ARE DIRECTLY RELATED TO DISEASE PREVENTION AND, AND, AND CONTROL, OR WILL IT BE THAT BROADER SCOPE LIKE FOOD PLANS AND, AND AND SUCH? AND, YOU KNOW, Y'ALL DON'T HAVE TO ANSWER TODAY, BUT I THINK THE, THERE, THERE'S A, YEAH, IT, IT'LL BE A HARD DECISION THAT YOU'LL HAVE TO MAKE BECAUSE THE DOLLARS ARE FEW.

AND AS COMMISSIONER WALLACE SAID, THERE ARE SOME THINGS THAT HAVE TO BE DONE, SOME THINGS THAT WILL NOT BE COMPLETED BY ANOTHER AGENCY BECAUSE IT'S, IT'S NOT THEIR JOB.

THEY DON'T GET TAX DOLLARS TO DO THAT.

AND IT WOULD BE WRONG OF US TO PUSH THAT BURDEN OFF ON THEM.

AND SO IF, IF THAT'S OUR STANCE, DOES THAT MEAN THEN THAT OUR NONPROFIT PARTNERS ARE LEFT OUT IN THE COLD WITH WHATEVER PLANNING OR ADVOCACY WE PUT FORWARD?

[01:25:02]

IT'S PART OF THAT WHOLE SAFETY NET THAT, THAT ECOSYSTEM THAT KEEPS US ALL SAFE AND HEALTHY.

AND I THINK THE RESEARCH THAT THE, SOME OF THE STUDENTS DO COULD HELP US INFORM, MAKE SOME INFORMED DECISIONS ABOUT WHERE WE, WE HAVE TO PRIORITIZE.

WE HAVEN'T BEEN HERE BEFORE.

THEN WE DON'T WANNA START CREATING CONVERSATIONS.

MY, MY, MY GUTTURAL RESPONSE TO THAT IS, UH, I WOULD LOVE TO SEE WHAT THE DATA, I MEAN, I FEEL LIKE WE'RE, WE ARE MAKING A LOT OF UNINFORMED DECISIONS AT THIS POINT OF WHAT DIRECTION WE CAN GO.

UH, WE'RE PASSIONATE ABOUT PUBLIC HEALTH.

I THINK THAT'S WHY WE'RE ALL HERE.

UM, WE'RE ALSO UNDERSTANDING THAT PUBLIC HEALTH IS NOW BECOMING THIS, I DON'T KNOW, TOXIC SPACE, SO TO SPEAK, FOR THOSE THAT ARE IN IT AND THOSE THAT ARE TRYING TO SUPPORT IT.

AND I'M CU I AM VERY CURIOUS AS THE, UH, INDIVIDUAL THAT I AM OF HOW WE CAN DISRUPT THAT IN A POSITIVE WAY.

WHERE YES, WE KNOW THAT THERE ARE THINGS THAT MUST BE ADDRESSED UNDER THE UMBRELLA OF PUBLIC HEALTH, BUT WE ALSO, IF WE UNDERSTAND PUBLIC HEALTH, WHICH I DO BELIEVE WE DO, IS THAT THAT PUBLIC HEALTH UMBRELLA IS VAST.

UM, AND MY REACTION IS, THERE ARE WAYS THAT I BELIEVE OUR COMMUNITY PARTNERS CAN SHIFT THAT ENTITIES CANNOT, FROM A FUNDING PERSPECTIVE, FROM A A DIRECTION, UH, PERSPECTIVE, FROM A LANGUAGE PERSPECTIVE.

UM, I DO BELIEVE THAT THERE ARE ORGANIZATIONS THAT CAN SAY, THIS IS WHAT WE DO, HOWEVER, WE CAN ALSO DO THIS.

A PH CAN'T DO THAT.

AND SO THE, MY HOPE WITH US CAPTURING BETTER DATA TO DRIVE WHAT WORK WE'RE DOING IS THAT WE CAN SAY, THIS IS A MUST FOR A PH.

THIS HAS TO BE DONE BY A PH.

SO HOW DO WE AS A COMMISSION SUPPORT THAT? WHAT DOES THAT MEAN? IS IT A LOCAL ORDINANCE THAT WE'RE PUT TRYING TO PUT INTO PLACE? IS IT A RECOMMENDATION THAT WE'RE PUTTING INTO PLACE? IS IT, IS IT DIRECTLY CONNECTED IS TO THE BUDGET AND MOVING FROM ONE POINT WHATEVER PERCENT TO 3%? 'CAUSE THAT IS A MASSIVE BUDGET SHIFT, BUT THAT MUST BE DONE IF WE'RE GONNA SAY IT BY JA BY MARCH 31ST FOR ANOTHER YEAR.

SO NOW WHAT DO WE DO IN THAT YEAR WHEN WE'RE WAITING FOR THAT RESPONSE OF, IS THIS APPROVED OR NOT? SO I THINK THAT THERE ARE THINGS THAT WE MUST DO IN THE MEANTIME IN ORDER TO HOLD OUR BREATH FOR THE BIGGER CONVERSATIONS WITH MONEY, WITH BUDGET, WITH ALLOCATION OF RESOURCES.

AND THAT'S MY TANGENT.

PLEASE CONTINUE.

I'M GONNA TURN MY MICROPHONE ON AND SAY SOMETHING I MIGHT REGRET.

SO FORGIVE ME FOR THAT.

UM, CENTRAL HEALTH HAS $700 MILLION IN, IN SOME FUND THAT'S MEANT TO BE ANTICIPATING A BUNCH OF THINGS, WHICH I'M NOT SURE I CAN EVEN SPEAK TO OR KNOW.

EXACTLY.

GOD BLESS PAT LEE AND, AND, UM, AND HIS TEAM.

UM, I WONDER IF THERE'S, WHATEVER THOSE PLANS MIGHT BE, IF THERE'S A MOMENT IN TIME WHEN YOU SAY THAT'S ACTUALLY HELD IN ABEYANCE FOR, YOU KNOW, AGAIN, A, A PLAN, A BUILD, AN INFRASTRUCTURE, A DELIVERY SYSTEM, WHATEVER THOSE THINGS ARE.

AND MAYBE THAT SHOULD BE SOMETHING THAT WE THINK ABOUT AS A COMMUNITY THAT GETS DELAYED TWO YEARS AND WE SAY, LET'S USE SOME OF THAT FUNDING TO ADDRESS THESE HUMAN AND PUBLIC HEALTH NEEDS THAT ARE CLEARLY IN THE TENS OF MILLIONS OF DOLLARS BEING, YOU KNOW, UM, CONTRACTED HERE LOCALLY CHAIR.

I, I, I THINK THAT GOES BACK TO A PREVIOUS COMMENT THAT I HAD AND, AND, AND COMMISSIONER RICE, I THINK YOU'RE RIGHT.

BUT I ALSO WOULD SAY IF, IF COMMUNITY CARE SENDERO AND THE OTHER ENTITIES IN THE ENTERPRISE OF CENTRAL HEALTH TAKE SIGNIFICANT HITS AND THEY STILL HAVE CERTAIN OBLIGATIONS THAT THEY HAVE TO PROVIDE, THAT FUNDING IS GONNA GET EXHAUSTED BY CENTRAL HEALTH'S RESERVES.

AND THAT'S WHAT I'M SAYING.

IF WE DON'T KNOW WHAT THEY CAN AND CAN'T DO WHAT THEY HAVE TO DO,

[01:30:01]

WE NEED TO START PREEMPTING DISCUSSIONS AND, AND, AND, AND WHAT THE RIPPLE EFFECT IS GOING TO BE TO THE COMMUNITY AND TO ORGANIZATIONS THAT ARE CURRENTLY RELYING ON OUR STATE, UH, OUR AGENCIES TO, TO BE ABLE TO GAP FILL RIGHT NOW.

AND THEY'RE ONLY ABLE TO GAP FILL RIGHT NOW BECAUSE THE FEDERAL SITUATION HASN'T HIT.

RIGHT.

THEY'RE STILL SEEING WHAT'S GONNA HAPPEN.

BUT ONCE THAT FEDERAL SITUATION BECOMES NEGATIVE AND, AND MONEY'S LOST, THEN ALL THE SERVICE AGREEMENTS, ALL THE CONTRACT AGREEMENTS THAT ARE HAPPENING BY, UH, BY THESE AGENCIES, THEY NOW HAVE TO SWITCH THAT FUNDING TO WHAT THEY ACTUALLY HAVE TO DO.

I JUST WANNA INTERJECT HERE.

LET'S BE VERY CLEAR THAT THERE'S CLINICAL MEDICINE AND THERE'S PUBLIC HEALTH AND THERE'S HUMAN SERVICES AND PUBLIC HEALTH STANDS IN THE GAP BETWEEN HEALTH AND DISEASE.

SO LET'S BE VERY CLEAR ON THAT.

AND WE ARE NOT RECEIVING THE FUNDING THAT WE NEED TO MAINTAIN THE HEALTH OF THE POPULATION AND THE DISEASE SURVEILLANCE AND THE RESTAURANT INSPECTIONS AND THE THIS AND THE THAT AND THE OTHER THAT WE DO TO KEEP PEOPLE HEALTHY.

SO LET'S BE VERY CLEAR ON THAT AND I'LL ADD, THANK YOU.

UM, CENTRAL HEALTH ALSO HAS A PRESCRIBED STATUTORY LIMITATIONS OF WHAT YOU CAN FUND OR NOT, YOU KNOW, MEDICAL SERVICES.

UM, I THINK WE HAVE HAD CONVERSATIONS WITH AUSTIN PUBLIC HEALTH, UM, REGARDING THEIR FUNDING, UM, CUTS.

AND I THINK THERE HAVE BEEN SOME DISCUSSIONS ABOUT WHAT CAN POTENTIALLY BE FUNDED WITHIN THE CONFINES OF STATUTE.

UM, I WILL SAY ALSO THAT OTHER, WE RECOGNIZE AND HAVE BEEN APPROACHED BY OTHER PARTNERS IN THE COMMUNITY AND WE'VE HAD SIMILAR CONVERSATIONS AND OUR BOARD HAS BEEN VERY, UM, WILLING TO BE OPEN AGAIN, AS LONG AS IT FITS IN THOSE STATUTORY PARAMETERS.

UH, WE, WE DO HAVE, UM, I THINK AS THERE IS NO SAFETY NET TO THE SAFETY NET .

AND SO I, YOU KNOW, WE DO HAVE TO BE CONSERVATIVE.

UM, AND WE DO, WE HAVE FORTUNATELY BUILT UP A CONTINGENCY RESERVE, UM, UM, FOR OUR, YOU KNOW, PART OF THAT WAS TO FUND OUR SEVEN YEAR STRATEGIC DELIVERY PLAN, OF WHICH NEXT YEAR I THINK WILL BE YEAR THREE.

NOW, SOME OF THE GUIDANCE WE'VE RECEIVED FROM OUR BOARD BECAUSE OF THESE, UH, PARTNER, UM, BECAUSE OF WHAT'S HAPPENING, YOU KNOW, UM, IN THIS CURRENT ENVIRONMENT WITH FEDERAL FUNDING CUTS AND POLICY SHIFTS, OUR BOARD, UM, WE'RE, WE'RE TAKING MEASURES, UM, AND HAVING LOTS OF CONVERSATIONS.

WE'VE BEEN DIRECTED TO, I DON'T WANNA SAY PAUSE, BUT TO, UM, MAYBE HOLD BACK A LITTLE BIT AND WORK ON OPTIMIZING CURRENT WHAT WE CURRENTLY HAVE DONE AND TO, AND WE'RE LOOKING AT WAYS, UM, TO, TO BE PREPARED FOR WHAT, FOR THE RISKS THAT WE EXPECT WILL COME AND THERE WILL BE SIGNIFICANT RISKS TO OUR, OUR TO OTHER SYSTEM PARTNERS, COMMUNITY CARE.

UM, AND I THINK WE'RE ALSO, UM, WAITING TO SEE WHAT HAPPENS AT THE FEDERAL LEVEL WITH A CA POLICY CHANGES AND SEE WHAT WHAT WILL BE THAT IMPACT TO SENDERO HEALTH PLANS AND NOT JUST TO SENDERO HEALTH PLANS, BUT I THINK, UM, I THINK THERE'S GONNA BE OTHER A CA PLANS ALSO IMPACTED, UM, THAT DON'T HAVE THE BENEFIT OF THE CENTRAL HEALTH.

UM, SO I'LL, I'LL, UM, I I'LL LEAVE IT AT THAT AND I'M HAPPY TO SHARE THE PRESENTATION TO OUR BOARD LAST WEEK.

FIRST OF ALL, THANK YOU.

LEMME JUST RESPOND JUST 'CAUSE I DIDN'T MEAN TO JUMP WAY OUT ON THE CLIFF THERE.

YES.

BUT APPRECIATE SO MUCH THAT STATUTORILY THAT YOUR CONSTRAINTS TO BEGIN WITH.

SO SOME OF WHAT I WAS ALMOST PEJORATIVELY SAYING IS, UM, IT'S NOT INTENDED TO BE THAT.

AND I APPRECIATE THAT THERE'S, UM, ALL THAT GOOD THINKING IN ADDITION TO THE STATUTORY CONSTRAINTS THAT, THAT, YOU

[01:35:01]

KNOW, ARE PART OF THE CONVERSATION.

BUT I, I, I WONDER IF WE GET TO THE POINT WHERE WE, WE EVEN HAVE TO EXAMINE THAT AND, AND, AND, AND WHAT THAT MEANS FULLY AND WHERE THERE AREAS OF, OF OVERLAP AND, AND, AND FLEXIBILITY.

RIGHT.

UM, AND THAT'S PART OF THE CHALLENGE I HAVE FOR MYSELF.

LIKE, I, EVERY TIME I SAY, NOPE, A PH NOPE, CAN'T DO IT.

AND I'M LIKE, NO.

WELL, LET ME THINK.

WE'RE IN A DIFFERENT ENVIRONMENT, ADRIAN.

AND, UM, YOU KNOW, MY, MY CHALLENGE WOULD BE TO ALL OF THE LEADERS IN SPACES, HOSPITALS, CLINICS, CENTRAL HEALTH NONPROFITS, TO REALLY BREAK OUTSIDE OF THE BOX THAT WE'VE BUILT FOR OURSELVES BECAUSE THAT FRAMEWORK IS CRUMBLING AND IT'S NOT GOING TO EXIST IN ONE WAY OR ANOTHER.

WE'RE GOING TO BE DOING SOMETHING DIFFERENT.

SO WE COULD WAIT TILL IT HITS THE FAN AND BE REACTIVE, OR WE COULD BE PROACTIVE AND THINK ABOUT HOW WE MAKE AGREEMENTS HERE LOCALLY.

UM, AGAIN, AND I, AND I'VE BEEN SAYING THAT THERE'S A LOT OF EMPHASIS ON FEDERAL AND STATE ADVOCACY, BUT THERE'S, THERE'S A LOT OF A CONTROL HERE LOCALLY THAT WE COULD EXERCISE THAT I DON'T KNOW IF WE FULLY HAVE AND TO, TO HAVE THOSE CONVERSATIONS.

CHARITY STARTS AT HOME.

LIKE, WHAT ARE THE WAYS WE CAN STRETCH OURSELVES TO, TO, TO MINIMIZE THE IMPACTS FOR OUR COMMUNITIES IN WAYS THAT MAKE US FEEL COMFORTABLE BEFORE IT'S KIND OF LIKE, MAN, WE GOTTA DO IT THIS WAY BECAUSE WE MISSED THAT WINDOW TO PROACTIVELY PLAN.

THAT KIND OF MAKES SENSE.

LET ME JUST ADD TO GO BACK ON THE LEDGE THAT, YOU KNOW, THAT WHICH IS STATUTORILY CONSTRAINED NOW IS BUT ONE ELECTION AWAY FROM NOT BEING.

SO YEAH, THAT'S MY PROVOCATIVE COMMENT FOR THE DAY.

AND I AGREE WITH THINKING OUTSIDE THE BOX AND GREATER COLLABORATION, AND I AM SEEING MORE OF THAT.

AND I WOULD JUST POINT TO, AS AN EXAMPLE, WHAT'S HAPPENING IN THE HOMELESS SPACE SERVICES FOR PEOPLE EXPERIENCING HOMELESSNESS? YEAH.

SO AS YOU'RE DELIBERATING ON WHAT'S IMPORTANT, MAYBE THAT'S THE, THAT'S SOMETHING TO THINK ABOUT BECAUSE THE, THE IMPORT OF UNDERSTANDING THAT WE NEED TO DO IT DIFFERENTLY AND MONEY IS THE ROOT OF ALL.

TO DISCUSSION ITEM NUMBER FIVE, WHICH IS TO RECEIVE UPDATES FROM COMMISSIONERS ON ASSIGN ACTION ITEMS. IF THERE ARE ANY UPDATES, LOVE TO HEAR THEM.

IT, IT ALSO IS, UM, OH, MAY I BE RECOGNIZED CHAIR .

IT ALSO IS AN INDICATION OF OUR MORAL COMPASS, RIGHT? WHERE WE INVEST.

UM, AND IT'S AN INDICATION OF THE THINGS THAT WE THINK ARE IMPORTANT.

ONE SMALL EXAMPLE, UM, ONE OF OUR FUNDERS WHO SHALL REMAIN NAMELESS OR NAMELESS AT THE FEDERAL LEVEL USING A TACTIC, UM, TRIED TO LIMIT, UM, THE USE OF THEIR FUNDS TO SUPPORT STAFF GOING TO A CONFERENCE THAT IS FOCUSED ON, UM, HIV AND AIDS IN BLACK AND BROWN COMMUNITIES.

AND SO, BECAUSE A LOT OF THE OTHER SISTER ORGANIZATIONS RELY ON THAT GRANT FUNDING, THEY COULDN'T SEND THEIR PEOPLE TO THE CONFERENCE.

AND THERE WAS CLEARLY A MOVE TO UNDERCUT THE CONFERENCE AND, YOU KNOW, HAVE IT KIND OF FALL OFF.

I SAID, WE GOING, WE GONNA FIND SOME OTHER MONEY AND WE'RE GONNA SEND THE SAME PEOPLE.

BECAUSE IF WE, IF WE TAKE OUR DOLLARS AWAY, WE'RE INDICATING THAT IT'S NOT IMPORTANT TO US, IT'S NOT WORTH THE SACRIFICE.

SO NOTHING WITHOUT SACRIFICE IS TRULY IMPORTANT.

WHAT AM I WILLING TO GIVE UP? AND THOSE ARE THE CONVERSATIONS THAT I'M PUSHING OUR TEAM TO HAVE EVERY DAY.

WHAT ARE THE THINGS THAT WE'RE WILLING TO GIVE UP BECAUSE WE BELIEVE THIS THING OVER HERE IS IMPORTANT.

AND I'M HOPEFUL AS A COMMISSION, YOU GUYS WILL COME TO THE CONCLUSION OF WHAT ARE THE THINGS THAT YOU FEEL ARE IMPORTANT AND THAT YOU'RE WILLING TO SACRIFICE FOR AND ENCOURAGE OTHER PEOPLE TO DO THE SAME.

THANK YOU FOR THAT SERMON.

UM, I THINK THAT WE CAN USE IT TO BE ACTIVATED.

WE'LL PASS AROUND THE OFFERING BASKET, UH, TO KEEP THE DOORS OPEN.

UM, BEFORE WE MOVE TO OUR FINAL DISCUSSION ITEM, ANYTHING ELSE? ALL RIGHT.

I KNOW WE ARE RUNNING TO OUR, TO THE END OF OUR TIME.

UH, WE ARE MOVING ON

[5. Receive updates from commissioners on assigned action items. ]

HOPEFULLY THERE ARE, UH, I JUST STILL CONTINUE TO WORK ON THE IDEA OF WHAT THE TAX AND OR THE,

[01:40:01]

WHAT IS IT CALLED? THE CAPTAIN STITCH.

THE TAX AND STITCH , UH, STILL WORKING ON THAT.

AND THEN ALSO LAST WEEK I JOINED, OR I ATTENDED THE JOINT SUSTAINABILITY COMMITTEE ON BEHALF.

UM, NOTHING REALLY TO REPORT OUT ON THAT.

I'LL JUST BRIEFLY MENTION, I CAN'T REMEMBER THE NAME OF MY COMMITTEE, BUT, UM, I THINK, WHAT IS IT? I DON'T REMEMBER.

YEAH, EXACTLY.

UM, BUT WHAT I, WHAT I'VE BEEN SORT OF ENDEAVORING TO DO MORE OR LESS THROUGH THE AUSTIN HEALTHCARE COUNCIL, WHICH I'M A PART OF, IS TO THINK ABOUT, UM, AN AGENDA OF ITEMS THAT WE MIGHT BRING AND DISCUSS AND THINK ABOUT AS IT RELATES TO PUBLIC HEALTH.

SO THAT'S PRETTY BROAD, BUT WE'RE, WE'RE MOVING DOWN THAT TRACK AND HAVE SOME INTEREST IN, IN THE CONVERSATION GOING.

AND, UM, ONE OF THE THINGS THAT CAME OUT OF THAT WAS SOMETHING THAT I THOUGHT MAYBE INTERESTING AND MAYBE NOT, BUT YOU KNOW, AND THIS IS NOT NEW, BUT YOU KNOW, WE, WE FRAME THE, UM, PUBLIC HEALTH CONVERSATION IN A CERTAIN WAY.

WE HAVE FOOD INSECURITY, WE HAVE HOMELESSNESS, WE HAVE ACCESS, WE HAVE ALL THESE DIFFERENT THINGS, OF COURSE.

YOU KNOW, AND, AND, UM, SOMEONE BROUGHT UP THE IDEA OF, OF LIKE TURNING THE TURN, TURN THE TABLES A LITTLE BIT AND ASKING, AGAIN, THIS IS NOT NEW, BUT FRAME IT UP IN THE TERMS OF LONGEVITY AND LONGEVITY SCIENCE AND SORT OF OVERLAP IT WITH MAYBE RESEARCH THAT'S BEING DONE AT THE UNIVERSITY AND OTHERS.

AND I DON'T WANNA DIGRESS TOO FAR HERE, BUT I THOUGHT IT WAS AN INTERESTING WAY TO TURN IT ALL AROUND AND WONDER AND THINK ABOUT LONGEVITY AS THE PREMISE OF, OF A CONVERSATION OR IF AS A CONSTRUCT FOR THINGS AND ACTIONS.

AND, AND THEN MAYBE THAT'S ALREADY SORT OF INHERENT IN THE WHOLE CONVERSATION ANYWAY.

BUT THERE'S AN INTEREST IN THAT IN DEVELOPING SORT OF, UM, A KNOWLEDGE BASE IN AUSTIN AND LONGEVITY SCIENCE, AND THERE'S A LOT OF, UM, YOU KNOW, UM, OPPORTUNITY FOR ESTABLISHING ACADEMIC EXCELLENCE IN THIS ARENA.

SO TRYING TO OVERLAP THAT WITH PUBLIC HEALTH SEEMED LIKE A MIXTURE I HADN'T SEEN SO MUCH.

AND SO THAT'S PART OF THE CONVERSATION, SORT ABOUT 10% OF THE CONVERSATION OF SOMETHING THAT'S GELLING.

AND SO MY PROMISE IS THAT I'LL HAVE SOMETHING MORE FORMED CERTAINLY IN NOVEMBER, BUT MAYBE IN OC IN, IN OCTOBER, JUST TO SORT OF LAY OUT, HERE'S 10 THINGS WE'RE THINKING ABOUT OR WHATEVER IT WOULD ALL TURN IN TO BE JUST FOR US TO THINK ABOUT AND SEE IF THAT CONVERSATION, YOU KNOW, HAS LEGS AND CAN GO OTHER PLACES IN THE COMMUNITY AND MAYBE WITH US SORT OF, UM, YOU KNOW, ENERGIZING OR BEING INTERESTED IN SOME OF IT OR ALL THAT ARE, OR, OR MAYBE ANOTHER, YOU KNOW.

SO THAT'S MY UPDATE.

ANY OTHER UPDATES FROM OUR FRIENDS ONLINE? NO, THE UPDATE, YOU ASKED HER YOUR EMAIL EARLIER.

ON TO OUR FUTURE AGENDA ITEMS. UH, I KNOW THAT WE HAVE A FEW PRESENTATIONS THAT WE ALREADY HAD PLANNED TO MOVE TO OCTOBER.

WITH, UH, THE FOLKS FROM UT.

SO THAT IS MY UPDATE IS THAT YOU PROVIDED THE NEXT STEP THERE.

SO, AND APOLOGIES FOR THAT DELAY.

UH, COMMISSIONER DOL, HASSEN, UH, AND COMMISSIONER WHITTY.

I KNOW I, WE WILL BE MEETING NEXT WEEK THIS WEEK, SO WE WILL HAVE BETTER UPDATES FOR OCTOBER.

UM, WONDERFUL.

LET'S MOVE

[FUTURE AGENDA ITEMS]

UM, ANY ITEMS THAT WE HAVE DISCUSSED THAT HAVE NOT MADE IT TO THE AGENDA IN OUR, FROM OUR PAST CONVERSATIONS? OKAY.

SO THEN I WILL SAY, UH, FOR OUR, OUR INTERNAL UPDATES, UM, GETTING THOSE ITEMS OVER TO DANNY SO THAT WE CAN MAKE SURE THAT WE ARE NOT ONLY PRIORITIZING WHAT WE WORK ON, BUT SPECIFICALLY FOCUSING ON PUBLIC HEALTH AND, UH, THE STRUCTURE OF IT AS A WHOLE.

UM, AND IF ANYTHING COMES UP, PLEASE MESSAGE DANNY AND JUANITA.

I WILL GO AHEAD AND OFFICIALLY CALL THIS MEETING ADJOURNED AT 4:20 PM OH, PLEASE.

I'M SO SORRY.

CONTINUE.

YES, I'M SORRY.

UM, JUST WANTED TO LET YOU KNOW THAT WE HAVE, UM, MADE A DECISION OR THE OFFICIALS HAVE MADE A DECISION ABOUT YOUR VACANCY.

SURE.

AND SO THAT ITEM WILL BE, UM, ON THE NOVEMBER, UH, NOT NOVEMBER, OCTOBER 9TH AGENDA, AND HOPEFULLY ON THE TRAVIS COUNTY'S AGENDA AS SOON AS, SO WE'RE TRYING TO COLLABORATE TO GET THEM ON, UM, AN APPROVED AS SOON AS POSSIBLE.

SO YOU'LL HAVE YOUR NINTH MEMBER, HOPEFULLY BY NO NOVEMBER MEETING AND CAN GO AHEAD.

CAN WE PROVIDE THEM LIKE THE RESUME WITH THE YEAH.

IDENTIFIED, OH, ARE WE ALLOWED TO PROVIDE THEM THE RESUME OF THE IDENTIFIED CANDIDATE BEFORE THEY, UH, THE RATIFICATION? THIS IS THE FIRST TIME WE'VE, WE FILLED THE SEAT, RIGHT? YEAH.

THIS IS THE FIRST TIME WE FILLED THE SEAT.

I CAN CONFIRM THAT, UM, WITH, UM, THE CLERK'S OFFICE, AND IF IT'S ALLOWABLE, WE'LL SHARE THAT WITH YOU SO YOU'LL HAVE AN IDEA OF THE PERSON THAT IS GONNA BE JOINING YOUR BOARD.

UM, HOPEFULLY

[01:45:01]

NOVEMBER.

PLEASE, CAN YOU CLARIFY WHAT'S THE MEETING DATE IN OCTOBER? I HAVE THE FIRST, BUT I HEARD YOU SAY 10TH.

I THOUGHT I I THOUGHT SHE SAID NINTH.

YOU'RE RIGHT.

SHE DID.

THE, THE ITEM WILL GO ON, ON CITY COUNCIL'S AGENDA FOR APPROVAL.

OCTOBER 9TH.

THAT'S THE NEXT CITY COUNCIL AGENDA.

IT WILL BE YOUR NOVEMBER MEETING THAT THAT PERSON WILL BE PRESENTED TO THE BOARD.

AND THEN WHEN, FOR, FOR FUTURE, FOR THOSE OF US THAT ARE ROLLING OFF IN APRIL OF 26, DO WE, I'M SORRY.

WAIT, WHAT? SAY THAT AGAIN.

UM, THERE'S, THERE, THERE'S MORE OF YOU LEAVING IN 27, NOT 26.

I'LL CONFIRM.

I THINK IT'S ONLY FOUR OF YOU.

BUT I LOOKED AT THAT TODAY AND I WAS LIKE, OH, I'VE GOT THEM FOR A WHOLE NOTHER TWO YEARS.

SO WAIT, ? YES, MA'AM.

, WE'RE NOT DONE IN APRIL.

THREE YEARS IN.

LOOK HOW THEY'RE ALL, I KNOW , I'M JUST TELLING YOU WHAT, WE HAD THIS CONVERSATION EARLIER THIS YEAR.

I THINK THE FIRST TWO DIDN'T COUNT AND THEN THAT IT'S, IT, IT WAS STAGGERED.

I THINK IT WAS THREE AND FOUR.

SO ONE PLUS THREE.

THREE.

AND THEN SHOULD BE THIS, THIS IS TWO.

SO TWO MORE WOULD BE, SO WE'RE AT 2030 IS WHAT I'M HEARING.

I, YOU'RE FOREVER BOUND TO THIS BOARD.

WELL, UM, THANK YOU FOR THAT UPDATE.

JUANITA, DIRECTOR, DOCTOR, DOCTOR, UH, I WILL OFFICIALLY CALL THIS MEETING ADJOURNED AT 4:23 PM TODAY.

THANK YOU SO MUCH EVERYONE.