* This transcript was created by voice-to-text technology. The transcript has not been edited for errors or omissions, it is for reference only and is not the official minutes of the meeting. [CALL TO ORDER] [00:00:03] HELLO. HELLO AND WELCOME TO THE AUSTIN TRAVIS COUNTY PUBLIC HEALTH COMMISSION REGULAR MEETING OF NOVEMBER 5TH. I'D LIKE TO GO AHEAD AND CALL THIS MEETING TO ORDER AT 2:35 PM UH, DO WE HAVE ANY PUBLIC ANNOUNCEMENT? OKAY, GREAT. OKAY, WONDERFUL. UH, LET'S GO AHEAD [APPROVAL OF MINUTES] AND JUMP INTO OUR AGENDA. FIRST ITEM ON OUR AGENDA TODAY IS APPROVAL OF THE MINUTES FROM THE PUBLIC HEALTH COMMISSION REGULAR MEETING ON OCTOBER 1ST, 2025. DO WE HAVE A MOTION TO MOVE APPROVING THE MINUTES? I MOVE. I SECOND. THANK YOU. ANY QUESTIONS TO THE MOTION? OKAY. UH, ALL IN FAVOR? AYE. YOUR HANDS? WONDERFUL. SO MOVED ON APPROVING THE MINUTES. I KNOW WE HAVE A PACKED HOUSE OF DISCUSSIONS TODAY. SO, UH, MOVING ON [2. Introduction of Austin Travis County Community Health Assessment & Improvement Plan (CHA/CHIP) partners by Kodjo Dodo, Program Manager, with Austin Public Health.] TO DISCUSSION ITEM ONE, WHICH IS THE INTRODUCTION OF THE AUSTIN TRAVIS COUNTY PUBLIC, OR, I'M SORRY, COMMUNITY HEALTH ASSESSMENT AND IMPROVEMENT PLAN, ALSO KNOWN AS THE CHA CHIP, UH, BY OUR PARTNERS, DR. UH, KOJO DODO, PROGRAM MANAGER OF AUSTIN PUBLIC HEALTH. WELCOME. SO GOOD AFTERNOON COMMISSIONERS AND EX OFFICIALS. THANK YOU FOR THE OPPORTUNITY TO SPEAK TODAY. I WOULD LIKE TO EXTEND A SPECIAL THANKS TO THE CHAIR FOR ALLOWING AUSTIN PUBLIC HEALTH, TRAVIS COUNTY HEALTH AND HUMAN SERVICES, AND OUR COMMUNITY HEALTH PLAN PARTNERS TO PRESENT THE LATEST FINDING FROM OUR COMMUNITY HEALTH NEED ASSESSMENT. , THIS AFTERNOON YOU WILL HEAR FIVE PRESENTATIONS. EACH WILL WALK YOU THROUGH THE ASSESSMENT METHOD, USED KEY FINDINGS, AND THE NEXT STEPS WE ARE TAKING WHILE AUSTIN PUBLIC HEALTH LEAD THE COMMUNITY HEALTH PLAN. THIS WORK IS A SHARED EFFORT. WE STAND BEFORE YOU TODAY AS ONE TEAM UNITED BY COMMON GOAL, WHICH IS IMPROVING THE HEALTH AND WELLBEING OF EVERYONE IN AUSTIN AND TRAVIS COUNTY. OUR PRESENTERS TODAY REPRESENT A BROAD COALITION FROM NO-PROFIT HOSPITAL, CENTRAL TEXAS FOOD BANK, AND BOTH CITIES AND COUNTY HEALTH DEPARTMENT UNDER THE AFFORDABLE CARE ACT. AND I RISK CODE SECTION 5 0 1 R THREE NO-PROFIT HOSPITALS MISCONDUCT, H AND I EVERY THREE YEARS TO MAINTAIN THE TASK EXAM STATUS. SIMILARLY, LOCAL HEALTH DEPARTMENT ARE REQUIRED TO COMPLETE A COMMUNITY HEALTH ASSESSMENT CHART TO MEET PUBLIC HEALTH ACCREDITATION BOARD STANDARD. THIS ASSESSMENT ENSURE TRANSPARENCY, ACCOUNTABILITY, AND PUBLIC ACCESS TO HEALTH DATA AND PRIORITIES. PEOPLE OFTEN ASK ME WHAT IT IS, THE PURPOSE OF CHAR AND THE CHIP, AND WHY DO THEY MATTER. HERE IS THE SIMPLEST WAY TO EXPLAIN IT. ONE CHIN NOT HELP US IDENTIFY AND PRIORITIZE THE MOST PRESSING HEALTH NEED IN OUR COMMUNITY TO TRY, GIVE US A BROADER PICTURE OF THE COMMUNITY HEALTH STATUS, NEED AND STRENGTH BY GUIDING HOW WE PLAN, SET POLICY, AND ALLOCATE RESOURCES TOGETHER, SHENA AND CHA HELP US FOCUS ON HEALTH ISSUES THAT MERIT MOST AND WHERE WE CAN MAKE THE BIGGEST IMPACT. EARLIER THIS YEAR, SCIENTIFIC FOUNDATION LAUNCH A CHURCH SHEET PARTNER CROSSWALK A COLLABORATIVE SPACE TO ALIGN STRATEGIES AND SHARE INSIGHT. THESE SESSIONS ARE ONGOING. IN FACT, BELLA SCOTT AND WHITE HEALTH SUGGESTED WE COORDINATE OUR PRESENTATION TO REDUCE DUPLICATION AND IDENTIFY GAPS. THAT SPIRIT OF COLLABORATION IS WHAT BRING US HERE TODAY. SO WHAT DOES THIS MEAN IN PRACTICE? IT MEANS WE ARE MORE ALIGNED THAN EVER. ALSO PUBLIC HEALTH. TRAVIS COUNTY HEALTH AND HUMAN SERVICES AND OUR PARTNERS ARE WORKING ACROSS SECTORS, BREAKING DOWN SILOS, ELIMINATING REDUNDANCIES, AND BUILDING [00:05:01] A STRONGER, MORE COORDINATED PUBLIC HEALTH SYSTEM. BY IDENTIFYING CROSS CURRENT TEAMS, WE ARE ABLE TO SEE THE BIGGER PICTURE, VALIDATE OUR DATA, AND DEVELOP STRATEGIES THAT ARE BOTH EVIDENCE-BASED AND COMMUNITY IN, UH, INFORMED. THIS PROGRAM DIDN'T HAPPEN OVERNIGHT. IT TOOK TIME, PERSISTENCE, AND A SHARED VISION. AS LOUIS PASTOR ONE SAID, CHANCE FAVORS ONLY THE PREPARED MIND, HIS BREAKTHROUGH LIKE VACCINATION AND PASTEURIZATION, WHERE THE RESULT OF DEEP PREPARATION AND CURIOSITY. LIKEWISE, OUR PROGRESS TODAY REFLECT THE DEDICATION OF MANY INDIVIDUALS. I WOULD LIKE TO RECOGNIZE JUST A FEW OF THEM. SHIRLEY ALONA CHURCH, AUSTIN PUBLIC HEALTH, JESSE SIMON ST. DAVID FOUNDATION, KELLY LOVELIES, IAN SETAN, OLIVIA STELTER, BILL SCOTT, AND WHITE HEALTH. MARY DO INTEGRAL CARE AND MANY OTHERS WHO HAVE WORKED TIRELESSLY BEHIND THE SCENE. THIS WORK WILL NOT BE POSSIBLE WITHOUT THE LEADERSHIP OF OUR CHAIRSHIP STEERING COMMITTEE. CHAIR ADRIAN STIR, DIRECTOR OF AUSTIN PUBLIC HEALTH. A FEL THANK YOU TO ALL OF OUR PARTNERS OF OUR PARTNER ORGANIZATIONS, ESPECIALLY THOSE SERVING ON THE CORE AND CORE COMMUNITY COMMITTEE AND WORK GROUPS, AS WELL AS OUR VOLUNTEERS, COMMUNITY MEMBERS, AND OUR CONSULTANT HEALTH RESOURCE IN ACTION. HERE IS THE ORDER OF TODAY'S PRESENTATION. FIRST OUR SESSION SETAN, FOLLOWED BY SAN DAVID FOUNDATION, THIRD CENTRAL FOOD BANK, SECOND BUREAUCRAT, AND WHITE HEALTH. THIRD SAN DAVID FOUNDATION, FOURTH CENTRAL FOOD BANK. AND FIFTH, BUT NOT THE LEAST, AUSTIN PUBLIC HEALTH. ON A CELEBRATORY NOTE, THE AUSTIN AMERICA STATEMENT RECENTLY RANKED THE TOP HOSPITAL IN CENTRAL TEXAS. WE ARE PROUD TO SHARE THAT OUR PARTNERS WERE RECOGNIZED. ST. DAVID MEDICAL CENTER WAS RANKED NUMBER NINE, A SECTION STATE MEDICAL CENTER NUMBER 10, AND BELLA SCOTT WHITE, ROUND ROCK NUMBER 11. KUDOS TO YOU ALL. WITH THAT, I'M [3. Presentation by Kelli Lovelace with Ascension Seton on their contribution to the Community Health & Needs Assessment Report. ] HONORED TO WELCOME OUR FIRST PRESENTER, KELLY LOVELACE FROM A SESSION SETTING WHO WILL INTRODUCE THEMSELF AND BEGIN TO THIS PRESENTATION. KELLY, CAN I USE THIS CLICKER TO THANK YOU. UH, HI. SO FIRST I WILL INTRODUCE MYSELF. THANK YOU FOR HAVING US. UM, I'M KELLY LOVELACE. I'M THE COMMUNITY BENEFIT DIRECTOR FOR ASCENSION, TEXAS, WHICH INCLUDES ASCENSION SETON. UM, I HAVE BEEN WITH ASCENSION SINCE 2019, AND PRIOR TO THAT I'VE WORKED IN NONPROFIT HEALTH SECTOR IN AUSTIN FOR ABOUT 10 YEARS. UM, AT ASCENSION, I AM RESPONSIBLE FOR OUR COMMUNITY HEALTH NEEDS ASSESSMENT, WHICH THE PRODUCT OF BECOMES A REPORT THAT CAN BE VIEWED BY THE COMMUNITY TO UNDERSTAND OUR PRESSING COMMUNITY HEALTH NEEDS AND INTERNALLY TO ASCENSION. IT'S MY VEHICLE THAT I'M ABLE TO USE TO ELEVATE COMMUNITY VOICE IN STRATEGIC PLANNING. SO SOMETHING THAT'S UNIQUE ABOUT THE WAY THAT WE DO A COMMUNITY HEALTH ASSESSMENT AT ASCENSION IS THAT WE DO A REGIONAL APPROACH. UM, AS YOU PROBABLY KNOW, PEOPLE DON'T STOP AT BORDERS OF COUNTIES, AND THIS IS THE WAY THAT OUR SYSTEM WORKS IN GENERAL. SO DOING OUR COMMUNITY HEALTH NEEDS ASSESSMENT AT A SYSTEM LEVEL HELPS US TO BE ABLE TO ALIGN THE COMMUNITY NEEDS WITH STRATEGIC INITIATIVES. 'CAUSE THAT'S THE WAY THAT THE SYSTEM IS WORKING. UH, SO THIS, ON THE LEFT HAND SIDE OF THE SLIDE IS A MAP OF THE 11 COUNTY REGION FOR ASCENSION, SETON, AND ALL THOSE LITTLE MARKS IN THERE ARE OUR HOSPITALS, THE HOSPITALS THAT ARE WITHIN TRAVIS COUNTY, OUR DELL CHILDREN'S MEDICAL CENTER, ASCENSION SETON MEDICAL CENTER, AUSTIN DEL SETON AT THE UNIVERSITY OF TEXAS, ASCENSION, SETON NORTHWEST AND ASCENSION SETON SOUTHWEST. THIS IS ANOTHER, UH, TO SPEAK TO THE COLLABORATION AMONG THE GROUP HERE. THIS IS ANOTHER, UH, THING THAT COMES UP WHEN WE'RE TALKING ABOUT COLLABORATION IS THAT WE ALL HAVE SOME OF THE SAME SERVICE AREA AND SOME DIFFERENT SERVICE AREAS. SO THAT'S JUST SOMETHING THAT WE WORK THROUGH TOGETHER AS WE'RE THINKING ABOUT OUR COLLABORATION. THIS IS THE SLIDE WE USE REALLY OFTEN [00:10:01] INTERNALLY AT ASCENSION. AND IT REMINDS US THAT EVEN IF WE WERE PROVIDING THE BEST IN CLASS WORLD CLASS HEALTHCARE, WHICH WE STRIVE TO DO, UH, THAT STILL DOES NOT IMPACT THE FULL HEALTH OF THE COMMUNITY BECAUSE, UH, HEALTH OUTCOMES ARE ALSO IMPACTED BY THINGS LIKE SOCIAL AND ECONOMIC FACTORS AND THE PHYSICAL ENVIRONMENT AND BEHAVIOR. SO EVEN, YOU KNOW, WE STRIVE TO PROVIDE THE BEST HEALTHCARE AND EVEN IF WE WERE DOING THAT THE BEST WE POSSIBLY COULD ALL OF THE TIME, THERE WOULD STILL BE REASONS WHY PEOPLE, UH, WERE HAVING POOR HEALTH OUTCOMES. SO THIS IS A REASON FOR US TO THINK ABOUT, UM, ADDRESSING HEALTH OF THE WHOLE PERSON AND THINKING ABOUT WHAT THE COMMUNITY HEALTH LOOKS LIKE. AND IT'S ALSO A GOOD REASON TO CONSIDER COLLABORATION WHEN WE'RE TALKING ABOUT HEALTH OUTCOMES OF THE COMMUNITY BECAUSE WE HAVE A ROLE TO PLAY AND SO DO OUR PARTNERS AS FAR AS HOW WE DO OUR GOVERNANCE OF THE COMMUNITY HEALTH ASSESSMENT ITSELF. BECAUSE WE TAKE REGIONAL APPROACH, IT'S REALLY IMPORTANT TO TAKE THE DATA AT EVERY STEP OF THE WAY TO OUR HOSPITAL SITE LEADERS SO THAT WE'RE GETTING INPUT FROM EACH OF THE LOCAL, MORE LOCAL GEOGRAPHIES THAT OUR REGION SERVES. SO WE REVIEW ALL OF THE DATA AND DO AN INITIAL PRIORITIZATION WITH OUR HOSPITAL LEADERS, AND THEN EVENTUALLY IT GOES TO A-C-H-N-A STEERING COMMITTEE AT THE SYSTEM LEVEL WHO HELPS US TO PRIORITIZE FINAL NEEDS. AND I'LL TALK AT THE END ABOUT WHAT WE PRIORITIZE THIS TIME. SO THE WAY THAT I'M APPROACHING THIS PRESENTATION IS TO SHOW YOU KIND OF LIKE THE OVERVIEW OF WHAT THE COMMUNITY HEALTH ASSESSMENT WAS. UM, SO IT'S SECONDARY DATA, WHICH IS DATA FROM PUBLICLY AVAILABLE SOURCES COMBINED WITH COMMUNITY INPUT. FIRST TO SPEAK TO THE SECONDARY DATA, UH, ON THE LEFT HAND SIDE OF THE SLIDE, HERE IS A MODEL THAT WE USE THAT COMES FROM COUNTY HEALTH RANKINGS. IT'S WHERE WE GET MOST OF THE COUNTY LEVEL DATA FOR THE REPORT. AND IT ALSO SPEAKS TO THIS FACT THAT WE LOOK AT INDICATORS ACROSS THE RANGE FROM CLINICAL CARE TO HEALTH OUTCOMES, HEALTH BEHAVIORS, SOCIAL AND ECONOMIC FACTORS, PHYSICAL ENVIRONMENT. UM, AND THEN THE RIGHT HAND OF THIS SLIDE I THINK IS EQUALLY AS IMPORTANT, WHICH ACKNOWLEDGES THAT THERE'S MANY ORGANIZATIONS IN OUR COMMUNITIES THAT ARE ALSO DOING ASSESSMENTS OF SOME KIND RELATED TO HEALTH OUTCOMES. AND SO WE DID TRY TO LOOK AT ALL OF THESE REPORTS. WE TRIED TO LOOK THROUGH ALL OF THEM, TAKE WHAT, UH, WAS IMPORTANT FROM THEM, SOMETIMES POINT OUT TO THEM IN OUR REPORT. SO OF COURSE THE TRAVIS COUNTY MEDICAL EXAMINER REPORT PROVIDE SOME MORE DETAIL ON SPECIFICALLY TRAVIS COUNTY. WE LOOKED AT THE CAPITAL AREA PLAN ON AGING, BLUE BONNET TRAILS AND INTEGRAL CARE BOTH HAVE REPORTS ON MENTAL HEALTH AND, UH, CENTRAL TEXAS FOOD BANK HAS THEIR REPORT ON FOOD ACCESS. SO WE TRY TO POINT OUT TO THOSE WHEN APPROPRIATE AND ALSO BRING THEM INTO OUR REPORT WHEN OUR APPROPRIATE. OKAY, SO THIS SLIDE HAS A LOT OF INFORMATION ON IT. I REALLY JUST WANT US TO TAKE LIKE A 500 FOOT VIEW OF IT, A THOUSAND FOOT VIEW. I DON'T KNOW. UM, BUT THIS IS HELPING TO SHOW HOW WE APPROACH DATA FOR A REGIONAL APPROACH, REGIONAL CHNA. SO THIS IS MAYBE LIKE FOUR INDICATORS OUT OF 80 THAT WE LOOK AT. BUT HOW WE LOOK AT THE REGION IS THAT WE TAKE EVERY COUNTY IN OUR 11 COUNTY REGION ON THE BAR CHART AND PUT IT AGAINST THE TEXAS BENCHMARK AND THE UNITED STATES BENCHMARK. UM, THEN WE LOOK TO SEE HOW THE COUNTIES ARE DOING AGAINST THOSE BENCHMARKS. THE COLOR CODING IS THAT IF IT'S BLUE, IT'S A STANDARD DEVIATION OR MORE BETTER THAN THE TEXAS BENCHMARK. IF IT'S PINK OR RED, IT'S A STANDARD DEVIATION OR MORE WORSE THAN THE TEXAS BENCHMARK. SO WE LOOK AT ALL OF THE INDICATORS LIKE THAT, AND THAT'S JUST A WAY TO VISUALLY SEE, UM, THE COUNTIES IN OUR REGION AND HOW WE'RE DOING. AND THEN VERY IMPORTANTLY, WHEN DATA IS AVAILABLE AT A SMALLER GEOGRAPHY, LIKE A CENSUS LEVEL OR ZIP CODE LEVEL, WE'RE LOOKING AT THAT AS WELL, THAT THAT'S WHAT THOSE MAPS SHOW. THOSE WOULD LINK OUT TO MAPS THAT YOU COULD ZOOM IN AND OUT OF. UM, AND I THINK EVERYONE IN THIS ROOM PROBABLY UNDERSTANDS WHY THAT'S SO IMPORTANT. BUT PARTICULARLY IN A COUNTY LIKE TRAVIS COUNTY, OFTEN IF YOU LOOK AT THE COUNTY LEVEL INDICATOR, IT MASKS WHAT'S REALLY GOING ON, WHICH IS GEOGRAPHIC DISPARITIES, UM, OF HEALTH OUTCOMES AND ACCESS TO SERVICES. AND, UM, BARRIERS TO HEALTH. SAME THING FOR DATA BY RACE AND ETHNICITY. WE DISAGGREGATE IT WHEN WE CAN, WHEN IT'S AVAILABLE. UM, FOR THE SAME REASON. WE WANNA MAKE SURE THAT WE ARE IDENTIFYING POPULATIONS THAT MAY EXPERIENCE HIGHER BARRIERS TO HEALTH OR, UH, WORSE HEALTH OUTCOMES BECAUSE THAT REALLY HAS IMPLICATIONS FOR HOW WE HAVE, [00:15:01] HOW WE MAKE INTERVENTIONS. THE SECOND PART OF THIS CHNA APPROACH IS COMMUNITY INPUT. AND AS ASCENSION, WE DID FOCUS GROUPS WITH COMMUNITY LEADERS AND, UH, COMMUNITY SERVICE PROVIDERS. WE ALSO DID A FOCUS GROUP SPECIFIC FOR MEDICAID RECIPIENTS AND INTERVIEWS TO KIND OF UNDERSTAND CERTAIN TOPICS IN MORE DETAIL AS WELL AS A STORYTELLING TOOL. AND THEN I'LL PAUSE HERE TO ALSO SAY THAT I THINK THIS IS WHERE COMMUNITY, UH, PARTNERSHIP AND OUR PARTNERSHIP WITH OUR HOSPITAL AND COUNTY PARTNERS REALLY COMES THROUGH IN THAT, PARTICULARLY WITH THE HOSPITALS. THE THREE OF US, WE WERE ON THE SAME TIME CYCLE. UM, DIFFERENT CHNAS HAPPEN AT DIFFERENT TIMES, BUT WE WERE ALL IN THE SAME TIME CYCLE. AND WE RECOGNIZED THAT IF ALL THREE OF US WERE OUT ASKING COMMUNITY LEADERS AND COMMUNITY MEMBERS VERY SIMILAR QUESTIONS ABOUT COMMUNITY HEALTH, THAT IT JUST WOULDN'T GO OVER SUPER WELL, , THAT'S NOT A GREAT WAY TO DO THINGS. UM, SO INSTEAD WE CAME TOGETHER AND WE PLANNED FOR COLLABORATION SO THAT WE COULD SHARE THEMES WITH EACH OTHER. WE ALSO HAD A LOT OF FREEDOM TO DO IT OUR OWN WAY WITH OUR OWN RESOURCES, BUT WOULD SHARE THE THEMES WITH EACH OTHER. I THINK THAT WORKED REALLY WELL TO REDUCE DUPLICATION AND LIKE AMPLIFY THE AMOUNT OF INPUT THAT WE WERE ABLE TO GET. SOME THEMES FROM OUR COMMUNITY, UH, INPUT WERE AFFORDABILITY AND ECONOMIC STRAIN. A LOT OF THINGS IN THERE LIKE CHILDCARE ACCESS, TRANSPORTATION, HEALTHCARE AND INSURANCE NAVIGATION IMPACTS OF POPULATION CHARACTERISTICS. A LOT OF POPULATION GROWTH, A LOT OF POPULATION MOVING, UH, DIVERSITY IN THE POPULATION AND ENSURING THAT WE COULD MEET THE NEEDS OF ALL OF THE GROUPS WITHIN OUR REGION. AND WORKFORCE SHORTAGES CAME UP A LOT THERE AS WELL. HEALTHCARE AND COMMUNITY HEALTH. A FEW DIFFERENT, UM, TYPES OF THINGS CAME UP, LIKE MENTAL AND BEHAVIORAL HEALTH CAME UP A LOT. UM, ONE THING I THOUGHT WAS INTERESTING WAS THE, WHAT PEOPLE WERE SAYING WAS LIKE THE UNINTENDED CONSEQUENCE OF DIGITIZATION. SO LIKE HOPEFULLY THAT MAKES THINGS MORE ACCESSIBLE, BUT SOMETIMES IT DOESN'T. UM, AND ALSO POLICY, A LOT OF PEOPLE TALKED ABOUT THE IMPACT OF STATE POLICIES, FOR EXAMPLE, NOT BEING A MEDICAID EXPANSION STATE. OKAY. SO ALL OF THAT INFORMATION COMES TOGETHER. WE DO AN ANALYSIS, WE PRIORITIZE . AND WHAT WE LANDED ON FOR OUR TOP FOUR PRIORITIZED NEEDS FOR THIS NEXT THREE YEAR CYCLE WERE HEALTHCARE ACCESS AND QUALITY, MENTAL AND BEHAVIORAL HEALTH, SOCIAL DETERMINANTS OF HEALTH AND MATERNAL AND CHILD HEALTH. AND YOU'LL SEE ON HERE, LIKE THE BROAD NEEDS ARE STATED WITH MORE SPECIFIC, MORE SPECIFICALLY KIND OF WHEN IT, WHAT WENT INTO THOSE NEEDS LISTED UNDERNEATH. UM, AND OUR NEXT STEP FROM HERE IS TO WORK WITH ALL 11 OF OUR HOSPITALS WITHIN THIS REGION TO COME UP WITH STRATEGIES TO ADDRESS THESE NEEDS. AND THAT'S ONE REASON WHY THOSE MORE SPECIFIC DOT POINTS UNDERNEATH IS SO IMPORTANT BECAUSE, YOU KNOW, IT GIVES YOU A LITTLE MORE SOMETHING TO GRASP ONTO WHEN COMING UP WITH STRATEGIES. UM, SO I'M GONNA STOP HERE. I THINK THAT WAS MY 10 MINUTES OF TALKING. WONDERFUL. UM, THANK YOU SO MUCH FOR THE CLARITY AND, UH, UNDERSTANDING OF WHAT YOU ALL ARE WORKING ON WITH THE, WITH WITH SETON. UM, I KNOW WE ONLY HAVE ABOUT FIVE MINUTES WORTH OF QUESTIONS FOR YOU FOR EACH GROUP. SO, UH, I WILL OPEN THE FLOOR UP TO COMMISSIONERS QUESTIONS. UM, I, I WILL GIVE YOU MY QUESTION AND THEN MAYBE WE CAN CIRCLE BACK TO THAT. UH, UNDERSTANDING WHAT YOU ALL ARE WORKING ON WITH YOUR FOUR PRIORITY AREAS. WHERE ARE SOME AREAS THAT THE COMMISSION COULD COME IN AND SUPPORT, WHETHER THAT IS FROM, UH, A POLICY LEVEL, AN ORDINANCE LEVEL, OR RECOMMENDATION OF SOME SORT TO, UM, HELP MOVE THE NEEDLE. YOU DON'T HAVE TO DIRECT, HAVE A DIRECT ANSWER TO THAT RIGHT AWAY, BUT, UH, I THINK THAT'LL, AND FOR OUR FUTURE PRESENTERS, YOU CAN RACK ON THAT NOW, , UH, BECAUSE IT'S COMING EVERY TIME. UM, BUT THAT WAY THAT WE ARE, ARE BEING ACTUALLY SUPPORTIVE IN THE WORK THAT YOU'RE DOING AS A COMMISSION INSTEAD OF, UH, POTENTIALLY DERAILING OR, OR MOVING IN THE WRONG DIRECTION. UM, A WAY THAT WE CAN SAY, OKAY, WHEN YOU SAY ACCESS IS THAT, UH, YOU'RE LOOKING AT TRANSPORTATION. WE'RE LOOKING AT TRANSPORTATION. WONDERFUL. HOW SHOULD WE APPROACH THAT? UH, YOU ARE LOOKING AT MENTAL HEALTH. WE ARE DIRECTLY CONNECTED WITH, UH, UH, THRA. YOU KNOW, HOW DO WE INTER, IS THAT AN INTER, IS THAT A COLLABORATION THAT EXISTS? DOES IT NOT EXIST? DO WE NEED TO EXIST? THINKING OF IT FROM THAT PERSPECTIVE, AGAIN, YOU CAN CIRCLE BACK WITH, WITH DANNY AND SHARE THAT BACK TO US. THAT IS ALSO FOR THE REST OF OUR, OUR, OUR CROWD. UM, OUR, BUT JUST HAVE THAT IN, IN YOUR MIND OF, YOU KNOW, NICE TO HAVE VISIONARY [00:20:01] OPPORTUNITIES, UM, AND THEN WAYS THAT WE AS A COMMISSION CAN SUPPORT YOU. YEAH, I MEAN, IT'S A GOOD QUESTION. I DON'T HAVE AN EXACT ANSWER, BUT I WILL SAY EVEN US BEING HERE I THINK IS LIKE A REALLY GOOD STEP IN THE RIGHT DIRECTION. LIKE THE AWESOME PUBLIC HEALTH TEAM THAT BROUGHT US HERE, WE ALL CAME AS A TEAM BECAUSE, YOU KNOW, WE DO HAVE THAT GROUP THAT COMES TOGETHER AROUND THE IMPLEMENTATION STRATEGIES WHILE WE'RE ALL DOING OUR OWN VERSION OF IT. SO I THINK THAT IS LIKE ONE BODY THAT CAN, THAT'S ALREADY CONNECTED HERE, , THAT CAN STAY CONNECTED. UH, I KNOW AT ASCENSION WE ARE ALSO ENGAGED WITH THE LIKE, CITYWIDE SPACE INITIATIVE. SO, YOU KNOW, WE DO TRY TO PLUG OURSELVES IN TO COLLABORATIVE WORK THAT'S CONNECTED TO CITY AND COUNTY, UH, INITIATIVES. I'M NOT SURE THAT THAT'S WHAT YOU CAN DO FOR US, BUT THAT'S MAYBE WHAT WE'RE DOING TO PUT OURSELVES IN THE RIGHT PLACE, UH, FOR COLLABORATION. SURE. AND, AND AGAIN, UM, I THINK THIS IS JUST SOMETHING AS A COMMISSION AS WE'RE DEVELOPING AND UNDERSTANDING WHAT OUR ROLE IS, UM, HEARING FROM FROM OUR, OUR SUPPORTERS, OUR CONNECTORS, OUR PARTNERS, HOWEVER YOU SO, SO FILL IN THAT, THAT BLANK, UM, WHAT WE CAN DO VERSUS WHAT'S NOT SOMETHING OUR COMMISSION HAS THE ABILITY TO ACTUALLY DO. UM, AND IT'S BETTER TO HEAR IT FROM YOU THAN IT IS FOR US TO MAKE IT UP. UH, AND SO THAT'S, THAT'S WHERE I'LL LEAVE THAT. ANY OTHER QUESTIONS, COMMENTS, INSIGHTS, UH, PLEASE, DOCTOR. HELLO. HI. UM, WHEN YOU WERE DOING THE WORK WITH EVERYONE IN THE ROOM, UM, WOULD HAVING REAL TIME DATA ON TRENDS HAVE BEEN HELPFUL TO THIS PROCESS? PROBABLY, YES. , THANK YOU. I'M JUST GONNA GO SAY YES. THANK YOU. I JUST, GOOD JOB. YES, THANK YOU. FIRST OF ALL, THANK YOU VERY MUCH FOR THE PRESENTATION. I KNOW WE HAVE MORE TO COME, SO I'M JUST GONNA BE BRIEF. BUT I WAS JUST THINKING YOU'VE GOT 25 THINGS, YOU HAVE 25 THINGS LISTED IN THE BULLET POINTS HERE, WHICH ARE ALL GREAT. AND I'M ALWAYS TRYING TO THINK ABOUT, YOU KNOW, WHO ELSE IN THE COMMUNITY IS WORKING ON THESE SIMILAR THINGS AND HOW DO YOU GET EVERYBODY TO BE PULLING THE, THE, THE WAGON SORT OF BY, BY PULLING ONE ROPE THAT WE CAN ALL PULL ON AS OPPOSED TO YOU'VE GOT A THREAD AND I'VE GOT A THREAD AND I'VE GOT A THREAD. THAT'S NOT REALLY A QUESTION, BUT I, I'M ALWAYS WONDERING IF WE CAN STRENGTHEN WHAT THE COMMUNITY DOES FOR ITSELF BY NOT APPROACHING FEWER THINGS. 'CAUSE YOU CAN'T DO THAT, BUT I'M JUST WONDERING HOW WE CAN ALL PULL IN THE SAME DIRECTION ANYWAY. YEAH. IN, IN ONE HARMONIOUS WAY THAT PULLS THE WAGON. YOU KNOW WHAT I'M SAYING? YEAH. AND I, I DON'T, ON EACH OF THESE TOPICS, THIS IS, THIS IS NOT NECESSARILY AN ANSWER EITHER, BUT WHAT, UH, I WILL SAY IS THAT THAT'S PART OF THE CHALLENGE IN COMING UP WITH THE PRIORITIZED NEEDS IN A COMMUNITY HEALTH ASSESSMENT. BECAUSE THIS REPORT SERVES AS A COMMUNITY REPORT, UH, WHERE THESE ARE OUR COMMUNITY NEEDS. SO WE DON'T WANNA GET TOO SPECIFIC IN THE PRIORITIZATION, BECAUSE THEN IT MIGHT LIMIT WHAT CAN HAPPEN WITHIN THAT SPACE, YOU KNOW? BUT THEN OF COURSE, WE CAN ONLY, WE DO NEED TO GET A LITTLE BIT, BIT SPECIFIC WHEN IT COMES TO WHAT ARE WE, WHAT WE DO, YOU KNOW? SO I THINK YOUR QUESTION IS A GOOD ONE. IT'S A SPACE TO CONTINUE TO FEEL INTO, BUT I DO THINK THAT THE GROUPS THAT ALREADY COME TOGETHER ARE PLACES TO EXPLORE THAT. YEAH. AND JUST FOR, FOR TIME, THANK YOU SO MUCH, KELLY. THANK YOU FOR THE PRESENTATION. UM, [4. Presentation by Nichole Edmonds and Olivia Stelter with Baylor Scott & White Health on their contribution to the Community Health & Needs Assessment Report. ] NICOLE, UH, EDMONDS AND OLIVIA, WELCOME. HI, GOOD AFTERNOON. UM, THANK YOU FOR HAVING US HERE TODAY. MY NAME IS NICOLE EDMONDS. I OVERSEE OUR COMMUNITY BENEFIT DEPARTMENT, UM, AT BAYLOR SCOTT AND WHITE HEALTH. UM, AND SO MY DEPARTMENT, UM, IS RESPONSIBLE FOR COMPLETING ALL OF OUR COMMUNITY HEALTH NEEDS ASSESSMENTS FOR ALL OF OUR NONPROFIT HOSPITALS. UH, COMMUNITY BENEFIT REPORTING, IMPLEMENTATION PLANNING, WHICH IS A PART OF THAT CHNA PROCESS, UM, AS WELL AS OUR GRANTS PROGRAM, UH, THE BAYLOR SCOTT AND WHITE HEALTH COMMUNITY INVESTMENT GRANT PROGRAM, WHICH ALLOCATES, UH, FUNDING TO NONPROFIT, UH, ORGANIZATIONS THAT ARE ADDRESSING SOME OF OUR CHNA PRIORITIZED NEEDS. UM, AND SO, AGAIN, THANK YOU FOR HAVING US HERE TODAY. I AM HERE TODAY TO PROVIDE AN OVERVIEW OF OUR 2025 COMMUNITY HEALTH NEEDS ASSESSMENT, OR CHNA. I WON'T GO OVER THIS SLIDE TOO MUCH, JUST BECAUSE ALL OF YOU ARE VERY MUCH AWARE, UM, THAT ALL NON-FOR-PROFIT HOSPITALS AND HEALTHCARE SYSTEMS MUST COMPLETE A-C-H-N-A EVERY THREE YEARS. UM, AND SO WE APPLY, UH, WE DEFINITELY, UH, APPLY THOSE STANDARDS, UM, TO ALL OF OUR HOSPITALS AS WELL. OUR LAST CHNA WAS COMPLETED IN JUNE OF 2025 AND IS AVAILABLE ON OUR WEBSITE. [00:25:01] SO WE HAVE OVER 19, UH, CHNA REGIONS, UM, COMPRISED OF OVER 52 HOSPITALS IN OUR JOINT VENTURES, UH, FOR GREATER AUSTIN REGION SPECIFICALLY. UM, IT INCLUDES SEVERAL COUNTIES, SO TRAVIS WILLIAMSON, HAYES, AND MILAM. UM, GREATER AUSTIN REGION ALSO INCLUDES SEVERAL OF OUR MEDICAL CENTERS, INCLUDING OUR AUSTIN ROUND ROCK, PFLUGERVILLE, TAYLOR BUDDHA, AND LAKEWAY, UH, MEDICAL CENTERS. I WON'T GO OVER EACH ONE OF THESE BULLET POINTS. UM, ALL OF OUR LOCATIONS AND CLINICS THAT ARE WITHIN TRAVIS COUNTY JUST BECAUSE OF TIME. UM, BUT WE DID LIST OUT ALL OF OUR CLINICS AS WELL AS OUR MEDICAL FACILITIES THAT ARE IN TRAVIS COUNTY. UM, THIS IS A CONTINUATION OF JUST LISTING ALL OF OUR LOCATIONS WITHIN TRAVIS COUNTY. SO THIS IS A HIGH LEVEL KIND OF SUMMARY OF THE STEPS THAT WE TOOK TO COMPLETE THE 2025 CHNA. UM, MOST IMPORTANTLY ON THIS SLIDE, UH, WE DID COMPLETE COMMUNITY SURVEYS, UM, AS YOU ALL ARE MORE THAN LIKELY AWARE, UH, THIS PROCESS REQUIRES US TO COLLECT PRIMARY QUALITATIVE AND QUANTITATIVE DATA. UM, AND SO WE DID WORK WITH OUR COMMUNITY PARTNERS TO CONDUCT COMMUNITY SURVEYS. WE WANTED TO BE SURE THAT WE INTEGRATED THE COMMUNITY VOICE INTO THIS PROCESS. AND SO OUR SURVEYS WERE GEARED TOWARD COMMUNITY RESIDENTS AND LEADERS REALLY WANTED TO HEAR BACK FROM THEM IN TERMS OF THE HEALTH AND WELLNESS NEEDS THAT THEY WERE SEEING WITHIN THEIR OWN COMMUNITIES. THIS TIMELINE ALSO INCLUDES OUR, UH, OTHER PRIMARY DATA COLLECTION METHODS, UH, WHICH INCLUDES, UH, KEY INFORMANT INTERVIEWS AND FOCUS GROUPS. SO FOCUS GROUPS WERE REALLY GEARED TOWARDS OUR COMMUNITY-BASED ORGANIZATIONS AND PARTNERS, UM, AND HEARING BACK FROM THEM IN TERMS OF THE HEALTH AND WELLNESS AND THE SOCIAL NEEDS THAT THEY WERE SEEING WITHIN THE POPULATIONS THAT THEY SERVED. UM, AND THEN FINALLY, KEY INFORMANT INTERVIEWS WERE GEARED TOWARDS OUR INTERNAL LEADERS AND TEAM MEMBERS, UM, INCLUDING OUR HOSPITAL PRESIDENTS, REALLY WANTING AN UNDERSTANDING OF WHAT THEY WERE SEEING IN TERMS OF HEALTH AND SOCIAL NEEDS, UH, WITHIN THE FOUR WALLS OF THE HOSPITAL. SO WITHIN THE PATIENT'S, UH, POPULATION, UM, JUST KIND OF WENT OVER A LOT OF THIS. JUST WANTED TO HIGHLIGHT AGAIN, UH, SOME OF OUR PRIMARY AND SECONDARY DATA COLLECTION, UH, SOURCES. SO FOR CENTRAL TEXAS, UH, BAYLOR SCOTT AND WHITE HEALTH, UH, COLLECTED OVER 840 SURVEY RESPONSES. UH, WE CONDUCTED 10 IN PERSON AND VIRTUAL FOCUS GROUPS ACROSS CENTRAL TEXAS. AND THEN WE COMPLETED 23 KEY INFORMANT INTERVIEWS. AND THEN IN TERMS OF SECONDARY DATA, WE LITERALLY HAD HUNDREDS OF SECONDARY DATA SOURCES, BUT JUST HIGHLIGHTING A FEW HERE, UM, TEXAS HEALTHCARE INFORMATION COLLECTION, ALSO KNOWN AS IC. UH, THEY ACTUALLY PROVIDED US WITH CLAIMS DATA, SO WE WERE ABLE TO INTEGRATE UTILIZATION AND EMISSIONS DATA INTO THE PROCESS AS WELL. UM, WE ALSO PULLED SECONDARY DATA SOURCES, SUCH AS AMERICAN COMMUNITY SURVEY, CDC, , AND THEN THE US CENSUS BUREAU. SO THESE ARE THE NINE HEALTH THEMES THAT WE LOOKED AT WHEN WE LOOKED AT OUR GREATER AUSTIN REGION AND ACTUALLY ACROSS ALL OF OUR COMMUNITIES. UM, WE WERE REALLY INTENTIONAL ABOUT IDENTIFYING OUR MOST DISPARATE, UH, POPULATIONS AND COMMUNITIES WITHIN EACH OF THESE NINE HEALTH THEMES. SO WE IDENTIFIED HEALTH DISPARITIES THAT WERE PRESENT WITHIN EACH OF THESE NINE HEALTH THEMES. WE ALSO LOOKED AT RATES, UH, WITHIN EACH OF THESE NINE HEALTH THEMES FOR VARIOUS ISSUES, UH, WHETHER THEY INCREASED OR DECREASED OVER THE THREE YEAR PERIOD. WE ALSO BENCHMARK, UH, RATES OF VARIOUS, UH, INCIDENTS AND PREVALENCE RATES WITHIN THESE NINE HEALTH THEMES, UM, WITH THE STATE OF TEXAS AND WITH NATIONAL RATES TO SEE HOW WE COMPARED. UM, AND AFTER DOING THAT, WE CAME UP WITH OUR TOP, UH, HEALTH NEEDS. SO WE PRESENTED ALL OF THIS DATA TO BOTH INTERNAL LEADERS AND EXTERNAL LEADERS. SO WE PARTNERED WITH VARIOUS COMMUNITY ORGANIZATIONS, UM, AND THEN ALSO OUR HOSPITAL LEADERS, INCLUDING HOSPITAL PRESIDENTS. WE PRESENTED ALL OF THE DATA IN A ONE HOUR SESSION. THEY WERE ABLE TO GO BACK, TAKE THAT DATA BACK, AND WHAT THEY'VE LEARNED ABOUT THE HEALTH NEEDS OF THEIR COMMUNITIES, HUDDLE INTERNALLY TO KIND OF DISCUSS WHAT MAKES THE MOST SENSE TO PRIORITIZE, UM, AND WORK ON FOR THE NEXT, UH, THREE YEARS. AND JUST WANTED TO, UM, AND JUST ONE SECOND, I'LL, UH, KIND OF DO AN OVERVIEW OF THE PRIORITIES, UH, THAT OUR LEADERS, OUR COMMUNITY, AND EXTERNAL, OUR COMMUNITY AND INTERNAL LEADERS, UM, SELECTED. BUT JUST WANTED TO GIVE YOU GUYS A SNAPSHOT OR AN IDEA OF THE TYPE OF DATA THAT WE COLLECTED. SO THIS SLIDE SHOWS, UM, KIND OF KEY THEMES THAT WE IDENTIFIED, UH, IN OUR KEY INFORMANT INTERVIEWS AND FOCUS GROUPS. SO SOME CHALLENGES THAT WE FREQUENTLY HEARD FROM OUR COMMUNITY LEADERS, COMMUNITY MEMBERS AND, UH, COMMUNITY BASED ORGANIZATIONS, THE LACK OF MENTAL HEALTH RESOURCES AND WORKERS, UM, ADOLESCENT ISOLATION, OPIOID ADDICTION. AND THEN, UH, FOR POPULATIONS IMPACTED, MOSTLY CHILDREN, COLLEGE STUDENTS, UNHOUSED INDIVIDUALS, AND LOW INCOME INDIVIDUALS, OR LOW INCOME COMMUNITIES, EXCUSE ME. UM, AND THEN THE CHART, JUST AGAIN, ANOTHER EXAMPLE OF PRIMARY DATA AND THE TYPES OF INSIGHTS THAT WE LOOKED AT WHEN WE LOOKED AT, UH, PRIORITIZING OUR HEALTH NEEDS AND JUST OVERALL DATA COLLECTION. UM, THIS CHART, OR THIS GRAPH SHOWS POOR SELF-REPORTED MENTAL HEALTH, UM, FROM 2 20 17 TO 2022. SO, AS YOU GUYS CAN SEE, UH, POOR SELF-REPORTED MENTAL HEALTH HAVE SIGNIFICANTLY INCREASED SINCE 2017. UH, MOST NOTABLY BETWEEN 2019 AND 2022, UH, IS WHERE THE INCREASES KICKED IN. [00:30:01] SO AFTER OUR DATA COLLECTION, UH, ANALYSIS, PRESENTING IN A ONE HOUR SESSION TO HOSPITAL AND EXTERNAL, UH, LEADERS, UM, THEY VOTED AND DECIDED TO PRIORITIZE ACCESS TO CARE AS WELL AS BEHAVIORAL HEALTH. SO, UM, NOW THAT WE HAVE, UH, YOU KNOW, ANALYZED ALL THIS DATA, WE HAVE SELECTED OUR HEALTH PRIORITIES, HOW ARE WE TRANSLATING DATA INTO ACTION? I FEEL LIKE SOMETIMES THAT'S THE HARDEST PART OF ALL OF THIS. SO, JUST WANTED TO GIVE YOU GUYS SOME EXAMPLES OF WHAT THE STRATEGIES THAT WE ARE INCLUDING IN OUR IMPLEMENTATION PLAN TO ADDRESS BOTH BEHAVIORAL HEALTH AND ACCESS TO CARE. UM, THE FIRST BULLET, OR THE FIRST, UM, ITEM HERE IS JUST OUR BAYLOR SCOTT AND WHITE HEALTH COMMUNITY BENEFIT GRANT PROGRAM. AGAIN, IT IS A PROGRAM WHERE WE ALLOCATE, UH, FUNDS, GRANTS TO VARIOUS NONPROFITS THAT ARE ADDRESSING THE PRIORITIZED HEALTH NEEDS. AND SO FOR OUR GREATER AUSTIN REGION, WE WILL ALIGN GRANT FUNDING WITH BEHAVIORAL HEALTH AND ACCESS TO CARE INITIATIVES WITHIN THE COMMUNITY. WE ALSO HAVE A NEW PARTNERSHIP WITH GEODE HEALTH, EXCUSE ME, WHICH IS A PARTNERSHIP THAT INCREASES ACCESS TO MENTAL HEALTH RESOURCES AND SERVICES. AND SO WE ARE REALLY EXCITED ABOUT THAT. UM, WE ALSO IMPLEMENT HEALTH SCREENINGS AND PARTNERSHIP WITH OTHER COMMUNITY BASED ORGANIZATIONS ACROSS THE GREATER AUSTIN REGION. HEALTH SPEAKS IS A PROGRAM THAT PROVIDES HEALTH AND NUTRITION EDUCATION IN THE COMMUNITY. UM, AND THEN FINALLY, OUR RIDE HEALTH PARTNERSHIP. WE PARTNER WITH AN ORGANIZATION BY THE NAME OF RIDE HEALTH. THEY PROVIDE TRANSPORTATION TO OUR PATIENTS, UM, WHO ARE TRANSPORTATION INSECURE, OR, UM, THEY JUST MAY NEED THAT ADDITIONAL SUPPORT TO MAKE SURE THAT THEY GET THE SERVICES THAT THEY NEED. UM, AND THEN THIS LAST ASTERISK HERE JUST INDICATES THAT ALL OF OUR IMPLEMENTATION PLANS WILL BE AVAILABLE ON OUR WEBSITE BY NOVEMBER THE 15TH. SO IF YOU'D LIKE TO READ MORE ABOUT THE GREAT WORK THAT WE'RE DOING IN THE COMMUNITY TO ADDRESS THESE PRIORITIZED NEEDS, UM, INVITE YOU ALL TO ACCESS OUR WEBSITE. IT WILL BE POSTED BY NOVEMBER 15TH. AND THEN FINALLY, WE'RE REALLY EXCITED ABOUT THIS. SO, AS A PART OF THIS ENTIRE PROCESS, WE HAVE BEEN BUILDING OUT WHAT WE CALL A COMMUNITY DATA ATLAS. IT IS AN INTERACTIVE DATA DASHBOARD THAT HAS HUNDREDS OF PUBLIC HEALTH INSIGHTS, AND WE ACTUALLY INTEGRATED CLAIMS DATA INTO, UM, OUR COMMUNITY DATA ATLAS AS WELL. UH, FOLKS EXTERNALLY AND INTERNALLY ARE ABLE TO ACCESS THIS WEBSITE. UM, YOU'RE ABLE TO PULL VARIOUS INDICATORS AND INSIGHTS AND STRATIFY THOSE DATA POINTS, UM, OR INSIGHTS BY RACE, ETHNICITY, AGE, GENDER, ZIP CODE, UM, SO THAT FOLKS ARE, ARE REALLY ABLE TO GAIN AN IN-DEPTH UNDERSTANDING OF THE COMMUNITIES THAT THEY SERVE, BUT ALSO, AGAIN, THE MOST DISPARATE POPULATIONS, SO THAT EFFORTS CAN BE MORE TARGETED OR FOCUSED, UM, RELATING REGARDING, EXCUSE ME, UH, THOSE PRIORITIZED HEALTH NEEDS. OKAY. AND WITH THAT, I'M HAPPY TO TAKE ANY QUESTIONS THAT YOU GUYS HAVE. FIRST OF ALL, THANK YOU AGAIN FOR THE PRESENTATION AND, UM, A LOT OF COMPACT INFORMATION. YOU MADE ME WONDER, AGAIN, I'M JUST ASKING RHETORICAL QUESTIONS TODAY, PROBABLY, BUT, UM, YOU SPENT, YOU SAID SPECIFICALLY RIDESHARE RIDE, RIDE HEALTH PARTNERSHIP TO HELP YOUR PATIENTS. AND, AND I LOVE THAT. I JUST WONDERED, ONE OF THE THINGS I ALWAYS HAVE TROUBLES WITH IS LIKE, I CAN'T FIGURE OUT IN MY MIND LIKE HOW MANY PEOPLE NEED, HOW MANY RIDES IN A YEAR, 10,000 TIMES, 10 RIDES, A HUNDRED THOUSAND RIDES, AND HOW MANY, HOW MANY GET THAT? AND ACROSS THE COMMUNITY, HOW, WHAT IS, WHAT'S REALLY GOING ON IN THAT SPACE? SO YOU MIGHT KNOW IN THIS PROGRAM THAT, AND AGAIN, I'M JUST ASKING A RHETORICAL QUESTION, BUT I HAVE TROUBLE IMAGINING HOW BIG THE PROBLEM IS AND, AND WHAT THE GAP IS AND, AND FULFILLING THAT GAP. AND THIS APPLIES MAYBE GENETICALLY TO MANY THINGS, BUT, UM, I'M NOT SURE HOW TO APPROACH THAT. BUT I, I WONDER IF THE WORK THAT THE COMMUNITY HEALTH NEEDS ASSESSMENT CAN BE DOING IS TO QUANTIFY THAT ACROSS THE WHOLE COMMUNITY TO SAY WHAT THAT IS, AND MAYBE TELL US LIKE, HERE'S HOW MUCH THE GAP WE THINK IS THERE, AND HERE'S WHAT WE REALLY NEED TO FILL. AND WE CAN, YOU KNOW, OUR ORGANIZATION, BAYLOR SCOTT WHITE'S GONNA FILL 9,000 OF 'EM, BUT WE HAVE 17,000 MORE TO GO, AND WHO ELSE IS GONNA STAND UP OR HOW THEY'RE GONNA DO IT? THEN I'D UNDERSTAND HOW THE PIECES FIT TOGETHER BETTER. AND MAYBE THAT'S PART OF THE CHALLENGE OF COMMUNITY HEALTH IN GENERAL. BUT, YOU KNOW, I, I NEVER CAN FOR MANY OF THESE TOPICS, THAT'S JUST ONE TOPIC OF MANY. I I CAN'T FIGURE OUT HOW BIG THE GAP IS AND WHO'S FILLING IT AND WHAT THE, YOU KNOW, WHAT THE, UM, DOMAIN LOOKS LIKE, SO TO SPEAK. YEAH, THAT'S UNDERSTANDABLE. AND I THINK THAT'S A GREAT, UH, YOU KNOW, UM, CONCEPT OF HAVING THIS COLLABORATIVE HERE THAT WE ALL TRY TO PARTNER TO YOUR POINT, NOT JUST ON THE CHNA AND DATA COLLECTION, BUT ALSO IN THE IMPLEMENTATION PLAN, RIGHT? LIKE, SO NOW THAT WE HAVE THESE HEALTH PRIORITIES, WE'RE ADDRESSING THEM, HOW CAN WE COLLECTIVELY ADDRESS 'EM, BUT ALSO MEASURE THE NEED IN A WAY WHERE, UM, WE'RE ACTUALLY FILLING THAT GAP AND ADEQUATELY ADDRESSING THAT NEED. SO, OTHER QUESTIONS PLEASE. SO, DR. RICE, TO YOUR POINT IN QUESTION, UH, I KNOW THAT AT SOME POINT, UH, CENTRAL HEALTH AND COMMUNITY CARE, UH, HAD A, A, I DON'T KNOW IF IT WAS LYFT OR AN UBER RIDE FOR PATIENTS. SO IT'D BE VERY INTERESTING TO LOOK AT, UH, WHAT THE, UM, [00:35:01] THE AT ATTEND, YOU KNOW, THE, THE APPOINTMENT, UH, COMPLETION RATE WAS COMPARED, AND I KNOW I'M USING THAT INCORRECTLY, BUT, BUT REALLY, YEAH, I THINK THAT GIVES YOU A BASELINE THEN AT LEAST A SENSE OF WHAT IS THE NEED VERSUS WHAT IS BEING MET OR NOT MET. AND JUST TO COMMENT, I THINK AS WE IMPLEMENT WATERSHED HEALTH AND CONNECT ALL OF OUR CARE COORDINATION EFFORTS TOGETHER, THAT WILL HELP INFORM SOME OF THIS INQUIRY THAT'S WE'RE DISCUSSING RIGHT NOW, AND HELP US UNDERSTAND REFERRAL LOOPS THAT ARE CLOSED AND WHAT THE NON-MEDICAL DETERMINANTS OF HEALTH REALLY ARE, WHAT THE NEED IS. THANK YOU FOR YOUR PRESENTATION. UM, I HAVE A QUESTION ABOUT THE, I GUESS JUST ACCESS TO HEALTHCARE IN GENERAL. YOU SAID THAT YOUR PRESIDENT'S NOMINATED THAT ONE AS THE NUMBER ONE ISSUE, AND THEN BEAVER HEALTH, I BELIEVE IS THE SECOND. CAN YOU GIVE KIND OF JUST A BROAD OVERVIEW OF THE, THE BARRIERS THAT Y'ALL ARE SEEING IN TERMS OF ACCESS TO HEALTHCARE? I'M, I'M CURIOUS FROM A HOSPITAL STANDPOINT, I MEAN PUBLIC HEALTH, SO I'M CURIOUS TO SEE WHAT, UH, WHAT YOUR OPINIONS ARE. UM, WELL, I DON'T KNOW IF THIS IS BACK BY DATA, 'CAUSE I DON'T KNOW ALL THE RATES OF THINGS, BUT I THINK OUR NUMBER ONE, UM, OR MAYBE NOT NUMBER ONE, BUT ONE OF THE TOP REASONS FOR ACCESS OR TOP REASONS FOR BARRIERS TO RECEIVING HEALTHCARE, UM, REALLY IS TRANSPORTATION. I THINK DEFINITELY IN OUR RURAL, MORE RURAL COMMUNITIES, WE HAVE A MARBLE FALLS FACILITY WHERE WE ARE ACTIVELY TRYING TO ADDRESS TRANSPORTATION NEEDS. BUT IT IS DIFFICULT BECAUSE THE RESOURCES JUST ARE NOT THERE. UM, SO LIKE THE UBER HEALTH ARE NOT IN THAT AREA. AND SO, UM, IT'S BEEN DIFFICULT TO ADDRESS THAT TRANSPORTATION PIECE IN ACCESSING CARE. THANK YOU. SO ACCESS IS REALLY SIMPLY THE TRANSPORTATION, THE, THE PHYSICAL GETTING THERE. IT'S, IT'S PROBABLY MORE THAN THAT, BUT I THINK THAT'S WHAT WE SEE THE MOST, UH, ACROSS, UH, MANY OF OUR HOSPITALS, ESPECIALLY, AGAIN, ARE MORE RURAL. OKAY. THANK YOU. I HAVE A VERY LOADED QUESTION THAT I WILL EMAIL YOU LATER, , UM, JUST TO SAVE ON TIME, 'CAUSE I THINK WE HAVE HIT OUR, OUR FIVE MINUTES OF QUESTIONS. UH, PLEASE. DR. WALKS, BEFORE WE, WE JUST ONE MORE QUESTION. UM, IS THE GEOCODE GEODE HEALTH GOING SO THAT THE VEHICLE THAT YOU'RE USING TO ADDRESS INCREASING THE CAPACITY NEEDS FOR MENTAL HEALTH? SO THAT'S ONE OF OUR STRATEGIES TO, IN, UH, INCREASING ACCESS TO MENTAL HEALTH SERVICES. THERE'S SEVERAL MORE JUST IN THE INTEREST OF TIME, OH, EXCUSE ME. IN THE INTEREST OF TIME, I WAS NOT ABLE TO GET THROUGH ALL THE STRATEGIES. BUT AGAIN, UH, NOVEMBER 19, UH, 15TH, IT'LL BE POSTED TO OUR WEBSITE AND YOU GUYS ARE WELCOME TO READ THROUGH ALL OF THOSE STRATEGIES. AND I SHOULD ALSO NOTE THAT WE DO JOINT IMPLEMENTATION PLANS. SO IN THE VERY BEGINNING I TALKED A LITTLE BIT ABOUT, UM, THE NUMBER OF HOSPITALS THAT ARE INCLUDED IN THE GREATER AUSTIN REGION. SO OUR HOSPITALS, UH, COLLECTIVELY ADDRESS THE TWO PRIORITIZED NEEDS. THANK YOU SO MUCH. THANK YOU. WE APPRECIATE YOUR TIME. NICOLE. OLIVIA. UM, YES. MOVING [5. Presentation by Jesse Simmons with St. David’s Foundation on their contribution to the Community Health & Needs Assessment Report. ] ON TO OUR NEXT GROUP, UH, JESSE FROM ST. DAVID'S FOUNDATION. WELCOME. GOOD AFTERNOON. UH, I'M JESSE SIMMONS. I'M THE SENIOR EVALUATION OFFICER AT ST. DAVID'S FOUNDATION. UH, BEFORE I GET STARTED, I JUST WANTED TO REITERATE WHAT SEVERAL PEOPLE SAID OF EVEN THOUGH WE ARE PRODUCING INDIVIDUAL CHNA REPORTS AND ARE PRESENTING THE FINDINGS IN EACH, UH, THAT'S TO MEET THE REQUIREMENTS OF, UH, NEEDING TO PRODUCE A COMMUNITY HEALTH NEEDS ASSESSMENT AND TO MEET THE UNIQUE, UH, NEEDS OF OUR UNIQUE ORGANIZATIONS. BUT WE COLLABORATED MORE THAN WE EVER HAVE BEFORE. I'VE BEEN WITH, UH, MY ORGANIZATION, ST. DAVID'S FOUNDATION FOR 18 YEARS. THIS IS MY FIFTH ROUND OF CHNAS, AND WE COLLABORATED ANYWHERE WE COULD. SO THIS MEANT MEETING EVERY OTHER WEEK, AND WE DID THAT, NOT JUST BECAUSE COLLABORATION IS GOOD, BUT UH, IN ORDER TO SHARE RESOURCES, REDUCED DUPLICATION OF EFFORTS, BUT MOST IMPORTANTLY, REDUCE SURVEY BURDEN ON COMMUNITY MEMBERS. SO WE'RE NOT ALL ASKING THE SAME PEOPLE THE SAME QUESTIONS, DO I POINT IT SOMEWHERE? THERE WE GO. SO, ST. DAVID'S FOUNDATION IS A PLACE-BASED COMMUNITY FOCUSED AND EQUITY DRIVEN FUNDER SERVING CENTRAL TEXAS, WHICH WE DEFINED AS THE FIVE COUNTIES SURROUNDING AUSTIN. SO THAT INCLUDES TRAVIS COUNTY, UH, BUT ALSO BASTROP, CALDWELL, HAYES, AND WILLIAMSON. UH, WE FOCUS ON REMOVING BARRIERS TO BETTER LIVING TODAY AND CHANGING SYSTEMS AND CONDITIONS TO IMPROVE OUTCOMES FOR A HEALTHIER COMMUNITY. TOMORROW. TO ACHIEVE THIS VISION, WE PRIORITIZE WORKING ALONGSIDE [00:40:01] COMMUNITIES FACING THE GREATEST HEALTH NEEDS. GEOGRAPHY ISN'T THE ONLY FACTOR WE UTILIZE TO IDENTIFY COMMUNITIES TO WORK WITH, BUT IT IS AN IMPORTANT ONE. KNOWING HEALTH COM HEALTH OUTCOMES CAN VARY WILDLY BY ZIP CODES WITHIN CENTRAL TEXAS. AS AN ORGANIZATION THAT STRIVES TO BE RESPONSIVE TO E EVER CHANGING NEEDS OF THE OF COMMUNITY MEMBERS, WE VIEW THE COMMUNITY HEALTH NEEDS ASSESSMENT OR CHIN, NOT JUST AS A REQUIREMENT, BUT CRITICAL TO DEVELOPING OUR ORGANIZATIONAL STRATEGIES, INCLUDING OUR INVESTMENTS AND ACTIONS. AS I MENTIONED BEFORE, THIS IS THE FIFTH CHNA THAT MY ORGANIZATION HAS CONDUCTED SINCE THEY BECAME A REQUIREMENT IN 2012. UH, BUT THIS ROUND WE ATTEMPTED TO TACKLE THE APPROACH VERY DIFFERENTLY FOR ONE, LEADERSHIP AT ST. DAVID'S FOUNDATION STRESSED THE DESIRE THAT THE REPORT BE ACTION ORIENTED AND FOSTER STRATEGIC STRATEGIC PLANNING, BOTH FOR US INTERNALLY, BUT FOR ANYONE WHO WANTS TO USE THE REPORT FOR STRATEGIC PLANNING. IT IS CURRENTLY LIVE ON OUR WEBSITE AND, UM, WE HAVE ATTEMPTED TO CREATE AN INTERACTIVE ONLINE REPORT THAT IS A LIVING BREATHING DOCUMENT. SO OUR PLAN IS THAT WE CONTINUOUSLY UPDATE IT AS NEW DATA BECOMES AVAILABLE. SO OUR ORGANIZATION CAN CONTINUE TO FOCUS ON COMMUNITY ENGAGEMENT. WHAT WE DON'T WANT TO DO IS WAIT THREE YEARS FOR THE NEXT REQUIREMENT TO GO BACK TO COMMUNITIES AND LISTEN TO THEM. SO OUR PLAN IS TO ENGAGE COMMUNITIES ON AN ONGOING BASIS, COLLECTING MORE AND MORE STORIES, AND, UH, TWEAK THE DIRECTION OF THE REPORT AS COMMUNITY MEMBERS, UH, HAVE CHANGING PRIORITIES. SECONDLY, THIS ROUND WE DECIDED TO CREATE A REGIONWIDE REPORT FOR THE FIVE COUNTIES I MENTIONED, RATHER THAN CREATING FIVE DIFFERENT REPORTS, ONE PER COUNTY, WHICH IS WHAT WE USED TO DO. UM, WHILE COUNTY SPECIFIC REPORTS ARE HELPFUL FOR CERTAIN AUDIENCES, I CAN THINK OF ONE RIGHT NOW OF PRESENTING TO THE TRAVIS, UH, COUNTY PUBLIC HEALTH COMMISSION. GENERALLY THE FEEDBACK WE HEARD, UH, FROM COMMUNITY MEMBERS IS THAT COUNTY LINES ARE BLURRING AND IT DOESN'T REFLECT THE REALITY OF EVERYDAY LIFE. SO, FOR EXAMPLE, I MIGHT LIVE IN WILLIAMSON COUNTY, WORK IN DOWNTOWN AUSTIN AND GO TO NIGHT CLASSES IN SAN MARCUS. SO FOR THIS REASON, WE DECIDED TO CREATE ONE, UH, CENTRAL TEXAS REPORT. WE DO EXPLORE DIFFERENCES BY COUNTY, UH, IN THE DATA WHEN APPROPRIATE. BUT FOR THIS PRESENTATION, I'VE USED QUOTES FROM TRAVIS COUNTY RESIDENTS. BUT JUST NOTE THAT THE BROAD THEMES WE ENCOUNTERED IN EVERY SINGLE COUNTY. THE LAST DIFFERENCE FROM PREVIOUS ROUNDS IS HOW MUCH WE EMPHASIZE THE QUALITATIVE RESEARCH AS THE STARTING POINT FOR DEVELOPING THE REPORT. WE SPENT ABOUT NINE MONTHS OF COMMUNITY ENGAGEMENT BEFORE WE EVEN BEGAN DEVELOPING THE REPORT. UH, WE DEVELOPED A COMMUNITY ADVISORY GROUP. UH, DR. RICE HAPPENED TO BE A MEMBER OF OUR ADVISORY GROUP. THANK YOU FOR YOUR PARTICIPATION, UH, WHICH REPRESENTED THE MORE REGIONAL OR SYSTEM LEVEL PERSPECTIVE THAT'S IMPORTANT TO INCLUDE, TO CREATE A WHOLE PICTURE OF CENTRAL TEXAS. WE THEN WORKED WITH NONPROFITS ACROSS CENTRAL TEXAS TO CO-CREATE ENGAGEMENT EVENTS. UH, THEY LED, UH, THEM AND, UH, CREATED SOME REALLY INNOVATIVE EVENTS. SO THIS INCLUDED THINGS LIKE FOCUS GROUPS THAT YOU WOULD EXPECT, UH, STORY CIRCLES, TIKAS, UM, A PHOTO VOICE, EVEN A COMMUNITY ART PROJECT. UM, THE PICTURE HERE DEPICTS AN EVENT LED BY THE NONPROFIT BLACK PARENTS AND FAMILIES COLLECTIVE AT CATHERINE FLETCHER PARK IN WELLS BRANCH. UH, IN ALL, WE COLLECTED OVER 130 STORIES FROM CENTRAL TEXAS RESIDENTS. FINALLY, WE DID A SYSTEMATIC REVIEW OF AVAILABLE DATA SOURCES TO DETERMINE WHAT MEASURES WE SHOULD INCLUDE IN THE REPORT. UM, WE TRY TO INCLUDE DATA THAT TELLS THE BEST STORY OF THE NEEDS OF CENTRAL TEXAS. SO THERE'S SO MUCH DATA THAT WE COULD INCLUDE IN THE REPORT AND IN PAST YEARS WE HAVE, AND IT'S JUST PAGES AND PAGES OF CHARTS. BUT BY LEADING WITH THE QUALITATIVE, WE ALLOWED WHAT COMMUNITIES TOLD US TO DRIVE THE DIRECTION OF THE REPORT AND ACCOMPANYING IT WITH DATA THAT EXPANDS ON THEIR STORIES. WE ALSO PRIORITIZE DATA THAT [00:45:01] HIGHLIGHTS THE STARKEST DISPARITIES IN OUR COMMUNITIES THAT, UH, COMMUNITY MEMBERS MIGHT NOT HAVE SPOKEN ABOUT DIRECTLY WHEN THEY'RE TALKING ABOUT THEIR DAY TO DAY EXPERIENCES, BUT HIGHLIGHT THE UNDERLYING AND STRUCTURAL ISSUES THAT LEAD TO THOSE EXPERIENCES. SO, FOR EXAMPLE, ON THE SCREEN, UH, THIS SHOWS THE DIFFERENCE IN AVERAGE LIFE EXPECTANCY BY ZIP CODE, WHICH CAN RANGE, UH, UP TO 12 YEARS BETWEEN WEST AUSTIN AND EAST AUSTIN. FOR ZIP CODES THAT ARE NOT THAT FAR AWAY FROM EACH OTHER. WE ORGANIZED THE TOP NEEDS INTO THREE BROAD CATEGORIES THAT WE'RE CALLING HEALTHCARE AND REACH, ECONOMIC STABILITY AND COMMUNITY AND BELONGING. BUT I WANT TO EMPHASIZE THESE ARE THE BROADEST DESCRIPTIONS OF, OF THESE CATEGORIES. AND WHILE I WON'T BE ABLE TO DIVE DEEPLY INTO EACH ONE OF THEM TODAY, I ENCOURAGE EVERYONE TO GO TO OUR WEBSITE. IT'S ON THE, UH, WHERE WE WORK SECTION OF OUR WEBSITE TO DIVE DEEPER TO UNDERSTAND WHAT WE MEAN BY THESE TERMS AND HOW THEY SHOW UP UNIQUELY IN CENTRAL TEXAS. BUT AT THE HIGHEST LEVEL, WHEN WE SAY HEALTHCARE AND REACH, UH, WE'RE TALKING ABOUT THAT CENTRAL TEXANS REPORTED THAT THEY'RE NOT SEEKING HEALTHCARE DUE TO THE COST OF THAT CARE. UH, POTENTIAL LOSS WAGES FOR TAKING OFF WORK. AND MOST IMPORTANTLY, THIS CAME UP AGAIN AND AGAIN. PAST EXPERIENCES NAVIGATING A BROKEN SYSTEM. WHAT WE HEARD IS THAT UNTIL THE PATIENT EXPERIENCES IMPROVED, WHICH INCLUDES HOW APPOINTMENTS ARE SCHEDULED, HOW MANY APPOINTMENTS IT TAKES TO ADDRESS A HEALTH CONCERN, ENROLLMENT AND ELIGIBILITY PROCESSES THAT FEEL LIKE THEY'RE MADE TO KEEP PEOPLE OUT AND HOW PEOPLE ARE TREATED WITHIN THE CLINIC, MANY FOLKS WILL CONTINUE TO AVOID GOING TO THE DOCTOR. ECONOMIC STABILITY REFERS TO THE FACT THAT WHEN A FAMILY IS STRUGGLING TO MAKE ENDS MEET EVERY MONTH, MONTH AFTER MONTH, IT IS VERY DIFFICULT TO PRIORITIZE OTHER THINGS LIKE THE CARE AND ACTIVITIES NEEDED TO FOSTER GOOD HEALTH. UM, KNOWING MY COUNTERPARTS, WE'RE GOING TO DIVE INTO SOME OTHER TOPICS. THIS IS THE TOPIC THAT I WANTED TO DIVE INTO FOR MY PRESENTATION. BUT FINALLY, UM, FOR COMMUNITY AND BELONGING, WE HEARD THAT MANY DO NOT FEEL CENTRAL TEXAS IS AS WELCOMING AS IT COULD BE DUE TO RACISM, DISCRIMINATION, AND COMMUNITY DISPLACEMENT. WE HEARD REPEATEDLY ABOUT THIS FEELING OF LOSS OF PROXIMITY DUE TO GENTRIFICATION, HIGHER COST OF LIVING, PEOPLE BEING PUSHED OUT. UM, SO A LACK OF PROXIMITY TO FAMILY SUPPORT SYSTEMS AND THOSE THAT MAY SHARE MY CULTURE. SO FOR ECONOMIC STABILITY, SPECIFICALLY, THE CONNECTION BETWEEN, UM, WEALTH AND HEALTH IS WELL RESEARCHED AND DOCUMENTED. IT TAKES RESOURCES TO IMPROVE THE HEALTH OF NEIGHBORHOODS AND COMMUNITIES. THIS SHOWED UP UNIQUELY IN CENTRAL TEXAS IN THE FOLLOWING WAYS, AS THE COST OF LIVING CONTINUES TO INCREASE. MANY FAMILIES ARE STILL STRUGGLING ECONOMICALLY, BUT DO NOT QUALIFY FOR ANY PROGRAMS OR SUPPORTS. MOST ARE WORKING, BUT MANY JOBS DO NOT PAY ENOUGH WAGES TO LIVE AND FUNCTION IN CENTRAL TEXAS. PARENTS IN PARTICULAR SHARED THAT THEY OFTEN SACRIFICE THEIR OWN PHYSICAL AND MENTAL HEALTH NEEDS IN ORDER TO FOCUS ON THE NEEDS OF THEIR CHILDREN. SO WHILE STRIVING TO PROVIDE THEIR KIDS WITH EVERY AND ALL OPPORTUNITIES THEY NEED TO SUCCEED, THEY DON'T HAVE THE TIME TO TAKE A STEP BACK AND FOCUS ON THEIR OWN HEALTH AS ONE, UH, TRAVIS COUNTY RESIDENT PUT IT. WE'RE NOT FOCUSED ON THRIVING WHEN WE'RE JUST SURVIVING EXPENSES LIKE CENTER-BASED CHILDCARE AND REGULAR AND PREVENTIVE HEALTHCARE CAN FEEL LIKE A DISTANT GOAL. CHILDCARE FOR TRAVIS COUNTY, SPECIFICALLY COMPARED TO THE OTHER COUNTIES, IS A PARTICULAR BARRIER. ONE DATA POINT WE USED IN THE REPORT TO HIGHLIGHT IS THE FACT THAT IT'S ALMOST AS EXPENSIVE TO PAY FOR A YEAR'S WORTH OF CHILDCARE AT A CENTER-BASED CHILDCARE CENTER FOR A PRESCHOOLER AS IT IS TO SEND A HIGH SCHOOL GRADUATE TO COLLEGE. UH, IT PROBABLY DOESN'T SURPRISE THIS GROUP THAT THE RISING COST OF HOUSING IN AUSTIN IS A MAJOR CAUSE OF STRESS FOR FAMILIES AND INDIVIDUALS. IT MAY SURPRISE YOU OR NOT THAT, UM, ABOUT HALF OF CENTRAL TEXAS RENTERS ARE CONSIDERED HOUSING COST BURDEN, MEANING THEY SPEND OVER A THIRD OF THEIR MONTHLY INCOME ON RENT, WHICH LEAVES LESS RESOURCES FOR [00:50:01] FOOD, GROCERIES, TRANSPORTATION, AND HEALTHCARE. UH, BEFORE I END, UM, I JUST WANT TO NOTE THAT THIS IS CALLED A COMMUNITY HEALTH NEEDS ASSESSMENT. SO BY ITS NATURE, IT TENDS TO ASK QUESTIONS ABOUT THE NEGATIVE ASPECTS OF ONE ONE'S COMMUNITY. UH, I THINK IT'S VERY ENCOURAGING THAT EVEN WITH THAT FOCUS, PEOPLE COULDN'T HELP THEMSELVES BUT SHARE THE STRENGTHS AND THE BENEFITS OF THEIR COMMUNITY. AFTER EACH OF THESE EVENTS, UM, WE FELT A HUNGER FOR PEOPLE WHO WANTED TO MOBILIZE AND TACKLE THESE SOCIAL ISSUES. UH, I REMEMBER ONE EVENT, AMAN STOOD UP AND SAID, I'M READY TO VOLUNTEER TO MAKE MY COMMUNITY A BETTER PLACE. I JUST DON'T KNOW WHERE TO GO. SHOW ME WHERE TO VOLUNTEER AND I'LL SHOW UP. UM, THAT PICTURE AND THEN I'LL, I'M SURE I'M OVER TIME, UH, IS, UH, A PICTURE OF AN APARTMENT COMPLEX IN SOUTHEAST AUSTIN OFF PARKER LANE. WE WORKED WITH FOUNDATION COMMUNITIES AND THIS EVENT WAS TO BRING BACK THE FINDINGS TO THE VERY FAMILIES THAT SHARED THEIR STORIES, TO LET THEM KNOW WHAT WAS HAPPENING WITH THEIR STORIES. AND EVEN AFTER A VERY, VERY HEAVY DISCUSSION ABOUT THE NEEDS OF THE COMMUNITY, WE COULD SENSE THE JOY IN THE ROOM AND THE EXCITEMENT TO WORK ON POSITIVE CHANGES. SO WHAT COMES NEXT? I ENCOURAGE EVERYONE TO TAKE A DEEPER LOOK. I ACTUALLY HAVE POSTCARDS, IF YOU WANT ONE FOR THIS QR CODE. UH, TO DIVE DEEPER INTO THE REPORT, I ALSO ENCOURAGE YOU TO GO TO THE COMPANION TO THE CHNA, WHICH IS OUR STRATEGIC PLAN. SO THE CHNA IS ON THE WHERE WE WORK PAGE. THE HOW WE WORK PAGE HAS OUR STRATEGIC PLAN CALLED PATHWAYS TO HEALTH EQUITY. IN ADDITION TO OUR STRATEGIC PLAN, IF YOU THINK OF OUR STRATEGIC PLAN AS HIGHLIGHTING THE PRIORITIES FOR THE FOUNDATION OVER THE NEXT FIVE YEARS, WE ARE CURRENTLY FINALIZING OUR COMMUNITY HEALTH IMPLEMENTATION PLAN. AND THE IMPLEMENTATION PLAN TALKS ABOUT THE SPECIFIC ACTIVITIES, UH, THAT WE WANT TO EXPLORE TO ACHIEVE THOSE PRIORITIES. SO THESE, UM, INCLUDE FUNDING OPPORTUNITY ANNOUNCEMENTS THAT NONPROFITS CAN APPLY FOR, FOCUSED ON IMPORTANT TOPICS LIKE AFFORDABLE HOUSING, CULTURALLY RESPONSIVE MENTAL HEALTH CARE AND CIVIC HEALTH IMPROVEMENT, AS WELL AS CHANGES TO OUR INTERNALLY OPERATED PROGRAMS SUCH AS OUR MOBILE HEALTH, UH, MOBILE DENTAL PROGRAM, AND OUR HEALTHCARE FOCUS SCHOLARSHIP PROGRAM. AND I'M HAPPY TO TAKE ANY AND ALL QUESTIONS. THANK YOU SO MUCH FOR THE PRESENTATION. JESSE. UH, I WOULD SAY IF WE HAVE ONE QUESTION JUST TO KEEP US ON TIME. I KNOW WE HAVE MORE PRESSING QUESTIONS JUST FROM SOME OF THE INFORMATION THAT YOU'VE SHARED, OR AT LEAST I'LL SPEAK FOR MYSELF AND SAY I HAVE A LIST OF THEM. UH, BUT YEAH, I WILL, I WILL YIELD MY TIME AND OPEN UP TO THE, THE FLOOR. PLEASE. THANK YOU FOR THE PRESENTATION. YOU MENTIONED YOU'VE BEEN DOING THIS FOR 18 YEARS, YOUR FIFTH CHANA. I'M JUST CURIOUS IF YOU COULD SHARE AN EXAMPLE OF A SUCCESS STORY OF SOMETHING THAT WAS IDENTIFIED AS A NEED HOWEVER MANY YEARS AGO THAT Y'ALL HAVE ADDRESSED AND THAT IS NO LONGER, YOU KNOW, A NEED THAT'S BEING IDENTIFIED. OKAY. WELL, , I FEEL LIKE THAT'S SLIGHTLY LOADED 'CAUSE THESE ARE STRUCTURAL SYSTEM GENERATIONAL ISSUES. YOU KNOW, ONE, ONE STORY THAT I LOVE THAT CAME OUT OF THIS CHNA IS THAT WE WERE AT A SENIOR COMMUNITY CENTER AND WE WERE LISTENING TO THE PEOPLE THERE TALK ABOUT THE NEEDS OF THE COMMUNITY. AND ONE OF THE PEOPLE SAID, STOOD UP AND SAID, DID YOU KNOW THAT THE CART ROUTE THAT WE ALL UTILIZE TO GET TO THIS COMMUNITY CENTER HAS BEEN STOPPED AND WE CAN NO LONGER RELY ON IT? AND THE EXECUTIVE DIRECTOR OF THE NONPROFIT WHO WAS LEADING THAT HAD CONNECTIONS WITH CART, GOT ON THE PHONE CALLED, AND IT WAS IMMEDIATELY REINST INSTALLED, AND THEY JUST SAID, OH, WE'RE, YOU KNOW, WE'RE HAVING HIRING SHORTAGES. WE, YOU KNOW, IT WAS KIND OF LOWER ON THE PRIORITY, WE'LL MAKE IT A PRIORITY. AND THEY BROUGHT THAT CART. SO I KNOW THAT'S NOT LIKE COMMUNITY LEVEL CHANGE, BUT IT'S MY FAVORITE STORY OF JUST SOMETHING THAT IMMEDIATELY HAPPENED BASED ON COMMUNITY FEEDBACK. I'LL JUST MAKE A QUICK COMMENT. I THINK THE WORK TO IDENTIFY AND LET PEOPLE TELL THEIR STORIES AND COLLECT THOSE SYSTEMATICALLY IS A PROFOUNDLY IMPORTANT THING THAT YOU'VE DONE. AND WHEN I ATTENDED OUR SESSIONS AND PEOPLE WERE TELLING STORIES THAT WAS MOVING AND TRANSFORMATIVE. YEAH. SO I JUST MAKE THAT COMMENT, UM, ABOUT THE IMPORTANCE OF THAT. I WILL SAY THIS, UH, JUST JUST TO KEEP ON OUR TIME, UM, IF WE HAVE ADDITIONAL QUESTIONS, THOUGHTS, IDEAS, PLEASE WE'LL COMPILE THEM. YEAH, GET THEM TO DANNY, [00:55:01] DANNY WILL THEN HOPEFULLY CLEAN THEM UP A LITTLE BIT AND ORGANIZE THEM FOR US BEFORE THEY COME OUT TO YOU ALL. UH, MY SCRIBBLE SCRABBLE WILL GET TYPED UP PRETTY, BUT, UH, APPRECIATE YOU JESSE, THANK YOU SO MUCH FOR SHARING THIS AND, AND GETTING US, UM, MORE INFORMATION ABOUT WHAT YOU GUYS ARE DOING AT ST. DAVID'S. THANK YOU. UM, NEXT UP WE HAVE BETH [6. Presentation by Beth Corbett and Emily Fox with Central Texas Food Bank on their contribution to the Community Health & Needs Assessment Report. ] AND EMILY FROM CENTRAL TEXAS FOOD BANK. WELCOME. THANK YOU. WELL, GOOD AFTERNOON. I THINK THIS IS MY FIRST TIME IN FRONT OF THIS COMMISSION, UM, AND I, BUT I'VE MET MANY OF YOU BEFORE AND HAD THE OPPORTUNITY TO WORK WITH YOU. UM, MY NAME'S BETH CORBITT. I AM THE VICE PRESIDENT OF GOVERNMENT AFFAIRS AND ADVOCACY FOR THE CENTRAL TEXAS FOOD BANK. AND MY COLLEAGUE EMILY FOXMAN IS HERE, UM, WHO IS REALLY THE BRAINS BEHIND WHAT WE'RE TALKING ABOUT TODAY. SO I'M GLAD SHE'S HERE TO ANSWER THE QUESTIONS THAT I'M SURE I WILL NOT BE ABLE TO. BUT, UM, WANTED TO GIVE YOU ALL A QUICK OVERVIEW OF THE, UH, FOOD ACCESS COMMUNITY NEEDS ASSESSMENT THAT OUR TEAM AND LED BY EMILY JUST, UH, RECENTLY WRAPPED UP. WHICH BUTTON DO I PUSH? I DID IT. ALRIGHT. UM, JUST TO SET THE TONE, I'M SURE THIS IS NOT A SURPRISE TO ANYONE IN THIS ROOM, BUT, UM, FOOD INSECURITY ACROSS THE REGION AND ACROSS THE COUNTRY HAS BEEN ON THE RISE. I THINK MANY OF US EXPECTED MAYBE, UH, A DECLINE FOLLOWING THE PANDEMIC, AND THAT AB ABSOLUTELY HAS NOT HAPPENED. IT'S JUST GOING UP AND UP AND UP. UM, I WOULD BE REMISS PROBABLY TO NOT ACKNOWLEDGE THE CURRENT MOMENT THAT WE ARE IN, UM, AND A REALLY RAPID, UH, INCREASE IN THOSE NUMBERS. AND THEN DIVING INTO OUR NEEDS ASSESSMENTS, I'M GONNA LOOK AT THAT ONE. THERE WE GO. UM, WE ARE CONDUCTING THESE ACROSS ALL 21 COUNTIES THAT WE SERVE. THIS MAP SHOWS YOU WHERE WE HAVE COMPLETED THE ASSESSMENTS, WHERE WE ARE CURRENTLY CONDUCTING ASSESSMENTS WHERE THEY'RE PLANNED. AND THEN THE COUNTIES IN BLACK WE WILL GET TO ONE DAY, RIGHT . UM, AND THIS HAS REALLY BEEN, UH, AN EFFORT TO LOOK AT THE AVAILABLE QUANTITATIVE DA DATA, UH, PUBLICLY AVAILABLE SOURCES, LOOKING AT GAPS IN FOOD ACCESS, BOTH DOWNSTREAM BUT ALSO UPSTREAM. SO WE THINK ABOUT THINGS SOMETIMES AT THE FOOD BANK AS THERE IS THE CHARITABLE RESPONSE. THERE'S THE WORK THAT WE'RE DOING EVERY DAY, BUT THERE ARE ALSO THESE UPSTREAM SOLUTIONS. UH, THINGS LIKE RETAIL OPPORTUNITIES, THINGS LIKE LOCAL AG PRODUCTION, ALL OF THOSE GAPS, WHERE ARE THEY? AND THEN WE TAKE A REALLY DEEP DIVE, UH, FOLLOWING FEEDBACK FROM LOCAL STAKEHOLDERS EMBEDDED IN THESE COMMUNITIES TO GET THE QUAL QUALITATIVE PIECE AND FEEDBACK FROM NEIGHBORS WHO ARE EXPERIENCING FOOD INSECURITY, MAKING SURE THAT THEIR VOICE IS INCORPORATED IN THESE ASSESSMENTS. UM, IN TRAVIS COUNTY, THIS IS A QUICK SCREENSHOT OF WHO WE TALKED TO, UH, WHERE THOSE NEIGHBORS WERE. WE, I THINK DID A REALLY GOOD JOB OF REACHING NEIGHBORHOODS WITH THOSE HIGH LEVELS OF FOOD INSECURITY. HAD A REALLY GREAT RESPONSE, UM, FROM THE SURVEYS THAT WE SENT OUT. AND NOTABLY, YOU SEE THAT 58% OF THOSE FOLKS HAVE RECEIVED CHARITABLE ASSISTANCE. WE LIKE THESE ASSESSMENTS BECAUSE THEY ALLOW US TO TALK TO THE FOLKS WHO AREN'T NECESSARILY ACCESSING OUR SERVICES. WE KNOW HOW TO FIND THOSE PEOPLE. WE KNOW WHEN THEY'RE COMING TO OUR PARTNER AGENCIES COMING TO FOOD PANTRIES, BUT WE KNOW THERE ARE A LOT OF FOLKS FACING FOOD INSECURITY THAT, THAT DON'T DO. SO. SO THESE ASSESSMENTS ARE A GREAT OPPORTUNITY FOR US, UH, TO REACH THOSE PEOPLE. UM, AND THIS IS HOW WE DO IT. WE PARTNER WITH COMMUNITY ORGANIZATIONS. HERE'S AN EXAMPLE OF, OF WHO WE WORKED WITH IN TRAVIS COUNTY TO MAKE SURE, AGAIN, WE WERE REACHING NEIGHBORS THAT MIGHT NOT, UM, BE CONSISTENTLY COMING TO OUR DISTRIBUTIONS, PARTICIPATING WITH OUR PARTNER NETWORK. UM, WE ALSO, UH, ENGAGE ELECTED OFFICIALS. UH, I MET SOMEONE ON THIS COMMISSION, MAY HAVE PARTICIPATED IN THE NEEDS ASSESSMENT, I DON'T KNOW. BUT, UM, YOU KNOW, LOOKING AT TRANSPORTATION PROVIDERS, EDUCATION LIBRARIES, WE, WE INTERVIEW EVERYONE AND, AND ANYONE THAT WE CAN, UM, TO GET AS ROBUST A PICTURE AS WE CAN ON WHAT, UH, WHAT FOOD ACCESS LOOKS LIKE IN COMMUNITIES. UM, AND THEN REAL QUICKLY, AGAIN, THIS WILL NOT BE A SURPRISE TO YOU ALL IN TRAVIS COUNTY. UM, AS OF THE LATEST DATA AVAILABLE THAT OUR DATA TEAM PUT TOGETHER, 18% OF FOLKS IN THE COUNTY ARE FACING FOOD INSECURITY. HIGHEST CONCENTRATION OF THOSE ALONG THAT I 35 REALLY EASTERN SIDE OF THE COUNTY. AGAIN, I KNOW THAT WON'T COME AS A SHOCK. UM, AGAIN, TO SPEAK TO THE CURRENT MOMENT IN THE GOVERNMENT SHUTDOWN, IF, FOR THOSE OF YOU WHO ARE NOT AWARE, I BELIEVE THERE ARE 9,000 FEDERAL EMPLOYEES HERE IN TRAVIS COUNTY THAT HAVE BEEN IMPACTED AND HAVEN'T BEEN RECEIVING A PAYCHECK. AND THERE ARE ALSO OVER 87,000 SNAP RECIPIENTS. SO PRETTY [01:00:01] BIG GAP, A PRETTY BIG JUMP IN THAT NUMBER. WHAT IS THAT 2 35? THAT'S POTENTIALLY ANOTHER A HUNDRED THOUSAND. UH, FOLKS JUST, JUST THIS MONTH, UM, THAT HAVE, HAVE EXPERIENCED A NEED. I WILL NOW TURN IT OVER TO EMILY TO TALK ABOUT A LITTLE MORE OF THE FINDINGS AND THEN I WILL WRAP US UP WITH SOME OF THE POSITIVE SOLUTIONS THAT CAME OUT OF THIS ASSESSMENT. YEAH, I'M REALLY EXCITED TO DIVE INTO THIS. THANKS FOR EVERYONE FOR OPENING THE FLOOR TO THIS CONVERSATION. UM, LIKE YOU'VE HEARD FROM A LOT OF OUR, OUR PARTNERS HERE, WHAT WE'RE REALLY SEEING IN TERMS OF FOOD INSECURITY IN TRAVIS COUNTY IS THAT SOCIAL DETERMINANTS OF HEALTH AND ACCESS TO ECONOMIC OPPORTUNITY ARE REALLY DRIVING WHETHER FOLKS HAVE ACCESS TO THE TYPES OF FOOD THAT THEY REALLY WANT AND NEED. UM, WHAT WE'RE SEEING IS THAT ACROSS THE BOARD, FOLKS WHO ARE EXPERIENCING FOOD INSECURITY IN TRAVIS COUNTY OVER HALF HAVE A CHRONIC ILLNESS, HALF HAVE, DO NOT HAVE ACCESS TO HIGHER EDUCATION. UM, AND MANY ARE MAKING REALLY TOUGH TRADE-OFFS EVERY MONTH BETWEEN FOOD AND OTHER ESSENTIALS. ONE IN THREE NEIGHBORS ARE MAKING MONTHLY TRADE-OFFS BETWEEN FOOD AND HOUSING, FOOD AND UTILITIES. AND TWO IN FIVE WOULD BE UNABLE TO AFFORD AN UNEXPECTED $400 EMERGENCY. UM, WE'RE SEEING, YOU KNOW, RIGHT NOW AS RESOURCES ARE PARTICULARLY LIMITED, THAT THAT IS SOMETHING THAT HAPPENS VERY QUICKLY. AN UNEXPECTED HEALTHCARE EXPENSE, A FLAT TIRE, A DENTAL EMERGENCY. A LOT OF FOLKS MOVE IN AND OUT OF FOOD INSECURITY AND IT'S NOT A, SOMETHING THAT STAYS CONSISTENT ACROSS THE BOARD. UM, FOLKS WHO ARE, YOU KNOW, DISPROPORTIONATELY IMPACT CONTINUE TO BE OLDER ADULTS, FAMILIES WITH CHILDREN, BLACK AND HISPANIC NEIGHBORS AND OUR REFUGEE AND IMMIGRANT COMMUNITIES. IN TERMS OF SOME OF THE KEY FINDINGS, WHAT WE REALLY HEARD IS THAT FOLKS NOT ONLY WANT ACCESS TO ENOUGH FOOD, THEY REALLY WANT ACCESS TO THE FOODS THAT THEY WANT AND NEED TO THRIVE, THAT PROMOTE OPTIMAL HEALTH, THAT ALIGN WITH THEIR CULTURAL TRADITIONS, THAT ALIGN WITH WHAT THEIR KIDS WILL EAT AND WHAT WORKS WITH THEIR DIETARY CONDITIONS AND HEALTH CONDITIONS. UM, AND THAT ALSO THERE'S A LOT OF REALLY CHALLENGING INFRASTRUCTURE GAPS AS WELL. UM, AS WE SEE FOLKS CONTINUE TO EXPERIENCE DISPLACEMENT IN TRAVIS COUNTY, PARTICULARLY IN THE EASTERN CRESCENT, WE'RE SEEING THAT POPULATION GROWTH AND GENTRIFICATION IS REALLY OUTPACING GROCERY AND TRANSPORTATION INFRASTRUCTURE. UM, AND THEN AT THE SAME TIME WE'RE NOT SEEING AGRICULTURAL LAND THAT'S RESPONSIVE IN THOSE DAYS AS WELL. WE'RE SEEING HISTORIC DECLINES IN THE NUMBER OF FARMS AND THE NUMBER OF RANCHES. AND IN TERMS OF AGRICULTURAL LAND IN TRAVIS COUNTY, UM, ONLY 1% OF AG LAND HERE IN TRAVIS COUNTY GOES TO PRODUCING FRUITS AND VEGETABLES. UM, AND THEN ACROSS THE BOARD, REALLY SOMETHING THAT WE HEARD IS THAT FOLKS WANT TO HAVE THE RESOURCES TO MAKE CHOICES ABOUT WHAT WORKS WELL FOR THEM, WHAT WORKS WELL FOR THEIR FAMILIES. AND THAT A HUGE GAP IS AROUND ACCESS AND AWARENESS OF COMMUNITY RESOURCES, WHAT'S AVAILABLE WHEN, AGAIN, THINKING ABOUT, WE HEARD SO MUCH APPETITE FOR SOLUTIONS, NOT ONLY FROM NEIGHBORS EXPERIENCING FOOD INSECURITY, BUT ALSO FROM STAKEHOLDERS WHO ARE ACTIVELY WORKING IN THIS SPACE AS WELL. AND A REALLY BIG THEME THAT WE HEARD WAS ABOUT MEETING NEIGHBORS WHERE THEY ARE BEING ABLE TO DELIVER PROGRAMS AND SERVICES THAT ARE CULTURALLY RELEVANT, THAT USE CLEAR PLAIN LANGUAGE, HAVE MULTI MULTILINGUAL OPTIONS, WORKING TO PROVIDE SERVICES ON WEEKENDS AND AFTER TRADITIONAL WORK HOURS IN PLACES THAT ARE TR TRUSTED, CONVENIENT, FAMILIAR, COMING BACK TO THOSE TRANSPORTATIONS AS WELL. AND ALSO CONTINUING TO ELEVATE COMMUNITY VOICE TO CO-CREATE SOLUTIONS THAT ARE FOREIGN BY THE COMMUNITY AS WELL. OKAY. BACK TO ME. UM, WE HAD GREAT FEEDBACK. I THINK FROM ON, ON THIS FRONT IN PARTICULAR IN TRAVIS COUNTY. UM, FOOD IS MEDICINE WAS A BIG THEME THAT, THAT CAME OUT OF THIS NEEDS ASSESSMENT. THAT'S ACTUALLY BEEN A RESONANT ON IN ALL THE COUNTIES, I BELIEVE, WHERE WE'VE CONDUCTED THESE SO FAR. UM, RESEARCH TO THE FOOD BANK IS WITH SOME FOLKS IN THE ROOM TODAY, UH, PARTICIPATING IN SOME PILOTS WITH BOTH CENTRAL HEALTH AND ASCENSION IN MEDICALLY TAILORED MEAL PROGRAMS FOR, FOR FAMILIES HERE IN TRAVIS COUNTY. WE HAVE, UH, EXPANDED OUR MOBILE PHARMACY. IF YOU'RE NOT FAMILIAR WITH THAT, IT'S BASICALLY A GROCERY STORE ON WHEELS. UH, WE HEARD FROM, UH, MICRO CNA WE DID IN THE DELL VALLEY COMMUNITY TO KICK OFF THIS ENTIRE PROCESS THAT THEY REALLY WANTED HEALTHY FOOD AVAILABLE AT HEALTHCARE SITES WHERE THEY WERE GOING TO THEIR APPOINTMENTS. UM, AND AS A RESULT, WE ARE NOW DEPLOYING THAT SPECIFICALLY TO THOSE LOCATIONS. IT'S ESSENTIALLY A FOOD, UH, PRESCRIPTION PROGRAM. UM, WE'VE OPENED UP PANTRIES IN SCHOOLS, SO AGAIN, BRINGING THAT HEALTHY FOOD TO PLACES THAT ARE CONVENIENT PEOPLE, MEETING PEOPLE WHERE THEY ARE, UM, AND THEN CONTINUE TO OPERATE OUR HOME DELIVERY PROGRAM THAT HAS BEEN BOTH IN PARTNERSHIP WITH THE COUNTY AND AT, UH, WITH THE CITY CURRENTLY, UM, SERVING FOLKS THAT AREN'T ABLE TO MAKE IT TO A TRADITIONAL DISTRIBUTION OR A FOOD PANTRY. UM, I SIT ON THE AUSTIN TRAVIS COUNTY FOOD POLICY BOARD, UH, WHICH IS GREAT. IT GIVES US SOME INSIGHT AS AN ORGANIZATION INTO, YOU KNOW, WHAT'S HAPPENING LOCALLY ACROSS THE FOOD [01:05:01] SYSTEM. AND THEN VERY EXCITED. WE JUST LAUNCHED OFFICIALLY, UH, THE CENTRAL TEXAS REGIONAL FOOD SYSTEM COUNCIL. THIS IS SOMETHING THE FOOD BANK IS GOING TO BACKBONE, BUT IT'S MADE UP OF STAKEHOLDERS ACROSS COUNTIES ALL OVER OUR SERVICE TERRITORY. IT, IT HAS RETAIL REPRESENTATION, IT HAS PRODUCER REPRESENTATION. UH, WE HAVE AN ELECTED OFFICIAL REPRESENTATION, REALLY WANTING TO BRING ALL THE STAKEHOLDERS TOGETHER. AGAIN, THINKING ABOUT THOSE UPSTREAM SOLUTIONS WHERE THE ANSWER ISN'T ALWAYS GONNA BE MORE FOOD PANTRIES, MORE OF A CHARITABLE RESPONSE, BUT WHAT ARE THOSE OPPORTUNITIES THAT WE CAN HARNESS REGIONALLY ELEVATING THE LOCAL VOICE OF, OR, UH, LIKE THE FOOD POLICY BOARD HERE, UH, BRINGING THOSE VOICES TO THE TABLE AS WELL SO THAT WE'RE LOOKING AT THIS THROUGH A REGIONAL LENS, UM, TO FILL THOSE GAPS AND ADDRESS THE NEEDS OF OUR NEIGHBORS. AND I THINK THAT IS IT. DID I MISS ANYTHING, EMILY? NO, THAT'S ALL THE EXPERT. OKAY. THEY DON'T USUALLY TRUST ME TO TALK ABOUT RESEARCH, SO I I FEEL KIND OF PROUD. . ANY QUESTIONS FOR US? I HAVE, UH, ONE QUESTION. UM, AND I WILL KEEP IT BRIEF IF POSSIBLE. AND ALSO IF YOU DON'T HAVE AN ANSWER, PLEASE, PLEASE EMAIL US. UM, HAVE YOU NOTICED ANY CONVERSATIONS OR HEARD ABOUT ANY CONVERSATIONS, UNDERSTANDING THAT 1% OF LAND IS GOING TO FOOD AND VEGGIE GROWTH, UH, ANY CONVERSATIONS AROUND, UM, THE NEW INFRASTRUCTURES THAT ARE BEING BUILT AND ROOFTOP GARDENS AND WHAT THAT INCENTIVE OR PROGRAMMING COULD LOOK LIKE? UH, FOR THOSE THAT ARE GETTING TONS OF OPPORTUNITIES TO BUILD THESE AMAZING BUILDINGS IN OUR CITY, UH, WHAT THAT COULD DO FOR OUR FOOD SYSTEM ONLY, THAT'S TO YOU . YES. YEAH. THERE, THERE'S A HUGE APPETITE TO EXPLORE HOW TO BOLSTER URBAN AGRICULTURE IN PARTICULAR RIGHT NOW. SO THINKING ABOUT SMALL SCALE AG, WHETHER THAT'S IN PUBLIC SPACES, USING PUBLIC LAND, UM, THERE'S ALSO CONVERSATIONS RIGHT NOW ABOUT EXPLORING CONSERVATION EASEMENTS, HOW TO SPECIFICALLY SAFEGUARD LAND FOR GROWING FOOD SPECIFICALLY AND EXPLORING WHAT THAT COULD LOOK LIKE. AND I THINK IT'S SOMETHING THAT THE AUSTIN TRAVIS COUNTY FOOD POLICY BOARD IS REALLY INTERESTED IN EXPLORING, UM, FROM A, A LOCAL NONPROFIT STANDPOINT. THERE'S ALSO A LOT OF PARTNERS THAT ARE DOING SOME TRAINING AROUND URBAN AGRICULTURE IN THAT WAY AND AROUND TRAINING SORT OF THE NEXT GENERATION OF LOCAL PRODUCERS. SO THOSE FARM INCUBATOR PROGRAMS AS WELL. AND IT CONTINUES TO BE AN AREA THAT, THAT NEEDS SOME EXTRA SUPPORT TO REALLY SCALE AND MEET THAT NEED. UNDERSTANDING. WE HAVE LIMITED TIME. ANY OTHER DR. WA GO FOR IT, PLEASE. UH, JUST TO FOLLOW UP ON YOUR QUESTION ABOUT ROOFTOP GARDENS. UM, IS THERE ANY COLLABORATION HAPPENING BETWEEN THE CLIMATE RESILIENCE GROUP AND THE FOOD POLICY BOARD ON THAT QUESTION? YES. I BELIEVE, UM, I BELIEVE THE FOOD POLICY BOARD WILL SEND A REPRESENTATIVE TO, YOU KNOW, ATTEND THOSE MEETINGS AND STAY IN TOUCH. UM, I AM NOT THAT PERSON, BUT I BELIEVE THE ANSWER IS YES, GOOD TO HELP DECREASE OUR, UM, HEAT ISLANDS. YEAH. THANK YOU. ALRIGHT, PLEASE, THANK YOU. JUST A GREAT PRESENTATION AS ALL HAVE BEEN. UM, IS YOUR, IS YOUR REPORT ONLINE AS WELL? IT IS. THANK YOU. YES, IT IS LIVE. THE FULL REPORT. WE PROVIDED A, A, A WRAP UP KIND OF HIGH LEVEL SUMMARY OVERVIEW FOR ALL OF THE STAKEHOLDERS WHO WERE INVOLVED IN HELPING US, UH, PUT THIS TOGETHER. BUT THEN THE TEAM HAS COMPLETED THE FULL LENGTHY REPORT FOR ALL OF YOU TO PERUSE AT YOUR LEISURE. WONDERFUL. THANK YOU SO MUCH BETH AND EMILY. UH, WE ARE GOING TO [7. Presentation by Kodjo Dodo and Shirley Aldana on their contribution to the Community Health & Needs Assessment Report. ] LEAN INTO OUR FINAL PRESENTATION AGAIN WITH, UH, KOJO AND SHIRLEY, SO PLEASE WITH SHIRLEY . ALRIGHT. A LOT OF PRESSURE HERE TO BE THE LAST ONE. IT'S BEEN AMAZING PRESENTATIONS TO FOLLOW UP. SO THANK YOU SO MUCH. UM, TO THE COMMISSIONERS HERE PRESENT AND EVERYONE JOINING US ONLINE, UM, IT'S A PLEASURE TO BE HERE. UH, MY NAME IS SHIRLEY ALDANA. UM, I GO BY CHERYL SOMETIMES, AND I AM WITH AUSTIN PUBLIC HEALTH AND I AM THE PLANNING COORDINATOR WITH THE AUSTIN TRAVIS COUNTY CHAT CHIP PROGRAM. UM, I'VE BEEN IN THIS ROLE JUST A LITTLE OVER A YEAR, AND THIS IS MY FIRST TIME PRESENTING, UM, BEFORE THE COURT IN THIS CAPACITY. SO YOU MIGHT HEAR A LITTLE BIT OF EXCITEMENT IN MY VOICE, AND THAT'S ONLY BECAUSE I'M REALLY EXCITED, UM, TO BE SHARING THE FINDINGS OF OUR COLLECTIVE WORK HERE. UM, SO THERE, OH, OKAY. UM, AS WE MOVE INTO THE PRESENTATION, I'LL BE SHARING HIGHLIGHTS FROM THE PRELIMINARY, UM, COMMUNITY HEALTH ASSESSMENT REPORT FOR THE AUSTIN TRAVIS COUNTY, WHICH I WILL REFER AS THE CHOP. UM, FROM HERE ONWARD, [01:10:01] UM, IT WAS COMPILED AND ANALYZED BY OUR CONSULTANT PARTNERS AT HUMAN RESOURCES IN ACTION, UM, H-R-A-H-R-I-A, AND, UH, THIS COLLECTIVE EFFORT BETWEEN AUSTIN PUBLIC HEALTH, TRAVIS COUNTY CENTRAL HEALTH, AND OUR REGIONAL HOSPITAL PARTNERS WHO PRESENTED HERE TODAY, AS WELL AS MANY OTHER ORGANIZATIONS WHO HELP BRING THE VOICES TO THE DATA. TOGETHER, WE GATHERED THE BEST AVAILABLE INFORMATION AND DATA THAT WAS OUT THERE AND TO UNDERSTAND OUR COMMUNITY'S HEALTH AND WHERE OUR COLLECTIVE ACTION CAN MAKE THE GREATEST IMPACT. LET'S BEGIN ON HOW WE APPROACH THE ASSESSMENT. OKAY. TOGETHER THESE RESOURCES OFTEN OFFER A CLEAR MORE HUMAN VIEW OF OUR COMMUNITY'S HEALTH, GROUNDED IN BOTH DATA AND LIVED EXPERIENCE. OH, SORRY, I SKIPPED A PAGE. I'M A LITTLE NERVOUS. UM, THE CHILD GIVES US A FULLER PICTURE OF HOW AUSTIN TRAVIS COUNTY RESIDENTS ARE DOING, WHAT'S WORKING WELL AND WHERE THE CHALLENGES REMAIN. WE USE TRIANGULATION APPROACH COMBINING DATA FROM THE US CENSUS BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM KNOWN AS THE B-R-F-S-S-C-D-C PLACES, ALONG WITH LOCAL REPORTS AND COMMUNITY FEEDBACK. OUR WORK IS GUIDED BY THE MOBILIZING THROUGH PLANNING AND PARTNERSHIP OF THE MAP TWO OH FRAMEWORK, WHICH CENTERS EQUITY, COLLABORATION, AND PARTNERSHIP. IT REMINDING US THAT HEALTH IS SHAPED BY ENVIRONMENTS, POLICIES IN THE SYSTEMS OF POWER. TOGETHER, THESE RESOURCES OFFER A CLEARER, MORE HUMAN VIEW OF OUR COMMUNITY'S HEALTH, GROUNDED IN BOTH DATA AND LIVED EXPERIENCE. HERE'S WHAT THE DATA REVEALED. OH, TRAVIS COUNTY'S HOME TO 1.3 MILLION RESIDENTS IS MANY OF YOU KNOW, A COMMUNITY THAT'S DIVERSE AND GROWING ACCORDING TO THE LATEST CENSUS, NEARLY HALF IDENTIFIED AS WHITE, A THIRD, A HISPANIC, OR LATIN 8% AS BLACK, 7% AS ASIAN, NEARLY 16% AS MULTIRACIAL. BUT DIVERSITY DOES NOT MEAN EQUITY. NEARLY ONE IN TWO THOU IN TWO HOUSEHOLD STRUGGLES TO MEET BASIC NEEDS. ABOUT A THIRD ARE ALICE AND ANOTHER 13% LIVE IN POVERTY. AND BY ALICE I MEAN PEOPLE WHO WORK, UM, WORKING FAMILIES THAT DON'T HAVE THE, THE CAPACITY TO MEET THEIR BASIC NEEDS. THESE INEQUITIES SHAPE HEALTH LIKE HEART DISEASE, CANCER, AND OVERDOSE REMAIN THE LEADING CAUSES OF DEATH WITH MENTAL DISTRESS AND FOOD AND WHAT I CALLED APPETITE CONTINUING TO, TO RISE. THESE REALITIES SHOW THAT WHY EQUITY CENTER CROSS SECTOR ACTION IS VERY CRITICAL WITH OUR COLLABORATION FOR THIS ASSESSMENT, WE ANALYZED 81 DIFFERENT INDICATORS COVERING FROM HEALTH OUTCOMES TO HOUSING, TRANSPORTATION, AND ENVIRONMENTAL CONDITIONS. WHEN WE THEN ORGANIZED THESE INDICATORS INTO NINE DOMAINS LISTED HERE, ALLOWING US TO TRACK PROGRESS ACROSS MULTIPLE AREAS THAT INFLUENCE COMMUNITY HEALTH. THIS STRUCTURE HELPS ENSURE TRANSPARENCY AND KEEPS OUR PRIORITIES GROUNDED IN SOLID EVIDENCE. BUT BEYOND THESE NUMBERS, WE ALSO LAID, PAID A CLOSE ATTENTION ON WHO IS REPRESENTED AND, AND WHOSE EXPERIENCES MIGHT NOT BE IN THIS REPORT. IN THIS LIGHT HIGHLIGHTS OUR INTIMATE, INTENTIONAL FOCUS ON SPECIALIZED SPECIAL POPULATIONS IN THE UNINCORPORATED AREAS WITHIN TRAVIS COUNTY. WE ARE PRIOR PRIORITIZE OLDER ADULTS, LGBTQ PLUS RESIDENTS, VETERANS, AND PEOPLE WITH DISABILITIES IN THEIR INTER EXTERNALITIES. EACH GROUP EXPERIENCES DISTINCT CHALLENGES. FOR EXAMPLE, OLDER ADULTS FACE CLIMATE AND MOBILITY CONCERNS, WHILE FOLKS IN THE LGBTQ PLUS OFTEN CITE MENTAL HEALTH NEEDS AND SEARCH FOR BELONGING WITHIN THE COMMUNITY. AS WE HEARD EARLIER, WE ALSO RECOGNIZE THE NEED TO STRENGTHEN LOCAL DATA AND IN AN UNINCORPORATED AREAS SO THAT NO COMMUNITY IS LEFT BEHIND IN THE FUTURE ASSESSMENTS. THIS BRINGS US TO THE INSIGHTS WE GATHER DIRECTLY FROM OUR COMMUNITIES HERE IN THIS, UM, SLIDE YOU'VE ALREADY HEARD FROM OUR REGIONAL PARTNERS, WHAT'S STRIKING IS HOW ALIGNED THEIR FINDINGS ARE ACROSS EVERY SYSTEM WE SEE THE SAME THEMES, PERSISTENT BARRIERS TO CARE, ECONOMIC PRESSURES DRIVING FAMILIES AND WORKFORCE STRAIN AND MENTAL HEALTH NEEDS THAT FAR EXCEEDS THE CAPACITY FOR [01:15:01] US TO SERVE THESE INTERCONNECTED CHALLENGES AFFECT HOW SERVICES ARE DELIVERED AND HOW TRUST IS BUILT IN THE COMMUNITY. REMINDING US THAT ADVANCING HEALTH EQUITY ALSO MEANS SUPPORTING THE PEOPLE WHO DELIVER THESE SERVICES. THANK YOU. ARE YOU MOVING IT FOR ME? , THROUGH THESE PARTNERS COMMUNITY SESSIONS. , IT'S JUST FOLLOWING ME. THROUGH THESE REPORTS AND COMMUNITY SESSIONS, WE HEARD BOTH SELF-DETERMINATION AND ON THE ONGOING STRUGGLES. RESIDENTS DESCRIBE HOW CONNECTION AND COLLECTIVE EFFICACY AND AGENCY SUSTAIN THEIR WELLBEING FROM PRO PROMA, TORES AND COMMITTEE HEALTH WORKERS AS WELL AS YOUTH LEADERS AND NEIGHBORS, HELPING NEIGHBORS CREATING INFORMAL NETWORKERS TO MEET THEIR NEEDS. AT THE SAME TIME, THE FAMILIAR CHALLENGES SHOWN HERE CONTINUE TO SHAPE DAILY LIFE ACROSS TRAVIS COUNTY AND AUSTIN. OKAY, , THESE ARE THE CONNECTIONS THAT HOLD OUR COMMUNITIES TOGETHER AND THEN THIS SHOWS HOW WE BROUGHT THE DATA TO LIFE. I MIGHT HAVE SKIPPED THE, THERE WE GO. YEAH. UM, THIS IS THIS, UH, SLIDE HERE, UM, SHOWS THE TRIANGULATION WE USE TO CONNECT COMMUNITY INSIGHTS WITH POPULATION DATA. AND THAT SHOWS, IT DOESN'T JUST SHOW US THE WHY, BUT IT ALSO HELP US CLARIFY DISPARITIES IN ORGANIZED POTENTIAL, POTENTIAL ACTIONABLE ITEMS FOR OUR CHIP, WHICH IS COMING, UM, UP NEXT YEAR. SO IN THIS LIGHT CAPTURES THE REAL WORLD FEEDBACK. THIS IS WHERE OUR PARTNERS REALLY CAME INTO PLAY IN SHAPING THE THE CHOP. WHAT'S HELPING US MOVE FORWARD AND WHAT'S HOLDING US BACK ON THE LEFT ARE THE DRIVING FORCES, LIKE EXPANDING SCHOOL-BASED SERVICES. AS WE HEARD FROM OUR, UM, FRIENDS AT CENTRAL TEXAS FOOD BANK, PEER AND PARENT NETWORKS, CULTURAL SPECIFIC AND FAITH-BASED GROUPS AND GROWING OPENNESS AROUND MENTAL HEALTH ARE ALL POWERFUL ASSETS ALREADY IN MOTION. ON THE RIGHT ARE THE RESTRAINING FORCES, PROVIDER SHORTAGES, UNEQUAL ACCESS AND TRANSPORTATION BARRIERS. AS YOU HEARD, THESE ARE THE PRESSURE POINTS THAT LIMIT COMMUNITY WELLBEING AND PROGRESS. THE KEY TAKEAWAY FROM THIS, AND GOING BACK, SORRY, , IS THAT, UM, TO CREATE IS THAT RESIDENTS ALREADY HAVE IDEAS AND WHERE IT WORKS TO CREATE SOLUTIONS, BUT THEY NEED SUSTAINED SUPPORT AND ALIGNMENT ACROSS THOSE SYSTEMS TO KEEP THOSE POSITIVE FORCES MOVING FORWARD. THIS NEXT SLIDE IS A DIAGRAM SHOWS OUR PUBLIC HEALTH ECOSYSTEM WITH COMMUNITY MEMBERS AT THE CENTER SURROUNDED BY THE FRONTLINE SERVICES THAT SUPPORT DAILY LIFE LIKE HOUSING, HOW HEALTH, FOOD AND TRANSIT AROUND THAT ARE SYSTEMS THAT SHAPE POLICY, FUNDING, DATA AND INFRASTRUCTURE AND ENCIRCLING ALL THAT ARE THE COORDINATING BODIES LIKE AUSTIN PUBLIC HEALTH, TRAVIS COUNTY HEALTH AND HUMAN SERVICES, CENTRAL HEALTH IN OUR CHA CHIP PARTNERS PRISON HERE TODAY. AND THOSE THAT ARE JOINING US ONLINE, WORKING TOGETHER FOR MORE THAN 14 YEARS TO IMPROVE COMMUNITY HEALTH. WE FACE CHALLENGES AND PROBABLY WE CONTINUE LIKE STAFF SHORTAGES, FEDERAL SHIFTS AND BEHAVIORAL HEALTH FRAGMENTATION. YET THIS ECOSYSTEM REMAINS COMMITTED TO AND ALIGNED TO THE RESPONSE AND NEEDS OF THE COMMUNITY. UM, THIS SLIDE HERE IS JUST FOR YOUR REFERENCE. UM, IT INCLUDES A SECURE CODES TO ALL THE PROGRAMS THAT ARE UNDER OUR UMBRELLA AND IT JUST, AND A SECURE CODE TO THE LAST SECURE CODE TO THE DIGITAL PILOT IMPLEMENTATION PLAN. AND I JUST WANTED YOU TO HAVE A SET OF RESOURCE. THIS NEXT SLIDE IS, UM, YOUR LEADERSHIP CONTINUES TO SHAPE THE CONDITIONS THAT INFLUENCE COMMUNITY. THESE ARE OPPORTUNITIES FOR COLLECTIVE ACTION. THERE ARE THREE KEY TAKEAWAYS THAT MAKE THE GREATEST IMPACT TOGETHER. FIRST, BY ADVANCING POLICIES THAT LINK HEALTH, HOUSING, TRANSPORTATION FOR A CO TO JUST MENTION A FEW, RECOGNIZING HOW OUR ENVIRONMENTS DIRECTLY AFFECT THE WELLBEING OF OUR COMMUNITIES. SECOND, BY HELPING DIRECT RESOURCES TO HISTORICALLY UNDER UNDERSERVED COMMUNITIES IN UNINCORPORATED AREAS WHERE DATA SHOWS ONGOING DISPARITIES. AND THIRD, BY SUSTAINING THE PARTNERSHIPS THAT HOLD THIS PUBLIC HEALTH ECOSYSTEM TOGETHER WE CAN TURN DATA INTO COLLECTIVE ACTION AND MEASURABLE CHANGE. AND SPEAKING OF COLLECT [01:20:01] COLLECTIVE ACTION , UM, WE INVITE YOU TO JOIN US FRIDAY, JANUARY 23RD, 2026 FOR THE CHAP PARTNER SUMMIT. WE'LL SHARE THE FINAL 2025 COMMUNITY COMMUNITY HEALTH ASSESSMENT FINDINGS AND BEGIN SHAPING THE NEXT STAGE OF OUR STRATEGY. THE QR CODE LINKS TO OUR MAILING LIST SO YOU CAN STAY CONNECTED AND INVOLVED. AND THIS CONCLUDES MY PRESENTATION. THANK YOU SO MUCH FOR YOUR TIME AND I'M HAPPY TO ANSWER ANY QUESTIONS YOU MAY HAVE. SHIRLEY, THANK YOU SO MUCH FOR THE PRESENTATION AND, UH, WRAPPING THAT UP SO NICELY TO HAVE THAT FINAL SLIDE OF OPPORTUNITIES FOR COLLECTIVE ACTION. I THINK THAT'LL BE SOMETHING THAT WE, UH, THAT I THINK IT'S GOING IN OUR FUTURE AGENDA ITEMS . SO, UH, WE WILL BE TALKING ABOUT THAT NEXT MONTH, UM, AND HOW WE CAN BE ACTIVATED. I KNOW WE ARE, UH, PRESSED FOR TIME, BUT I WILL OPEN IT UP FOR QUESTIONS, COMMENTS, UH, FROM THE COMMISSIONERS. IT WAS THAT WONDERFUL OF A PRESENTATION. SHIRLEY, WE DIDN'T HAVE ANY WOW. . MAYBE, MAYBE NOT. MAYBE WE'RE, WE ARE GOOD TO GO. THANK YOU. UM, THANK YOU SO MUCH FOR THE PRESENTATION. THANK YOU FOR BEING HERE AS WELL AS, UH, THE COLLECTIVE PARTNERS THAT HAVE COME AND JOINED AND PRESENTED WITH US, SHARED WITH US, UH, GIVEN US A THINK A LOT TO HOLD ONTO AND, AND DETERMINE HOW WE CAN TAKE THIS INFORMATION, UH, AND NOW, UM, ACTIVATE OUR COMMISSION. SO, UH, WE APPRECIATE YOU, WE APPRECIATE YOUR ENERGY, YOUR EFFORTS, UH, ESPECIALLY WITH CREATING THE CHA CHIP. I KNOW THAT IS A TIRELESS EXPERIENCE. UM, WE'RE [FUTURE AGENDA ITEMS] GONNA JUMP INTO FUTURE AGENDA ITEMS BECAUSE I DON'T KNOW ABOUT YOU ALL, BUT I AM A LITTLE BIT INUNDATED WITH EXTRA DATA TODAY. UM, AND SO, UH, ON OUR FUTURE AGENDA ITEMS, UM, WE DO HAVE OUR DECEMBER RETREAT HAPPENING NEXT MONTH. SO PLEASE KEEP THAT IN MIND. UM, I JUST REALIZED THAT WE HAVE DIRECTOR STIR ON THE LINE AND, UH, DIRECTOR STIR, IF YOU NEED US, PLEASE HOLLER. UM, I KNOW THAT WE ARE ALSO WORKING ON, UH, LOOKING AT COMMISSIONER DOHAS RECOMMENDATION. SO I WOULD, I'LL WORK WITH DANNY TO, UH, PUT TOGETHER A PLOT OF WHAT OUR TIME WILL LOOK LIKE, UH, FOR OUR RETREAT. I WOULD ALSO LOVE TO ADD, UH, JUST FROM OUR CONVERSATION WITH SHIRLEY TODAY AND OTHERS, UM, HOW WE CAN DISSECT THE COMMUNITY HEALTH WORKER RECOMMENDATION THAT WE PRESENTED, UM, TO REFORMAT IT AND MAYBE GO AFTER THAT AGAIN IN A DIFFERENT DIRECTION, A DIFFERENT WAY. UH, AND THEN OF COURSE, UH, PRIORITIZING, UH, THE LAST SLIDE OF OPPORTUNITIES FOR COLLECTIVE ACTION WITH IMPLEMENTING, UM, SOME OF THE RECOMMENDATIONS AND SUGGESTIONS FROM THE CHA CHIP. AND THEN FINALLY, I DO KNOW, UH, THAT COMMISSIONER LUHAN HAS BEEN WORKING TO GET KA METRO OVER HERE TO TALK TO US, UM, SEE IF WE CAN'T MAYBE PROJECT THEM FOR JANUARY JUST BECAUSE I KNOW OUR, OUR RETREATS ARE USUALLY LENGTHY OF AN EXPERIENCE. UM, COMMISSIONERS, I WILL ASK THAT IF YOU DO HAVE ANY ADDITIONAL QUESTIONS FOR OUR PARTNERS, UM, PLEASE COMPILE THOSE, GET THOSE OVER TO DANNY SO THAT SHE CAN SHARE THEM OUT, UH, AND WE CAN GET FEEDBACK AND INSIGHT FROM THEM. UM, AND THEN, YEAH, I THINK IF WE COULD EVEN LOOK AT A WAY TO DO A QUARTERLY ENGAGEMENT, HOW ARE THINGS GOING? DID WE DO WELL WITH OUR RECOMMENDATION, SUGGESTIONS, POTENTIAL POLICIES, UM, AND NOT WAIT FOR ANOTHER THREE YEARS TO HAVE YOU ALL COME BACK AND TELL US HOW IT WENT. UH, JUST TO KEEP THAT, THAT LINE OF COMMUNICATION OPEN. UM, AND FOR US TO CONTINUE TO, TO MOVE THE NEEDLE. WE DON'T KNOW WHAT WE DON'T KNOW AND, UH, WE CAN'T DO ANYTHING ABOUT IT IF WE DON'T KNOW IT. UM, ANY FINAL AGENDA ITEMS THAT ARE PRESSING THAT HAVE, UH, FROM THE COMMISSIONERS THAT MAY, WE MAY NOT HAVE? YOU MAY NOT HAVE HEARD ME SAY. YEAH, I AM GONNA SAY THANK YOU TO EVERYONE THAT WAS HERE. UM, I WOULD, AS MENTIONED, WE ARE WORKING ON, IT SEEMS EVERYBODY'S ONE OF THE BIGGEST THING IS GONNA BE TRANSPORTATION AND WE ARE WORKING AND WE'RE HAVING THAT CONVERSATION. SO AS MUCH AS IT'S A LOT OF INFORMATION IF POSSIBLE, IF I MAY REQUEST FOR, UH, THERE IS GONNA BE A PARTICULAR MEETING WITH SOME MAJOR, UM, ORGANIZATIONS TO TRY TO BRING SOME TRANSPORTATION TO RURAL AREAS, WHICH OBVIOUSLY IT'S IN SOME OF YOUR, UM, UM, ASSESSMENTS NEEDS. THE MAJOR ONE IS IF THERE'S ANY WAY YOU GUYS CAN COMPILE SOMETHING THAT REALLY EMPHASIS THAT, THAT, SO WHEN WE HAVE THIS MEETING, WE HAVE NOT ONLY WHAT WE ARE BRINGING TO THE TABLE AND INFORMATION FROM THE COMMUNITY, BUT [01:25:01] ALSO FROM THIS ASSESSMENT FROM ALL OF YOU. THREE WILL ACTUALLY HELP US MORE TO WEIGH IN MORE ON THE NEED OF TRANSPORTATION AND HOW TO FIGURE OUT A WAY TO MAKE IT HAPPEN WITHOUT ALL THE GOVERNANCE OVER IT, IF THAT MAKES SENSE. WONDERFUL. OKAY. WELL, UH, WITH THAT BEING SAID, THANK YOU SO MUCH FOR THAT ADDITION. UM, I WILL GO AHEAD AND CALL THIS MEETING ADJOURNED AT 4:00 PM THANK YOU ALL SO MUCH. * This transcript was created by voice-to-text technology. The transcript has not been edited for errors or omissions, it is for reference only and is not the official minutes of the meeting.