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[CALL TO ORDER]
GOOD AFTERNOON EVERYONE.I CALL TO ORDER THIS MEETING OF THE AUSTIN CITY COUNCIL PUBLIC HEALTH COMMITTEE MEETING.
IT IS 1:01 PM ON WEDNESDAY, MARCH 4TH, 2026, AND WE ARE HERE IN CITY COUNCIL CHAMBERS.
HELLO, FORMER COUNCIL MEMBER ANN KITCHEN IS WITH US TODAY.
GOOD TO SEE YOU, COUNCIL MEMBER.
IT IS OUR MARCH PUBLIC HEALTH COMMITTEE MEETING.
I'M JOINED ON THE DAIS BY OUR VICE CHAIR COUNCIL MEMBER UCHIN, AS WELL AS MEMBERS, COUNCIL MEMBERS RYAN ALTER AND JOSE VELASQUEZ.
FOR OUR AGENDA TODAY, WE'LL START WITH PUBLIC COMMUNICATION, THEN WE'LL MOVE ON TO CONSIDERATION OF APPROVAL OF MINUTES FROM THE FEBRUARY 4TH COMMITTEE MEETING.
WE'LL THEN DISCUSS AND TAKE ACTION ON THE REAPPOINTMENT OF TWO MEMBERS TO THE SOBERING CENTER BOARD OF DIRECTORS.
FROM THERE, THE COMMITTEE WILL RECEIVE AN UPDATE BY CENTRAL HEALTH COMMUNITY CARE HEALTH CENTERS AND INTEGRAL CARE ON THE MENTAL HEALTH SYSTEM OF CARE FOR LOW INCOME AND UNINSURED PEOPLE IN TRAVIS COUNTY.
AND THEN LASTLY, WE WILL HAVE A BRIEFING ON THE 2025 TRAVIS COUNTY COMMUNITY HEALTH ASSESSMENT.
THAT WAS, WE WERE ORIGINALLY GONNA HAVE THAT LAST COMMITTEE MEETING, BUT THAT GOT BUMPED TO TODAY.
ANY QUESTIONS OR COMMENTS? VERY GOOD.
IF THE CLERK MAY PLEASE WELCOME
[Public Communication: General]
OUR SPEAKERS FROM THE COMMUNITY.GOOD AFTERNOON, MEMBERS OF THE COMMITTEE.
MY NAME IS MARIA ISO AND I'M HERE REPRESENTING COMMITTEES AND SCHOOLS OF CENTRAL TEXAS IN SUPPORT OF OUR CONTINUED PARTNERSHIP WITH THE CITY OF AUSTIN.
CIS IS A DIRECT RESPONSE TO TWO URGENT CHALLENGES.
THE CITY HAS PRIORITIZED THE STUDENT ATTENDANCE CRISIS AND YOUTH MENTAL HEALTH.
WE PROVIDE RELATIONSHIP-BASED TRAUMA-INFORMED SUPPORTS ON CAMPUS IF STUDENTS GET HELP EARLY BEFORE CHALLENGES ESCALATE INTO CRISIS CARE, EMERGENCY RESPONSE, OR MORE COSTLY PUBLIC SYSTEMS. WE NOW HAVE RIGOROUS TEXAS-BASED EVIDENCE SHOWING THIS APPROACH WORKS AND PAYS OFF A NEW HARVARD CORNELL STUDY WITH OPPORTUNITY INSIGHTS ED REDESIGN LAB USING EDUCATION RECORDS AND LEAKED CENSUS DATA AND FEDERAL TAX DATA ANALYZED OUTCOMES FROM MORE THAN 16 MILLION TEXAS STUDENTS AND FOUND THAT SUSTAINED SUCCESS TO CIS MIDDLE SCHOOL INCREASES HIGH SCHOOL GRADUATION AND STRENGTHENS LONG-TERM ECONOMIC MOBILITY.
HERE IS WHY IT MATTERS FOR THE CITY IN TERMS OF RETURN ON INVESTMENT.
THE STUDY FINDS THAT CIS CHANGES ADULT OUTCOMES BY REDUCING THE LIKELIHOOD OF STUDENTS ENDING UP IN THE BOTTOM INCOME QUARTILE DEFINED AS UNDER 15,000 A YEAR WHERE 80% ARE NOT WORKING.
INSTEAD, COMMUNITIES AND SCHOOLS OF CENTRAL TEXAS INCREASES THE LIKELIHOOD STUDENTS MOVE INTO THE NEXT QUARTILE, MEANING MORE YOUNG ADULTS ATTACHED TO EMPLOYMENT AND STABLE EARNINGS.
AND THE FISCAL IMPACT IS REAL.
THREE YEARS OF CIS AT AN ESTIMATED COST OF $3,000 PER STUDENT AS PROJECTED TO GENERATE APPROXIMATELY $7,100 IN ADDITIONAL LIFETIME FEDERAL TAX REVENUE PER STUDENT AND PRESENT VALUE.
IN OTHER WORDS, CIS MORE THAN PAYS FOR ITSELF THROUGH INCREASED EARNINGS AND TAX CONTRIBUTIONS.
THIS IS WHY COMMUNITIES AND SCHOOLS OF CENTRAL TEXAS IS NOT ONLY A STUDENT SUPPORT STRATEGY, IT IS SMART AND GOOD FISCAL PUBLIC POLICY.
INVESTING IN CIS HELPS PREVENT LONG-TERM COSTS TIED TO NON-EMPLOYMENT AND ECONOMIC INSTABILITY, AND IT STRENGTHENS AUSTIN WORKFORCE AND TAX BASE.
THANK YOU FOR YOUR TIME AND YOUR CONTINUED COMMITMENT TO AUSTIN STUDENTS AND FAMILIES.
GOOD AFTERNOON COUNCIL MEMBERS AND AUSTIN PUBLIC HEALTH STAFF.
MY NAME IS JACOB BREECH AND I'M THE NEW CHIEF OPERATIONS OFFICER AT COMMUNITIES AND SCHOOLS OF CENTRAL TEXAS.
I ALSO HAVE A STRONG HISTORY HERE IN AUSTIN, SPENDING MANY YEARS SERVING AUSTIN STUDENTS AT OUR LOCAL SCHOOL DISTRICT DURING THAT TIME.
AND NOW DURING MY TIME AT CIS, ONE THING HAS BEEN EVIDENT AND THAT'S THAT RELATIONSHIPS MATTER AND I AM GRATEFUL TO HAVE SUCH A STRONG PARTNER IN THE CITY OF AUSTIN AND AUSTIN PUBLIC HEALTH IN THIS WORK.
THANKS TO YOUR PARTNERSHIP, CIS IS ABLE TO PROVIDE MENTAL HEALTH SUPPORTS DIRECTLY TO AUSTIN STUDENTS AT A SCALE AND EFFICIENCY THAT MAY NOT BE POSSIBLE THROUGH OTHER AVENUES.
OUR PARTNERSHIP ALSO ALLOWS US TO PROVIDE THE MALE STUDENT
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ACHIEVEMENT PROGRAM AT AUSTIN, ISD HIGH SCHOOLS, WHICH ENCOURAGES MALE STUDENTS TO CREATE POSITIVE BROTHERHOOD AND EMPOWERS THEM TO SUPPORT AND BUILD SKILLS THAT THEY NEED TO AUTHOR THEIR OWN PATHS OF SUCCESS.BUT WHAT I'M REALLY EXCITED TO SHARE TODAY IS THE NEW GROUNDBREAKING STUDY CONDUCTED BY OPPORTUNITY INSIGHTS IN PARTNERSHIP WITH ED REDESIGN LABS AT THE HARVARD GRADUATE SCHOOL OF EDUCATION.
THIS STUDY EMPIRICALLY PROVES THAT CIS HAS POSITIVE IMPROVEMENTS TO STANDARDIZED TEST SCORES, RAISES GRADUATION RATES, AND INCREASES EARNINGS IN ADULTHOOD.
THIS RESEARCH WAS RECENTLY, UH, FEATURED IN THE ATLANTIC AND YOU CAN ALSO FIND IT ON COMMUNITIES AND SCHOOLS, NATIONAL WEBSITE AND COMMUNITIES AND SCHOOLS OF CENTRAL TEXAS WEBSITE.
UH, IF YOU WANT AN EASY WAY TO FIND IT, IF YOU JUST SEARCH FOR CIS HARVARD STUDY, IT'S GONNA BE THE FIRST THING THAT COMES UP, UH, THAT RESEARCH WHEN RESOURCES MEET RELATIONSHIPS, THE RETURNS TO PERSONALIZED SUPPORTS FOR LOW INCOME STUDENTS DEMONSTRATES THAT CI S'S RELATIONSHIP DRIVEN APPROACH DRIVES OUTCOMES.
TWO THINGS THAT I WANT TO BRIEFLY HIGHLIGHT IS THAT THE STUDY FOUND THAT EXPOSURE TO CIS INCREASED GRADUATION RATES BY 5.2%.
UH, IT ALSO SHOWED ADVANCED ECONOMIC MOBILITY.
THREE YEARS OF EXPOSURE TO CIS INCREASES LIFETIME LIFETIME EARNINGS BY MORE THAN $75,000.
I DID BRING, UM, SOME SUMMARY COPIES OF THE REPORT AND I'LL LEAVE THEM WITH YOUR STAFF.
UH, BUT I JUST WANT TO THANK YOU FOR OUR CONTINUED PARTNERSHIP AND OUR COMMITMENT TO BUILDING REALLY STRONG RELATIONSHIPS WITH ALL OF AUSTIN STUDENTS AS WE CONTINUE TO SUPPORT THEIR SOCIAL, MENTAL AND ACADEMIC NEEDS HERE IN AUSTIN.
LASTLY, WE'LL HAVE LISA BARDEN.
MY NAME IS LISA BARDEN AND I SERVE AS THE EXECUTIVE DIRECTOR OF KEEP AUSTIN FED AND A MEMBER OF ONE VOICE CENTRAL TEXAS.
I'M HERE TODAY TO SPEAK TO HOW THE CURRENT AND FUTURE POTENTIAL CUTS TO SOCIAL SERVICES, PARTICULARLY THOSE AFFECTING FOOD ACCESS IMPACT.
NOT ONLY CONTRACTED PROVIDERS, BUT ALSO NONPROFITS LIKE OURS THAT DO NOT RECEIVE ANY GOVERNMENT FUNDING.
WHEN FUNDING THE FOOD ACCESS PROGRAMS IS REDUCED, THE NEED DOES NOT DISAPPEAR.
FAMILIES WHO LOSE ACCESS TO SUPPORTIVE PROGRAMS STILL NEED GROCERIES.
SENIORS WHO CAN NO LONGER ACCESS SERVICES STILL NEED MEALS.
STUDENTS WHO RELY ON COMMUNITY FOOD PROGRAMS STILL NEED NOURISHMENT SO THEY LEAN MORE ON ORGANIZATIONS LIKE OURS EVERY DAY, KEEP AUSTIN FED RESCUES AND REDISTRIBUTES SURPLUS FOOD ACROSS AUSTIN AT NO COST TO THE COMMUNITY.
WE ARE NOT FUNDED THROUGH CITY CONTRACTS, BUT WE ARE DEEPLY INTERCONNECTED WITH THE HEALTH AND HUMAN SERVICE ECOSYSTEM.
AND WHEN THAT ECOSYSTEM CONTRACTS, OUR WORKLOAD EXPANDS.
CUTS TO SOCIAL SERVICES CREATE SEVERAL RIPPLE EFFECTS.
WE DISTRIBUTE FOOD TO MANY PARTNER ORGANIZATIONS WHOSE BUDGETS ARE BEING CUT AND SUPPLEMENT FOOD PANTRIES THAT ARE SUPPORTED BY THE FOOD BANK, INCLUDING THE CITY'S OWN REC AND NEIGHBORHOOD CENTERS.
WHEN THOSE PROGRAMS SHRINK MUTUAL AID GROUPS AND OUR SMALLER NON-PROFIT PROVIDERS ARE CALLED ON TO FILL THE GAPS, YET WE CANNOT MATCH, TYPICALLY MAKE SURPLUS FOOD APPEAR AND THOSE POPULATIONS REMAIN UNDERSERVED.
WE'VE SEEN THE OUTCOME OF THIS DURING VERY BIG WEATHER EMERGENCIES WHERE WELL-KNOWN LOCATIONS ARE PRONE TO DONATION DUMPING WHILE OTHERS WITH SMALLER VOICES RECEIVE NO ASSISTANCE.
CITY FUNDED PROGRAMS OFTEN PROVIDE REFERRAL PATHWAYS, CASE MANAGEMENT AND STRUCTURED ACCESS POINTS.
WHEN THOSE ARE REDUCED, NONPROFITS MUST TRY TO ABSORB MORE OUTREACH WORK WITH WITHOUT ADDITIONAL RESOURCES.
THIRD, THE NEED BECOMES MORE ACUTE WHEN PREVENTION PROGRAMS ARE CUT, WHETHER IT'S FOOD ASSISTANCE, RENTAL ASSISTANCE, OR HEALTH SERVICES, FAMILIES FALL FURTHER INTO CRISIS.
NONPROFITS LIKE KEEP AUSTIN FED ARE OFTEN REFERRED TO AS SAFETY NETS, BUT WE ARE ACTUALLY PROVIDING INFRASTRUCTURE.
WE ARE PART OF THE PUBLIC HEALTH STRATEGY THAT ENSURES NUTRITIOUS FOOD REACHES COMMUNITIES CONSISTENTLY AND EQUITABLY.
AND WE ARE PART OF THE ECONOMIC SYSTEM AND ENVIRONMENTAL SYSTEMS THAT PREVENT WASTE AND REDUCE THE STRAIN ON LANDFILLS.
I ENCOURAGE COUNCIL TO CONSIDER THAT REDUCTIONS IN SOCIAL SERVICE CONTRACTS DO NOT SIMPLY REDUCE LINE ITEMS IN A BUDGET.
THEY INCREASE PRESSURE ON THE BROADER NONPROFIT ECOSYSTEM, INCLUDING ORGANIZATIONS WITHOUT CITY CONTRACTS, AND THEY RESULT IN HIGHER DOWNSTREAM COSTS IN HEALTHCARE EMERGENCY RESPONSE AND CRISIS SERVICES.
SUSTAINING FOOD ACCESS AND OTHER CORE HUMAN SERVICES IS NOT CHARITY.
IT IS FOUNDATIONAL INFRASTRUCTURE THAT SUPPORTS WORKFORCE PARTICIPATION, STUDENT SUCCESS, COMMUNITY HEALTH AND ECONOMIC STABILITY.
THANK YOU FOR YOUR LEADERSHIP DURING A DIFFICULT BUDGET ENVIRONMENT.
UH, THANK YOU EVERYONE FOR YOUR TESTIMONY TODAY.
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COLLEAGUES WILL NOW MOVE ON[Approval of Minutes]
TO APPROVAL OF PREVIOUS MEETING MINUTES FOR ITEM NUMBER ONE.CAN I GET A MOTION? AND SECOND MOTION VICE CHAIR UCHIN SECONDED BY COUNCIL MEMBER ALTER TO APPROVE THE FEBRUARY 4TH, 2026 MEETING MINUTES.
ANY DISCUSSION OR CORRECTIONS? ALRIGHT, ANY OBJECTIONS TO THE APPROVAL OF THE FEBRUARY MEETING MINUTES? SEEING NONE, THOSE STAND APPROVED.
[2.Discussion and possible action regarding the reappointment of members to the Sobering Center Board of Directors.]
TWO, DISCUSSION AND POSSIBLE ACTION ON THE REAPPOINTMENT OF MEMBERS TO THE SOBERING CENTER BOARD OF DIRECTORS COLLEAGUES, WE HAVE TWO MEMBERS ON THE SOBERING CENTER BOARD, JUDGE VARGA AND JESSICA VINNO, WHO HAVE RECENTLY EXPIRED.MS. VINNO HAS EXPRESSED INTEREST IN BEING REAPPOINTED FOR ANOTHER TERM AS WELL AS JUDGE VARGA.
AND, UH, WELL, JUDGE ALVARENGA IS A JOINT APPOINTMENT WITH TRAVIS COUNTY.
THE COMMISSIONER'S COURT HAS CONFIRMED THEY HAVE TAKEN ACTION TO NOMINATE THE REAPPOINTMENT OF THE JUDGE TO ANOTHER TERM ON THEIR END.
UH, CAN I GET A MOTION? MOTION BY VICE CHAIR UCHIN? SECONDED BY COUNCIL MEMBER VELASQUEZ FOR THE APPROVAL OF A REAPPOINTMENT OF BOTH JUDGE AGUE AND JESSICA PAULINO TO THE SOBERING CENTER BOARD OF DIRECTORS.
ANY OBJECTION? ALRIGHT, THAT STANDS APPROVED AND WE'LL GO TO THE FULL COUNSEL FOR CONSIDERATION OF THE REAPPOINTMENT OF THOSE POSITIONS.
[3. Update by Central Health, CommUnityCare Health Centers, and Integral Care on the Mental Health System of Care for low-income and uninsured people in Travis County. [Pat Lee, President & CEO - Central Health; Jeff Richardson, President & CEO - Integral Care; Nick Yagoda, EVP of Ambulatory Services & CEO -Community Care].]
ON TO ITEM NUMBER THREE.I'D LIKE TO WELCOME PAT LEE, PRESIDENT AND CEO OF CENTRAL HEALTH.
JEFF RICHARDSON, PRESIDENT CEO OF INTEGRAL CARE.
NICK JAGODA, EVP OF AMBULATORY SERVICES AND CEO OF COMMUNITY CARE FOR AN UPDATE ON THE MENTAL HEALTH SYSTEM OF CARE FOR LOW INCOME AND UNINSURED PEOPLE IN TRAVIS COUNTY.
THANK YOU ALL SO MUCH FOR BEING HERE.
AND I ALSO SEE, SEE WE HAVE MEMBERS OF THE BOARD FOR CENTRAL HEALTH ALSO IN ATTENDANCE, AND WE WELCOME Y'ALL'S PARTICIPATION AND PRESENCE.
HELLO AND THANK YOU CHAIR FUENTES, VICE CHAIR UCHIN COUNCIL MEMBER ALTER COUNCIL MEMBER VELAZQUEZ, AND ALSO AS YOU MENTIONED, WANNA, UH, THANK AND ACKNOWLEDGE, UH, INTEGRAL CARE BOARD CHAIR TRISH YOUNG BROWN, CENTRAL HEALTH VICE CHAIR, ELISA MAY, CENTRAL HEALTH BOARD MEMBER AND KITCHEN AND CENTRAL HEALTH BOARD MEMBER, UH, SIDOR JEFFERSON HERE WITH US TODAY.
UM, SO THIS AFTERNOON I'M HONORED TO BE JOINED BY JEFF RICHARDSON, CEO OF INTEGRAL CARE, AND DR.
NICK KODA, CEO OF COMMUNITY CARE HEALTH CENTERS TO PROVIDE AN UPDATE ON THE GROWING BEHAVIORAL HEALTH PARTNERSHIP BETWEEN OUR THREE ORGANIZATIONS.
WE'VE BEEN WORKING, UH, WORKING TO BETTER ALIGN HOW WE DELIVER CARE SO THAT RESIDENTS OF THE CITY OF AUSTIN EXPERIENCE A CARE SYSTEM THAT IS MORE CONNECTED, MORE TIMELY, AND MORE RESPONSIVE TO THEIR NEEDS.
WHILE THERE IS STILL PLENTY OF WORK AHEAD, WE ARE BUILDING A SYSTEM THAT WE BELIEVE CAN BECOME A REAL MODEL FOR CONNECTING PHYSICAL AND MENTAL HEALTH CARE ACROSS COMMUNITIES IN TEXAS AND POTENTIALLY NATIONWIDE.
AND WE'RE THRILLED TO SHARE THAT WITH YOU TODAY.
UH, BEFORE WE GET INTO THE PARTNERSHIP, AND BECAUSE WE HAVEN'T HAD AN OPPORTUNITY TO UPDATE YOU ON THIS IN A WHILE, I WANNA TAKE A MOMENT TO ACKNOWLEDGE A SEPARATE BUT RELATED TOPIC, WHICH IS THE BREADTH OF CENTRAL HEALTH'S FUNDING FOR SERVICES RELATED TO BEHAVIORAL HEALTH AND HOMELESSNESS, AND HOW THIS WORK HAS RECENTLY GROWN.
SO IN THE LAST TWO AND A HALF YEARS ALONE, CENTRAL HEALTH HAS INCREASED OUR INVESTMENT IN ADDRESSING HOMELESSNESS THROUGH PHYSICAL AND MENTAL HEALTHCARE SERVICES FROM ABOUT FOUR AND A HALF MILLION DOLLARS PER YEAR TO ABOUT $33 MILLION PER YEAR.
WE DO THIS THROUGH OUR BRIDGE PROGRAM, OUR MOBILE TEAMS, OUR STREET TEAMS, OUR NALOXONE DISTRIBUTION PROGRAM, OUR TRANSITIONS OF CARE TEAMS AND HOSPITALS, OUR NEW 50 BED MEDICAL RESPITE, AND MANY OTHER APPROACHES THAT ARE PART OF OUR COMMITMENT TO STAYING ALONGSIDE OUR PATIENTS AND ALONGSIDE OUR PARTNERS IN THE COMMUNITY THROUGHOUT THIS ENTIRE CARE JOURNEY.
ON TOP OF THIS, ABOUT 10% OF OUR PATIENTS WHO HAVE HEALTH COVERAGE UNDER OUR MEDICAL ACCESS PROGRAM OR MAP ABOUT 10,000 PEOPLE SELF-REPORT AS HOMELESSNESS, AS HOMELESS.
UH, THIS INCLUDES FOLKS MAY BE COUCH SURFING AND EXPERIENCING OTHER FORMS OF LESS VISIBLE HOMELESSNESS THAT DON'T NECESSARILY SHOW UP IN OUR BIANNUAL POINT IN TIME COUNT, HENCE THE LARGER NUMBERS.
WE ALSO PROVIDE AN HONOR TO PROVIDE BEHAVIORAL HEALTH FUNDING TO INTEGRAL CARE AND INVESTMENT THAT HAS GROWN FROM ABOUT $7 MILLION A YEAR TO ABOUT $34 MILLION PER YEAR OVER THE PAST THREE YEARS.
WE BELIEVE THESE INVESTMENTS ARE VITAL AND WE ARE HONORED TO PARTNER WITH THE CITY AND THE COUNTY TO HELP SUPPORT THIS IMPORTANT WORK.
BECAUSE THIS HAS CHANGED SO SUBSTANTIALLY IN THE LAST SEVERAL YEARS, WE APPRECIATE THE OPPORTUNITY TO PROVIDE THIS BRIEF UPDATE TO THE PUBLIC HEALTH COMMITTEE TODAY.
SO, TURNING BACK TO OUR PRESENTATION, AS YOU ALL KNOW, OUR COMMUNITY'S BEHAVIORAL HEALTH NEEDS CONTINUE TO GROW.
HISTORICALLY, INDIVIDUALS NAVIGATING SERVICES ACROSS OUR THREE ORGANIZATIONS, CENTRAL HEALTH, COMMUNICA AND INTEGRAL CARE, HAVE SOMETIMES EXPERIENCED CARE THAT CAN FEEL FRAGMENTED OR SILOED.
BEFORE WE FORMALIZED THIS PARTNERSHIP,
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MUCH OF THE COORDINATION THAT DID HAPPEN BETWEEN OUR TEAMS RELIED ON INFORMAL RELATIONSHIPS PROVIDERS, CALLING PROVIDERS ON THEIR PERSONAL SELVES, FOR EXAMPLE, TO FACILITATE.IT BECAME CLEAR THAT WE NEEDED A MORE SYSTEMIC SOLUTION, ONE THAT CLEARLY OUTLINES WHO IS BEST SERVED BY WHICH ORGANIZATION AND WHICH SERVICES SHOULD BE AVAILABLE WHEN AND AND WHERE IN WHICH SETTING.
AND SO WE BELIEVE THAT BY STRENGTHENING OUR COORDINATION, WE ARE REDUCING DUPLICATION OF EFFORT, WE ARE EASING TRANSITIONS, AND WE ARE IMPROVING TIMELY ACCESS TO THE RIGHT SUPPORT IN THE RIGHT SETTING, IN THE RIGHT TIME FOR OUR PATIENTS ACROSS OUR SYSTEMS. INTEGRAL CARE, AS YOU ALL ARE AWARE, BRINGS DEEP BEHAVIORAL HEALTH EXPERTISE WHILE COMMUNITY CARE BRINGS BROAD REACH ACROSS INTEGRATED PRIMARY AND BEHAVIORAL HEALTHCARE AND CENTRAL HEALTH ADDS DEPTH IN SPECIALTY CARE AND A WIDE RANGE OF BRIDGE, MOBILE, AND CARE NAVIGATION SERVICES.
WHEN WE CONNECT THAT DEPTH WITH THAT BREADTH, WE CAN INTERVENE EARLIER AND SUPPORT PEOPLE MORE EFFECTIVELY AND EFFICIENTLY, IMPROVING OUTCOMES FOR OUR PATIENTS, WHILE ALSO BEING STRONGER STEWARDS OF TAXPAYER DOLLARS AND DELIVERING GREATER VALUE TO OUR COMMUNITY.
AND THANK YOU ALL FOR YOUR TIME TODAY, REALLY JUST OUR PARTNERSHIP IS BUILT AROUND A SHARED VISION OF WHAT A TRULY INTEGRATED BEHAVIORAL HEALTH SYSTEM CAN LOOK LIKE.
UM, THERE'S SOME VERY PRACTICAL THINGS THAT WE ARE DOING TO MAKE THAT HAPPEN.
UM, AND AS MANY OF YOU KNOW, ALREADY IN OUR COMMUNITY, THERE'S A GROWING DEMAND FOR THESE SERVICES AND A STRUGGLE WITH RESOURCES OR ANY, ANY GIVEN YEAR.
THERE'S CLOSE TO 265,000 PEOPLE WITH A DIAGNOSABLE BEHAVIORAL HEALTH CONDITION IN OUR COMMUNITY.
AND ON AVERAGE, LESS THAN HALF ACTUALLY ACCESS CARE.
SO THIS ISN'T JUST A GOOD IDEA.
UM, THIS IS A PRACTICAL STRATEGIC DIRECTION TO COORDINATE AND USE OUR RESOURCES IN THE MOST EFFICIENT WAY POSSIBLE.
AND AT ITS CORE, OUR VISION IS ABOUT COORDINATING ALL OF THESE ELEMENTS THAT YOU SEE ON THIS SLIDE TO WHICH TOGETHER COMPROMISE AN IDEAL BEHAVIORAL HEALTH MODEL.
AND AGAIN, WE WANTED TO HIGHLIGHT THIS BECAUSE WE HAVE SOME VERY PRACTICAL WAYS THAT WE'RE TRYING TO SOLVE THIS.
IF TOGETHER WE'RE ABLE TO CREATE THAT CONTINUUM THAT EXECUTES THIS WELL.
WE BELIEVE THAT THIS KIND OF LOCALLY BUILT, UM, INTEGRATED SYSTEM BEYOND WALLS CAN HELP INFORM SYSTEMS WELL BEYOND TRAVIS COUNTY, AGAIN, USING THESE RESOURCES VERY EFFICIENTLY AND DOING IT AS THE MOST EFFECTIVE WAY POSSIBLE.
SO I DON'T WANT TO GET TOO MUCH INTO THE WEEDS SINCE YOU GUYS PROBABLY JUST HAD LUNCH AND DON'T WANT TO HEAR, HEAR A GRANULAR, PAINFUL CLINICAL ASSESSMENT OF WHY WE DO WHAT WE'RE DOING.
BUT FOUNDATIONALLY OUR APPROACH TO THIS AND HOW WE'RE LOOKING AT, AT THE WORK THAT WE DO IS IN A EVIDENCE-BASED CLINICAL NATIONAL MODEL CALLED THE FOUR QUADRANTS.
AND IN THAT MODEL, ESSENTIALLY WE'RE TRYING TO LOOK AT WHERE, WHAT SERVICES ARE DELIVERED BY WHOM IN THIS MODEL AROUND BEHAVIORAL HEALTH.
IF SOMEONE HAS HIGH BEHAVIORAL HEALTH NEED AND HIGH MEDICAL NEEDS, HOW CAN WE CO-LOCATE AND SUPPORT SOMEONE IN A INTEGRAL CARE ENVIRONMENT SPECIFICALLY? AND AGAIN, OUR TEAMS ARE WORKING ACROSS ALL THESE DOMAINS TO ENSURE THERE'S A SMOOTH FLOW OF SERVICE PROVISION, UM, SO THAT OUR, THE FOLKS WHO HAVE TO EXPERIENCE CARE DON'T START OVER, END UP IN ANOTHER SILO AND, AND HAVE TO ENDURE OUR SYSTEMS RATHER THAN IN THEIR BEST CLINICAL INTERESTS.
UM, SO ON THIS SLIDE YOU'LL SEE THAT WE'VE, WE'VE PUT THAT FOUR QUADRANT MODEL IN THE BACKGROUND, AND ON TOP OF IT, WE, WE'VE OVERLAID OUR LOCAL MODEL.
AND SO YOU SEE A BLENDING NOW OF THAT, UM, QUADRANT, UH, THINKING WITH THE, WITH THE LOCAL ENVIRONMENT.
AND WE CALL THESE, UM, OUR THREE ISLANDS OF CARE, OUR CHARGES TO DESIGN A SYSTEM THAT MEETS ALL OF THE RANGE OF NEEDS OF A PATIENT FROM THE LOW TO THE HIGH PHYSICAL NEEDS, THE LOW TO THE HIGH BEHAVIORAL NEEDS, THE COMBINATION OF THOSE.
UM, AND AS YOU'LL SEE, THERE'S A SPACE IN BETWEEN THOSE THREE ISLANDS RIGHT NOW WHERE OUR PATIENTS STILL HAVE TO SWIM, IF YOU WILL, FROM ONE ISLAND TO THE OTHER.
AND NAVIGATING THAT DISTANCE IS HARD TO DO, CAN BE DANGEROUS TO DO, UH, FOR PATIENTS IN THESE SITUATIONS.
UH, BUT AS WE BUILD OUT THIS WORK, OUR GOAL IS TO BUILD CONNECTIONS AND, UH, SUPPORT THAT STRETCH AND CREATE BRIDGES BETWEEN THESE ISLANDS TO ENSURE PEOPLE CAN SMOOTHLY FLOW BACK AND FORTH AND GET ALL OF THE KINDS OF CARE THEY NEED.
SO, TO ORIENT YOU TO THE ISLANDS ON THE EAST ISLAND, IF YOU WILL, YOU SEE CENTRAL HEALTH, UH, WE PLAY MULTIPLE ROLES.
UH, FOR EXAMPLE, AS A PAYER OF CARE, EITHER THROUGH MAP OR THROUGH SENDERO OR AS A PROVIDER OF SPECIALTY OR COMPLEX CARE.
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CENTRAL HEALTH OR COMMUNICATE FOR PHYSICAL HEALTH NEED, WE WANNA MAKE SURE THAT BEHAVIORAL HEALTH SERVICES ARE READILY AVAILABLE TO THEM THERE IN THE NORTHWEST ISLAND.YOU SEE INTEGRAL CARE, INTEGRAL CARE HAS DEEP EXPERTISE TO HELP PATIENTS WITH COMPLEX BEHAVIORAL HEALTH ISSUES.
IF A PATIENT COMES INTO INTEGRAL CARE WITH A SEVERE MENTAL ILLNESS, IT'S OUR DUTY TO ALSO PROVIDE THEM WITH WELL QUOTED PRIMARY OR PHYSICAL HEALTHCARE THROUGH COMMUNITY CARE, CENTRAL HEALTH WHILE THEY'RE THERE.
AND THE CARING FOR INDIVIDUALS LESS COMPLICATED BEHAVIORAL NEED, HEALTH NEEDS OF COMMUNITY CARE ALSO OPENS UP SPACE AT INTEGRAL CARE TO SERVE FOLKS WHO HAVE MORE COMPLEX NEEDS.
SO COMMUNITY CARE IN THAT SOUTHWEST ISLAND PROVIDES INTEGRATED BEHAVIORAL HEALTHCARE IN A PRIMARY CARE SETTING TO A LARGE NUMBER OF OUR RESIDENTS.
HERE WE CAN SERVE PATIENTS WITH LESS COMPLEX NEEDS.
WE CAN CATCH THOSE WHO NEED MORE AND CONNECT THEM WITH THE RESOURCES THEY NEED AT INTEGRAL CARE IN A MORE SOPHISTICATED WAY THAN WE COULD BEFORE.
OUR GOAL, AGAIN, IS TO BRIDGE THESE GAPS AND TO HELP PEOPLE MOVE SEAMLESSLY BETWEEN THESE QUADRANTS AND ACROSS THE FULL SPECTRUM CARE.
SO I WANNA NOW WALK US THROUGH A REAL WORLD EXAMPLE.
UM, WE RECENTLY WORKED WITH A PATIENT WHO WAS DIAGNOSED WITH A SEIZURE DISORDER WE CALL EPILEPSY, UM, WHO ALSO HAD AN AUTOIMMUNE DISEASE THAT AFFECTED THEIR MUSCLES AND BONES AND SIMULTANEOUSLY DIAGNOSED WITH A, UH, MAJOR DEPRESSIVE DISORDER.
OVER SEVERAL YEARS, THIS PATIENT MOVED IN AND OUT OF CARE SETTINGS ACROSS ALL THREE OF OUR ISLANDS, WHILE ALSO EXPERIENCING PERIODICALLY HOMELESSNESS.
DURING THIS PERIOD, AT TIMES SHE WAS REGULARLY RECEIVING PRIMARY CARE, BUT THE GAPS IN COORDINATION BETWEEN OUR VARIOUS ISLANDS MEANT HER BEHAVIORAL HEALTH NEEDS ESCALATED WITHOUT THE DEEPER SPECIALTY CONNECTIONS TO INTEGRAL CARE THAT YOU REQUIRED.
FINALLY, FOLLOWING A HOSPITALIZATION, SHE ENTERED CENTRAL HEALTH'S MEDICAL RESPITE PROGRAM WHERE THE TEAM THERE WAS ABLE TO SEAMLESSLY CONNECT HER TO THE DEEPLY SPECIALIZED PSYCHIATRIC CARE AND COUNSELING AT INTEGRAL CARE AND ONGOING MEDICAL TREATMENT AT COMMUNITY CARE.
WITH INTEGRATED SUPPORT ACROSS ALL THREE OF OUR ORGANIZATIONS.
SHE'S ENGAGED IN HER PHYSICAL AND MENTAL HEALTH TREATMENT, AND SHE'S DOING SIGNIFICANTLY BETTER.
HER STORY UNDERSCORES EXACTLY WHY OUR COORDINATED MODEL MATTERS.
HER PATIENT, THE PATIENT'S NEEDS WILL SHIFT OVER TIME, EXACERBATED BY A LOSS OF HOUSING OR ANY OTHER NUMBER OF STRESSORS IN OUR LIVES.
AND OUR SYSTEM MUST BE ABLE TO MOVE WITH THEM.
WE'D LIKE TO TALK ABOUT THERE NEVER BEING A WRONG DOOR, AND IN FACT, THE REAL SOLUTION IS HAVING MANY, MANY DOORS.
THAT'S WHAT THIS COORDINATED WORK BETWEEN OUR THREE ORGANI ORGANIZATIONS IS HELPING TO PROVIDE.
NOW, THIS NEXT SLIDE HERE, UM, HAP IS WHAT IT LOOKS LIKE WHEN OUR PARTNERSHIP IS ACTUALLY WORKING WELL.
INSTEAD OF OPERATING A SEPARATE SILOED ISLANDS WHERE PATIENTS ON THEIR OWN MUST SWIM ISLAND TO ISLAND, OUR ORGANIZATIONS ARE BECOMING MORE AND MORE TIGHTLY COORDINATED WITH SHARED CARE PLANNING, COORDINATED DATA SHARING AND CLINICAL COLLABORATION IN PRACTICE THAT LOOKS LIKE COMMUNITY CARE'S, PRIMARY CARE TEAMS DELIVERING SERVICES INSIDE CENTRAL INTEGRAL CARES CLINICS, MENTAL HEALTH SERVICES EMBEDDED BACK IN PRIMARY CARE CLINICS AND REAL TIME COORDINATION AND INFORMATION SHARING AROUND MEDICATION TREATMENT PLANNING AND DISCHARGE TRANSITIONS.
THE RESULT IS A SYSTEM WHERE PATIENTS DON'T FALL THROUGH THE CRACKS BECAUSE THE PROVIDERS AROUND THEM ARE WORKING AS ONE TEAM.
THESE BIDIRECTIONAL BRIDGES BETWEEN OUR ISLANDS MAKE IT EASY TO MOVE BACK AND FORTH BETWEEN, BETWEEN AND WITHIN OUR CARE.
WE DON'T HAVE GAPS WHERE PATIENTS AREN'T RECEIVING THE CARE THEY NEED IN THIS MODEL BECAUSE WE'RE TALKING TO EACH OTHER ABOUT THEIR CARE NEEDS AT ALL TIMES.
SO, SO THIS JUST DOESN'T HAPPEN BECAUSE WE, UM, LIKE EACH OTHER AND LIKE TO HANG OUT AND HAVE LUNCH TOGETHER AND TALK ABOUT IT ONCE IN A WHILE.
WE BUILT SOME GOOD STRUCTURES TO BE ABLE TO SUPPORT THIS HOLD EACH OTHER ACCOUNTABLE, BOTH AT A MACRO LEVEL AND AT INDIVIDUAL PATIENT LEVEL.
AND SO, ALONG WITH ALL THE THINGS THAT YOU'VE HEARD, UH, DR. LEE AND DR.
YUGO TO TALK ABOUT, WE HAVE OUR STAFF MEETING REGULARLY.
WE HAVE INDIVIDUAL DATA THAT WE'RE LOOKING AT AROUND HOW WE'RE, WE'RE DELIVERING SERVICES.
WE NOW HAVE SH WE SHARE, UH, EACH OTHER'S ELECTRONIC HEALTH RECORDS, WHICH IS A SIGNIFICANT SHIFT.
WE'RE ALSO PARTNERING ON SOME WIDER STRATEGIES AROUND DATA AND, AND INFORMATION SHARING THROUGH CONNEXUS AND THE WATERSHED INITIATIVE.
AND WE'RE, WE'RE HOLDING EACH OTHER ACCOUNTABLE FOR THESE PROCESSES.
BUT I WANTED TO END WHERE WE STARTED, WHICH IS WHAT DR. LEE HAD MENTIONED.
WE REALLY SEE THIS AS A VISION, A SHARED VISION ABOUT HOW OUR ORGANIZATIONS CAN WORK TOGETHER IN A WAY THAT WILL BENEFIT OUR PATIENTS.
ALL THREE OF US HAVE BEEN CLINICIANS AND KNOW
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WHAT IT'S LIKE TO AND KNOW WHAT IT'S LIKE FOR PEOPLE TO ENDURE, UM, INEFFICIENT, DISCONNECTED SYSTEMS OF CARE.AND WE ALSO KNOW THAT WE'RE STRUGGLING TO, TO MEET ALL OF THE NEEDS OF ALL OF OUR CITIZENS WITH LIMITED RESOURCES.
SO ALL OF THIS IS HELPING US DRIVE MORE EFFICIENCY AND EFFECTIVENESS THROUGH ALL, ALL OF OUR SYSTEMS. SO I'M GONNA HAND IT OFF TO DR. LEE TO WRAP IT UP.
UH, THERE'S NO DENYING IT'S DIFFICULT WORK, BUT IT'S ALSO DEEPLY IMPORTANT WORK THAT ONLY SUCCEEDS THROUGH PARTNERSHIP.
WE ARE GRATEFUL AND HAVE ENORMOUS PRIVILEGE OF WORKING WITH SO MANY LEADERS IN OUR COMMUNITY WHO ARE WILLING TO GIVE US THEIR TIME AND THEIR TRUST TO HELP US STEER IN THIS DIFFICULT SPACE, A SPACE THAT ONLY IMPROVES IF WE LINK ARMS FACE THE PROBLEM AND PUT OUR PATIENTS AT THE CENTER.
SO THANK YOU SO MUCH FOR YOUR ATTENTION TODAY, AND WE'RE HAPPY TO TAKE ANY QUESTIONS.
IT IS A BEAUTIFUL THING TO SEE OUR PARTNERS WORKING TOGETHER AND COMING FORWARD WITH THIS INCREDIBLE INITIATIVE TO ESTABLISH A BEHAVIORAL HEALTH CONTINUUM OF CARE.
SO WHAT, IT'S EXCITING AND CERTAINLY A MILESTONE COLLEAGUES WHO WOULD LIKE TO START US OFF, VICE CHAIR, THANK YOU CHAIR, AND THANK YOU GUYS FOR THEIR PRESENTATION.
AND IT DOES SOUND VERY ENCOURAGING THE WORK YOU'RE DOING IN THIS SPACE AND, UM, THE WAY YOU'RE ABLE TO BRIDGE SOME OF THE GAPS YOU'VE IDENTIFIED IN THE PAST.
I DO HAVE A SERIES OF QUESTIONS.
I'M PROBABLY GONNA START AND THEN LET OTHER FOLKS JUMP IN.
UH, 'CAUSE I PROBABLY HAVE TOO MANY QUESTIONS TO START OUT WITH.
BUT, UM, I'D LIKE TO, FIRST OF ALL, YOU ALL TOUCHED ON, I THINK AT THE BEGINNING, UM, THE CONNECTION HERE WITH THE UNHOUSED COMMUNITY AND THAT REPRESENTING A PERCENTAGE OF THE POPULATION GROUP THAT YOU SERVE AS ELECTED OFFICIALS.
WE'RE OFTEN HEARING FROM RESIDENTS AND BUSINESSES ABOUT PEOPLE EXPERIENCING, UH, MENTAL HEALTH CRISES THAT MAY ALSO BE HOMELESSNESS.
UM, SO I'M CURIOUS BEYOND, UH, WHAT YOU LAID OUT AT THE BEGINNING OF THE PRESENTATION, ARE THERE ANY SPECIFIC STRATEGIES YOU HAVE IN MIND TO HELP ADDRESS THAT PARTICULAR POPULATION GROUP? ACTUALLY, YES.
THERE'S, WE HAVE A, WE HAVE A NUMBER OF THINGS THAT WE'RE WORKING ON, BUT MOST IMPORTANTLY, WE'VE IDENTIFIED A VERY SPECIFIC NEED IN OUR COMMUNITY TO YOUR COMMENTS ABOUT FOLKS WHO ARE STRUGGLING WITH SEVERE AND PERSISTENT UNTREATED MENTAL ILLNESS AND NEEDING ACTUALLY MORE, UM, INPATIENT AND MORE ONGOING TREATMENT IN A, IN AN INPATIENT SETTING.
SO WE ARE, WE ARE TALKING ABOUT WAYS THAT WE CAN UTILIZE EITHER THE DIVERSION CENTER MODEL TO BUILD OFF OF, TO CREATE AN INPATIENT CAPACITY, UM, OR LOOK AT OTHER WAYS TO WIDEN THAT ACCESS.
BECAUSE MUCH OF THE FOLKS THAT WE'RE SEEING IN OUR COMMUNITY ARE CYCLING THROUGH, UM, THE CRIMINAL JUSTICE SYSTEM.
THEY'RE GETTING ARRESTED INTO CARE RATHER THAN US PROVIDING THE ADEQUATE LEVEL OF TREATMENT TO ENSURE THAT THAT CYCLE IS BROKEN.
AND SO ONE OF THE THINGS THAT WOULD BE CRITICAL FOR US TO BE ABLE TO HAVE IS A, AN A TREATMENT CAPACITY SO THAT SOMEONE COULD GET INPATIENT CARE FOR THE LENGTH, THE DURATION, AND THE QUALITY OF CARE THAT THEY NEED.
AND THAT CONNECT TO OUR FULL CONTINUUM OF CARE AND TIE INTO WHAT WE WERE JUST TALKING ABOUT.
BECAUSE FOLKS WHO ARE EXPERIENCING HOMELESSNESS, THERE IS A HUGE CHALLENGE, UM, WITH THEIR MENTAL ILLNESS ACCESS TO PRIMARY HEALTH.
AND FRANKLY, IF YOU'RE NOT GETTING GOOD TREATMENT, YOU'RE NOT GONNA BE ABLE TO DO ANYTHING.
AND SO OUR, OUR ABILITY TO PROVIDE THAT HIGH LEVEL, HIGH INTENSITY NEED, UM, AND BUILD ON THAT IS SOMETHING THAT WE ARE, WE ARE LOOKING AT RIGHT NOW.
AND IF I COULD BUILD ON THAT FOR A MOMENT.
IT'S AN REALLY IMPORTANT QUESTION.
UH, WE THINK OF THIS FROM A SYSTEMS PERSPECTIVE.
AND SO I'M GONNA LIFT UP THE WORDS OF, UH, OUR HOMELESS STRATEGY OFFICER DAVID GRAY, WHO HAS REFERENCED WHAT HE CALLS A CAROUSEL OF DEATH.
THIS NOTION THAT AS YOU CYCLE FROM THE STREETS TO THE HOSPITAL, BACK THE STREET TO THE JAIL, BACK TO THE STREET, UH, WHAT ECHO HAS MEASURED AS, UH, A STATE IN WHICH YOUR LIFE EXPECTANCY IS 20 YEARS OR MORE SHORTER, UM, AND ALSO INCREDIBLY COSTLY TO OUR TAXPAYERS, UM, THAT CYCLING ON THE CAROUSEL OF DEATH IS THE PROBLEM WE WANNA SOLVE.
UH, PART OF THE WAY WE SOLVE THAT IS THAT ANY POINT IN THE SYSTEM, ONCE WE ARE ABLE TO, UH, MEET AN INDIVIDUAL, THE FIRST AND MOST IMPORTANT THING IS TO ESTABLISH TRUST.
UH, THAT IS EASIER SAID THAN DONE.
MANY INDIVIDUALS WHO HAVE BEEN ON THIS CAROUSEL, UM, HAVE LEARNED FOR GOOD REASON NOT TO TRUST, UH, UH, THAT CARE.
AND PERHAPS IT'S THE THING THAT IF ANYTHING, WE DO BETTER THAN ANY ANYTHING ELSE OR ANYBODY ELSE, UH, IN, IN OUR COMMUNITY.
WE AIM TO DO THAT AS OUR NUMBER ONE THING TO EARN THAT TRUST.
UM, FROM THERE, WE THEN WANNA PROVIDE, UM, THE WRAPAROUND CARE THAT THAT PERSON NEEDS.
THEY MIGHT NEED NUTRITIONAL SUPPORT,
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THEY REALLY NEED HOUSING SUPPORT.THEY MIGHT NEED AN INCOME SOURCE FROM A DISABILITY, THEY MAY NEED THEIR MAP CARD ACTIVATED AND THEN A WHOLE BUNCH OF CLINICAL CARE FROM WOUND CARE TO PRIMARY CARE AND SO ON.
UM, BUT WE CAN'T STOP THERE BECAUSE EVENTUALLY, UM, THE GOAL IS TO HELP THOSE INDIVIDUALS FIND THE HOUSING THAT'S RIGHT FOR THEM TO HAVE THE CARE THAT'S RIGHT FOR THEM AND TO HAVE A CONTINUOUS TRUSTING RELATIONSHIP, UM, THAT HELPS 'EM NAVIGATE TO THAT PLACE AND PERHAPS STAYS WITH THEM FOR THE LONG TERM.
AND SO WE FRAMED THIS GOAL TO STAY WITH PATIENTS WHO ENTER OUR CARE FOR AT LEAST THE FIRST YEAR AFTER THEY JOIN US, LET'S SAY, IN A MEDICAL RESPITE, AND GET THEM THROUGH THAT FIRST YEAR TO THE HOUSING THE CARE WITH THE TRUSTED CONTINUITY THEY NEED.
AND I'M DELIGHTED TO SHARE, UH, WITH YOU VICE CHAIR UCHIN, THAT WHILE WE STILL HAVE WORK TO DO SCALE THAT WORK UP, THERE ARE NUMEROUS INDIVIDUALS NOW WHO HAVE MADE IT ALL THE WAY THROUGH THAT JOURNEY, UH, ARE SAFELY IN THEIR NEW HOMES, UM, WITH THE CARE WRAPPED AROUND THEM THAT THEY NEED.
AND THEY HAVE NOT GONE BACK, UH, ON THAT CAROUSEL OF DEATH.
AND SO WHILE THAT IS LONG AND DIFFICULT WORK, UM, WE THINK THERE'S A WAY OUT OF THIS BY ENSURING THAT ONCE WE MEET YOU, WE, UH, WE NEVER LET YOU GO AND WE HELP YOU GET, WE NEED TO GO SAFELY.
AND, AND THAT PROBABLY IS THE BEST AND WISEST USE OF PUBLIC DOLLARS AS WE DO THAT, UM, MOST EFFECTIVE USE OF THOSE DOLLARS.
NO, THAT'S VERY ENCOURAGING AND I APPRECIATE YOU BOTH SHARING THE ANSWERS TO THAT.
I WANNA BUILD UP A POINT THAT DR. RICHARDSON MADE A MOMENT AGO ABOUT, AND I THINK YOU DID TOO, ABOUT THE SORT OF CYCLE THAT CONNECTED TO THE CRIMINAL JUSTICE SYSTEM AND THE HEALTHCARE SYSTEM AND THE JUDICIAL SYSTEM.
UM, I KNOW THAT OUR POLICE CHIEF AND OTHERS HAVE BEEN WORKING ON A PILOT EFFORT TO CLOSE SOME OF THE GAPS, UH, BETWEEN THOSE DIFFERENT SYSTEMS AS WELL AS THE HEALTHCARE SYSTEM AND HOSPITALS.
AND I'M WONDERING, AS THE MENTAL HEALTH AUTHORITY FOR TRAVIS COUNTY, HOW YOU SEE YOUR ROLE IN FILLING THOSE GAPS BEYOND WHAT WE JUST COVERED A MOMENT AGO.
AND, AND IF ANY OF THE THINGS THAT YOU OUTLINED TODAY IN TERMS OF THE COLLABORATIVE EFFORTS ON THE SLIDE OR ANYTHING ELSE OR SUPPORTING THAT EFFORT, IF I CAN JUST BUILD ON THAT, UH, 'CAUSE BY SURE.
YOU HIT ONE OF MY QUESTIONS THAT I HAVE IS THE CITY'S, ARE YOU TALKING ABOUT THE NO WRONG DOOR INITIATIVE OR THE AUSTIN FIRST? BOTH.
SO IF Y'ALL COULD SPEAK TO KNOWING THESE ARE TWO NEW CITY LED INITIATIVES THAT OUR MANAGER HAS STARTED IN THE LAST SIX MONTHS, A YEAR MM-HMM
HOW THAT PAIRS WITH WHAT YOU HAVE LAID OUT HERE FOR US.
SO WE'RE PARTICIPATING IN BOTH OF THOSE AND WE'RE OUR, OUR CLINICIANS AND OUR TEAM ARE AT CORE IN THAT, THAT PROCESS.
BUT THAT'S ONLY ONE PIECE OF, OF THE, THE PIE IN TERMS OF WHAT WE'RE DOING.
UM, IN TOTAL, OUR, AS THE LOCAL MENTAL HEALTH AUTHORITY HERE, WE SERVE CLOSE TO ABOUT 30,000 PEOPLE A YEAR.
I FEEL THAT NUMBER SHOULD BE THREE TIMES THAT.
AND SO OUR CONSTRAINTS ARE AROUND ACCESS TO RESOURCES AND PEOPLE GETTING ACCESS TO CARE MORE EFFECTIVELY.
AND I THINK THAT'S, UH, FOUNDATIONALLY AN ISSUE THAT WE HAVE IN THIS COUNTRY.
WE HAVE CRIMINALIZED BEHAVIOR, YOU KNOW, BEHAVIORAL HEALTH NEEDS IN, IN A WAY WE'VE MOVED PEOPLE INTO GETTING CARE BECAUSE WE HAVEN'T FILLED THE, THAT, THAT NEED CORRECTLY.
UM, I THINK THE, THE SERVICES, AS DR. LEE MENTIONED EARLIER, WE HAVE A TREMENDOUS AMOUNT OF SUCCESS STORIES WHEN, WHEN THE RESOURCES ARE PROVIDED, WHEN THEY'RE NOT, UM, OUR SYSTEM DEFAULTS INTO WHAT IS WE'RE BEST SUITED FOR.
PEOPLE GET ARRESTED AT A CERTAIN THRESHOLD OR PEOPLE DIE, AND NEITHER ONE OF THOSE IS AN ACCEPTABLE OUTCOME.
BUT THERE ARE LOTS OF SERVICES ALONG WITH THOSE TWO THAT YOU MENTIONED THAT HAVE HAD TREMENDOUS SUCCESS.
OUR YA COT PROGRAM, OUR DIVERSION CENTER PROGRAM, OUR OUTPATIENT CLINICS, OUR PERMANENT SUPPORTED HOUSING PROGRAMS, OUR MOBILE CRISIS TEAMS, ALL OF THESE ARE CRITICAL.
WE NEED TO BUILD THESE AT A WIDER SCALE TO MAKE THEM MORE AVAILABLE RATHER THAN LESS AVAILABLE.
AND FRANKLY, I'M REALLY WORRIED ABOUT THAT RIGHT NOW.
UM, SO, BUT WE HAVE EVIDENCE ABOUT WHAT WORKS AND, AND WHAT DOESN'T.
AND WE KNOW IF, IF WE CAN DELIVER SERVICES EARLY AND PREVENTION WISE, WE CAN PREVENT MORE ACUTE CHRONIC NEEDS.
UM, SO ALL OF THOSE ARE CRITICAL TO MAKING THAT HAPPEN.
I GUESS JUST TO DIG A LITTLE DEEPER, ARE THEY SERVING DIFFERENT INDIVIDUALS? ARE THEY, IS AUSTIN FIRST AND EM COD AND OR NO WRONG? I KNOW NO WRONG DOORS MORE G DOWNTOWN BASE, RIGHT? FOR THAT ONE.
UM, BUT HOW DOES YOURS, LIKE, IS THERE ENOUGH, I GUESS I'M JUST TRYING TO UNDERSTAND HOW ARE THEY COORDINATED? ARE THEY ADDRESSING DIFFERENT GAPS IN THE SYSTEM OR IS IT DUPLICATIVE? THEY'RE NOT DUPLICATIVE.
THEY'RE DIFFERENT TOUCH POINTS THAT PEOPLE ARE EXPERIENCING OUR SYSTEM.
SO IF SOMEBODY IS IN, IN OUR CURRENT ENVIRONMENT, IF SOMEONE IS CHRONICALLY MENTALLY ILL AND DOES NOT WANT CARE, THEY'RE NOT REQUIRED TO RECEIVE IT.
UM, AND AS A RESULT, YOU KNOW, SOME PEOPLE MAY HIT A THRESHOLD IN TERMS OF THEIR OWN
[00:35:01]
NEEDS THAT REQUIRES SOME INTERVENTION.AND THEN THE, OUR INTERVENTIONS NOW ARE THE ONES YOU JUST DESCRIBED ALONG WITH OUR EM COT.
WHEN SOMEONE HITS A THRESHOLD WHERE THEIR BEHAVIOR BECOMES A BARRIER TO OUR COMMUNITY AND THEM GETTING ACCESS TO CARE, MANY OF THOSE FOLKS THAT IS THEIR FIRST PORTAL INTO GETTING MORE ONGOING TREATMENT WITHIN OUR SYSTEM OF CARE.
AND AS YOU SAW US TALK EARLIER, MANY OF THOSE FOLKS MAY ALSO BE GETTING THE CORE OF THEIR SERVICES IN COMMUNITY CARE OR MAY END UP IN THE RESPITE PROGRAM, UH, DELIVERED, UM, THROUGH CENTRAL HEALTH.
BUT ONGOING TREATMENT AND PREVENTATIVE CARE IS PART OF THAT.
SO MANY OF THE FOLKS THAT, THAT THOSE TWO PROGRAMS YOU MENTIONED ARE MAY NOT BE ACTIVELY IN TREATMENT UNTIL THEY GET ENGAGED BY THAT.
OUR GOAL IS TO BE ABLE AT THAT POINT IS TO GET THEM INTO CARE, UH, AND SUPPORT THEM WHEREVER THEY ARE IN THEIR JOURNEY.
I'M NOT SURE, HOPEFULLY THAT ANSWERS YOUR QUESTION OR WE CAN GO INTO MORE DEPTH IF YOU'D LIKE.
WELL, I'VE, I THINK THERE'S A LOT OF GROUND TO COVER.
I KNOW MY COLLEAGUES ALSO HAVE SOME QUESTIONS.
SO I THINK WHAT I'LL PROBABLY DO IS FOLLOW UP ON OFFLINE, UM, WITH THE CHAIR AND SEE IF WE CAN'T GET SOME ADDITIONAL CLARITY ON SOME OF THAT AND SOME OF THE DETAILS, THE GRANULARITY YOU'RE TALKING ABOUT, UH, YOU ALL, AND, AND WE'VE HAD OTHER SPEAKERS THIS MORNING TALK ABOUT HOW WE'RE REASSESSING SOCIAL SERVICES RIGHT NOW.
I'M WONDERING IF YOU CAN HELP GET ME SOME CLARITY ON HOW YOU'RE THINKING ABOUT METRICS THAT ARE FOCUSED ON OUTCOMES, INCLUDING, AGAIN, IN THE CHART YOU LAID OUT THE COLLABORATIVE EFFORTS.
I KNOW THAT, UH, FROM LOOKING AT SOME OF THE, THE DATA REGARDING THE, UM, THE OC CONTRACT THAT ONE OF THE METRICS IS THE NUMBER OF PHONE CALLS YOU RECEIVE, UH, AND ALSO THE NUMBER I THINK THAT ARE, THAT ARE DEFERRED AS PART OF THAT.
SO FOR MY CLARITY, CAN YOU HELP WALK ME THROUGH HOW THOSE SORT OF OUTCOMES OR THOSE DEFERRALS OR DIVERSIONS ARE LEADING TO GOOD OUTCOMES FOR INDIVIDUALS? YEAH, ABSOLUTELY.
I THINK THE IDEAL MODEL IS THAT PERSON WHO'S STRUGGLING WITH THE BEHAVIORAL HEALTH NEED THAT AT THAT POINT IN TIME, WHEN THEY'RE READY TO GET THAT CARE, WE'RE ABLE TO CONNECT THEM TO THE RIGHT SET OF SERVICES THAT MAKE SENSE FOR THEM.
SO ON A VOLUNTARY BASIS, PREFERABLY THEY'LL ENGAGE IN ONGOING TREATMENT.
IT MAY BE TO SEE A PSYCHIATRIST, IT MAY BE A THERAPIST, IT MAY BE TO WRAP THEM INTO ONE OF OUR CRISIS RESIDENTIAL PROGRAMS, WHILE WE CAN WORK WITH THEM IN ENSURING THEIR MEDICATION IS SUPPORTED, THAT WE CAN ALLOW THEM TO GET PERMANENT SUPPORTED HOUSING AND THEN CONTINUE THAT TREATMENT AND SUPPORT AT A LOWER LEVEL AND A LOWER COST TO OUR COMMUNITY.
THOSE TWO PROGRAMS WE JUST MENTIONED ARE GREAT, BUT THEY'RE VERY LABOR AND COST INTENSIVE TO DELIVER.
THE, REALLY, THE WORK THAT WE DO THAT'S REALLY GONNA MATTER IS ONGOING SUPPORT AND PREVENTATIVE CARE THAT KEEP PEOPLE OUT OF THAT, THAT ENGAGEMENT WHATSOEVER.
UM, AND SPECIFICALLY, UM, COUNSEL, AND WE, I'M HAPPY TO SHARE WITH YOU THE ROI AND ANY OF THESE PROGRAMS IN TERMS OF BOTH RETURN ON THE INVESTMENT DOLLARS AND THE CLINICAL OUTCOMES BECAUSE IT'S SOMETHING THAT WE TRACK.
AND AS DR. LEE MENTIONED EARLIER, WE'RE ALSO LOOKING AT THAT AS IT RELATES TO ALL OF OUR PROGRAMS AND SERVICES.
SO IF SOMEBODY ENTERS A SERVICE IN COMMUNITY CARE, HOW ARE WE ENSURING THAT THAT PERSON'S GETTING THE RIGHT SERVICES WITHIN OUR SYSTEM OF CARE? JUST TO BUILD ON THAT QUESTION, THE, THE ASSESSMENT OF IMPACT IS REALLY IMPORTANT.
SO CENTRAL HEALTH THINKS ABOUT THIS IN A FEW DIFFERENT WAYS.
WHAT IS THE TIME FROM WHEN SOMEBODY NEEDS A SERVICE TO THE TIME THAT THEY CAN GET IN TO BE SEEN, WHETHER THAT'S A PRIMARY CARE NEED OR A SPECIALTY CARE NEED.
SO THAT'S THE PRIMARY FOCUS OF THIS YEAR'S YEAR OF ACCESS FOR CENTRAL HEALTH.
UM, THERE ARE ASPECTS OF THAT.
IF WE DO THAT RIGHT, WE SHOULD SEE QUALITY IMPROVES CANCER SCREENINGS, DIABETES CONTROL, PRENATAL CARE, AND SO ON.
WE JUST SEE FEWER PEOPLE NEEDING TO GO TO THE EMERGENCY DEPARTMENT OR GO TO THE HOSPITAL OR RE READMITTED FROM THE HOSPITAL FOR WHAT ARE CALLED AVOIDABLE CONDITIONS.
THINGS THAT WE OUGHT TO BE ABLE TO MANAGE IN AN OUTPATIENT SETTING.
SO WE MEASURE THAT, UM, ON THE FARM OF THE SPECTRUM COMING OUT OF RESPITE, WE MEASURE HOW MANY FOLKS END UP DISCHARGED TWO-WAY HOUSING SITUATION THAT'S RIGHT FOR THEM.
AND SO ARE WE COMPLETING THAT JOURNEY? AND THEN WE, WHEN WE ZOOM ALL THE WAY OUT, WE ARE DEVELOPING A WAY OF MEASURING SOMETHING.
WE'RE CALLING OUR TAXPAYER RETURN INVESTMENT.
UM, I'LL WALK YOU THROUGH BRIEFLY CONCEPTUALLY, WE HAVEN'T BUILT THIS YET, BUT WE ARE BEGINNING TO PULL THIS TOGETHER.
UH, LOOKING AT MEDICAL RESPITE, FOR EXAMPLE, AT A PROGRAMMATIC LEVEL.
SO IMAGINE THAT THE KINDS OF, UH, IMPACT AND THE NUMERATOR OF THIS METRIC INCLUDE THE VALUE OF THE CARE THAT'S DELIVERED, THE DIRECT VALUE OF CARE WE'RE PROVIDING, BUT ALSO THE VALUE OF THE CARE THAT WE PREVENTED.
WE DID NOT NEED TO CARE FOR THIS CANCER IN A METASTATIC LEVEL BECAUSE WE CURED IT.
THIS INDIVIDUAL NEVER HAD THAT DEBILITATING STROKE.
SO WHAT DID WE AVOID? UH, THEN THE VALUE OF THE ECONOMIC VALUE WE HAD DIRECTLY JOBS, CONTRACTS, BUILDINGS, DIRECT MEASUREMENT,
[00:40:01]
THE VALUE OF THE ECONOMIC SAVINGS WE CREATED.THERE WERE FEWER SICK DAYS, OR MAYBE WE BENT THE COST OF CARE FOR THOSE WHO GET INSURANCE WITH US.
AND THEN FINALLY, THE VALUE OF LIFE ITSELF, UM, AT A CONSERVATIVE ESTIMATE PER LIFE YEAR SAVED, UH, THAT, THAT, UH, THAT COMPONENT VARIES FROM A LOW AND ABOUT $50,000 PER LIFE YEAR TO A HIGH END, ABOUT $500,000 PER LIFE YEAR.
OBVIOUSLY, WE'RE AIMING AT THE LOW END OF THAT, BUT CRITICALLY IT CANNOT BE ZERO.
WHEN WE ASSIGN ZERO TO THINGS THAT ARE HARD TO MEASURE, WE END UP DISTORTING HOW WE THINK ABOUT RETURN ON INVESTMENT, PARTICULARLY AS A MATTER OF PUBLIC INVESTMENT.
WE HAVE TO SEE THAT INVISIBLE BURDEN THAT OUR PUBLIC CARRIERS, THE TAXPAYERS DO PAY FOR THE FRAGMENTED CARE THAT FOLKS DON'T GET.
WE KNOW THAT'S AT LEAST A BILLION DOLLARS PER YEAR HERE IN TRAVIS COUNTY AT THE CONSERVATIVE END.
SO WE'RE TRYING TO GO AFTER THAT PROBLEM, AND YOU TAKE ALL THOSE COMPONENTS AND DIVIDE IT BY THE TAX REVENUE OR DIVIDED BY THE PROGRAMMATIC INVESTMENT, ET CETERA.
IT'S A BROADER WAY OF LOOKING AT PUBLIC IMPACT FOR OUR INVESTMENT.
AND WE'RE TRYING TO DEVELOP THIS METHODOLOGY IN A WAY THAT WE CAN SHARE IT AND IT CAN BE REPRODUCED.
NO, THAT SOUNDS, UH, ENORMOUSLY HELPFUL AND I LOOK FORWARD TO, AS YOU ALL BUILD IT OUT, AND CERTAINLY WE'LL FOLLOW UP ON SPECIFICS THAT YOU'VE GOT REGARDING THE WORK THAT YOU'VE CURRENTLY DONE.
LAST QUESTION BEFORE I HAND THIS OFF IS JUST TO HELP ME FIGURE OUT OR SPEAK TO WHAT ARE THE CURRENT BOTTLENECKS YOU ALL ARE EXPERIENCING RIGHT NOW AS YOU'RE AND I I'M GONNA BROADEN THIS BOTH AS YOU'RE, UM, EXCHANGING OR SENDING PEOPLE OR REFERRING THEM BETWEEN THE DIFFERENT GROUPS, BETWEEN THE THREE OF Y'ALL AS WELL AS ALSO THE CITY, RIGHT? SO WE'VE GOT SAY, A CITY SHELTER THAT'S INVOLVED.
UM, ARE THERE GAPS IN GETTING ASSESSMENTS DONE? ARE THERE GAPS IN SHELTER BEDS BETWEEN EITHER US AND YOU ALL, YOU ALL IN THE CITY? CAN YOU SPEAK TO WHAT YOU'RE DISCOVERING SO FAR WITH THESE EFFORTS? I MEAN, I, I THINK THIS IS, I'LL END UP IN MY SECOND YEAR HERE IN AUSTIN, UM, IN A COUPLE OF WEEKS.
AND I HAVE FOUND THAT THERE'S INCREDIBLY EARNEST DEDICATED PEOPLE OPERATING ALL OF THESE THINGS, BUT IN AN INCREDIBLY DISCONNECTED WAY.
UM, AND ONE OF THE THINGS THAT OUR ROLE, AND ONE OF THE EXAMPLES WE'RE TRYING TO BUILD OFF OF THIS SYSTEM IS A WAY FOR US TO EFFECTIVELY COORDINATE AND BREAK DOWN HISTORIC SYSTEMS AND HOW WE'VE DELIVERED THESE SERVICES.
AND THOSE, OTHER THAN TALKING ABOUT THAT SPECIFICALLY, SOME OF THE THINGS THAT WE'RE WORKING ON AS, AS, UH, PAT MENTIONED EARLIER, WE'RE LOOKING AT HOW WE'RE, UM, SHARING INFORMATION.
SO IF SOMEBODY ENDS UP IN A SHELTER, HOW EFFECTIVELY IF THAT PERSON NEEDS CARE IN COMMUNITY CARE OR IN INTEGRAL CARE, WE'RE EFFECTIVELY ABLE TO MAKE THAT REFERRAL AND TRACK THAT IN ACROSS OUR SYSTEMS THAT TRADITIONALLY WE'VE, PEOPLE HAVE HAD TO ENDURE THESE SILOS, WELL INTENTIONED AS THEY ARE, BUT WE'VE CREATED REALLY DIFFICULT BARRIERS ACROSS THESE SYSTEMS. AND AUSTIN ISN'T UNIQUE.
UM, THIS IS A, A NATIONAL PROBLEM ABOUT HOW THIS, BUT WE HAVE A TREMENDOUS OPPORTUNITY BECAUSE WE ARE ALL GOVERNMENTAL ENTITIES TO BE ABLE TO TRY AND, AND MOVE PAST THAT AND ALSO BE ABLE TO DO THIS IN OTHER SYSTEMS OF CARE.
UH, WE ALSO PROVIDE SERVICES IN A NUMBER OF OTHER SYSTEMS, THE SCHOOL SYSTEMS IN THE JAILS, UH, WITHIN OTHER, WITH OTHER PARTNERS THAT HELPS.
BUT AS WE START TO HOLD EACH OTHER ACCOUNTABLE FOR THAT, THAT FLOW OF INFORMATION, THAT'S WHAT WE'RE TRYING TO DO HERE TODAY.
AND THAT'S WHAT WE'RE REALLY TALKING ABOUT.
IT DOESN'T, IT'S, IT, IT'S SOUNDS GOOD, BUT IT'S HARD TO DO.
AND THE ONLY, AND THAT'S ONE OF THE REASONS WHY THE THREE OF US ARE HERE TO LET YOU KNOW THAT WE'RE PUBLICLY COMMITTED TO DOING THIS.
AND THIS IS A VERY DIFFERENT APPROACH.
WE CAN EACH TALK ABOUT ALL OF OUR GREAT WORK IN SILOS AND NEVER GET ANYWHERE.
WE'RE REALLY TRYING TO BREAK THAT DOWN.
I THINK I CAN, UH, BUILD ON THAT A LITTLE BIT.
UH, JEFF, PLAINLY, THERE ARE A NUMBER OF GAPS IN THE NUMBER OF PROVIDERS THAT, UH, THE DEMAND FOR SERVICES FOR OUTPATIENTS THE CAPACITY, BUT WE'RE THINKING THROUGH VARIOUS WAYS THROUGH COORDINATION, EFFICIENCY, USE OF TECHNOLOGY TO EXPAND ACCESS IN THAT REGARD.
BUT I WANNA BUILD ON WHAT, UH, JEFF SHARED, AND THAT WAS THAT LARGELY ONE OF THE MAJOR GAPS IS WE WEREN'T TAKING A BIRD'S EYE VIEW TO THE ENTIRE SYSTEM.
AUSTIN IS A RELATIVELY NEW HEALTHCARE LANDSCAPE IF I, IF I CAN STATE THAT SAFELY.
UM, A LOT OF FRACTURE FRAGMENTED, UH, SYSTEMS THAT ARE GRADUALLY COMING TO REALIZE THE HOLE TOGETHER.
AND I THINK THE FACT THAT THE THREE OF US ARE SITTING HERE TODAY TRYING TO SPEAK ABOUT ONE PROBLEM FOR ALL DIFFERENT ANGLES IS AN ATTEMPT TO START CLOSING THAT GAP.
SO WHILE THE USUAL GAPS OF, UH, SUPPLY AND DEMAND EXISTS, THEY'RE VERY REAL HERE.
WE HAVE JUST AS MUCH OF A PROBLEM OF RECRUITING PRIMARY CARE AND BEHAVIORAL HEALTH SPECIALISTS, ET CETERA.
[00:45:01]
IN MANY WAYS TO CREATE POLICY THAT ALLOWS FOR GREATER, UH, A BROADER WORKFORCE TO BE ABLE TO HELP LEAN IN TO HELP SOLVE THESE PROBLEMS. THE FACT THAT, UH, WE ARE ALL LEANING IN TOGETHER, THAT OUR BOARDS ARE ALL LEANING IN TOGETHER TO COLLABORATE ON WHAT IS A BROADER BIRD'S EYE VIEW ON THE, OF THE PROBLEM WE'RE TRYING TO SOLVE, COLLATE DATA TO START CREATING MORE SEAMLESS, UH, JOURNEYS FOR EACH OF THESE PATIENTS IS PROBABLY THE BIGGEST GAP THAT WE'RE ON ROUTE TO CLOSING.AND I'LL JUST SAY IT'S BEEN, UH, YOU KNOW, I'VE ONLY BEEN HERE FOR A YEAR AND A LITTLE BIT AND IT'S BEEN A CHALLENGE EVEN WITHIN THE CITY TO SORT OF BREAK DOWN SOME OF THE SILOS THAT WE'VE RUN INTO.
I DO HAVE SOME ADDITIONAL QUESTIONS BASED ON COUNCIL MEMBER DO TWO? YEAH, I WANNA ADD ONE THING.
I WANNA ADD ONE THING THAT YOU ALL ARE VERY MUCH AWARE OF, UM, AND WE REALLY APPRECIATE THE WORK THAT Y'ALL ARE DOING, BUT, BUT WE, YOU KNOW, IT IT, WE HAVE TO, WE HAVE TO SAY THE WORD HOUSING.
UM, WE ALL KNOW THAT ACCESS TO HOUSING IS A HUGE BARRIER AND A PROBLEM FOR THESE FOLKS.
WE ALL KNOW THAT ACCESS TO HA TO, UM, HOUSING IS A, IS A SOMETHING THAT WE ALL STRUGGLE WITH AND IT'S A CHALLENGE, UM, ACROSS THE BOARD.
THOSE THAT NEED SUPPORTIVE HOUSING AS WELL AS THOSE THAT ARE, UH, EXPERIENCING HOMELESSNESS, THEY DON'T HAVE A PLACE TO LIVE, THEY'RE GONNA HAVE A MUCH HARDER TIME RECOVERING.
AND SO OUR, OUR THREE ENTITIES ARE WORKING VERY HARD TO DO WHAT WE CAN AND WE'RE REALLY APPRECIATING THE EFFORTS THAT THE CITY IS, UM, CARRYING OUT AND WORKING WITH YOU ON THAT, BUT IT REMAINS A HUGE BARRIER.
AND I DO WANNA FLAG COLLEAGUES.
I BELIEVE CARRIE ROGERS HAS JOINED US ONLINE.
I THINK SHE WAS GONNA HOP ON TO SPEAK TO THE CITY PROGRAMS AND PROVIDE SOME CONTEXT ON BEHALF OF THE CITY OF THE FUNCTION AND, UH, INTENTIONS OF THOSE PROGRAMS. OKAY.
UM, THAT LAST COMMENT ABOUT HOUSING IS, WAS KIND OF THE DIRECTION I WAS GONNA GO.
I'M, I'M TRYING TO FIGURE OUT, YOU, YOU TALK ABOUT THESE ISLANDS, WHERE'S THE CITY'S ISLAND, RIGHT? WHAT IS OUR ROLE IN ALL OF THIS? UM, YOU KNOW, WE HAVE PUBLIC HEALTH HERE AND OF COURSE WHAT THEY DO TOUCHES ON WHAT YOU DO.
UM, WE OBVIOUSLY ARE A LARGE FUNDER IN THE HOMELESSNESS SPACE AND, AND THEN DEAL WITH MANY OF YOUR CLIENTS.
SO WHAT ONE OF THE STRUGGLES I'M GRAPPLING WITH UP HERE AT THE MOMENT, UM, YOU KNOW, WHERE DO, WHERE DO YOU NEED OUR SUPPORT? WHERE, WHERE DO YOU SEE OUR ISLAND IN YOUR GRAPH? UH, COUNCIL ALTO, THANK YOU FOR CALLING THAT OUT.
UM, WHAT I FAILED TO SAY WHEN I INTRODUCED THE ISLANDS IS WE RECOGNIZED IN THE BEGINNING THAT THERE ARE MANY ISLANDS.
UH, AND, UH, WHAT YOU SAW WAS INITIALLY, UM, WORK THAT OUR, OUR BOARDS ASKED US TO DO.
AND SO WE, WE LIMITED OUR SCOPE THAT THESE THREE ISLANDS RECOGNIZING THAT THE PRINCIPLE OF SEEING THE SPACE BETWEEN GROWING THE ISLANDS TOWARD EACH OTHER, FIGHTING THAT LITTLE YIN YANG REPRESENTATION OF EACH OTHER ON EACH THOSE ISLANDS.
SO WE'RE NOT JUST KIND OF PHYSICALLY IN SPACE TOGETHER, BUT WE'RE, WE'RE INTEGRATED AND THEN BUILDING BRIDGES BETWEEN THEM FOR PEOPLE WHO FLOW BETWEEN.
I THINK THAT IS THE SET OF PRINCIPLES THAT I WOULD SAY I BELIEVE WE ARE EMBARKED ON, UH, WITH, UH, UH, MULTIPLE COLLEAGUES AT THE CITY, WHETHER IN THE, UM, HOMELESS STRATEGY OFFICE OR THE PUBLIC HEALTH TEAM OR WITH EMS AND SO ON AND WITH THE COUNTY.
UH, AND I THINK INCREASINGLY TOGETHER THAT THAT ISLAND BRIDGING WORK IS NECESSARY.
UM, IF I COULD BRIDGE FROM YOUR COMMENT TO THE ONE THAT YOU'D ASKED, UH, VICE AROUND BOTTLENECKS.
THE, THE, THE REASON I LOVE THAT QUESTION SO MUCH IS THAT A BOTTLENECK PROBLEM IS NOT NECESSARILY A, A PROBLEM OF DEMAND OR SUPPLY, IT'S A PROBLEM OF THROUGHPUT.
UH, AND I THINK THAT IS A, THAT IS AN IMPORTANT WAY TO FRAME OUR CHALLENGE HERE.
WE PROBABLY HAVE, UM, QUITE A LOT OF COLLECTIVE RESOURCES AND QUITE A LOT OF COLLECTIVE EXPERTISE AND CERTAINLY A LOT OF NEED IF WE COULD SOLVE THE THROUGHPUT CHALLENGE.
UM, SO WHAT WOULD IT LOOK LIKE TO ALIGN THE GOVERNANCE CONVERSATIONS THAT WE HAD THE SAME AREAS OF IMPORTANT FOCUS, UM, TO ALIGN THE FUNDING EMPHASIS SO THAT WE WERE PUTTING OUR EGGS IN THE RIGHT BASKETS TOGETHER, UH, TO CONNECT THE DATA SYSTEMS. SO WE'RE WORKING OFF THE SAME FACTS AND OUR TEAMS CAN SOLVE PROBLEMS IN REAL TIME TO SOLVE THE WORKFORCE PIPELINE BOTTLENECKS THAT WE NEED TO SOLVE THIS PROBLEM.
AND THEN FINALLY, TO CLOSE THE GAPS IN THE SERVICES, WHETHER THAT'S SHELTER BASED CARE OR, UH, SERIOUS ACUTE MENTAL ILLNESS CARE AND THE FUNDING GAPS TO PROVIDE THAT CARE APPROPRIATELY SO THAT CARE CAN FLOW.
BUT TO SEE THE BOTTLENECK PROBLEM TOGETHER, TO, UH, ATTACK THAT PROBLEM TOGETHER,
[00:50:01]
MAYBE DO FEVER THINGS BETTER TOGETHER, I THINK WOULD BE A, AN INTERESTING OPPORTUNITY.UM, MAYOR WATSON SAID IN A, IN A EARLIER SPEECH WHERE HE WAS INTRODUCING HIS GEN A TX, UH, INITIATIVE, THAT COLLABORATION IS OUR SUPERPOWER, UH, HERE IN AUSTIN.
AND I THOUGHT THAT WAS A REALLY INTERESTING AND INSIGHTFUL STATEMENT.
UM, IF WE COLLABORATE MORE EFFECTIVELY, WE MIGHT BE ABLE TO SOLVE THESE BALD NECK PROBLEMS, MAYBE BETTER THAN A LOT OF OTHER SIMILARLY SIZED, UH, ENVIRONMENTS BE BECAUSE OF THE WAY WE CAN COLLABORATE.
I'LL PUT IT IN A MORE, I, I JUST BECAME A GRANDPARENT, SO I'M FASCINATED WITH, WITH, UH, LITTLE KIDS PLAYING SOCCER.
AND IF YOU EVER SEE LITTLE KIDS PLAY SOCCER, THEY ALL CHASE THE BALL IN THE SAME SPOT, RIGHT? EVERYONE SEES THE BALL AND THEY CHASE IT.
ONE OF THE THINGS THAT WE HAVE TO DO TO ANSWER YOUR QUESTION SPECIFICALLY WHERE THE CITY, THE, THE WORK THAT WE'RE DOING, WE NEED TO WIDEN AND COORDINATE WHO DOES WHAT IN OPTIMIZING THESE RESOURCES IN THE MOST EFFECTIVE FASHION.
SPECIFICALLY YOUR QUESTION ABOUT THE CITY, YOU KNOW, ONE OF THE THINGS THAT WE HAVE DONE A LOT IN THIS COMMUNITY, THANKS TO THE LEADERSHIP OF ALL OF YOU ABOUT BUILDING HOUSING, HOUSING IS GREAT, BUT WITHOUT THESE SERVICES TO SUPPORT PEOPLE MAINTAINING THAT HOUSING, WE'RE GONNA FAIL.
SO PART OF THE WORK WE HAVE TO LOOK AT IS WHAT, NOT ONLY HOW ARE YOU GONNA BUILD AND PROVIDE SERVICES FOR PEOPLE WHO ARE, ARE STILL UNHOUSED, BUT HOW ARE WE GONNA KEEP PEOPLE IN THE HOUSING THAT WE'VE MADE THIS TREMENDOUS INVESTMENT IN? AND THAT'S THROUGH SUPPORTIVE CLINICAL SERVICES THAT WE HAVE TO COORDINATE WHO IS DOING WHAT IN THE MOST EFFECTIVE DIRECTED WAYS POSSIBLE, AS DR. LEE MENTIONED.
SO THE WORK THAT WE'RE TALKING ABOUT, AS PAT SAID EARLIER, IS AN EXEMPLAR IS SOMETHING WE WANNA WIDEN ACROSS OUR WHOLE SYSTEM OF CARE, BUT YEAH, WE NEED TO MAKE SURE THE CITY CAN HELP MAINTAIN THAT SUPPORT COMPONENT OF HOUSING.
AND I WANNA PICK UP RIGHT THERE, BECAUSE THAT IS WHAT WE HAVE HEARD BOTH INTERNALLY AND WHEN I'VE TALKED TO OUR HOUSING DEPARTMENT OR WHEN WE TALK TO DEVELOPERS OF SUPPORTIVE HOUSING, YOU KNOW, THEY HAVE SAID WE'RE NOT BUILDING ONE MORE SUPPORTIVE HOUSING UNIT UNTIL YOU SHOW US WHERE THOSE SUPPORT DOLLARS ARE COMING FROM.
RIGHT? AND I THINK THERE'S THIS OPEN QUESTION RIGHT NOW OF, YOU KNOW, WE'VE DONE IT ONE WAY WHERE INTEGRAL CARE HAS ITS SUPPORTIVE HOUSING PROJECT AND THE CITY HAS ITS SUPPORTIVE HOUSING PROJECT, THE COUNTY HAS ITS PRO AND, YOU KNOW, FIGURE IT OUT AMONGST YOUR LITTLE PROJECT, RIGHT? UM, IS THAT THE BEST WAY TO DO THINGS OR IS IT, YOU KNOW, WE, WITHIN THE SUPPORTIVE HOUSING MODEL, WE RECOGNIZE, AND I'M MAKING THESE NUMBERS UP, BUT THAT 25% OF THE NEED IS A, A MENTAL HEALTH NEED.
AND SO WE'RE GONNA SAY INTEGRAL CARE, WE NEED TO RELY ON YOU FOR THAT PIECE OF THE SUPPORT SERVICE.
AND, YOU KNOW, ANOTHER 25% IS A, A MEDICAL, YOU KNOW, MORE CLINICAL DOCTOR NEED, AND SO CENTRAL HEALTH WE NEED TO RELY ON YOU FOR THAT 25%.
AND THE OTHER IS, YOU KNOW, SOME OF THE SOCIAL SERVICES THAT MAYBE THE CITY THEN STEPS IN.
I, I DON'T HAVE THE ANSWER, BUT I DO KNOW THAT WE ARE FACING A REALLY LONG GAP OF ANY NEW SUPPORTIVE HOUSING IF WE, WE DON'T FIGURE IT OUT.
UM, YOU KNOW, I CERTAINLY WANNA COMMEND MY PREDECESSOR, UH, FORMER COUNCIL MEMBER KITCHEN WHO WE ARE REAPING THE BENEFITS OF THE WORK THAT SHE AND HER COLLEAGUES DID IN TERMS OF BUILDING THAT SUPPORTIVE HOUSING, DEDICATING THE RESOURCES, YOU KNOW, MORE THAN DOUBLING OUR CAPACITY AND, AND HAVING NOW, UH, THOUSANDS, WHETHER IT'S RAPID OR PSH FOR COMMUNITY MEMBERS THAT NEED IT THE MOST.
BUT WHAT'S THE NEXT CHAPTER IN IN THAT STORY AND HOW DO WE DO THAT? UH, I'M CURIOUS TO KNOW HOW, HOW YOU THINK ABOUT IT OR WHAT YOU SEE AS THE SOLUTION.
WE DIDN'T HAVE A LOT OF TIME TO GO THROUGH THAT FOUR QUADRANT DISCUSSION, BUT IF YOU IMPOSE THAT ON A MODEL OF HOUSING, IT'S THE SAME.
IT'S HOW DO WE, WHICH, WHICH OF THOSE QUADRANTS DO WE NEED TO ADDRESS PEOPLE WITH HIGH MEDICAL, HIGH MENTAL HEALTH NEEDS AND HOUSING FOCUS THOSE RESOURCES THERE AND WORK ON A FLOW TO MOVE PEOPLE AND MOVE RESOURCES THE MOST EFFECTIVE WAY BASED ON THAT INDIVIDUAL'S NEEDS AND WRAP OUR SYSTEMS AROUND THAT.
THE SECOND PIECE OF THAT IS WHAT'S THE MOST EFFECTIVE WAY TO LEVERAGE THE MOST FEDERAL, STATE AND LOCAL DOLLARS? AND WHO CAN, WHO CAN EXTRACT THOSE AND POTENTIATE THOSE IN THE MOST EFFICIENT WAY POSSIBLE? AND SO THAT'S, THAT'S THE OTHER PART OF THIS WORK, BUT THE NOTION ABOUT HOW WE DELIVER THOSE SERVICES IN A IN A RESIDENTIAL SETTING, WE CAN, THAT MODEL WORKS WITHIN THAT, THAT STRUCTURE AS WELL.
I THINK THERE'S A LOT OF WORK THAT THIS
[00:55:01]
COMMUNITY HAS DONE AROUND BUILDING THIS, AND IT DOESN'T ALWAYS LOOK VERY EFFICIENT, BUT IT, IT, WE GOT TO A TREMENDOUS PLACE HERE THAT MOST COMMUNITIES DON'T HAVE, BUT I REALLY DO THINK WE HAVE TO NOW FIGURE OUT HOW DO WE MAINTAIN THIS EFFORT AND START ALL OF US WORKING MORE IN A, IN A COORDINATED FASHION RATHER THAN SELLING OUR PIECE OF THIS STORY.IT'S ALL OF OUR STORY AND HOW DO WE DO THIS MORE EFFECTIVELY? AND THAT ISN'T JUST TALKING IN BROMIDES ABOUT HOW GREAT THAT IS.
IT'S DOING THE THINGS THAT WE JUST TALKED ABOUT, LOOKING AT DATA, UM, AND HOLDING EACH OTHER ACCOUNTABLE FOR HOW WE'RE WORKING WELL WITH EACH OTHER.
AND, AND I THINK THAT'S SOMETHING THAT I THINK WE HAVE A LOT MORE OF THAT JOURNEY TO GO HERE IS HOW DO WE DO THIS MORE EFFECTIVELY AND HOLD EACH OTHER ACCOUNTABLE FOR COLLABORATING MUCH MORE EFFECTIVELY AND YOU, AND DOING THIS AT THE MOST COST EFFECTIVE WAY POSSIBLE.
THERE'S EXAMPLES WHERE IF WE HAVE A, EVEN A PARAPROFESSIONAL STAFF DOING AN INTERVENTION VERSUS HAVING SOMEONE FROM EMSA DOCTOR AND A SOMEONE, SOMEONE FROM INTEGRAL CARE DOING COULD HAVE A SIMILAR OUTCOME WITHOUT THE SAME LEVEL OF COST.
SO HOW DO WE DETERMINE THE MOST EFFICIENT WAY TO USE THESE LIMITED RESOURCES AND THERE, AND WE DON'T, THE GOOD NEWS IS WE DON'T HAVE TO BUILD THIS FROM SCRATCH.
THERE'S EVIDENCE AND CLINICAL MODELS ALL OVER THE COUNTRY THAT HAVE DONE THIS.
WHAT WE'RE TRYING TO DO THOUGH IS UNIQUE ABOUT HOW WE SCALE THIS AND HOW WE GET THIS, THIS LEVEL OF COMMITMENT AMONGST ALL OF US.
UM, WHERE I COME FROM, THERE WAS NOTHING BUT PRIVATE NOT-FOR-PROFITS FIGHTING FOR THAT LITTLE PIECE OF THE PIE.
AND YOU GUYS HEAR IT ALL DAY WHERE ALL OF US COME AND TALK ABOUT WHAT WE NEED AND WE'RE THE ONE ANSWER TO ALL OF YOUR PROBLEMS. BUT WE'RE SAYING IS THAT WE CAN DO THIS, BUT WE NEED TO DO THIS IN A MORE COORDINATED FASHION, IN A MORE CLINICALLY EVIDENTIARY SUPPORTED WAY.
IF I CAN ADD, UH, ONE ADDITIONAL POINT, THIS IS AN INCREDIBLY DYNAMIC POPULATION.
UM, IF YOU TAKE A CROSS SECTION OF THE POPULATION TODAY, SIX MONTHS FROM NOW, IT WILL BE VERY DIFFERENT PEOPLE WHO POPULATE THAT GROUP.
THE FREQUENCY WITH EACH PEOPLE JOIN THIS GROUP OF HIGHLY VULNERABLE INDIVIDUALS IS SOMETHING THAT WE CAN ALSO ADDRESS WHILE WE'RE TALKING ABOUT PEOPLE WITH ACUTE NEEDS AND FIGURING OUT HOW TO BRING THEM SAFETY, UH, BOTH PSYCHOLOGICALLY AND UH, PHYSICALLY.
THERE IS AN UPSTREAM, UM, ASPECT TO THIS AS WELL THAT WE HAVE TO THE CAPACITY THAT DR. LEE WAS TALKING ABOUT BEFORE.
IF WE POOL OUR RESOURCES, WE SHOULD KNOW WHO IS GOING TO ENTER THAT GROUP.
WE SHOULD KNOW WHO IS AT RISK AND WE SHOULD KNOW WHAT ARE THE PROCEDURES TO BE ABLE TO PREVENT THEM FROM EVEN JOINING THEM.
THE PRESSURE ON THE SYSTEM IS OVERWHELMING AT THIS POINT.
WE'RE ALL, WE'RE ALL SEEING IT.
IF THIS IS ALL WHAT IS ABOVE THE SURFACE OF THE WATER, RIGHT BELOW THE SURFACE OF THE WATER IS AN AT RISK GROUP THAT IS PROBABLY MANY TIMES, MANY FOLD LARGER.
AND WITH EVERY ATTEMPT THAT WE, UH, WE MAKE TO TAKE CARE OF THE FOLKS WHO HAVE CRESTED THAT SURFACE AND EVIDENTLY NEED ACUTE HELP, SUPPORT NEEDS OUR EFFORTS TO WORK UNDERWATER AS WELL, TO ENSURE THAT, UH, MORE DO NOT RISE TO THAT SURFACE, UM, WILL RETURN ON THAT INVESTMENT MULTI TIMES MANY TIMES OVER.
SO, UM, AS WE THINK ABOUT THIS PARTNERSHIP.
THERE'S A DEEP, DEEP COMMITMENT TO, UH, THE EMERGENT OR URGENT NEEDS OF THE COMMUNITIES OUT THERE.
THERE'S A SIMULTANEOUS BUILD OF DEEP STRATEGY, HOW WE RECOGNIZE NEED BEFORE IT ACTUALLY PRESENTS.
UM, WORKING IN THE PRIMARY CARE SPACE AND THE HOSPITAL SPACE, WHATEVER IT MAY BE, WE SHOULD BE ABLE TO FIND INDIVIDUALS AT GREATEST RISK AND PREVENT THEM FROM E UH, FROM NEEDING TO RECEIVE THE NEXT LEVEL OF, UH, ACUTE SERVICES.
THANK YOU ALL FOR THE WORK YOU'RE DOING.
COLLEAGUES, I WANNA ACKNOWLEDGE WE HAVE CARRIE ROGERS WITH US LINE.
UM, MS. ROGERS, IF YOU COULD SHARE WITH US A LITTLE BIT OF CONTEXT ON THE NO WRONG DOORS INITIATIVE, THE AUSTIN FIRST INITIATIVE AS WELL, IF YOU HAVE IT.
UM, YOU KNOW, WE'RE, I, I ESPECIALLY WANNA HONE IN ON, 'CAUSE WHAT IT HAS BEEN PRESENTED TODAY FOR, FOR US, FROM OUR PARTNERS, UM, ON THIS BEHAVIORAL HEALTH CONTINUUM OF CARE MODEL IS, IS IS ENCOURAGING.
IT'S EXCITING, AND I'M LOOKING AT IT THROUGH THE LENS OF, UM, EFFICIENCY AND TRYING TO UNDERSTAND WHERE DO THE CITY'S PROGRAMS PLUG IN.
SO IF YOU COULD SPEAK TO THOSE PROGRAMS. THANK YOU SO MUCH, CHAIRWOMAN, UH, AND COMMITTEE MEMBERS.
AND FOR THE RECORD, I'M CARRIE ROGERS AND I'M THE LEGISLATIVE DIRECTOR HERE AT THE CITY OF AUSTIN.
WE HAVE, UM, A COUPLE OF PROGRAMS, SPECIFICALLY AUSTIN FIRST, WHICH BEGAN IN THE FALL, AND IS AN INTERDISCIPLINARY TEAM OF, UM, OUR MENTAL HEALTH AUTHORITY, EMS AND A PD TO RESPOND TO CALLS OF, UH, REQUIRING MENTAL HEALTH INTERVENTION.
AND FOLKS CAN CLEAN THAT UP AS THEY NEED.
NO WRONG DOOR WAS REALLY BORN OUT OF, UM, A LEGISLATIVE NEED CHAIRWOMAN.
[01:00:01]
UM, AND, AND WHAT I'LL SAY JUST ANECDOTALLY, YOU KNOW, AS THE LEGISLATIVE DIRECTOR AND TRAIPSING BACK AND FORTH BETWEEN CITY HALL AND MY OFFICE, UM, DURING THIS LAST LEGISLATIVE SESSION AND BEING NEW HERE AS A RESIDENT, UM, I WAS HEARING A LOT OF RHETORIC AROUND THE CITY'S RESPONSE TO HOMELESSNESS AND, UM, AND MAKING INQUIRIES AND, AND BEGINNING TO WORK WITH DAVID GRAY AND OTHER FOLKS IN OUR SPACE.I THINK, AND I'M GENERALIZING AFTER LOTS OF WORK AND, AND CONVERSATIONS AND MEETINGS WE'VE HAD WITH PARTNERS, INCLUDING THOSE THERE AT THAT TABLE, IS THAT THERE, UM, WAS, IT WAS LESS ABOUT A TRADITIONAL RESPONSE TO TRADITIONAL HOMELESSNESS AND MORE ABOUT THE HIGH ACUITY, UH, MENTAL HEALTH INTERVENTION THAT WAS NEEDED.
UM, AND SPECIFICALLY, AND YOU HAD NOTED THIS FOCUSED ON DOWNTOWN IN CONGRESS AVENUE AND, AND I LOVED WHAT ONE OF THE GENTLEMEN HAD SAID, UM, IN MENTIONING WORKING UPSTREAM.
'CAUSE I THINK THAT'S WHERE WE STARTED.
UM, BUT SO NO WRONG DOOR IS INTENDED TO FOCUS ON THOSE HIGHEST UTILIZERS.
AND SO LOOKING AT THE DATA ACROSS OUR PUBLIC SAFETY SYSTEM, SO, UM, A PD CRIMINAL JUSTICE SYSTEM, THE COURTS EMS AND HMIS AND LOOKING TO SEE WHO ARE OUR TOP 50 TO A HUNDRED UTILIZERS IN THOSE SYSTEMS TO SEE WHERE WE CAN DO INDIVIDUALIZED SERVICE PLANS FOR THOSE FOLKS.
AND I THINK IT REALLY SPEAKS TO WHAT I'M HEARING OUR GUESTS HERE SAY TODAY, AND I THANK THEM SO MUCH FOR THEIR WORK IS THAT SPACE OF SWIMMING BETWEEN ONE SERVICE TO ANOTHER.
AND SO WHERE, WHERE I COME IN, AGAIN, YOU KNOW, THESE WERE QUESTIONS JUST COMING OUT OF JUST A LEGISLATIVE EXPERIENCE THIS LAST YEAR, IS I AGREE IT IS SOMETHING THAT WE ALL HAVE TO DO TOGETHER.
WHETHER IT'S INTEGRAL CARE, OUR HOSPITAL SYSTEM, TRAVIS COUNTY AND OTHERS, AND THE PARTNERS HAVE BEEN AMAZING.
AND SO WHAT I WILL, UM, PIVOT TO, AND THIS WILL ALL BE COMING TO YOU AS PART OF A DRAFT LEGISLATIVE PACKAGE FOR THE CITY COUNCIL'S CONSIDERATION IN THE COMING MONTHS.
BUT I THINK, THINK WHEN WE LOOK FROM A POLICY PERSPECTIVE, WHAT WE CAN DO TO FILL THOSE GAPS, UM, ONE OF THOSE IS THAT HEALTH HOLD, THAT EMERGENCY HEALTH HOLD THAT RIGHT NOW THAT AUTHORITY IS ONLY AFFORDED TO POLICE OFFICERS.
AND SO YOU HAVE POLICE OFFICERS WHO ARE COMING OFF, YOU KNOW, UH, TRADITIONAL PUBLIC SAFETY, ET CETERA, AND GOING AND SPENDING, UM, AN, UH, INORDINATE AMOUNT OF TIME TRYING TO GET FOLKS COMMITTED, UM, FILLING OUT PAPERWORK AND THINGS LIKE THAT.
AND WHAT WE REALLY WANNA DO IS REFRAME PEOPLE'S MIND THAT MENTAL HEALTH IS HEALTH AND THEY NEED A HEALTHCARE RESPONSE, NOT A PUBLIC SAFETY RESPONSE.
AND SO THAT'S ONE OF OUR LEGISLATIVE ITEMS. REPRESENTATIVE DONNA HOWARD FROM RIGHT HERE IN OUR COMMUNITY HAS FILED THIS BILL AND HAS INDICATED SHE, UM, IS GOING TO BE FILING ANOTHER BILL AGAIN THIS NEXT SESSION.
AND I CAN GO OVER A NUMBER OF CRITERIA, BUT THE OTHER ONE IS FILLING THIS GAP OF THE WARM HANDOFFS.
AND RIGHT NOW, AND I THINK I HEARD SOMEONE SAY SWIMMING BETWEEN THE ISLANDS, WHAT WE SEE IS, AND UM, I'LL JUST USE, YOU KNOW, A GENERAL ANECDOTE.
IF A PD PICKS UP SOMEONE IN A GENERAL DETERIORATED MENTAL HEALTH STATE AND SAY THEY TAKE 'EM TO A TRADITIONAL HOSPITAL, IF THE HOSPITAL DETERMINES FOR WHATEVER REASON THAT THEY'RE AT THEIR BASE LEVEL MENTAL HEALTH, WHICH IS NOT WELL, BUT, YOU KNOW, CARRIE'S BEEN IN HERE 10 TIMES IN THE LAST WEEK AND CARRIE'S ABOUT WHERE SHE NORMALLY IS, THAT THOSE FOLKS MAY BE RELEASED WITHOUT ANY, UM, WARM TRANSFER TO SERVICES.
AND SO THAT'S WHY YOU OFTEN WILL SEE FOLKS IN STILL IN THEIR HOSPITAL GOWN WITH THEIR BRACELET ON, YOU KNOW, AT THE CORNER OUTSIDE A HOSPITAL BECAUSE THERE'S NO PHONE CALL TO SAY, LET'S GET KERRY OVER THERE AND GET, UM, AND GET THAT SERVICE.
AND SO I THINK THERE'S A, A HUGE MENTAL HEALTH POPULATION FOCUS THAT'S GOING ON.
BUT FOR NO WRONG DOOR, WE ARE TRYING TO FOCUS ON THOSE HIGHEST UTILIZERS THAT ARE TOUCHING ALL OF OUR SYSTEMS AND THEN USING THAT DATA TO GO MAKE THIS CASE FOR US LEGISLATIVELY ON WHY THE CITY OF AUSTIN IS THE PLACE THAT WE NEED TO BE PUTTING SOME OF THESE PRACTICES, UM, OR SOME OF THESE POLICIES IN PLACE.
SO I COULD TALK ABOUT THIS ALL DAY.
I'M JUST GRATEFUL FOR THE OPPORTUNITY TO SPEAK TO THE COMMITTEE.
UM, AND AGAIN, I WANNA THANK YOU AND THANK OUR PARTNERS THERE AT THE TABLE FOR THEIR, UM, COMMITMENT TO WORKING WITH US.
THANK YOU FOR THAT CONTEXT AND INFORMATION COLLEAGUES.
ANY QUESTIONS? FURTHER QUESTIONS? ONE THING, UH, THAT
[01:05:01]
MS. ROGERS HAS, SHE HAS HIGHLIGHTED THE GAP OF A WARM HANDOFF BETWEEN OUR HOSPITAL SYSTEMS. DO Y'ALL WANNA SPEAK TO THE ROLE OF OUR YES.HOSPITAL SYSTEM? I DIDN'T MEAN TO INTERRUPT.
DID YOU TRY PLEASE? WHAT? YOUR QUESTION? UH, NO, JUST IT, THE ROLE THAT THEY HAVE IN THIS CONTINUUM OF CARE.
HAS THERE BEEN CONVERSATIONS WITH THEM? YES.
AND UH, I REALLY WANTED TO LIFT UP AND THANK YOU, UH, MS. ROGERS FOR, UM, FOR YOUR LEADERSHIP AND YOUR, AND YOUR INSIGHT INTO THAT.
ON THE GROUND EXPERIENCE OF SOMETHING LIKE THE WARM HANDOFF.
THIS IS WHERE THE BOTTLENECKS TEND TO HAPPEN AT THE KIND OF GROUND LEVEL.
UM, SOMEONE'S LEAVING AN ACUTE CARE SETTING LIKE A HOSPITAL, THERE'S A REASONABLE CARE PLAN IN PLACE, A SET OF MEDICATIONS AND SO ON.
BUT IF THAT INFORMATION IS NOT EFFECTIVELY TRANSITION TO THE NEXT CARE PROVIDER SETTING, A LOT OF THAT WORK IS PUT AT RISK.
UM, WHAT I'LL SHARE IS THAT I DON'T THINK WE HAVE THAT WARM HANDOFF, UH, IN PLACE AS WELL AS WE NEED TO IN THE MENTAL HEALTH SPACE, PARTLY 'CAUSE WE DON'T HAVE THAT STEP DOWN RESOURCE, THE MENTAL HEALTH SPACE THAT WE NEED IN THE PHYSICAL HEALTH SPACE COMING INTO SKILLED NURSING FACILITIES AND SO ON, ON THE PHYSICAL HEALTH SIDE, WE HAD A HUGE WARM HANDOFF PROBLEM THREE YEARS AGO, LESS THAN 25% OF THE TIME, UH, WILL BE ACTUALLY HAVING SOME KIND OF CONVERSATION BETWEEN THE SENDING PHYSICIAN AND THE RECEIVING PHYSICIAN.
AND TOGETHER WITH THAT MEDICATION ERRORS WERE RAMPANT.
UM, AND A LOT OF FOLKS ENDED UP HAVING TO COME RIGHT BACK TO THE HOSPITAL.
UM, AND, UH, AND THIS WAS THE USUAL STATE.
UM, I'M PLEASED TO REPORT THAT TODAY, UM, WE GET A WARM HAND UP ABOUT 100% OF THE TIME THAT HAS BEEN STEADY FOR, UH, SIX QUARTERS IN A ROW.
UH, BECAUSE CENTRAL HEALTH HAS CREATED THAT LAYER, UH, FROM THE HOSPITALS TO THE SKILLED NURSING FACILITIES.
AND OUR HOSPITALIST LED NURSE, PHARMACIST, SOCIAL WORKER, COMMUNITY HEALTH WORKER TEAMS HAVE A BRIDGE DIRECTLY THERE.
WE DELIVER THE RIGHT MEDICATIONS SEVERAL TIMES A DAY, MOST RECENTLY FROM COMMUNITY CARE PHARMACIES BECAUSE WE'VE CONNECTED THE DOTS THERE.
AND SO WE'RE, WE'RE CREATING A FIRM BRIDGE IN THAT HANDOFF.
AND WITH THAT, WE CAN SEE THE READMISSION RATES TO THE HOSPITAL COMING DOWN SUBSTANTIALLY.
AND WHILE WE HAVE NOT YET BEEN ABLE TO ACCURATELY MEASURE THE MORTALITY OR DEATH RATES, UM, AS A PHYSICIAN, I WOULD, I WOULD BET GOOD MONEY THAT THOSE ARE LOWER AS WELL, ONCE WE CAN GET OUR ARMS AROUND THEM.
AND SO IT'S EXACTLY THOSE KINDS OF VULNERABLE TRANSITION POINTS, UM, WHERE THE SYSTEM BREAKS AND SOMEONE GETS DROPPED INTO THAT DEEP WATER TO SWIM.
SOMETIMES THEY MAKE IT BACK TO THE NEXT ISLAND SAFELY, SOMETIMES THEY DON'T.
AND THAT'S WHERE A LOT OF THE MORTALITY SHOWS UP IN OUR COMMUNITY.
SO, UM, I THINK THAT'S EXACTLY PUTTING OUR FINGER ON THE PAIN POINT.
UM, AND THE KIND OF PROBLEM THAT WE CAN BEGIN TO SOLVE AS JOINT PUBLIC HEALTH SYSTEM ENTITIES HERE.
UM, BUILDING THOSE CONNECTIONS IS NOT A PROFITABLE ENDEAVOR ON A, UM, ON A COMMERCIAL BASIS, BUT IT IS A HUGELY VALUABLE ENDEAVOR ON A PUBLIC BASIS, WHICH IS WHY IT IS SO VITAL THAT THE PUBLIC AGENCIES FACE THAT FULL PROBLEM OF THE TAXPAYER BURDEN, THE TAXPAYER ROI, AND BUILD THESE CONNECTIONS THAT ADD VALUE TO OUR COLLECTIVE EFFORT, UM, THAT THE PRIVATE MARKETS ARE JUST NOT INCENTIVIZED, UM, TO SOLVE FOR MM-HMM
I JUST WANTED TO GIVE MORE SPECIFIC COLOR AROUND BEHAVIORAL HEALTH.
AND THAT TO PAT'S POINT, THERE ISN'T ALWAYS AN INCENTIVE FOR OUR INPATIENT PARTNERS TO BE ABLE TO, AND ALSO FOR MANY OF THE PATIENTS WHO SIMPLY IT'S VOLUNTARY.
IF THEY STAY AND IF, AND IF THEY DO NOT WANNA STAY, THEY MANY CASES WILL LEAVE WITHOUT GETTING THAT LEVEL OF, OF SUPPORT MET AT THE INPATIENT.
OUR, OUR GENERAL HOSPITAL PARTNERS, THAT'S WHY THE, THE STEP DOWN SERVICES, OUR DIVERSION PILOT HAS SHOWN TREMENDOUS SUCCESS WITH PEOPLE BEING ABLE TO STAY, UM, OVER 89 TO 90 DAYS IN THAT.
AND WE'VE BEEN ABLE TO ESTABLISH PERMANENT HOUSING, PROVIDE CLINICAL TREATMENT, GET THE KIND OF MEDICATIONS PEOPLE NEED TO BE STABLE, ALL THAT TAKES A LITTLE BIT OF TIME AND ENGAGEMENT TO MAKE HAPPEN.
AND, YOU KNOW, I WANT TO ECHO WHAT CARRIE SAID EARLIER TOO AROUND, UM, THE, THE EMERGENCY HOLD PIECE.
UM, UH, IN MARYLAND WHERE I CAME FROM, I WAS ABLE TO, UH, EMERGENCY PETITION SOMEONE INTO CARE.
UM, SO BE CAREFUL, PAT, IF YOU LOOK AT ME THE WRONG WAY, THIS COULD CHANGE THINGS.
BUT WE, UM, IT, IT IS AN IMPORTANT FEATURE TO BE ABLE TO HAVE THE BEHAVIORAL HEALTH FOLKS IN INVOLVED IN THOSE DISCUSSIONS TO BE ABLE TO DO THAT.
I DO THINK THIS NOTION ALSO OF US HAVING A PUBLIC MODEL THAT WE, WE PROVIDE THAT SUPPORT ACROSS ALL OF THESE DOMAINS AND HAVE THE SAME ALIGNED INCENTIVES REALLY MATTERS.
HOSPITALS ARE IN A DIFFERENT MODEL FINANCIALLY AND INCENTIVE WISE TO BE ABLE TO SUPPORT PEOPLE IN THAT WAY.
UM, I THINK ALL OF US ARE CLEARLY ALIGNED IN THE SAME WAY.
AND I THINK HAVING THAT CONTINUITY OF CARE, EVEN IN AN INPATIENT MODEL INTO WHAT WE'RE DOING, REALLY WOULD BE
[01:10:01]
THE SECRET SAUCE TO MAKE THAT HAPPEN.AND JUST TO KIND OF, I WANNA CIRCLE BACK TO UNDERSTANDING THE PUBLIC HEALTH MODEL FOR THIS CONTINUUM OF CARE AND, AND REALLY TRYING TO GET A, A GRASP ON WHAT IS THE CITY'S ROLE, ESPECIALLY AS IT COMES TO A FUNDER, RIGHT? BECAUSE WE'RE GOING THROUGH, IN FACT, WE JUST LAST WEEK, UH, ADOPTED OUR HOMELESSNESS STRATEGY, STRATEGIC PLAN, UM, THAT CALLED FOR AN ESCALATION OF OUR EMERGENCY, UH, TEMPORARY EMERGENCY SHELTER BEDS FOR THE UNHOUSED.
AND WE KNOW THAT WE HAVE PERMANENT SUPPORTIVE HOUSING UNITS COMING ONLINE THAT CURRENTLY DO NOT HAVE FUNDING FOR THE PERMANENT SUPPORTIVE SERVICES COUPLED WITH IT.
SO I'M TRYING TO HOLD, KNOWING THAT WE HAVE BOTH OF THESE THINGS, UH, IT SEEMS THAT A KEY PIECE OF THE BEHAVIORAL HEALTH CONTINUUM OF CARE IS THE RESPITE BEDS AND HAVING THAT, UH, AVAILABLE AND REALLY SCALING THAT SUPPORT UP.
CAN Y'ALL SPEAK TO WHERE ARE WE AT WITH THE RESPITE BEDS AND HOW DO YOU ALL SEE WHEN YOU VISION OUT THIS MODEL THAT YOU'VE CREATED, UM, WHERE DOES THAT, LIKE, WHAT IS THE, THE PLAN TO, TO INCREASE OUR CAPACITY THERE? SO PACKET TALK SPECIFICALLY TO THE MEDICAL RESPITE BEDS, BUT WE ALREADY HAVE ESSENTIALLY CRISIS BEDS RIGHT NOW IN THE, IN OUR COMMUNITY, BUT NOT AT SCALE.
BUT YOU'RE RIGHT, I THINK THAT REALLY WOULD MATTER.
THE ABILITY FOR PEOPLE TO STEP DOWN FROM AN INPATIENT SETTING, OR IF SOMEBODY IS STRUGGLING IN ONE OF OUR, EITHER IN ANY OF OUR HOUSING PARTNERS BEDS, TO BE ABLE TO, TO BE SOMEWHERE TEMPORARILY AND THEN GET BACK TO WHERE THEY NEED TO BE ON A SHORT TERM WAY IF THEY'RE EXPERIENCING A BEHAVIORAL HEALTH CRISIS, THAT THAT WORK AND THAT STEP TOWN WORK IS A REALLY IMPACTFUL PIECE OF THIS CONTINUUM AND NOT NEARLY AS COSTLY AS AN INPATIENT BED OR INCARCERATING SOMEBODY.
UM, SO THAT ABILITY TO HAVE RESPITE AND CRISIS BEDS THAT CAN BE USED FOR PEOPLE IN BEHAVIORAL HEALTH CRISIS REALLY WORKS.
THE DIVERSION CENTER PILOT, FOR EXAMPLE, THAT WE'RE IN THAT RIGHT NOW, THOSE BEDS, THOSE 50 BEDS ARE FULL MOST OF THE TIME.
AND THOSE ARE FULL WITH THOSE FOLKS THAT WOULD OTHERWISE, UM, BE OUT ON THE STREET OR TEMPORARILY NOT LOSE ALL OF THEIR HOUSING, IF NOT FOR THAT SERVICE.
SO, PAT, ANYTHING ABOUT THE RESPITE? SURE.
AND ON THE MEDICAL RESPITE SIDE, AND WITH A NOD TO, UH, UH, BOARD MANAGER AND FORMER COUNCILMAN KITCHEN, UH, FOR LEADING THIS CHARGE FOR MANY YEARS, UH, ABOUT SIX MONTHS AGO, CENTRAL HEALTH OPENED ITS DOORS FOR ITS FIRST MEDICAL RESPITE, UH, PROGRAM, UH, AT THE, UH, UM, BRACKENRIDGE CAMPUS ON THE GROUND FLOOR WITH A HEALING GARDEN NEXT TO IT AND ONSITE DEDICATED CLINICAL SERVICES, WOUND CARE, UH, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, UH, AND CLINICAL SERVICES THAT A LOT OF PATIENTS NEED.
AND IN THE FIRST SIX MONTHS, WE ARE SEEING, UM, DRAMATIC REDUCTIONS IN EMERGENCY DEPARTMENT UTILIZATION, HOSPITAL READMISSION, AND A VERY HIGH RATE OF FOLKS GETTING APPROVED FOR DISABILITY AND CONNECTED ONTO HOUSING.
UH, AND SO, UH, THE MODEL IS, UH, IS WORKING, UM, ALSO NOT FULLY AT SCALE.
UM, CENTRAL HEALTH, UH, RELATIVELY RECENTLY ACQUIRED A PROPERTY AT CAMERON ROAD, UH, NEAR, UH, 180 3 NORTH CAMERON ROAD.
AND THE VISION FOR THAT PROPERTY IS TO FURTHER SCALE THIS MEDICAL RESPITE, UM, UM, UH, PART OF OUR WORK WITH ROOM FOR ADJACENT SERVICES TO BE ROUTED ALONGSIDE.
UM, AND SO THAT'S THE NEXT STEP FOR US.
WHAT I WOULD ADD, THOUGH, TO YOUR, UH, TO YOUR QUESTION, CHAIR FUENTES, IF I HAD A MAGIC WAND, AND I RECOGNIZE THE MAGIC WAND, UM, DOESN'T NECESSARILY SOLVE THE FUNDING PROBLEMS, BUT IF I HAD A MAGIC WAND, UM, IF THE CITY WAS ABLE TO PROVIDE THE NON-MEDICAL SERVICE SUPPORT FOR HOUSING, UM, THAT WOULD BE, UH, OF HUGE, UH, ASSISTANCE AND WE COULD ATTEMPT TO MEET, UH, TOGETHER IN THE MIDDLE ON THE MEDICAL SIDE.
UM, UH, AND ALSO, UM, COLLECTIVELY, UM, THE CITY, THE COUNTY AND CENTRAL HEALTH COLLECTIVELY SUPPORT INTEGRAL CARE.
UM, AND EVEN AT THE LEVEL THAT WE SUPPORT INTEGRAL CARE, THERE IS NOT ENOUGH FUNDING FOR THE MENTAL HEALTH NEED.
UM, OUR FAILURE TO MEET THE MENTAL HEALTH NEED MEANS THAT SOME OF THE, UM, YOU KNOW, THE CAROUSEL OF DEATH, IF YOU WILL, WE SIMPLY CANNOT GET OUR ARMS AROUND THAT IF WE LEAVE THE MENTAL HEALTH DOOR OPEN LIKE THAT.
AND SO TO THE DEGREE THAT WE CAN ALL LEAN IN, THAT'S WHY CENTRAL HEALTH HAS INCREASED ITS FUNDING SO DRAMATICALLY FROM 7 MILLION TO 34 MILLION IN THE LAST THREE YEARS.
'CAUSE WE RECOGNIZE THERE IS NO HEALTH WITHOUT MENTAL HEALTH.
THERE'S NO STABLE HOUSING IN CHRONIC HOMELESSNESS WITHOUT MENTAL HEALTH.
WE DON'T SOLVE THE 40% OF OUR JAIL POPULATION THAT IS EXPERIENCING SERIOUS MENTAL ILLNESS UNLESS WE HAVE MENTAL HEALTH CARE, UM, ACROSS THE CARE CONTINUUM AS WE'VE DESCRIBED, AND THE CONNECTIONS BETWEEN THEM.
AND SO, UM, IF THERE WERE A WAY, AGAIN, A MAGIC WAND WAY WHERE WE LEANED IN TOGETHER, UM,
[01:15:01]
MAYBE EVEN WITH THE STATE TO THINK ABOUT HOW WE FUND ACUTE MENTAL HEALTH AT THE STATE LEVEL, WE, WE, UM, WE FUND A VERY LOW AMOUNT COMPARED TO OTHER STATES.AND THAT IS A BOTTLENECK AT A LEGISLATIVE FUNDING LEVEL THAT MAKES THE DISTANCE BETWEEN THE ISLAND WE'RE ON NOW AND THE ISLAND WHERE WE HAVE ENOUGH ACUTE MENTAL HEALTHCARE ALMOST IMPOSSIBLE TO BRIDGE UNLESS YOU BRING THOSE ISLANDS CLOSER, WHICH MIGHT REQUIRE A LEGISLATIVE ACTION.
AND SO, UM, IF WE COULD SOLVE THE MENTAL HEALTH, UH, CAPACITY AND FUNDING PROBLEM TOGETHER, I THINK THAT WOULD BE A MAGIC WAND, UH, WORTH WAIVING.
AND IN OTHER STATES THAT HAVE TAKEN MEDICAID EXPANSION DOLLARS, THAT'S WHAT'S COVERING THE TAB FOR A LOT OF THIS.
AND WE'RE HAVING TO COME UP TO BE VERY CREATIVE ABOUT THIS.
AND, UM, UM, THAT'S WHY WE HAVE THESE GAPS, NOT FOR LACK OF WILL AND LEADERSHIP.
THERE'S ENORMOUS CREATIVITY IN THIS COMMUNITY.
UM, UM, THERE'S A, A CHALLENGE WITH HAVING BOTH A STATE AND FEDERAL PARTNER TO HELP US WIDEN AND FILL THOSE GAPS CRITICALLY.
AND THAT'S DESPERATELY WHAT WE NEED.
AND WE ALSO HAVE TO FIND WAYS TO WORK WITH THE CURRENT ADMINISTRATION TO BE ABLE TO TAP INTO RESOURCES THAT CAN HELP FILL THOSE NEEDS.
BUT IT'S THAT ONGOING SUPPORT TO HELP PEOPLE MAINTAIN THAT WHERE THEY ARE IN THE, IN OUR COMMUNITY IS SO IMPORTANT AND IS THE BIGGEST, AS YOU BROUGHT UP, IS THE, IS THE PIECE THAT WE NEED TO SPEND A LOT MORE ENERGY BECAUSE WE DON'T HAVE A, A, A STANDING RESOURCE FOR, AND WE ARE NOT STANDING STILL.
WE'VE, AS WE'RE SPEAKING, INTEGRAL CARE HAS, HAS SAW DRAMATIC CUTS FROM, UH, SAMHSA IN PARTICULAR OVER THE PAST YEAR AND A HALF.
UM, AND WITHOUT THE LEADERSHIP OF YOU ALL, UM, AND CENTRAL HEALTH AND OTHERS, WE, WE WOULD, THIS COMMUNITY WOULD BE STRUGGLING EVEN FURTHER.
THAT'S WHY THIS PARTNERSHIP THAT WE'RE TALKING REALLY MATTERS IS HOW DO WE MOST EFFICIENTLY LEVERAGE EACH DOLLAR AS THAT COMES IN OUR DOOR TO MEET THESE NEEDS.
COLLEAGUES, ANY FURTHER QUESTIONS? THANK YOU.
THANK YOU FOR THIS PRESENTATION, FOR THIS INFORMATION.
YOU'VE GIVEN US A LOT TO THINK ABOUT AND TO DIG THROUGH AND REALLY APPRECIATE YOUR TIME AND, AND WELCOME YOUR SUPPORT AS WELL.
ALRIGHT, COLLEAGUES, THAT NOW BRINGS
[4.Briefing on the 2025 Austin-Travis County Community Health Assessment. [Laura La Fuente, Assistant Director- Austin Public Health].]
US TO THE, UM, NEXT BRIEFING ON OUR AGENDA.THIS IS THE 2025 AUSTIN AUSTIN, TRAVIS COUNTY COMMUNITY HEALTH ASSESSMENT.
I'D LIKE TO WELCOME LAURA FUENTE, ASSISTANT DIRECTOR OF AUSTIN PUBLIC HEALTH FOR A BRIEFING ON THIS ASSESSMENT.
AND, UM, AS A REMINDER, WE, UH, THE SOCIAL SERVICE FRAMEWORK THAT WE PASSED LAST WEEK ALSO DREW SPECIAL ATTENTION TO THE COMMUNITY HEALTH ASSESSMENT AND USING THAT AS A GUIDE FOR HOW WE, UM, DO OUR SOCIAL SERVICE RESET AND MAKING SURE THAT WE'RE GROUNDING IT IN THE DATA AND THE RECOMMENDATIONS THAT HAVE COME FROM OUR COMMUNITY AND OUR PARTNERS.
AND WE ARE WITH US TODAY, OUR DIRECTOR OF AUSTIN PUBLIC HEALTH, ADRIAN STR.
WE HAD TO CALL AN AUDIBLE, UM, TODAY ASSISTANT DIRECTOR, LARA LA FUENTE IS TRAVELING BACK FROM A CONFERENCE.
UM, SO I AM HERE, I WILL TRY TO REPRESENT HER WORK WELL.
UM, WITH ME, I HAVE SHIRLEY ALDANA, WHO IS THE BRAINS, THE BRAUN, AND THE ENERGY BEHIND, UM, WHAT WE LOVINGLY CALL THE CHA CHIP PROCESS.
ALL RIGHT, SO FOR TODAY, WE'RE GONNA PROVIDE A BRIEF OVERVIEW OF THE COMMUNITY HEALTH PLAN.
WE'RE GONNA TALK ABOUT WHAT IT IS, WE'RE GONNA TALK ABOUT WHY IT MATTERS, AND WE'LL ALSO DISCUSS HOW IT CONNECTS TO ACTION.
UM, TO HELP BUILD THAT CONTEXT, WE'LL SHARE THE EVOLUTION AND TIMELINE OF THE COMMUNITY HEALTH PLAN AND, UM, GIVE YOU, EXCUSE ME, SHARE THE PRIORITIES FROM THE 2024 COMMUNITY HEALTH IMPROVEMENT PLAN OR CHIP, AND ALSO PRESENT THE KEY FINDINGS FROM THE 2025 COMMUNITY HEALTH ASSESSMENT OR CHA.
SO WHY COMMUNITY HEALTH? AND ON THIS SLIDE YOU'LL SEE A QUOTE FROM THE ROBERT WOOD JOHNSON FOUNDATION, WHICH SAYS, GOOD HEALTH BEGINS WHERE WE LIVE, LEARN, WORK, AND PLAY STABLE HOUSING QUALITY SCHOOLS, ACCESS TO GOOD JOBS AND NEIGHBORHOOD SAFETY ARE ALL IMPORTANT INFLUENCES, AS IS CULTURALLY COMPETENT HEALTHCARE.
SO WHAT DOES THAT MEAN? IT MEANS THAT THESE NON-MEDICAL EVERYDAY CONDITIONS POWERFULLY SHAPE OUR HEALTH OUTCOMES.
AND SO IN THE, IN THE PUBLIC HEALTH REALM, WE REFER TO THESE AS THESE SOCIAL DETERMINANTS OF HEALTH.
UM, IN THE KEY CATEGORIES FOR THOSE SOCIAL DETERMINANTS OF HEALTH ARE ECONOMIC
[01:20:01]
STABILITY, SO POVERTY, EMPLOYMENT, FOOD SECURITY, HOUSING STABILITY.WE TALKED A LOT, LOT ABOUT THAT IN THE PREVIOUS PRESENTATION.
UM, EDUCATION, ACCESS AND QUALITY.
SO WE THINK ABOUT THINGS LIKE EARLY CHILDHOOD EDUCATION, HIGH SCHOOL GRADUATION, GRADUATION RATES AND LITERACY SKILLS.
UM, WE THINK ABOUT HEALTHCARE ACCESS AND QUALITY.
UM, SO INSURANCE COVERAGE, ACCESS TO PRIMARY CARE, UM, AND ALSO LANGUAGE AND CULTURAL APPROPRIATENESS.
SOMETIMES ACCESS IS MORE ABOUT MORE THAN BRICK AND MORTAR.
UM, WE TALK ABOUT NEIGHBORHOOD AND BUILT ENVIRONMENT, SO THE QUALITY OF OUR HOUSES, UM, TRANSPORTATION, WALKABLE NEIGHBORHOODS, ACCESS TO HEALTHY FOODS, GREEN SPACES, AND COMMUNITY VIOLENCE.
UM, AND THEN THE LAST THING IS SOCIAL AND COMMUNITY CONTEXT.
UM, SO THOSE INCLUDE THINGS LIKE SOCIAL COHESION, CIVIC PARTICIPATION, RACISM, UM, AND SOCIAL SUPPORTS.
THESE THINGS MATTER BECAUSE THEY OFTEN HAVE A GREATER IMPACT ON HEALTH, MORE SO THAN OUR GENETICS OR EVEN DIRECT HEALTHCARE.
AND AGAIN, WE, WE SPENT A REALLY LONG TIME WITH OUR PARTNERS, AND I LOVE THE PRESENTATION 'CAUSE IT KIND OF MADE WHAT I HAVE TO SAY A LOT EASIER.
IT'S GONNA LIKE NAIL IT STRAIGHT HOME, UM, WHEN SYSTEMS DON'T WORK, RIGHT? UM, WHEN WE DON'T HAVE GROCERY STORES, UM, WHEN WE DON'T HAVE PHARMACIES.
THINK ABOUT THE COVID PANDEMIC AND ALL OF THOSE NEIGHBORHOODS IN THE EASTERN CRESCENT THAT DIDN'T HAVE A CVS.
SO THEY WEREN'T, THEY DIDN'T HAVE EASY ACCESS TO A VACCINE.
UM, WHEN WE THINK ABOUT HOUSING QUALITY, UM, AND, UH, POLLUTED ENVIRONMENTS THAT LEAD TO HIGHER ILLNESS RATES.
AND THEN WHEN WE THINK ABOUT SYSTEMIC AND STRUCTURAL INEQUITIES, THAT ALSO IMPACT NOT ONLY OUR MENTAL HEALTH, BUT OUR PHYSICAL HEALTH AND WELLBEING.
BEFORE I GO ANY FURTHER, I WANNA RECOGNIZE THAT ONE ENTITY CANNOT ADDRESS THESE PROBLEMS ALONE.
UM, AND THERE'S WORK ACROSS OUR COMMUNITY TO KIND OF BREAK DOWN SILOS AND REALLY LEAN IN, UM, TO OUR COLLECTIVE, UH, BRAIN POWER.
AND SO THE PARTNERS THAT YOU SEE LISTED ON THE SCREEN THERE ARE ALL PART OF OUR CHOP CHIP PROCESS.
OKAY? SO UNDERSTANDING THE COMMUNITY HEALTH PLAN.
SO THE COMMUNITY HEALTH PLAN IS A COLLABORATIVE INITIATIVE SPEARHEADED BY THE 11 PARTNERS THAT I SHOWED ON THE PREVIOUS SLIDE, AND IS FACILITATED BY AUSTIN PUBLIC HEALTH.
THE PLAN IS A REQUIREMENT FOR ACCREDITED HEALTH DEPARTMENT, WHICH A PH IS ONE YAY US.
AND IT'S AN EQUITY FOCUS PLAN THAT IS IMPLEMENTED OVER THREE TO FIVE YEARS.
SO THE COMMUNITY HEALTH ASSESSMENT, OR THE CHA, IS THE FOUNDATIONAL PROCESS FOR IDENTIFYING HEALTH NEEDS, STRENGTHS AND GAPS.
IT DRAWS FROM BOTH POPULATION LEVEL DATA, BUT ALSO FROM COMMUNITY VOICE.
WE ENGAGE COMMUNITY MEMBERS AND LOCAL PUBLIC HEALTH SYSTEM PARTNERS TO COLLECT AND ANALYZE HEALTH RELATED DATA FROM MANY SOURCES.
THE CHA INFORMS OUR COMMUNITY DECISION MAKING.
IT PRIORITIZES HEALTH PROBLEMS AND IT ASSISTS IN THE DEVELOPMENT AND IMPLEMENTATION OF COMMUNITY HEALTH IMPROVEMENT PLANS.
THIS ASSESSMENT UTILIZES DATA TO HIGHLIGHT WHO IS HEALTHIEST AND LEAST HEALTHY IN COMMUNITY, AS WELL AS TO EXAMINE THE LARGER SOCIAL AND ECONOMIC FACTORS ASSOCIATED WITH GOOD AND ILL HEALTH.
THE COMMUNITY HEALTH IMPROVEMENT PLAN, OR CHIP IS OUR ACTION FRAMEWORK FRAMEWORK.
SO IT TRANSLATES THE FINDINGS OF THE CHA OR THE ASSESSMENT INTO GOALS, STRATEGIES, AND MEASURABLE OBJECTIVES.
AND, AND I LOVE THAT THEY TEED UP, UM, HOW IMPORTANT IT IS TO WORK TOGETHER.
THE CHIP PROVIDES THAT OPPORTUNITY FOR COMMUNITIES TO WORK TOGETHER TO NOT ONLY IDENTIFY HOW ISSUES WILL BE ADDRESSED AND HOW TO MEASURE PROGRESS.
IT HELPS ESTABLISH COLLECTIVELY AGREED UPON LONG-TERM GOALS TO IMP IMPROVE OUR COMMUNITY'S HEALTH.
SO THE CHACHA PROCESS IS, IS MORE THAN AND THAN JUST A MEETING, IT'S MAKING A SHARED INFRASTRUCTURE FOR HEALTH POLICY AND INVESTMENT.
IT'S BUILT ON EQUITY PRINCIPLES, AND IT'S NOT JUST ABOUT IDENTIFYING DISPARITIES, BUT ALIGNING SYSTEMS TO ADDRESS THEM.
UM, SINCE 2012, OUR REGION HAS EMBRACED
[01:25:01]
A MORE STRUCTURED AND COLLABORATIVE APPROACH TO COMMUNITY HEALTH PLANNING.OVER THAT TIME, THERE HAS BEEN FOUR CHAS AND THREE CHIPS WITH A FOURTH CHIP IN PROGRESS.
UM, IN 2018, OUR CHIP PRIORITIES WERE BEHAVIORAL HEALTH EQUITY STRATEGIES AND LIVING HEALTHY IN AUSTIN, TEXAS.
IN 2024, OUR CHIP PRIORITIES WERE MENTAL HEALTH, ECONOMIC STABILITY, AND BUILT ENVIRONMENT.
AND I'M SURE THAT'S NOT A SURPRISE TO, TO ANY OF YOU LISTENING TODAY.
UM, SO CURRENTLY WE'RE, WE'RE MOVING BACK TO A FIVE YEAR PLANNING CYCLE.
SO IN 2025, WE DID THE CHA, WHICH WAS THE ASSESSMENT.
AND WE'RE CURRENTLY WORKING ON THE COMMUNITY DRIVEN PLAN TO ADDRESS THE PRIORITIES.
SO WHAT BEGAN AS A TECHNICAL HEALTH ASSESSMENT HAS EVOLVED INTO A LIVING COMMUNITY ENGAGED PROCESS THAT IS RESPONSIVE TO CHANGE, INCLUDING THE PANDEMIC CLIMATE THREATS AND SHIFTS IN POPULATION HEALTH TRENDS.
THE CHILD CHIP IS NOW A COALITION HUB, A SPACE TO CONVENE, ALIGN, AND SCALE IMPACT ACROSS SECTORS.
ALL RIGHT, SO DOING A DEEPER DIVE INTO THE 2024 CHIP PRIORITIES, UM, MENTAL HEALTH WAS, UM, IDENTIFIED.
SO OUR GOAL WAS TO INCREASE ACCESS TO MENTAL HEALTH CARE FOR AUSTIN TRAVIS COUNTY RESIDENTS.
UM, IN 2024, WE ALSO RECOGNIZED ECONOMIC STABILITY.
AND THE GOAL THERE WAS TO IMPROVE ACCESS TO RESOURCES THAT SUPPORT FINANCIAL SECURITY AND STRENGTHEN NAVIGATION TO TRUSTED RESOURCES.
IN 2024, WE HAD A GOAL AROUND BUILT ENVIRONMENT, AND THAT WAS TO SUPPORT ENVIRONMENTS THAT PROMOTE HEALTH AND SAFETY.
AND SO, UM, TO HIGHLIGHT THE, THE WORK GROUP OR THE WORK OF THAT COMMITTEE, UM, IT INVOLVED A TEACHING FOCUSED PRESENTATION FROM TEXAS A AND M SCHOOL OF PUBLIC HEALTH, WHICH EXAMINED ENVIRONMENTAL IMPACTS ON HEALTH AND HELPED GROUND THE PRIORITY AREA IN EV, EVIDENCE-BASED PUBLIC HEALTH CONCEPTS.
ENGAGEMENT DURING THIS PERIOD FOCUSED ON LEARNING ALIGNMENT AND EXPLORATORY DISCUSSION RATHER THAN FORMAL IMPLEMENTATION ACTIVITIES.
SO SOME SPOTLIGHTS, UM, AROUND, UH, SOME OF THE 2024 PRIORITIES, MENTAL HEALTH, UM, WE HAD A HUGE, UH, LIFT WITH CAN, UH, THE COMMUNITY ADVANCEMENT NETWORK AND OTHER PARTICIPATING ORGANIZATIONS TO REALLY FOCUS ON INCREASING THE AWARENESS AND ACCESS TO EXISTING MENTAL HEALTH AND WELLNESS RESOURCES, UM, BY STRENGTHENING COORDINATION ACROSS PROVIDERS AND INCORPORATING COMMUNITY INFORMED INSIGHT INTO THE CHILD ANALYSIS.
AND ONE OF THE THINGS THAT CAME OUT OF THAT, UM, CHAIRWOMAN FUENTES, I KNOW YOU REMEMBER, WE REALLY PUSHED TO HAVE MORE MENTAL HEALTH FIRST AID CLASSES.
UM, AND THAT EFFORT WAS SUPPORTED BY EMS AND AUSTIN PUBLIC HEALTH.
UM, WE ALSO DID OUR FIRST CAMPAIGN THAT FOCUSED ON YOUTH MENTAL HEALTH.
AND IT WAS ASK, LISTEN, REPEAT.
AND THERE WERE CUTE LITTLE CARDS THAT HELP PARENTS ENGAGE IN CONVERSATIONS WITH THEIR YOUNG ONES ABOUT HOW THEY WERE FEELING.
UM, AND THAT WAS IN RESPONSE TO US SEEING A RISE IN, UH, PEDIATRIC SUICIDE.
AND THEN AGAIN, TO SOME OF THE ISSUES THAT WERE DISCUSSED BY OUR COLLEAGUES, KNOWING THAT WE DIDN'T HAVE ENOUGH PEDIATRIC MENTAL, UM, HEALTH BEDS IN OUR COMMUNITY TO ADDRESS.
SO WE WANTED TO HAVE A MORE PREVENTATIVE APPROACH TO HELP FAMILIES.
UM, SHIRLEY WAS REALLY INSTRUMENTAL IN, UM, PILOTING, UH, A REALLY GRASSROOTS, UM, COMMUNITY ENGAGEMENT THROUGH A SERIES CALLED DID YOU KNOW? OKAY.
AND THAT JUST BROUGHT, PEOPLE DON'T LAUGH AT MY PRE MY PRONUNCIATION
IT WAS REALLY AN OPPORTUNITY FOR FOLKS TO GET TOGETHER ACROSS COMMUNITY AND SYSTEMS TO TALK ABOUT HOW WE STRENGTHEN ALIGNMENT, UM, HOW WE INTERATE IN INTEGRATE QUALITY CARE AND HOW WE ESTABLISH SCALABLE, UM, ACTIVITIES TO REALLY SEE SOME RESULTS.
AND WE FOCUSED ON LGBTQ PLUS COMMUNITIES WITH AFFIRMING MENTAL HEALTH CARE.
UM, A LOT OF FOCUS ON IMMIGRANT FAMILIES AND THEIR, UH, EVOLVING NEEDS AND, UM, HOW WE CAN SUPPORT THEM WITH ALL OF THE EXTERNAL SHOCKS AND STRESSORS THAT THAT COMMUNITY IS GOING THROUGH.
UM, AND THEN JUST COMMUNITY-WIDE WELLNESS.
YOU KNOW, UH, DR. LEE SAID IT BEST, MENTAL HEALTH IS HEALTH
[01:30:01]
AND, AND IT, IT NEEDS THE ATTENTION TO MAKE SURE THAT, UM, WE ARE SERVING OUR COMMUNITY WELL.ALRIGHT, SO NOW WE'RE GONNA JUMP TO, OH NO, LEMME GO BACK.
AND SO THERE WERE, UM, WE ALWAYS TALK ABOUT HOW DO WE MEASURE PROGRESS.
UM, AND SO FOR THE, UH, PILOT FOR, DID YOU KNOW, UM, THERE WERE SOME PROCESS METRICS, REALLY, UH, LIGHT LEVEL, HOW MANY WORK GROUPS WE HAD, UM, THE DIVERSITY AND NUMBER OF PARTNER ORGANIZATIONS AND ATTENDANCE.
UM, WE ALSO HAD SOME IMPLEMENTATION OUTPUTS.
SO THE, THE DELIVERY OF, UH, MULTIPLE MENTAL HEALTH FOCUS FORUMS, UM, GATHERING AND DOCUMENTING RESOURCES AND THE COLLECTION OF PARTICIPANT QUESTIONS AND DISCUSSION THEMES.
OUR QUALITATIVE INDICATORS WERE HOW WE NAVIGATE NAVIGATED CHALLENGES, UM, ACCESS TO AFFIRMING AND CULTURALLY RESPONSIVE CARE.
UM, AND, AND THAT'S ONE OF THE, THE BEAUTIES OF THE SPACE THAT WE HAVE HERE IN AUSTIN AND TRAVIS COUNTY, LIKE YOU, WE HAVE THE BIG THREE WHO WERE HERE AND THEY DID A GREAT JOB PRESENTING.
UM, BUT THERE WAS ALSO THAT RESPONSIVE NEED TO THAT CULTURALLY, UH, CONGRUENT AND WHAT RELEVANT CARE THAT IS SOMETIMES BEST DELIVERED BY SOME OF OUR SMALLER, MOST GRASSROOTS ORGANIZATIONS.
AND THEN OF COURSE, THE CONNECTIONS TO HOUSING, CHILDCARE, AND TRANSPORTATION AS THOSE ARE, UM, MENTAL HEALTH STRESSORS.
ALRIGHT, SO NOW WE CAN TALK ABOUT THE 2025 ASSESSMENT.
SO THAT ASSESSMENT REVEALS SOME URGENT AND COMPLEX, UH, CHALLENGES.
I'M GONNA TALK ABOUT THEM PURELY IN ALPHABETICAL ORDER AND NOT, UM, IN IMPORTANCE.
SO THE FIRST, AND THIS IS LIKE A REPEAT OFFENDER, CHRONIC AND COMMUNICABLE DISEASE, HEART DISEASE, CANCER, DIABETES, HIV, UM, THOSE CONTINUED TO BE THE LEADING CAUSES OF DEATH IN TRAVIS COUNTY ACCOUNTING FOR NEARLY 40% OF ALL DEATHS.
UM, AND THAT'S PRETTY SIGNIFICANT 'CAUSE MOST CHRONIC DISEASES ARE PREVENTABLE.
AND WITH THAT, DESPITE SOME SLIGHT IMPROVEMENTS IN SOME OUTCOME, UM, THE DISPARITIES BY RACE AND GENDER REMAIN STARK.
UM, FOR EXAMPLE, BLACK RESIDENTS EXPERIENCE HIGHER CANCER AND MOR AND DIABETES MORTALITY RATES COMPARED TO OTHER GROUPS.
ANOTHER, UM, CHALLENGE WAS ECONOMIC INSECURITY.
UM, AND THIS IS A POWERFUL INDICATOR OF POOR HEALTH, UM, ESPECIALLY IN TRAVIS COUNTY WHERE NEARLY ONE IN THREE HOUSEHOLDS ARE WORKING BUT CANNOT AFFORD BASIC NECESSITIES LIKE HOUSING, FOOD, AND HEALTHCARE.
UM, OUR POVERTY RATES AND UNEMPLOYMENT VARY WILDLY BY RACE AND GEOGRAPHY.
WITH BLACK AND HISPANIC RESIDENTS FACING THE HIGHEST FINANCIAL HARDSHIP, HIGH HOUSING COSTS AND CHILDCARE BURDENS COMPOUND THE ISSUE, FORCING MANY FAMILIES INTO DIFFICULT TRADE-OFFS THAT AFFECT LONG-TERM HEALTH OUTCOMES.
ENVIRONMENTAL THREATS SUCH AS CLIMATE STRESS AND AIR QUALITY.
AGAIN, THESE THEMES ARE NOT ISOLATED.
THEY ARE DEEPLY CONNECTED AND DEMAND A COORDINATED MULTI-AGENCY RESPONSE.
OTHER HIGHLIGHTS ARE, UH, AGAIN, HEALTHCARE ACCESS, HOUSING INSTABILITY, MATERNAL CHILD HEALTH AND, UM, WELLNESS AND MENTAL HEALTH AND SUBSTANCE USE.
AND AGAIN, YOU KNOW, UH, WHEN WE TALK ABOUT MATERNAL AND CHILD HEALTH OUTCOMES, WE'RE STILL SEEING, UM, LOW BIRTH RATES, LOW BIRTH WEIGHT RATES, AND MATERNAL MORBIDITY HIGHER IN OUR BLACK AND LATINO FAMILIES.
UM, MENTAL HEALTH, AGAIN, WAS ONE OF THE MOST VOICED CONCERNS IN THE CHA WITH RESIDENTS AND PROVIDERS DESCRIBING, AND WE, WE HEARD THIS A LITTLE BIT EARLIER, A SYSTEM THAT IS FRAGMENTED, DIFFICULT TO ACCESS AND OFTEN MISALIGNED WITH CULTURAL NEEDS.
SO DEPRESSION, ANXIETY, AND SUBSTANCE USE ARISING PARTICULARLY AMONG YOUTH AND CAREGIVERS.
SUICIDE RATES REMAIN SIGNIFICANT AND OVERDOSE DEATHS ARE INCREASING.
STIGMA, COST AND LACK OF BILINGUAL AND CULTURALLY RESPONSIVE SERVICES CONTINUE TO CREATE BARRIERS TO MENTAL HEALTH CARE ACCESS.
SO OUR NEXT STEPS AS WE FINALIZE OUR PRIORITIES IS TO CREATE A PLAN THAT'S NOT JUST ACTION ACTIONABLE, BUT SUSTAINED.
[01:35:01]
OUR GOAL IS TO IDENTIFY THREE TO FOUR ACTIONABLE PRIORITY AREAS TO FOCUS ON FROM 2026 TO 2029.THIS WORK WILL BE GROUNDED IN, EVIDENCED AND SHAPED BY EQUITY CRITERIA BECAUSE WE BELIEVE THAT WILL ISSUE THEM IMPACT TO MOST RESIDENTS, REDUCE THE GREATEST DISPARITIES AND OFFER THE CLEAREST PATHWAYS TO SYS TO SYSTEMIC CHANGE.
OUR FIRST STAKEHOLDER SESSION FOR PRIORITIZATION CONVENED ON JANUARY 23RD, AND WE HAD OVER 100 FOLKS IN ATTENDANCE, AND IT INCLUDED REPRESENTATIVES FROM ACROSS ALL OF OUR SECTORS.
SO HOUSING, EDUCATION, BEHAVIORAL HEALTH, TRANSPORTATION, BECAUSE AS WE LEARNED EARLIER, AND I'M AFFIRMING TODAY, HEALTH DOESN'T HAPPEN IN ISOLATION.
AS PART OF THAT PROCESS, WE'LL CONTINUE TO BUILD WORK GROUPS THAT WILL TRANSLATE EACH PRIORITY INTO POLICY INFORMED STRATEGIES WITH PERFORMANCE INDICATORS.
THESE WORK GROUPS WILL CO-DEVELOP MEASURABLE OBJECTIVES, STRATEGIES AND SHARED ACCOUNTABILITY STRUCTURES.
AND, UH, WE EXPECT TO LAUNCH THE CHIP PUBLICLY THIS SPRING.
UM, I, I WILL CLOSE WITH, AND YOU DIDN'T, YOU DIDN'T ASK ME, BUT I'M GOING TO ANSWER THE QUESTION ANYWAY, LIKE, WHAT, WHAT COULD BE THE ROLE OF THE CITY? THE CHA POINTS OUT OPPORTUNITIES ARE DEFINITELY WITHIN THE WHEELHOUSE OF A CITY AS IN ADDITION TO BEING A FUNDER, ARE THERE POLICY OPPORTUNITIES, UM, TO IMPROVE SYSTEMS AND ENVIRONMENT TO MAKE IT EASIER FOR OTHER ORGANIZATIONS TO DO THEIR WORK? UM, I THINK HISTORICALLY THE, THE ISSUES HAVE BEEN THE SAME AND WE'VE DONE AN EXCELLENT JOB AT CREATING, SUPPORTING, AND FUNDING PROGRAMMATIC INITIATIVES, BUT THE CHILD PROVIDES A FRAMEWORK AND A PARTNERSHIP THAT REALLY ALLOWS FOR THE OPPORTUNITY TO LEAN INTO HOW CAN WE CHANGE THE SYSTEM, RIGHT? IT'S LIKE, IF, IF I'VE GOT A SLASH OF MY CAROTID ARTERY AND YOU KEEP PASSING ME BANDAIDS, THAT MIGHT HELP A LITTLE BIT.
BUT HOW DO WE, HOW DO WE STOP THE BLEED? AND I THINK THAT'S THE OPPORTUNITY THAT, UH, CHAIRWOMAN FUENTES INTENDS FOR US TO, UM, LOOK INTO, NOT ONLY INTO HOW WE, UH, INVEST, BUT AGAIN, HOW WE DO THE WORK OF THE CITY.
AND WITH THAT, I DON'T HAVE ANY OTHER QUESTIONS.
HOPEFULLY I, I DID WELL BY YOU DID AMAZING.
THANK YOU FOR THE PRESENTATION FOR THE INFORMATION COLLEAGUES QUESTIONS? YES.
VICE CHAIR, FIRST OF ALL, THANK YOU FOR THIS AND THANK YOU FOR PUBLISHING THE, THE, UH, THE REPORT.
I JUST HAD A, A COUPLE OF QUESTIONS I WONDER, GET YOUR THOUGHTS ON.
UM, ONE IS HAVING GONE THROUGH IT AND RECOGNIZING, AND I THINK IN SOME WAYS YOU TOUCH ON THE VARIOUS POINTS IN THE REPORT THAT THESE DISPARITIES, EVEN THE ONES YOU'VE TALKED ABOUT THIS AFTERNOON, THEY'RE COMPLEX, THEY'VE GOT MULTIVARIATE CAUSES, UH, AND WE'VE SEEN NUMEROUS ORGANIZATIONS TRYING TO AFFECT OUTCOMES, UH, AS WE'RE, AND, AND IN THIS, I THINK, UH, CHALLENGING SPOT, WE'RE TRYING TO PRIORITIZE WHERE DOLLARS ARE SPENT AND AS WE'RE EVALUATING WHICH PROGRAMS MAY BE TOO EXPENSIVE OR DUPLICATIVE WITH STATE OR COUNTY OR OTHER PROGRAMS OR FEDERAL PROGRAMS, WE'LL NEED TO COMPARE OUTCOME DATA AS PART OF THAT.
AND SO MY QUESTION IS, TO WHAT EXTENT HAS A PH ASSOCIATED THE OUTCOME DATA, NOT NECESSARILY DEMOGRAPHIC DATA, BUT THE OUTCOME DATA PRESENTED IN THE REPORT WITH PROGRAMS THAT ARE CONNECTED OR FUNDED THROUGH A PH WITH THE CITY? THAT IS A VERY GOOD QUESTION.
UM, ONE OF THE THINGS THAT I LOVE ABOUT THE SOCIAL SERVICES RESET IS THAT IT WILL PROVIDE THE DEPARTMENT A GREATER OPPORTUNITY TO DO THAT WORK.
UM, BUT WE, WE DO, AS PART OF THE SOLICITATION PROCESS, UM, APPLICANTS HAVE TO SHOW HOW THEY WILL SUPPORT, UM, SOME OF THE PRIORITIES IDENTIFIED IN THE CHA.
AND THEN WHEN WE ARE LOOKING AT PERFORMANCE METRICS, UM, IN THAT NEGOTIATION PROCESS, WE, WE TRY TO ENCOURAGE THE PROVIDER TO, UM, GIVE US THE PERFORMANCE THAT MATCHES NOT
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ONLY WITH WHAT WE'RE SEEING IN THE CHA, BUT ALSO IN OUR CRITICAL HEALTH INDICATORS REPORT.AND SO IT IS, IT IS A DELICATE BALANCE OF, UM, UNDERSTANDING THAT, YOU KNOW, EACH ORGANIZATION COMES WITH A VERY SPECIFIC WHEELHOUSE AND WORKING WITH THEM TO MOVE TOWARDS THE OUTCOMES THAT THE CITY IS DESIRING TO PURCHASE.
UM, THE OTHER QUESTION I HAD WAS JUST GETTING YOUR SENSE OF A RECOMMENDATION GOING FORWARD.
WERE WE TO TIE ONGOING FUNDING PRIORITIES TO THE DIFFERENT OUTCOMES AND SNAPSHOTS THAT ARE LISTED IN THE REPORT? AND SO FOR INSTANCE, UM, I'LL JUST PICK AN EXAMPLE.
SHOULD WE JUDGE THE SUCCESS OF THE COMMUNITY INFORMED LANGUAGE, APPROPRIATE STI EDUCATION PROGRAMS ON THE RATES OF STI IN THAT COMMUNITY RELATIVE TO A NATIONAL AVERAGE? OR IS THERE A DIFFERENT, OR IS THAT INAPPROPRIATE FOR SOME WAYS THERE A DIFFERENT WAY WE SHOULD BE LOOKING AT THINGS BECAUSE, UM, THOSE NATIONAL AVERAGES, JUST FOR EXAMPLE, UH, MAYBE NOT BE APPROPRIATE FOR US TO MAKE, MAYBE NOT BE THE BEST METRIC FOR US TO JUDGE AGAINST, RIGHT? BECAUSE THIS WOULD BE A, A SHIFT IN, IN HOW WE'RE ASKING AGENCIES TO PERFORM AND REPORT.
I WOULD SUGGEST A COMBINATION.
SO WHAT YOU SUGGESTED IS A VERY GOOD ONE TO START OUT WITH, BUT THEN IT WOULD BE, UM, SOME PROGRESS OR PROCESS METRICS.
UM, WE ASK AGENCIES ABOUT THEIR ORGANIZATIONAL DIVERSITY, NOT ONLY FROM THE STAFF WHO WERE PROVIDING SERVICES, BUT FROM YOUR BOARD REPRESENTATION AS WELL, BECAUSE THE, THE STRATEGY COMES FROM THAT LEADERSHIP.
AND IF THERE IS NOT, UH, A FOCUS ON ADDRESSING DISPARITIES OR UNDERSTANDING THE IMPORTANCE OF CULTURALLY RELEVANT PROGRAMS, THAT THAT COULD BE PROGRAMMATIC.
AND SO IN THE BEGINNING, THE, IT SHOULD BE YES, POINTING TO DISEASE RATES AND COMPARING THEM TO A NATIONAL AVERAGE, BUT ALSO LOOKING AT HOW AN ORGANIZATION STRUCTURES THEIR PROGRAMS, HOW THEY'RE DELIVERING SERVICES SPECIFIC TO, TO THOSE POPULATIONS.
AND IF THEY'RE ABLE TO ATTRACT, RETAIN, AND, UH, KEEP, UH, THE FOCUS POPULATION IN CARE.
SO IT SOUNDS LIKE YOU'RE THINKING THROUGH A NUMBER OF DIFFERENT CRITERIA THAT MAY BE VERY LOCALIZED DOWN TO THE, THE GROUP.
THAT'S LESS TIED TO, UM, LESS TIED TO, YOU KNOW, NATIONAL DATA.
LAST QUESTION IS, YOU TOUCHED ON IT IN YOUR, UH, I THINK IN YOUR COMMENTS OR STEPPING THROUGH THE PRESENTATION, THE IDEA THAT, AND I THINK IT'S ALSO MENTIONED OR ALLUDED TO MANY TIMES IN THE REPORT, WHICH IS SHIFTING TO A MODEL THAT IS MORE LOCALIZED, LOCALIZED GROUPS, UH, UH, TRYING TO FIGURE OUT WHAT YOU SAID, UM, CARE DELIVERED BY SMALLER LOCAL GROUPS MM-HMM
UM, I'M JUST CURIOUS IF THAT'S PART OF TYING IT TOGETHER ABOUT HOW, HOW WE'RE EVALUATING, RIGHT, THIS CONNECTION AND THE ANSWER YOU JUST SHARED WITH ME, HOW WE'RE EVALUATING, UM, OUTCOMES AND SUCCESS AND PROGRAMS IF WE'RE, UH, GETTING AWAY FROM POTENTIALLY NATIONAL DATA AND LOOKING AT THE SMALL LOCAL GROUPS THAT MAY BE DOING THAT.
AND THEN ALSO HOW TO FACILITATE THAT.
DO THEY EXIST? WHERE IS IS THAT A PLACE WITH A, WITH A LARGE AMOUNT OF GAPS, LIKE THAT SEEMS, UH, I DON'T WANNA SAY ASPIRATIONAL, BUT I CAN SEE THE VALUE IN IT.
I JUST, I HAVE NO SENSE OF THE LANDSCAPE OF WHETHER THAT'S, IT SEEMS VERY HARD AND TO, TO STAND UP AS I GUESS IS MY QUESTION.
SO CAN YOU SPEAK A LITTLE BIT TO THAT? ABSOLUTELY.
AND, AND SO I DO WANNA SAY TOO, TO BENCHMARK OURSELVES AGAINST NATIONAL DATA AS WELL AS STATE AND COUNTY DATA IS ALWAYS GOING TO BE IMPORTANT.
UM, AS A CITY WE SHOULD BE FOCUSED ON POPULATION HEALTH OUTCOMES VERSUS, UM, INDIVIDUALS.
SO THAT'S, THAT'S ALWAYS GONNA BE A, A BENCHMARK, UM, THAT DRIVES OUR WORK.
I THINK IT'S IMPORTANT FOR US TO CONTINUE TO FIGURE OUT A WAY TO KEEP A DIVERSITY OF PROVIDER, UM, THE DEPARTMENT, EVEN THOUGH WE HAVE A, UH, COMPETITIVE PROCESS AND APPLICATIONS ARE SCORED, UM, THERE ARE FACTORS THAT ARE, UH, IN INGRAINED INTO THE RUBRIC TO MAKE SURE THAT, UM, THERE ARE ORGANIZATIONS THAT HAVE THAT SENSE OF COMMUNITY, THAT HAVE GRASSROOTS CONNECTIONS, THAT HAVE DEMONSTRATED EXPERIENCE, UM, WITH THE IDENTIFIED POPULATIONS OF FOCUS.
AND I WILL GIVE YOU AN EXAMPLE.
WE CURRENTLY HAVE, UM, AN AGREEMENT WITH UT AUSTIN TO FOCUS ON MATERNAL HEALTH,
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UM, INDICATORS OR OUTCOMES.THEY HAVE AN APPROVED, UH, SUBCONTRACT WITH MAMA ASANA, VIBRANT WOMAN, MAMA ASANA, UM, HAS CULTURALLY COMPETENT, UH, CARE, UM, IT'S DOULA BASED.
UM, IT'S, IT'S, IT'S A, AN AMAZING ORGANIZATION THAT, YOU KNOW, REALLY DOES A GREAT JOB OF REACHING OUT NOT ONLY TO WOMEN OF COLOR, BUT ALL WOMEN WHO ARE LOOKING FOR SOMETHING THAT'S DIFFERENT FROM THE, THE TRADITIONAL CLINICAL STANDARD OF CARE.
AND SO AUSTIN IS VERY FORTUNATE THAT IN A LOT OF THE ISSUE AREAS THAT THE CHA HAS IDENTIFIED, THAT WE DO HAVE, UM, ORGANIZATIONS THAT HAVE THAT, UH, CULTURAL RELEVANCY, UH, CONGRUENCE AND COMPETENCY NOT ONLY IN PROGRAM DELIVERY, BUT HOW THEIR ORGANIZATION IS SET UP, UM, THEIR BOARD STRUCTURE, THEIR STAFF STRUCTURE, THEIR POLICIES.
AND SO AS WE ARE LOOKING TO, TO SHIFT, UM, MY HOPE WOULD BE IS THAT WE, WE DO THAT IN A WAY THAT KEEPS THAT BALANCE AND KEEPS THAT DIVERSITY OF PROVIDER.
THAT HELPS ME ON BOTH THE, THE DATA QUESTION AS WELL AS, UH, TRYING TO CREATE, CULTIVATE THOSE, THOSE LOCAL GROUPS TO SUPPORT US.
WELL THANK YOU AGAIN FOR THE PRESENTATION AND REALLY VALUABLE INFORMATION.
CERTAINLY, UH, YOU KNOW, OUR COMMITTEE PRIORITIZES AND HAS SIGNALED, UM, JUST OUR VALUE FOR THE CHA AND LOOK FORWARD TO HEARING ABOUT THE CHIP WHENEVER THAT GETS, UH, FINALIZED IN THE COMING YEAR.
[5. Identify items to be discussed at future meetings]
UM, ARE THERE ANY FUTURE ITEMS THE COMMITTEE WOULD LIKE TO DISCUSS OR RECEIVE A BRIEFING ON AT FUTURE COMMITTEE MEETINGS? UH, CHAIRWOMAN, COULD WE PLEASE GET A BRIEFING ON THE, UH, EDUCATION, SOCIAL SERVICES THAT THE CITY IS INVESTING IN, UH, DURING THE JUNE MEETING OR BEFORE? AND IF WE CAN'T GET IT, UH, BY THEN, IF WE CAN GET A, A MEMO ON THAT.BRIEFING ON, UH, OUR EDUCATION RELATED SOCIAL SERVICE CONTRACTS OR THE INVESTMENTS THAT WE HAVE MADE IN, UH, IN THE EDUCATION SECTOR.
I'D ALSO LIKE TO INVITE THE OTHER ONES FOUNDATION TO PROVIDE AN UPDATE ON ESPANZA TO EXPANSION IN THEIR WORKFORCE DEVELOPMENT PROGRAM.
STAFF HAS ALSO REQUESTED TO PROVIDE AN UPDATE ON THE VAPE AND TOBACCO FREE ZONES THAT WE PASSED VIA COUNCIL POLICY.
UH, I DON'T KNOW, LAST FALL, I THINK.
UH, SO LOTS OF GOOD STUFF COMING UP AND WANNA THANK EVERYONE FOR THEIR PARTICIPATION AND CONTRIBUTIONS.
IF THERE'S NO FURTHER BUSINESS BEFORE US, I WILL ADJOURN THIS COMMITTEE MEETING AT 2:49 PM THANK YOU.