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[00:00:04]

WE HAVE, UM, AND IT'S A MEMBER ALTAR ACCOUNTS MEMBER, KITCHEN COUNCIL MEMBER, PRO COUNCIL MEMBER FLAN AGAIN, COUNCIL MEMBER RENT, A RE UH, I AND MYSELF.

WE HAVE A FULL DAY.

SO LET'S GO AHEAD AND GET STARTED.

UH, THIS IS THE, UH, AUSTIN CITY COUNCIL WORK SESSION.

TODAY IS JULY 28, 2020 IT'S NINE OH TWO.

OH.

WE HAVE A QUORUM PRESENT MEETING.

HOW, UH, VIRTUALLY, UM, COLLEAGUES WE'RE GOING TO, UM, START THIS MORNING WITH COVID, UM, UH, BRIEFING, UH, AT 11 O'CLOCK.

WE NEED TO GO INTO EXECUTIVE SESSION COUNSEL.

IF WE FINISHED THE COVID BRIEFING PRIOR TO 11, OR GO TO PULL THE ITEM UNTIL 11 AT 11, WE'RE GOING INTO EXECUTIVE SESSION.

WE'LL BREAK FROM NOON TO ONE FOR LUNCH.

UH, AND AT ONE O'CLOCK, UH, WE HAVE, UM, SPEAKERS TO SPEAK THE SECOND, UH, BRIEFING ISSUE, WHICH IS ST.

JOHN.

UH, WHEN WE'RE DONE WITH ST.

JOHN, WE'LL GO INTO THE, UM, BUDGET BRIEFING AND SENT OUT AND OUTLINE, UH, THIS MORNING, I WILL FOLLOW THAT AND THEN WE'LL DO THE PULLED ITEMS. OKAY.

SO WE'RE GOING TO BEGIN

[B1. Briefing on Covid-19 related matters, including a report on nursing homes.]

WITH THE COVID A BRIEFING, UH, DOCTOR, UH, S GOD, I'M GOING TO TURN IT OVER TO YOU.

TODAY'S BRIEFING WILL BE BOTH THE GENERAL BRIEFING.

UM, WE'LL HAVE THE OPPORTUNITY TO ASK QUESTIONS ABOUT THAT, BUT IN THAT BRIEFING, UH, HOW THERE'S GOING TO BE SPECIAL ATTENTION PAID, I THINK TO THE NURSING HOME THAT WERE ISSUE OVER KITCHEN ASKED FOR, AND WE'RE GOING TO BE INCORPORATING THAT INTO THIS PRESENTATION, RIGHT? DR.

ASCOT OR DIRECTOR HAYDEN, WHICHEVER ONE OF YOU, UH, WANTS TO LEAD US OFF OR MANAGER.

DID YOU WANT TO SAY SOMETHING BEFORE WE DID YOU'RE MUTED? IT IS A FULL DAY MAYOR AND COUNCIL, AND SO WE'LL GET RIGHT STARTED, BUT WE'LL HAVE GOOD DIRECTOR HAYDEN LEAD OFF, THEN WE'LL PASS IT TO DR.

SCOTT, WE'LL ASK QUESTIONS TO DR.

SCOTT.

SO THEN HE CAN LEAVE TO GO TO COMMISSIONER'S COURTS.

BEFORE WE GET INTO THE UTC PRESENTATION ON NURSING HOMES, BUT DIRECTOR HAYDEN WANTING TO CUSS OFF GOOD MORNING, I'M STEPHANIE HAYDEN, DIRECTOR OF AUSTIN PUBLIC HEALTH.

THANK YOU FOR THE OPPORTUNITY TO PROVIDE AN UPDATE STAFF, CONTINUE TO CONTACT TRAITS AND TARGET POPULATIONS.

WE ARE REVIEWING AND EXISTING, OUR TESTING AND CONTACT TRACING SERVICES.

WE ARE CONTINUING TO, UM, PRIORITIZE SPANISH TRANSLATION AND ENSURE THAT WE ARE PROVIDING SERVICES THAT ARE BILINGUAL AS WELL.

WE HAVE, UM, WITH OUR TESTING, UM, LOCATIONS, WE CURRENTLY HAVE THE SPRINGS IN WALNUT CREEK, UM, COMMUNITIES.

AND, UM, THIS SATURDAY YOU BEGAN TESTING ON SATURDAY.

SO WE WILL BE TESTING FOUR DAYS A WEEK, AS WELL AS THE LITTLE REAL LOCATION, WHICH IS ALSO A MONDAY THROUGH SATURDAY SITE.

THESE ARE WALKUP SITES, CONTINUE TO HAVE OUR TESTING AVAILABILITY IF INDIVIDUALS GO ONLINE, UM, AND, UM, SCHEDULE A TEST IF THEY ARE UNABLE TO DO THAT, UM, OUR NURSE LINE IS AVAILABLE WELL TO ASSIST THEM TO REGISTER AND SCHEDULE AN APPOINTMENT.

WE ARE, UM, LOOKING AT A FEW MORE, UM, TESTING SITES, UM, YEAH, SEVEN, EIGHT, SEVEN FOUR ONE, AND THE SEVEN EIGHT SEVEN FOUR FIVE AND FOUR EIGHT, UM, TO ESTABLISH TESTING IN THOSE COMMUNITIES.

WE ARE COMMITTED TO, UM, HAVING A TESTING STRATEGY THAT IS FLEXIBLE AND RAPIDLY RESPOND TO CHANGES IN THE COMMUNITY.

WE CURRENTLY HAVE TWO VENDORS THAT ARE ASSISTING US WITH TESTING, AND, UM, WE ARE IN THE PROCESS OF, OF WORKING WITH A COUPLE OF MORE VENDORS.

UM, ULTIMATELY WE WANT INSURANCE OR THAT THE SERVICES THAT WE ARE PROVIDING, UH, ARE CULTURALLY APPROPRIATE.

UM, AND WE ARE ABLE TO PROVIDE TARGETED POPULATION SERVICES WITH OUR NURSING HOME IN LONGTERM CARE FACILITIES, OUR NURSING, UM, OUR, OUR INCIDENT COMMAND STAFF CONTINUE TO MEET WEEKLY WITH, UM, OUR LONGTERM CARE STAFF FROM NURSING HOMES AND ASSISTED LIVING AND PER A TESTING PLAN.

WE CONTINUE TO PROVIDE THAT SUPPORT TO THEM AS FAR AS A YEAR TO DATE, UM, NUMBER, UM, WE HAVE COORDINATED,

[00:05:02]

UM, 7,000, UM, COBIT TESTS IN FACILITY SETTINGS AFTER THE, THE INITIAL 32 NURSING HOMES IN TRAVIS COUNTY.

UM, WE HAVE, UM, PROCESS AN ADDITIONAL, UM, 29 LONGTERM CARE FACILITY TESTS REQUESTS.

YES.

SO AS WE CONTINUE TO, UM, WORK IN THAT SPACE, UM, OFF OF CLUSTERS AND OUR TESTING PLAN, WE WILL CONTINUE TO, UM, WORK THROUGH THE LONGTERM CARE FACILITIES.

IN ADDITION TO THAT, UM, WE ARE ALSO, UM, A SYSTEM SEEING OTHER FACILITIES THAT MAY HAVE, UM, TESTING NEEDS AS WELL.

WE'VE DETERMINED THAT THERE ARE SOME SOCIAL SERVICE AGENCIES THAT REQUIRE THIS TEST.

AND SO WE ARE USING ONE OF OUR VENDORS TO DO THAT.

OUR STRIKE TEAMS, UM, HAVE THE PRIMARY FUNCTION OF STABILIZING STAFF AT THESE IMPACTED.

AND SO, UM, THE PROVISION OF THE STRIKE TEAM ASSURES THE FACILITIES HAVE THE STAFF TO PROVIDE RESIDENT CARE, BUT IT ALSO, UM, PROVIDES ADDITIONAL STAFFING FOR THE TEAM WHERE PEOPLE WERE WHEN THEY HAVE KOBE POSITIVE INDIVIDUALS.

AND THEN WE'RE, WE'VE ALSO BEEN ABLE TO MODEL APPROPRIATE PPE USE.

SO WE'VE BEEN ABLE TO PROVIDE SOME TRAINING TO ENSURE THAT APPROPRIATE USE OF PPE AND, UM, AND MAKE SURE THAT OUR TEAMS ARE FOCUSED ON PROCESS IMPROVEMENT AND PATIENT CARE TO ADDRESS THE OUTBREAK YOU'RE TODAY.

OUR STRIKE TEAMS HAVE BEEN DEPLOYED TO 19 FACILITIES.

THIS IS, UM, 13 ADDITIONAL STRIKE TEAMS. UM, SINCE WE RESPONDED IN MAY, SO A TOTAL OF 134 AGENCY STAFF HAVE RECEIVED STRIKE TEAM TRAINING, AND 167 AGENCY STAFF HAVE RECEIVED AN IN 95 FIT TESTING AS FAR AS THE NEED FOR THE STRIKE TEAMS. UM, WE ARE CONTINUING TO, UM, TO WORK WITH THE AGENCIES JUST TO DETERMINE THEIR NEEDS.

WE ARE CONTINUING TO ADDRESS THIS CHALLENGE BY, UM, ADDING STAFFING, UM, THROUGH A CONTRACT WITH OUR PPE, OUR LONGTERM FACILITIES.

UM, WE'RE OFFERED A ONE TIME, UH, WHAT WE'RE CALLING A PPE PUSHBACK TO ALL OF THE FACILITIES.

UM, 35 ASSISTED LIVING AND 32 NURSING HOMES HAVE ASSISTED, UM, THIS PPE AS OF TODAY WITH, UM, WITH TRAINING, WE CONTINUE TO, UM, PROVIDE TRAINING TO OUR, UM, TO OUR LONGTERM CARE STAFF.

AND SO 299 LONGTERM CARE FACILITY STAFF HAVE BEEN TRAINED ON VARIOUS TOPICS, UM, INCLUDING IN 95 FIT TESTS, INFECTION CONTROL, ONSITE, PPE, AND HAND HYGIENE CHECKOFF.

SO THIS IS JUST, UH, SOME OF THE THINGS THAT OUR, OUR, OUR TEAM HAVE BEEN DOING.

UM, AS I SHARED IN A MEMO LAST WEEK, UM, THE US DEPARTMENT OF HEALTH AND HUMAN SERVICES WILL DEVOTE $5 MILLION TO THE PROVIDER RELIEF FUND, WHICH IS REALLY GOOD NEWS TO OUR LEARNED LONGTERM CARE FACILITIES, UM, TO BUILD OUT THE NURSING HOMES AND ENHANCE NURSING HOME SUPPORT.

AND SO THE FUNDING CAN BE USED FOR, UM, FOR HIRING ADDITIONAL STAFF, IMPLEMENTING INFECTION CONTROL AND MENTORSHIP PROGRAMS AS A PART OF THAT, UM, 15,000 TESTING DEVICES WILL BE SENT OVER THE NEXT FEW MONTHS.

UM, AND 600 WERE SHIPPED OUT LAST WEEK, ACCORDING TO THE CENTER FOR MEDICARE AND MEDICAID SERVICES TO RECEIVE A POINT OF CARE TESTING SITE, YOU MUST BE CONSIDERED A HOTSPOT AND IN TEXAS THERE DALLAS HARRIS HILDAGO AND TRAVIS ARE CONSIDERED TO BE HOTSPOTS IN ORDER TO RECEIVE THE POINT OF CARE TESTING DEVICE.

THE FACILITY MUST MEET THE CRITERIA AND MUST HAVE THE CLINICAL LABORATORY IMPROVEMENT AMENDMENT CERTIFIED OF A WAIVER TO RECEIVE A TESTING DEVICE WITH OUR HOMELESS.

ALL FOUR OF OUR, UM, PROLOGIS ARE FULL THAT'S 300 GUESTS, UM, 17 PEOPLE WE'RE REALLY EXCITED ABOUT THIS 17, UM, PEOPLE HAVE EXITED, UM, TO PERMANENT HOUSING, AND WE ARE GOING TO ACTIVATE OUR PROTECTIVE LODGE AS THE ONGOING EMERGENCY RESPONSE AND INFECTION STRATEGY WITH OUR PARTNERSHIP.

UM, WE HAVE TESTED OVER 650 TESTS HAVE BEEN ADMINISTERED AND FOCUS OPPORTUNITIES FOR MULTIPLE SHELTERS AND ENCAMPMENT AREAS ACROSS THE CITY.

UM, UM, DOWNTOWN AUSTIN, COMMUNITY COURT, FRONT STEPS, SALVATION ARMY, AND COMMUNITIES FOR RECOVERY INTEGRAL CARE ARE CONTINUING TO PROVIDE THAT FOCUS CASE MANAGEMENT AND SUPPORTIVE SERVICES WITH OUR CHILDCARE FACILITY,

[00:10:01]

AS WELL AS OUR SCHOOL AGED CHILDREN, WE HAVE, UM, UH, ESTABLISHED AN INCIDENT COMMAND STRUCTURE THAT INCIDENT COMMAND STRUCTURE WILL WORK WITH OUR CHILDCARE FACILITIES, UM, WITH OUR TASK FORCE, AS WELL AS SCHOOL DISTRICTS TO ASSIST THEM WITH REOPENING PLANS.

SO MORE OF THAT, UM, WILL BE COMING.

UM, THE, THE LAST THING I DID WANT TO SHARE IS, UM, WE HAVE, UM, CONTINUE TO WORK ON, UM, THE SURVEY RESULTS AS WE REVIEWED THE RESULTS THAT CAME INTO THE DEPARTMENT.

UM, 29 OF THOSE 53 STRATEGIES HAVE BEEN IMPLEMENTED.

UM, OUR TEAM IS WORKING WITH, UM, OUR OUTREACH FOLKS, SO WE CAN ESTABLISH AND WORK TOGETHER A LITTLE CLOSELY ON THE 24 THAT NEED TO BE IMPLEMENTED.

SO AT THIS TIME WE WANT TO REALLY SPEND SOME TIME TO, UM, MEET WITH THE COMMUNITY IN THOSE STRIKE TEAMS TO ADDRESS HOW CAN WE DO MORE TARGETED WORK IN THE POPULATIONS, UM, THAT HAVE DISPARITIES.

THAT INCLUDES MY REPORT.

AND I AM GOING TO SHIFT OVER TO DR.

ED.

THANK YOU.

THANK YOU, STEPHANIE.

AND THANK YOU, MAYOR AND COUNCIL.

I'M GOING TO ASK OUR FOLKS TO PULL UP MY SLIDES IF YOU DON'T MIND.

THANK YOU.

EXCELLENT.

NEXT SLIDE PLEASE.

AS MAYOR AND COUNCIL, AS YOU CAN SEE, WE'VE HAD A, UH, A SUBSTANTIAL DECREASE IN OUR NUMBER OF NEW CONFIRMED CASES, UH, OVER THE PAST 12 DAYS.

UH, RIGHT NOW OUR SEVEN DAY MOVING AVERAGE FOR NEW CASES IS, UH, 275.

UH, AND, UH, AND JUST A FEW WEEKS AGO AT THE BEGINNING OF JULY, UH, YOU KNOW, WE WERE CLOSER TO FIVE 50 TO 600, UH, SO DEFINITE IMPROVEMENTS.

UH, WE SAW A REPORT YESTERDAY THAT THE TRAVIS COUNTY HAS THE 15TH HIGHEST, UH, NUMBER OF ACTIVE CASES IN, UH, IN COUNTIES ACROSS TEXAS.

AND WE'RE PROUD OF THE, THE PROGRESS THAT WE'VE MADE.

UH, AND I, I THINK THIS IS A RESULT OF A COMMUNITY THAT HAS BEEN ENGAGED TOGETHER, UH, TO REALLY GET A LID BACK ON THIS.

WE'VE GOT MORE WORK TO DO, BUT WE'RE CERTAINLY HEADED IN THE RIGHT DIRECTION.

NEXT SLIDE, PLEASE.

THIS IS A GRAPH OF OUR DOUBLING TIME WITH THE YELLOW REPRESENTING THE SEVEN DAY MOVING AVERAGE OF OUR DOUBLING TIME.

UH, YOU CAN SEE BACK ON, UH, JUNE THE SEVENTH, UH, WE WERE AT 40, A LITTLE OVER 40 DAYS.

UH, AT THE BEGINNING OF THIS MONTH, WE HIT OUR LOWEST, UH, DOUBLING TIME, WHICH WAS AROUND SEVEN OR CORRECTION, WHICH WAS AROUND 12 DAYS.

UH, NOW I'M PROUD TO SAY THAT WE ARE OVER 60 DAYS NOW WITH A SEVEN DAY MOVING AVERAGE OF 65 DAYS, UH, AT THIS STAGE.

UH, SO THIS IS THE, THE BEST POSITION WE'VE BEEN IN, IN, UH, IN TERMS OF, OF THE DOUBLING TIME.

AGAIN, THIS IS ALSO A FUNCTION OF THE NUMBER OF CASES THAT WE HAVE.

UH, THE MORE CASES WE HAVE, THE MORE DIFFICULT IT IS TO DOUBLE IT.

UH, BUT IT'S ALSO REFLECTIVE OF THE FACT THAT WE HAVE FEWER CASES BEING REPORTED EACH DAY.

AND WE CERTAINLY HOPE THAT TREND CONTINUES.

NEXT SLIDE, PLEASE.

THIS SLIDE IS SHOWING YOU OUR, UH, OUR KEY INDICATOR OF NEW ADMISSIONS.

UH, AGAIN, THE YELLOW IS SHOWING THE SEVEN DAY MOVING AVERAGE OF THOSE NEW ADMISSIONS.

UH, SO AGAIN, WE'VE HAD 12 DAYS OF DECREASING, UH, UH, NUMBERS ON THE MOVING AVERAGE, WHICH IS CURRENTLY AT 47.

UH, AND THIS IS A NOW FULL 21 DAYS FROM THE PEAK OF THAT, OF THAT MOVING AVERAGE.

SO AGAIN, THIS CERTAINLY DOES APPEAR TO BE A DOWNWARD TREND.

UH, AGAIN, THIS DID NOT OCCUR BY MAGIC AND IT OCCURRED BECAUSE WE HAD A COMMUNITY COMMITTED TO DECREASING THE SPREAD OF DISEASE.

UH, IF WE REMOVE THAT COMMITMENT, THE DISEASE WILL RETURN AGAIN.

UH, AND THIS IS WHY IT'S MORE IMPORTANT THAN EVER TO STAY THE COURSE AND FOR US TO CONTINUE THOSE PROTECTIVE EFFORTS, NOT ONLY DOES IT DECREASE THE, THE ADMISSIONS AND THE BURDEN ON THE HOSPITALS, BUT SO THAT WE CAN BE IN A BETTER POSITION TO REOPEN OUR SCHOOLS AND GET KIDS BACK IN THE CLASSROOM.

NEXT SLIDE, PLEASE.

NOW THIS GRAPH IS SHOWING US THREE THINGS.

UH, THE BLUE AGAIN IS SHOWING US THE TOTAL HOSPITALIZED INDIVIDUALS.

THE ORANGE

[00:15:01]

IS SHOWING THE ICU ADMISSIONS AND THE GRAY IS SHOWING THOSE INDIVIDUALS ON A VENTILATOR.

UH, THE HOSPITALIZATIONS HAS, UH, HAS HAD A SEVEN DAY, UH, DECREASE IN THAT MOVING AVERAGE, WHICH IS CURRENTLY AT 424.

UH, YOU CAN SEE A MORE GENTLE DOWNWARD TREND IN THE ICU IN VENTILATED PATIENTS, ALTHOUGH IT'S, WE'D STILL CALL THAT A PLATEAU AT THIS STAGE.

AGAIN, IT'S NOT INCREASING.

AND, UH, AND THAT'S SOMETHING TO BE GRATEFUL FOR.

UM, BUT, UH, UH, ON A, UH, A SLIDE THAT I'LL SHOW YOU HERE SHORTLY, UH, EXPLAIN A LITTLE BIT WHY THAT NUMBER IS LIKELY TO STAY PLATEAUED FOR, FOR AT LEAST A LITTLE WHILE LONGER.

NEXT SLIDE, PLEASE.

UH, THIS IS AN UPDATE ON OUR GRAPH, UH, RELATED TO RACE AND ETHNICITY AMONG OUR HOSPITALIZED INDIVIDUALS.

THE RIGHT SIDE IS SHOWING YOU THE LAST WEEK ADMISSIONS AND THE, THE RACE AND ETHNICITY BREAKDOWN.

UH, THAT'S SHOWING THAT OUR HISPANIC POPULATION IS REPRESENTING 51.1% OF THE ADMISSIONS LAST WEEK, AGAIN, A DOWNWARD TREND FROM THE PREVIOUS WEEKS, BUT STILL OVER REPRESENTATIVE, UH, UH, THE, UH, THE HISPANIC POPULATION IN OUR COMMUNITY, OUR WHITE NON-HISPANIC AND BLUE IS AT 31%.

SO RELATIVELY PLATEAUED FROM LAST WEEK AND OUR AFRICAN AMERICAN IN GRAY, UH, PERCENTAGES 11%, WHICH CONTINUES TO INCREASE AGAIN ALSO, UH, REPRESENTING OUR AFRICAN AMERICAN COMMUNITY, UH, IN, UH, IN TERMS OF HOSPITALIZATIONS.

NEXT SLIDE, PLEASE.

THIS GRAPH IS SHOWING YOU THE BREAKDOWN OF HOSPITALIZATIONS BY AGE GROUP.

UH, YOU CAN SEE THAT ON THE RIGHT SIDE OF THE SCREEN IS, IS THE RESULTS FROM THE LAST WEEK.

AND YOU SEE A CLUSTER OF, OF, UH, OF LINES REPRESENTING THE 50 PLUS AGE GROUPS, UH, ABOUT 50% OF THE HOSPITALIZATIONS LAST WEEK, WHERE AN INDIVIDUALS WHO ARE 60 YEARS OR OLDER, UH, ABOUT A THIRD OF THEM ARE 70 YEARS OR OLDER.

AND AGAIN, THIS, THIS TELLS US THAT, THAT THE LIKELIHOOD THAT THE, UH, VENTILATOR NUMBERS AND I SEE NUMBERS ARE GOING TO CONTINUE TO PLATEAU AND ALSO IS A BIT OMINOUS IN TERMS OF OUR PREDICTIONS REGARDING DEATHS.

WE KNOW THAT PARTICULARLY OVER THE AGE OF 60, UH, THE RISK OF DEATH IS SUBSTANTIALLY HIGHER.

UH, SO I THINK THIS TELLS US IN THE, IN THE PAST SEVERAL WEEKS HAS TOLD US THAT WE CAN EXPECT THAT OUR DEATH NUMBERS ARE GOING TO INCREASE, UH, AS THESE INDIVIDUALS HAVE, UH, INCREASED THEIR REPRESENTATION AMONGST HOSPITALIZED INDIVIDUALS.

NEXT SLIDE, PLEASE LET'S SLIDE YOU A AGGREGATION OF DATA FROM A NUMBER OF DIFFERENT TESTING ENTITIES AROUND TRAVIS COUNTY.

UH, SO THIS INCLUDES AUSTIN PUBLIC HEALTH, COMMUNITY CARE, AUSTIN, REGIONAL CLINIC, ESSENTIALLY SETON SAINT DAVID'S AND OTHERS.

AND THIS SHOWS US TRENDS OVER A WHILE SINCE, UH, SINCE THE BEGINNING OF JUNE.

UH, AND YOU HAVE TO REMEMBER THAT THE RIGHT SIDE, UH, THE LAST COLUMN OF, UH, UH, JULY 19TH THROUGH THE 25TH, UH, STILL HAS SOME RESULTS WHICH HAVE NOT BEEN RECEIVED YET.

UH, SO THAT'S NOT GOING TO BE A COMPLETE PICTURE YET.

UM, AND, UH, IN TERMS OF THE NUMBER OF CASES THAT, THAT, UH, OR A NUMBER OF TESTS THAT WERE PERFORMED AS WELL AS THEY, UH, PERCENT POSITIVE, UH, BUT YOU CAN SAY THAT WE HAVE HAD A, A THREE WEEKS, UH, OR PARTICULARLY THE PAST TWO WEEKS WHERE, UH, WE'VE HAD SUBSTANTIAL DECREASES IN THE RATE OF POSITIVITY.

UM, WE ARE ALSO NOTICING THAT WE HAVE A DECREASE IN THE NUMBER OF INDIVIDUALS, UH, WHO ARE REQUESTING TESTING THROUGH OUR DRIVE THROUGH SITE.

UH, AGAIN, WE WANT TO ENCOURAGE FOLKS IF, IF THEY HAVE SYMPTOMS OR THEY HAVE AN EXPOSURE, UH, TO GO ONLINE TO THE AUSTIN, TEXAS.GOV FORWARD SLASH COVID-19 WEBSITE, AND DO A SELF ASSESSMENT TO SEE IF, IF THEY NEED TO BE TESTED.

UH, WE ARE TESTING INDIVIDUALS WHO, UH, WHO HAVE RISK FACTORS WHO HAVE EXPOSURES, UH, AND WHO MAY NOT BE SYMPTOMATIC AT THIS STAGE.

AND SO IT'S IMPORTANT FOR FOLKS TO GO AND SIGN UP FOR TESTING TO SEE IF, IF IT TRIGGERS A REQUEST FOR A TEST.

NEXT SLIDE, PLEASE.

YOU CAN GO TO THE NEXT SLIDE PLEASE.

SORRY, THAT'S JUST A REDUNDANT SLIDE.

UM, THIS IS, UH, THIS GRAPH IS SHOWING US THE PERCENT OF POSITIVE CASES BY AGE GROUP.

UH, AGAIN,

[00:20:01]

LAST WEEK, THIS IS THE DATA FROM SEVEN 21 TO SEVEN 27.

YOU CAN SEE THAT THE 20 TO 29 AGE GROUP IS MORE THAN 20%, UH, OF, OF THE CASES.

SO THE HIGHEST NUMBER OF BASES, UH, YOU KNOW, FOLLOWED CLOSELY BY 30 TO 39 AND 40 TO 49.

SO THERE STILL IS QUITE A BIT OF SPREAD AMONGST THE, UH, THE INDIVIDUALS WHO ARE TESTING POSITIVE IN TERMS OF THEIR AGE GROUP.

UH, WE ARE, UH, TRYING TO, TO GET SOME, UH, ADDITIONAL INFORMATION ON THIS DATA TO DETERMINE PERCENT POSITIVE BY AGE GROUP, UH, LOOKING AT SOME OTHER DATA SETS, UH, THOSE DATA SETS OF SUGGESTING THAT THEY, UH, TEND TO 19 AGE GROUP HAVE THE HIGHEST RATE OF POSITIVITY, UH, OVER THE PAST, UH, TWO WEEKS.

UM, YOU KNOW, THE FACT THAT THEY ARE, ARE BEING TESTED LESS, UH, IS, IS WHY THEY, THEY, THEY REPRESENT A SMALLER NUMBER OF THE PERCENT POSITIVE CASES.

UH, BUT WE ARE SEEING DISEASE SPREAD AMONGST THAT GROUP.

AND WE WANT TO BE ABLE TO PROVIDE ADDITIONAL INFORMATION FOR YOU, PARTICULARLY AS WE CONSIDER, UH, THE SCHEDULE FOR SCHOOL.

REOPENINGS NEXT SLIDE, PLEASE.

UH, THIS, UH, THIS CHART IS AN UPDATE ON OUR NURSING HOME, UH, AND LONGTERM CARE FACILITY, UH, OUTBREAKS.

UH, SO A TOTAL OF 113 NEW CASES IN THE PAST SEVEN DAYS.

UH, THIS IS A DECREASE FROM, FROM THE PREVIOUS TWO WEEKS, BUT WE CLEARLY HAVE MORE WORK TO DO IN TERMS OF, OF NURSING HOME OUTBREAKS.

UH, YOU CAN SEE THAT THIS INFORMATION IS STILL, UH, CODED AND IS NOT LISTING THE, THE FACILITY NAME.

UH, THIS IS A RESULT OF, OF A LEGAL OPINION BY THE CITY ATTORNEY'S OFFICE, THAT THE RECENT RULE RULING, WHICH APPLIED TO HHSC DOES NOT APPLY TO THE CITY.

UH, SO WE'LL CONTINUE, UH, CONTINUE UTILIZING THIS, THIS FORMAT OF SHARING INFORMATION, UH, UNTIL WE GET A DIFFERENT RULING.

UH, NEXT SLIDE PLEASE.

UH, AND, AND FINALLY, I WANT TO TOUCH A LITTLE BIT OF BOND WHERE WE ARE WITH, WITH THE SCHOOL'S DISCUSSION.

UH, WE ARE WORKING WITH OUR SCHOOL DISTRICTS AS DIRECTOR HAYDEN SAID, UH, WE HAVE A TEAM WORKING ON GUIDELINES.

UH, ONE OF THOSE GUIDELINES IS GOING TO BE CENTERED AROUND OUR, OUR STAGING AND, AND, YOU KNOW, IF THE THING WE'RE LIKELY TO ADVOCATE FOR A PHASED REOPENING OF SCHOOLS, BASED UPON THE LEVEL OF RISK THAT WE'RE IN, UH, YOU KNOW, WE, WE FACE A LOT OF QUESTIONS ABOUT, YOU KNOW, WHEN'S THE RIGHT TIME, HOW MANY STUDENTS DO WE LET IN? UH, WHAT ABOUT EXTRACURRICULAR ACTIVITIES? AND THOSE ARE ITEMS THAT WE'RE WORKING ON.

I WILL SAY THAT OUR PARTY HAS TO BE A SAFETY.

IT HAS TO BE MAINTAINING PUBLIC HEALTH.

WE'VE SEEN OVER AND OVER AGAIN, THAT WHEN WE RUSH TO OPEN THINGS, IF WE DON'T HAVE THE APPROPRIATE PROTECTIONS IN PLACE, IT LEADS TO CASES, SURGING AND SHUTTING THOSE THINGS DOWN AGAIN.

AND WE DO NOT WANT TO BE IN THAT SITUATION IN TERMS OF SCHOOLS, IT IS IMPORTANT FOR US TO TRY TO GET KIDS BACK IN THE CLASSROOM, BUT WE ALSO MUST CONSIDER THE CONTINUITY OF EDUCATION FOR THESE STUDENTS.

AND WE DO NOT WANT TO BE IN A SITUATION WHERE SCHOOLS ARE OPEN AND CLOSE AND OPEN AND CLOSED, UM, BECAUSE THAT MAY BE WORSE, UH, THAN JUST WAITING, UH, PROGRESSIVELY OPENING SCHOOLS WITH, WITH A RELATIVELY FEW, A NUMBER OF STUDENTS ALLOW THE, THE SCHOOLS TO WORK OUT THE PROCESSES, ALLOW US TO BE IN A BETTER PLACE IN TERMS OF THE STAGE OF RISK IN THE COMMUNITY, AND THEN PROGRESSIVELY ALLOWING MORE STUDENTS INTO THE CLASSROOM.

UH, AGAIN, WE ARE WORKING ON THESE GUIDELINES, WE'RE WORKING ON ALGORITHMS TO, UH, TO ALLOW SCHOOLS, TO HAVE SOME, SOME UNIFORMITY AND HOW THEY RESPOND TO, UH, VARIOUS EVENTS, SUCH AS A NEW CASE OR A CLUSTER.

AND WE'RE ALSO WORKING ON, UH, SOME REQUIREMENTS FOR SCHOOL REOPENING.

UH, SO THESE ARE THINGS THAT WE HOPE TO HAVE DRAFTED THIS WEEK, THAT WE WILL ENGAGE OUR SUPERINTENDENTS AND OTHER STAKEHOLDERS ON, UH, SO THAT WE CAN, WE CAN HAVE A, A RELATIVELY UNIFORM APPROACH TO, UH, TO SCHOOL REOPENING.

UM, I ALSO WANT TO MENTION THAT I DO HAVE CONCERN ABOUT THE DIFFERENCES IN APPLICATION OF PUBLIC HEALTH PRINCIPLES BETWEEN PUBLIC SCHOOLS AND PRIVATE RELIGIOUS SCHOOLS.

[00:25:01]

UM, YOU KNOW, I, I UNDERSTAND THAT THE ATTORNEY GENERAL, UH, OF THE STATE OF TEXAS HAS, HAS STATED THAT THIS IS A FIRST AMENDMENT ISSUE.

AND I, I DON'T PERSONALLY BELIEVE THAT'S CORRECT.

UH, PUBLIC HEALTH ISSUE IS A PUBLIC HEALTH ISSUE.

AND WHEN WE HAVE A UNIFORM CONCERN AND A UNIFORMLY APPLIED A STANDARD OR PUBLIC AND RELIGIOUS SCHOOLS, IT'S FAIR.

AND IT MAKES SENSE.

UH, OUR, OUR TEACHERS AT PRIVATE SCHOOLS ARE IN THE SAME CIRCUMSTANCES, TEACHERS IN PUBLIC SCHOOLS.

AND I THINK WE HAVE TO CONTINUE TO WORK TOGETHER AS A COMMUNITY TO ADDRESS ALL OF THESE VARIOUS SETTINGS, UH, TO ENSURE THAT THE PROTECTIONS ARE IN PLACE UNIFORMLY, UH, FOR, UH, FOR OUR EDUCATORS AND FOR OUR SCHOOL STAFF.

AND WITH THAT, UH, MAYOR, I WILL TURN IT BACK OVER TO YOU FOR QUESTIONS, MARY YOU'RE MUTED.

THERE YOU GO.

AND WE RETURNED THE SCREEN PARTICIPANT OUR ACCOUNTS.

COOL.

THANKS MAYOR.

AND GOOD MORNING EVERYBODY.

I'M DR.

ASCOT.

I HAD A QUESTION FOR YOU.

AND THEN, UM, I GUESS, I DON'T KNOW IF IT'S A QUESTION FOR YOU OR FOR ILLEGAL.

SO ON THE POSITIVELY POSITIVITY CHART THAT SHOWS, WHICH SHOWED HOSPITALIZATIONS, IT LOOKED LIKE WE HAD ABOUT 8,000 TESTS ADMINISTERED LAST WEEK.

SO CAN I JUST REALLY ESTIMATE VR TESTING A THOUSAND? UH, SO COUNCIL MEMBER THAT'S, THAT'S THE, UH, THE TOTAL TESTING FROM THE ENTITIES THAT ARE CONTRIBUTING RESULTS TO US, AND THOSE ARE THE ONES THAT WE HAVE RESULTS FOR.

SO THERE MAY BE ADDITIONAL ONES FROM LAST WEEK THAT WERE STILL PENDING RESULTS.

THAT'S JUST WHAT WE HAVE BACK.

SO, BUT JUST LOOKING AT THAT CHART, KNOWING THAT IT IS ALL THE REPORTS THAT HAVE BEEN, THAT HAVE COME IN IN A CERTAIN TIMEFRAME, CAN WE JUST DO A SIMPLE DIVISION AND SAY, GENERALLY WE HAVE ABOUT X, THOUSANDS PER DAY BEING TESTED.

YES.

UH, BUT, UH, BUT AGAIN, THIS IS ONLY ABOUT EIGHT DIFFERENT CONTRIBUTORS.

THERE ARE MANY MORE DOING TESTING, INCLUDING URGENT CARE CENTERS AND FREESTANDING EMERGENCY ROOMS AND IN CLINICS.

UH, SO THIS IS A SNAPSHOT, BUT SNAPSHOT, OH, LIMITED UNIVERSE.

DO YOU KNOW WHAT THE LARGER UNIVERSE IS THAT IS NOT BEING CAPTURED IN THESE THEN? I DO NOT.

OKAY.

UM, AND THEN THE SECOND QUESTION I HAD IS RELATING TO THE AG RULING AND THE, UM, PUBLICATION OF THE NAMES OF THE DIFFERENT NURSING HOMES.

WE TALKED ABOUT BEING ABLE TO LIST THEM.

WE WENT TO THE CODING PROTOCOL IN ORDER TO PRESERVE SOME ANONYMITY, ALTHOUGH THAT IS NOW IN MY MIND, THE SAME THING AS HOLDING PRIVATE PARTICULAR PATIENTS PARTICULARS.

SO WHY DOES THE ATTORNEY GENERAL'S RULING NOT APPLY THE CITY OF AUSTIN? UH, IF THAT INFORMATION IS NOW PUBLIC AND IN THE NEWSPAPER OF RECORD HERE IN AUSTIN, WHY WOULDN'T WE ALSO ADD THAT TO OUR CHARTS FOR TRANSPARENCY AND ACCOUNTABLE? THIS IS, THIS IS, UM, WE GOT A RULING FROM THE ATTORNEY GENERAL TELLING US THAT WE HAD TO KEEP THE INFORMATION CONFIDENTIAL.

WE ALREADY HAVE A RULING.

SO THAT'S WHAT WE'RE ABIDING BY.

CAN WE GO BACK PLEASE TO THE ATTORNEY GENERAL AND TRY TO ALIGN THE MORE RECENT MEANING WITH THE PREVIOUS RULING SO THAT THERE ARE NO GAPS.

IT SEEMS ODD, AND PEOPLE WERE QUESTIONING WHY THE CITY OF AUSTIN DOESN'T HAVE THE SAME INFORMATION THAT IS PUBLICLY AVAILABLE ON THE NEWSSTANDS.

WE CAN, WE CAN LOOK AT IT AGAIN.

UM, SO WHAT I'M ASKING IS WILL LEGAL PLEASE CONNECT WITH THE ATTORNEY GENERAL'S OFFICE AND REVIEW THE DISPARATE RULING SO WE CAN GET SOME CLARITY.

WE ARE THINKING CLARITY AS WE OFTEN DO WHEN WE GET RULINGS JUDICIAL TYPE.

CAN WE DO THAT? BE HAPPY TO CONNECT WITH THEM? THAT'D BE GREAT.

THANKS.

I THINK THAT INFORMATION DOES NEED TO BE RECORDED IN OUR, IN OUR FILE FOR CLUSTER NEXT THAT'S OUR KITCHEN.

UM, I JUST WANT TO SAY, I AGREE WITH COUNCIL MEMBER POOL.

I ACTUALLY, UM, AT SOME POINT I KNOW OUR SCHEDULES ARE PACKED RIGHT NOW, BUT AT SOMETIME AT SOME POINT I'D LIKE TO HAVE ANOTHER LEGAL CONVERSATION ABOUT OUR DISCRETION.

I THINK IT MAKES NO SENSE TO HAVE, UM, THE NAMES AVAILABLE

[00:30:01]

PUBLICLY.

UM, AND THEN WE'RE NOT RELEASING THEM.

I MEAN, SOME OF IT IS A DISCONNECT, BUT SO AS A RESULT, WE GET A DISCONNECT.

UM, WHAT'S ACTUALLY HAPPENING WITH REGARD TO THESE FACILITIES.

SO I CAN TALK WITH YOU OFFLINE, UM, CITY, ATTORNEY, AND OTHERS TO SEE IT.

AND AGAIN, I KNOW THAT OUR SCHEDULES ARE PACKED, BUT, UM, I WOULD LIKE TO HAVE FURTHER CONVERSATION ABOUT OUR DISCRETION, UM, AS A CITY TO, TO MAKE, UM, DATA AVAILABLE.

I THINK IT'S REALLY IMPORTANT FOR A FAMILY.

THANK YOU.

IT'S COME FROM NUMBER ELLIS.

THANK YOU.

QUESTION MIGHT BE FIRST DOCTOR ASCOT.

THERE IS A CHART THAT A COUPLE OF TIMES THAT TALKS ABOUT RACE AND ETHNICITY AND THE VERY FIRST DAY OR TWO, THERE'S THIS JUMP FROM 50 TO ZERO.

CAN YOU TELL ME IF THAT IS AN ANOMALY OR IS THERE A CHANGE IN THE WAY THE DATA WAS COLLECTED DURING THE EARLY ON, OR WHAT MIGHT BE CAUSING THOSE NUMBERS TO JUMP IN THAT WAY? COUNCIL MEMBER IT'S BECAUSE WE HAD VERY FEW CASES.

UH, SO THERE WAS LOTS OF VARIATION IN, IN THE BEGINNING BECAUSE WE HAD, UH, A HANDFUL OF INDIVIDUALS HOSPITALIZED BACK THEN.

OKAY.

THAT'S HELPFUL.

THANK YOU.

YOU BET COLLEAGUES, ANY OTHER QUESTIONS? YES, MARY, I JUST WANTED TO FOLLOW UP ON A COVER AND WE HAD, I THINK AT OUR LAST COVET BRIEFING, UM, WE HAD TALKED ABOUT THE SITUATION WITH THE SCHOOLS AND THE QUESTIONS THAT PARENTS WERE FACING AS THEY MADE THAT DECISION OF WHERE THEIR STUDENTS SHOULD GO TO SCHOOL, WHERE THEIR SCHOLARS SHOULD GO TO SCHOOL.

UM, A GREAT PHRASE OF, OF COUNCIL MEMBER HARPER MADISON'S.

AND I JUST WANTED TO SAY THAT WE DID, UM, EXPLORE THE IDEA OF HAVING A JOINT SUB COMMITTEE CONVERSATION AROUND THAT OR HAVING A DIFFERENT COMMUNITY MEETING AND BECAUSE OF THE WAY IT WAS CHANGING SO QUICKLY, AND INDEED, YOU KNOW, THAT WEEK AISD AND OTHER SCHOOL DISTRICTS ANNOUNCED THAT THEY WOULD NOT BE GOING BACK TO SCHOOL IN PERSON UNTIL SEPTEMBER.

WE HAVE NOT, WE ARE NOT MOVING FORWARD WITH THAT PLAN OF HAVING A COMMITTEE THAT CAN BE IN THAT CONVERSATION AT THIS TIME, BECAUSE THEY'RE JUST ARE, ARE STILL CHANGING SITUATIONS EVERY DAY WITH REGARD TO SCHOOLS.

I THINK YOU AND I JUST REMIND FOLKS, UM, YOU KNOW, YOU AND I HAD TALKED IN THE MEETING ABOUT CONVENING, SUCH A CONVERSATION.

I JUST WANTED TO FOLLOW UP WITH MY COLLEAGUES AND LET THEM KNOW THAT AT THIS POINT, WE'RE KIND OF WATCHING, WATCHING THE SITUATION DR.

ASCOT.

I KNOW THAT YOU WERE, AS YOU SAID IN CLOSE COMMUNICATION.

AND SO IF THERE IS, UH, AN INTEREST AND YOU THINK THERE WOULD BE A FACILITY TO HAVING THAT BROADER CONVERSATION, THEN SOMEWHERE DOWN THE ROAD, THAT WOULD BE GOOD.

OF COURSE THEY ISD IS, IS ALSO CONVERSATIONS WITH THEIR, THANK YOU, THANKS FOR THE PRESENTATION.

AND OF COURSE, WE WANT TO KEEP URGING PEOPLE TO DO WHAT THEY'RE DOING.

EVEN WITH THAT.

THERE ARE OF COURSE, PEOPLE WHO ARE STILL GETTING VERY SERIOUSLY SICK AND DYING.

HOW ARE WE CLEAN ON GETTING INFORMATION TO US ABOUT, UM, UH, BROKEN DOWN ABOUT WHAT TARGETED STRATEGIES WE SHOULD BE PUSHING FURTHER TO REDUCE, SPREAD, ESPECIALLY BASED ON ECONOMICS.

I KNOW WE'VE HAD CONVERSATIONS HERE ABOUT, DO WE KNOW HOW MANY PEOPLE ARE DENIED UNEMPLOYMENT INSURANCE? AND THAT'S WHY THEY'RE GOING TO WORK WITH KIDS THAT ARE SPREADING AT WORK VERSUS PEOPLE WHO AREN'T GIVEN SICK TIME.

AND THAT'S WHERE WE SEE SPREAD VERSUS PEOPLE GETTING SICK BECAUSE OF A GATHERING OR BECAUSE THEY DIDN'T KNOW THEY HAD IT IN WEREN'T TESTED, OR WE CAUSE EACH OF THOSE THINGS MERITS A DIFFERENT STRATEGY.

AND I KNOW WE'RE WORKING ON EACH OF THEM, BUT I STILL AM NOT CLEAR ABOUT HOW MUCH WE'RE SEEING EACH OF THOSE COMMON DRIVERS OF CASES, UM, BEING, YOU KNOW, GETTING PEOPLE INTO THE HOSPITAL.

I'LL, I'LL START.

AND THEN I'LL, I'LL HAVE, UH, DIRECTOR HAYDEN RESPOND AS WELL.

UM, YEAH, THERE, THERE CONTINUED TO BE BARRIERS IN TERMS OF, UH, PEOPLE GETTING TESTED AND, AND PEOPLE ISOLATING.

UH, SOME OF THOSE ARE ECONOMIC.

UH, WE'RE STILL HEARING THAT THAT FOLKS, UH, ARE GOING TO WORK, UH, DESPITE THE FACT THAT THEY'VE BEEN, UH, YOU KNOW, IDENTIFIED AS A CASE.

AND, UH, AND THERE'S CONCERN THAT, THAT PEOPLE WILL LOSE THEIR JOB OR CERTAINLY LOSE THE ABILITY TO JUST SUPPORT THEIR FAMILIES.

UH, HAVING SAID THAT, YOU KNOW, I THINK WE HAVE A GROWING EVIDENCE ACROSS THE COUNTRY THAT THAT DISEASE SPREAD IS, IS MORE LIKELY TO HAPPEN IN GATHERINGS,

[00:35:01]

UH, IN FAMILY GATHERINGS, UH, GATHERINGS FOR PARTIES, FOR BIRTHDAYS, FOR FUNERALS, UH, BECAUSE OF THE DURATION AND THE NATURE OF THOSE INTERACTIONS.

UM, SO, YOU KNOW, I THINK IT'S IMPORTANT FOR US WHILE WE FOCUS ON, ON THE, THE, THE IMPORTANCE OF GETTING FOLKS TO HAVE THE SUPPORT THEY NEED TO STAY HOME WHEN THEY'RE SICK.

UH, WE ALSO NEED TO FOCUS ON REMINDING THE COMMUNITY THAT, THAT THEY'RE NOT SAFE AROUND FAMILY AND FRIENDS.

UH, IN FACT, THEY PROBABLY HAVE INCREASED DANGER OF TRANSMISSION IN THOSE PERSONAL SETTINGS, THOSE FACE TO FACE SETTINGS THAN THEY DO IN A WORKPLACE, OR, UH, YOU KNOW, GOING TO A RESTAURANT OR A BUSINESS.

AND I'LL PASS IT OVER TO DIRECTOR HAYDEN WHO MAY COMMENT FURTHER ON SOME OF THE OTHER ELEMENTS AND RIGHT BEFORE DIRECTOR HAYDEN DOES THAT.

THAT IS ALSO ANECDOTALLY WHAT I HAVE SEEN AND HEARD THE MAYOR.

AND I GOT TOGETHER WITH, UH, A GROUP OF ABOUT 20 SPANISH SPEAKERS, PRIMARILY FROM, FROM MY DISTRICTS THE OTHER DAY, JUST A GROUP OF CONSTITUENTS.

AND IT WAS, UM, HEARTBREAKING, BUT, AND REAL THAT, OF THAT GROUP OF 20 PEOPLE, A LOT, A DECENT HANDFUL THAT HAD COVID-19 SEVERAL HAD BEEN HOSPITALIZED.

AND EVERY SINGLE PERSON KNEW PEOPLE WITH COVID-19 AND PEOPLE KNEW FOLKS THAT HAD DIED.

UM, AND THE STORIES WERE VARIED.

A PROBLEM.

PEOPLE BEING FORCED TO GO TO WORK, HAVING NO OTHER OPTION THAN TO WORK, NOT GETTING TESTED OR NOT KNOWING, OR GETTING IT AT A GATHERING.

WE KNOW THAT ALL OF THESE ARE SERIOUS.

I THINK MY QUESTION IS MORE TO, HOW ARE WE GETTING INFORMATION ABOUT HOW MUCH OF EACH OF THOSE KINDS OF SPREAD WE'RE SEEING IN THE COMMUNITY? BECAUSE OF COURSE WE HAVE TO WORK ON ALL OF THEM, BUT IT'S HARD TO KNOW WHICH ONES ARE IMPACTING US THE MOST RIGHT NOW, WHEN YOU GO TO A MEETING AND HEAR THAT ALL OF THESE THINGS ARE HAPPENING, I DON'T KNOW IF IT'S EACH THING IS HAPPENING EQUALLY, OR IF THERE'S MORE OF ONE, THAT'S AN ISSUE, YOU KNOW, ACCORDING TO MY CONVERSATIONS WITH OUR EPIDEMIOLOGISTS, UM, YOU KNOW, THEY FEEL THAT IT IS MORE OF THE, THE PERSONAL GATHERING.

UM, I, I THINK THAT, UM, YOU KNOW, EVEN WHEN YOU DON'T LIVE WITH ANOTHER PERSON, THAT'S YOUR FAMILY.

I MEAN, IT, IT'S YOUR FAMILY.

SO EVEN THOUGH YOU MAY NOT BE GOING OUT IN PUBLIC IN PUBLIC SPACES, THE GATHERINGS ARE CONTINUING.

UM, AND SO IT IS, UH, IT IS STILL A SIGNIFICANT AMOUNT OF THAT THAT IS OCCURRING, UM, YOU KNOW, IN OUR COMMUNITY.

AND THAT IS WHY WE HAVE ALWAYS EMPHASIZED THE IMPORTANCE OF, UM, YOU KNOW, JUST TRYING TO FIND OTHER TRADITIONS.

AND IT'S REALLY HARD TO HAVE PEOPLE TO DO THAT IF, YOU KNOW, IF, IF A GRANDPARENT IS, YOU KNOW, TURNING 90 OR A HUNDRED, I MEAN, EVERYBODY WANTS TO COME AND, AND BEING IN THAT SPACE.

AND SO, UM, YOU KNOW, WE CONTINUE TO EMPHASIZE THAT, UM, WE, WE HAVE RECEIVED, UM, INFORMATION AS WELL, UM, THAT, YOU KNOW, OUR STAFF HAVE REALLY EMPHASIZED TO FOLKS THAT WE'RE TALKING TO REMINDING THEM, YOU KNOW, IT'S NOT A GOOD IDEA, UM, YOU KNOW, TO STAY HOME AND, YOU KNOW, SOME FOLKS ARE DOING THAT.

I MEAN, IT IS REFLECTIVE IN THE NUMBERS, BUT WE KNOW THAT THERE IS GOING TO BE MORE TARGETED WORK THAT WE'RE GOING TO NEED TO DO.

AND SO IN THOSE STRIKE TEAM CONVERSATIONS THAT WE WILL BE HAVING, WE NEED TO GET MORE IDEAS FROM OUR PARTNERS OF WHAT STRATEGIES THAT WE, ADDITIONAL STRATEGIES WE CAN TAKE.

THANK YOU.

IT'S VERY USEFUL DR.

HAYDEN, UM, UH, CAN YOU CLOSE THE LOOP ON THAT MEMO? THERE WAS A PLAN THAT, UH, YOUR OFFICE PUT OUT, WHICH I APPRECIATED YOU TOOK IT TO THE COMMUNITY.

UH, THERE WAS INPUT THAT CAME FROM THE COMMUNITY JUST TO CLOSE THE LOOP ON THAT, BY IDENTIFYING WHAT, UH, UH, UM, WELL, FINISH IT WITH WHATEVER INPUT THAT YOU'VE GOTTEN, BUT THEN TO IDENTIFY FOR THE COMMUNITY, WHAT THEY COULD EXPECT TO SEE HAPPENING, WHAT IS THE PRIORITY OF THE THINGS THAT ARE IN THERE AND WHEN THEY'RE GOING TO BE DONE AND WHO'S GOING TO DO THEM, AND IN THAT REGARD, IF EVENTS ARE NOW OVERTAKING THOSE KINDS OF THINGS, AND IT'S MORE THE FAMILY KIND OF STUFF THAT MAY OR MAY NOT HAVE BEEN MADE, IF YOU COULD CLOSE THE LOOP ON THAT MEMO SO THAT PEOPLE COULD SEE WHAT THE PRIORITIES ARE, WHAT THE TIME FRAMING IS ON WHAT THEY COULD EXPECT TO HAPPEN FROM THAT, I WOULD APPRECIATE THAT.

AND THEN THE OTHER QUESTION THAT, THAT COUNCIL MEMBER COSARA ANSWER, WHICH IS I GET ASKED A LOT RELATES TO KIND OF THE CONTACT TRACING, UH, IN THE CITY.

UH,

[00:40:01]

WE HAD A CHART THAT SHOWED WHERE THE CONTACT TRACING WAS SHOWING THE GREATEST INCIDENT OF STUFF.

IF WE COULD RENEW THE REPORTING OF THAT CHART, I THINK THAT WOULD BE HELPFUL FOR THE COMMUNITY TO SEE WHAT, WHERE, WHERE WE'RE SEEING THINGS AND, AND COLLEAGUES, AS WE TAKE A LOOK AT WHERE WE ARE ON THE, ON THE LONGER ARC AS WE BRING THE NUMBERS DOWN AND THE INFECTIVITY GOES DOWN, UM, UM, UH, DR.

UM, DIRECTOR HAYDEN, UM, UH, I'VE, I'VE ASKED THEM TO TAKE A LOOK AT WHAT THE CONTACT TRACING IS IN A WORLD WHERE THE NUMBERS COME BACK DOWN AND TO TAKE A LOOK AT WHAT WOULD HAPPEN IF WE WERE TO QUADRUPLE THE NUMBER OF CONTACT TRACING THAT WE DO RELATIVE TO WHAT THE NATIONAL STANDARD IS TO ACTUALLY HAVE SOMETHING THAT MORE CLOSELY APPROXIMATES WHAT'S HAPPENING IN OTHER COUNTRIES, WHAT WOULD THAT TAKE? WHAT WOULD THAT LOOK LIKE? WHAT WOULD THAT COST, AND THEN WHAT WOULD THE BENEFITS, IF ANY, DOING THAT IN OUR COMMUNITY? SO DOCTOR, UH, DIRECTOR, THANK YOU, UH, COUNCIL MEMBER ALTAR.

GOOD MORNING.

AND THANK YOU FOR THIS INFORMATION.

I WAS WONDERING IF I'M NOT SURE IF THIS WOULD BE DR.

S SCOTT OR DR.

HAYDEN.

UM, IF YOU COULD SPEAK TO ANY MORE INFORMATION WE HAVE ABOUT POTENTIAL SPREAD IN CHILDCARE CENTERS, OR IF WE'RE NOT EXPERIENCING THAT HERE IN AUSTIN, IF YOU CAN COMMENT ON WHAT WE ARE EXPERIENCING, UM, CURRENTLY, UM, ONE OF THE REASONS WHY WE, UM, ADDED WHAT WE'RE CALLING, UM, AN INCIDENT COMMAND STRUCTURE WAS WE, WE WERE STARTING TO SEE AN INCREASE IN CHILDCARE FACILITIES.

UM, INITIALLY, UM, WE ESTABLISHED, UM, A, A CHILDCARE TASK FORCE.

AND SO BECAUSE OF THE INCREASE IN THE NUMBER OF FACILITIES, BECAUSE MORE PEOPLE ARE GOING TO WORK, THEY'RE TAKING THEIR, UM, YOU KNOW, THEIR CHILDREN INTO FACILITIES.

AND SO THE GOAL OF THIS GROUP WILL BE, IS, IS, IS THEY WILL HAVE BE SET UP JUST LIKE THE NURSING HOME TASK FORCE, AND THEY WILL BE ABLE TO PROVIDE MORE TECHNICAL ASSISTANCE.

AND, UM, YOU KNOW, IF THERE'S A NEED TO SHOW THEM HOW TO USE PPE, UM, HOW TO CLEAN, UM, THE CHILDCARE FACILITIES, UM, BUT BE ABLE TO PROVIDE THAT WEEKLY, UM, YOU KNOW, DAILY KIND OF INTERVENTION, THERE'LL BE A MAILBOX SET UP, WE'VE IDENTIFIED, UM, EPIDEMIOLOGY STAFF THAT ARE GOING TO BE ASSIGNED TO THAT AREA.

UM, AND WE'RE DOING THIS JUST SO, BECAUSE WE DID SEE THAT INCREASE AND WE WANT TO GET AHEAD OF THE CURVE AND BE ABLE TO PROVIDE THE ADDITIONAL ASSISTANCE AT THESE FACILITIES AS WE SEE CLUSTERS, UM, AT EACH SITE.

THANK YOU.

AND THEN I WANTED TO JUST ADD ONTO THE CONVERSATION THAT A COUNCIL MEMBER TOVO RAISED BEFORE ABOUT THE JOINT MEETING.

UM, I BELIEVE THAT DR.

S SCOTT AND SOME OTHER STAFF SPOKE WITH A BUNCH OF SCHOOL BOARD MEMBERS, UM, RECENTLY, AND I KNOW THAT WAS VERY MUCH APPRECIATED TO HAVE THAT OPPORTUNITY FOR THEM TO INTERACT DIRECTLY WITH, UH, DR.

S SCOTT.

UM, AND I KNOW I'M IN TOUCH REGULARLY, UM, WITH TRUSTEES, UM, AND YOU KNOW, THERE'S A LOT OF, A LOT OF CONVERSATIONS, A LOT OF COMPLICATED, UM, DECISIONS GOING ON, UM, BUT JUST WANT TO, YOU KNOW, CONTINUE TO REINFORCE OUR NEEDS TO BE AVAILABLE AND SUPPORTING, UM, OUR SCHOOL LEADERSHIP AS THEY MAKE, UM, THESE REALLY DIFFICULT DECISIONS ABOUT OPENING, UM, AND SUPPORT THEM, UM, IN ANY WAYS THAT, OKAY, ANYTHING ELSE FOR ROD, UH, THEO DOCTOR, THIS IS FOR SCOTT, HAVE YOU NOTICED IF THERE'S EVER A CLUSTER OF INFECTIONS IN A DAYCARE CENTER, OR ARE YOU ALLOWED TO REPORT THAT WHERE THE LOCATIONS COUNCIL MEMBER? I DON'T KNOW THE ANSWER TO THAT.

UM, YOU KNOW, I THINK GENERALLY, UH, WE APPROACH IT IN A SECOND TO, UH, TO NURSING HOMES WHERE THE CHILDCARE CENTER IS RESPONSIBLE FOR NOTIFYING, UH, FAMILY AND STAFF, IF THERE'S A CASE THERE, UH, TO ENSURE THAT, THAT THOSE INDIVIDUALS WHO, WHO MAY BE EXPOSED ARE NOTIFIED, UH, I DON'T KNOW THAT WE'VE LOOKED AT THE ISSUE OF PUBLIC DISCLOSURE OF THAT YET OR NOT.

DR.

ESCADA.

I DON'T THINK THAT WE HAVE, I'M HAPPY TO TAKE A LOOK AT THAT.

I THINK A DIFFERENCE MIGHT BE WITH A NURSING HOME, PEOPLE ARE LIVING THERE.

SO THAT IS THE REAL ISSUE

[00:45:01]

THAT HAS BEEN A CONCERN THAT HAPPENED TO TAKE A LOOK AT THAT, UH, COUNSEL OVER INTO REIA AND DR.

ASCOT I'LL GET BACK TO YOU.

YEAH.

CAUSE I WOULD REALLY LIKE TO KNOW, UH, YOU KNOW, IF THERE'S A ARE INFECTIONS GOING ON AT, AT THESE DAYCARE CENTERS, BECAUSE WE'RE, WE'RE GETTING PRETTY CLOSE TO OPENING UP OUR SCHOOLS, EVEN AT A VERY, HOPEFULLY IN A, IN A WAY THAT'S THROUGH THE SCIENCE SCIENTIFIC WAY.

BUT, UH, I I'M REALLY CONCERNED BECAUSE IF, IF, UH, TRANSMISSION IS BEING PASSED AROUND IN DAYCARE CENTER, THEN IT WOULD BE ALSO PASSED AROUND.

I WOULD HAVE TO, AND, UH, KINDERGARTEN AND ELEMENTARY SCHOOLS ALSO.

YEP.

COUNCIL MEMBER.

LET ME JUST SAY THAT YES, THERE IS ACTIVITY IN CHILDCARE CENTERS ACROSS THE STATE OF TEXAS.

UH, YES, WE'LL BE FISHING IN SCHOOLS ACROSS THE STATE OF TEXAS.

UM, YOU KNOW, WE'VE, WE'VE GOTTA BE VERY CAREFUL AGAIN WHEN WE REOPENED SCHOOLS AND, UH, YOU KNOW, WE DON'T HAVE FINALIZED GUIDANCE YET.

UH, BUT IT'S LIKELY THAT, THAT THE FIRST STEP OF, YOU KNOW, REOPENING SCHOOLS WILL PROBABLY BE CAPPED AT AROUND 25% OF STUDENTS IN PERSON, UH, BECAUSE WE'RE SURE THAT, THAT THOSE CHILDREN WHO REALLY MUST BE IN PERSON HAVE THE OPPORTUNITY TO BE IN PERSON.

THOSE ARE OUR, YOU KNOW, OUR SPECIAL NEEDS STUDENTS.

THOSE ARE INDIVIDUALS, UH, STUDENTS WHO MAY NOT HAVE ACCESS TO DIGITAL SERVICES AT HOME, OR A SUPPORT STRUCTURE AT HOME TO SUPPORT EDUCATION.

UH IT'S YOU KNOW, THOSE K THROUGH FIVE STUDENTS THAT I'VE MENTIONED BEFORE, UH, AND WE'VE GOT TO MAKE SURE THAT WE HAVE THE PROCESSES WORKING WITH A SMALL PERCENTAGE OF STUDENTS, MAKE SURE THAT WE WORK OUT THE DETAILS OF THE SPACING AND THE MASKING AND THE SOCIAL DISTANCING AND THE HAND WASHING AND, AND HOW THE CAFETERIA SERVICES AND TRANSPORTATION SERVICES ARE GOING TO WORK.

UH, THERE'S STILL A LOT OF HEAVY LIFTING TO DO FOR OUR SCHOOL DISTRICTS.

UH, AND YOU KNOW, ONE OF THE THINGS THAT I WANT TO MENTION IS THAT, YOU KNOW, THERE'S STILL ONGOING DISCUSSION ABOUT, ABOUT ATHLETICS AND WHAT WE SHOULD DO ABOUT THAT, BOTH AT THE, AT THE, UH, YOU KNOW, SECONDARY SCHOOL LEVEL AND AT THE COLLEGE LEVEL.

AND, YOU KNOW, I, I THINK WE REALLY HAVE TO FOCUS ON THE PRIMARY MISSION AND THAT'S EDUCATION.

AND ONCE WE SORT THAT OUT, ONCE WE GET INTO A BETTER SITUATION TO GET KIDS IN CLASSROOMS, THEN WE NEED TO HAVE THE DISCUSSION ABOUT, ABOUT THE OTHER ELEMENTS OF, OF, UH, THE ACTIVITIES AFTER CURRICULAR ACTIVITIES.

UH, BUT WE'VE GOT A LOT OF WORK TO DO.

YEAH.

WHAT CONCERNS ME A LOT IS, YOU KNOW, ONE OF THESE YOUNG KIDS COULD GET INFECTED AND, YOU KNOW, A LOT OF MY PEOPLE IN DISTRICT THREE, AND I'M PRETTY SURE IT'S THE DISTRICT ONE AND TWO ALSO.

AND THEN FOR WHERE THE BIG FAMILIES ARE WITH THE ACADEMY, THE WAY, UH, THEY'RE MOVING IN INTO ONE HOUSE.

SO YOU PROBABLY GOT MULTI-FAMILIES LIVING THERE.

AND THAT'S WHAT REALLY FRIGHTENED ME IS YOU'RE, YOU'RE, YOU'RE GOING TO SEND A KID TO SCHOOL THAT WE SHOULD ALSO REALLY FOCUS ON.

THE FAMILIES ARE SENDING THEIR KIDS THERE AND EDUCATE THEM TO IMMEDIATELY, YOU KNOW, TAKE CARE OF ONE OF THEM GET AFFECTED BECAUSE I KNOW INCIDENT WHERE ONE PERSON GETS AFFECTED INFECTED AND THEY GO, THEY ARE ONES GET TESTED AS NEGATIVE, AND THEN FIVE OR SIX DAYS DOWN THE ROAD, THEY, THEY GET INFECTED, YOU KNOW, SO IT'S JUST BECAUSE YOU GET A TEST AND IT COMES NEGATIVE THE FIRST TIME DOESN'T MEAN YOU CAN'T GET IT LATER ON, BUT SHE HAD A HEART CONDITION AND WHERE BUDDIES THERE AND THE HEAT, THE WAY IT IS HERE IN TEXAS, EVERYBODY'S STAYING INSIDE HER CONDITION.

SO, UM, I'M VERY CONCERNED ABOUT THAT.

GREAT.

THANK YOU.

ANYTHING ELSE WHILE WE HAVE THE KITCHEN, UH, THIS CAN BE ANSWERED LATER.

UM, I WOULD JUST LIKE, AT SOME POINT TO UNDERSTAND WHAT THE DECISION MAKING IS AROUND, UM, ADDING AN ADDITIONAL PRO-LIFE.

UM, LAST I HEARD THAT WE HAD A WAITING LIST FOR OUR PRO LODGES, UH, FOR HOMELESS INDIVIDUALS.

AND SO, UM, I'D LIKE TO UNDERSTAND, UM, IF IT'S BEING, I THOUGHT IT'D BEEN CONSIDERED TO OPEN A PROLOGUE, I'D LIKE TO UNDERSTAND WHAT ARE THE, UH, CRITERIA TO DETERMINE IF THAT'S A YES OR NO, AND WHO'S MAKING THAT DECISION WHEN, SO, UM,

[00:50:01]

SO A AGAIN, IT'S NOT SOMETHING YOU HAVE TO SPEAK TO TODAY UNLESS YOU, YOU KNOW THAT, BUT, UM, I WOULD LIKE TO UNDERSTAND THAT THE PRO LODGES HAVE BEEN PRETTY SUCCESSFUL, UH, IN TERMS OF DRESSING OUR HOMELESS RISKS FOR HOMELESS INDIVIDUALS.

IT'S ALSO, IT'S ALSO, UM, INTENDED TO BE A PATH TO HOUSING, AS YOU MENTIONED EARLIER.

UM, AND SO A 300 IS, IS, IS CERTAINLY TO BE, UM, YOU KNOW, TO FEEL, TO FEEL GOOD ABOUT 300 PEOPLE IN OUR PRO LODGES, YOU KNOW, THERE'S ADDITIONAL NEED.

SO I'M WANTING TO UNDERSTAND WHERE THAT STANDS.

MAYBE IT'D BE HELPFUL MANAGER TO GET AN UPDATE ON THE REAL ESTATE ISSUES.

CAUSE I KNOW THAT THERE'S SOME ACTIVITY HAPPENING THERE IN PART IN RESPONSE TO COUNCIL KITCHENS, A QUESTION WE'LL DO WHEN WE PLAN TO BRING THIS UP AT THE AUGUST 4TH WORK SESSION, AND SOME WILL HAVE A FULL BRIEFING ON THIS.

THANK THANKS COUNCIL MEMBER ALTAR.

THANK YOU.

ON THAT SAME POINT, IF YOU CAN ALSO UPDATE US ON THE, THE HOTEL THAT WE PURCHASED AND WHEN THAT WILL BE ONLINE, CAUSE IT SHOULD BE ABOUT ONLINE FROM THE PRIOR, UM, PREDICTIONS AND THAT MAY PROVIDE SOME ADDITIONAL WAY TO TRANSITION FOLKS INTO, UM, HOUSING WE'LL DO.

OKAY.

ANYTHING ELSE? ALRIGHT, SORRY.

JUST BEFORE WE CLOSE OUT, I WANT TO ADD MY VOICE TO THE CHORUS THAT I REALLY LIKE US TO SEE.

SHE HAS TO MAKE ANOTHER PURCHASE SOON.

AND, UH, BECAUSE I THINK WE'RE IN MY VIEW BEHIND TIMELINE ON THAT AS WELL AS THE WORKER RESOURCE CENTER QUESTION THAT I HAD ASKED EARLIER.

SO I'D REALLY LIKE TO SEE BOTH OF THOSE UP AND RUNNING AS SOON AS, AND I THINK THAT'S TRUE FOR ME BEFORE.

I THINK THE COMMUNITY NEEDS TO SEE US PROACTIVELY TAKING STEPS TO, TO PROVIDE PERMANENT SUPPORTIVE HOUSING OPPORTUNITIES AND TO TRY TO LEVERAGE THE OPPORTUNITIES YOU HAVE NOW TO DELIVER THAT.

AND THEN I JUST WANT TO CONCLUDE AS YOU GUYS DO OFF, UM, I THINK THAT YOU AND YOUR STAFFS HAVE DONE A REALLY GOOD JOB, ESPECIALLY WITH DR.

ASCOT AND DIRECTOR HAYDEN, UH, FOR US TO HAVE HALF THE COMMUNITY RESPONSE.

AND WE HAD HAPPENS IN NO SMALL PART BECAUSE OF THE MESSAGING THAT'S COMING OUT OF OFFICES AND THE WORK THAT YOUR STAFFS ARE DOING.

UM, WE'VE DRIVEN DOWN THE NUMBERS AND THAT GIVES OUR CITY A REALLY UNIQUE OPPORTUNITY, UH, TO BE ABLE TO GET TO A PLACE WHERE MAYBE WE'RE GOING TO BE IN A STRONGER AND BETTER POSITION TO BE ABLE TO SUSTAIN THE OPENING IN SCHOOLS OR IN A BETTER, STRONGER POSITION, TO BE ABLE TO SUSTAIN BUSINESSES, BEING OPEN.

IF WE'RE INCREDIBLY PROTECTIVE OF THIS OPPORTUNITY, WE HAVEN'T GIVEN OURSELVES.

UH, WHICH MEANS THAT EVEN WHILE THE NUMBERS LOOK GOOD, AS YOU SAID, DR.

SCOTT PEOPLE HAVE TO DOUBLE DOWN ON THEIR WEARING FACE COVERINGS AND SOCIAL DISTANCING.

NOW THAT WE SEE THAT THAT WORKS, THEN PEOPLE HAVE TO BE PREPARED TO DO THIS INDEFINITELY UNTIL THERE'S A BACKSEAT.

BUT WITH THAT INCONVENIENCE MAY REALLY COME OPPORTUNITIES THAT WE CAN SHOW HOW IT WORKS.

AND THERE HAVE NOT BEEN MANY CITIES THAT HAVE BEEN ABLE TO MAINTAIN THAT VIGILANCE AND DILIGENCE WHEN THINGS GET GOOD, UM, OR WE NEED TO MAKE SURE THAT OUR COMMUNITY IS OKAY WITH THAT.

WE'LL LET YOU GO.

UM, THANK YOU VERY MUCH.

THE MAYOR.

YES, MAYOR.

HOW'S THAT GOING? I JUST WANTED TO ACKNOWLEDGE SOMETHING.

DIRECTOR HAYDEN SAID EARLIER ABOUT 17 INDIVIDUALS LEAVING THE PRO LODGES INTO PERMANENT HOUSING.

YOU KNOW, WE ALL HAD QUESTIONS AND COMMENTS AND NOBODY HIT ON THAT.

AND I JUST WANT TO RECOGNIZE THE SIGNIFICANCE OF THAT.

THAT'S REALLY TREMENDOUS.

AND SO THANK YOU TO BELLA CARMEN AND DIRECTOR HAYDEN AND ALL OF MANY OTHERS IN PUBLIC HEALTH WHO ARE MAKING SURE THAT, YOU KNOW, FOR OUR, OUR NEIGHBORS WHO ARE EXPERIENCING HOMELESSNESS, THAT THE PANDEMIC BECOMES A WAY OF, OF REALLY, UM, GETTING THEM INTO SAFE AND STABLE HOUSING.

SO THANK YOU FOR, THANK YOU FOR HIGHLIGHTING THAT, THAT INFORMATION.

THIS MORNING, DIRECTOR HAYDEN, WE'RE GOING TO RELEASE SIDE'S ROCK DR.

SCOTT AND THEN DIRECTOR.

CADEN IS GOING TO INTRODUCE THE PRESENTATION FROM THE UT PARTNERS THAT WE HAVE ON THE NURSING HOME STUDY.

OKAY.

THANK YOU.

THANK YOU VERY MUCH FOR THE PRESENTATION.

UM, AT THIS TIME ON THIS ON MAY SEVEN, UM, COUNCIL, UM, PASSED A RESOLUTION THAT DIRECTED THE CITY MANAGER TO PLAN AND COLLABORATE WITH THE DESIGN INSTITUTE FOR HEALTH, UM, AT DELL MEDICAL SCHOOL TO ANALYZE, EVALUATE, AND IDENTIFY APPROACHES FOR SYSTEMS IMPROVEMENTS, TO PROTECT RESIDENTS AND REDUCE THE RISK OF SPREAD

[00:55:01]

OF COVID-19 IN NURSING HOMES, ASSISTED LIVING CENTERS AND OTHER LONGTERM CARE FACILITIES.

TODAY I HAVE STACY CHAIN IS WHO IS GOING TO PROVIDE A PRESENTATION, AND THIS IS, UM, ONE OF THE FIRST, UM, PRESENTATIONS THAT THEY ARE GOING TO PROVIDE.

AND SO I WILL TURN OVER TO HIM AND KEITH, THANK YOU, DIRECTOR HAYDEN, HOPEFULLY YOU ALL CAN HEAR ME.

YES.

UH, IF, UH, IF YOU COULD BRING UP THE SLIDES, UM, UH, WE'LL, UH, I'LL BEGIN THE BRIEFING THEN, WHILE WE'RE WAITING FOR THAT, BY WAY OF INTRODUCTION, MY NAME IS STACY CHANG.

I AM THE EXECUTIVE DIRECTOR FOR THE ZIONIST STATE FOR HEALTH.

UM, AND AS A DIRECTOR HAYDEN MENTIONED, UM, UH, THIS BRIEFING IS A REPORT.

IF YOU GO TO THE NEXT SLIDE, UM, IS A REPORT BACK ON THE FIRST PHASE OF STUDY THAT WE'VE CONDUCTED OVER THE COURSE OF THE LAST TWO MONTHS.

UM, A PARTICULAR NOTE OF GRATITUDE TO DIRECTOR HAYDEN, DR.

ESCADA AND TO ANDREA HAN FEEDS FROM AUSTIN PUBLIC HEALTH FOR HELPING TO FACILITATE THIS STUDY.

UM, THEY'RE HARD ONE PERSPECTIVE FROM THE FRONT LINES OF THIS CRISIS HAS BEEN PARTICULARLY HELPFUL.

UM, SO I'M GOING TO GIVE YOU A BRIEF RUNDOWN ON, UM, THE WORK THAT WE'VE DONE TO DATE A LITTLE BIT OF GROUNDING AROUND NURSING HOMES, BUT I WANT TO SPEND THE BULK OF THE TIME DISCUSSING, UM, FOR, UH, INSIGHTS THAT HAVE EMERGED FROM THIS FIRST PHASE OF WORK AND LEAVE ROOM FOR A BIT OF DISCUSSION AND QUESTIONS FROM THE COUNCIL ITSELF.

UM, IF YOU GO TO THE NEXT SLIDE, UH, WE ARE JUST CONCLUDING THIS FIRST PHASE OF STUDY, WHICH WE TERMED THE FOCUS INVESTIGATION, UH, BECAUSE IN IT, UH, WE STUDY KNOWN AREAS OF CONCERN.

SO WE LOOKED AT FACILITY ISSUES SUCH AS PHYSICAL SPACE AND LAYOUT AND PROXIMITY OF STAFF AND RESIDENTS AND DENSITY AND FLOW THROUGH THE FACILITIES AS WELL AS SHARED UTILIZATION OF SPACE.

UH, WE ALSO LOOKED AT OPERATIONAL FRAMEWORKS AND PROCESSES, INCLUDING CARE PROTOCOLS, UH, GROUP ACTIVITIES, UH, CAREGIVER, HANDOFFS, AND SCHEDULING AND TIMING OF CARE.

AND THEN FINALLY, UH, FOCUSED A FAIR AMOUNT OF EFFORT, UH, UNDERSTANDING, UH, THE CHALLENGES AROUND STAFFING, WHICH I WOULD CONSIDER BOTH PERSONNEL ROLES AND RESPONSIBILITIES AS WELL AS STAFF CONCERNS AND PRIORITIES.

UM, THE SUBSEQUENT PHASE OF RESEARCH, UM, WHICH BEGINS THIS WEEK, UH, WHICH WE'VE TERMED THE BROADENED INVESTIGATION WILL BE INFORMED BY THE DISCOVERIES FROM THIS FIRST PHASE, UH, WHICH I WILL SHARE SHORTLY.

UM, AND THEN PHASES THREE, FOUR, AND FIVE ARE MEANT TO DEVELOP RESPONSES TO THE CHALLENGES IDENTIFIED IN PHASES ONE AND TWO, UM, TOGETHER EVIDENCE FOR EFFICACY, AND THEN TO MAKE RECOMMENDATIONS FOR CHANGES, UH, BASED ON THAT EVIDENCE, I WILL NOTE, UM, AT THIS MOMENT WE HAVE, WE ARE NOT PROPOSING SOLUTIONS JUST YET, ALTHOUGH WE HAVE PLENTY OF IDEAS, UM, AS WE REQUIRE SOME ADDITIONAL DEPTH AND BREADTH FROM THE RESEARCH EFFORT BEFORE WE DRAW SPECIFIC CONCLUSIONS ABOUT, ABOUT THE DEFINITIVE ISSUES WE WANT TO ADDRESS, UH, NEXT SLIDE, PLEASE, THE INSTITUTE, UM, HAS SPECIFIC EXPERTISE IN THE PROCESS OF IDENTIFYING AND SOLVING COMPLEX SYSTEMIC PROBLEMS. UM, BUT WE ARE NOT EXPERTS IN NURSING HOMES PER SE.

AND SO WE, UH, RECRUITED A NOTABLE CAST TO SERVE AS THE STEERING COMMITTEE ON THIS PROJECT, INCLUDING FROM, FROM APH, UM, AS WELL AS MICHELLE DION MAHOLICK AND MICHAEL GALE FROM THE STATES HEALTH AND HUMAN SERVICES COMMISSION.

UH, I WANT TO MAKE PARTICULAR NOTE OF THAT.

UM, AS PART OF THE, AS THE STATE AGENCY WITH STATUTORY OVERSIGHT OVER THE NURSING HOMES, UM, THEY'VE BEEN QUITE INVALUABLE AND PROVIDING PERSPECTIVE ON REGULATION, QUALITY IMPROVEMENT, UM, POLICY AND ENFORCEMENT, UH, THEIR PARTICIPATION IN PARTICULAR HAS BEEN, UH, UNIQUELY HELPFUL AND UNDERSTANDING THE BALANCE OF INFLUENCES ON NURSING HOMES.

UM, THE REMAINDER OF THE STEERING COMMITTEE IS ROUNDED OUT BY LEADERSHIP FROM THE, FROM THREE SCHOOLS AT UT, UH, SCHOOL OF NURSING SOCIAL WORK.

AND, UH, OF COURSE THE MEDICAL SCHOOL AS WELL.

NEXT SLIDE, PLEASE.

UM, IN THIS FIRST PHASE OF WORK, WE BEGAN, UH, WITH SECONDARY RESEARCH TO FORM A BASELINE UNDERSTANDING OF THE NURSING HOME LANDSCAPE AND, UM, AND THE CURRENT COVID, UH, 19 RESPONSE, UH, BOTH THAT LOCAL REGIONAL AND NATIONAL LEVELS.

UH, AND THEN THE CONDUCTED NEARLY 50 INTERVIEWS AND OBSERVATIONS IN FACILITIES, UH, WITH EVERY MANNER OF STAFF, UH, LISTED HERE, UM, ALONG WITH SUBJECT MATTER EXPERTS, UM, UH, EITHER ON THE STEERING COMMITTEE OR RECOMMENDED BY THE STEERING COMMITTEE MEMBERS, UH, MUCH OF THE INTERVIEW AND OBSERVATION WORK WAS DONE ONSITE IN NURSING HOME FACILITIES.

WE HAD PLANNED TO, UM, UH, VISIT FIVE SITES, UH, SPREAD AROUND AUSTIN.

UM, WE COMPLETED FOUR OF THEM.

THE FIFTH HAD A COVERT OUTBREAK JUST AS WE WERE ABOUT TO, UM, UH, TO VISIT, UH, AND WITH RESPECT TO, UM, MANAGING INFECTION, BOTH FOR STAFF AND RESIDENTS AND FOR THE TEAM.

WE DEFERRED THAT UNTIL LATER THIS WEEK, GO TO THE NEXT SLIDE, PLEASE.

THESE ARE THE FIVE FACILITIES REPRESENTED IN THE PHASE OF WORK.

YOU'LL SEE, ON THE LEFT A MAP OF THE FIVE FACILITIES AND THEN SOME DETAILS IN THE IMAGES ON THE RIGHT.

UM, THERE'S A GEOGRAPHICAL DIVERSITY HERE THAT IS NOT YET COMPLETE.

UM, WE RECOGNIZE

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THAT THERE'S A GAP ON THE EAST AND SOUTH SIDE, UH, WHICH WE WILL REMEDY IN THE COMING, UH, PHASE OF WORK.

UH, WE WILL, UM, SOME OF THE FACILITIES INCLUDED MEMORY CARE UNITS, UH, CARING FOR PATIENTS WITH DEMENTIA, UM, UH, AND ONE INCLUDED INDEPENDENT LIVING FACILITIES AS WELL.

UM, WE WILL FOCUS MORE INTENTIONALLY ON ASSISTED LIVING AND INDEPENDENT LIVING IN THE SECOND PHASE OF WORK FOR THIS FIRST PHASE OF WORK.

UH, THE FOCUS REALLY WAS ON SKILLED NURSING FACILITIES.

UH, ALSO KNOWN AS NURSING HOMES.

IF YOU GO TO THE NEXT SLIDE, JUST AS A BRIEF GLIMPSE INTO OUR PROCESS, WE DON'T JUST CONDUCT INTERVIEWS.

WE ACTUALLY OBSERVED FACILITIES AND PERSONNEL IN OPERATION FIRSTHAND INTERVIEWS ARE USUALLY ONLY THE BEGINNING OF THE STORY.

THEY ARE THE TRUTH THAT PEOPLE, UH, CAN OR CHOOSE TO RELATE.

WE'D LIKE TO SEE WHAT LIES BEHIND, UH, BENEATH THAT VENEER.

UM, I WON'T NARRATE EACH OF THESE PHOTOS TO YOU.

THEY ARE IN THE COMPREHENSIVE REPORT THAT WE FILED WITH THE CITY, AND I THINK WAS PROVIDED TO THE COUNCIL MEMBERS AS A PREREAD.

YOU'RE WELCOME TO DIG INTO MORE OF THAT DETAIL.

UM, I WILL SAY THAT WE HAD THE OPPORTUNITY TO SEE EVERY MANNER OF OPERATION IN A COVID-19 CONTEXT FROM LAUNDRY AND FOOD SERVICE TO SOCIAL DISTANCING AND ISOLATION PROTOCOLS.

AND IF YOU GO TO THE NEXT SLIDE, UM, UM, UH, WE SAW QUITE A BIT OF, UH, HOW SPACE INSIDE NURSING HOMES WAS BEING CONVERTED AND WORKFLOW WAS BEING ADJUSTED TO ABIDE BY INFECTION PROTOCOLS.

SO THAT'S THE BRIEF INTRODUCTION.

I WANT TO ESTABLISH A LITTLE BIT OF CONTEXT IF YOU GO TO THE NEXT SLIDE.

UM, I THINK UNLESS YOU'VE SPENT SUBSTANTIAL TIME, OOPS, SORRY.

THE SLIDE PREVIOUS, UH, UM, THANK YOU.

UH, UNLESS YOU'VE SPENT SUBSTANTIAL TIME INSIDE A NURSING HOME OVER THE LAST DECADE, YOU MIGHT NOT RECOGNIZE HOW MUCH IT HAS CHANGED.

UM, AND THE INSIGHTS THAT HAVE EMERGED FROM THIS FIRST PHASE OF WORK, I THINK REQUIRE A BIT OF FAMILIARITY WITH SOME OF THE CHALLENGES THAT THE FACILITIES, THE STAFF AND THE INDUSTRY FACES A WHOLE.

I WON'T PRESERVE YOU.

I WON'T PRESUME YOU ARE ALL EXPERTS IN NURSING HOME CARE.

SO I'LL SHARE WITH YOU A FEW FACTS TO GROUND YOU IN THE REALITY OF THE INDUSTRY BEFORE WE DIG INTO THE INSIGHTS.

NEXT SLIDE PLEASE.

UM, SO THE, THE TYPE OF FACILITY DEPENDS, UM, UH, UH, QUITE SIGNIFICANTLY ON PATIENT ACUITY, ESSENTIALLY HOW MUCH MEDICAL CARE AND LIVING ASSISTANT AND INDIVIDUAL NEEDS.

OUR FOCUS IN THE FIRST PHASE OF WORK IS AT THE HIGH NEED HIGH LEVEL OF CARE SIDE OF THE SPECTRUM, THE SKILLED NURSING FACILITIES.

AGAIN, WHAT WE, UH, USUALLY CALLED NURSING HOMES.

UM, WE WILL EXPAND, UH, OUR INVESTIGATION INCLUDE INDEPENDENT LIVING ASSISTED LIVING AND MAYBE EVEN SOME IN HOME CARE.

UM, UH, WE, UH, UH, THOSE ASSISTANT DEPENDENT LIVING ARE SOMETIMES PART OF WHAT WE CALL A COMMUNITY CONTINUING CARE RETIREMENT COMMUNITY, UH, WHICH USUALLY INVOLVES ALL THREE LEVELS OF CARE.

UH, AND WE DID HAVE AN OPPORTUNITY TO SEE ONE OF THOSE IN THIS FIRST PHASE OF STUDY.

NEXT SLIDE PLEASE.

SO AN IMPORTANT POINT TO EMPHASIZE HERE IS THAT THE LEVEL OF PATIENT CARE IN NURSING HOMES TODAY IS SIMILAR TO WHAT YOU WOULD HAVE FOUND IN A HOSPITAL JUST A DECADE OR TWO AGO, UH, UM, WOUND CARE, INTRAVENOUS THERAPY, ORTHOPEDIC CARE, BREATHING TREATMENTS ARE ALL STANDARD PROTOCOLS IN NURSING HOMES.

RIGHT NOW THEY'RE VERY MUCH MEDICAL FACILITIES AND NOT RETIREMENT HOMES, AS YOU MIGHT HAVE REMEMBERED FROM, UM, FROM A COUPLE OF DECADES AGO.

NEXT SLIDE PLEASE.

UM, THE MOST COMMON REASON FOR RESIDENTS IN THE NURSING HOME IS THE INABILITY FOR SOMEONE TO PERFORM ACTIVITIES OF DAILY, LIVING BATHING, UH, UH, UH, CHANGING CLOTHES, FEEDING THEMSELVES, UH, MORE THAN 80% OF RESIDENTS NEED HELP WITH THREE OR MORE, UH, ACTIVITIES OF DAILY LIVING.

UH, MORE THAN 90%