* This transcript was created by voice-to-text technology. The transcript has not been edited for errors or omissions, it is for reference only and is not the official minutes of the meeting. [00:00:04] I WANNA WELCOME YOU TO OUR DECEMBER MEETING OF THE COMMUNITY HEALTH AND EQUITY COMMITTEE CLERK. MAY I HAVE A ROLL CALL? COUNCIL MEMBER TREVINO HERE. COUNCIL MEMBER ANDREW SULLIVAN. HERE. COUNCIL MEMBER VRAN. HERE. COUNCIL MEMBER GONZALEZ AND CHAIR SANDOVAL HERE. THANK YOU. OKAY. NANCY, I'M IMAGINING YOU SAID THAT WE HAVE A QUORUM. I DID. I'M SORRY. WE DO HAVE A QUORUM CHAIR. . NO PROBLEM. OKAY. I'M GONNA MOVE [1 20-7265 Approval of the meeting minutes for the November 16, 2020 Community Health and Equity Committee Meeting.] ON TO, UH, TO ITEM ONE, AND THAT IS APPROVAL OF THE MEETING MINUTES FOR NOVEMBER 16TH TO APPROVE. SECOND. ALL IN FAVOR SAY AYE. AYE. AYE. ANY OPPOSED? MOTION PASSES. ALRIGHT. UH, BEFORE [Additional Item] WE MOVE INTO OUR BUSINESS, I WANNA TAKE A MOMENT TO, UH, RECOGNIZE DR. BRIDGER. SHE IS HAS BEEN THE ONLY LIAISON TO THIS COMMITTEE, UH, SINCE IT BEGAN, UH, BECAUSE OF HER ROLE. AND, OH, ACTUALLY IT WAS ROD FIRST. SORRY, I FORGOT ABOUT THAT. . UH, BUT, UH, SOMETHING THAT'S CALLED COMMUNITY HEALTH AND EQUITY. I THINK WE'RE VERY LUCKY TO HAVE SOMEONE LIKE DR. BRIDGER LEAD IT AND, UH, I DON'T THINK THERE, THERE COULD HAVE BEEN A, A BETTER FIT BASED ON HER, HER BACKGROUND AND HER INTEREST AND, AND THE REAL GOALS OF THIS COMMITTEE. SO I WANTED TO THANK HER BECAUSE TODAY IS HER LAST, UH, CHECK MEETING, NOT HER LAST COUNCIL MEETING. THERE'LL BE MORE OF THOSE, BUT IT IS HER LAST CO COMMITTEE MEETING WITH US. SO I WANNA THANK HER FOR HER SERVICE TO, TO THE COMMITTEE, AND I'LL OPEN IT UP TO COMMENTS FROM, FROM THE OTHER MEMBERS. CHAIR. MAY I START? UH, I JUST, I WANT TO THANK, UH, DR. BRIDGE FORAL. SHE'S DONE, UH, BECAUSE HER WORK REALLY EXTENDS, UH, IS, IS AN EXAMPLE. IT EXTENDS OUTSIDE OF THIS COMMITTEE AND, AND HELPS MANY OF THE GROUPS. UH, WE, WE WERE JUST, WE JUST HAD ANOTHER, UM, BOARD MEETING WITH THE BEAR APPRAISAL DISTRICT AND I JUST CAN'T THANK HER ENOUGH FOR, UH, GOING ABOVE AND BEYOND AND HELPING, UH, ANOTHER ORGANIZATION LIKE THAT THAT WAS REQUESTING SOME HELP AND SUPPORT AND SHE PROVIDED IT. SO, THANK YOU. ARE WE JUST GONNA GO ON THE ROW? OKAY. GREAT. UM, DR. BRIDGER, THANK YOU. THANK YOU, THANK YOU, THANK YOU. I DON'T KNOW HOW MANY WAYS AND SHAPES AND FORMS AND FASHIONS WE CAN SAY THANK YOU. UM, THANK YOU FOR STAYING UP ALL THE LATE NIGHTS, WORKING ALL THE EARLY MORNINGS, UM, LISTENING TO ALL OF OUR QUESTIONS AS WE ASK YOU QUESTION AFTER QUESTION AND BEING READY TO ANSWER. UM, AND IF YOU DIDN'T HAVE IT, FINDING THAT ANSWER AND GETTING IT BACK TO US. UM, THANK YOU FOR AMPLIFYING OUR VOICES WHEN WE WERE TALKING ABOUT RACISM AS A PUBLIC HEALTH CRISIS. AND JUST THANK YOU FOR BEING THE GENUINE PERSON THAT YOU ARE TO THE CITY OF SAN ANTONIO, AND THE WORK THAT YOU CONTINUE TO DO. WE ASK THAT YOU CONTINUOUSLY BE BLESSED AND WE LOOK FORWARD TO THE WORK THAT YOU'RE GONNA CONTINUE TO DO FOR THE REST OF THE CITY OF SAN ANTONIO. SO, THANK YOU AGAIN. THANK YOU MADAM CHAIR. DR. PRITCHER, UM, I'M KIND OF NEW TO THIS COMMITTEE, SO THANK YOU VERY, UH, THANK YOU JUST FOR YOUR WORK IN GENERAL. I MEAN, UH, WE'LL, I, I KNOW YOU'VE DONE A LOT OF WORK FROM STARTING AS THE DIRECTOR, UH, OF METRO HEALTH TO CONTINUING TO WORK IN THIS CAPACITY, SO, UH, HEY, DON'T WORRY. PLENTY MORE WORK, . WELL, THANK YOU EVERYBODY. THANK YOU CHAIR. UM, THAT I WAS NOT EXPECTING THIS. I DO NOT HAVE A SPEECH. UM, I JUST WILL SAY WE'RE FORTUNATE THAT WE HAVE A COMMITTEE LIKE THIS AND WE HAVE PEOPLE LIKE YOU ON THIS COMMITTEE THAT KEEP COMMUNITY HEALTH AND EQUITY AT THE FOREFRONT OF OUR DECISION. SO, UM, CITY'S IN GREAT HANDS. IT'S BEEN A PLEASURE TO WORK WITH ALL OF YOU AND, UM, I DON'T IMAGINE, UH, THIS WILL BE THE LAST OPPORTUNITY WE HAVE EACH OTHER. SO THANK YOU. AND THOSE ARE MY COMMENTS. THANK YOU. NO, THANK YOU FOR YOUR SERVICE TO THIS COMMITTEE. SORRY, THAT JOKE NEVER GETS OLD. I'M GONNA KEEP USING IT. ALRIGHT, IN ALL SERIOUSNESS, THANK YOU DR. BRIDGER, FOR YOUR SERVICE TO OUR COMMITTEE. UM, [2 20-7200A briefing on COVID-19 vaccines and distribution plans [Colleen M. Bridger, MPH, PhD, Assistant City Manager; Anita Kurian, MBBS, MPH, DrPH, Assistant Director, Health]] ALL RIGHT, WE'LL MOVE ON TO OUR BUSINESS FOR TODAY, A BRIEFING ON C OVID [00:05:01] 19 VACCINES AND DISTRIBUTION PLANS, DR. BRIDGER. SO, UM, TODAY YOU'LL BE HEARING FROM DR. ANITA DURIAN, UH, WHO WILL GIVE YOU A PRESENTATION OF, UM, WHAT WE KNOW TODAY ABOUT C 19 VACCINATION. SO, DR. K, TAKE IT AWAY HERE. I'M JUST WAITING FOR MY SLIDES TO LOAD. GOOD AFTERNOON. THERE YOU GO. THANK YOU. WITH, UM, F D A WORKING RAPIDLY TOWARDS FINALIZING, UH, GRANTING AN EMERGENCY USE AUTHORIZATION FOR THE COVID PFIZER COVID-19 VACCINE, UH, WE EXPECT THE LARGEST MASS VACCINATION CAMPAIGN EVER ATTEMPTED IN THE HISTORY OF OUR NATION TO BEGIN AS SOON AS NEXT WEEK. UM, SO THIS TITLE SLIDE APLY SUMS UP ALL OUR SENTIMENTS. VACCINES ARE COMING, AND BEFORE WE KNOW IT, IT WILL BE THE WE DAY. THE VACCINE DAY WILL BE UPON US, AND THE BEGINNING OF THE END TO THIS, UM, LONG PANDEMIC IS STARTING TO FINALLY COMING TO FOCUS. UM, SO I'LL JUMP RIGHT INTO MY PRESENTATION. UM, NEXT SLIDE, PLEASE. YES, SO I'M SURE MANY OF YOU HAVE SEEN THIS SLIDE ALREADY. HERE'S THE LIST OF THE SIX VACCINE CANDIDATES THAT HAVE BEEN SELECTED BY OPERATION WAP SPEED AS THE MOST PROMISING COUNTERMEASURE CANDIDATES, AND THEY HAVE BEEN ALSO PROVIDED COORDINATED, UH, FOR SUPPORT TO DEVELOP THESE VACCINES. SO , THESE VACCINES. SO I'M GONNA FOCUS ON THE FIRST FOUR, WHICH ARE FURTHEST ALONG IN THIS LIST IN TERMS OF CLINICAL TRIALS AS WELL AS F D A SUBMISSIONS FOR E U A OR APPROVALS. UM, PFIZER AND MODERNA, THEY ARE THE MRNA VACCINES THAT IS USING THE NOVEL GENE TECHNOLOGY PLATFORMS, ASTRAZENECA AND JAN OR JOHN AND JANSSEN AND JOHNSON JOHNSON VACCINES. THEY'RE NON REPLICATING VIRAL VECTOR VACCINES. SO WHAT THAT MEANS IS THAT RELEASE VACCINES CONTAIN VIRUSES THAT ARE ENGINEERED TO CARRY THE CORONAVIRUS GENES. ALL FOUR OF THEM REQUIRE TWO DOSES EXCEPT FOR THE JANSSEN ONE, SORRY, EXCEPT FOR THE JANSSEN. ALL THREE OF THEM, UH, THE OTHER THREE REQUIRE TWO DOSES. THE FINAL VACCINE HAS THE ULTRA COLD STORAGE, WHICH IS CERTAINLY GOING TO POSE SOME CHALLENGES FOR THE COVID 19 VACCINE PROVIDERS. MODERNA AND JANSSEN VACCINE HAS FROZEN STORAGE REQUIREMENTS AND ASTRAZENECA VACCINE CAN BE STORED REFRIGERATED. NOW, ONE THING TO REMEMBER WITH THIS COVID 19 VACCINE IS THAT YOU CAN MIX AND MATCH VACCINE DOSES FROM DIFFERENT MANUFACTURERS. SO IF YOU BEGIN, IF YOU BEGIN WITH PFIZER VACCINE, YOU ARE EXPECTED TO END WITH PFIZER VACCINE. SO IF YOU RECEIVE, UM, UH, MODERNA AS THE FIRST DOSE, YOU ARE EXPECTED TO HAVE THE SECOND DOSE AS A MODERNA UH, VACCINE ALSO. SO BASED ON, UH, BOTH THE, UH, MODERNA AS WELL AS THE PFIZER REPORTS, BOTH THESE VACCINES WERE PUT OUT THERE AS SAFETY EFFICACY DATA IN PUBLIC DOMAIN. BOTH THESE VACCINES HAVE EFFICACY RATES, UH, APPROXIMATELY ABOUT, UH, UPWARDS OF 92% AT THIS TIME. NEXT SLIDE, PLEASE. SO WHAT YOU SEE UP THERE, UM, I REFER TO AS THE PATHWAY TO VACCINATION. AND THIS IS PATHWAY TO VACCINATION FOR THE PFIZER VACCINE SPECIFICALLY, UH, WHICH IS ESSENTIALLY, UH, THE TE TIMELINE FOR WHEN YOU CAN EXPECT THE PFIZER VACCINE, SHOULD WE BE AVAILABLE FOR ADMINISTRATION INTO THE ARMS OF THE PRIORITY POPULATION TO BEGIN WITH. SO AS YOU ALREADY KNOW BY THIS TIME, UM, WE'RE BACK, WHICH IS A VACCINE AND RELATED BIOLOGICAL PRODUCT PRODUCT ADVISORY COMMITTEE OF F D A. THEY MET IN AN OPEN SESSION YESTERDAY, AND ACCORDING TO THE F D A, UM, RELEASE THIS, UH, LATE YESTERDAY EVENING, THEY ARE WORKING TOWARDS GRANTING THE EMERGENCY USE AUTHORIZATION TO THE PFIZER VACCINE AND HAVE NOTIFIED C D C AND OPERATION WEB SPEED TO MOVE FORWARD WITH THEIR PLAN FOR TIMELY VACCINE DISTRIBUTIONS. SO THIS PAVES THE WAY TO BEGIN SHIPPING THESE VACCINES TO THE STATES AND THE VACCINES, UM, CANNOT BE GIVEN, AND THIS IS VERY IMPORTANT TO KNOW THEY CAN BE SHIPPED TO THE STATES, BUT THEY CANNOT BE GIVEN UNTIL THE CDCS VACCINE ADVERSARY, UM, GROUP MEETS AND MAKE VACCINE SPECIFIC RECOMMENDATIONS. SO THAT COMMITTEE, WHICH IS THE ASIP, UH, WILL MEET IN AN EMERGENCY SESSION TODAY AND TENTATIVELY ON DECEMBER 13TH IF A DECISION IS NOT MADE IN TODAY'S MEETING. SO THE ASIP MEETING AGENDA SAYS THAT THE GROUP WILL WATER THE VACCINE SPECIFIC RECOMMENDATIONS TENTATIVELY BY DECEMBER 13TH, WHICH IS A SUNDAY. SO ONCE THE A OF RECOMMENDATIONS ARE RELEASED, [00:10:01] IT'LL BE IMMEDIATELY ADOPTED BY C D C AND PUSHED OUT TO THE STATE AND LOCAL HEALTH DEPARTMENTS. SO WE COULD TENTATIVELY BEGIN VACCINATING BY THE WEEK OF DECEMBER 14TH. BUT THE VACCINE ARRIVAL DATES AT THIS TIME IS PROJECTED TO BE DECEMBER 16TH. SO WE HOPE TO BEGIN VACCINATING WITH PFIZER VACCINE HERE LOCALLY ON DECEMBER 16TH. UM, THE NEXT SLIDE IS, UH, ESSENTIALLY AGAIN THE SAME PATHWAY TO VACCINATION FOR THE MODERNA VACCINE, WHICH IS THE SECOND VACCINE IN THE PIPELINE. MODERNA ANNOUNCED ITS, UM, F D A, UH, SUBMISSIONS TO F D A ON NOVEMBER 30TH, WHICH WAS ALMOST, UH, 10 DAYS AFTER THE PFIZER SUBMISSION TO F D A. AND SO THE WORK BACK IS EXPECTED TO MEET ON DECEMBER 17TH, UH, TO CONSIDER THE E U A APPLICATION FOR THE MODERNA VACCINE. SO FOLLOWING THE SAME PATHWAY THAT I JUST DESCRIBED FOR PFIZER VACCINE, WE EXPECT THE MODERNA VACCINE SHOULD BE IN THE ARMS OF THE PRIORITY POPULATION BY DECEMBER 23RD, WHICH IS ALMOST A WEEK AFTER THE PFIZER VACCINE. THE NEXT SLIDE IS THE REACTOGENIC DATA, WHICH IS ESSENTIALLY YOUR EXP EXPECT, UH, EXPECTED ADVERSE REACTIONS TO THE PFIZER VACCINE. SO WITH THE PFIZER VACCINE, BASED ON THE PUBLISHED DATA, MOSTLY, UH, MOSTLY MILD TO MODERATE TOLERABILITY PROFILE WAS OBSERVED BOTH AFTER THE FIRST AND THE SECOND DOSES, AND REACTIONS WERE LESS COMMON AND MILDER IN OLDER ADULTS. THESE ARE ADULTS OLDER THAN 55 YEARS OF AGE, UH, COMPARED TO THE YOUNGER ADULTS WHO ARE ENROLLED IN THE CLINICAL TRIALS, THE 16 TO 55 YEARS OF AGE. IN GENERAL, THE LOCAL REACTIONS THAT WERE OBSERVED IN RESPONSE TO THE PFIZER VACCINES WERE PAIN INJECTION, SITE REDNESS AND SWELLING. AND THESE LOCAL REACTIONS WERE MOSTLY MILD TO MODERATE IN SEVERITY AND RESOLVED WITHIN ONE TO TWO DAYS AFTER, UH, THE VACCINE ADMINISTRATION OR DEVELOPING OF THESE LOCAL REACTIONS. THE SYSTEMIC EVENTS, THE SYSTEMIC SYMPTOMS WERE MOSTLY REPORTED, UM, BY YOUNGER VACCINE RECIPIENTS, UM, COMPARED TO THE OLDER VACCINE RECIPIENTS, JUST LIKE THE LOCAL REACTIONS. AND THEY WERE REPORTED MORE OFTEN AFTER THIS SECOND DOSE COMPARED TO THE FIRST DOSE. SO MOST COMMONLY REPORTED SYSTEMIC SYMPTOMS WHERE FATIGUE, HEADACHE FEVER WAS REPORTED AFTER THE SECOND DOSE BY 16% OF THE VACCINE RECIPIENT, YOUNGER VACCINE RECIPIENTS OCCUR, AND BY 11% OF THE OLDER, UM, UH, VACCINE RECIPIENTS SYSTEMIC EVENTS, JUST LIKE LOCAL REACTIONS WERE OBSERVED WITHIN ONE TO TWO DAYS AFTER VACCINATION AND RESOLVED VERY SHORTLY THEREAFTER. NEXT SLIDE. OKAY, THERE YOU GO. THE CDCS VACCINE ADVISORY GROUP, WHICH IS ASEP ADVISORY COUNCIL ON IMMUNIZATION PRACTICES, THEY IN AN EMERGENCY MEETING ON DECEMBER 1ST, APPROVE THE INTERIM RECOMMENDATIONS FOR WHO SHOULD RECEIVE THE FIRST C OVID 19 VACCINE DOSES UPON F D A AUTHORIZATION OR EMERGENCY USE AUTHORIZATION, UM, GRANT, UM, UH, OR, OR, OR GRANTING OF THOSE EMERGENCY USE AUTHORIZATIONS. AND THESE INTERIM RECOMMENDATIONS BY ASIP PUT HEALTHCARE WORKERS AND NURSING HOME RESIDENTS TO THE FRONT OF THE LINE, SO THEY ARE, UH, BEING CLASSIFIED, UH, OR CATEGORIZED INTO THAT PHASE ONE A CATEGORY. UM, AS FAR AS THE CRITICAL POPULATION WORK GROUPS GO, THOUGH THE RECOMMENDATION MENTIONS HEALTHCARE WORKERS FIRST FOR ASIP. JUST WANNA POINT OUT, THERE IS NO PREFERENTIAL ORDER BETWEEN THEM AND THE LONG-TERM CARE RESIDENTS. HEALTHCARE WORKERS ARE DEFINED AS PAID AND UNPAID PERSONS SERVING IN HEALTHCARE SETTINGS WHO HAVE THE POTENTIAL FOR DIRECT OR INDIRECT EXPOSURE TO PATIENTS OR INFECTIOUS MATERIALS. LONG-TERM CARE FACILITY RESIDENTS ARE BEING DEFINED AS ADULTS WHO RESIDE IN FACILITIES THAT PROVIDE A VARIETY OF SERVICES, INCLUDING MEDICAL AND PERSONAL CARE TO PERSONS WHO ARE UNABLE TO LIVE INDEPENDENTLY. SO THESE ARE YOUR FOLKS LIVING IN, UH, SKILLED NURSING HOME FACILITIES. YOUR ASSISTED LIVING HOME FACILITY RESIDENTS. JUST WANNA POINT OUT THE AS OF WORK RECOMMENDATIONS SUPPORTING VACCINATING HEALTHCARE PERSONNEL IN PHASE ONE A. IT WAS AND WAS PRIMARILY BASED ON THE EPIDEMIOLOGICAL DATA FOR C OVID 19 INFECTIONS. TO DATE NATIONALLY, THERE HAVE BEEN AT LEAST 243,000 CONFIRMED C OVID 19 CASES AMONG HEALTHCARE PERSONNEL AND 858 DEATHS DOCUMENTED AMONG HEALTHCARE PERSONNEL. AS FOR INCLUDING LONG-TERM CARE FACILITY RESIDENTS IN PHASE ONE A, THERE IS AMPLE EVIDENCE OF OLDER ADULTS IN CONGREGATE SETTINGS BEING DISPROPORTIONATELY AFFECTED BY [00:15:01] C OVID 19. LONG-TERM CARE FOR, UH, RESIDENTS, FACILITY RESIDENTS AND STAFF NATIONALLY HAVE ACCOUNTED FOR 6% OF CASES AND 40% OF DEATHS. UM, HERE LOCALLY, 20% OF OUR DEATHS HAVE BEEN ATTRIBUTED TO LONG-TERM CARE FACILITY RESIDENTS, UM, AS, AS FOR AS THE MAJOR. AND, AND, UH, FURTHERMORE, MAJORITY OF THE C OVID 19 ASSOCIATED HOSPITALIZED PATIENTS OLDER THAN 75 YEARS WERE ADMITTED FROM LONG-TERM CARE FACILITY. SO THESE WERE THE RATIONALE THAT WAS LOOKED AT AND USED BY ASIP TO MAKE THESE INTERIM RECOMMENDATIONS. AS FAR AS THE CRITICAL POPULATIONS GO AFTER HEALTHCARE WORKERS AND NURSING HOME RESIDENTS, UH, ASIP HAS RECOMMENDED ESSENTIAL WORKERS IN PHASE ONE B AND PEOPLE WITH UNDERLYING MEDICAL CONDITIONS AND ADULT 65 AS AND OLDER IN PHASE ONE C. NEXT SLIDE, PLEASE. SO WHAT YOU SEE UP THERE IS THE TEXAS DEPARTMENT OF STATE HEALTH SERVICES PRIORITIZATION. UM, ALL THOSE STATES ARE NOT BOUND BY ACI RECOMMENDATIONS. THEY DO CARRY A STRONG WEIGHT. SO TEXAS, JUST LIKE OTHER STATES IN THE NATION, UM, ADOPTED THE INTERIM A A C I P RECOMMENDATIONS ONCE THEY WERE MADE OR MADE PUBLIC. SO, AS YOU SEE HERE, THE, THE TEXAS' PRIORITIZATION PHASE ONE, A FIRST TIER, UM, INVOLVES HEALTHCARE PERSONNEL WHO ARE INVOLVED, UH, IN INPATIENT, UM, SETTINGS OR WORK IN INPATIENT SETTINGS, UM, AND THE RESIDENTS OF LONG-TERM CARE FACILITIES. THE PHASE ONE, A TIER TWO, WHICH IS THE NEXT SLIDE, UM, ARE AGAIN, HEALTHCARE WORKERS. BUT THESE ARE HEALTHCARE WORKERS INVOLVED IN OUTPATIENT CARE SETTINGS IN YOUR FREESTANDING MEDICAL CARE FACILITIES, URGENT CARE CLINICS, UH, COMMUNITY PHARMACY STAFF, PUBLIC HEALTH PERSONNEL WHO ARE INVOLVED WITH THE, UM, PROVIDING VACCINATIONS AND OR TESTING, UH, FOR C OVID 19. THEY ALSO ARE CLASSIFIED IN THIS SECOND TIER, PHASE ONE A. UM, ADDITIONAL, UM, CATEGORIES OR, UH, OR ADDITIONAL FOLKS WHO ARE CLASSIFIED IN THIS, IN THIS SECOND TIER, ARE YOUR FUNERAL HOME WORKERS, YOUR MEDICAL EXAMINERS, AND IMPORTANT NO SCHOOL NURSES. THEY ARE PHASE ONE, A SECOND TIER HERE IN THE STATE OF TEXAS. NEXT SLIDE, PLEASE. SO THE FIRST AVAILABLE VACCINE DOSES WON'T COVER ALL OF THOSE IN THE PHASE ONE A GROUP. UM, YOU'VE, YOU'VE SEE, HEARD THIS IN THE NEWS, THE FED PROJECTED THAT 40 MILLION DOSES WILL BE AVAILABLE BY THE END OF DECEMBER, WHICH COULD VACCINATE 20 MILLION PEOPLE, GIVEN THAT IMMUNIZATION REQUIRES TWO DOSES. FURTHERMORE, THESE 40 MILLION DOSES ARE NOT EXPECTED TO COME ALL AT ONCE. UM, WE EXPECT, UM, FIVE TO 10 MILLION DOSES, UH, BEING ALLOCATED ON WEEKLY BASIS. SO THERE IS A NEED FOR SUB PRIORITIZATION, UM, WITH THIS INITIAL LI UH, LIMITED SUPPLY TO ROLLOUT VACCINATION PROGRAM, EVEN AMONG YOUR PHASE ONE, A TIER ONE POPULATION. UM, ALSO WANNA MENTION THAT THE COVID 19 VACCINE PROVIDERS, THEY ARE NOT EXPECTED TO HOLD BACK ANY DOSES FOR THE SECOND DOSE ADMINISTRATION. SO THEY'RE EXPECTED TO ADMINISTER ALL THEIR WEEKLY ALLOCATIONS AS AND WHEN THEY GET IT, THE VACCINES FOR THE SECOND DOSE WILL BE HELD BACK AT THE FEDERAL LEVEL, AND THEY WILL BE ALLOTTED WHEN IT'S TIME, UH, TO THESE COVID 19 VACCINE PROVIDERS. THE COVID 19, NEXT SLIDE PLEASES. THERE YOU GO. THE COVID 19 VACCINATION AT THIS TIME IS GOING TO BE COMPLETELY VOLUNTARY. IT'S GOING TO BE LEFT UP TO THE INDIVIDUALS TO DECIDE IF AND WHEN TO RECEIVE THE VACCINE. ALTHOUGH NEW POLLING DI INDICATES, UM, MORE AMERICANS ARE WILLING TO GET THE COVID 19 VACCINE THAN FEW MONTHS AGO, UH, IT IT'S SOMEWHERE, UH, UP TO 60% NOW, THE WILLINGNESS OR WILLINGNESS TO GET THE VACCINE, BOTH HEALTHCARE PROVIDERS AND GENERAL PUBLIC CONTINUE TO BE SKEPTICAL OF COVID 19 VACCINE SAFETY AND EFFICACY. AND I'VE ALWAYS MAINTAINED THAT SKEPTICS ARE MOST OPEN TO TRANSPARENCY. SO, RECENT ARTICLE IN JAMA, IF YOU'VE HAD A CHANCE TO READ THAT, IT CLEARLY STATES THAT GENERAL PUBLIC PREFERRED C OVID 19 PUBLIC HEALTH MESSAGING THAT ACKNOWLEDGES SCIENTIFIC UNCERTAINTY, SUGGESTING THAT ADMITTING TO INCOMPLETE KNOWLEDGE FOSTERS PUBLIC TRUST AND MOTIVATES COMPLIANCE. SO ONE OF THE PUBLIC HEALTH STRATEGIES WE AT METRO HEALTH, UM, HAVE ADOPTED TO BOOST TRANSPARENCY AND PUBLIC TRUST IS TO RESIST THE URGE TO OVER PROMISE. WITH REGARDS TO THIS COVID 19 VACCINE PERFORMANCE. UM, THERE ARE A NUMBER OF THINGS WE DON'T KNOW ABOUT THIS VACCINE. [00:20:01] UM, AND, AND IT'S ESSENTIAL TO BE VERY CLEAR ABOUT THINGS THAT WE DON'T KNOW AT THIS TIME. AND AS YOU CAN SEE ON THE SLIDE, WE DON'T KNOW IF THE IMMUNITY THAT IS GOING TO BE CONFERRED BY THIS VACCINE, UM, IS GOING TO LAST LIFELONG. WE DON'T KNOW HOW LONG THAT IMMUNITY IS GOING TO LAST. WE DON'T KNOW WHETHER VACCINATED INDIVIDUALS WILL BECOME ONLY MILDLY ILL, WOULD STILL BE INFECTIOUS TO OTHERS. WE DON'T KNOW IF VACCINATION WILL PREVENT ASYMPTOMATIC TRANSMISSIONS AT THIS TIME, AND WE CERTAINLY DON'T KNOW FOR, UM, WITH ABSOLUTE CERTAINTY WHAT PERCENT OF POPULATION WILL OPT FOR THIS VACCINE. SO WHILE MANY OF THESE QUESTIONS, I BELIEVE WILL BE ANSWERED IN THE COMING MONTHS, ONCE THE VACCINATIONS BEGIN, IT'S ALSO LIKELY THAT MORE WILL ARISE. SO IT'S IMPORTANT TO NOTE THAT THESE VACCINES ARE NOT GOING TO BE THE SILVER BULLET THAT BRINGS US BACK TO THE PRE PANDEMIC LEVEL OR PRE PANDEMIC PERIOD. WE ARE GOING TO NEED, UH, PARTICULARLY IN THE MONTHS MOVING FORWARD TO CONTINUE TO WEAR MASKS AND PRACTICE SOCIAL DISTANCING OR PHYSICAL DISTANCING. NEXT SLIDE PLEASE. BUT WHAT WE KNOW FOR CERTAIN IS THIS, UH, HOW THESE VACCINES ARE THE PROCESS OF HOW THESE VACCINES WILL BE DISTRIBUTED, UM, AND, AND HOPEFULLY ADMINISTERED, UH, TO THE, TO THE PRIORITY AS WELL AS THE GENERAL POPULATION. UH, THE VACCINES AND THE PFIZER VACCINE IN PARTICULAR WILL BE SHIPPED DIRECTLY FROM THE MANUFACTURER TO THE VACCINE VACCINATION PROVIDER, OR THE POINT OF DISPENSING PRIMARILY TO MAINTAIN THE COLD CHAIN. IT HAS VERY STRINGENT, UM, STORAGE AND HANDLING REQUIREMENTS. UM, THE ANCILLARY SUPPLIES, WHICH IS NEEDED FOR VACCINE ADMINISTRATION, AND THESE WILL BE SHIPPED BY C D C, UH, FROM THE C D C WAREHOUSE THROUGH THE C D C DISTRIBUTOR, WHICH IS MCKESSON TO THE PROVIDERS. UM, THE ANCILLARY KITS WILL INCLUDE, UH, SYRINGES, NEEDLES, ALCOHOL, FACE MASKS, FACE SHIELDS, EVERYTHING YOU NEED FOR SAFE ADMINISTRATION OF VACCINES. AND MOST IMPORTANT, THEY ALSO WILL INCLUDE VACCINATION CARDS THAT COULD BE USED FOR, UH, BY THE PROVIDERS FOR THE SECOND DOSE ADMINISTRATION REMINDERS. NOW, THIS PROCESS I WANNA POINT OUT IS COMPLETELY DIFFERENT PROCESS OF DISTRIBUTION, UM, FROM THE MASS VACCINATION EFFORTS WE'VE SEEN IN THE PAST, UH, FOR INSTANCE WITH H ONE N ONE, UH, WHERE LOCAL PUBLIC HEALTH DEPARTMENTS WHERE THE VACCINE DEPOTS AND THE DISTRIBUTORS. SO ALL VACCINES CAME TO THE HEALTH DEPARTMENT, AND THE HEALTH DEPARTMENT WAS RESPONSIBLE FOR ALLOCATION AS WELL AS ADMINISTRATION OF, OF, OF THESE VACCINES, NOT SO WITH THIS C OVID 19 VACCINE. NEXT SLIDE, PLEASE. OH, THAT'S, UH, THAT'S THE OVERVIEW OF THE THERMAL SHIPPERS. WE, YOU, YOU'VE HEARD, UH, FOLKS TALK ABOUT HOW THE VACCINE WILL BE SHIPPED IN THESE THERMAL SHIPPERS, UM, BECAUSE OF THIS ULTRA LOW TEMPERATURE REQUIREMENTS. SO WHAT YOU SEE UP THERE THAT, UH, THAT TRIGGER TO YOUR LEFT HAND SIDE OF THE SCREEN IS THE ACTUAL PICTURE OF THE THERMAL SHIPPING. THE SHIPPER BOX ITSELF, UH, IT HAS AN INSULATED LID, UM, FOLLOWED BY, UM, UH, UH, UH, A DRY ICE POD SECTION. THAT'S WHERE THE DRY ICE IS KEPT TO MAINTAIN THE COLD CHAIN. AND THEN BENEATH THAT DRY ICE, UH, SECTION, YOU HAVE PAYLOAD SLEEVES THAT CAN, UH, THAT CAN ACCOMMODATE ANYWHERE FROM ONE TO FIVE WILD TRAYS. UH, EACH WILD TRAY, UH, IT'S LIKE A PIZZA BOX SIZE TRAY. IT CAN HOLD, UM, UP TO ONE 90 WHILE EACH WHILE ONCE RECONSTITUTED WILL HAVE FIVE DOSES. SO THE MINIMUM DOSES THAT CAN BE SHIPPED, UM, UH, FOR FI UH, AS FAR AS PFIZER VACCINE GOES IS ABOUT 975 DOSES. AND THE MAXIMUM THAT CAN BE SHIPPED HERE IS ABOUT 5,000 DOSES. AND, UH, THE TABLE THAT YOU SEE ON THE RIGHT HAND SIDE IS JUST THE DIMENSIONS OF THE BOX, THE WEIGHT, AND THE HEIGHT AND THE WEIGHT DIMENSION OF THE BOX. NEXT SLIDE, PLEASE. THAT'S THE OVERVIEW PACKAGING, UH, PA UH, OVERVIEW OF THE PRODUCT PACKAGING ITSELF. SO YOUR PRIMARY PACKAGING WILL BE, UH, YOUR TWO ML, UH, GLOSS, UH, PRESERVATIVE FREE MULTI-DOSE VI. UH, EACH MULTI-DOSE VI WILL HAVE 0.45 ML OF FROZEN LIQUID IN IT. AND ONCE THE FROZEN LIQUID IS THAWED AND RECONSTITUTED WITH THE BAR WITH SODIUM CHLORIDE 0.9 ML OF SODIUM CHLORIDE, EACH WHILE WILL HOLD FIVE DOSES. THE SECONDARY PACKAGE IS THAT, UH, WHILE TRAY OR, UH, THE PIZZA BOX THAT I WAS REFERRING TO IN THE PREVIOUS LINE, EACH OF THOSE BOXES WILL HOLD 195 VIALS. SO EACH TRAY, EACH, EACH PIZZA PIZZA BOX WILL HAVE 975 DOSES. [00:25:01] UM, AND THE TERTIARY CON, TERTIARY CONTAINER IS THE BOX ITSELF WITH THE, WHICH, WHICH WE DISCUSSED IN THE PREVIOUS SLIDE. UH, NEXT SLIDE PLEASE. SO THIS IS THE, THE BILLING COST AND THE REIMBURSEMENT, IT'S ONE OF THE MOST FREQUENTLY ASKED QUESTIONS BY THE PROVIDERS AS WELL AS THE GENERAL PUBLIC. SO I WANTED TO MAINTAIN THE INTEGRITY OF THE LANGUAGE THAT'S BEING USED BY THE FEDERAL GOVERNMENT WITH REGARDS TO BUILDING COST AND REIMBURSEMENT. SO WHAT YOU SEE UP ON THE SLIDE IS WHERE VERBATIM, THE LANGUAGE USED, UH, USED BY THE FEDERAL GOVERNMENT, UH, COVID 19 VACCINES WILL BE PROCURED AND DISTRIBUTED BY THE FEDERAL GOVERNMENT AT NO COST TO ENROLL C OVID 19 VACCINE PROVIDERS. VACCINE PROVIDERS WILL BE ABLE TO CHARGE AN ADMINISTRATION FEE AND MAY SEEK APPROPRIATE REIMBURSEMENT FROM A HEALTH PLAN. UM, HEALTHCARE WORKERS MAY BE REIMBURSED FOR ADMINISTERING C OVID 19 VACCINES TO UNINSURED INDIVIDUALS THROUGH HEALTH AND HUMAN SERVICES. C OVID 19 UNINSURED PROGRAMS, AND THIS IS THE LAST BULLET, IS IMPORTANT. C OVID 19 VACCINE PROVIDERS, UM, ARE NOT TO DENY ADMINISTRATION OF VACCINE FOR ANY VACCINE RECIPIENTS WHO'S, WHO'S UNABLE TO PAY, UH, THE ADMINISTRATION FEE OR DOESN'T HAVE THE PROPER INSURANCE COVERAGE TO RECEIVE THE ADMINISTRATION FEE. SO THIS IS SOMETHING THAT EACH AND EVERY C OVID 19 VACCINE PROVIDER HAS TO ATTEST, SIGN, AND ATTEST AT THE TIME OF THE REGISTRATION. NEXT SLIDE, PLEASE. AND THIS IS AN IMPORTANT SLIDE. THIS IS METRO HEALTH'S ROLE. SO, LIKE I SAID BEFORE, UM, UNLIKE VACCINATION, UM, UM, EFFORTS IN THE PAST, WE WILL NOT BE, UH, VACCINE DEPOT OR DISTRIBUTOR WITH THE COVID 19 VACCINES. UH, PROVIDERS, UM, ARE BEING ASKED TO REGISTER AT THE TEXAS DEPARTMENT OF STATE HEALTH SERVICES REGISTRATION PORTAL, UH, TO BECOME A C OVID 19 VACCINE PROVIDER. AND YOU SEE THE PORTAL, UM, WEBSITE UP THERE, AND, AND ONCE YOU REGISTER YOU, YOU'VE COMPLETED THE REGISTRATION, YOU'VE GOTTEN THE GREEN LIGHT FROM TEXAS DEPARTMENT OF STATE HEALTH SERVICES, THEN YOU CAN ORDER VACCINES ONLINE AND THE VACCINES WILL BE SHIPPED DIRECTLY FROM PFIZER TO YOU, UH, TO, TO THE PROVIDER. UM, WE ARE CERTAINLY NOT RESPONSIBLE FOR VACCINE ALLOCATIONS. I CANNOT TELL YOU HOW MANY EMAILS I'VE GOTTEN THE PAST FEW WEEKS, UH, BECAUSE, UH, PROVIDERS, OUR FACILITIES HAVE NOT GOTTEN, UM, OR ARE NOT IN LINE TO GET THOSE WEEKLY ALLOCATIONS. UM, WE CERTAINLY DON'T, WE, METRO HEALTH DON'T HAVE ANY CONTROL OVER EITHER WHICH FACILITY IN OUR JURISDICTION RECEIVES THE VACCINE OR THE NUMBER OF DOSES THEY RECEIVE. THE VACCINE ALLOCATION DECISIONS ARE ENTIRELY MADE BY THE EXPERT VACCINE ALLOCATION PANEL, WHICH IS THE EVAP PANEL AT TEXAS DEPARTMENT OF STATE HEALTH SERVICES. UM, BASED ON THE NUMBER OF CRITICAL POPULATION GROUPS EACH FACILITY SERVES, UH, THE TYPE OF CRITICAL POPULATION GROUP THEY SERVE, UM, THEIR CAPACITY TO STORE VACCINES AND CERTAINLY THEIR CAPACITY TO ADMINISTER VACCINES. KEEP IN MIND, FOR PFIZER VACCINE, THE MINIMUM DOSES THAT CAN BE ORDERED IS 975. SO FACILITIES THAT CANNOT ADMINISTER THAT MINIMUM DOSAGE, MINIMUM NUMBER OF DOSES, UM, ARE HAVING A HARD TIME GETTING THOSE PFIZER VACCINES THE FIRST FEW WEEKS. UM, WE WILL CERTAINLY BE VACCINATOR. WE JUST LIKE OTHER PROVIDERS ACROSS THE COMMUNITY, HAVE REGISTERED AT THE TEXAS DEPARTMENT OF STATE HEALTH SERVICES REGISTRATION PORTAL. WE ARE, UM, A C OVID 19 VACCINE PROVIDER, BUT WE ARE CERTAINLY NOT IN LINE TO RECEIVE THOSE ALLOCATIONS IN THE FIRST FEW WEEKS, ESPECIALLY BECAUSE WE DID NOT THAT EVAP IS USING TO MAKE THOSE DETERMINATIONS. UM, BUT WHAT WE ARE RESPONSIBLE FOR AS A LOCAL HEALTH DEPARTMENT IS TO PROVIDE THE TECHNICAL SUPPORT, TECHNICAL SUPPORT TO THE C OVID 19 VACCINE PROVIDERS ON REPORTING REQUIREMENTS. THERE ARE VERY STRINGENT RE REPORTING REQUIREMENTS SET FORTH BY C D C AS WELL AS THE TEXAS DEPARTMENT OF STATE HEALTH SERVICES. UM, WE ARE ALSO, UM, UH, RESPONSIBLE FOR PROVIDING ANY COVID 19 VACCINE UPDATES, CHANGES TO THE PRIORITY GROUPS, YOU KNOW, UH, ESSENTIALLY KEEPING THE PROVIDER COMMUNITY INFORMED WITH REGARDS TO WHAT'S HAPPENING ON THE VACCINE FRONT. SO, UM, ONCE WE GET THE VACCINES, WE, WE CERTAINLY, AND I CAN TELL YOU OUR GOAL AND COMMITMENT IS TO VACCINATE BOTH WITH VELOCITY AS WELL AS AT, AS WELL AS EQUITY. BUT UNTIL THEN, WE HAVE TO JUST RELY ON, UM, SYSTEMS OF FACILITIES THAT HAVE, UH, GOTTEN THE VACCINE HERE IN OUR COMMUNITY. THE NEXT SLIDE THAT YOU WILL SEE, UH, THE, UH, REGISTERED VACCINE PROVIDERS. THIS IS AS OF YESTERDAY EVENING. UH, THIS IS A LIVING DOCUMENT. THE ENROLLMENT [00:30:01] IS AN ONGOING PROCESS. THERE IS NO END DATE TO VACCINE COVID 19 VACCINE PROVIDER ENROLLMENT. UH, SO WE GET UPDATES FROM THE STATE, UM, ON WEEKLY BASIS. THIS IS THE UPDATE AS OF YESTERDAY EVENING. UH, 368 PROVIDERS HAVE COMMENCED, UM, ENROLLMENT PROCESS AT THE, UH, STATE REGISTRATION PORTAL. NEXT SLIDE, PLEASE. PS THE GEOGRAPHIC DISTRIBUTION OF THOSE, UM, UH, PROVIDERS WHO HAVE ENROLLED, UH, OR COMMENCED ENROLLMENT. UM, AND AS YOU CAN SEE, WE, WE DO HAVE A BIG GAP IN THE SOUTH SIDE OF OUR COMMUNITY, AND THIS IS IN SPITE OF INTENSE EFFORTS BY US TO RECRUIT PROVIDERS ON THE SOUTH SIDE. WE'VE NOT SEEN MUCH SUCCESS WITH THE ENROLLMENT PROCESS WE HAD, UM, WE HAD, WE HAD ENLISTED, OR WE HAD COLLABORATED WITH BAY COUNTY MEDICAL SOCIETY WITH TRACK. UH, WE SENT OUT EMAIL ALERTS BLAST THROUGH OUR DOCK ALERT SYSTEM. UM, YET WE'VE NOT BEEN VERY SUCCESSFUL IN, IN, UH, IN MOVING UP THAT ENROLLMENT, UH, PROVIDER ENROLLMENT IN THAT SOUTH SIDE. SO ONE THING WE HAVE, UH, PLAN IN, IN, IN THE PIPELINE, OR WE'VE ALREADY PLANNED, UM, IS TO, UM, USE OUR COMMUNITY HEALTH WORKERS WHO ARE ALREADY HITTING THE PAVEMENT ON THE SOUTH SIDE. UM, WE HAVE MANY COMMUNITY HEALTH WORKERS GOING TO THE SOUTH SIDE, UM, PROVIDING EDUCATION ON C OVID 19, UM, UH, INFECTIONS OR DISEASE TO, TO BUSINESSES, TO RESIDENTS. SO WE WILL BE USING THOSE HEALTHCARE WORKERS, UM, WHO ARE HITTING THE PAYMENT CURRENTLY ON THE SOUTH SIDE TO NOW ACTIVELY ENGAGE WITH THE PROVIDERS AND HAVE A FACE-TO-FACE MEETING AND, AND, AND, UH, SEE IF WE CAN BRING UP THAT ENROLLMENT ON THE SOUTH SIDE. UM, I AM, UH, UM, UM, I AM CLOSELY, WELL, METRO HEALTH IS CLOSELY MONITORING THIS ENROLLMENT SITE, SO, UH, WE WILL KEEP YOU UPDATED, UM, ON THAT AS WE AS, AS WE GET MORE INFORMATION. UH, THE NEXT SLIDE THAT YOU'LL SEE IS THE FEDERAL PHARMACY CONTRACT PARTICIPANTS, UM, NURSING HOMES, UH, OR LONG-TERM CARE FACILITIES. UM, THEY, THERE ARE TWO WAYS THAT THE LONG-TERM CARE FACILITIES, UM, CAN GET, UH, VACCINATIONS FOR THEIR STAFF AS WELL AS THEIR RESIDENTS, RIGHT? SO ONE, THE MOST COMMON, UH, METHOD, WHICH IS, UH, OPTION ONE IS TO CONTRACT, UM, WITH THE, UM, OR, OR HAVE A CONTRACT WITH THE RETAIL PHARMACIES, UH, AS PART OF THE FEDERAL PHARMACY CONTRACTS. AND NUMBER TWO OPTION IS JUST LIKE OTHER PROVIDERS DIRECTLY REGISTER AT THE PORTAL TO BECOME A COVID 19 VACCINE PROVIDER. MAJORITY OF OUR LONG-TERM CARE FACILITIES, ALMOST ALL OF OUR NURSING HOMES HAVE, UM, HAVE CHOSEN OPTION ONE, THEY HAVE CONTRACTS WITH RETAIL PHARMACIES, AND YOU SEE THOSE BREAKDOWN OF THOSE RETAIL PHARMACIES UP THERE. NEXT SLIDE, PLEASE. THAT THE, THE FIRST WEEK'S ALLOCATION FOR THE STATE OF TEXAS IS, UH, 224,250 DOSES OF PFIZER VACCINES. AND THESE WILL BE SHIPPED TO 109 SITES ACROSS THE STATE OF TEXAS IN THE FIRST WEEK OF ALLOCATION. AND WHAT YOU SEE UP THERE IS THE GEOGRAPHIC DISTRIBUTION OF THE SITES THAT WILL RECEIVE THE C OVID 19 VACCINES IN THE FIRST WEEK OF ALLOCATIONS. UM, NEXT SLIDE. AND I THINK THAT'S THE LAST SLIDE I HAVE. UH, NOT ALL C OVID 19 VACCINE PROVIDERS IN OUR JURISDICTION WILL RECEIVE THE DOSES IN THE FIRST WEEK OR EVEN THE FIRST FEW WEEKS AFTER VACCINES BECOME AVAILABLE. AGAIN, AS I MENTIONED, THESE DECISIONS ARE BEING MADE BY EVAP AT THE TEXAS DEPARTMENT OF STATE HEALTH SERVICES. UM, IT IS PROJECTED THAT 11 SITES IN OUR JURISDICTION WILL RECEIVE THE VACCINE, SUFFICE A VACCINE IN THE FIRST WEEK OF ALLOCATION, TOTAL NUMBER OF DOSES THAT IS PROJECTED TO BE COMING OUR WAY IN THE FIRST WEEK, A SLIGHTLY OVER 28,000 DOSES. SO AFTER THE FIRST WEEK ALLOCATION, ADDITIONAL ALLOCATIONS ARE EXPECTED TO OCCUR ON WEEKLY BASIS. SO WHAT YOU SEE UP ON THE SLIDE IS THE NUMBER OF HEALTHCARE WORKERS AND THE LONG-TERM CARE RESIDENTS WE HAVE IN OUR COMMUNITY AT THIS TIME. THESE ARE OUR PHASE ONE A POPULATION. UM, SO THE FIRST WEEK OF ALLOCATION WILL ONLY COVER A FRACTION OF OUR PHASE ONE A POPULATION. AT THIS TIME. WE WILL NEED MANY ADDITIONAL WEEKS TO COVER ALL OUR PHASE ONE A POPULATION. UM, AND, AND THIS TIMELINE, UH, WE EXPECT THE PHASE ONE A POPULATION TO BE COMPLETELY VACCINATED, UH, SOMETIME BY, UH, EARLY FEBRUARY, MID MID-FEBRUARY. [00:35:01] UH, THAT IS THE PROJECTED TIMELINE, TENTATIVE TIMELINE, AND THIS TIMELINE MAY SPEED UP WITH ADDITIONAL VACCINES BEING AVAILABLE, UM, WITH MODERNA COMING INTO THE PICTURE A WEEK LATER. UM, WE CERTAINLY HOPE THE TIMELINE SPEEDS UP. UH, THE PFIZER VACCINE, LIKE I MENTIONED, IS EXPECTED TO ARRIVE ON DECEMBER 16TH, AND MODERNA WILL FOLLOW, UM, ON DECEMBER 23RD. UM, AND I WANNA END BY SAYING THAT THESE ARE EXTRAORDINARY, EXTRAORDINARY TIMES FOR US, AMAZING SCIENCES HAPPENING, UM, ALL AROUND US. AND TO HAVE TWO VACCINES LESS THAN A YEAR FROM RECOGNIZING A NORMAL PATHOGEN AND BE HEADING CLOSELY, UH, HEADING, HEADING, UM, TOWARDS THE F D APPROVAL IN THE COMING DAYS. IT'S, IT'S REALLY HISTORIC, AND WE CAN GET ENOUGH VACCINE COVERAGE IF WE CAN, IF WE CAN. UH, AND IF WE, IF WE GET ENOUGH VACCINE COVERAGE IN OUR, UH, COMMUNITY, WE CERTAINLY CAN HAVE AN IMPACT ON THE, ON THIS PANDEMIC VERY, VERY QUICKLY. UM, THANK YOU FOR YOUR TIME, AND I'LL STOP HERE. I'LL BE HAPPY TO TAKE ANY QUESTIONS YOU MIGHT HAVE. THANK YOU VERY MUCH, DR. KAN. THAT WAS AN EXTREMELY THOROUGH PRESENTATION. UM, I'D LIKE TO SAY IT ANSWERED ALL MY QUESTIONS, BUT NO , WE, WE'LL HAVE SOME COMMENTS FOR SURE. UH, WHAT I'D LIKE TO DO IS SET US AT THREE MINUTES, JUST BECAUSE WE HAVE TWO OTHER ALSO VERY WEIGHTY TOPICS TO DISCUSS. AND IF WE NEED TO COME BACK AROUND THEN, THEN WE'LL DO THAT. UH, I'M GONNA START BY SAYING THANK YOU, DR. KIAN, FOR TELLING US WHAT, UH, WHAT THE VACCINE AND WHAT THE VA WHAT, WHAT IT IS AND WHAT IT ISN'T. I THINK WE NEED TO BE, UH, VERY CLEAR IN SETTING EXPECTATIONS, UH, THAT IT IS NOT A PANACEA, THAT THERE ARE STILL MANY OTHER THINGS THAT WE NEED TO CONTINUE DOING. UM, AND I, I SAID THIS THE OTHER DAY, BUT I'LL SAY IT AGAIN. THIS IS THE HOME STRETCH. THE VACCINE IS ON THE HORIZON. IT'S PRACTICALLY HERE, BUT IT'S ALSO GOING TO BE THE HARDEST STRETCH FOR US BECAUSE EVERYONE IS FATIGUED. EVERYONE IS TIRED OF DOING THIS. I, I WANNA HUG , YOU KNOW, MY, MY FRIENDS OR MY COLLEAGUES, AND WE JUST CAN'T DO THAT RIGHT NOW. UM, ONE, UH, ONE THING I DID WANNA ASK, IS IT THE F THE ROLE THAT METRO HEALTH IS PLAYING? SO WE'RE NOT DISTRIBUTING THE VACCINES DIRECTLY, BUT IT SOUNDS LIKE OUR ROLE IS TO, OR THE ROLE OF THE CITY, IS TO RECRUIT, UH, DISTRIBUTORS FOR THE VACCINE IN OUR COMMUNITY. AM I GETTING THAT RIGHT? THAT'S CORRECT. AT THIS TIME, YES. OKAY. UM, I DO LIKE WHERE, UH, AT THE END YOU BASICALLY BROKE IT DOWN FOR US AND SAID, THIS IS HOW MANY PEOPLE WE HAVE IN THAT CATEGORY. THIS IS HOW LONG IT'S GOING TO TAKE US TO GET THROUGH THAT CATEGORY. I, I'D APPRECIATE IT IF IN THE FUTURE WE COULD GET ANOTHER UPDATE POSSIBLY NEXT MONTH WHERE, UH, WHERE YOU LAY THAT OUT FOR ONE A, ONE B, AND THEN WE AS, AS COMMUNITY LEADERS CAN GET AN IDEA OF HOW THIS IS PROGRESSING IN OUR COMMUNITY AND WHAT THAT TIMELINE EXPECTATION IS. WHAT I'D ALSO LIKE FOR US TO DO IS TO MONITOR, YOU KNOW, ARE WE KEEPING UP WITH THOSE TARGETS, RIGHT? ARE WE VACCINATING AS, AS QUICKLY AS WE SHOULD? UH, SO IT WOULD BE GREAT IF, IF YOUR TEAM COULD ALSO GIVE US WHAT, WHAT YOU THINK ARE REASONABLE TARGETS, AND THAT WAY WE CAN HAVE MILESTONES AS, AS WE MOVE ALONG. UM, AND THEN I THINK THE, THE LAST QUESTION I HAD WAS, UM, ONE THING THAT I WANTED TO HIGHLIGHT ACTUALLY IS THAT YOU SAID, WE DON'T KNOW IF PEOPLE WILL NEED BOOSTERS IN THE FUTURE. SO WE DON'T KNOW HOW, HOW LONG THESE ARE GOING TO BE GOOD FOR, BUT WE ALSO DON'T KNOW IF IT'S JUST ABOUT SUPPRESSING SYMPTOMS OR THE ACTUAL INFECTION. SO IF IT'S REALLY ONLY ABOUT SUPPRESSING SYMPTOMS, IF THAT'S THE EFFECTIVENESS OF IT, THEN WE WANNA MAKE SURE AS MANY PEOPLE AS POSSIBLE HAVE IT. AND THEN WE NEED TO CONTINUE BEING CAREFUL BECAUSE THERE ARE PEOPLE WHOSE IMMUNE SYSTEMS WILL NOT ALLOW THEM TO GET A VACCINE, AND WE NEED TO BE CAREFUL FOR THEM AND AROUND THEM. SO I THINK THAT'S JUST SOMETHING THAT FOR US TO KEEP IN MIND AS WE MOVE FORWARD WITH OUR MESSAGING. I'M GONNA TURN IT OVER, UH, TO THE COUNCIL MEMBERS, AND I'M GOING TO START WITH, UH, DISTRICT TWO THIS TIME AND THEN GO AROUND COUNCILWOMAN. UM, THANK YOU CHAIR AND, AND THANK YOU DR. KAREN. THIS IS VERY THOROUGH INFORMATION ON HOW THIS IS GOING TO HAPPEN. UM, THANK YOU FOR BREAKING DOWN THE PROCESS OF HOW IT'S GONNA BE SHIPPED AND WHAT IS NEEDED. THE QUESTIONS THAT I HAVE ARE IN IONS TO SOME OF THE THINGS THAT WE STILL DON'T KNOW, SUCH AS ALLERGIC REACTIONS AND WHAT ARE THE ACTIVE, UM, INGREDIENTS OF THIS VACCINE FOR THOSE THAT MIGHT HAVE AN ALLERGY TO PENICILLIN OR MIGHT HAVE AN ALLERGY TO [00:40:01] SOMETHING THAT'S IN THAT, THAT VACCINE. HOW DO WE SPEAK TO THAT, UM, AS WE GO FORWARD, EVEN IF IT'S WITH OUR HEALTHCARE WORKERS? UM, AND THEN TO, TO ALSO SPEAK ABOUT THE COMPROMISED IMMUNE SYSTEMS. WE KNOW THAT COVID AFFECTS THOSE THAT HAVE THE COMPROMISED IMMUNE SYSTEM MORE. UM, IS THERE AN ACTIVE ACTUAL ANTIBODY IN THE VACCINE? UM, SO THOSE ARE THE QUESTIONS THAT I HAVE. UM, AND THEN HOW MANY STORAGE UNITS DO WE HAVE HERE IN THE CITY OF SAN ANTONIO THAT ARE READY TO GO FOR STORAGE? UM, SO THOSE ARE THE QUESTIONS I HAVE. AND, UM, I KNOW THAT THERE ARE A LOT, BUT I DON'T WANT TO TAKE UP ANY TOO MUCH TIME FROM THE OTHER COUNCIL MEMBERS. UM, SO THOSE ARE MY QUESTIONS, DR. IAN. THANK YOU. I CAN ANSWER THE EASY QUESTION FIRST. HOW MANY STORAGE UNITS DO WE HAVE? MOST OF THE BIG HOSPITAL SYSTEMS HAVE THE ULTRA COLD STORAGE FACILITY. UH, UT HEALTH, UM, BAPTIST, UH, ALL BIG HOSPITAL SYSTEMS HAVE THE ULTRA COLD STORAGE. UM, BUT THAT IS NOT THE REQUIREMENT PER FEDERAL GOVERNMENT. UM, YOU KNOW, THEY DID NOT SAY THAT YOU SHOULD OR YOU SHALL HAVE ULTRA COLD STORAGE FREEZERS AVAILABLE IN ORDER TO GET THESE VACCINES. REMEMBER THE THERMAL SHIPPER, AND I SHOULD HAVE PUT THAT SLIDE UP THERE, THERE ARE THREE WAYS TO STORE THESE VACCINES. EITHER IF YOU HAVE ULTRA STORE COLD COLD STORAGE FREEZERS, YOU CERTAINLY CAN PUT THESE VACCINES UPON RECEIPT INTO THESE ULTRA COLD STORAGE FREEZERS WHERE IT'S GOOD FOR SIX MONTHS OR, UM, WHAT MOST OF OPERATION WARP SPEED AND C D C IS RECOMMENDING IS, YOU KNOW, DON'T GO BY BY THESE FREEZERS JUST YET. YOU CAN USE THE THERMAL SHIPPERS THAT THE VACCINES ARE BEING SHIPPED IN, AND YOU CAN KEEP THOSE VACCINES IN THOSE THERMAL SHIPPERS FOR UP TO 25 DAYS WITH THE REGULAR REPLENISHMENT OF THOSE DRY ICE. UH, SO THAT'S, THAT'S ANOTHER, UH, WAY OF SORTING THIS VACCINES IN THE ABSENCE OF HAVING THE FREEZER ITSELF. RIGHT. UM, THEN I THINK YOUR QUESTION WAS ABOUT ALLERGIC REACTIONS. UM, IF YOU LOOK AT THE CLINICAL TRIAL DATA BY PFIZER, THEY DID NOT STUDY SPECIFICALLY, UM, THIS VACCINE SAFETY AND EFFICACY AMONG PATIENTS WITH A ALLERGIES, EXISTING ALLERGIES. UM, UK HAS ALREADY STARTED ADMINISTERING THE PFIZER VACCINE, AND IF YOU'VE SEEN IN THE NEWS, MUST HAVE SEEN THIS ALREADY IN THE NEWS. UM, THE FIRST LADY TO GET THE PFIZER VACCINE WAS A 90 YEAR OLD GRANDMA. SHE WAS DOING GREAT. THEN THERE WAS ANOTHER 80 YEAR OLD, UH, PATIENT, WHICH IS WHO'S DOING WELL AS WELL. BUT THERE WERE FOUR PATIENTS WHO ACTUALLY HAD SOME NOT ALLERGY OR FOOD ALLERGIES AND CARRYING EPIPENS, AND THEY RECEIVED THE PFIZER VACCINE AND HAD STRONG ANAPHYLACTIC REACTIONS. SO, UM, WE DON'T KNOW WHAT THAT MEANS. IF, IF WE CAN'T, WE NEED TO PAUSE VACCINE, UH, ADMINISTRATION IN PATIENTS WITH ALLERGIC REACTIONS HERE IN THE UNITED STATES. WE DON'T KNOW THAT YET. I'M, I'M, I'M CURIOUSLY WAITING FOR THE ASAP RECOMMENDATIONS TO COME OUT BEFORE WE SAY ONE WAY OR THE OTHER. BUT YES, MORE RESEARCH HAS TO BE DONE. UM, AS FAR AS CLINICAL TRIALS GO AMONG THESE ALLERGIC PATIENTS WHO HAVE EXISTING ALLERGIES, DID I COVER EVERYTHING? UM, THANK YOU DR. KERRY. AND I KNOW THAT WAS MOST OF IT, AND, AND I'LL FOLLOW BACK UP WITH YOU, BUT I'LL TURN IT BACK OVER TO, UH, MADAM CHAIR. THANK YOU. SO THANK YOU COUNCILWOMAN, COUNCILWOMAN VIAGRA. THANK YOU CHAIR. UH, THANK YOU DR. KIAN. I THINK IT'S VERY TIMELY THAT WE HAVE THIS PRESENTATION. YOU TIMED IT, THIS WONDERFULLY CHAIR TO HAVE THIS, UH, PRESENTATION, UH, TODAY. A COUPLE QUESTIONS. ONE, I I THINK THIS PRESENTATION, I THINK THAT THE GRAVITY AND THE ENORMITY OF WHAT WE'RE GOING THROUGH GLOBALLY IS REALLY HITTING AS WE'RE LOOKING AT A DISTRIBUTION OF A VACCINE. NEVER DID, I THINK IN MY TENURE, WOULD WE BE TALKING ABOUT SOMETHING LIKE THIS, UM, THIS GLOBAL PANDEMIC AND I, I THINK OF, UM, JUST WHAT HAS HAPPENED OVER THE, THE CENTURIES AND, AND WE ARE HERE AT THIS MOMENT. UM, FIRST OFF, THE, IS THERE A TIME, A, A TIME ALLOTMENT THAT THEY WANT US TO ADMINISTER ALL OF THE VACCINATIONS, OR IF A CERTAIN, UH, HOSPITAL GETS THIS MANY, THEY HAVE TO BE ALL USED BY A CERTAIN AMOUNT OF TIME. [00:45:01] DO YOU KNOW THAT? YES. IT ALL DEPENDS UPON YOUR STORAGE CAPACITY. SO IF YOU HAVE, UH, ULTRA COLD STORAGE, THOSE VACCINES CAN BE STORED FOR SIX MONTHS IN THE ULTRA COLD STORAGE FREEZERS, RIGHT? MM-HMM. . BUT THE IDEA IS NOT TO KEEP THOSE VACCINES ON THE SHELF. THE IDEA IS TO ADMINISTER YOUR WEEKLY ALLOCATIONS AS QUICKLY AS POSSIBLE. BECAUSE REMEMBER, THE INTENT IS TO GET, UH, AS MANY FOLKS VACCINATED AS QUICKLY AS POSSIBLE TO GET ONTO THE OTHER SIDE OF THIS PANDEMIC. UM, OKAY. UM, AND THEN IF WE ARE PUT GIVING IT TO OUR FRONTLINE WORKERS, THEY'RE NOT GOING TO, ARE THEY GOING TO HAVE TO QUARANTINE OR ANYTHING AFTER THEY GET THE VACCINE? UH, NO, WE DON'T HAVE ANY RECOMMENDATIONS ON, ON QUARANTINING POST VACCINE. UM, THE ID DOCS ARE LOOKING AT, UH, YOU KNOW, ISOLATING FOLKS WHO DEVELOP SYSTEMIC REACTIONS LIKE FEVER AFTER VACCINE INSTANCE. UH, THOSE RECOMMENDATIONS ARE BEING MADE BY THE HOSPITAL FACILITY. BUT AGAIN, I WANNA WAIT UNTIL ASEP RECOMMENDATIONS COME OUT. SO TWO THINGS I'M GONNA ASK YOU. UM, I KNOW YOU SAID THE, THE PANEL AT THE STATE LEVEL IS THE ONE DOING THE DETERMINATIONS, UH, AT THE CRITICAL, AT THE CRITICAL POPULATION GROUPS. UM, I, I THINK WE NEED TO DO MORE AS IN TELLING THEM THE GRAVITY OF THE SITUATION THAT WE HAVE HERE IN OUR POPULATION AND THEIR HEALTH DISPARITIES. UM, AND IF THAT IS TELLING ALL OF OUR STATE REPRESENTATIVES AND OUR STATE SENATORS, LET'S DO THAT. AND TWO, ON SLIDE 17, I WOULD LIKE TO GET THAT SLIDE, THAT MAP, AND IF YOU CAN OVERLAY THE NUMBER OF COVID CASES IN THE CITY ON THAT AND OVERLAY THE NUMBER OF COVID DEATHS IN THE CITY, AND THEN OVERLAY THE NUMBER OF TEST SITES THAT WE HAVE IN THE CITY WITH WHERE THIS ALLOCATION OF THE VACCINES ARE GOING TO TAKE PLACE. THANK YOU. THANKS, CHAIR. THANK YOU. UH, WE'LL ADD IT TO THE FOLLOW UP LIST, UH, COUNCILWOMAN GONZALEZ. UH, THANK YOU SO MUCH. UM, SO LET ME JUST START WITH, UM, A QUESTION. UH, SO IT'S ONE OF YOUR, YOUR, UM, WHAT WE STILL DON'T KNOW, IT SAYS WHETHER VACCINE VACCINATION WILL PREVENT ASYMPTOMATIC TRANSITION TRANSMISSION. SO CAN YOU EXPLAIN THAT? SO AT THIS TIME, YOU KNOW, WE BELIEVE, UH, 50%, UH, ANYWHERE FROM, UH, UH, 30 TO 50% OF THE TRANSMISSIONS ARE OCCURRING, UH, DEPENDING UPON WHERE, WHICH, WHICH GEOGRAPHIC LOCATION YOU LOOK ARE, UH, THE 30 TO 50% OF THE TRANSMISSIONS ARE OCCURRING AMONG ASYMPTOMATIC CASES OR BY ASYMPTOMATIC CASES. UM, SO WE DON'T KNOW, UH, AGAIN, IT'S, I PUT THAT UP THERE NOT SPECIFICALLY TO HIGHLIGHT THE ASYMPTOMATIC TRANSMISSIONS, BUT JUST TO SAY THAT JUST BECAUSE WE GOT, WE ARE VACCINATED, WE STILL DON'T KNOW IF THE IMMUNITY THAT IS CONFERRED AS A RESULT OF THIS VACCINATION IS, IS HIGH ENOUGH, GOOD ENOUGH TO PREVENT TRANSMISSION OF THIS INFECTION TO OTHERS, SHOULD WE GET THE INFECTION POST VACCINATION? UH, WE JUST DON'T HAVE THAT DATA. WE DO HAVE GOOD CLINICAL TRIAL DATA THAT SAYS, YES, IT'S EFFECTIVE, IT, IT IS SAFE, AND IT IS EFFECTIVE, AND IT DOES CUT DOWN ON TRANSMISSION. BUT BECAUSE WE DON'T HAVE THE PHASE FOUR, WHICH IS THE, WHICH IS, WHICH IS WHAT WILL HAPPEN NOW ONCE THE VACCINATION IS ROLLED OUT TO THE GENERAL POPULATION, RIGHT? IN REAL LIFE CONDITIONS, WE DON'T HAVE THE DATA JUST YET TO MAKE ALL THOSE DETERMINATIONS. SO ESSENTIALLY ALL IT'S SAYING IS WE DON'T KNOW IF THAT IMMUNITY THAT'S CONFERRED BY THOSE TWO DOSES, WOULD THAT BE ENOUGH IN UNDER REAL LIFE CONDITIONS TO, TO PREVENT, UH, A PERSON WHO GETS INFECTIONS AFTER VACCINATIONS TO, UH, TO, TO BE INFECTIOUS AND TRANSMIT THAT ILLNESS TO OTHERS? I THINK IT'S A LOT OF WORDS IN HERE. UM, OKAY. I, I'M, I I, I MIGHT NEED A LITTLE BIT OF, UM, UH, FOLLOW UP WITH THAT, BUT, BUT LET ME MOVE ON TO ANOTHER QUESTION. UM, THE DE UH, DEMOGRAPHIC DISTRIBUTION AS COVID 19 VACCINE PROVIDERS, AND YOU MENTIONED THE GAPS ON THE SOUTH SIDE, SO I, I DON'T SEE A GRAPH HERE. WHAT IS THE BLUE AND WHAT IS THE GREENS? THE GREENS, UH, SO 363, I THINK, HAVE, HAVE COMMENCED THE REGISTRATION PROCESS, BUT NOT ALL OF THEM HAVE BEEN APPROVED BY THE TEXAS DEPARTMENT OF STATE HEALTH SERVICES. SO THOSE GREEN DOTS ARE PROVIDERS WHO ACTUALLY, UH, [00:50:01] HAVE SUCCESSFULLY REGISTERED AT THE PORTAL, AND THE BLUE HAVE COMMENCED AND ARE STILL WAITING TO COMPLETE THE REGISTRATION PROCESS. OKAY. UH, THANK YOU FOR THAT CLARITY. AND THEN, UM, UH, REGARDING THE, UM, THE, THE PEOPLE WHO GET IT FIRST AND SECOND AND THIRD, THE ONE THAT, UM, SLIDE 19, THE FIRST PHASE AND THE SECOND PHASE. SO THAT WAS DETERMINED BY THE STATE, THAT WAS THAT. SO FEDERAL GOVERNMENT ALLOWED THE STATES TO DETERMINE HOW THEY WOULD DISTRIBUTE. SO THAT PHASE ONE A, ONE B, ONE C THAT YOU SAW WAS THE ASAP RECOMMENDATIONS, THAT'S THE CDCS ADVISORY COMMITTEE RECOMMENDATIONS. UH, STATES ARE NOT REQUIRED TO ADOPT IT, BUT THEY DO, LIKE I MENTIONED IN THE PRESENTATION, THEY DO CARRY STRONG WEIGHTS, AND MORE OFTEN THAN NOT, STATES DO ADOPT AND FOLLOW THOSE RECOMMENDATIONS. OKAY. OKAY. BUT, BUT, UM, AND HAS TEXAS ADOPTED THESE, UH, THEY HAVEN'T, UH, EXPLICITLY STATED, IF THEY HAVE ADOPTED THOSE PHASE ONE B AND ONE C, THEIR, THEIR FOCUS IS CURRENTLY ON THAT ONE, A POPULATION. SO A DECISION IS GOING TO BE MADE AND IT'LL BE PUT OUT. UM, I EXPECT IT TO BE OUT SOMETIME NEXT, IN THE NEXT FEW WEEKS, THE NEXT TWO WEEKS. UM, OKAY. OKAY, GREAT. THANK YOU. I, I MIGHT HAVE A FEW MORE QUESTIONS, SO I'LL, I, I MAY CHIME BACK IN. THANK YOU, CHAIR. THANK YOU. COUNCILMAN TRIVIO. THANK YOU CHAIR. AND, UH, THANK YOU DR. AND I, UH, I THOUGHT YOUR, YOUR PRESENTATION WAS, UH, A AN EXAMPLE OF WHY WE SHOULD BE LEANING ON OUR, OUR EXPERTS, SUBJECT MATTER EXPERTS. UM, WHEN IT COMES TO, UH, LIFE SAFETY ISSUES LIKE THIS ONE, UH, MY CONCERN IS THAT YOU'RE COMPETING WITH, UH, POLITICAL MESSAGES THAT EXIST OUT THERE, AND THAT COMPETITION, UH, TENDS TO DEVALUE A LOT OF THE WORK THAT YOU'RE, OR THE MESSAGING YOU'RE TRYING TO GET OUT. SO, UH, THIS IS REALLY MORE BROADLY TO THE CITY. MY REQUEST IS THAT WE TAKE ADVANTAGE OF EVERY POTENTIAL RESOURCE THAT WE HAVE, UH, TO, TO MAKE SURE THAT ALL THOSE ARE ALIGNED WITH WHAT YOUR MESSAGING NEEDS TO BE. FOR EXAMPLE, UH, JEFF COYLE AND HIS TEAM NEED TO BE REACHING OUT AND MAKING SURE THAT, THAT THAT MESSAGE IS ALIGNED WITH WHAT YOU'RE DOING. OUR 3 1 1 SYSTEM NEEDS TO PROVIDE ANSWERS FOR PEOPLE. SO EVERYWHERE WE HAVE A TOUCHPOINT WITH PEOPLE AS A CITY, THAT THAT MESSAGE MUST BE CLEAR, UH, BECAUSE YOU'RE COMPETING WITH, UH, JUST WAY TOO MUCH, UH, UM, UH, UH, MIXED MESSAGING AND, AND, AND FOLKS ARE GONNA BEGIN ARE, ARE OBVIOUSLY MISTRUSTING, UH, THE, THE, WITH THE THINGS YOU'RE TRYING TO SAY. UH, ON TOP OF THAT, YOU KNOW, I JUST, I WANNA ASK YOU, I DO WANNA ASK YOU ABOUT SOMETHING YOU DIDN'T PRESENT ABOUT THIS, BUT I WANNA, I WANNA GET YOUR THOUGHTS ON THIS AND GET YOU ON THE RECORD, BUT RESEARCHERS HAVE FOUND THAT STATES THAT ALLOW, HAVE ALLOWED THEIR EVICTION MORATORIUMS TO EXPIRE, HAVE CAUSED AS MANY OF, AS MANY AS 433,700 EXCESS CASES OF COVID, AND 10,700 ADDITIONAL DEATHS BE BETWEEN MARCH AND SEPTEMBER WITH THE EVICTION MORATORIUM, UH, ABOUT TO EXPIRE. DO YOU SEE THAT THIS AS A POTENTIAL HEALTH CRISIS THAT'S GONNA ADD TO THE BURDEN OF WHAT YOU'RE TRYING TO DO WITH THIS VACCINE? THE SHORT ANSWER IS YES. YES, COUNCILMAN? UM, I DON'T HAVE, UH, THE, THE STATS TO, TO SUPPORT WHAT I'M SAYING, BUT THE SHORT ANSWER IS ABSOLUTELY YES. OKAY. AND, AND SO, AND WE'VE SAID THIS BEFORE, HOUSING IS HEALTHCARE. AND SINCE I'M RUNNING OUTTA TIME, I JUST WANNA FOLLOW UP QUICKLY WITH SPEAKING OF, OF THAT, YOU KNOW, OUR HOMELESS POPULATION, UH, WHO I SEE AS THE MOST POP VULNERABLE POPULATION IN OUR, IN OUR COMMUNITY. UH, WHAT ARE WE GONNA BE DOING FOR OUR HOMELESS POPULATION? SO WE WILL BE, UM, WORKING WITH, UM, I DON'T HAVE THE, UH, THE NAME OF THE GROUP, BUT, UM, HOMELESS POPULATION, UH, THEY HAVE MEDICAL DIRECTORS. WE ARE, UM, WE ARE STRONGLY ENCOURAGING THEM TO BE VACCINE PROVIDERS THEMSELVES. UH, ONCE WE GET VACCINES, LIKE I SAID, WE WILL BE VACCINATORS AND WE'LL BE ANOTHER VENUE FOR THIS HOMELESS POPULATION, UM, TO, TO ACCESS THE VACCINES THROUGH OURS. UM, I KNOW ALL, UM, UNIVERSITIES, U I W U H SS, UT HEALTH, UM, THEY ARE ALL VACCINE PROVIDERS. THEY'RE ALL, UM, REGISTERED VACCINE PROVIDERS. AND AFTER [00:55:01] THE, THEIR PHASE ONE A PRIORITY POPULATION HAS BEEN TAKEN CARE OF, I THINK THAT WE ARE IN CONVERSATIONS WITH THESE FACILITIES TO NOW REDIRECT THEIR ATTENTION, UH, TOWARDS THESE POPULATIONS THAT DON'T HAVE MUCH ACCESS TO CARE AT THIS TIME OR THE INITIAL FEW WEEKS OF ALLOCATIONS. SO, WELL, AND I'LL MAKE THE, AND I'M GONNA MAKE THE PITCH THAT, THAT THERE'S A CONNECTION WITH D H S AND THE NEW SHOWER TRAILER THAT WE HAVE, THAT THERE'S SOME OPPORTUNITIES THERE TO MAYBE COMBINE, UH, OUR RESOURCES, UH, WHERE WE HAVE THOSE TOUCHPOINTS. AGAIN, IT KIND OF GOES BACK TO MY FIRST COMMENT ABOUT LET'S ALIGN ALL THOSE RESOURCES WHERE WE HAVE COMMUNITY TOUCHPOINT. THANK YOU SO MUCH. THANKS, CHAIR. UM, IT JUST A QUICK ANNOUNCEMENT. UH, WE, WE ARE GONNA GO BACK FOR, UH, COUNCILMAN GONZALEZ IN SECOND ROUND. I THINK THIS TOPIC IS EXTREMELY, UH, WEIGHTY AND I KNOW THAT THERE ARE ADDITIONAL QUESTIONS FROM AT LEAST TWO COUNCIL MEMBERS. SO WHAT I'M GOING TO RECOMMEND IS THAT WE HOLD ON OUR THIRD ITEM AND, UH, HEAR THAT ON A, AT A FUTURE TIME, IF WE CAN, UH, HOPEFULLY FIND A, A DATE BEFORE THE END OF JANUARY TO HEAR THAT. AND, UH, GO AHEAD AND GIVE THIS A LITTLE BIT MORE TIME AND THEN JUMP INTO HEALTHY NEIGHBORHOODS. UM, SO, UH, GOING BACK TO, UH, COUNCILWOMAN, ACTUALLY COUNCILWOMAN ANDREW SULLIVAN, AND THEN WE'LL GO TO, UM, TO COUNCILWOMAN GONZALEZ. THANK YOU. THANK YOU, MADAM CHAIR. THE LAST QUESTION I HAVE, UM, KIND OF STARTS WHERE COUNCIL MEMBER TREVINO LEFT OFF AS FAR AS THE CAMPAIGNING TO OUTREACH AND EDUCATE THE COMMUNITY. THERE ARE STILL FEARS ABOUT TAKING VACCINATIONS, UM, AMONGST OUR COMMUNITY. SO WHAT IS THE CAMPAIGN, OR WHAT IS THE, THE ROUTE THAT METRO HEALTH IS GOING TO BE TAKING TO SPEAK TO THOSE FEARS? WE KNOW WE HAVE THE VIRTUAL TOWN HALL THAT IS COMING UP, BUT WHAT OTHER, UM, MATERIALS ARE WE USING? WE KNOW THAT THERE'S A FEAR OF WHAT HAPPENED DURING THE TUSKEGEE AIRMEN, UM, VACCINES, AND SO WE WANNA KNOW HOW ARE YOU GONNA SPEAK SPECIFICALLY TO THOSE COMMUNITIES THAT HAVE FEAR ABOUT WHAT A VACCINATION, UM, SUCH AS THIS BEING NEW AND NOT REALLY HAVING THE FULL, UM, UNDERSTANDING OF IT. HOW ARE WE GONNA SPEAK TO THAT? SO YOU'VE ALREADY MENTIONED THE COMMUNITY TOWN HALLS. THAT'S ONE WAY, ONE VENUE, ONE OPPORTUNITY, UH, FOR US TO GET THIS MESSAGE OUT TO THIS COMMUNITY. AND WHAT WE ARE DOING IS COMPILING THE, UH, INFORMATION WE ARE GLEANING OR GETTING FROM THESE COMMUNITY TOWN HALLS AND COMPILING THEM, AND, UH, COMING, TRYING TO COME UP WITH SOME TARGETED MESSAGES AROUND THOSE, UH, QUESTIONS OR ISSUES OR CONCERNS THAT WERE BROUGHT UP WITH THE COMMUNITY, UH, IN THESE COMMUNITY CONVERSATIONS. UM, WE ARE ALSO CLOSELY WORKING WITH OUR EDUCATION ENFORCEMENT WORK GROUP. UH, THEY HAVE BEEN GREAT PARTNERS. UH, WE ARE WORKING WITH THEM TO COME UP WITH SOME TARGETED MESSAGES, TARGETING, ESPECIALLY THESE, UM, SEGMENTS OF POPULATION THAT HAVE THIS MISTRUST OF, UH, YOU KNOW, THE GOVERNMENT, UM, NOT JUST, UH, WITH THE GENERAL POPULATION MESSAGING. UH, EDUCATION ENFORCEMENT WORK GROUP IS ALSO ASSISTING US WITH PROVIDING TARGETED MESSAGING TO THE PROVIDERS. ALSO, THERE ARE EQUAL NUMBER OF PROVIDERS THERE THAT ARE JUST AS SKEPTICAL OF THIS VACCINE AS THE GENERAL POPULATION. UM, ONE, UH, ONE IDEA, UH, THAT WE HAVE BEEN, UH, THROWING AROUND AND WHICH WE WILL BE IMPLEMENTING PRETTY SOON IS TO, UM, IS TO HAVE, UM, IDENTIFY TRUSTED SPOKESPERSONS AND RELY ON COMMUNITY LEADERS AND INFLUENCERS, UH, FROM THIS, THIS SEGMENT OF POPULATION THAT CAN BE CRUCIAL IN, IN GETTING OUR WORD OUT THERE. OKAY. AND THEN TO CIRCLE BACK ON ONE QUESTION, DR. KIAN, UM, WITH THE EMPHASIS ON THE COMPROMISED IMMUNE SYSTEMS, UM, DO WE KNOW IF ANY RELATION HAS BEEN LINKED TO, UH, THE TRIALS AND THOSE THAT, UM, PARTICIPATED WITH COMPROMISED IMMUNE SYSTEMS AND WHAT THE OUTCOME WAS OF THAT? OR HOW DO WE SPEAK TO INDIVIDUALS THAT HAVE THE, THE COMPROMISED IMMUNE SYSTEMS AND HOW THIS VACCINE WILL TRULY RELATE TO THEIR HEALTH? SO, UM, IF YOU LOOK AT THE ASAP RECOMMENDATIONS, THE PHASE, UM, PHASE ONE C POPULATION ARE THOSE FOLKS WITH UNDERLYING MEDICAL CONDITIONS THAT ARE BELIEVED TO BE IMMUNOCOMPROMISED. UM, THERE WERE, UM, UH, THE CLINIC, UH, THE CLINICAL TRIAL PARTICIPANTS, UH, ALTHOUGH THERE WAS A SMALL GROUP, THERE WERE FOLKS, UH, WHO WERE, WHO HAD UNDERLYING MEDICAL CONDITION CONDITIONS WHO WERE ENROLLED IN THESE TRIALS TOO. UM, AND, AND, UH, AND THE VACCINE WAS FOUND TO BE UNDER CLINICAL TRIAL SETTINGS, WAS FOUND TO BE EFFECTIVE AND SAFE EVEN AMONG THESE IMMUNOCOMPROMISED POPULATIONS. BUT [01:00:01] LIKE I SAID, IT REMAINS TO BE SEEN HOW IT'S GONNA BEHAVE IN UN IN, IN REAL LIFE CONDITIONS. AND I AM CERTAINLY LOOKING FORWARD TO THAT. I KNOW, I, I DEFAULT BACK TO THOSE A OF RECOMMENDATIONS WHO, YOU KNOW, THESE ARE, UH, A GROUP OF EXPERTS, PUBLIC HEALTH AND MEDICAL EXPERTS WHO ARE LOOKING AT ALL THIS TRIAL DATA. SO I'M CURIOUS TO KNOW WHAT THE RECOMMENDATIONS WILL BE, AND IT SHOULD BE OUT THERE BY, BY EITHER, EITHER LATER THIS EVENING OR FIRST THING MONDAY MORNING. OKAY. THANK YOU SO MUCH, DR. KIAN. THANK YOU, MADAM CHAIR. THANK YOU, COUNCILWOMAN. ALL GREAT QUESTIONS. UH, COUNCILWOMAN VRAN, DID YOU HAVE ANY FOLLOW UP? YES, I DID. THANK YOU. UM, ON YOUR, UH, TIERS, UM, THE, THE TIERS OF THE POPULATION OF THE ONE A POPULATION, OH, FIRST OF ALL, UM, I'M CURIOUS TO FIND OUT A LITTLE BIT MORE ABOUT THE, THE DOSES, BECAUSE YOU MENTIONED THAT THE DOSES CANNOT BE MIXED, NOT A PFIZER OR WITH A MODERNA, ET CETERA. SO IF WE ARE GETTING OUR FIRST, UH, SHIPMENT, IF YOU WILL, OF PFIZER, AND THEN THE SMALLER COMMUNITIES ARE GETTING MODERNA, THEN THAT MEANS THAT THEY'RE NOT GOING TO BE ABLE TO, THEY'RE ESSENTIALLY, WE'RE ALL GONNA BE ON THE TIMELINE FOR THE, THE MANUFACTURERS OF THE VACCINES PERIOD. UM, SO HAVE THEY GIVEN US ANYTHING TO FIND OUT IS IT GOING TO BE ANOTHER, IF THEY TAKE THE FIRST DOSE OF MODERNA, WHEN IS THE SECOND DOSE SUPPOSED TO BE ADMINISTERED? SO FOR PFIZER, UH, THE, THE DURATION BETWEEN THE FIRST AND THE SECOND DOSE IS 21 DAYS. AND WITH MODERNA THE DURATION IS 28 DAYS. BUT, BUT WE HAVE NO ASSURANCES FROM THE MANUFACTURERS THAT THEY'LL, THEY'LL BE GETTING THEM OUT IN THAT YES. ENOUGH TIME, OR DO WE NO, THEY, WE WILL. SO, SO WHEN THE FEDERAL GOVERNMENT SAYS WE ARE RELEASING 20 MILLION DOSES OF, SAY, MODERNA, THEY'VE ALREADY HELD BACK 20 MILLION DOSES OF MODERNA AT THE FEDERAL LEVEL FOR THE, FOR THE SECOND DOSE. SO, SO WE CAN BE REST ASSURED THAT IF A HUNDRED DOSES OF MODERNA IS RELEASED FOR THE FIRST DOSE VACCINATIONS, HUNDRED DOSES OF MODERNA FOR THE SECOND DOSE VACCINATIONS ARE BEING HELD AT THE FEDERAL LEVEL. OKAY. ALRIGHT. SO THAT, THANK YOU FOR THAT. C D C MAKING THOSE CLAIMS. 40 MILLION, UH, DOSES ARE OF PFIZER IS AVAILABLE, HOWEVER, IT CAN ONLY VACCINATE 20 MILLION PEOPLE. THEY'RE TAKING INTO ACCOUNT THOSE TWO DOSES. OKAY. AND SO, UM, AGAIN, THE, THE NURSING HOMES, ARE THE NURSING HOMES THEMSELVES GOING TO HAVE TO REGISTER OR CAN THEY ASSIGN SOMEONE TO GO AND ADMINISTER THESE VACCINES TO THE NURSING HOMES? YEAH, IT'S, OH, YOU MENTIONED THAT THEY'RE GOING WITH THE, THE COMMERCIAL OR THE RETAIL. YEAH. OKAY. YEAH. AND SO THAT MAP SHOULD TELL US WHICH NURSING HOMES HAVE ENROLLED? YES, YES. OKAY. AND, UM, SORRY, THE MAP THAT I PUT UP IN MY PRESENTATION IS THE MAP OF C OVID 19 VACCINE PROVIDERS WHO'VE REGISTERED WITH THE TEXAS DEPARTMENT OF STATE HEALTH SERVICES REGISTRATION PORTAL. UM, BUT I CAN CERTAINLY PROVIDE YOU, I DID NOT PRESENT THE MAP OF THE NURSING HOMES WHO'VE CONTRACTED WITH THE RETAIL PHARMACIES. I CAN PROVIDE THAT. IF, IF YOU CAN PROVIDE THAT, I THINK THAT WOULD BE HELPFUL INFORMATION. JUST WANNA MAKE SURE THAT THOSE, I'VE HAD THOSE SMALL OUTBREAKS ARE PART OF THAT. THANK YOU. THANK YOU CHAIR. THANK YOU. COUNCILWOMAN COUNCILWOMAN GONZALEZ. UH, SO, UM, A FOLLOW UP QUESTION I HAD, UM, WAS, UH, REGARDING, UM, CHILDREN. SO I KNOW THAT CHILDREN ARE NOT NECESSARILY IN THE FIRST OR SECOND TIER, BUT I DO SEE THAT THE VACCINE PRESENTED SHOWS THAT THEY'RE FOR PEOPLE 18 AND OVER AND THEN ONE FOR 12 AND OVER. UM, ARE CHILDREN JUST NOT PART OF THE SAMPLE? YES. SO INITIAL TRIAL DATA, UH, THAT WAS PRESENTED TO F D A BY PFIZER, THAT WAS FOR 16 YEARS AND OLDER. UH, NOW PFIZER GOT AN EMERGENCY USE AUTHORIZATION ON, I BELIEVE IT WAS, UH, [01:05:01] OCTOBER 22ND TO EXPAND THEIR CLINICAL TRIAL PARTICIPANTS TO INCLUDE CHILDREN WHO ARE 20, UH, 12 YEARS AND OLDER. SO, UM, ALTHOUGH THAT TABLE SAYS 12 YEARS AND OLDER, THE E U A IS ONLY FOR 16 YEARS AND OLDER, UH, ACTUALLY 17 YEARS AND OLDER. SO NOTHING FOR YOUNG CHILDREN. YEAH, WE DON'T HAVE SUFFICIENT DATA AT THIS TIME, UH, SAFETY OR EFFICACY DATA AT THIS TIME IN THAT, UH, PEDIATRIC POPULATION. BUT SINCE THE TRIAL IS NOW ENROLLING 12 YEARS AND OLDER, WE HOPE TO SEE SOMETHING PRETTY SOON. UM, OKAY. UH, AND THEN ANOTHER QUESTION I HAD, WAS IT PEOPLE THAT HAVE ALREADY HAD THE VIRUS? DO THEY NEED A VACCINE? AGAIN, I'M GONNA DEFAULT TO ACEP. SO PEOPLE WHO HAVE ALREADY BEEN INFECTED WITH C OVID 19, WE KNOW THAT THEY HAVE IMMUNITY FOR A FINITE PERIOD, RIGHT? WHICH IS AT THIS TIME FOR 90 DAYS. SO WE DON'T KNOW POST 90 DAYS, UH, TO BE IMMUNE FOR FUTURE INFECTIONS, WOULD THEY HAVE TO TAKE THIS VACCINE? SO THAT'S SOMETHING THAT I AM WAITING FOR ASEP RECOMMENDATIONS TO COME OUT BEFORE WE COMMENT ON THIS ONE WAY OR THE OTHER. SO ASEP IS GOING TO MAKE THOSE VACCINE SPECIFIC RECOMMENDATIONS. OKAY. UM, OKAY. WELL I THINK THAT THOSE ARE ALL THE QUESTIONS THAT I HAVE FOR THE MOMENT. UM, THIS IS, UM, THIS IS JUST THE BEST NEWS I'VE HEARD IN A LONG, LONG TIME. SO, UM, YOU KNOW, THANK YOU, UM, FOR, FOR, UH, ADVANCING IT AS QUICKLY AS POSSIBLE, UM, CHAIR SO THAT WE COULD GET THIS INFORMATION OUT. AND I KNOW THAT, UM, YOU KNOW, HOPEFULLY IF THERE'S ANY, UH, TIME THAT PEOPLE TUNED INTO OUR MEETINGS, UM, AND THAT NOW WE HAVE A, A WAY TO COMMUNICATE WITH PEOPLE, UM, THAT IT'S TODAY. SO, UH, THANK YOU FOR THE PRESENTATION. THANK YOU. THANK YOU, DR. CORIAN. AND, UH, COUNCILMAN TRUO, IF YOU HAD ANY FOLLOW UP QUESTIONS? UH, NO, JUST TO, AGAIN, REEMPHASIZE, UH, YOU LINING UP ALL OUR AVAILABLE RESOURCES AS MUCH AS POSSIBLE. UM, YOU KNOW, I THINK THAT, UH, YOU KNOW, THERE'S SO MANY THINGS THAT, THAT, THAT REALLY CONNECT THE DOTS AND, UH, WE LEFT OFF WITH THE HOMELESS POPULATION AND, UM, WE'RE DOING EVERYTHING THAT WE CAN TO, UH, EXPAND ON THE OUTREACH PROGRAM. NEXT WEEK. WE'RE GETTING A BRIEFING ON THIS, UH, AND, UH, WE, UH, WE GOT A SHOWER TRAILER. WE'RE GETTING MORE. AND, UH, YOU KNOW, I REALLY WOULD LIKE TO SEE, UM, SOME KIND OF A PLAN, SOME COORDINATED EFFORT BETWEEN, UM, METRO HEALTH AND, UH, D H SS, UH, TO HELP WITH, WITH THIS PARTICULAR ISSUE. AND AS COUNCIL MEMBER GONZALEZ POINTED OUT, KIDS, YOU KNOW, WE ARE SEEING A LOT OF KIDS OUT HERE IN THE STREETS, AND IT'S, IT'S HEARTBREAKING. UH, SO, YOU KNOW, LET'S, LET'S CONSIDER, UM, NOT ONLY ARE WE SEEING, UM, THE, THE, UH, ADULTS OUT HERE, BUT WE'RE SEEING, UH, SINGLE MOMS AND WITH THEIR KIDS OUT HERE HOMELESS. UM, AND IT'S, IT'S, IT'S JUST HEARTBREAKING. THANK YOU. THANK YOU. UM, THANK YOU DR. CORIAN, AND TO THE WHOLE TEAM. UH, I, I KNOW IT'S A, A TEAM EFFORT OVER THERE. THAT WAS VERY THOROUGH PRESENTATION. WE LOOK FORWARD TO HAVING YOU BACK HERE NEXT MONTH, YOU OR YOUR DESIGNEE BACK HERE NEXT MONTH, UH, TO, TO GIVE US AN UPDATE. SO THANK YOU. AT THIS POINT, WE WILL MOVE ON TO OUR NEXT ITEM, WHICH [3 20-7199 A briefing on the Metro Health Healthy Neighborhood program expansion model and plan for working in new neighborhoods. [Colleen M. Bridger, MPH, PhD, Assistant City Manager; Sandra Guerra, MD, MPH, Interim Deputy Public Health Director, Health]] IS A BRIEFING ON THE HEALTHY NEIGHBORHOOD PROGRAM EXPANSION MODEL AND PLAN, UH, FOR WORKING IN NEW NEIGHBORHOODS. UH, BEFORE WE START, I'M JUST GOING TO SAY, IF YOU'RE EXCITED ABOUT VACCINES, YOU'LL ALSO BE EXCITED , ABOUT THE EXPANSION OF THE HEALTHY NEIGHBORHOOD PROGRAM. UM, FOR THE FIRST TIME IN A, I GUESS IN A LONG TIME, WE EXPANDED THE BUDGET FOR THIS PROGRAM, SO I'M REALLY GRATEFUL TO ALL THE COUNCIL MEMBERS FOR, FOR, UH, CONTRIBUTING TO THAT AND AGREEING TO PUT AN ADDITIONAL HALF MILLION DOLLARS INTO THIS PROGRAM. I FEEL THAT IT IS GOING TO BE SO IMPACTFUL, AND I'VE, I'VE GOTTEN A, A LITTLE BIT OF A SNEAK PEEK AT WHAT'S GOING TO HAPPEN WITH THAT. AND I, I AM JUST TREMENDOUSLY EXCITED AND, AND I WILL TURN IT OVER TO, TO METRO HEALTH TO SHARE THE, THE GOOD NEWS. ALRIGHT, ANNA, ARE YOU READY TO KICK US OFF? I SURE AM. THANK YOU FOR THAT, THAT INTRO COUNCILWOMAN. UM, I'M GLAD THAT YOU GOT A SNEAK PEEK AT WHAT WE'RE SO EXCITED ABOUT TOO. AND I APPRECIATE THIS INVITATION TO SHARE WITH EVERYBODY ON THIS COMMITTEE REALLY ABOUT, UM, A LITTLE BIT ABOUT OUR PROGRAM. I WANNA MAKE SURE EVERYBODY KIND OF KNOWS WHAT WE HAVE BEEN DOING AND THEN OUR PROGRESS ON EXPANDING THE PROGRAM AND SERVICES WITH THIS ADDITIONAL FUNDING. SO, UM, JUST START US OUT. MY NAME IS ANNA [01:10:01] MNA, AND I AM A REGISTERED DIETICIAN AS WELL AS THE PROGRAM COORDINATOR FOR OUR HEALTHY NEIGHBORHOODS PROGRAM. AND WE'LL DIVE IN HERE. FIRST, I JUST WANNA KIND OF GIVE US A, A LITTLE BIT OF CONTEXT TO WHERE OUR PROGRAM IS WITHIN THE BIGGER STRUCTURE. UM, WITHIN METRO HEALTH, WE ARE PART OF THE COMMUNITY HEALTH AND SAFETY DIVISION, UM, IN THE CHRONIC DISEASE PREVENTION SECTION. SO THAT'S US IN THE CHRONIC DISEASE PREVENTION SECTION THERE. UM, DENISE BENOIT ZUMA IS OUR PROGRAM MANAGER FOR THIS, UM, SECTION, WHICH INCLUDES SOME OF OUR SISTER PROGRAMS AS WELL, UM, INCLUDING THE DIABETES PREVENTION PROGRAM, THE COMMUNITY NUTRITION PROGRAM, MAYOR'S FITNESS COUNCIL, UM, AND SO WE'RE ALL ABLE TO REALLY WORK TOGETHER TO MEET THE NEEDS OF THE COMMUNITY. UM, NEXT SLIDE, PLEASE. AND I WANNA KIND OF GROUND US IN N R Y. SO WE BELIEVE THAT ALL FAMILIES DESERVE HEALTHY NEIGHBORHOODS, AND THEY POSSESS THE ASSETS TO CREATE POSITIVE CHANGE. THIS IS WHY WE DO WHAT WE DO, AND THIS IS WHY WE DO IT IN THE WAY WE WE DO IT. AND SO THIS SENTENCE REALLY CAME OUT OF A TEAM ACTIVITY WHERE WE WORK TOGETHER TO COME UP WITH A STATEMENT THAT WOULD CAPTURE OUR COLLECTIVE PASSION ABOUT THIS WORK. UM, WHILE THIS IS MORE KIND OF A FUZZY SENSE OF WHAT WE DO, A WARM AND FUZZY SENSE. AND THE NEXT SLIDE I'LL KIND OF START SHARING WITH YOU A LITTLE MORE THAN NUTS, SIMPLE BOLTS. UM, SO I'VE OVERSIMPLIFIED IT A LITTLE BIT, BUT WHAT I REALLY WANNA DEMONSTRATE HERE IS THAT, UM, THIS PROGRAM STARTED AT A, AS AN 1115 MEDICAID WAIVER FUNDED PROGRAM IN THE 2011 2012 TIMEFRAME TO ADDRESS CHILDHOOD OBESITY THROUGH AN INNOVATIVE APPROACH USING THIS COMMUNITY HEALTH WORKER MODEL AS COMMUNITY ORGANIZERS TRAINED IN OUR ASSET-BASED COMMUNITY DEVELOPMENT FRAMEWORK. AND IT'S A MODEL THAT REALLY TAPS INTO THOSE LOCAL RESOURCES AND KNOWLEDGE TO UNLOCK THE SOLUTIONS THAT PEOPLE, UM, THAT LIVE IN THOSE SPACES ALREADY HAVE WITHIN THEM. SO IN 2018, WE WERE ALSO AWARDED THE REACH GRANT, WHICH ALLOWED US TO EXPAND AT THAT TIME, AND IT REALLY COMPLIMENTED THE EXISTING WORK WE'RE DOING BY VALUING THOSE COMMUNITY HEALTH WORKERS AS THE AGENTS OF CHANGE IN, IN COMMUNITIES OF COLOR. AND SO COMBINING THESE TWO APPROACHES HAS BEEN A KEY TO OUR SUCCESS THESE LAST COUPLE YEARS. THE REACH FUNDING FROM THE C D C BRINGS IN THAT FRAMEWORK THAT REALLY LOOKS AT SYSTEM POLICIES AND ENVIRONMENTAL CHANGES TO SUPPORT HEALTH AND COMMUNITIES OF COLOR. AND OUR WAIVER PROGRAM, WHICH WE CAN'T REALLY CALL THAT ANYMORE, WE'LL CALL IT OUR NEIGHBORHOOD BASED PROGRAM, OR, UM, THE COMMUNITY HEALTH WORKERS PREFER IT TO BE CALLED THE COMMUNITY CONNECTOR PIECE OF OUR PROGRAM. UM, THIS REALLY COMPLIMENTS THAT WE, WE, THESE STRATEGY CHANGES THAT ARE INVOLVED IN THE POLICY ENVIRONMENTAL. AND THEN WE HAVE A TEAM THAT'S REALLY SKILLED IN, IN EDUCATION AND COMMUNITY ORGANIZING AND OUTREACH. AND SO WITH THESE TWO FUNDING SOURCES REALLY DEEPLY ENTWINED, UM, UM, WE'RE ABLE TO BRING THOSE ADDITIONAL RESOURCES INTO THE COMMUNITIES THAT WE, THAT WE SERVE. AN EXAMPLE OF THIS WOULD BE, UM, THE TOBACCO FREE LIVING WORK, UM, THROUGH THE REACH GRANT, WHICH IS ONE OF OUR PRIORITY STRATEGIES. UM, WE'RE DOING THIS WORK AT APARTMENT COMPLEXES AND THE REACH COMMUNITY HEALTH WORKERS ARE LEADING THAT PROJECT AND BECOMING THE EXPERT EXPERTS IN TOBACCO FREE LIVING. UM, AND THEY'RE USING TAPPING INTO THE KNOWLEDGE OF THE NEIGHBORHOOD BASED COMMUNITY HEALTH WORKERS TO LEVERAGE THOSE EXISTING RELATIONSHIPS, BRINGING THE RESOURCES FROM THE REACH GRANT INTO THE APARTMENTS, UM, IN THE AREAS THAT WE'RE SERVING. GO AHEAD AND ADVANCE, UH, SOME EXAMPLES OF THIS BECAUSE EVERYBODY WANTS TO KNOW WHAT WE DO IN HEALTHY NEIGHBORHOODS, AND IT'S, IT'S LIKE SO MUCH TO JUGGLE. SOMETIMES I, SOMETIMES I'M LIKE, OH, WHERE DO I START? SO WE WANTED TO PROVIDE YOU WITH JUST A COUPLE PICTURES OF SOME OF THE EXAMPLES OF OUR WORK. UM, THE COMMUNITY HEALTH WORKERS ARE REALLY COMMUNITY ORGANIZERS AS WELL AS EDUCATORS, AS WELL AS THAT PULSE OF THE COMMUNITY, ABLE TO GET AN IDEA OF WHAT THE COMMUNITY NEEDS, UM, AND WORK WITH THEM TO BRING THAT TO THE COMMUNITY. SO THESE TWO EXAMPLES HERE, BOTH THE PICTURE OF YOUR WORLD, UM, PROGRAM AND MISSIONS, SAN JOSE AND THE GIRLS ON THE RUN AT VILLAREAL ELEMENTARY ARE BOTH REALLY GOOD EXAMPLES OF RESOURCES IN OUR SAN ANTONIO COMMUNITIES THAT ARE COMMUNITY HEALTH WORKERS ARE BRINGING INTO THE NEIGHBORHOODS THAT THEY'RE SERVING. SO I REALLY LIKE THOSE AND THEY DO GREAT WORK. THE NEXT SLIDE IS SOME EXAMPLES ABOUT PROGRAMS THAT WERE SPECIFICALLY CREATED AND THEN IMPLEMENTED BY THOSE COMMUNITY HEALTH WORKERS BASED IN THE NEIGHBORHOOD. SO THE FRUIT TREE MAPPING IN HIGHLAND PARK IS, UH, JUST AN AWESOME PROGRAM THAT WAS CREATED JUST BASED ON SEEING FRUIT TREES IN THE NEIGHBORHOOD THAT WERE FULL OF FRUITS. AND SOMETIMES THE HOMEOWNERS WERE MAYBE ELDERLY OR, OR [01:15:01] WEREN'T ABLE TO PICK THE, THE FRUIT FOR UNDER MANY NUMBER OF REASONS. AND SO, UM, WE HAVE A KINDA A REGISTRY OF THESE HOMES THAT HAVE AGREED TO PARTICIPATE IN THIS PROGRAM. AND WHEN THEIR FRUIT IS RIPE, THEY CAN GIVE OUR ORGANIZERS A CALL. THEY CALL OTHER ORGANIZERS. THEY CALL VOLUNTEERS ORGANIZATIONS. WE'VE GOT THESE AWESOME FRUIT PICKERS. UH, WE GET A TEAM OF FOLKS OVER THERE PICKING THE FRUIT. AND THEN WE HAVE, UH, THE DISTRIBUTION TO EITHER FOOD PANTRIES IN THE AREA OR SOME DIFFERENT ORGANIZATIONS THAT ARE INTERESTED IN, IN MAKING SURE THAT THIS LOCALLY GROWN IN THEIR BACKYARD. UM, FRUIT IS DISTRIBUTED TO THE PEOPLE OF THE NEIGHBORHOOD. SO REALLY AWESOME PROGRAM AND DEFINITELY A JUST AN ORGANIC CREATION OF THAT. UM, OUT OF THAT, THAT PARTICULAR NEIGHBORHOODS ASSETS, THE FAMILY YOGA AT CAMELOT, WE HAVE OUR COMMUNITY HEALTH WORKER ETTE WHO WORKS IN THAT NEIGHBORHOOD, UM, ALSO TRAINED IN IN YOGA AND A, A BILINGUAL, UM, EDUCATOR THERE. AND YOGA IS NOT JUST ABOUT YOGA, IT'S ALSO ABOUT CONNECTION. AND WHAT SHE DID IS SHE BROUGHT YOGA TO A SCHOOL FREE CLASSES WHERE THE PARENTS AND THE KIDS ARE ENCOURAGED TO DO THIS ACTIVITY TOGETHER. AND IT SO, UM, EMBODIES OUR KIND OF HOLISTIC WHOLE FAMILY APPROACH TO HEALTH. UM, SO I LOVE THAT EXAMPLE, AND THERE'S A GREAT VIDEO ON THAT ON OUR WEBSITE, THE WALKING SCHOOL BUS, ANOTHER, UM, ORGANIC KIND OF PROGRAM. IT'S, IT'S A MODEL THAT'S BEEN USED THROUGHOUT THE COUNTRY, BUT IN THIS PARTICULAR NEIGHBORHOOD, THE PARENTS AND THE, AND THE FOLKS, THE TEACHERS AT, UM, THE SCHOOL, UM, WE'RE SAYING WE, WE NEED A SAFE WAY FOR OUR KIDS TO GET TO SCHOOL. WE HAVE AN PROBLEM HERE. WE'VE GOT, UM, KIDS THAT ARE WALKING, UM, YOU KNOW, WITHOUT A FAMILY MEMBER OR AN ADULT. AND THIS WAS A TRULY COLLABORATIVE PROCESS WHERE THE SCHOOL CAME TOGETHER, COMMUNITY ORGANIZATIONS, JOB PLUS, UM, SS A P D, THE HEALTHY NEIGHBORHOODS TEAM, UM, AND, AND CAME TOGETHER AND A COUPLE DAYS A WEEK WOULD WALK TO AND FROM, UM, SCHOOL WITH, WITH THESE KIDS. AND TRULY BEAUTIFUL. I WAS REALLY HAPPY TO BE ABLE TO PARTICIPATE IN THAT A COUPLE OF TIMES. SO IN THE NEXT SLIDE, UM, I WANTED TO SHOW THIS VIDEO. Y'ALL HAVE IT IN YOUR, YOUR INBOXES? I THINK SO. GO AHEAD AND WATCH THIS AT YOUR CONVENIENCE. IT'S ABOUT A THREE MINUTE VIDEO, AND IT'S WORTH EVERY SECOND BECAUSE IT PUTS EVERYTHING THAT I SAID ABOUT WHAT WE ARE IN, INTO ONE LITTLE PACKAGE. IT'S, UM, A REALLY AWESOME WAY TO DEMONSTRATE HOW REACH AND OUR NEIGHBORHOOD-BASED PROGRAM, UM, COMMUNITY HEALTH WORKERS WORK TOGETHER TO BRING CHANGE IN THE COMMUNITY. THIS IS THE PECON VALLEY, UM, WIC CLINIC TEACHING GARDEN. AND SO THIS WAS ALSO A COLLABORATION WITH GUARDIA GARDENS, WHICH IS, UM, IT'S BEEN AN AMAZING COMMUNITY PARTNER, HAS DONE SO MUCH GOOD WORK, UM, IN GARDENING, ESPECIALLY ON THE, THE EAST REGION AND IN SAN ANTONIO. AND, UM, THEM CREATING THIS GARDEN, OUR COMMUNITY HEALTH WORKERS, UM, ENGAGING BLOCK, WALKING IN THE COMMUNITY, INVITE OUR WIC UM, STAFF, ALSO INVITING THEIR PARTICIPANTS IN. UM, WE'VE HAD I THINK, FOUR, UM, EVENTS SO FAR. UH, COUNCILWOMAN ANDREW SULLIVAN, THANK YOU, UM, FOR COMING TO OUR REMIC CUTTING AND TREE PLANTING EVENT THAT WAS REALLY SPECIAL. AND, UM, IT WAS SO WONDERFUL TO SEE THE COMMUNITY, UM, EMBRACING THIS OPPORTUNITY TO HAVE GARDEN BASED EDUCATION AND PROGRAMMING AND, YOU KNOW, YOU CAN CALL IT FITNESS, THE GARDEN BASED EDUCATION. UM, IT ALL WRAPS IN TOGETHER AGAIN OF THAT, THAT WHOLE LOOK APPROACH. SO THE ULTIMATE GOAL OF THIS PROJECT IS GONNA BE FOR THE WIC CLINIC THERE, AS WELL AS THE COMMUNITY MEMBERS TO, TO SUSTAIN THE PROJECT. BUT, UM, THIS DOES TAKE TIME. SO I ANTICIPATE FOR THE NEXT COUPLE OF YEARS US NEEDING TO CONTINUE TO ACTIVATE THAT SPACE SO THAT IT'S REALLY ACCEPTED. UM, AND THEN THERE'S THOSE CHAMPIONS, THOSE LEADERS THAT COME FORTH WHO ARE READY TO TAKE ON THE PROJECT AND MAKE IT THEIR THEIR OWN. SO NEXT ONE, UM, THIS SLIDE IS OUR NEIGHBORHOOD BASED TEAM. SO AS I GET INTO TALKING ABOUT THE EXPANSION, UM, THIS IS KIND OF WHERE WE'RE TALKING ABOUT THE EXPANSION WORK TO BE DONE, WHICH IS REACHING, UM, MORE NEIGHBORHOODS. THIS IS OUR MODEL. IT'S A MODEL OF ONE COMMUNITY HEALTH WORKER IN EACH NEIGHBORHOOD WE'RE SERVING. AND SO THIS ONE-TO-ONE MODEL MEANS THAT WE REALLY HAVE SOMEBODY WHO'S, WHO'S VERY MUCH ON THE GROUND, UM, BEING WITH THE COMMUNITY, UM, DEFINITELY BEEN A, A CHALLENGE IN, IN COVID TIMES, UM, TO CONTINUE THAT SAME LEVEL OF CONNECTION. BUT WE'RE BEING AS CREATIVE AS POSSIBLE TO CONTINUE OUR CONNECTIONS IN THE COMMUNITIES. UM, AND WE HIRE OUR COMMUNITY HEALTH WORKERS BASED ON EITHER THEIR EXPERIENCE WITH LIVING IN THAT NEIGHBORHOOD, UM, OR A STRONG CULTURAL KINDA AFFINITY TO THE PEOPLE, UM, THAT WE'LL BE SERVING. SO, [01:20:01] SO, UM, WE, WE MATCH AS BEST AS POSSIBLE TO TRY TO, TO SERVE THE COMMUNITY. AND, AND THIS TEAM RIGHT HERE, WHAT AN AMAZING TEAM. I'M GONNA TELL YOU WHAT, UM, THEY WORK SO HARD AND THEY'RE SO PASSIONATE. AND, AND THERE'S TWO THINGS THEY'VE ASKED ME FOR IN THE THREESOME YEARS I'VE BEEN WITH THE PROGRAM. THEY ALWAYS SAY, WE WANT MORE NEIGHBORHOODS. AND THEY SAY, WE WANT MORE OF US IN EACH NEIGHBORHOOD. SO THOSE ARE THE THINGS THAT THEY'VE ALWAYS ASKED US FOR. SO WHEN THIS FUNDING OPPORTUNITY CAME AROUND, UM, WE PUT OUR HEADS TOGETHER PRETTY QUICK ALREADY KNOWING WHAT THE NEED WAS, UM, TO BE ABLE TO PUT TOGETHER, UM, A PROPOSAL TO, TO MEET BOTH OF THOSE DEMANDS THAT I'M HEARING FROM OUR, OUR TEAM. SO THE NEXT SLIDE IS A LITTLE BUSY, UM, BUT I'M GONNA TRY TO WALK US THROUGH IT HERE. I'M TRYING TO GIVE YOU THE SENSE OF, UM, HOW THIS THIS FUNDING SUPPORTS A REALLY STRONG SUSTAINABLE STRUCTURE FITTING INTO WHAT WE HAVE. IT'S ACTUALLY A LITTLE ASPIRATIONAL BECAUSE ALL THESE PIECES HAVE NOT BEEN PUT INTO PLAY YET, BUT, UM, WE ARE MOVING THEM AS WE SPEAK, UM, MAKING ROOM TO HAVE THE BEST POSSIBLE STRUCTURE FOR THE PROGRAM, UM, TO BE ABLE TO, TO SUPPORT THE TEAM ON THE GROUND. AND SO THE, THE, AND IN OUR PROGRAM PEOPLE ARE THE MOST IMPORTANT ASSETS. WE NEED REALLY VERY LITTLE RESOURCES TO CONDUCT OUR WORK, BUT WE DO NEED THOSE PEOPLE TO BUILD THOSE CONNECTIONS TO MAKE THAT WORK SUCCESSFUL. SO, UM, JUST THE COLOR CODING HERE IS ORANGE EQUALS WAIVER. UH, GREEN EQUALS OUR C D C REACH FUNDING. UM, AND YOU'LL NOTICE THERE'S A COUPLE CHWS, UH, COMMUNITY HEALTH WORKERS THAT ARE CURRENTLY FUNDED BY REACH, BUT WILL BE WAIVER AGAIN AFTER THIS YEAR. THEY HAVE A SPECIFIC ASSIGNMENT. UM, AND THEN THE BLUE ARE THE NEW POSITIONS. SO THE 500,000 SUPPORTS EIGHT NEW POSITIONS, THREE LEAD COMMUNITY HEALTH WORKERS, UM, WHICH ARE THE EXPERIENCED COMMUNITY HEALTH WORKERS, WHICH ARE REALLY THE KEY TO RETAIN, UM, MORE EXPERIENCED, UM, PEOPLE ON OUR TEAM, AS WELL AS, UM, HAVING THOSE INCREASED RESPONSIBILITIES OF MENTORSHIP, OF, OF BEING MORE FEET ON THE GROUND, PROVIDING THAT SUPPORT TO OUR EXISTING NEIGHBORHOODS, BEING OUT THERE AND MAKING SURE THAT OUR PROGRAMS ARE SUCCESSFUL. THERE. THERE'S ONE OTHER THING I WANT TO SAY ABOUT THAT. LET'S SEE, IT'LL COME TO ME IN A MOMENT. UM, BUT THAT WILL BE ONE OF OUR KEYS TO WORKING FASTER IN SOME OF OUR NEW EXPANSION NEIGHBORHOODS, IS HAVING THESE, UM, FOLKS WHO, UH, ARE GONNA BE ABLE TO SUPPORT OUR ADDITIONAL NEIGHBORHOODS. AND I HOPE VISUALLY THIS REALLY DEMONSTRATES TO OUR PROGRAM'S COMMITMENT TO HAVING COMMUNITY HEALTH WORKERS, LEADING COMMUNITY HEALTH WORKERS. UM, TO ME, HEALTH WORKER IS A PROFESSION. IT IS NOT JUST A JOB. UM, I'M NOT A COMMUNITY HEALTH WORKER, BUT I RECOGNIZE THE IMPORTANCE THAT TO HAVE AS MUCH, UM, LEADERSHIP FROM COMMUNITY HEALTH WORKERS OF OTHER COMMUNITY HEALTH WORKERS TO REALLY SUPPORT THEM BEST IN THEIR WORK. SO, UM, THAT WAS ABOUT THE THREE LEAD COMMUNITY HEALTH WORKERS, THE ADDITIONAL FOUR COMMUNITY HEALTH WORKERS WILL BE NEW TALENT BROUGHT INTO THIS PROGRAM TO SERVICE THE NEW NEIGHBORHOODS. UM, WHEN WE PUT TOGETHER A PROPOSAL, WE PROMISED TO BRING ON TWO, THREE NEIGHBORHOODS INTO THE PROGRAM. AND I THINK WE'RE ACTUALLY GONNA BE ABLE TO GET PAST THAT, GUYS. SO, UM, SO I WANNA LET YOU KNOW THAT, UM, WE ARE GONNA BE ABLE TO BRING IN FOUR NEW NEIGHBORHOODS THIS YEAR WITH THESE FOUR ADDITIONAL COMMUNITY HEALTH WORKERS. I KNOW. YAY. UM, AND SO, UH, I'M A PROMISE OLDER DELIVER, RIGHT? AND SO I, I'M SUPER EXCITED ABOUT THIS. UM, AND WE CAN REALLY STAY TRUE TO THAT MODEL OF THE ONE COMMUNITY HEALTH WORKER ASSIGNED TO THAT ONE NEIGHBORHOOD FOR THOSE CONNECTIONS THROUGH THIS WAY. SO THE OTHER POSITION I WANNA HIGHLIGHT IS A BRAND NEW POSITION FOR OUR PROGRAM. THIS IS THE EQUITY COMMUNICATIONS AND EDUCATION SPECIALIST POSITION. THIS FILLS A NEED THAT WE'VE HAD, WHICH IS REALLY GETTING OUR MESSAGES, EVENTS, AND COMMUNICATION PRIORITIZE TO GO OUT TO THOSE MEETINGS THAT WE'RE SERVING. UM, WE HAVE VERY AMBITIOUS, UM, PLANS FOR THIS POSITION, AND WE ARE JUST ABOUT AT THAT MOMENT, WELL, I THINK MAYBE WITHIN THE NEXT DAY OR TWO, OF MAKING AN OFFER TO SOMEONE WHO'S INCREDIBLY TALENTED, UM, IN HER VISUAL SKILLS AND, AND HER ABILITY, I THINK, TO, TO REALLY MAKE OUR MESSAGES, UM, TAILORED TO THE COMMUNITY WE'RE SERVING, AND BE ABLE TO ADVANCE PUBLIC HEALTH IN THE COMMUNITIES. AND PLEASE NOTE THIS KIND OF VERY INTENTIONAL INCLUSION OF EQUITY WITHIN OUR WORK, WITHIN OUR PROGRAM, BOTH THAT HEALTH EQUITY COORDINATOR THROUGH OUR REACH GRANT AND THIS EQUITY COMMUNICATIONS SPECIALISTS ARE ACTUALLY EMBEDDED WITHIN THE LARGER ME METRO HEALTH, UM, SO THAT THEY HAVE A LEADER THAT CAN REALLY TAKE THEM, UM, WHERE THEY NEED TO GO, AS WELL AS WORKING A HUNDRED PERCENT IN THE PROGRAM. BUT HAVING THAT DIRECT LINE TO THE DIRECTOR'S OFFICE AND THE LARGER VISION OF METRO HEALTH, THAT KIND OF BI-DIRECTIONAL COMMUNICATION FOR THE PROGRAM WITH THESE EQUITY [01:25:01] POSITIONS, UM, IS SUPER IMPORTANT. AND THEN I JUST WANTED TO KIND OF POINT THAT OUT. THAT'S WHY THE ORG CHART KIND OF SHOWS THEM UP. THEY'RE WORKING A HUNDRED PERCENT IN OUR PROGRAM, BUT THEY ARE REPORTING TO, UM, FOR THE HEALTH EQUITY COORDINATOR TO THE OFFICE OF HEALTH EQUITY AND FOR THE EQUITY COMMUNICATIONS POSITION TO THE, UM, MARKETING MANAGER. SO, SO TO WRAP UP THIS SLIDE, THE 500,000 PRIMARILY GOES TO THE PERSONNEL COST OF EXPANSION WITH SOME FUNDS, UM, GOING TO THE SUPPORT OF THOSE PEOPLE AS WELL AS FAR AS AN OFFICE SPACE, UM, THE I T S C EQUIPMENT WE NEED FOR THESE NEW TEAM MEMBERS, THE MILEAGE REIMBURSEMENT. UM, AND, AND THIS MODEL REALLY ALLOWS US TO LEVERAGE SOME OF THE OTHER, UM, ASSETS WE HAVE IN THE PROGRAM AS FAR AS WE CAN PAY FOR FOOD FOR, FOR SOME OF OUR FOOD DEMOS IN THE POST COVID WORLD, UM, OUT OF OUR WAIVER. AND, AND, AND WE CAN DO PRINTING NEEDS FOR EDUCATIONAL MATERIALS RELATED TO REACH OUT OF OUR REACH BUDGET. SO WE'RE ALL, WE'RE REALLY, UM, HIGHLY COORDINATING THOSE TOGETHER TO GET THE MOST, UM, BANG FOR THE BUCK WITH THIS, UM, EXPANSION. SO, I KNOW THAT WAS A LOT. THANK YOU FOR GETTING THROUGH THAT ONE. THE NEXT ONE I WANNA TALK ABOUT OUR SECOND APPROACH TO THIS EXPANSION, WHICH IS HOW DO WE SELECT PLACES? AND I KNOW THERE'S PROBABLY 1 MILLION WAYS TO GO ABOUT THIS. I'LL SHARE WITH YOU, UM, HOW WE KIND OF TACKLED IT, UM, TO DETERMINE WHERE TO EXPAND, WE FIRST DID THE NEEDS ASSESSMENT, WHICH UTILIZED THE CITY OF SAN ANTONIO OFFICE OF EQUITY'S EQUITY ATLAS TO NARROW DOWN THOSE CENSUS TRACKS, UM, THAT HAD A COMBINED SCORE OF NINE OR 10 BEING THE MAXIMUM, UM, AND WITH A HIGH PR RATIO. SO WITH THAT INFORMATION, AND I INCLUDED, UM, IN THE EMAIL THAT, UM, THAT WAS SENT OUT BEFORE, WAS BOTH JUST A, A SNAPSHOT OF THE EQUITY SCORE CENSUS TRACK, UM, IF YOU HAVEN'T LOOKED AT THAT RECENTLY. AND THEN ALSO THE NET PIECE, UM, WHICH WAS OUR ASSET ASSESSMENT, WHICH, UM, WAS OUR TOOL FOR CONDUCTING AND FIGURING OUT WHERE WE ALREADY HAD EXISTING CONNECTIONS AND WHERE WE WERE REALLY GOING TO BE ABLE TO, TO GET TO WORK. AND BASED ON SOME OF THE, THE ASSET BASED MODEL. SO THIS WAS FOR FORM BY COMMUNITY HEALTH WORKERS. THEY CANVASED THOSE PROPOSED NEIGHBORHOODS TO IDENTIFY THE AVAILABLE ASSETS AND COMMUNITY INTERESTS. THEY ALSO, UM, DOCUMENTED KIND OF THEIR EXISTING RELATIONSHIPS THERE, UM, AND IF THEY HAD WORKED PREVIOUSLY WITH THEM. UM, SO WITH THESE TWO ASSESSMENTS IN HAND, WE WERE REALLY ABLE TO SEE THAT THERE WERE THREE VERY CLEAR, KIND OF FIT BASED ON OUR APPROACH, UM, THAT, THAT WERE WHEATLEY HEIGHTS, LOS FIMAS, AND WOODLAWN NEIGHBORHOODS ALL APPEAR TO BOTH BE HIGH NEED AND VERY ASSET RICH. AND ASSETS FOR US ALSO INCLUDES THOSE CONNECTIONS THAT WE HAVE WITHIN THE COMMUNITIES TOO. SO, UM, WE'RE DOING SOME ADDITIONAL WORK IN THE SOUTH REGION TO IDENTIFY FIT AS WELL AS A CLEAR FIT DIDN'T COME, UM, REALLY ON THE SAME TIMELINE. SO WE'RE, WE'RE STILL IN THE NEEDS ASSESSMENT, UM, PORTION OF THAT. UM, AND IDENTIFYING POSSIBLE NEIGHBORHOODS. WE'RE A LITTLE BIT FARTHER AHEAD WITH THE OTHER THREE, SO NOW WE'RE READY TO CHECK IN, REALLY DO THAT. CHECK IN WITH THE COMMUNITY TO MAKE SURE THE COMMUNITY WANTS US IN THESE SPACES. UM, THIS IS CERTAINLY A DIFFICULT TIME, UM, TO DO THIS PART AS FAR AS, UM, PEOPLE NOT GATHERING AND WHATNOT. UM, AND OUR ALREADY BARRIERS TO COMMUNITY ENGAGEMENT, BUT OUR APPROACH IS TO REACH OUT TO THE COUNCIL PERSON. UM, SO, UM, COUNCILWOMAN SMA, HOPE YOU GOT MY EMAIL THERE FROM DEIDRE, REALLY. BUT, UM, WE LOOK FORWARD TO WORKING WITH YOU AND SEE IF WHEATLEY HEIGHTS IS A GOOD FIT FOR YOU. AND WE'LL BE REACHING OUT TO, UM, D SIX AND D SEVEN, UH, FUND OF ALL, UM, VIA ARON AS WELL SHORTLY. SO REALLY EXCITED TO GET WORK, UM, TO WORK IN THOSE NEIGHBORHOODS TO MAKE SURE THAT WE ARE REALLY WANTED THERE. AND ONE OF THOSE WE NEED TO FOCUS ON IS THE AREA SCHOOLS. WE NEED TO MAKE SURE THAT, THAT OUR SERVICES ARE GOING TO BE ABLE TO, GOING, TO BE ABLE TO, UM, INTEGRATE INTO THEIR SYSTEM AND THAT PEOPLE WOULD LIKE TO RECEIVE, UH, WHAT WE WE HAVE TO OFFER. SO WE WANNA MAKE SURE THAT WE CAN REACH, UH, THE CHILDREN AND THE FAMILIES OF THE COMMUNITY. UM, THIS PROCESS DOES TAKE TIME. UH, I, I WAS A LITTLE AMBITIOUS IN HOW, HOW I THOUGHT IT WOULD PLAY OUT, BUT WE ARE RIGHT WHERE WE NEED TO BE FOR GETTING READY FOR A NEW YEAR AND A FRESH 2021, WHICH WE'RE ALL LOOKING FORWARD TO. SO I THINK WE'RE IN A GOOD PLACE. UM, IF ALL STARS LINE, WE'LL BE STARTING TO WORK FAIRLY SOON IN, IN SOME OF THESE IDENTIFIED NEIGHBORHOODS. THIS ALL IS KIND OF HAVE TO WORK TOGETHER IN THE TIMELINE WHERE FOR ALL THE STARS ALIGNED, BECAUSE AT THE SAME TIME, WE'RE, WE'RE HIRING COMMUNITY HEALTH WORKERS TO MAKE SURE THAT THEY FIT THOSE COMMUNITIES. SO, SO THESE PIECES ARE KIND OF NEED TO MOVE TOGETHER, BUT, UM, AND, AND SO IT'S BEEN, BEEN FUN AND I THINK WE HAVE SOME REALLY EXCELLENT CANDIDATES THAT I THINK WE'RE ABOUT TO MAKE SOME DECISIONS ON TOO, FOR THOSE COMMUNITY HEALTH WORKER. SO THIS PICTURE, UM, [01:30:01] IS JUST THE ASSET BASED COMMUNITY DEVELOPMENT MODEL. SO IF THIS IS SOMETHING, WE HAVE AN EXCELLENT LITTLE VIDEO ON OUR WEBSITE AS WELL, THAT GOES THROUGH THE ASSET BASED COMMUNITY DEVELOPMENT MODEL, IF THAT'S SOMETHING YOU WANNA LEARN MORE ABOUT. BUT WHAT I LOVE ABOUT IT IS IT REALLY FOCUSES ON ALL THE RESOURCES THAT WE HAVE, WHICH ARE PEOPLE, PLACES, ORGANIZATIONS, AND CONNECTIONS. IT'S, UM, A COMMUNITY LED APPROACH. SO WE KNOW THAT THE POWER LIES IN THE COMMUNITY. THEY THEMSELVES ARE THE EXPERTS. SO HOW CAN WE WORK WITH 'EM? UH, WE VALUE THOSE CONTRIBUTIONS OF THE COMMUNITY, RESIDENTS, THE LEADERS AND ORGANIZATIONS. AND WE BELIEVE THAT ALL, ALL THIS WORK NEEDS TO BE RELATIONAL. EVERYONE CARES ABOUT SOMETHING AND HAS SOMETHING TO CONTRIBUTE. SO IT'S THOSE RELATIONSHIPS OF UNTAPPING, WHAT PEOPLE'S INTERESTS ARE AND HOW THEY CAN CONTRIBUTE THAT LEADS TO THE CHANGE. SO NEXT ONE IS, THE NEXT SLIDE IS A BIG PICTURE OVERVIEW OF KIND OF OUR WORK PLAN FOR THE YEAR. UM, FINISHING UP QUARTER ONE HERE, WE'RE ON TRACK WITH OUR, WITH OUR HIRES, UM, AND SELECTING THE NEIGHBORHOODS. UM, LET'S SEE. CURRENTLY WE'VE HIRED ONE OF EIGHT OF THE POSITIONS FOR HAVE ACCEPTED OFFERS AND ARE WORKING THROUGH THE FREE EMPLOYMENT PROCESS. AND, UM, THREE MORE ARE ARE PRETTY GOOD CANDIDATES THAT WE ARE GETTING READY TO SEE ABOUT OFFERING IN JANUARY. WE HOPE TO HIT THAT GROUND RUNNING BY BUILDING THOSE CONNECTIONS IN THE EXPANSION NEIGHBORHOODS AND STARTING THAT KIND OF WORK I WAS TALKING ABOUT AT THE BEGINNING OF THE PRESENTATION, UM, BRINGING THOSE PROGRAMS TO KIDS AND FAMILIES. UM, THE TEAM DID ALSO WANNA MAKE SURE THAT I MENTIONED THAT, YOU KNOW, THESE, THESE NUMBERS THAT WE HOPE TO REACH THESE PEOPLE WE HOPE, HOPE TO REACH WITH OUR SERVICES THIS YEAR, UM, IS DEFINITELY A GOAL. AND, AND WE'RE GONNA DO OUR BEST TO REACH IT. BUT THEY DID WANT ME TO REMIND EVERYBODY THAT, YOU KNOW, COMMUNITY CONNECTIONS CAN BE A LITTLE HARDER RIGHT NOW AND DATA COLLECTION TOO. AND, UM, WE ARE GOING TO DO OUR BEST TO REACH THAT. BUT, UM, I WANT ME TO BE REAL TOO. I THINK THEY THOUGHT MAYBE I WAS A LITTLE TOO AMBITIOUS, BUT I DON'T THINK SO. WE, WE MEET MOST EVERYTHING WE SET OUT TO DO. SO OUR PRIORITY POPULATIONS, WHAT THAT MEANS IS WE'RE LOOKING AT OUR MEDICARE LOW INCOME, UM, UNINSURED POPULATIONS. WE'RE LOOKING FOR OUR RACIAL AND ETHNIC PRIORITY POPULATIONS. UM, AND SO THAT, WHAT THAT MEANS, AND ALSO IN THE, THE END OF THIS YEAR, WE, WE WILL, UM, BE ABLE TO PUT TOGETHER A ROBUST REPORT OF OUR APPROACH AND WHAT WE WERE ABLE TO ACCOMPLISH FOR THE YEAR. SO THE NEXT SLIDE IS ABOUT THE HEALTHY CORNER STORES. UM, I'M SO JUST THRILLED THAT THIS EXPANSION CAME UNDER THE HEALTHY NEIGHBORHOODS PROGRAM AND WE'RE ABLE TO REALLY PARTNER WITH THE COMMUNITY TO INCREASE, UM, THAT CONSUMPTION AND ACCESS TO FRESH FRUITS AND VEGETABLES. THIS WAS A RECIPIENT OF THE ESSAY TOMORROW SUSTAINABILITY AWARD IN 2019. AND THANK YOU COUNCILWOMAN VIRON FROM THE BOTTOM OF OUR HEARTS, UM, REALLY WHO HAS BEEN OUR, THIS PROGRAM, THIS INITIATIVE'S BIGGEST SUPPORTER FROM DAY ONE AND HAS MADE THIS EXPANSION TO THE OTHER DISTRICTS POSSIBLE. I THINK THAT'S REALLY INCREDIBLE, UM, AND SEEKS YOUR PASSIONATE ABOUT THIS WORK AS WELL. UM, PRESS RELEASE JUST WENT OUT, I THINK A FEW MINUTES AGO, OR MAYBE 30 MINUTES AGO OR SO HERE. UM, SO WE ARE GETTING THE WORD OUT ABOUT THE, THE, THE WORK WE'RE DOING, THESE INCREDIBLE PARTNERSHIPS. UM, SO WITH THE NEXT SLIDE, A LITTLE BIT OF HOW THAT EXPANSION LOOKS. UM, I HOPE THAT EVERYBODY RECEIVED THE FLYERS. GO AHEAD TO THE NEXT ONE. UM, THERE'S SOME FLYERS WITH ALL THE STORE NAMES AND ADDRESSES THAT ARE READY TO GO. SO, UM, HOPEFULLY A COUPLE OF THOSE ARE FAMILIAR. UM, THIS PROGRAM, THE 120, UM, THOUSAND, UM, REALLY PRIMARILY GOES TO BUYING THE FRIDGES AND PAYING FOR THE PRODUCE. THERE'S, UM, A LITTLE BIT OF MARKETING AND THINGS LIKE THAT, BUT THIS ONE DOES NOT COME WITH A PERSONNEL BUDGET. SO WE'RE REALLY, UM, USING THE RESOURCES WE HAVE TO CARRY OUT THE WORK ABOUT, UM, 10 OF OUR TEAM MEMBERS HAVE BEEN WORKING VERY HARD ON THIS, AND I'M SO HAPPY TO SAY THAT WE HAVE ONBOARDED ALL 12 STORES THAT WE SET OUT TO ONBOARD THIS YEAR. UM, THREE IN EACH OF THOSE LISTED DISTRICTS, WE ARE CONTINUING TO ENGAGE AND SUPPORT THE EIGHT EXISTING STORES IN D THREE. UM, WE, WE DID A VERY DETAILED PROCESS OF FIGURING OUT WHO WOULD BE SELECTED FOR THIS PROGRAM. UM, AND IT, AND I GOTTA TELL YOU, UM, MEETING THE STORE OWNERS AND HEARING, HEARING THEIR, UM, STORIES FOR WANTING TO BE INVOLVED IN THE WORK, THAT THAT IS MY FAVORITE PART OF THIS PROGRAM. SO I JUST WANTED TO ADD THAT BECAUSE, UM, IF YOU GET A CHANCE TO STOP BY AND, AND SAY HI TO THE STORE OWNERS, ONE OF THE CRITERIA FOR SELECTION FOR THIS PROGRAM WAS THAT THE STORE OWNERS WOULD HAVE A WILLINGNESS, AND MY GOSH, A LOT OF THEM DO AND REALLY CARE ABOUT THIS AND ARE EXCITED TO SEE PEOPLE CHOOSING MORE FRESH FOODS. UM, THAT PART IS, IS ONE OF MY FAVORITE PARTS. UM, SO [01:35:01] OUR PARTNERS ON THIS, THE FOOD POLICY COUNCIL CONTINUES TO BE HIGHLY ENGAGED IN THE PLANNING, AND THEY LEVERAGE THEIR OWN FUNDS AS WELL FROM SOME DONATIONS THAT COME THROUGH TO BE ABLE TO, UM, GET SOME ADDITIONAL SUPPORT PIECES SUCH AS THE BASKETS FOR NON REFRIGERATED ITEMS. UM, U I W THEIR ROLE HAS CHANGED THIS YEAR, BUT THEY CONTINUE TO SUPPORT THE PROGRAM. UM, THEY'D LIKE TO, UM, SUPPORT US WITH SOME RESEARCH PROJECTS, AND THEY'RE ALSO HELPING WITH SOME FLU EVENTS THAT WE'RE, WE'RE PROMOTING, UM, THAT WILL BE CROSS-PROMOTION FOR THIS PROGRAM AS WELL. AND THE FOOD BANK, UM, IS OFFERING EDUCATION AND SUPPORT TO THE STORE OWNERS AS WELL AS DOING, UH, MONTHLY CHECK-INS WITH THE STORE OWNERS TO KIND OF SEE, BECAUSE THE, THESE STORE OWNERS, THEY ARE BUSINESS PEOPLE, THEY'RE VERY SKILLED IN BUSINESS, BUT SELLING FRESH PRODUCE IS A DIFFERENT PIECE OF THAT BUSINESS. AND SO WE WANNA MAKE SURE THAT THEY'RE SUCCESSFUL. THE GOAL OF THIS WORK, UM, OVER THE NEXT NINE MONTHS WILL BE TO, UM, YOU KNOW, WE'LL BE REDUCING THE AMOUNT OF MONEY PAID FOR PRODUCE, SO REDUCING KIND OF THE SUBSIDIES, SO TO SPEAK, FOR THE PRODUCE. AND, UM, WE'LL BE DOING LESS HANDHOLDING AS TIME GOES ON TOO. SO WE MIGHT BE DOING WEEKLY CHECKS NOW WITH THEM, AND THEN LATER PETERING DOWN TO MONTHLY TO MAKE SURE THAT THEY ARE, UM, ABLE TO STAND ON THEIR TWO FEET WITH THIS PROGRAM AND CONTINUE IT EVEN, UM, BEYOND THE, THE LIFE OF THE PROGRAM AS WELL. SO, UM, THAT IS WHY I WANTED TO SHARE ABOUT THAT. UM, CERTAINLY CAN ANSWER ANY ADDITIONAL QUESTIONS I DIDN'T GET ON THAT. UM, BUT REALLY AWESOME, AND I THINK YOU ALL FOR, FOR YOUR SUPPORT ON THAT. SO THAT IS, THAT IS IT. THE NEXT ONE IS JUST AN ENDING SLIDE THERE. I HOPE THAT, YOU KNOW, I'VE BEEN ABLE TO SHARE A BIT ABOUT THE PROGRAM, GIVE YOU IDEA ABOUT WHAT WE DO AS WELL AS, UM, HOW WE'RE USING, UM, THESE FUNDS TO GROW THE PROGRAM, TO REACH THE NEEDS AND THE COMMUNITY MEMBERS THAT WE SERVE. AND, AND I WANT TO THANK YOU AGAIN FOR, FOR THIS OPPORTUNITY, ANNA AND THE WHOLE TEAM, THANK YOU SO MUCH FOR A THOROUGH PRESENTATION ON THE HEALTHY NEIGHBORHOODS PROGRAM. AND I'M SORT OF, UH, ASHAMED THAT I'VE, I'VE BEEN SHARING THIS COMMITTEE FOR A FEW YEARS NOW, AND THIS IS THE FIRST TIME WE ACTUALLY GET TO LEARN ABOUT YOUR PROGRAM, BUT, UM, BETTER LATE THAN, THAN NEVER. SO, SO WELCOME. GLAD TO HEAR ABOUT IT. UH, ONE THING I DO WANT TO, UH, POINT OUT TO, UH, TO THE COMMITTEE MEMBERS IS THAT, IN CASE YOU DIDN'T CATCH IT, ANNA TALKED ABOUT THE DIFFERENT FUNDING SOURCES THAT WE'RE USING RIGHT NOW FOR THE PROGRAM, AND SOME OF IT IS THE REACH GRANT, SOME OF IT IS THE MEDICAID WAIVER, AND THEN OUR LOCAL GENERAL FUND MONEY. SO THAT MEDICAID WAIVER IS, UH, IS ON ITS WAY, UH, OUT, IS MY UNDERSTANDING. SO I, I THINK WE'RE GONNA HEAR SOME COMMENTS ABOUT THAT FROM MY COLLEAGUES. UH, BUT JUST SOMETHING TO, TO KEEP IN MIND. UM, I WANNA THANK YOU, UH, ANNA, FOR THE PRESENTATION. AND, UH, I WANNA TELL YOU, I REALLY BELIEVE IN THE, IN THE PROGRAMS THAT YOU RUN, AND THAT IS, I THINK THE WAY OUT OF THESE HEALTH DISPARITIES THAT WE HAVE IN OUR COMMUNITY IS WE MUST CONTINUE TO INVEST, UH, IN THEM WHEREVER THEY NEED THE INVESTMENT. AND NOT JUST IN IN PROGRAMS, BUT LIKE YOU SAID IN PEOPLE, UH, BECAUSE WE WANT THE SOLUTIONS TO BE SUSTAINABLE LONG-TERM. AND, AND THAT'S WHAT IT'S GOING TO TAKE. SO, UM, ALL RIGHT, I'M GONNA TURN IT OVER TO, UH, COUNCILWOMAN VIA THANK YOU CHAIR. THANK YOU, ANNA. I'M VERY EXCITED. UH, THANK YOU, ANNA. I'M VERY EXCITED, UH, TOO, YOU'RE RIGHT CHAIR. UH, VACCINES WAS VERY EXCITING, BUT THIS IS VERY EXCITING, UM, AS WELL. COUPLE OF THINGS, UH, FIRST THE, I'M GLAD TO HEAR THAT, THAT THIS PRESENTATION IS HAPPENING HERE, AND YOU CAN SEE THE ENTHUSIASM THAT YOU HAVE, BUT IT'S, I KNOW IT'S SHARED WITH ALL OF YOUR COMMUNITY HEALTH WORKERS, AND THANK YOU FOR SAYING, AND I THINK WE NEED TO CONTINUE TO SAY THIS, THAT COMMUNITY HEALTH WORKERS IS A PROFESSION, AND THEY ARE VERY SERIOUS ABOUT THIS, BUT IT IS ALSO, UM, SOMETHING THAT IS, IS SO NEEDED, ESPECIALLY NOW TO MY, UH, TO THE CHAIR WHO JUST MENTIONED WHAT SHE DID ABOUT THE WAIVER, UM, AS SOON AS YOU STARTED. AND I WANTED TO, UM, SAY LIKE, YES, WE NEED MORE MONEY. THIS ISN'T ENOUGH MONEY. WE NEED MORE MONEY. WE NEED TO GET MORE MONEY, UH, FOR THIS PROGRAM. AND AT I G R COMMITTEE THIS PAST WEEK, UH, WE'RE PUTTING FORWARD OUR LEGISLATIVE AGENDA. AND ONE OF THE THINGS THAT I ASK THAT WE MAKE FOOD INSECURITY AND, UM, UH, MAKE THAT A PRIORITY. AND, UH, SO I THINK WE ARE GOING TO BE FIGHTING, OKAY, WE'LL BE ADVOCATING, I WON'T SAY FIGHTING. WE WILL BE ADVOCATING [01:40:01] FOR, UM, MORE DOLLARS FOR, YOU KNOW, COMMUNITY HEALTH WORKERS FOR FOOD INSECURITY, FOR A BUNCH OF, UH, ITEMS THAT ARE IN THIS, UNDER THIS UMBRELLA. SO I THINK I, I WANTED TO NOTE THAT, UM, I ALSO WOULD LIKE TO SEE, YOU KNOW, BECAUSE THESE COMMUNITY HEALTH WORKERS DO A LOT AND THEY ARE IN ON THE GROUND AMBASSADORS FOR OUR COMMUNITIES, AND THEY ARE EVEN MORE EMBEDDED THAN OUR, THE NEIGHBORHOOD ASSOCIATIONS, IF YOU WILL. SO I WAS WONDERING, UH, CHAIR, IF IN THE FUTURE, UM, WE CAN EVEN GET A REPORT FROM THE COMMUNITY HEALTH WORKERS, UM, TO MAYBE EACH OF OUR DISTRICTS OR THIS COMMITTEE AS A WHOLE OF WHAT THEY ARE HEARING ON THE GROUND FROM THEIR NEIGHBORHOODS THAT THEY ARE WORKING ON, BECAUSE MAYBE IT IS, UM, IT'S STILL EXPANSION. UH, IT'S HEALTHCARE, MAYBE IT IS, UH, CHILDCARE. WHAT ARE THOSE BOOTS ON THE GROUND IMPACTS THAT WE, THAT THEY ARE HEARING, AND HOW CAN WE GET THAT FEEDBACK TO THIS COMMITTEE AND START PUTTING THAT INTO OUR POLICY DECISIONS IN THE FUTURE? I'D REALLY LIKE TO SEE SOMETHING LIKE THAT. UH, AND THEN I'M GOING TO ADVOCATE FOR, UM, ANOTHER HEALTHY NEIGHBORHOOD IN THE RIVERSIDE, UH, AREA IN DISTRICT THREE. IT CAN COVER BOTH THE DISTRICT THREE AND DISTRICT FIVE. SO, UM, IT'S OFF OF ROOSEVELT, NOT FAR FROM 90. UH, WE HAVE A LOT, WE HAVE RIVERSIDE ACADEMY THERE, AND THEY ARE, UH, GOING THROUGH A, A TRANSITION. THEY'RE, UH, THEY'RE TRANSITIONING NEIGHBORHOOD SINCE A LOT OF DEVELOPMENT IS COMING, UH, FURTHER SOUTH. SO I THINK THAT WOULD BE A GREAT AREA TO LOOK AT. AND THEN FINALLY, OF COURSE, UM, HEALTHY CORNER STORES. ABSOLUTELY LOVE. I JUST, I ALWAYS THANK LESLIE AND MITCH FOR COMING INTO MY OFFICE AND PITCHING IT TO ME. AND GRATEFUL FOR AN NADIA WHO WORKS SO MUCH WITH THE NEIGHBORHOOD ASSOCIATION, AND ACTUALLY ALL OF THEM GO TO ALL OF THE NEIGHBORHOODS. THEY'RE NOT JUST IN ONE NEIGHBORHOOD, THEY ARE EVERYWHERE. OUR COMMUNITY HEALTH WORKERS. AND, UM, YES, IN OUR, OUR HIGHLAND MART, OUR HIGHLAND FOOD MART THAT WE HAD, UH, JUST WHEN WE WERE THERE BEFORE THE PANDEMIC, THE NEIGHBORHOOD, UM, THE OWNER OF THE HIGHLAND FOOD MART WAS THERE TALKING ABOUT THE FOOD. PEOPLE WERE COMING IN AND THERE WAS A FRUIT THERE, BUT PEOPLE ARE GOING ACROSS THE STREET AND PULLING FRUIT FROM NEIGHBORS TREES ACROSS THE STREET. SO THAT FRUIT TREE MAPPING IS ABSOLUTELY A HUNDRED PERCENT BECAUSE THEY'RE PULLING NEIGHBORHOODS FRUIT OFF OF THEIR TREES TOO. UM, SO THAT IS, I'M VERY EXCITED ABOUT THIS CONTINUING TO INVEST IN THIS PROGRAM, OF COURSE. AND THEN, UM, I HAVE TO THANK, UH, MY, MY CHIEF OF STAFF, RUBEN ALDE, WHO REALLY DID PUT HIS OWN LITERAL BLOOD, SWEAT, AND TEARS INTO THIS PROGRAM TO LITERALLY, AND WHO WOULD DRIVE AND GET THOSE DOCUMENTS SIGNED FROM THE, THE FOOD MART OWNERS. AND A THANK YOU TO YOUR TEAM TOO, 'CAUSE WE DID HOST THE LUNCHEON HONORING ALL OF THE, THE FOOD MAR THE CORNER STORE OWNERS, JUST THANKING THEM FOR THEIR PARTICIPATION. SO THOSE ARE MY COMMENTS, CHAIR. THANK YOU VERY MUCH. GOOD WORK. MORE MONEY, . THANK YOU, CHAIR. MOVING ON TO DISTRICT FIVE, COUNCILWOMAN GONZALEZ. THANK YOU. UH, THANK YOU FOR THE PRESENTATION. UM, SO I, I, UH, ALSO, UM, I I DO LOVE THE COMMUNITY HEALTH WORKER MODEL AND YOU KNOW, I HAVE A PILOT PROJECT WITH SOME CONNECTORS THERE, UH, ESPECIALLY TO TALK ABOUT, UM, YOU KNOW, WE, IT WAS SORT OF PRE COVID TO TALK TO PEOPLE ABOUT, UM, HOW TO, UH, PROTECT THEMSELVES, UM, IN A PRECO IN A COVID ENVIRONMENT, BUT PERHAPS, UM, THE VACCINE IS ANOTHER MODEL THAT WE COULD USE THEM FOR. I DON'T KNOW IF THAT'S BEEN DISCUSSED OR NOT A SUSPECTED HAS, ARE YOU KIND OF SAYING YES? ARE YOU SHAKING YOUR HEAD THERE, ANN? YES, I CAN SPEAK TO THAT IF WHENEVER YOU'RE READY. OKAY. UM, YEAH, SO I, I JUST HAVE TO SHARE THAT DURING THE, THE FIVE MONTHS, UM, WHEN COVID STARTED, MY TEAM WAS FULLY DEPLOYED TO THE COVID PROJECT, AND THEY DID PRETTY MUCH EVERY JOB THERE. THERE IS, UM, IN THE COVID RESPONSE FROM BEING IN THE KENYA HEALTH PREVENTION TEAM, UM, FROM ANSWERING THE PHONES WITH THE HOTLINE, UM, TO BEING ON THE EQUITY COMMITTEE, [01:45:01] UM, WORKING ON FOOD DISTRIBUTIONS, ADDRESSING THE FOOD CRISISES. UM, THEY, THEY DID EVERY JOB IMAGINABLE FOR THE HEALTH DEPARTMENT, UM, BASED ON THEIR, THEIR GIFTS AND TALENTS AND RESOURCES. UM, AND I, I DO SEE A PLACE FOR THEM IN THIS, UM, IN THE ROLLING OUT OF THE, THE VACCINE. AND I, I THINK THAT, UM, THEIR GIFT IS REALLY TALKING TO THE COMMUNITY AND HOPEFULLY INCREASING ACCEPTANCE. UM, WE DO HAVE ALSO THE COMMUNITY HEALTH PREVENTION TEAM, WHICH THEIR JOB IS A HUNDRED PERCENT, YOU KNOW, DEDICATED TO THE, UM, TO THE COVID RESPONSE, WHEREAS, UM, OUR FOLKS WOULD, WOULD WORK IT INTO THE, THE OUTREACH THAT WE WERE CURRENTLY DOING AND THE, AND THE METHODS THAT WAY. SO, UM, YES, THEY'RE DEFINITELY VERY PASSIONATE ABOUT THAT AS WELL, AND, AND THERE WILL BE A ROLE FOR THEM. WELL, GOOD, THANK YOU. I KNOW THAT, UM, IT'S, YOU KNOW, IT'S A MODEL THEY'VE USED IN LATIN AMERICAN CON LATIN AMERICAN COUNTRIES, ESPECIALLY FOR VACCINES. SO, UM, YOU KNOW, HOPEFULLY, WE'LL, AS, AS WE HAVE WIDER DISTRIBUTION AND GET MORE DATA, UH, IF WE'RE FINDING THAT WE ARE STILL LACKING, UM, PARTICIPATION IN CERTAIN AREAS, WE WOULD USE THE SAME, UH, APPROACH. UM, SO THAT'S, UH, I I THINK IT'S REALLY GREAT THAT WE ALREADY HAVE THEM IN PLACE. UM, AND OF COURSE WE DO KNOW THEM ALL VERY WELL. UM, YOU KNOW, WE'VE SEEN THEM OVER SO MANY YEARS. UM, JENNIFER LOPEZ IS IN MY NEIGHBORHOOD, AND, UH, JUAN, UM, LOPEZ ALSO, UM, UH, WE JUST, I THINK WE'VE BEEN SEEING HIM FOR MANY, MANY YEARS NOW, AND SO THAT IT TAKES TIME TO BUILD COMMUNITY TRUST. I THINK THAT'S WHY IT IS SO IMPORTANT THAT PEOPLE STAY IN THOSE JOBS, UH, FOR AS LONG AS THEY CAN, AND THAT THEY'RE PAID APPROPRIATELY TO DO SO, AS THE COUNCIL MEMBER SAID, UM, YOU KNOW, IT IS A PROFESSION AND, AND THEY, YOU KNOW, DESERVE TO BE PAID ACCORDINGLY. SO, UM, I HOPE THAT THAT'S REFLECTED IN, IN THEIR PAYCHECKS EVERY MONTH. UM, UH, ANOTHER QUESTION OR A, UM, COMMENT, I JUST, I WANTED TO MAKE ABOUT THE, UM, UM, UH, THE CORNER STORES, UM, AND ABOUT, UM, THE, UM, THAT MODEL, YOU KNOW, HOPING THAT OF COURSE WE CAN EXPAND IT. I KNOW THAT THERE WAS, UM, DISTRICT FIVE WAS NOT SELECTED AS, AS ONE OF THE LOCATIONS, UM, BECAUSE WE TECHNICALLY ARE NOT IN THE TWO DESERT. UM, AND I DON'T KNOW IF, IF DR. BRIDGER'S STILL AROUND, BUT, UM, DID, I DID, I DID TALK TO HER ONE OF, TO ONE OF HER CLASSES NOT TOO LONG AGO ABOUT, UM, YOU KNOW, WE, WE ARE NOT, WE TECHNICALLY, DISTRICT FIVE IS NOT IN A NEW DESERT. WE DO HAVE, UH, PLENTY OF HEALTHY OPTIONS AROUND US, BUT WHAT WE ALSO HAVE IS AN ABUNDANCE OF FAST FOOD RESTAURANTS. AND, YOU KNOW, THIS COMMITTEE HAS HEARD ME, UM, YOU KNOW, COMPLAIN ABOUT THE EASE OF WHICH IT IS TO DO THAT. UM, AND, AND, YOU KNOW, WHAT, WHAT MODEL CAN WE USE, UM, TO, TO ENCOURAGE PEOPLE TO MAKE DIFFERENT CHOICES THAT DOESN'T MAKE US FEEL GUILTY ABOUT OURSELVES. SO, UM, I DON'T KNOW, UH, HOW I, I HAVE YET TO SEE SOMETHING THAT I THOUGHT WOULD WORK, UM, UH, YOU KNOW, THAT DOESN'T PLACE A LOT OF, UH, MOM GUILT ON, YOU KNOW, THE, THE BEST THAT ARE WORKING AND DOING THE BEST WE CAN AND DON'T WANNA DO DISHES AND EVERYTHING ELSE. SO, UM, YOU KNOW, I I, I, MAYBE ONE DAY WE'LL HAVE THE OPPORTUNITY TO HEAR, UM, MAYBE FROM SOME OF DR. BRIDGER'S STUDENTS, IF SHE CAME UP, IF THEY CAME UP WITH ANYTHING I DID SPECIFICALLY ASK THEM IN CLASS, UH, TO COME UP WITH SOMETHING DIFFERENT. SO, UM, SO THIS IS REALLY GREAT WORK. I THINK IT'S, IT'S SOME OF THE BEST WORK WE DO AT OUR CITY. ALL THE PREVENTION AGAIN, THAT WE KNOW IS SO HARD TO, UM, TO QUANTIFY. UH, AND, AND WHILE, YOU KNOW, I THINK YOUR BUDGET IS SMALL, UM, I WISH WE HAD MORE, MORE HARD DATA TO SHOW THE IMPORTANCE OF IT ALL SO THAT WE COULD INVEST APPROPRIATELY, UM, IN, IN THE, UM, IN THE DEPARTMENT. SO, UH, THANK YOU VERY MUCH. THAT'S ALL I HAVE. THANK YOU, COUNCILWOMAN, COUNCILMAN REO, UH, THANK YOU CHAIR. UH, I AGREE AGAIN, UH, GREAT PROGRAM AND THANK YOU FOR ALL THAT YOU DO. I AGREE, UM, WITH THE SENTIMENT ABOUT COMMUNITY HEALTH WORKERS, I, I THINK IT'S, IT'S, IT'S, UH, IT'S A GOOD MODEL. UM, AND, UH, ONE, I I KNOW I'VE SEEN, UH, MR. JUAN LOPEZ AT REGULARLY AT, UM, THE NEIGHBORHOOD MEETINGS AND FIVE POINTS, AND, UH, I KNOW HE DOES A LOT OF WORK ON THE WEST SIDE AS WELL. SO I WANNA THANK HIM, UH, FOR WHAT HE DOES. AND, UH, YOU KNOW, SOME OF THE, THE, THE, THE, THE CRITICAL WORK, UM, SOMETHING THAT CAME UP, UH, LAST YEAR AROUND THIS TIME FOR ME, UM, AND I, AND I, AND I, I'M THINKING OF THIS PANDEMIC, UH, [01:50:01] BECAUSE THERE'S, YOU HAVE THESE FOLKS SO CONNECTED INTO THE NEIGHBORHOODS, HAVE WE THOUGHT ABOUT, UH, SOME FOLKS WHO, WHO MAY FEEL LIKE THEY'RE, THEY ARE DISCONNECTED AND, AND HOW, HOW WE CAN UTILIZE THIS POTENTIAL, UM, CONNECT CONNECTION TO THESE NEIGHBORHOODS AND THIS IDEA OF, OF, OF PROVIDING SOME SUPPORT DURING A TIME THAT, THAT SOME FOLKS MIGHT FEEL, UH, EXTRA LONELY, UH, DISCONNECTED, UH, AND, UH, AND, AND, AND, UM, EXAMINE HOW WE CAN, UM, BETTER, UM, SORT OF GET PEOPLE THROUGH THIS VERY DIFFICULT TIME. YEAH, I'D LOVE TO, TO HEAR PEOPLE'S IDEAS ON THAT MORE. THAT IS, UM, VERY TROUBLING TO THE DISCO MEUS. I KNOW THAT, UM, YOU KNOW, RIGHT NOW, I THINK, UH, WITH THE TRIPLE P PARENTING CLASSES WE'RE OFFERING, AS WELL AS SOME OF THE WORK WE'RE DOING IN, UH, UM, THE NEW MOTHERS AND THE BREASTFEEDING WORK, UM, I THINK THAT THOSE ARE SOME REALLY IMPORTANT, UM, PLACES TO CONNECT WITH PEOPLE THERE. I MEAN, EVERYBODY'S FEELING LONELINESS TO SOME DEGREE, BUT REALLY THINKING ABOUT FAMILIES AND MOTHERS AND CHILDREN. UM, BUT, UM, I WOULD LOVE TO HEAR MORE IDEAS ABOUT, UM, YEAH, CONNECTEDNESS AND, AND USING, UM, YOU KNOW, OUR, OUR MODEL TO HELP WITH THAT. OKAY, GREAT. I, UH, GOOD TO HEAR. AGAIN, LAST YEAR WE, UNFORTUNATELY, WE HAD A, A SUICIDE, UM, OF ONE OF OUR, UH, SECURITY GUARDS AT THE CENTRAL LIBRARY. AND IT JUST REALLY MADE ME THINK ABOUT, UH, YOU KNOW, JUST, IT, IT'S, ESPECIALLY NOW WITH THIS PANDEMIC, IT'S, IT'S WITH, WITH THE SOCIAL DISTANCING, UM, YOU KNOW, AS, AS I THINK YOUR MODEL IS, IS SO I, I THINK COULD BE USEFUL IN TERMS OF BEING IN TUNE WITH, WITH FOLKS THAT, THAT YOU MAY BE TALKING TO, TO TRY TO UNDERSTAND WHO MAY BE HAVING, UH, TROUBLE, UM, WHO MAY, WHO MAY BE REALLY, UH, UM, HAVING BE HAVING A, A DIFFICULT TIME, ESPECIALLY NOW DURING, DURING THE HOLIDAYS. AND BECAUSE OF THIS PANDEMIC EVEN, EVEN MORE SO. UH, SO YEAH, LET'S, I'D LOVE TO TALK MORE ABOUT THAT. IT, IT IS, IT'S JUST, I'M JUST REMINDED OF THIS, THIS, UH, FROM LAST YEAR. IT, IT WAS, UH, IT WAS HEARTBREAKING. AND, UM, YOU KNOW, I THINK ABOUT ALL OUR FOLKS IN, AT THE CITY AND, YOU KNOW, UH, PEOPLE IN, IN NEIGHBORHOODS, UH, THAT MAY, MAY NOT FEEL LIKE THEY CAN, UH, GET OUT AND CONNECT. UM, AND, AND SO PROGRAMS, FOR EXAMPLE, LIKE, LIKE THAT, THAT HEALTHY, UM, FOOD, UH, CORNER STORE IS SUCH A GREAT, UH, GREAT, UH, MESSAGING AS WELL, BECAUSE I THINK PEOPLE FEEL LIKE, UH, YOU KNOW, THE COMMUNITY IS, IS DOING WHAT THEY CAN TO TRY TO REACH OUT AND, AND PROVIDE THEM, UM, YOU KNOW, SOME, SOME HEALTHY OPTIONS WHERE THEY, THEY MIGHT FEEL LIKE, UM, YOU KNOW, THEY, THEY, UM, THAT'S KIND OF OUTTA REACH. SO, SO THANK YOU COUNCILMAN BRAN AND, UH, SPECIAL THANKS TO YOUR CHIEF, UH, RUBEN. HE'S, HE'S, HE'S A, HE'S A GREAT GUY AND, AND I KNOW HE REALLY CARESS A LOT ABOUT THIS COMMUNITY. UM, YOU KNOW, I, IT, THOSE STORIES REMIND ME WHEN I WAS A KID AND, AND I, UM, YOU KNOW, I, I GREW UP WITH, WITH A, A FRIEND WHO HE WOULD, HE WOULD BUY HIS BREAKFAST, UH, AT THE DOLLAR STORE, UH, WHERE YOU COULD BUY A TON, A TON OF COOKIES. THEY WERE THE WORST KIND OF COOKIES, BUT THERE WERE 99 CENTS. AND IT, IT'S JUST, IT WAS, I COULDN'T BELIEVE IT. I WAS, I MEAN, I WAS SO LUCKY THAT MY KNOW MY MOTHER, WHILE WE DIDN'T HAVE MUCH, SHE REALLY TRULY SACRIFICED A LOT FOR US. BUT, YOU KNOW, IT, IT'S, IT'S A REAL THING. AND, UH, I'M JUST GLAD DISTRICT ONE IS VERY MUCH INCLUDED IN, IN THOSE INITIATIVES. 'CAUSE 'CAUSE THEY'RE REAL AND THEY, THEY TRULY TRANSFORM LIVES. THEY REALLY, UM, THEY, THEY SERIOUSLY IMPACT, UH, YOUR, IN FACT THE WAY YOU, UH, SEE YOUR HEALTH, UH, WELL INTO YOUR ADULTHOOD AND HOW YOU, UH, TAKE CARE OF YOUR FAMILY. SO, SO THANK YOU. THANK YOU FOR ALL YOU DO. UM, GREAT, GREAT HOLIDAY MESSAGE. THANKS, CHAIR. THANK YOU, COUNCILMAN, ALL SUCH GREAT POINTS. UM, YEAH, COUNCILWOMAN ANDREW SULLIVAN. UH, THANK YOU MADAM CHAIR AND ANNA, YOU KNOW, WE HAD SO MUCH FUN OUT THERE AND BEING ABLE TO ACTUALLY, UH, TAKE ONE OF THE WATERMELONS AND CUT IT OPEN AND EAT IT FRESH FROM THE GARDEN, IT WAS DELICIOUS. AND I WANT MORE PEOPLE TO UNDERSTAND WHAT THAT IS LIKE. UM, AND THANK YOU SO MUCH TO YOUR TEAM FOR CONTINUING TO DO THE WORK. UM, I WANNA THANK STEVEN LUCKY FROM OPIA AND GARCIA FARMS OVER IN THE DISTRICT FOR CONTINUING TO PRODUCE, UM, SUCH HEALTHY FOOD AND PRODUCE [01:55:01] AND FOR CONTINUING TO TEACH THE EDUCATION OF HEALTHY INITIATIVES AND WHAT DOES THAT LOOK LIKE AND HOW TO IMPLEMENT IT IN YOUR OWN BACKYARD. UM, THOSE ARE THE THINGS THAT ARE HAPPENING RIGHT NOW, AND WE KNOW THAT THE INFRASTRUCTURE IS NEEDED FOR ACROSS THE CITY. SO WITH THAT BEING SAID, HAVE WE LOOKED AT ANY OF THE U SS D A GRANTS OR EVEN URBAN AGRICULTURE OR FARMING OR EVEN THROUGH THE T E A, UM, ABOUT GRANTS THAT MIGHT BE AVAILABLE FOR SUCH INITIATIVES AS ITS, YES, DEFINITELY. UM, THOSE ARE USUALLY ON OUR RADAR AND, UM, GARCIA STREET FARMS IN PARTICULAR, UM, YOU KNOW, I'M FORGETTING THE NAME OF THE GRANT, BUT RECENTLY, UM, SUBMITTED AND WE WERE SURE TO OFFER SUPPORT ON THAT, UM, TO BE ABLE TO, TO PARTNER ON THAT. SO, SO WE JUST HAVE TO LOOK AT THE GRANTS AND DECIDE WHICH ARE THE ONES THAT, UM, WILL HELP THE PROGRAM, OR WHICH ARE THE ONES THAT ARE COMMUNITY PARTNERS ARE, ARE LEADING, AND WHERE THE, WHERE THE PATH TO HELPING THEM COMPLETE THE TASK. SO, UM, YEAH, IF YOU HEAR OF ANY THAT YOU, YOU THINK OF OUR, IN OUR WHEELHOUSE, UM, WE WOULD, WE WOULD LOVE TO, TO LEARN MORE. UM, I THINK WE HAVE ON OUR, ON OUR TEAM, WE HAVE, UM, A LOT OF, UM, COMMUNITY HEALTH WORKERS THAT HAVE GIFTS AND PASSIONS RELATED TO GARDENING AND FOOD SECURITY, UM, AND HEALTH EQUITY THROUGH FOOD. AND, UM, THERE'S, I THINK THERE'LL BE FUTURE, UM, FUNDING OPPORTUNITIES THAT WILL, THEY'LL PROBABLY MATCH WITH THAT VERY WELL. OKAY. AWESOME. WE'LL DEFINITELY START TAKING A LOOK AT THAT. UM, DO YOU KNOW WHAT THE COST DIFFERENCE WOULD BE TO USE OUR LOCAL COMMUNITY GARDENS THAN USING, UM, RETAIL PRODUCE? AND SPEAKING FROM JUST MY, MY LIMITED EXPERIENCE WITH THAT, UM, I, I THINK THE, THE CHALLENGE WITH, WELL, UH, ARE YOU TALKING GARCIA STREET FARMS OR ARE YOU TALKING, UH, COMMUNITY GARDENS? UH, BECAUSE A LOT OF COMMUNITY GARDENS ACTUALLY REALLY, UM, STRUGGLE WITH PRODUCTION, AND SO A LOT OF THEM ARE MORE, AND THAT'S WHY WITH PECAN VALLEY, WE REALLY CALLED IT A TEACHING GARDEN BECAUSE WE KNEW THAT THE PRODUCTION WOULDN'T BE HIGH ENOUGH TO SERVICE. UM, BUT AT THE SAME TIME, UM, WE ARE LOOKING INTO WHERE THERE WOULD BE ADDITIONAL SPACE WHERE THERE'S ENOUGH ROOM FOR PRODUCTION SO THAT WE CAN, UM, ACTUALLY HAVE ENOUGH THAT WE COULD SHARE, SAY, UM, IN A DIFFERENT WAY OR THROUGH THE HEALTHY CORNER STORES OR THROUGH SOME OF THE OTHER, UM, BODEGAS OR PLACES, UM, WHERE FRUITS AND VEGETABLES ARE SOLD. SO I THINK THERE ARE SOME FARMS THAT CAN SUPPORT THAT MODEL. UM, BUT WHEN IT COMES TO MEA GARDENS, THEY TEND TO BE A BIT MORE ON THE EDUCATIONAL SIDE BECAUSE THEY, THEY HAVE SOME DIFFERENT STRUGGLES. UM, GUARDIA GARDENS, OF COURSE, AND GARCIA STREET FARMS ARE LIKE, AH, THEY'RE SO AMAZING. UM, AND THEY CAN REALLY, UM, MEET NEEDS LIKE THAT. BUT, UM, FROM THE OTHER GARDENS THAT ARE IN THE AREA, THAT WOULD BE A, A CHALLENGE TO, TO EXPECT PRODUCTION IN A WAY THAT WOULD REALLY SUPPORT FOOD SECURITY. BESIDES, UM, TEACHING PEOPLE TO GARDEN THEMSELVES. UM, WE'RE SO BLESSED IN SAN ANTONIO WITH BLESSED THE PEOPLE HAVING A BIT OF SPACE TO BE ABLE TO GARDEN, UM, OR EVEN IN POTS OR A YARD, UM, THAT WE CAN, WE CAN HELP PEOPLE BE MORE, UM, SUSTAINABLE IN THEIR OWN LIVES. AND, AND THAT'S ONE OF OUR BIG GOALS. OKAY. AND THEN SPEAKING TOWARDS THAT, ARE WE LEVERAGING THE FAMILIES, UM, THAT WE HAVE, THAT WANT TO UTILIZE THEIR HOME SPACE FOR GARDENING OUR, OUR FOOD AND HEALTHY FOOD SECURITY? AND THEN ARE WE TEACHING THEM HOW TO TURN THAT INTO GENERATIONAL ECONOMIC WEALTH, UM, AND HOW DO WE USE THOSE ASSETS TO REALLY PUSH THAT FORWARD INTO THE COMMUNITY? I CAN TELL YOU THAT HERE, WE HAVE LIKE A FLOODPLAIN AREA RIGHT OVER OFF OF MARTIN LUTHER KING, AND BY THE FREEDOM BRIDGE, THERE'S ALL GREEN SPACE BECAUSE THAT LAND WAS FLOODED OUT BACK IN 1998, AND IT'S JUST GROWING, WAITING FOR SOMEBODY TO TURN IT AND PUT LIFE BACK INTO IT. UM, SO I WANTED TO KNOW HOW DO WE SPEAK TO A FAMILY ABOUT BECOMING A PARTNER WITH THE CITY OF SAN ANTONIO TO USE THIS MODEL AS A FORM OF ECONOMIC, UH, STIMULUS TO THOSE COMMUNITIES THAT ARE LOOKING FOR RESOURCES AND ASSET BUILDING? YEAH, I WANNA SHARE WITH YOU, UM, ONE OF OUR BROCHURES FOR THE FRUIT TREE PROJECT, BECAUSE WE ALWAYS ANTICIPATED THAT PROJECT AS BEING ABLE TO BE EXPANDED TO TALK ALSO ABOUT HOME GARDENING AND BEING ABLE TO, THE ECONOMIC BENEFIT OF BEING ABLE TO FULL SELL, UM, WHOLE UNPROCESSED, UM, PRODUCE, WHICH IS, UM, TOTALLY ALLOWED IN THE SAN ANTONIO ORDINANCES. SO, UM, WITH OUR PARTNERS AT THE FOOD POLICY COUNCIL, THAT IS A AREA THAT WE'RE, UM, WE'RE HIGHLY READY TO DO MORE WORK IN. UM, AND AGAIN, WITH OUR, THE TALENT WE HAVE ON OUR TEAM CURRENTLY, WE HAVE A LOT OF CAPACITY TO, TO MOVE THE NEEDLE ON THAT. OKAY. WELL, THANK YOU SO MUCH FOR THE WORK. I KNOW, UM, I HAVE MORE AND MORE QUESTIONS AS WE GO, BUT I DON'T WANNA TAKE UP, UH, TOO MUCH TIME. SO MAYBE WE CAN TALK OFFLINE, ANNA, AND, AND REALLY LOOK INTO THIS SOME MORE. SO THANK YOU. THANK YOU, MADAM CHAIR. [02:00:02] ALL RIGHT. UH, THANK YOU ANNA. AND I SEE JENNIFER, HARRIET IS, IS HERE WITH US, TOO. UH, JENNIFER, I DON'T KNOW IF YOU WANTED TO ADD ANY COMMENTS. YOU'RE WELCOME TO, TO TAKE A FEW MINUTES. HEY, I JUST WANNA SAY HOW PROUD I AM OF OUR TEAM. YOU CAN SEE FROM ANNA'S, UM, TONE AND HER DEMEANOR, HOW PASSIONATE SHE IS ABOUT THE PROJECT. AND, UM, I THINK I CAN SAY THIS AND I'M CORRECT IN SAYING THAT, UM, I DON'T THINK WE'VE HAD ANY TURNOVER IN OUR COMMUNITY HEALTH WORKERS, MAYBE ONE OR TWO PEOPLE, BUT FOR THE YEARS THAT THE PROGRAM HAS BEEN IN PLACE AND THE FACT THAT THEY ARE TECHNICALLY ENTRY LEVEL POSITIONS, IT SPEAKS LOUDLY TO THE LEADERSHIP AND THE SUPPORT THAT'S BEEN OFFERED FOR THESE INDIVIDUALS TO STAY IN A GOVERNMENT ENTITY, ORGANIZATION TYPE JOB WITH ALL OF THE CRAZINESS THAT THEY HAVE TO PUT UP WITH SOMETIMES THAT, UH, THE CITY OR METRO HEALTH PUT UPON THEM. SO I'M JUST REALLY PROUD OF THE TEAM. UM, SO GRATEFUL FOR THE EXPANSION. I THINK THESE ARE FABULOUS MODELS THAT WE CAN NOT ONLY, UM, EXPAND WHERE WHAT WE'RE DOING HERE LOCALLY IN SAN ANTONIO, BUT WE WILL BE MODELS FOR OTHER COMMUNITIES IN . I, WE KIND OF LOST, COULDN'T STAY OUT MORE. OKAY. WE KIND OF LOST WHAT YOU SAID, BUT I GOT THE GIST OF IT THAT YOU'RE VERY PROUD OF . OKAY. OF THEM IS THE, THE SIGNAL. UH, SO, UH, THANK YOU AGAIN FOR THAT PRESENTATION AND THANK YOU FOR, UH, FOR OPENING THOSE NEW CORNER STORES. UH, IN CASE YOU DIDN'T KNOW, BECAUSE I DIDN'T KNOW THAT I LIVED IN A FOOD DESERT, UH, BECAUSE I ALWAYS HAD MY CAR TO BE ABLE TO, TO DRIVE TO PICK UP GROCERIES. UM, BUT I DO. AND, UH, THERE ARE ACTUALLY A NUMBER OF, UH, APARTMENT COMPLEXES NEARBY, SO IT IS ACTUALLY A GREAT LOCATION FOR A CORNER STORE IN IT. I'M GLAD THE DEPARTMENT IDENTIFIED THAT. SO I WENT BY THE, THE OTHER DAY, AND, UH, LET ME TELL YOU, IT WAS TOUGH TO GET PICTURES OUTSIDE OF THERE BECAUSE , SHE'S LIKE, DON'T SAY IT, DON'T SAY IT, BECAUSE, YOU KNOW, CORNER STORES SELL A LOT OF OTHER THINGS BESIDES, UH, BESIDES FRESH PRODUCE, AND THEY LIKE TO ADVERTISE ALL THOSE OTHER THINGS. UH, AND THE COMPANIES THAT MAKE THOSE OTHER THINGS SEND THEM LOTS AND LOTS OF SIGNAGE AND YOU, I JUST NEVER KNEW. THEY, THEY HAVE ADVERTISEMENTS THAT YOU CAN WRAP AROUND PARKING BALLARDS. THAT'S EXACTLY WHAT THEY'RE MADE FOR. YOU JUST, YOU JUST PUT 'EM LIKE THAT. SO ANYWAY, THANK YOU SO MUCH FOR THE PRESENTATION. I WANNA THANK, UH, ALL THE COUNCIL MEMBERS FOR THEIR GREAT COMMENTS AND FOR THE GREAT DIALOGUE THAT WE HAD. THIS GIVES US PLENTY OF DIRECTION TO, TO MOVE FORWARD, NOT JUST ON THE PROGRAM, BUT UH, ON OUR AGENDA FOR, FOR THIS COMMITTEE. SO THANK YOU VERY MUCH. ALL HAVE A WONDERFUL WEEKEND. * This transcript was created by voice-to-text technology. The transcript has not been edited for errors or omissions, it is for reference only and is not the official minutes of the meeting.