* 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.
          [00:00:02]
          GOOD AFTERNOON EVERYBODY. 
          WELCOME TO THE MARCH 25TH COMMITTEE MEETING OF THE COMMUNITY HEALTH EQUITY OH, ENVIRONMENT CULTURE COMMITTEE MEETING. 
          THANK YOU ALL FOR BEING HERE. 
          UM, MADAM CLERK, COULD WE PLEASE HAVE A ROLL CALL? COUNCIL MEMBER BARO HERE. 
          COUNCIL MEMBER MAKI RODRIGUEZ. 
          PRESENT. 
          COUNCIL MEMBER VIE HERE. 
          COUNCIL MEMBER CASTILLO HERE. 
          CHAIR SANDOVAL. 
          HERE, MA'AM. 
          WE HAVE A QUORUM. 
          THANK YOU. 
          I HAVE A, UH, SOME BRIEF ANNOUNCEMENTS BEFORE WE JUMP INTO OUR AGENDAS ITEMS. NUMBER ONE, WE WILL NOT BE HEARING ITEMS FOUR AND FIVE TODAY ON THE ARPA FUNDING. 
          THOSE WILL BE MOVED TO AN UPCOMING COMMITTEE MEETING. 
          UM, OH, SORRY. 
          UM, THE, UH, AND THAT WILL GIVE US, UH, SOME TIME TO REALLY SAVOR, UH, THE, THE TWO METRO HEALTH ITEMS THAT I AM VERY EXCITED TO, TO HEAR ABOUT. 
          UM, LET'S SEE. 
          UM, LAST TIME THAT WE WERE HERE, WE HEARD THREE ITEMS ON DOMESTIC VIOLENCE. 
          AND NORMALLY WE GET A RES, A WRITTEN RESPONSE TO SOME OF THE QUESTIONS THAT ARE ASKED BY THE COMMITTEE MEMBERS AT OUR NEXT MEETING. 
          HOWEVER, IN LIEU OF A WRITTEN DOCUMENT, FOLLOWING UP ON THAT LAST COMMITTEE MEETING, METRO HEALTH WILL RETURN TO THE COMMITTEE IN MAY TO ADDRESS THE QUESTIONS THAT WERE ASKED BY THE COMMITTEE. 
          UM, WE HAVE AN UPCOMING AGENDA ITEM IN THE FUTURE, THE MARCH 16TH GOVERNANCE COMMITTEE MEETING. 
          AT THAT MEETING, UM, THE COMMITTEE REFERRED COUNCILMAN MCKEE RODRIGUEZ AND MY C C R ON FOOD ACCESS TO THIS COMMITTEE. 
          SO WE WILL PLACE IT ON AN UPCOMING AGENDA. 
          YOU WILL SEE IT MAY SHOW UP IN SOMETHING THAT WE DISCUSSED TODAY AS WELL. 
          AND, UH, LET'S SEE. 
          ANOTHER ANNOUNCEMENT IS, OH, AT THE FEBRUARY 24TH COMMITTEE MEETING, WE HEARD FROM THE OFFICE OF SUSTAINABILITY ABOUT THEIR EFFORTS TO DEVELOP AN BUILDING ENERGY BENCHMARKING ORDINANCE THIS PAST TUESDAY. 
          THAT BENCHMARKING ADVISORY SUBCOMMITTEE HELD THEIR THIRD MEETING, AND THEY WILL HAVE AT LEAST ONE MORE MEETING BEFORE THEY SEND AN ORDINANCE RECOMMENDATION TO THEIR CLIMATE ACTION ADVISORY COMMITTEE. 
          AND THAT COMMITTEE WILL SEND SOMETHING TO THIS COMMITTEE. 
          SO IF YOU FALL, I KNOW I NEED A FLOW CHART PROBABLY TO EXPLAIN THAT TO YOU. 
          UH, THE MESSAGE IS, IT'S IN THE WORKS. 
          AND KEEP YOUR EYE OUT. 
          WE WILL SEE SOMETHING HERE FOR BENCHMARKING. 
          UM, THANK YOU, UH, ALL OF YOU WHO HAVE SENT STAFF MEMBERS TO THOSE, UH, ADVISORY, THOSE BENCHMARKING COMMITTEE MEETINGS, UH, I KNOW D FIVE WAS ONE OF YOUR STAFFERS, WAS THERE ALL ARE WELCOME TO PARTICIPATE AND TO OBSERVE. 
          UM, AND THEN, LET'S SEE, EARTH DAY WILL BE CELEBRATED ON APRIL 23RD AT WOODLAWN LAKE PARK AT 10:00 AM WE'LL HAVE MORE DETAILS ON THAT IN THE FUTURE AND PROBABLY AT A COUNCIL MEETING. 
          SO YOU ARE ALL INVITED TO ATTEND, EXCUSE ME. 
          AND NATIONAL PUBLIC HEALTH WEEK IS COMING UP. 
          I KNOW CLAUD YOU WILL PROBABLY MENTION SOMETHING ABOUT THAT AS WELL. 
          OKAY. 
          NOW, UH, HAVING, UH, HAVING GONE THROUGH THOSE UH, MINUTES, UH, SORRY, HAVING GONE THROUGH THOSE 
          [Approval of Minutes
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ANNOUNCEMENTS, I WOULD LIKE TO MOVE ON TO THE MINUTES. 
          UM, HOWEVER, UH, I'M GOING TO ASK THE CLERK TO PRESENT THE ITEM AND, UH, MAKE SOME COMMENTS ON IT, AND THEN WE'LL TAKE A MOTION. 
          THANK YOU, MADAM CHAIR. 
          THERE IS A SLIGHT CORRECTION TO PAGE FOUR. 
          UH, THE SECOND PARAGRAPH OF THE DRAFT MINUTES FOR MARCH 8TH, 2022 OF THE CHECK MEETING. 
          UH, THERE IS NO SUBSTANTIAL CHANGE. 
          IT'S JUST SOME CLARIFICATION IN LANGUAGE FROM THE CITY ATTORNEY'S OFFICE WHERE, UH, THEY ARE RESPONDING THAT THEY WOULD BE LOOKING INTO THE EXPLORATION OF THE READY TO WORK PROGRAM AND LEGAL, WHAT THE RECENT STATE LAWS IMPACTED IT, IMPACTING IT, UH, TO EDUCATION AND SCHOOLS FOR FAMILY VIOLENCE AND SEX TRAFFICKING. 
          AND THAT IS THE ONLY CLARIFICATION THAT IS, IT IS NOT SIGNIFICANT, BUT JUST CLARIFYING. 
          THANK YOU VERY MUCH. 
          MADAM CLERK, COULD I PLEASE HAVE A MOTION TO APPROVE THE MINUTES AS DESCRIBED BY THE CLERK? SO MOVED. 
          I SECOND. 
          THANK YOU. 
          UH, ALL IN FAVOR, PLEASE VOTE ON YOUR SCREENS. 
          MOTION. 
          CARRIE, THE MOTION CARRIES. 
          THANK YOU VERY MUCH. 
          AT THIS 
          [Briefing and Possible Action on
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POINT, WE WILL MOVE ON TO OUR ITEM TWO, WHICH IS OUR MONTHLY UPDATE ON THE CITY'S C OVID 19 RESPONSE AND PREPAREDNESS UPDATES BY METRO HEALTH STAFF. 
          UM, AS WE HAVE CLAUDE JACOB, UH, JOIN US. 
          I WOULD, UH, RECOMMEND TO MY COMMITTEE COLLEAGUES IF YOU WANT TO CONSIDER WHAT ADDITIONAL INFORMATION YOU'D LIKE TO SEE IN NEXT MONTH'S BRIEFING. 
          UH, TODAY'S WILL BE FAIRLY, FAIRLY BRIEF, BUT I'VE PROVIDED SOME COMMENTS TO CLAUDE 
          [00:05:01]
ALREADY. 
          FEEL FREE TO SHARE THOSE IN YOUR, IN YOUR COMMENTS TODAY. 
          THANK YOU, CLAUDE. 
          THANK YOU, COUNCILWOMAN SANDOVAL. 
          GOOD AFTERNOON CHECK COMMITTEE MEMBERS. 
          UH, THIS IS MY MONTHLY VISIT AND I'M, I'M JOINED BY THE FABULOUS METRO HEALTH CREW IN THE BACKGROUND. 
          SO YOU MAY HEAR SOME SHOUTS AND HOOPS. 
          WELL, WE'LL TRY TO KEEP IT DOWN. 
          ALL RIGHT. 
          WE'LL TRY TO KEEP IT DOWN. 
          UM, SO LET'S GO TO THE FIRST SLIDE. 
          SO, CAN I DO THAT? ALRIGHT, ON THE COVER SLIDE AS CUSTOMARY, THIS IS A PHOTO OF, UH, OUR COVID MURALS SCATTERED ABOUT THE CITY. 
          SO, ALEX RUBIO'S MURAL IS AT EXPRESS FOODS AT LA UH, NIA FRUIT AND GROCERY, A NEIGHBORHOOD MARKET ON SOUTH FLORES. 
          IN COUNCIL DISTRICT FIVE RUBIO'S MURAL DEPICTS A FAMILIAR FACE, ARTHUR ART VALDEZ, A 73 YEAR OLD RETIRED AIRCRAFT ENGINEER IN SAN ANTONIO, I S D BOARD TRUSTEE, WHO HAS BEGUN HIS THIRD TERM REPRESENTING DISTRICT FOUR. 
          RUBIO SAID THAT HE HOPES THE ART WILL INSPIRE PEOPLE TO PROTECT EACH OTHER BY GETTING VACCINATED. 
          AND AGAIN, UH, WE'RE SHARING AN UPDATE ABOUT THIS ODYSSEY FOR THESE TWO YEARS. 
          AND THIS IS GOING TO BE A QUICK UPDATE ON WHERE WE ARE TODAY. 
          SO, AS CUSTOMARY A SNAPSHOT, UM, AS OF THE 24TH OF THIS, UH, AS OF YESTERDAY, WE NOW HAVE REPORTED 530,000 184 CASES TO OUR DEPARTMENT SINCE THE BEGINNING OF THE PANDEMIC BACK IN MARCH OF 2020. 
          AND SADLY, WE REPORT 5,307, UH, RELATED FATALITIES TO C O V I D. 
          OUR SEVEN DAY MOVING AVERAGE CONTINUES TO DECREASE, AND WE ARE NOW AT AVERAGING 16 NEW CASES PER DAY, DOWN FROM OVER 300, UH, UH, CASES PER DAY WHEN I WAS HERE LAST MONTH. 
          SO WE ARE AT 3 48, UH, WHEN I WAS HERE JUST A MONTH AGO, UH, NEW CASES PER DAY. 
          OUR POSITIVITY, UH, PERCENT POSITIVITY HAS ALSO COME DOWN TO 2.3%, WHICH IS WAY DOWN FROM A PEAK OF NEARLY 40% BACK IN JANUARY. 
          AND CURRENTLY WE SHOW 76.4% OF THE ELIGIBLE POPULATION, MEANING THOSE, UH, FIVE YEARS AND OLDER ARE FULLY VACCINATED. 
          KEEP IN MIND THAT WE ONLY, WE SHOW ONLY 35% OF THOSE ELIGIBLE TO HAVE RECEIVED A BOOSTER. 
          SO KEEP IN MIND THAT THAT'S OUR TAKE HOME MESSAGE TO FOLKS REMINDING THEM TODAY OF THE IMPORTANCE OF GETTING THEIR BOOSTER SHOTS. 
          SO WE REALLY NEED TO WORK TOGETHER TO GET EVERYONE BOOSTED AND TO MAKE SURE THAT EVERYONE REALIZES THAT THE BOOSTER IS NOT OPTIONAL, BUT IS NECESSARY TO PROVIDE ADDITIONAL PROTECTION. 
          UH, EARLIER THIS MORNING, WE CELEBRATED THE CLOSURE OF THE MASS VACCINATION TESTING SITE OVER AT THE ALAMO DOME. 
          AND THAT SITE OPERATED CONTINUOUSLY FOR 15 STRAIGHT MONTHS. 
          REALLY JUST A SPECIAL THANKS. 
          AND SHOUT OUT TO THE FIRE DEPARTMENT, THE DOME OPERATORS, AND THE TEAMS LED BY DR. 
          NITA KIAN AND MARIO MARTINEZ. 
          UH, THIS IS A QUICK SNAPSHOT. 
          UH, AGAIN, THE PERCENT OF ELIGIBLE POPULATION FULLY VACCINATED. 
          UH, WE TRY TO MAKE SURE THAT WE ADDRESS THE PERCENT OF THE POPULATION HERE BY RACE AND ETHNICITY. 
          AND SO THIS IS JUST A QUICK SNAPSHOT TO SHOW BY THE PROPORTION OF THOSE WHO ARE FULLY VACCINATED, AS WELL AS THOSE WHO HAVE RECEIVED THEIR BOOSTER SHOTS. 
          AGAIN, BROKEN DOWN BY RACE AND ETHNICITY. 
          IN TERMS OF SNAPSHOT WITH HOSPITALIZATIONS AS OF MARCH 24TH, UH, IN HOSPITAL, AGAIN, THE DARK BLUE LINE, WE SHOW 117, UH, ADMISSIONS. 
          ONE MONTH AGO, THIS NUMBER WAS 448. 
          UH, OUR PEAK DURING THE FOURTH SURGE WAS AT 1308, UH, 1,308. 
          ADMISSIONS RELATED TO COVID, UH, THE I C U, THE INTENSIVE CARE UNIT, WHICH IS A YELLOW LINE TO AS OF TODAY, WE SHOW 30, OR AS OF YESTERDAY, WE SHOW 37, UH, UM, ONE MONTH AGO. 
          THIS WAS 113. 
          UH, THOSE ON VENTILATORS RELATED TO COVID, THE LIGHT BLUE LINE, UH, WE SHOW 16 AS OF YESTERDAY, A MONTH AGO. 
          THAT FIGURE WAS 58. 
          IN TERMS OF THE PERCENTAGE OF THOSE UNVACCINATED IN PATIENTS, UH, WE SHOW 57%. 
          SO A LITTLE MORE THAN HALF OF THOSE ADMITTED, UH, STILL UNVACCINATED A MONTH AGO. 
          THAT FIGURE WAS 67%. 
          SO JUST KEEP IN MIND THAT WE KEEP TRACK OF THIS. 
          UM, CLEARLY WE'VE BEEN PAYING ATTENTION TO THE IMPACT ON OUR AREA HOSPITALS, AND, UH, AS OF THIS WEEK, WE STILL SHOW THAT OUR OVERALL COMMUNITY RISK LEVEL IS AT LOW, UH, FOR TWO OUT OF THE THREE LAST REPORTING PERIODS. 
          AND THIS IS JUST A REMINDER OF THE SNAPSHOT AND THE DIFFERENT INDICATORS THAT WE KEEP TRACK OF AND WE REPORT OUT ON A REGULAR BASIS TO OUR COMMUNITY. 
          SO IN TERMS OF, UH, AGAIN, WHERE WE ARE IN TERMS OF THESE VARIANTS. 
          SO WE HAVE BEEN COLLABORATING WITH UT HEALTH TO UNDERSTAND WHICH VARIANTS OF COVID ARE CURRENTLY CIRCULATING IN THE COMMUNITY. 
          THAT MAY BE A LITTLE HARD TO DISTINGUISH, BUT JUST KNOW THAT THE, UM, UH, THE ALPHA, UH, THIS CHART INDICATES WHICH VARIANT WAS CIRCULATING LOCALLY OVER TIME. 
          SO EARLY IN THE PANDEMIC, THE PREDOMINANT STRAIN WAS ALPHA. 
          UH, THEN IN AUGUST OF LAST SUMMER, UH, THE, IT SHIFTED TO DELTA. 
          AND SINCE MID-DECEMBER, WE'VE BEEN TALKING ABOUT OMICRON, WHICH IS THE, THE LAR THE DARKER PURPLE. 
          UM, SO IN 
          [00:10:01]
THE RIGHT SIDE, WE'RE SHOWING AT LEAST BROKEN DOWN BY THE LINEAGE OF THESE DIFFERENT VARIANTS. 
          AND AS WE'VE EXPERIENCED, UH, OMICRON TENDS TO BE EASIER TO TRANSMIT THAN OTHERS. 
          AND JUST KNOW THAT IN ADDITION TO THESE VARIANTS, THIS GRAPH INDICATES THE SUB LINEAGE OF THE VARIANTS FOR DELTA AND OMICRON. 
          YES, IT DOES NOT STOP AT JUST DELTA AND OMICRON. 
          SO WE SEE THE BREAKDOWN. 
          IT MAY BE A LITTLE HARDER TO, TO SEE, BUT JUST KNOW AGONE TO THE SCIENCE OF OUR WORK. 
          EACH OF THESE HAVE SUB LINEAGES, AND WE SEE THAT FOR OMICRON. 
          WE SEE THAT AT THE BEGINNING IT WAS PRIMARILY BA ONE AND BA ONE ONE, WHICH WAS SEEN ACROSS THE NATION. 
          AND NOW WE ARE SEEING BA TWO BEING IDENTIFIED. 
          SO LOCALLY, BA TWO IS BEING IDENTIFIED IN ABOUT 9% OF CASES. 
          UM, HERE IN BEXAR COUNTY, NATIONALLY, IT IS UP TO ABOUT 35% OF THE REPORTED CASES. 
          SO WE WOULD EXPECT TO SEE THE SAME TREND OVER TIME. 
          AGAIN, THE PREVENTION OF THESE MEASURES ARE THE SAME. 
          MASK UP, BOOST UP, GET TESTED, STAY AT HOME IF YOU'RE SICK OR YOU'RE NOT FEELING WELL. 
          AND WE'LL CONTINUE TO MONITOR THE SITUATION AS THESE SPECIMEN ARE BEING TESTED. 
          SO OVER THE COURSE OF THESE COUPLE YEARS, IT'S BEEN ABOUT THE VIRUS, IT'S BEEN ABOUT VULNERABLE POPULATIONS. 
          WE'RE TALKING ABOUT VACCINES, WE'RE TALKING ABOUT VARIANTS. 
          BUT AT THE END OF THE DAY, WE REMAIN VIGILANT. 
          SO, LAST REMINDERS HERE, UH, FOR THIS QUICK UPDATE. 
          IN TERMS OF INCENTIVES, WE'VE TRIED OUR BEST TO BE AS CREATIVE AS WE CAN BE. 
          UH, WE DID LAST FALL LAUNCH AN INCENTIVE PROGRAM, UH, BASED ON THE FUNDING THAT WE, UH, RECEIVED FROM OUR FEDERAL PARTNERS. 
          UH, WE, UH, PROCURED, UH, 10,000 GIFT CARDS. 
          AND TO DATE, UH, WE'VE DISTRIBUTED OVER 9,000. 
          THE TOP ZIP CODES HAVE BEEN 7 8 2 0 7, 7 8, 2 45, 7, 8, 2, 2, 3, 7, 8, 2, 2 8, AND 7, 8, 2, 1 0. 
          SO JUST KNOW THAT WE APPRECIATE THE FEEDBACK FROM THIS BODY OVER THE COURSE OF THE LAST FEW MONTHS. 
          WE'VE TRIED OUR BEST TO MAKE SURE THAT THOSE WHO ARE ELIGIBLE RECEIVED, AND WE ACTIVELY PUSH THIS OUT AS OUR INCENTIVE PROGRAM. 
          AND I'M PLEASED BY THE, AT LEAST THE EFFORT. 
          AND I JUST WANNA SAY THANKS FOR YOUR SUGGESTIONS OVER THESE MANY, MANY MONTHS. 
          I'LL END BY SAYING, AGAIN, A REMINDER THAT THIS IS STILL WITH US, THIS COVID EXPERIENCE. 
          WE DO KNOW, BASED ON THE UPDATES FROM THE FEDS AND OUR STATE LEVEL PARTNERS, THAT THIS B A TWO SUB LINEAGE IS MORE TRANSMISSIBLE. 
          WE KNOW THAT VACCINES AND TREATMENTS THAT WORK AGAINST OMICRON ALSO WORK AGAINST THE BA TWO, UH, VARIANT. 
          UH, WE KNOW, AND WE ARE PAYING ESPECIALLY CLOSE ATTENTION FOR THOSE WHO ARE OLDER. 
          SO THE ELDERLY, WE KEEP PUSHING THAT MESSAGE, AND YOU'LL HEAR US KEEP ON THAT REFRAIN. 
          IN TERMS OF THE IMPACT ON OUR VULNERABLE POPULATIONS, UH, AS I'VE MENTIONED, CURRENTLY 9% OF THE CASES SEQUENCED IN BEXAR COUNTY HAVE BEEN SHOWN, HAVE BEEN SHOWING THIS, THIS VARIANT. 
          SO IN THE END, WE DO PAY ATTENTION TO THE OTHER, UH, CHANGES THAT ARE HAPPENING ACROSS OUR ECOSYSTEM. 
          UH, FEDERAL FUNDING HAS BEEN ENDING IN TERMS OF THE REIMBURSEMENT FOR TESTING AND THE VACCINATE AND, UM, VACCINATING THOSE WHO ARE UNINSURED. 
          UH, WE DO KNOW THAT OUR PARTNERS AT COMMUNITY LABS, ESPECIALLY THE WONDERLAND MALL AND ELMO COLLEGES DISTRICT, UH, WILL CONTINUE TO TEST INDIVIDUALS WITHOUT INSURANCE. 
          UM, AND OUR POP-UP CLINICS ARE AVAILABLE, AND OUR SITES CONTINUE TO PROVIDE THE SERVICE FREE OF CHARGE. 
          THE, THE ONLY OTHER REMINDER IS THAT EACH HOUSEHOLD CAN NOW ORDER, UM, UM, ANOTHER FOUR NO-COST TESTS THROUGH COVID TEST.GOV FOR A TOTAL OF EIGHT TESTS THIS YEAR. 
          UH, THOSE WITH HEALTH INSURANCE CAN ORDER UP TO EIGHT NO-COST TESTS EACH MONTH AT RETAIL STORES, PHARMACIES, AND CAN BE REIMBURSED OR COVERED THROUGH THEIR INSURER. 
          UM, I DO WANT TO, AGAIN, ACKNOWLEDGE OUR INCREDIBLE TEAM. 
          I ALSO WANT TO THANK DR. 
          RITA ESPINOZA AND HER TEAM AT EPI WORLD. 
          UH, WE HAVE A GAGGLE OF DISEASE DETECTIVES ON THE GROUND. 
          UH, WE ARE UNIQUE IN OUR STRUCTURE AT THE DEPARTMENT. 
          MOST LOCAL HEALTH DEPARTMENTS AT THE LOCAL LEVEL DO NOT HAVE EPIDEMIOLOGISTS ON STAFF. 
          SO I'M PLEASED AND PROUD OF THE TEAM THAT'S BEEN WORKING REALLY HARD OVER THE COURSE OF THIS PANDEMIC ANCHORED TO THE DIVISION OF COMMUNITY COMMUNITY, UM, COMMUNICABLE DISEASES AND LED BY DR. 
          KERRY. 
          SO, I'LL STOP THERE AND WE'LL OPEN IT UP FOR ANY QUESTIONS BEFORE THE SECOND PRESENTATION. 
          THANK YOU VERY MUCH, CLAUDE, AND IT'S A DELIGHT TO HAVE, UH, SO MUCH OF YOUR TEAM WITH US TODAY. 
          IT'S GREAT TO SEE THE PEOPLE WHO DO ALL OF THE WORK. 
          THANK YOU VERY MUCH FOR YOUR HARD UNENDING WORK. 
          I KNOW IT'S BEEN A LONG, UH, TWO YEARS, BUT IT IS MUCH APPRECIATED. 
          UH, A COUPLE OF QUESTIONS ABOUT, UM, COULD WE TALK A LITTLE BIT ABOUT BA TWO AND WHAT WE NEED TO DO, UM, AS IT IS ON THE HORIZON? AGAIN, THE TAKE HOME MESSAGE THAT WE HAVE NOW, MORE TOOLS AT OUR DISPOSAL, BUT THE RESPONSE EFFORTS REMAIN THE SAME IN TERMS OF THE BEST WAY THAT WE CAN PROTECT 
          [00:15:01]
OURSELVES. 
          SO IT'S MAKING SURE THAT FOLKS GET VACCINATED THAT THEIR VACCINE SERIES ARE UP TO DATE. 
          UH, RIGHT NOW, THE PUSH IS TO MAKE SURE THAT THE BOOSTERS, WE HAVE FOLKS WHO ARE IN THIS, UH, SORT OF MALAISE FATIGUE, THINKING THAT THEY HAVE MORE TIME. 
          AND WE'RE TRYING TO REMIND THEM THAT THIS VIRUS PUNISHES THE PROCRASTINATOR. 
          AND SO WHATEVER WE CAN DO TO REMIND FOLKS TO GET VACCINATED, GET THEIR BOOSTER SHOTS, WE, WE WE'RE SEEING THAT THE EFFECTIVENESS OF THIS VACCINE ON THIS, ON THE VARIANT, UM, THE OMICRON VARIANT AND THE BA TWO VARIANT. 
          AND SO THAT'S THE TAKEAWAY. 
          LET'S MAKE SURE THAT FOLKS GET VACCINATED, GET THEIR BOOSTER SHOTS, UM, AND, UH, DEPENDING ON THE CIRCUMSTANCE TO CONTINUE TO MASK UP, UM, AND TO MAKE SURE THAT IF THEY'RE SICK, STAY HOME. 
          WHAT ARE THE CIRCUMSTANCES FOR MASKING UP CLAUDE CIRCUMSTANCES? WELL, AGAIN, EACH INDIVIDUAL KNOWS THEIR, UH, POTENTIAL RISK OF EXPOSURE. 
          UM, OUR TEAM ON THE GROUND IS MAKING SURE THAT WE MESSAGE THIS ACCORDINGLY. 
          UM, THOSE WHO ARE IMMUNOCOMPROMISED, UH, THOSE WHO ARE IN CERTAIN SPACES WHERE THEY WONDER WHETHER OR NOT THEY'RE MORE AT RISK TO BE EXPOSED TO THIS, UH, VIRUS. 
          SO YOU'VE SEEN, UM, THE RESTRICTIONS BEING RELAXED FROM COAST TO COAST. 
          UH, IT'S NOT A REQUIREMENT, IT'S A RECOMMENDATION. 
          IT'S A PRACTICE THAT WE'RE, WE'RE RECOMMENDING TO FOLKS. 
          UM, PUBLIC TRANSPORTATION, YOU'LL SEE STILL THE, THE REQUIREMENT FOR FOLKS TO MASK UP. 
          UH, BUT RIGHT NOW IT'S, IT'S A, IT'S A PRACTICE. 
          SO IT'S NOT A REQUIREMENT AND IT'S BASED ON ONE'S RISK OF EXPOSURE AND ALSO THEIR CONDITION. 
          SO, UM, TODAY IS, UM, AN OZONE ALERT DAY. 
          MM-HMM. 
          , RIGHT? SO, UM, THERE IS A RECOMMENDATION TODAY FOR PEOPLE WHO ARE IN SENSITIVE GROUPS AND WHAT IS TERMED AS THOSE WHO HAVE RESPIRATORY DISEASE TO, YOU KNOW, AVOID THE OUTDOORS. 
          AND, AND THERE'S A WHOLE BUNCH OF OTHER RECOMMENDATIONS TOO. 
          UM, SO I'M, I'M USING THAT AS A, AS A PARALLEL WHEN IT COMES TO MASK WEARING. 
          SO WE'VE HEARD WHEN THE C D C RELAXED THE REQUIREMENTS, UM, IT WASN'T A FULL-BLOWN RELAXATION. 
          IT WAS, UH, VERY MUCH DEPENDS ON YOUR CASELOAD IN YOUR COMMUNITY. 
          UM, BUT THAT REALLY PUT THE ONUS ON EACH INDIVIDUAL TO GO LOOK UP THE CASELOAD AND SEE, DOES THIS MEET THE THRESHOLD THAT THE C D C IS RECOMMENDING TO ME? WHEREAS WHEN WE LOOK AT THE E P A MODEL, IT'S A GREEN RED, AND, AND I KNOW WE HAVE OUR OWN THERMOMETER, RIGHT? THAT, THAT WE USE. 
          UH, I GUESS IS THERE AN EASY WAY TO SAY MASKS RECOMMENDED MASKS, YOU KNOW, IN PUBLIC PLACES, UNLESS YOU ARE IMMUNO, YOU KNOW, ADDITIONALLY IMMUNOCOMPROMISED, WHATEVER, OR MASKS. 
          UM, I DON'T KNOW IF YOU EVER WANNA SAY NOT RECOMMENDED . 
          I JUST, I, I JUST AM CONCERNED THAT WITH THAT, IT'S, IT'S A HOOP THAT PEOPLE HAVE TO JUMP THROUGH AND THEY'RE NOT GOING TO JUMP THROUGH IT. 
          SO WHAT CAN, CAN WE HELP IN THAT PROCESS? GREAT QUESTION. 
          UM, PART OF THIS EXPERIENCE THE LAST COUPLE YEARS, IT'S NOT ONLY DEALING WITH THE REALITY AND THE DISRUPTION, TIDE OF THE PANDEMIC OF INFORMATION THAT FOLKS GET THE INFO DEMO. 
          AND SO WE HAVE BEEN TRYING TO BE MORE CREATIVE ABOUT WORD CHOICE. 
          HOW DO WE LAY OUT THE INFORMATION SO IT'S EASIER FOR FOLKS TO FOLLOW? SO WHETHER IT'S A STOPLIGHT MODEL, RED, YELLOW, GREEN, OR JUST THINKING ABOUT THE CONTINUUM OR THE RISK OF EXPOSURE. 
          SO WE'LL GIVE IT SOME MORE THOUGHT. 
          THE CHALLENGES THAT THERE'S SO MANY DIFFERENT WAYS THAT THE INFORMATION'S BEING PACKAGED, WHETHER IT'S BY OUR FEDERAL PARTNERS, OUR STATE LEVEL AGENCIES. 
          SO I DON'T HAVE A A A A SOLUTION EXCEPT TO SAY WE'RE PAYING ATTENTION, WE'RE RESPONDING TO RESIDENTS, AND WE'RE TRYING TO MAKE SURE THAT THEY HAVE THE APP, THE INFORMATION SO THEY CAN MAKE THE BEST DECISION TO PROTECT THEMSELVES. 
          I THINK YOU'VE GOT SOME REINFORCEMENTS WHO ARE READY TO, TO COME UP. 
          IT'S UP TO YOU. 
          CLAUDE. 
          WHAT? WHATEVER YOU OKAY. 
          OH, REINFORCE. 
          OH, I DIDN'T SEE. 
          I LOOKED, COME ON DOWN. 
          I LOOKED, I DID THE BASEBALL SIGN, BUT I DIDN'T SEE HER GET UP. 
          COME ON DR. 
          WU. 
          WELL, BUT, BUT CLAUDE IS, IS RIGHT. 
          UNFORTUNATELY, THERE'S NOT ONE SI IT'S NOT ONE SIZE FITS ALL ANYMORE. 
          SO IT, YOU KNOW, WE WANNA ASK PEOPLE TO PAY ATTENTION TO THE COMMUNITY RISK LEVEL, THEIR VACCINE STATUS, AND THEIR OWN HEALTH STATUS AND THEIR PERSONAL PREFERENCE. 
          AND I HOPE THAT WE ARE TOLERANT OF EVERYBODY'S PERSONAL PREFERENCES OR WHETHER THEY CHOOSE TO MASK OR THEY DON'T MASK. 
          THANK YOU VERY MUCH, DR. 
          WU. 
          UH, WE HAVE SOME, UH, QUESTIONS IN THE QUEUE HERE. 
          SO I'LL START WITH COUNCILMAN MCKEE RODRIGUEZ, THANK YOU SO MUCH, AND THANK YOU AGAIN FOR THE PRESENTATION. 
          SORRY, I'VE BEEN TOLD THAT I'M VERY DEMURE AND QUIET, AND SO I NEED TO SPEAK UP INTO THE MICROPHONE. 
          UM, I'LL START BY ASKING, UM, ONE, I WAS JUST ON THE CITY'S DASHBOARD, UM, AND IT SHOWS VACCINATION STATISTICS FOR ONE AND TWO DOSES. 
          UM, I KNOW IT SAID 35.4% OF FOLKS ARE BOOSTED. 
          DO WE KNOW HOW MANY PER ZIP CODE HAVE RECEIVED BOOSTERS? AND IS IT POSSIBLE TO GET THAT INFORMATION ON A DASHBOARD? 
          [00:20:01]
WE'RE WORKING ON IT. 
          SO THANK YOU FOR THAT. 
          AGAIN, I'VE GOT THE, UH, SUPPORTING CAST BACK HERE, SO YES, WE'RE WORKING ON THAT. 
          UM, AND BASED ON THIS FEEDBACK, WE TRY OUR BEST TO MAKE SURE THE INFORMATION'S PACKAGED AND MAKES IT EASIER FOR RESIDENTS. 
          BUT YES, ABSOLUTELY, WE'RE WORKING ON THAT BREAKDOWN. 
          I KNOW IT FEELS AMAZING TO HAVE A GREAT TEAM. 
          OH, YEAH. 
          UM, I WILL ALSO ASK, SO, UM, MY TEAM AND I HAVE HAD A LOT OF CONVERSATIONS ABOUT LONG COVID AND ITS IMPACTS. 
          AND SO I'M INTERESTED IN A, UM, FORMAL RESPONSE AND ASSISTANT, LIKE A, A PLAN FOR HOW WE, UM, SUPPORT THOSE WITH LONG C O V I D. 
          AND I'M WONDERING, HAVE WE DONE A COMMUNITY HEALTH AND, UM, WORKFORCE ANALYSIS OF THOSE WHO HAVE BECOME DEEPLY AND ADVERSELY, UH, HARMED AND DISABLED BECAUSE OF COVID? I'M GONNA ASK DR. 
          WU TO FEEL THE QUESTION ABOUT THE IMPACTS OF LONG IMPACTS OF LONG COVID. 
          UT HEALTH IS PROBABLY DOING MORE ON THAT THAN ANYBODY RIGHT NOW. 
          IT'S NOT A DISEASE THAT HAS ONE SPECIFIC DEFINITION MM-HMM. 
          . 
          SO, UM, THE SHORT ANSWER IS AS SOON AS, AS SOON AS PEOPLE CAN GET A BETTER HANDLE ON IT, THEN THAT WILL BE THERE. 
          BUT IT'S PREMATURE FOR US IN PUBLIC HEALTH RIGHT NOW. 
          OKAY. 
          THANK YOU FOR THAT. 
          UM, I GUESS THE ISSUE THAT I, SO I IMAGINE THAT THERE ARE MANY WHO CANNOT MAINTAIN THEIR PREVIOUS JOBS OR ANY JOB, UM, AND ARE IN NEED OF ASSISTANCE. 
          AND SO I'M WONDERING HOW CAN WE CONTINUE AS HOW CAN WE PROVIDE FURTHER ASSISTANCE? YOU DON'T HAVE TO, YOU DON'T HAVE TO ANSWER IT. 
          I THINK IT'S JUST A, LET'S MARINATE ON IT AND LET'S, UM, THANK YOU FOR THAT. 
          AND THIS IS JUST A, A PREVIEW OF COMING ATTRACTIONS TIED TO THE ROLLOUT OF OUR GROWTH PLAN ESSAY FORWARD. 
          SO THE IMPACTS OF THIS COVID EXPERIENCE, UM, ONE OF THE PROCESSES WE'LL BE GOING THROUGH IS AN ASSESSMENT OF THE DISRUPTION. 
          UM, SO YOU'LL HEAR US TALK ABOUT DETERMINANTS OF HEALTH, THESE CONDITIONS THAT HAVE BEEN DISRUPTED BECAUSE OF COVID. 
          SO WE'RE STILL GATHERING INFORMATION, WE'RE WORKING WITH OUR ACADEMIC PARTNERS, BUT THANK YOU FOR, FOR BRINGING THAT UP. 
          THANK YOU. 
          UM, ALSO WITH AN INCREASE, UM, IN THE NUMBER OF PATIENTS ADMITTED AND PLACED ON SUICIDE RISK PREVENTION, UM, NATIONWIDE, I'M HOPING, OR I'M WONDERING, ARE WE ENSURING THAT SOME OF OUR MENTAL HEALTH BUDGET AND RESOURCES, UM, IS GOING SPECIFICALLY TO THOSE, UM, WITH EXACERBATED MENTAL HEALTH ISSUES DUE TO COVID? AND I'M THINKING ESPECIALLY LIKE CHILDREN. 
          I HAD A NUMBER OF STUDENTS WHO, UM, ATTEMPTED SUICIDE. 
          AND SO THAT'S SOMETHING THAT'S TOP OF MIND. 
          UM, YOU'VE TOUCHED ON, AGAIN, IN THE NEXT SEGMENT, I'LL TALK ABOUT THE PRIORITIES, UM, WHICH INCLUDES MENTAL HEALTH AND COMMUNITY RESILIENCE. 
          UH, WE'VE LEARNED A LOT SADLY, ABOUT THE IMPACTS OF THIS EXPERIENCE TIED TO COVID. 
          BUT LET'S BE CLEAR THAT WHAT WE'RE SEEING EXACERBATED BY COVID, THAT THERE'S BEEN A LONG HISTORY OF TRAUMA AND, AND STRESS AND, AND EXPOSURES THAT KIDS AND ELDERLY AND ADULTS AND ACROSS THE COMMUNITY OF EXPERIENCE. 
          SO WE ARE PAYING ATTENTION TO THAT. 
          AND, UM, WHETHER WE CAN DRAW A DIRECT TIE TO THE EXPERIENCE AND SUICIDAL IDEA, WHATEVER IS THE IMPACT HAS BEEN, BUT THAT IS ONE OF OUR HEALTH PRIORITIES FOR THE NEXT COMING YEARS. 
          THANK YOU. 
          THANK YOU. 
          UM, THE LAST LITTLE BIT I THINK IS KIND OF A COMMUNITY P S A A LITTLE BIT. 
          UM, I THINK ON SLIDE, WHAT IS IT, SLIDE FOUR. 
          IT, IT'S SHOWN EVERY TIME WHEN WE, WHEN WE'VE HAD THE SPIKES AND WHEN IT, WE'VE SEEN LIKE, IT KIND OF SUBSIDE A LITTLE BIT. 
          UM, I DON'T THINK THAT'S SLIDE FOUR. 
          UM, BUT ANYWAY, WE SAW A SPIKE IN ORIGINALLY, I THINK IT WAS JULY, AND THEN JANUARY, FEBRUARY, THEN JULY, AUGUST, SEPTEMBER, THEN JANUARY, FEBRUARY, WHERE I THINK LAST YEAR, UM, FOLLOWING FIESTA WE SAW A LITTLE BIT OF A SPIKE STARTING IN LIKE JULY-ISH GOING INTO THE, 'CAUSE WE DIDN'T HAVE IT IN APRIL. 
          UM, I AM CONCERNED THAT WE CAN EXPECT TO SEE IT HAPPEN VERY SOON. 
          AND SO JUST ANOTHER THING THAT I DON'T NEED A RESPONSE RIGHT NOW, BUT HOW WE ARE PREPARING FOR WHAT THAT'S GONNA LOOK LIKE AND BE. 
          THANK YOU. 
          THANK YOU, COUNCILMAN. 
          UH, WE HAVE COUNCILWOMAN GUSTI NEXT. 
          THANK YOU CHAIR. 
          THANKS, CLAUDE. 
          AND TEAM, UM, UH, AS WE CONTINUE TO SEE THE, THE POSITIVE RATES GO DOWN, BUT WE'RE LEARNING ABOUT HOW THE VIRUS CONTINUES TO MUTATE AND THERE'S POTENTIALLY A NEW VARIANT GOING AROUND. 
          IS THERE A SPECIFIC THRESHOLD THAT, UH, WE WOULD NEED TO HIT IN ORDER TO REOPEN, UH, THE MASS TESTING SITES? IS IT, UH, MOVING, UM, FROM LOW TO MILD, MILD TO MODERATE? UH, WHAT DO WE HAVE IN MIND? WHAT ARE WE PLANNING FOR? YEAH, GREAT QUESTION. 
          IT'S NOT AS LINEAR AS A THRESHOLD, SO YOU WON'T SEE ONE FIGURE. 
          UM, JUST KNOW THAT EACH SCENARIO PRESENTS A DIFFERENT CIRCUMSTANCE. 
          IF YOU GO BACK TO THE FIRST TWO SURGES. 
          AND WHAT WAS DRIVING THAT COMPARED TO THE LAST TWO SURGES? WHAT I CAN SAY IS THAT WE NOW HAVE TOOLS AT OUR DISPOSAL THAT WE DIDN'T HAVE IN SOME OF THE PREVIOUS EPISODES. 
          UH, THE FACT THAT WE DO HAVE VACCINES, WE KNOW ABOUT THE EFFECTIVENESS OF 
          [00:25:01]
THE VACCINES, THE SAFETY OF THE VACCINES. 
          WE DO HAVE DIFFERENT MODALITIES TO MAKE SURE THAT WE MINIMIZE THE STRESS ON AREA HOSPITALS, RECOGNIZING THE PRESSURES THERE. 
          UM, SO NO, IN TERMS OF A SPECIFIC THRESHOLD, UM, BUT JUST THINK BACK TO WHERE WE WERE JUST 60 DAYS AGO, UM, AND WHAT WE WERE EXPERIENCING DURING THE MONTH OF JANUARY. 
          AND YET HERE WE ARE. 
          SO WE REMAIN VIGILANT AND WE'LL CONTINUE TO MAKE FOLKS AWARE OF WHATEVER OPTIONS ARE AVAILABLE, LIKE THE POP-UP CLINICS, LIKE MAKING SURE THAT THEY GET THEIR VACCINATIONS FROM THE AREA PHARMACIES AND THEIR PROVIDERS. 
          SO THAT'S THE BEST WAY TO PROTECT YOURSELF IS TO GET VACCINATED AND TO GET YOUR BOOSTER SHOT. 
          YES, ABSOLUTELY. 
          AND AS FOLKS START TO CONGREGATE, AGAIN WITH VIESS EVENTS, I'M ALSO CONCERNED, UH, ABOUT, UH, ANY PREMATURE STEPS THAT WE'RE TAKING. 
          UM, HOWEVER, UM, SEEING THAT THERE'S ROUGHLY 35.4% OF FOLKS WHO HAVE RECEIVED THE BOOSTER, IS THERE A SPECIFIC BOOSTER CAMPAIGN, UH, THAT YOU ALL ARE ENTERTAINING OR HAVE IN MIND? UM, I, I THINK, YOU KNOW, WITH FIESTA, THERE COULD HAVE BEEN AN OPPORTUNITY TO PROVIDE, UH, FIESTA METALS TO GET YOUR BOOSTER. 
          UM, BUT DO Y'ALL HAVE, UH, ANYTHING IN MIND THAT YOU'RE WORKING ON TO INCREASE THE BOOSTER RATES? YEAH, SO JUST KNOW WE'RE STAYING ON MESSAGE REMINDING FOLKS, ESPECIALLY FOCUSING ON THE IMPACTS ON THE ELDERLY. 
          SO MAKING SURE THAT THEY HAVE THEIR BOOSTER SHOTS. 
          UH, WE ARE JUST A THIRD OF THE ELIGIBLE POPULATION HAS RECEIVED THEIR BOOSTERS, SO WE DO HAVE SPECIFIC MESSAGING REMINDING FOLKS. 
          UM, AND YOU'LL SEE THAT OVER THE COURSE OF THE COMING WEEKS, WE HAVE BEEN STAYING ON MESSAGE THROUGH PSAS, THROUGH BILL BILLBOARDS. 
          BUT YES, WE ARE MAKING SURE THAT THAT TAILORED MESSAGE IS GETTING OUT THERE. 
          AND ALL WE CAN DO IS ASK EACH AND EVERY ONE OF YOU TO ALSO SPREAD THE WORD ABOUT THE BEST WAY TO PROTECT YOURSELF AND YOUR LOVED ONES. 
          ABSOLUTELY. 
          THANK YOU, CLAUDE. 
          THANK YOU, CHAIR. 
          THANK YOU. 
          UM, I JUST WANTED TO, UH, EXTEND ONE OF HER QUESTIONS A LITTLE BIT. 
          WHEN A COUNCILWOMAN ASKED ABOUT A THRESHOLD, CLEARLY THERE ARE MANY FACTORS THAT YOU TAKE INTO ACCOUNT THAT WE CAN'T SEE THEM ALL RIGHT FROM, FROM OUR WORK. 
          UH, WHAT WHAT I'M CONCERNED ABOUT IS WE'LL HEAR THAT SOMETHING IS GOING ON, AND THEN WE'LL ALL BE LIKE, OPEN THAT NOT WE'LL ALL, BUT SOME OF US ON THE COUNCIL WILL SAY, OPEN THE MASS TESTING SITES, WHY AREN'T THERE, WHY AREN'T THERE? THEY OPEN AND WE WON'T UNDERSTAND WHY THEY'RE NOT OPEN. 
          SO I THINK WHAT WE'RE HOPING FOR IS JUST A LITTLE BIT OF CLARITY AROUND THAT DECISION MAKING, BECAUSE OTHERWISE WE WILL HAVE CONSTITUENTS CONTACTING US AND WE'LL SAY ALL, ALL WE'LL BE ABLE TO TELL THEM IS, HEY GUYS, WE TRIED, CLAUDE SAID NO, OR CLAUDE SAID, THERE'S SOMETHING ELSE GOING ON. 
          SO I CAN YOU, CAN YOU HELP US OUT HERE? Y YEAH, THANK YOU. 
          UNDERSTANDABLE. 
          UM, STILL BUILDING THE PLANE WHILE FLYING IT. 
          JUST KNOW THAT WHAT WE REPORT OUT IN TERMS OF COMMUNITY RISK LEVEL, WE, WE HAVE CERTAIN INDICATORS THAT WE PAY ATTENTION TO. 
          LOOKING AT THE TRENDS OVER A COUPLE WEEKS, LOOKING AT THE IMPACTS ON HOSPITALS, LOOKING AT PERCENT POSITIVITY. 
          YOUR QUESTION ABOUT THE TRIP WIRE, WELL, THE DECISION AROUND THAT ANCHORED TO THE CITY MANAGER ANCHORED TO INPUT FROM THE SENIOR TEAM LIKE MYSELF OR THE FIRE CHIEF. 
          SO IT'S NOT LINEAR IN SCOPE. 
          AND I UNDERSTAND THE PRESSURES THAT YOU MAY GET FROM CONSTITUENTS, BUT JUST KNOW THAT BASED ON GUIDANCE FROM THE C D C BASED ON RECOMMENDATIONS FROM THE STATE, WE TRIANGULATE AND WE LAND AT THE BEST ACTION HERE IN THIS LOCAL JURISDICTION. 
          SO WHAT WE ASK IS THAT YOU TRUST US IN THE PROCESS, IN THE RESPONSE, OUR VACCINATION RATES AMONGST THE BIG CITIES HERE IN TEXAS, UH, WE ARE PROBABLY ONE OF THE HIGHEST PERFORMING CITIES OVER THE COURSE OF THESE COUPLE YEARS. 
          WE ARE MAKING SURE THAT WE'RE APPLYING THE SCIENCE OF OUR WORK TO GET TO THE AREAS OF HIGHEST NEED ACROSS THE CITY. 
          SO JUST KNOW THAT WE RESPOND ACCORDINGLY AND HOW THAT TRANSLATES TO YOU ALL. 
          UM, WE TRY TO MAKE SURE THAT THE INFORMATION, THE UPDATES, ESPECIALLY FROM THE CITY MANAGER'S OFFICE COMES TO YOU DIRECTLY. 
          SO I'M NOT SURE IF THAT GETS AT, WELL, WHAT'S THE TRIP WIRE? BUT JUST KNOW THAT THAT'S HOW WE'VE NAVIGATED OVER THE LAST COUPLE YEARS. 
          OKAY. 
          I, I THINK YOU SHOULD JUST BE PREPARED THAT IF SOMETHING, IF SOME, IF IT FLARES UP AGAIN, YOU'LL PROBABLY HEAR FROM MEMBERS OF THE COUNCIL PERHAPS BEFORE YOU ARE READY TO TAKE ACTION. 
          AND THAT WE WILL GO BACK TO THAT  TO THAT POSITION IS, UM, I THINK THAT'S JUST OUR, WHAT WE'LL HAVE TO BE PREPARED FOR IS FINE. 
          UNDERSTOOD. 
          THANK YOU. 
          UM, UH, WE HAVE COUNCILWOMAN IRAN. 
          THANK YOU, COUNCILWOMAN. 
          THANK YOU. 
          CLAUDE, THANK YOU FOR THE UPDATE. 
          UH, AND I KNOW YOU'VE HAD DIFFERENT GRAPHS BEFORE. 
          DO WE HAVE A GRAPH, AND I KNOW MY AGE AND GENDER, ARE WE DOING ANYTHING FOR VETERANS AND THOSE LIVING WITH DISABILITIES? ARE WE KEEPING TRACK OF, UM, UH, THE PERCENTAGE OF, UH, RATES THAT THEY'RE GETTING? THAT NO. 
          GOOD QUESTION. 
          AGAIN, WE, WE ARE AWARE, BASED ON THE LITERATURE ABOUT THE DISPROPORTIONATE BURDEN OF ANY CONDITIONS FOR THE DISABLED. 
          UM, CAN'T SPEAK TO ANY GRANULARITY ABOUT VETERANS SPECIFICALLY. 
          UH, WE KNOW THAT THE VULNERABLE POPULATIONS LIKE THE ELDERLY ARE AT HIGHER RISK. 
          SO, BUT IT'S, IT'S, IT WOULD BE A STRETCH FOR US TO GET TO WHAT YOU'RE TO THAT DEMOGRAPHIC, BUT WE CAN MAKE SOME ASSUMPTIONS 
          [00:30:01]
BASED ON THE CATEGORY THAT THEY FIT IN. 
          SO, UM, AND MAYBE WE DO THIS ONCE WE GET COMPLETELY, ONCE C OVID 19 STOPS MUTATING, BUT , WE, WE DO A, A BETTER STUDY WITH, UH, MAYBE UT OR TEXAS A AND M ON THAT. 
          THANK YOU. 
          UM, SO WHEN WE TALK ABOUT THESE NEW VARIANTS, I REALLY ENJOY, I REALLY THOUGHT THAT, UM, THE AT-HOME TEST KITS WERE KEY AND MY OFFICE PARTNERED WITH METRO HEALTH. 
          WE DISTRIBUTED A HUNDRED C OVID 19 AT-HOME TESTING KITS, UM, TO THE NEIGHBORHOOD ASSOCIATION SENIORS, D THREE CONSTITUENTS. 
          SO, UM, CAN WE GET MORE OF THOSE IN ANTICIPATION OF MAYBE A NEW VARIANT COMING OUT? THANK YOU. 
          I KNOW THAT WE PURCHASED AND WE DEPLOYED THEM, SO THANK YOU FOR GETTING THAT OUT. 
          UM, THE FEDERAL PROGRAM DOES HAVE A PROGRAM IN PLAY NOW, UM, FOR FOLKS TO GET THOSE KITS DIRECTLY. 
          UM, BUT IN TERMS OF SECURING OTHERS, UH, WE CAN LOOK INTO IT, BUT JUST KNOW THAT WE ARE DEFERRING TO THE FEDERAL ORDERS THAT FOLKS CAN GET AND ORDER THOSE KITS. 
          UM, SO, UH, THEN LET'S JUST KEEP TRACK OF THAT BECAUSE I KNOW THEY'RE GOING FEDERALLY, BUT IF THEY DON'T TRUST THE FEDERAL GOVERNMENT OR THEY'RE NOT DOING IT, I, I WOULD LIKE TO SEE IF WE COULD HAVE SOME KITS ON HAND SO THAT WE'RE NOT LOOKING AT LET'S DO ANOTHER MASS TESTING SITE. 
          UH, BUT WHAT WE DO HAVE IS PEOPLE TESTING AT HOME. 
          AND WHAT I WOULD ALSO LIKE TO SEE, UM, WHEN WE DO YOUR SOCIAL MEDIA AND, AND METRO HEALTH HAS BEEN DOING A GOOD JOB, BUT, UM, THAT WHOLE, YOU TESTED POSITIVE, NOT NOW. 
          WHAT IF WE COULD HAVE SOME WAY TO JUST REMIND THEM, UM, THIS IS A VARIANT, IT'S NOT, IT, IT MIGHT BE THIS VARIANT AND THESE ARE THE PRACTICES YOU WANNA DO. 
          WEAR YOUR MASK, STAY ISOLATED, DRINK LOTS OF WATER. 
          UM, AND THEN ANYTHING THAT MAY COME UP THAT WASN'T PART OF THIS, THE, THE ORIGINAL, UH, C OVID 19 THAT SENT US INTO THIS PANDEMIC, WHICH I KNOW WITH THE OMICRON, IT WAS LIKE I LOST MY TASTE, I LOST MY SENSE OF SMELL AND TASTE. 
          I DIDN'T LOSE IT. 
          AND SO THINGS LIKE THAT. 
          SO I'D JUST LIKE TO SEE THAT INFORMATION GIVEN OUT. 
          THANK YOU. 
          THANK YOU VERY MUCH, COUNCILWOMAN. 
          SO, UH, THANK YOU FOR TODAY'S PRESENTATION, CLAUDE. 
          I THINK, UH, JUST TO SUMMARIZE SOME OF THE THINGS THAT I'VE HEARD INTEREST IN FROM THE COUNCIL MEMBERS IN POSSIBLY, UH, BRINGING BACK IN A FUTURE UPDATE WOULD BE, UM, THE LONG COVID IMPACT. 
          I MEAN, YOU DID TELL US THAT WAS UNDERWAY, BUT ANY INFORMATION YOU COULD PROVIDE ABOUT THAT, UM, WE ARE GONNA GO INTO THE MENTAL HEALTH IMPACTS IN THE NEXT, UH, PRESENTATION AND, UH, THE, A LITTLE BIT MORE ABOUT THE BOOSTER CAMPAIGN. 
          AND THEN, UM, COUNCILWOMAN, IF YOU COULD JUST, UH, PLEASE REITERATE YOUR LAST COMMENT SO THAT I CAPTURE IT CORRECTLY. 
          UH, THE ONE ABOUT THE, THE INFORMATION? YES, YES, YES. 
          YEAH, IF, IF, IF THIS, THE NEW VARIANTS COME UP WITH NEW, UM, KIND OF LOSS OF SMELL, UH, HEADACHES, THINGS LIKE THAT, THAT WE, WE HAVE THAT INFORMATION AVAILABLE SOMEWHERE. 
          OH, RIGHT. 
          OKAY. 
          THANK YOU. 
          SO ANY NEW SYMPTOMS OR CHANGE OF SYMPTOMS? YES, ANY NEW SYMPTOMS? ANY, ANYTHING WHERE THE SYMPTOMS INCREASE THAT THEY SHOULD GO SEE A DOCTOR. 
          OKAY. 
          THANK YOU VERY MUCH. 
          THANK YOU. 
          CLAUDE, DO YOU WANNA SIT DOWN FOR A MINUTE BEFORE WE COME BACK FOR THE NEXT ITEM? , WHAT ARE THE RULES? NO, I'M OKAY. 
          I'M GOOD. 
          WE'LL KEEP IT GOING. 
          OKAY. 
          UM, SO I, I FEEL LIKE THERE SHOULD BE A DRUM ROLL RIGHT NOW OR SOME KIND OF MUSIC, BUT I AM, UM, GUYS, THIS IS HISTORIC. 
          WE'RE GONNA GET A PRESENTATION ON, UH, THE NEW, UH, ME. 
          ARE YOU, ARE YOU SET? YOU'VE GOT YOUR AV METRO HEALTH PLAN AND UM, TAKE IT AWAY. 
          ALRIGHT, THANK YOU. 
          AND AGAIN, THIS IS PART TWO OF OUR TWO PART SERIES TODAY. 
          SO THANK YOU FOR THE OPPORTUNITY TO PROVIDE A PREVIEW OF THE ESSAY FORWARD PLAN, FORMERLY KNOWN AS THE STRATEGIC GROWTH PLAN. 
          UH, AGAIN, FOR THIS PART OF THE PRESENTATION, I'M JOINED BY DR. 
          GORE AGA, OUR CHIEF OF INFORMATICS AT METRO HEALTH. 
          JUST ALSO WOULD LIKE TO ACKNOWLEDGE OUR INCREDIBLY PROUD STAFF FROM THE NATIONALLY ACCREDITED, UH, METRO HEALTH DEPARTMENT, WHO ARE ALSO IN THE GALLERY THIS AFTERNOON. 
          SO Y'ALL CAN WAVE, RIGHT? CAN YOU WAVE? ALRIGHT, THERE WE GO. 
          ALRIGHT, THANK YOU. 
          UM, SO BROAD STROKES, THIS REFLECTS OUR VISION, HEALTHY PEOPLE THRIVING IN A HEALTHY COMMUNITY. 
          OUR MISSION IS ABOUT THE THREE PS OF PUBLIC HEALTH, ABOUT PROMOTING HEALTHY BEHAVIORS, PREVENTING THE SPREAD OF DISEASE OR INJURY, AND PROTECTING THE COMMUNITY AT LARGE. 
          WE ASSURE THE CONDITIONS WHERE ALL CAN BE HEALTHY REGARDLESS OF THE ABILITY TO PAY. 
          UH, SO WITH THIS, AGAIN, BIG PICTURE, I'M QUEUING THIS UP TO 
          [00:35:01]
SHARE HOW WE'RE ORGANIZED. 
          WE'RE GOING TO AT LEAST TAKE A MOMENT THROUGH A VIDEO TO AT LEAST REMIND US ALL OF THE CON THE THE CONTEXT OF OUR WORK AND THE IMPORTANCE. 
          AND THEN, UM, WE'LL TALK BIG PICTURE ABOUT THE DIFFERENT DRIVERS OF HEALTH, AND WE'LL WALK THROUGH EACH OF THE PRIORITY AREAS AND OUR JOURNEY OVER TIME. 
          SO WHAT THIS REFLECTS THESE DIVISIONS, SO COMMUNICABLE DISEASES, COMMUNITY HEALTH AND SAFETY, ENVIRONMENTAL HEALTH AND OPERATIONS, THAT'S HOW WE'RE CURRENTLY STRUCTURED. 
          WHAT THIS REFLECTS IS OUR, UH, CORE REGULATORY FUNCTIONS, OUR ONGOING COVID RESPONSE EFFORTS, AND GETTING TO THE FAR RIGHT SIDE IN THE ORANGE BOX, WE'LL TALK ABOUT OUR COMMUNITY RESILIENCE. 
          AND SO AT THE END OF THE DAY, THIS CONTINUUM SPEAKS TO OUR WORK ON THE GROUND. 
          IT'S HARD TO READ THE TEXT, AND I'M NOT GONNA GO INTO DETAIL ABOUT ALL THE DIFFERENT PROGRAMS AND INITIATIVES. 
          THERE'S A LOT HAPPENING WITHIN OUR AGENCY. 
          WE ARE A ROBUST AGENCY. 
          WE ARE BENEFITING FROM THE SUPPORT FROM THE CITY MANAGER, FROM THE, THE, THE ELECTED BODY, UM, ESPECIALLY OVER THE COURSE OF THIS PAST YEAR FROM SOME FEDERAL GRANTS THAT WE'VE RECEIVED. 
          SO THIS IS OUR CURRENT STRUCTURE. 
          AND AS, UH, YOU MAY KNOW AND I KNOW, UH, COUNCIL COUNCILMAN, UH, R KEY RODRIGUEZ ASKED ABOUT OUR FOCUS ON BEHAVIORAL HEALTH. 
          SO JUST KNOW THAT THE UNIT ON MENTAL HEALTH AND COMMUNITY RESILIENCE, THIS IS NEW. 
          THIS IS BRAND SPANKING NEW. 
          UM, AND BECAUSE OF THE FEEDBACK THAT WE'VE GOTTEN OVER TIME, WHILE OUR WORK IN THIS SPACE IS NOT NEW, WE HAVE BEEN PAYING CLOSER ATTENTION TO TRAUMA. 
          WE'VE BEEN PAYING CLOSER ATTENTION TO THE IMPACTS ON CHILDREN AND ADULTS. 
          WE'VE BEEN PAYING CLOSER ATTENTION ABOUT BEING MORE, UM, UH, MORE INTENTIONAL WITH SHAPING A CULTURE HERE THAT'S TRAUMA INFORMED. 
          SO JUST KNOW THAT WE'RE TRYING TO ORGANIZE OURSELVES, ESPECIALLY THE EXPERIENCE THAT DOVETAILS, UH, WITH, UH, EXPOSURES TO INJURY, NOT JUST PHYSICAL INJURY, BUT EMOTIONAL INJURY. 
          SO I'LL TALK MORE ABOUT THIS, UH, DURING THE PRESENTATION IN THAT UNIT. 
          SO BEFORE WE DIVE IN, UH, JUST WANTED TO TAKE A MOMENT TO TAKE US BACK TO OUR, UM, UH, TO REFLECT AND REMIND US BODY ABOUT OUR BROADER CONTEXT OF OUR WORK, UH, WHICH HAS ALLOWED US TO SERVE ALL THOSE WHO LIVE, LEARN, WORK, PLAY OR PRAY HERE IN THE CITY. 
          FOLLOWING THIS VIDEO, WHICH IS ABOUT FOUR MINUTES, DR. 
          AGA WILL WALK THROUGH THE CONTEXT OF THE DIFFERENT FACTORS THAT IMPACT THE QUALITY OF LIFE OF RESIDENTS, AND THEN I'LL HIGHLIGHT EACH OF THE PRIORITY AREAS. 
          SO IF WE COULD QUEUE UP THE VIDEO, SOME OF YOU MAY HAVE SEEN THIS, BUT THIS PROVIDES A CONTEXT OF WHAT'S BEEN EXACERBATED BECAUSE OF THIS COVID STORM THE LAST COUPLE YEARS. 
          SO I'LL PAUSE AND THEN I'LL COME BACK WITH DR. 
          AGA. 
          IN EARLY SAN ANTONIO, CONTAGIOUS DISEASES SUCH AS SMALLPOX, YELLOW FEVER AND CHOLERA WERE LIKE WILD WEST KILLERS ON THE LOOSE, IMPORTED ILLNESSES FROM THE OLD CONTINENT WIPED OUT INDIGENOUS PEOPLE ACROSS THE LAND. 
          SAN ANTONIO WAS THE FIRST CITY IN TEXAS TO INOCULATE AGAINST SMALLPOX BY ORDER OF THE KING OF SPAIN. 
          IN 1806, ORPHAN CHILDREN INFECTED WITH SMALLPOX WERE SENT TO SAN ANTONIO TO INOCULATE CHILDREN IN THE COMMUNITY. 
          SPANISH DOCTORS RUBBED PUS FROM THE ORPHAN, SMALLPOX BLISTERS ONTO THE ARMS OF HEALTHY CHILDREN TO CAUSE A MILD INFECTION. 
          THIS EARLY INOCULATION SUCCESS LED TO MANDATORY IMMUNIZATIONS OF ALL CHILDREN IN SAN ANTONIO. 
          BY 1830, IN 1849, CHOLERA SWEPT SAN ANTONIO CAUSING PANIC. 
          MOST FAMILIES EXPERIENCED AT LEAST ONE DEATH, AND A THIRD OF THE CITY FLED TO THE COUNTRYSIDE AND CAMPED IN THE WOODS. 
          IN RESPONSE, THE CITY COUNCIL CREATED SAN ANTONIO'S FIRST BOARD OF HEALTH DURING THE NEXT BIG CHOLERA EPIDEMIC. 
          IN 18 66, 3 INCARNATE WORD SISTERS FROM FRANCE CREATED THE SANTA ROSA INFIRMARY, WHICH BECAME THE CITY'S FIRST HOSPITAL TO PREVENT CHOLERA, WHICH THRIVES IN STAGNANT WATER. 
          THE BOARD OF HEALTH RECOMMENDED PAVING STREETS AND IMPROVING DRAINAGE. 
          BUT THE NEW SEWAGE LINES IN 1894 FUNNELED WASTE TO THE WEST SIDE OF TOWN LEADING TO GREATER PROBLEMS IN AN ALREADY NEGLECTED AREA. 
          DECADES LATER, IN 1934, THE US PUBLIC HEALTH SERVICE WOULD EXPOSE RAMPANT UNSANITARY CONDITIONS ON SAN ANTONIO'S WEST SIDE, INCLUDING UNPAVED STREETS, LACK OF ELECTRICITY, AND RUNNING WATER, AND UNCOVERED OUTDOOR TOILETS. 
          DIARRHEA DISEASES WERE COMMON AND 75% OF ALL TUBERCULOSIS CASES OCCURRED IN THE SO-CALLED MEXICAN CORRALS. 
          MEANWHILE, DOWNTOWN SAN ANTONIO HAD THE NATION'S THIRD LARGEST RED LIGHT DISTRICT IN THE EARLY 19 HUNDREDS. 
          THEN AS NOW SYPHILIS WAS EPIDEMIC, THE BLUE BOOK FOR VISITORS AND TOURISTS, AND THOSE SEEKING A GOOD TIME WHILE IN SAN ANTONIO, TEXAS CONTRIBUTED TO THE INFAMY OF THIS ZONE. 
          SAN ANTONIO WOULDN'T CLOSE THE ZONE UNTIL WORLD WAR II. 
          AFTER THE US MILITARY THREATENED TO BORROW TROOPS FROM VISITING DOWNTOWN SAN ANTONIO. 
          THROUGHOUT MOST OF THE 20TH CENTURY, SAN ANTONIO BATTLED INFECTIOUS DISEASES 
          [00:40:01]
SUCH AS POLIO, THE SPANISH FLU, MEASLES, AND DIPTHERIA, WHICH ARE NOW PREVENTABLE WITH VACCINES. 
          TACTICS AGAINST POLIO INCLUDED SPRAYING THE ENTIRE CITY WITH THE PESTICIDE D D T IN 1946, IN THE MISTAKEN BELIEF THAT INSECTS TRANSMIT POLIO VIRUS. 
          THE 1950S BROUGHT DESEGREGATION AND BETTER ACCESS FOR AFRICAN-AMERICANS TO FACILITIES THAT AFFECT HEALTH, SUCH AS PUBLIC TRANSPORTATION AND PARKS. 
          ACCESS TO PUBLIC SWIMMING POOLS DIDN'T COME UNTIL AFTER A CROSS BURNING AT THE WOODLAWN POOL. 
          A FRACTIOUS CITY COUNCIL SESSION AND A COURT CHALLENGE BY THE NAACP THE 1960S BROUGHT HISTORIC LOWS AND INFANT MORTALITY THANKS TO MEDICAL ADVANCES AND A NEW PROGRAM CALLED MEDICAID. 
          IN THE 1970S, AFTER SEVERAL WEST SIDE CHILDREN DROWNED IN A RAINSTORM. 
          COMMUNITIES ORGANIZED FOR PUBLIC SERVICE, COPS WAGED A CAMPAIGN THAT WON DRAINAGE, PAVED STREETS AND SIDEWALKS FOR THE WEST SIDE. 
          AT LAST, DURING THE 20TH CENTURY, CHRONIC DISEASES SUCH AS HEART DISEASE REPLACED INFECTIONS. 
          AS THE LEADING CAUSES OF DEATH. 
          IN 2000, SAN ANTONIO STOPPED BEING THE LARGEST CITY IN THE US WITHOUT FLUORIDATED WATER VOTERS NARROWLY APPROVED IT BY A 53% MAJORITY. 
          IN 2003, THE CENTERS FOR DISEASE CONTROL AND PREVENTION NAMED SAN ANTONIO THE MOST OBESE CITY IN THE NATION. 
          OUR COMMUNITY NOW WORKS IN MANY WAYS TO MAKE HEALTHY CHOICES BE THE EASY CHOICES. 
          IN 2018, RECOGNIZING THE DEVASTATING HEALTH IMPACT OF TOBACCO, THE SAN ANTONIO METROPOLITAN HEALTH DISTRICT AND ITS PARTNER SUCCESSFULLY FOUGHT TO RAISE THE CITY'S LEGAL AGE TO BUY TOBACCO FROM 18 TO 21 IN THE 21ST CENTURY. 
          METRO HEALTH AS THE CITY'S CHIEF HEALTH STRATEGIST, WILL CONTINUE TO CONVENE ADVOCATES AND COLLABORATE WITH THE COMMUNITY TO CREATE A SAFE, HEALTHY SAN ANTONIO FOR EVERYONE, REGARDLESS OF RACE OR ZIP CODE. 
          ARE WE OKAY WITH GETTING BACK TO IT? SEEMS LIKE WE'RE GOOD. 
          ALRIGHT. 
          HELLO COUNCIL MEMBERS. 
          IT'S SO GOOD TO BE HERE AGAIN. 
          I WAS HERE A FEW MONTHS AGO. 
          HOW ARE Y'ALL DOING? ? SO I AM THE DATA SIDE KICK THAT'S GONNA JUMP IN JUST QUICKLY FOR A FEW SLIDES, AND THEN I'LL HAND IT BACK TO CLAD. 
          BUT I WILL BE BACK AT THE END AGAIN TO WALK THROUGH OUR NEW BRAND NEW ESSAY FORWARD DASHBOARD. 
          SO WE'LL DO A LITTLE BIT OF SWAPPING RIGHT NOW. 
          SO BASICALLY, AS YOU SAW IN THE VIDEO, UM, WE ARE INCREASINGLY MOVING TOWARDS A SOCIAL DETERMINANTS OF HEALTH MODEL. 
          OUR PUBLIC HEALTH PERSPECTIVE IS INCREASINGLY FOCUSING ON A SOCIAL DETERMINANTS OF HEALTH MODEL. 
          AND A STATISTIC THAT I REALLY LIKE TO SHARE IS THAT THE SOCIAL, ECONOMIC AND ENVIRONMENTAL CONDITIONS THAT WE EXPERIENCE ACCOUNT FOR AT LEAST 80% OF HEALTH OUTCOMES. 
          AND YET TRADITIONALLY, LESS THAN 3% OF HEALTHCARE SPENDING PER CAPITA IN THE US HAS GONE TO PUBLIC HEALTH. 
          SO WE ARE REALLY HERE TO TALK ABOUT THE SHIFT IN PUBLIC HEALTH IN MOVING TOWARDS ADDRESSING SOCIAL DETERMINANTS OF HEALTH AND HEALTH EQUITY. 
          SO SOCIAL DETERMINANTS OF HEALTH ARE VERY MUCH AT PLAY IN SAN ANTONIO, BUT HOW DO THESE SOCIAL DETERMINANTS OF HEALTH MANIFEST HERE? THEY MANIFEST AS SOCIOECONOMIC DISPARITIES. 
          THEY MANIFEST AS RACIAL ETHNIC DISPARITIES, AS WELL AS REGIONAL DISPARITIES. 
          A LOT OF THE DATA THAT WE SHARE AND TRACK SHOWS THESE DISPARITIES ACCORDING TO SOCIOECONOMIC STATUS, RACIAL ETHNIC STATUS, AND, AND REGION LIKE ZIP CODE AND CENSUS TRACK. 
          THESE DISPARITIES ARE INTERLINKED, OFTEN SHOWING THE SAME THING FROM A DIFFERENT LANG ANGLE. 
          SO LET'S JUST LOOK AT A FEW STATISTICS TO PUT OUR ESSAY FORWARD PLAN INTO CONTEXT OF HOW WE WILL BE ADDRESSING THESE SOCIAL DETERMINANTS OF HEALTH. 
          A KEY STATISTIC THAT YOU, I'M SURE YOU'RE ALL VERY WELL AWARE OF IS POVERTY IN SAN ANTONIO. 
          THE POVERTY RATE IS NOTICEABLY HIGHER THAN THE RATE ACROSS TEXAS AND THE US OVERALL AT 17.8% HERE IN SAN ANTONIO. 
          WHEN WE LOOK AT THE CHILD POVERTY RATE, IT'S EVEN MORE ALARMING. 
          26.1% OF CHILDREN LIVE BELOW THE POVERTY LEVEL. 
          AND, UM, THIS IS 2019 DATA. 
          WE'VE JUST GOTTEN 2020 DATA, AND THE NUMBERS ARE VERY MUCH THE SAME AND SIMILAR. 
          SO THIS IS IMPORTANT TO KEEP IN MIND WHEN WE TALK ABOUT SOCIOECONOMIC DISPARITIES HERE IN SAN ANTONIO. 
          ANOTHER KEY METRIC IS MEDIAN HOUSEHOLD INCOME ACROSS SAN ANTONIO. 
          THE MEDIAN HOUSEHOLD INCOME IS NOTABLY LOWER THAN THE MEDIAN HOUSEHOLD OF INCOME ACROSS TEXAS AND THE US. 
          AND WHEN WE FURTHER DISAGGREGATE THE DATA BY RACE ETHNICITY, WE SEE THAT OUR BLACK AND AFRICAN AMERICAN COMMUNITIES HAVE THE LOWEST MEDIAN HOUSEHOLD INCOME. 
          [00:45:01]
AND I'M SURE THIS IS, YOU KNOW, STATISTICS THAT WE ARE ALL FAMILIAR WITH. 
          OF COURSE, RACIAL, RACIAL. 
          SO SOCIOECONOMIC AND RACIAL ETHNIC DISPARITIES TRANSLATE INTO HEALTH DISPARITIES. 
          AS YOU SAW IN THE VIDEO, HEART DISEASE, CANCER, DIABETES, THESE ARE THE TOP CAUSES OF DEATH NOWADAYS. 
          AND IN SAN ANTONIO, WE SEE CLEAR RACIAL ETHNIC DISPARITIES IN THIS HEALTH OUTCOMES. 
          NON-HISPANIC BLACK COMMUNITIES ARE MORE LIKELY TO BE HOSPITALIZED FOR DIABETES AND ALSO MORE LIKELY TO DIE FROM DIABETES. 
          AS YOU COULD SEE IN THE BOTTOM RIGHT, THE DIABETES MORTALITY RATE AMONG NON-HISPANIC BLACK COMMUNITIES IS DOUBLE THE RATE THAN AMONG NON-HISPANIC WHITE COMMUNITIES. 
          SO THOSE ARE JUST A FEW STATISTICS THAT I WANTED TO SHARE WITH YOU, AND WE CAN THINK ABOUT THE THIS DATA AND EVIDENCE AS WE FRAME OUR ESSAY FORWARD PLAN INTO, INTO ACTION. 
          THANK YOU. 
          OH, DOCTOR AGA, THANK YOU FOR THAT OVERVIEW AND THE CONTEXT, AGAIN, THE WHOLE POINT OF THE VIDEO, THE WHOLE POINT OF REMINDING US ALL OF THESE DIFFERENT FACTORS THAT IMPACT THE QUALITY OF LIFE OF RESIDENTS IS TO PUT INTO CONTEXT NOT JUST THIS COVID STORM, BUT ALSO THE CONDITIONS THAT WE'RE TRYING TO ADDRESS AS A LOCAL HEALTH DEPARTMENT. 
          SO THE TIMELINE HERE REFLECTED ON THIS SLIDE SPEAK TO THE EVOLUTION OF THIS PROCESS OVER MANY YEARS BY SYSTEMATICALLY GATHERING DATA AND ASSESSING THE AREAS OF HIGHEST NEED ACROSS THE CITY. 
          SO THE C OVID 19 PANDEMIC BECAME A FLASHPOINT OVER THE LAST COUPLE YEARS. 
          AND OUR COMMITMENT TO ESSAY FORWARD AGAIN, THIS, UH, THIS FORMERLY KNOWN AS THE GROWTH PLAN, IS OUR RENEWAL OF OUR COMMITMENT BY THE CITY'S LEADERSHIP AND ADDRESSING THE FACTORS THAT IMPACT THE QUALITY OF LIFE OF RESIDENTS. 
          SO, UM, ADDED TO THIS, THERE HAS BEEN THIS ONGOING NATIONAL DIALOGUE ABOUT THE IMPACTS ON HEALTH DEPARTMENTS. 
          SO THE QUESTIONS ARE THINGS LIKE, WELL, WHAT ARE THE STRENGTHS AND WEAKNESSES OF THE PUBLIC HEALTH SYSTEM? UH, WHAT ARE THE BEST RULES AND FUNCTIONS OF GOVERNMENTAL PUBLIC HEALTH? UH, WHAT INNOVATIONS IN PUBLIC HEALTH POLICY AND PRACTICE WILL BEST ADVANCE HEALTH AND RACIAL EQUITY? UH, HOW DO WE STRENGTHEN, SUPPORT AND GROW OUR PUBLIC HEALTH WORKFORCE? UM, IN THIS CONTEXT, I SHOULD ALSO SHARE THAT MY LENS, MY FRAME OF REFERENCE. 
          AGAIN, I, I'VE SERVED IN PUBLIC HEALTH IN ILLINOIS, IN MARYLAND, IN MASSACHUSETTS, AND NOW HERE IN TEXAS. 
          UH, I AM A PAST CHAIR OF THE BOARD FOR N, WHICH IS THE NATIONAL ASSOCIATION OF COUNTY AND CITY HEALTH OFFICIALS, REPRESENTING THE NEARLY 3000 LOCAL HEALTH DEPARTMENTS. 
          AND I CURRENTLY SERVE ON THE BOARD OF THE ACCREDITING BODY FOR HEALTH DEPARTMENTS THAT BECOME NATIONALLY ACCREDITED. 
          SO LOCAL, STATE, TRIBAL TERRITORIAL HEALTH DEPARTMENTS THAT HAVE ENTERED INTO THE FRAY, A VOLUNTARY PROCESS MADE AVAILABLE OVER THE COURSE OF THE LAST DECADE. 
          AND AGAIN, IT'S, IT'S OUR INVESTMENT IN ENSURING THE QUALITY OF THE INFRASTRUCTURE FOR HEALTH DEPARTMENTS. 
          SO THIS IS, UH, INTER, THESE NEXT TWO SLIDES ARE REALLY TO WALK YOU THROUGH OUR EVOLUTION WITHIN THE DEPARTMENT. 
          SINCE MY ARRIVAL LAST SUMMER, WE SPENT SOME TIME ASSESSING THE AGENCY ONGOING WEAR AND TEAR FOR OUR TEAM. 
          IT'S BEEN A LONG TWO YEARS FOR THE COMMUNITY, AND WE ESTABLISHED A TIMELINE FOR POSITIONING FOR THE ROLLOUT OF WHAT'S HAPPENING, UH, OVER THE COURSE OF THE NEXT, UH, COUPLE OF WEEKS. 
          AND THIS IS A MULTI-YEAR PROCESS. 
          SO THE NAME CHANGE, AGAIN, THAT'S THE INTERNAL REFERENCE TO, TO ESSAY FORWARD RATHER THAN THE STRATEGIC GROWTH PLAN. 
          UH, WE'VE RESTRUCTURED, AND YOU'LL, I'LL WALK THROUGH THE SIX PRIORITY, UH, THE HEALTH PRIORITY AREAS. 
          UH, WE HAVE AN INTERNAL STEERING COMMITTEE AND AN INTERNAL CORE TEAM. 
          AND THIS IS REALLY, UH, THANKS TO OUR INCREDIBLE STAFF FOR HELPING US TO WALK THROUGH THIS PROCESS. 
          AND WE WILL BE LAUNCHING THIS DURING NATIONAL PUBLIC HEALTH WEEK. 
          THE THEME THIS YEAR IS PUBLIC HEALTH IS WHERE YOU ARE. 
          UM, WE WILL ALSO BE, UH, UH, HANDING OUT FIESTA METALS, UM, UH, THAT WITH THAT THEME. 
          SO WEAR IT WITH PRIDE. 
          AGAIN, I HAVE MINE HERE STILL IN THE JACKET. 
          PUBLIC HEALTH IS WHERE YOU ARE. 
          UM, AND WE HAVE FOR YOU ALL AS YOUR, UM, UH, FOR, FOR COMING TO THIS SESSION THIS AFTERNOON. 
          THE ONE THING I DID WANNA MENTION, SORRY, I'M JUST SAYING YEAH, I'M TELLING YOU. 
          I MEAN, THAT'S THE BONUS. 
          THAT'S A DOOR PRIZE. 
          UM, IT, IT, IT  IT IS WITH GREAT ENTHUSIASM THAT I PRESENT THE, UM, UH, THE ESSAY FORWARD, UH, THIS, THIS PLAN FOR THESE COMING YEARS. 
          THE PLAN BUILDS ON OUR PREVIOUS STRATEGIC PLAN, WHICH TOOK A COMMUNITY INFORMED APPROACH TO IDENTIFY OUR MOST PRESSING HEALTH ISSUES. 
          UH, IN ADDITION, IT RESPONDS TO PANDEMIC RELATED LESSONS LEARNED AROUND HEALTH DISPARITIES, SOCIAL JUSTICE, PUBLIC HEALTH CAPACITY, AND THE STATE OF THE PUBLIC HEALTH WORKFORCE. 
          SO AGAIN, JUST KNOW THAT THIS IS BY DESIGN AND BACK. 
          AS ADDITIONAL BACKGROUND, AS EARLY AS 2019, OUR METRO HEALTH STAFF CONDUCTED AN EXTENSIVE PRIORITY HEALTH ISSUES ASSESSMENT TO IDENTIFY THE MOST PRESSING HEALTH ISSUES AFFECTING OUR COMMUNITY. 
          UH, WE WORKED IN CONCERT WITH OUR COMMUNITY PARTNERS USING SOME DOT BOARDS, AT ESSAY SPEAKUP EVENTS, ELECTRONIC, UH, PAPER SURVEYS, ELECTRONIC AND PAPER SURVEYS. 
          IN A PRIORITIZATION TASK FORCE, THE INFORMATION GATHERED HELPED US TO ANSWER THE QUESTION, WHAT ARE YOUR COMMUNITY'S HEALTH PRIORITIES? 
          [00:50:01]
WE HAD NEARLY, UH, 5,000 RESPONDENTS. 
          AND THROUGH THAT PROCESS, WE RESULT, IT RESULTED IN A FOUR YEAR STRATEGIC PLAN WITH FOUR, UM, HEALTH PRIORITY ISSUES THAT WERE IDENTIFIED AROUND ACCESS TO CARE, ADVERSE CHILDHOOD EXPERIENCES, OR TRAUMA-INFORMED CARE NUTRITION AND VIOLENCE PREVENTION. 
          UH, LAST YEAR IN RESPONSE TO THE LESSONS FROM THE COVID PANDEMIC, UH, METRO HEALTH GUIDED BY OUR PREVIOUS, UH, HEALTH DIRECTOR, AND WITH THE SUPPORT OUR CITY MANAGER, UH, WE REVISITED THAT STRATEGIC PLAN AND IDENTIFIED AREAS FOR EXPANSION TO MITIGATE THE EFFECTS OF C OVID 19 AND ENHANCE OUR ABILITY TO ADDRESS CRITICAL HEALTH DISPARITIES. 
          SO RIGHT NOW, I'M JUST GONNA WALK THROUGH EACH OF THESE. 
          UM, WE DO HAVE AT LEAST, UH, THEY HAVE, OH, THEY HAVE THEM. 
          ALL RIGHT. 
          SO YOU SHOULD HAVE, UH, HANDOUT FOR EACH ONE OF THESE. 
          I'LL QUICKLY ZIP THROUGH THIS. 
          UM, AND I JUST WANT TO AT LEAST, UH, ACKNOWLEDGE THE HEAVY LIFT, BUT ALSO THANK OUR INCREDIBLE TEAM FOR HELPING TO PUT THIS TOGETHER. 
          IT'S BEEN ALL COVID ALL THE TIME. 
          THIS IS WHAT A PIVOT LOOKS LIKE TO REVISIT WHERE WE ARE WITH THESE, UH, PRIORITIES. 
          KEEP IN MIND THAT AS I GO THROUGH THIS, THIS IS NOT THE ONLY WORK AT METRO HEALTH, RIGHT? SO THIS IS ON TOP OF OUR CORE REGULATORY FUNCTIONS ON TOP OF WHAT WE DO TO MAKE SURE THAT ALL THOSE WHO LIVE, LEARN, WORK, PLAY, OR PREY HERE IN THE CITY ARE SAFE. 
          UM, BUT I DO WANNA MAKE SURE THAT GIVEN THE EXPERIENCE TIED TO C OVID 19, WE WANT TO AT LEAST HIGHLIGHT, UH, OUR FOCUS FOR THESE, UH, FIVE YEARS. 
          SO WITH THAT, UH, TWO QUICK EXAMPLES. 
          SO, ACCESS TO CARE. 
          THE GOAL IS TO ADDRESS SYSTEMIC, SYSTEMIC BARRIERS TO PATIENT-CENTERED HEALTHCARE. 
          UH, AND TWO EXAMPLES OF THIS INITIATIVE ARE DEVELOPING A COMMUNITY HEALTH WORKER HUB TO UNITE AND TRAIN HEALTH NAVIGATORS ACROSS SAN ANTONIO. 
          UM, THIS YEAR, YEAR ONE, UH, SOME OF OUR STEPS INCLUDE TRAINING A HUNDRED CHWS COMMUNITY HEALTH WORKERS ON MENTAL HEALTH, PEER SUPPORT MEASURE, SELF-REPORTED HEALTH STATUS AMONG A SAMPLE OF CH H W CLIENTS AT BASELINE. 
          AND SIX MONTHS AFTER TRAINING, ESTABLISHING A STEERING COMMITTEE FOR THE CH H W HUB, UM, WHICH INCLUDES, UH, THE SAN ANTONIO COMMUNITY HEALTH WORKERS ASSOCIATION AND THE BEXAR COUNTY HEALTH COLLABORATIVE. 
          AGAIN, THAT THEY CO-LEAD THAT PROCESS. 
          IN ADDITION TO THAT, ESTABLISHING A CLINICIAN AMBASSADORS PROGRAM TO VISIT AREA HEALTHCARE PROVIDERS AND PROMOTE EVIDENCE-BASED PUBLIC HEALTH PRACTICES. 
          AND THIS YEAR WE'RE LOOKING AT, UH, NOT ONLY ESTABLISHING, UH, LINKAGES WITH THE NATIONAL RESOURCE, UH, CENTER FOR ACADEMIC DETAILING, BUT ALSO TRAINING 300, UH, HEALTHCARE WORKERS IN EVIDENCE-BASED PRACTICES. 
          SO HOW WE'VE ORGANIZED THIS IS JUST TO GIVE YOU HIGHLIGHTS OF THESE INITIATIVES SO YOU GET A FLAVOR OF THE WORK ON THE GROUND, BUT WE'RE ALSO, UH, HIGHLIGHTING WHAT WE HOPE TO MOVE THE NEEDLE OVER THE COURSE OF THE FIVE YEAR WINDOW. 
          SO IN THIS CASE, MAKING SURE THAT WE CONDUCT, UH, TWO COMPREHENSIVE ASSESSMENTS ABOUT THE DISRUPTION ATTRIBUTED TO C OVID 19, THAT WE DEVELOP THIS COMMUNITY HEALTH WORKER HUB, THAT WE WORK WITH OUR AREA CLINICIANS, AND THAT WE ESTABLISH A MEDICAL-LEGAL PARTNERSHIP TO REDUCE THE IMPACT OF MEDICAL DEBT. 
          SO I'LL GO THROUGH EACH OF THESE AND THEN WE'LL FIELD QUESTIONS. 
          AND AGAIN, I'M JOINED BY OTHER MEMBERS OF OUR STAFF WHO ARE SUBJECT MATTER EXPERTS IN THESE AREAS. 
          IN TERMS OF DATA AND TECHNOLOGY INFRASTRUCTURE, AGAIN, WE'VE HAD SOME VERY ARCHAIC, OUTDATED WAYS OF, OF, OF RUNNING THE DEPARTMENT, OF MAKING SURE THAT WE SHARE INFORMATION. 
          AND SO THE GOAL OF THIS PARTICULAR AREA IS ABOUT UPDATING OUR TECHNOLOGY AND INFRASTRUCTURE TO ENSURE A STRONG FOUNDATIONAL WORKFORCE THROUGH ADVANCED TECHNOLOGICAL SERVICES, SOFTWARE AND EQUIPMENT. 
          UM, SO WITH THAT, IT'S REALLY, AND YOU JUST HEARD FROM DR. 
          AGA EXPANDING, UH, BECOMING AN INFORMATIC SAVVY HEALTH DEPARTMENT, E EXPANDING THAT SKILLSET ACROSS OUR DIVISIONS, WORKING HAND IN HAND WITH THE GAGGLE OF EPIDEMIOLOGISTS THAT WE HAVE WITHIN METRO HEALTH, UM, MAKING DATA-DRIVEN DECISIONS. 
          THIS IS OUR CORE WORK. 
          UM, THIS IS BY DESIGN AND NOT BY DEFAULT, AND JUST KNOW THAT WE'RE WORKING ON A UNIFIED APPROACH TO DATA ANALYSIS AND PRESENTATION. 
          AND THIS YEAR WE'RE FOCUSED ON THE TRANSITION OF RESPONSIBILITY, FOR EXAMPLE, THE CHILD FATALITY REVIEW TO METRO HEALTH THAT WE'RE CONDUCTING, UM, UH, LOOKING AT SOME OF OUR, UH, CONTRACTS AND SERVICES ACROSS OUR NETWORK HERE AND LAUNCHING A DATA DASHBOARD. 
          AND YOU'LL HEAR A LITTLE BIT MORE ABOUT THAT AT THE END OF THIS PRESENTATION. 
          IN ADDITION TO LESSONS LEARNED WITH THE COVID, THE ONGOING COVID STORM, IMPROVING OUR CAPACITY TO CONDUCT NEXT GENERATION GENOMIC SEQUENCING ON INFECTIOUS DISEASES OF HIGH CONSEQUENCE, UM, FOR EXAMPLE, UH, AMPLIFYING OUR CONTRACT WITH UT HEALTH, UH, TO PRO, TO PROVIDE THIS, UH, THIS CAPABILITY AND MAKING SURE THAT WE WORK WITH AREA HEALTHCARE PROVIDERS, UM, TO, UH, SUBMIT SPECIMEN TO UT HEALTH AND TO POPULATE OUR DASHBOARD. 
          SO AGAIN, JUST KNOW THAT THIS IS BY DESIGN AND WE ARE, UH, ANCHORED AS THIS IS ONE OF OUR HEALTH PRIORITIES SPECIFICALLY TO FOOD INSECURITY AND NUTRITION. 
          UM, HERE WE'RE LOOKING AT ADDRESSING, UH, FOOD INSECURITY BY INCREASING 
          [00:55:01]
ACCESS TO HEALTHY FOODS IN ORDER TO PREVENT, UH, OBESITY AND DIABETES. 
          BUT JUST KNOW THAT AT THE END OF THE DAY, PART AND PARCEL OF THIS PROCESS IS THAT WE'RE NOT BY OURSELVES. 
          THIS IS IN COMMUNITY, IN CONCERT WITH OUR PARTNERS, AND IT'S REALLY ABOUT SHAPING THE SYSTEMS. THIS ECOSYSTEM HERE IN SAN ANTONIO, UH, WE'VE DONE A LOT OF WORK IN THIS SPACE OVER THE YEARS. 
          WE ARE LEANING IN A BIT MORE IN CONCERT WITH OUR, OUR COMMUNITY PARTNERS. 
          WE ARE LOOKING AT, UH, UM, SERVING AS A BACKBONE ORGANIZATION FOR OUR FOOD INSECURITY WORK GROUP. 
          AND I KNOW THAT THAT TOPIC WAS BROUGHT HERE OVER THE LAST COUPLE WEEKS. 
          UH, THIS DOVETAILS WITH HAVING ANOTHER DIMENSION OF COMMUNITY HEALTH WORKERS TO EXPAND OUR OUTREACH EFFORTS, UM, TO EXPAND OUR PROGRAMMING AROUND VEEVA HEALTH. 
          AND BORDA IN PARTICULAR, UH, IS FLEXING A BIT MORE IN TERMS OF A COMMUNITY-WIDE, UH, CAMPAIGN EDUCATION CAMPAIGN TO MAKE SURE THAT FOLKS KNOW WHAT THEIR OPTIONS ARE SO WE CAN LEAN IN A BIT MORE, EXPANDING OUR PEER LED DIABETES PREVENTION AND CONTROL PROGRAM, AND EXPANDING OUR TOUCHPOINTS IN HEALTHY NEIGHBORHOODS. 
          AND OUR HEALTHY CORNER STORE PROJECT. 
          WHAT WE HOPE TO ACCOMPLISH OR AIM TO ACCOMPLISH OVER THE COURSE OF THESE NEXT FEW YEARS, UH, RECRUITING ADDITIONAL ORGANIZATIONS TO BE ANCHORED TO THE, OUR ADDRESSING FOOD INSECURITY HERE WRIT LARGE, ESTABLISHING ADDITIONAL, UH, POOR VITA HEALTHY, UH, DESIGNATED HEALTHY RESTAURANTS, AND VIVA HEALTH PARTNERS, UH, MAKING SURE THAT WE EXPAND OUR HEALTHY NEIGHBORHOODS PROGRAM INTO FOUR NEW NEIGHBORHOODS. 
          EXPANDING THE HEALTHY STORE, UH, CORNER STORE PROJECT TO 50 LOCATIONS. 
          UM, AND AGAIN, UH, EXPANDING OUR PEER LED DIABETES PREVENTION AND CONTROL PROGRAM, MAKING SURE THAT WE'RE GETTING TO THE AREAS OF HIGHEST NEED ACROSS THE CITY, HEALTH, EQUITY AND SOCIAL JUSTICE. 
          UM, BESIDES COVID, WE KNOW THAT IN MAY OF 2020 IT BECAME A, A FLASHPOINT WITH THE TRAGIC DEATH OF GEORGE FLOYD. 
          UM, AND IT'S SET IN MOTION, UH, ONGOING RIPPLE EFFECTS. 
          UM, SADLY THAT EXPERIENCE IS NOT NEW. 
          UM, BUT JUST KNOW THAT IN ADDITION TO THE EXPERIENCE AROUND THE GLOBE, UH, THIS BECAME AN OPPORTUNITY FOR, UH, COMMUNITIES ACROSS THE UNITED STATES TO AT LEAST RESPOND TO A CALL TO ACTION. 
          AND SO WHAT WE HAVE HERE IS MAKING SURE THAT WE FOCUS ON STRENGTHENING THE CITY'S ECOSYSTEM BY ADDRESSING, UH, STRUCTURAL RACISM AND OTHER FACTORS SUCH AS THE SOCIAL DETERMINANTS OF HEALTH THAT IMPACT THE HEALTH AND THE QUALITY OF LIFE OF ALL HERE IN THE CITY. 
          AND WITH THAT, WE HAVE ESTABLISHED, UH, AN OFFICE OF POLICY AND CIVIC ENGAGEMENT AT METRO HEALTH. 
          IT DOVETAILS WITH OUR OFFICE OF HEALTH EQUITY THAT'S BEEN IN PLAY NOW FOR THE LAST FEW YEARS. 
          WE DO HAVE A DEFINED EQUITY ACTION PLAN, WHICH ENCOMPASSES 14 STRATEGIES, UH, AND WE REPORT OUT TO THIS BODY TWICE A YEAR. 
          UM, WE ARE BUILDING A STRONGER EQUITY LENS, UH, ANCHORED TO LESSONS LEARNED FOR OUR C OVID 19 RESPONSE EFFORTS. 
          UM, AND THANKS IN LARGE PART TO OUR COMMUNITY C OVID 19 COMMUNITY RESPONSE AND EQUITY COALITION. 
          AND I KNOW THAT, UH, COUNCILWOMAN SANDOVAL IS A DUES PAYING MEMBER OF THAT BODY. 
          UM, BUT WE'RE ALSO LEANING IN, AND THIS DOVETAILS WITH OTHER, UM, PRIORITY AREAS ABOUT PROMOTING ANTI-RACIST AND ANTI SIG STIGMA PRACTICES WITHIN OUR MEDICAL AND HEALTHCARE SETTINGS. 
          AND SO THIS IS BY DESIGN. 
          UH, WHILE WE DO HAVE A CODIFIED RESOLUTION HERE ON DECLARING RACISM AS A PUBLIC HEALTH CRISIS, WE'RE ALSO AMPLIFYING OUR EQUITY ACTION PLAN. 
          AND WHAT WE ARE, UH, ACCOMPLISHING THIS YEAR IS TO, UH, HOST AND SUPPORT PATIENT STORYTELLING EVENTS IN ENGLISH AND IN SPANISH. 
          WE ARE LOOKING AT, UH, ENHANCING OUR, UH, OUR LINKAGES WITH ACADEMIC AND NONPROFIT PARTNERS FOR FOCUS GROUPS AND SURVEYS. 
          UH, WE'RE LOOKING AT, UH, COMPLETING, UH, FOUR POLICY PAPERS, AGAIN, ANCHORED TO OUR ONGOING COLLABORATIONS WITH THE C R E C CONVENING COMMUNITY PARTNERS AND TO BEGIN DEVELOPING A HEALTH EQUITY AND ALL POLICIES FRAMEWORK. 
          SO JUST KNOW THAT THIS IS ANCHORED TO THIS PRIORITY AREA LAST TWO, AND THEN I'LL BE DONE HANGING IN THERE. 
          ALL RIGHT. 
          I KNOW THERE'S NOT A QUIZ AT THE END OF THIS. 
          IT'S A LONG LIST, BUT JUST KNOW THAT WE ARE EXCITED THAT WE'RE SHARING THIS WITH EACH AND EVERY ONE OF YOU, AND SO THAT YOU CAN HELP SPREAD THE WORD ABOUT THE IMPORTANCE ABOUT THE LESSONS LEARNED, BUT MORE IMPORTANTLY, WHAT'S COMING ONLINE AT METRO HEALTH AND HERE IN THE CITY. 
          SO WITH THIS, THE GOAL HERE AROUND MENTAL HEALTH AND COMMUNITY RESILIENCE, UM, IT'S BEEN A LONG TWO YEARS, AND WE HAVE YET TO SEE THE IMPACTS OF THIS EXPERIENCE, NOT JUST FOR KIDS IN SCHOOL, BUT FOR ADULTS. 
          UH, THERE ARE, AGAIN, DISEASES OF DESPAIR. 
          WE KNOW THAT THE DISPROPORTIONATE BURDEN OF THESE EXPERIENCES IMPACT CERTAIN POCKETS OF OUR COMMUNITY. 
          SO JUST KNOW THAT THE GOAL HERE IS TO IMPROVE THE COORDINATION OF MENTAL HEALTH SERVICES BY STRENGTHENING OUR COMMUNITY ASSETS TO ENSURE THE EMOTIONAL, PSYCHOLOGICAL AND SOCIAL WELLBEING FOR INDIVIDUALS AND COMMUNITIES ACROSS THE CITY. 
          SO, WITH THAT, THE INITIATIVES, UH, WE DO HAVE SOME PILOT PROJECTS IN QUEUE. 
          UM, WE ARE IN A PROCESS RIGHT NOW OF COMPLETING A NATIONAL SEARCH, FOR EXAMPLE, OF HIRING A CHIEF MENTAL HEALTH OFFICER THAT 
          [01:00:01]
SPEAKS TO THAT UNIT THAT'S BEING ESTABLISHED. 
          UH, SO OVER THE COMING WEEKS, WE'LL BE GOING THROUGH THAT VETTING PROCESS, AND, UH, LATER IN THE SPRING, WE'LL BE ABLE TO ANNOUNCE WHO THAT INDIVIDUAL WILL BE, BUT JUST KNOW THAT THAT IS, UH, A LONG PROCESS, AND WE ARE EXCITED TO BE ABLE TO HAVE THAT RESOURCE ANCHORED AT METRO HEALTH. 
          UH, BUT WITH THAT, WE ARE ALREADY PILOTING INITIATIVES THAT WE'VE SHARED HERE WITH THIS BODY, AND YOU'VE HEARD THIS WORK, UM, ANCHORED TO THE PUBLIC OR REPORTED TO THE PUBLIC SAFETY COMMITTEE. 
          SO WE ARE WORKING, FOR EXAMPLE, WITH THE IMPLEMENTATION OF THE SAN ANTONIO COMMUNITY OUTREACH RESILIENCY EFFORT. 
          UM, AND THAT IS THE PILOT PROJECT THAT IS IN CONCERT WITH OUR PARTNERS AT, UH, SS A P D AND THE FIRE DEPARTMENT. 
          AND IN COLLABORATION WITH OUR PARTNERS, ATRAC AND THE CENTER FOR HEALTHCARE SERVICES, WE'RE LOOKING AT EXPANDING ACCESS TO COGNITIVE BEHAVIORAL THERAPY FOR SUR FOR CHILD SURVIVORS OF VIOLENCE. 
          WE'RE LOOKING AT ENHANCING, UH, OUR PROJECT WORTH TEEN AMBASSADOR PROGRAM THROUGH THE INCLUSION OF SOCIO-EMOTIONAL, UH, CURRICULUM. 
          AND WE'RE LOOKING AT ESTABLISHING, UH, AGAIN, WE DO HAVE A CENTER OF EXCELLENCE IN TRAUMA-INFORMED CARE. 
          SO THIS IS AMPLIFYING THAT CENTER AND MAKING SURE THAT WE A, WE WORK ON GETTING THE COASTAL DEPARTMENTS, THE CITY OF SAN ANTONIO DEPARTMENTS, UM, THE LEVEL ONE CERTIFICATION IN TRAUMA-INFORMED CARE. 
          LASTLY, VIOLENCE PREVENTION. 
          THIS IS PROBABLY ONE OF THE FASTEST GROWING SECTIONS WITHIN OUR AGENCY. 
          VIOLENCE IS AN URGENT PUBLIC HEALTH PROBLEM. 
          METRO HEALTH, OUR TEAM AND PARTNERS ACROSS THE CITY, WE'RE COMMITTED TO PREVENTING VIOLENCE SO THAT EVERYONE CAN BE SAFE AND HEALTHY. 
          UH, AT THE END OF THE DAY, WHAT WE'RE FOCUSED ON IS MAKING SURE THAT WE ENHANCE, UH, OUR EFFORTS ON THE GROUND. 
          WE'VE HAD AN INCREDIBLE COMMITMENT FOR MANY YEARS IN THIS SPACE. 
          UH, WE'RE IMPLEMENTING AND ENHANCED DOMESTIC VIOLENCE CRISIS RESPONSE ADVOCATE PROGRAM, AND OUR, AND WE'VE RECRUITED CASE MANAGERS TO AUGMENT, UM, THAT THE PROGRAMMING FOR OUR DV PROGRAM. 
          UH, WE ARE EXPANDING OUR TRIPLE P, UH, POSITIVE PARENTING PROGRAM, AGAIN, BASED ON THAT NATIONALLY, UH, UH, RECOGNIZED CURRICULUM, UH, TO, UH, AND WE'RE EXPANDING THAT TO JUSTICE INVOLVED PARENTS. 
          UH, WE ARE EXPANDING THE STANDUP ESSAY, UH, PROGRAM, UH, TO INCLUDE SCHOOL-BASED RESTORATIVE JUSTICE WORK. 
          UM, STANDUP ESSAY, AGAIN, THE INTERRUPTER MODEL. 
          THIS HAS NOW BEEN IN VOGUE FOR OVER 25 YEARS NOW, A PRO A, A PROGRAM THAT WAS INITIALLY CONCEPTUALIZED ON THE WEST SIDE OF THE CITY OF CHICAGO. 
          AND I WAS WORKING AT SINAI HOSPITAL WHEN IT WAS THE CHICAGO PROJECT FOR VIOLENCE PREVENTION THAT THEN BECAME CEASEFIRE, THAT THEN BECAME CURE VIOLENCE, AND NOW IT'S CURE VIOLENCE OF GLOBAL. 
          THE PRIDE HERE IN SAN ANTONIO IS THAT I DO BELIEVE TO DATE, WE ARE STILL THE ONLY CITY IN TEXAS TO OFFER THIS INTERRUPTER MODEL, AND WE'VE HAD IT HERE FOR EIGHT YEARS. 
          SO, KUDOS TO THE LEADERSHIP AND THE COMMITMENT AND THE INNOVATIONS. 
          UM, AGAIN, YOU'VE ALREADY HEARD MY REFERENCE TO THE CENTER OF EXCELLENCE AND TRAUMA-INFORMED CARE. 
          SO JUST KNOW THAT THESE ARE HIGHLIGHTS OF THESE HEALTH PRIORITIES. 
          JUST KNOW THAT THIS IS BY DESIGN. 
          THIS IS REALLY TO LEAN IN BASED ON THE EXPERIENCE OF THE LAST COUPLE YEARS. 
          UM, I'M PROUD OF THE WORK. 
          I'M, I'M PROUD OF THE INNOVATIONS. 
          I APPRECIATE THE STAFF'S COMMITMENT. 
          I THANK OUR COMMUNITY PARTNERS, BUT WHY WE'RE DOING THIS, UM, AND, AND WHY IT'S IMPORTANT, THE TIMING OF THIS, I'LL REFERENCE THIS AND I'LL TURN IT OVER TO DR. 
          AGA. 
          UM, THERE'S A NATIONAL MOVEMENT AFOOT TO MODERNIZE OUR US PUBLIC HEALTH SYSTEM, AND IT'S CALLED PUBLIC HEALTH FORWARD. 
          AND SO JUST KNOW THAT WHILE OUR, UH, PRODUCT HERE HAS A LITTLE DIFFERENT TWIST, UH, WE'RE ALSO UPGRADING FUNCTIONALITIES AND THE LOOK AND FEEL OF OUR AGENCY. 
          SO WE ARE UNDER CONSTRUCTION. 
          I'M GONNA ASK DR. 
          AGA TO AT LEAST GIVE YOU A, A, A TEASER OF HOW WE'RE CAPTURING AND KEEPING TRACK AND SHARING THIS INFORMATION FOR OUR VIEWING AUDIENCE. 
          BUT THIS IS, UH, THIS COMPLETES AT LEAST THIS SEGMENT OF MY PRESENTATION. 
          AND THEN WE WILL, UH, DO THE DEMO AND FIELD QUESTIONS. 
          FAIR ENOUGH. 
          HELLO, I'M BACK AGAIN. 
          SO, AS CLAUDE MENTIONED, UM, COUNCILWOMAN SANDOVAL COUNCIL MEMBERS, I WAS HERE A FEW MONTHS AGO. 
          IF YOU REMEMBER, WE WERE SPEAKING ABOUT OUR PLAN TO LAUNCH, UH, A DASHBOARD THAT WOULD ACCOMPANY OUR STRATEGIC PLAN. 
          SO TODAY, I'D LIKE TO TAKE ABOUT FIVE TO SEVEN MINUTES TO DEBUT IT TO YOU. 
          WE'RE VERY EXCITED ABOUT IT. 
          WE'RE GONNA DO A VERY QUICK, FUN WALKTHROUGH. 
          NOT A LOT OF DETAILS, UM, BUT WE THOUGHT IT'D BE A REALLY GOOD IDEA TO COME AND SHOW YOU WHAT WE'VE DEVELOPED. 
          AND AS CLAUDE MENTIONED THIS, THIS DASHBOARD, THIS IS NOT JUST A DATA DASHBOARD. 
          THIS IS NOT A 200 PAGE REPORT WITH 75 FIGURES. 
          THIS IS A PLATFORM, A RESOURCE, A COMMUNITY FACING PLATFORM THAT TELLS THE STORY OF OUR COMMUNITY'S MOST PRESSING CHALLENGES AND HEALTH ISSUES FRAMED WITHIN THE CONTEXT OF OUR ESSAY FORWARD PLAN TO ADDRESS THESE CHALLENGES AND IMPROVE UPON THESE HEALTH ISSUES. 
          SO, I'M GONNA GIVE YOU A WALKTHROUGH. 
          IF IT DOESN'T SHOW UP ON YOUR SCREEN, PLEASE TURN AROUND AND SEE IT ON THE BIGGER SCREEN BEHIND YOU. 
          SO HERE IS THE INTRO PAGE, UM, TO 
          [01:05:01]
OUR BRAND NEW ESSAY, FORWARD DASHBOARD TO BE LAUNCHED TODAY. 
          AND, UM, REALLY HIGHLIGHTED DURING NATIONAL PUBLIC HEALTH WEEK. 
          UH, IT STARTS WITH A OVERVIEW PAGE. 
          I THINK YOU'RE GONNA HAVE TO GO TO, I THINK YOU'RE GONNA HAVE TO GO TO THIS ONE PAGE UP THERE THE SAME WAY WE PLAYED THE VIDEO. 
          IT'S, IT'S, UH, SAN ANTONIO.GOV/SA FORWARD. 
          DO Y'ALL READ ME UP THERE? SHOW THE SECONDARY EXTENDED MONITOR RATHER THAN THE PRIMARY. 
          WELL, HOW CAN WE FIX THAT? HOLD ON. 
          LET'S, LET'S DO THIS. 
          SEE, WHILE THAT'S UP AGAIN, UM, I, I SEE IN THE GALLERY, UM, ONLY BECAUSE I, THEY MUST HAVE SNUCK IN BACK THERE, BUT I, I REFER TO THEM AS BATMAN AND ROBIN. 
          UM, I REFERENCED THE OFFICE OF HEALTH EQUITY AND THE OFFICE OF POLICY AND CIVIC ENGAGEMENT. 
          SO I SEE CARLOS RODRIGUEZ, WHO'S A PUBLIC HEALTH ADMINISTRATOR OVER THE OFFICE OF HEALTH EQUITY, AND I SEE SEAN GREEN, WHO'S OVER THE OFFICE OF POLICY AND CIVIC ENGAGEMENT. 
          AND I ONLY REFER TO THEM BECAUSE WE'VE WE'RE APPLYING LESSONS LEARNED WHILE THE OFFICE OF HEALTH EQUITY, WHICH REALLY DOVETAILS WITH OUR WORK AROUND DIVERSITY, EQUITY, AND INCLUSION HERE IN THE CITY. 
          IT'S BEEN A RESOURCE, BUT IT ALSO ALLOWS US TO BE MORE INTENTIONAL WITH ENGAGING PARTNERS. 
          SO, I DO WANT TO THANK CARLOS AND SEAN IN PARTICULAR. 
          AND AS WE'RE TRYING TO BECOME MORE INTENTIONAL, UM, ABOUT OUR WORK, I JUST WANTED TO AT LEAST POINT TO, TO THOSE TWO, AGAIN, BATMAN AND ROBIN, SEND UP THE BAT SIGNAL, THEY'LL RESPOND. 
          UM, NOW I'LL TURN IT BACK OVER TO DR. 
          ARGA. 
          OKAY, IT LOOKS LIKE WE'RE UP AND RUNNING AGAIN. 
          SO, BACK TO THE ESSAY, FORWARD DASHBOARD. 
          WE START ON OUR INTRO PAGE THAT SORT OF GIVES A WELCOME AND OVERVIEW OF WHAT METRO HEALTH IS ALL ABOUT. 
          THE THEME THROUGHOUT THIS DASHBOARD IS THAT IT IS TAILORED, THE LANGUAGE IS TAILORED TO COMMUNITY MEMBERS, TO US AS COMMUNITY MEMBERS, AS OPPOSED TO DATA PROFESSIONALS AND EXECUTIVE PROFESSIONALS. 
          UM, OUR OUR INTRO PAGE STARTS WITH A BRIEF INTRODUCTION OF METRO HEALTH, FOLLOWED WITH A BRIEF, BRIEF INTRODUCTION OF WHAT IT IS THAT OUR METRO HEALTH'S ESSAY FORWARD STRATEGIC PLAN AND DASHBOARD. 
          IT TALKS ABOUT WHAT THE SECTIONS IN THE DASHBOARD, UM, ENTAIL AND WHAT THEY'LL BE COVERING. 
          THERE IS A COMPREHENSIVE SUBPAGE THAT EXPLAINS HOW TO USE THIS DASHBOARD, ALL OF THE INTERACTIVE FEATURES, THE DATA COLLECTIONS, THE LINKS TO DIFFERENT RESOURCES AND PROGRAMS. THIS PAGE GOES THROUGH IT AND EXPLAINS IT TO THE USER AND TO THE READER. 
          THE NEXT MAJOR SECTION IS CALLED OUR CITY AT A GLANCE. 
          THIS IS THE SOCIAL DETERMINANTS OF HEALTH DATA SECTION, THE HEAVY DATA SECTION. 
          WE TALK ABOUT HOW OUR CITY'S DOING, WHAT THE DEMOGRAPHIC FACTORS ARE, UP TO DATE, TIMELY, GRANULAR, ACTIONABLE, DISAGGREGATED DATA THROUGHOUT THE ENTIRE DASHBOARD, ALL OF WHICH CAN BE DOWNLOADED AT A CLICK OF A BUTTON. 
          UM, FOR ANYBODY WHO WANTS TO BE ABLE TO ACCESS THE DATA, IT GIVES A DEMOGRAPHIC SNAPSHOT OF OUR CITY. 
          THE PLATFORM BEHIND THIS DASHBOARD ALLOWS US TO PULL DATA FROM 700 DIFFERENT DATA SOURCES. 
          UM, AGAIN, THE DATA DISAGGREGATED BY AGE BY SIX, THE READER CAN, CAN, THE USER CAN EXTEND UPON ALL THESE AND SEE THE DATA FIGURES AND UNDERSTAND, UM, WHAT IT'S ALL ABOUT AND WHAT IT MEANS. 
          BUT HOW IS OUR CITY DOING THEN EXPLAINS A THOROUGH WAY OF EXPLAINING THE SOCIAL FACTORS THAT AFFECT OUR HEALTH, THE HEALTH STATUS OF OUR COMMUNITY, AS WELL AS THE LINK BETWEEN THE SOCIAL FACTORS AND THE HEALTH OUTCOMES. 
          SO IF WE GO TO THE NEXT PAGE FOR SOCIOECONOMIC CHARACTERISTICS, THIS IS AGAIN, THE PAGE THAT UP THAT PROVIDES TIMELY, GRANULAR, DISAGGREGATE DATA ON THE BIGGEST SOCIOECONOMIC, UM, FACTORS THAT AFFECT OUR COMMUNITY, WHETHER IT BE EDUCATION LEVEL, EDUCATION LEVEL BY ZIP CODE. 
          ONCE AGAIN, THE DATA IS FULLY DOWNLOADABLE. 
          THE FIGURES ARE FULLY DOWNLOADABLE FOR THOSE WHO WANT TO USE IT. 
          I'M SCROLLING PRETTY FAST, BUT YOU'RE GONNA HAVE, THIS IS GONNA BE LAUNCHED AND THERE'S GONNA BE PLENTY OF TIME TO GO THROUGH IT. 
          UM, OUR FINANCIAL HEALTH, LOOKING AT THE DATA ON STUDENT LOAN DEBT, IT TALKS ABOUT WHAT WE DEAL WITH AS A COMMUNITY WHEN WE THINK ABOUT LOANS COMMITTED DEBT IN COMMUNITIES OF COLOR VERSUS MAJORITY WHITE COMMUNITIES. 
          A LITTLE BIT ABOUT HOUSING AND AFFORDABILITY. 
          SO THIS IS THE PAGE THAT BASICALLY GIVES A SNAPSHOT OF ONE OF THE, OF THE MOST IMPORTANT SOCIAL DETERMINANTS THAT AFFECT OUR COMMUNITY AND AFFECT US AS COMMUNITY MEMBERS, INCOME AND POVERTY. 
          NEXT, THE PAGE GOES TO GIVE A HEALTH SNAPSHOT, AND THIS IS, AGAIN, FOCUSING ON THOSE TOP CAUSES OF DEATH THAT WE TALKED ABOUT. 
          AND THE VIDEO SHOWED IT TOP. 
          IT TALKS ABOUT THE IMPORTANCE OF UNDERSTANDING 
          [01:10:01]
THE FACTORS THAT AFFECT OUR HEALTH OUTCOME. 
          IT SHOWS A LOT OF DATA ON THE STATUS OF DIABETES IN OUR COMMUNITY, WHICH IS ONE OF THE MOST PREVALENT HEALTH CONDITIONS IN OUR COMMUNITY. 
          DISAGGREGATES THE DATA, AGAIN, ACCORDING TO CENSUS, TRACK, ZIP CODE, RACE, ETHNICITY, TRENDS OVER TIME. 
          AND ONCE AGAIN, THERE ARE EXPLAINERS HERE TO HELP THE READER UNDERSTAND WHAT THEY'RE TAKING AWAY FROM THE DATA THEY'RE LOOKING AT. 
          IT FOCUSES ON ASTHMA, OVERALL MORTALITY, UM, AS WELL AS MANY MORE OVER TIME. 
          WE'LL BE ADDING MORE AS WE GET MORE DATA. 
          THERE IS A LOT HERE, AND I KNOW I'M SCROLLING REALLY FAST, BUT I, I WANNA BE ABLE TO GET THROUGH ALL THE PAGES AND GIVE YOU A SNEAK PEEK. 
          FINALLY, OUR SOCIAL DETERMINANTS OF HEALTH PAGE. 
          IT SORT OF HELPS THE USER UNDERSTAND THE LINK BETWEEN SOCIAL FACTORS AND HEALTH OUTCOMES. 
          SO WHAT IT IS, WHAT IS IT THAT WE MEAN WHEN WE SAY SOCIAL DETERMINANTS OF HEALTH? IT GIVES A CLEAR, CONCISE, MEANINGFUL UNDERSTANDING OF WHAT SOCIAL DETERMINANTS ARE AND WHAT, HOW THEY AFFECT OUR HEALTH. 
          AND IT ALSO HAS MORE COMPREHENSIVE DATA TO HELP PEOPLE CONNECT THE LINK BETWEEN SOCIAL FACTORS AND HEALTH OUTCOME. 
          HERE'S AN EXAMPLE OF A BI-VARIATE MAP THAT SHOWS THE OVERLAY OF PERCENT OF POPULATION WITHOUT A HIGH SCHOOL DIPLOMA LAYERED WITH ADULTS REPORTING DIABETES. 
          THIS IS ACTIONABLE DATA THAT CAN BE USED TO TARGET OUR PROGRAMS, INITIATIVES AND RESOURCES. 
          THIS IS NOT ONLY ASIDE FROM BEING FOR THE COMMUNITY, THIS ALLOWS OUR PROGRAMS AND OUR STAKEHOLDERS TO USE THIS DATA TO MAKE DECISIONS, HOVER OVER, SEE WHICH CENSUS TRACKS ARE EXPERIENCING, UM, YOU KNOW, WHICH OUTCOMES, MORE OR LESS SO, AND AGAIN, REALLY INTERACTIVE FEATURES. 
          UM, SO THAT'S A LITTLE BIT ABOUT THE SHOW, SOCIAL DETERMINANTS OF HEALTH PAGE. 
          UM, IN PLACES WHERE THE GRAPHICS ARE A LITTLE BIT MORE ADVANCED, IT PROVIDES A COMPLETE DEEP UNDERSTANDING OF WHAT IT IS THAT WE'RE LOOKING AT AND HOW THEY CAN UNDERSTAND RIGHT DOWN TO THEIR ZIP CODE WHAT THESE FACTORS ARE, ARE DOING, UH, WITHIN OUR ZIP CODE AND WITHIN OUR NEIGHBORHOODS. 
          THE NEXT LARGE SECTION IS, OF COURSE, AS CLAUDE MENTIONED TO YOU, OUR STRATEGIC, UM, OUR ESSAY FORWARD PRIORITY AREAS. 
          THIS SECTION STARTS WITH A, BASICALLY DISCUSSING THE EVOLUTION OF HOW OUR ESSAY FORWARD PLAN CAME TO BE, STARTING WITH THE HUGE PRIORITY HEALTH ISSUES SURVEY THAT WE DID, UH, BACK THREE YEARS AGO, AND HOW IT TRANSLATED OVER TIME AND AFTER EXPERIENCES C O V I D TO BECOME OUR ESSAY FORWARD PLAN. 
          IT GIVES A BRIEF ENGAGING AND MEANINGFUL, UM, PARAGRAPH EXPLANATION OF EACH OF THE PRIORITY AREAS, AT WHICH POINT THE READER CAN DIRECTLY HIT THE, THE, THE PRIORITY AREA AND GO TO THAT PAGE AS AN EXAMPLE. 
          WE'LL START WITH THE FIRST PRIORITY AREA OF ACCESS TO CARE. 
          EACH OF THE PRIORITY AREA PAGES START WITH CONTEXT. 
          WHY IS THIS A PRIORITY AREA? HOW IS THIS ACTUALLY AFFECTING OUR COMMUNITY? WHAT IS THE NATIONAL CONTEXT AROUND THIS ISSUE? UH, IT GIVES A DEEPER UNDERSTANDING, AGAIN, IN LANGUAGE TAILORED TO US AS COMMUNITY MEMBERS AND NOT AS DATA EXPERTS OR ACADEMICS ABOUT THE IMPORTANCE OF THIS ISSUE, WHAT THE NATIONAL CONTEXT AND TRENDS OF IT ARE. 
          IT THEN PROVIDES CONTEXTUALIZED DATA THAT SPEAKS TO THE ISSUE. 
          FOR EXAMPLE, THE PERCENT OF UNINSURED POPULATION IN BEXAR COUNTY BY AGE GROUP BY RACE, ETHNICITY, ALL THAT DATA IS AVAILABLE WHEN YOU, WHEN YOU CLICK ON IT TO OPEN IT, UM, WITH, WITH TEXT THAT GIVES CONTEXT AND MEANING, PRENATAL CARE, MEDICAL DEBT. 
          THIS IS JUST SOME OF THE EXAMPLES OF THE DATA WE'RE HIGHLIGHTING FOR THIS PRIORITY AREA ON THIS PAGE. 
          THEN EACH SECTION FOLLOWS WITH OUR ESSAY FORWARD ACTION PLAN FOR IMPROVING UPON THAT PRIORITY AREA. 
          AS CLAUDE MENTIONED, THIS GIVES A, A SLIGHT SORT OF MEANINGFUL UNDER LAY TERM AUDIENCE, UM, EXAMPLE OF WHAT IT IS THAT OUR ACTION PLANS ARE FOR THAT ESSAY FORWARD AREA. 
          UM, SO THIS WILL BASICALLY BE ABLE TO BE CLICKED ON FOR, FOR A PERSON TO READ WHAT IT IS THAT WE PLAN TO DO OVER THE NEXT FIVE YEARS. 
          FINALLY, IT PROVIDES LINKS TO OUR PROGRAMS AND PARTNER ORGANIZATIONS THAT ARE RELEVANT TO THAT PRIORITY AREA. 
          AND MOST IMPORTANTLY, IT HIGHLIGHTS OUR STAFF, OUR COMMUNITY HEALTH WORKERS, OUR FOLKS IN THE COMMUNITY THAT ARE DOING THE WORK IN ALL OF OUR PROGRAMS, WHICH ARE GOING TO BE EXPANDED UPON IN OUR ESSAY FORWARD PLAN. 
          SO YOU COULD SEE HERE EXAMPLES AND PICTURES OF OUR S T I H I V MOBILE CLINIC OUT IN THE COMMUNITY, OUR, OUR, UM, SAN ANTONIO LACTATION SUPPORT CENTER, AND, UM, YOU KNOW, OUR ORAL HEALTH TEAM. 
          AND AGAIN, IT SHOWS METRO HEALTH STAFF AS COMMUNITY, UM, COMMUNITY MEMBERS. 
          WE'RE ALL COMMUNITY MEMBERS. 
          OUR DATA AND TECHNOLOGY INFRASTRUCTURE PAGE, UM, GIVES AN UNDERSTANDING AND EXPLANATION OF, YOU KNOW, WHAT IT IS THAT WE NEED TO DO, HOW IT IS THAT WE NEED TO IMPROVE UPON OUR INFRASTRUCTURE, UM, FROM, ESPECIALLY DUE TO LESSONS LEARNED FROM THE PANDEMIC, OUR PLAN TO IMPROVE UPON DATA AND TECHNOLOGY. 
          YOU KNOW, WE CAN READ ABOUT IT, UM, AS WELL AS HIGHLIGHTING OUR PROGRAMS. HERE'S 
          [01:15:01]
INFORMATICS TEAM. 
          HERE ARE MY INFORMATICS STAFF DOING THE WORK AS WELL AS DR. 
          RITA ESPINOZA'S EPI STAFF, UM, DOING THE WORK IN THE EPI WORLD, FOOD INSECURITY AND NUTRITION. 
          THIS PAGE SPEAKS ABOUT THE IMPORTANCE OF FOOD INSECURITY IN DETERMINING SOME OF THE TOP HEALTH ISSUES IN SAN ANTONIO, LIKE DIABETES AND HEART DISEASE. 
          IT GIVES A FULL EXPLANATION. 
          IT PROVIDES TIMELY DATA ON FOOD INSECURITY ON, UM, HOUSEHOLDS RECEIVING STA SNAP AND, UH, BENEFITS THE, THE STATE OF OUR CHILDREN'S HEALTH SODA CONSUMPTION, UM, PHYSICAL INACTIVITY. 
          UM, AND AGAIN, ONCE AGAIN, IT PROVIDES OUR ACTION PLAN, THE ACTION PLAN FOR ADDRESSING THIS PRIORITY AREA, FOLLOWED BY OUR PROGRAMS AND ORGANIZATIONS THAT ARE WORKING TO ADDRESS, UH, FOOD INSECURITY AND IMPROVE NUTRITION. 
          YOU'LL SEE HERE THAT WITHIN OUR DASHBOARD, WE HAVE EMBEDDED IMPORTANT LINKS LIKE, YOU KNOW, VIDEOS TO NUTRITIONAL, UM, RECIPES, UM, AS WELL AS HIGHLIGHTING OUR COMMUNITY MEMBERS THAT ARE OUT THERE DOING THE WORK IN THE HEALTHY CORNER STORE INITIATIVE, PORT VIDA AND VEEVA HEALTH. 
          SO IT, AGAIN, IT CONTEXTUALIZES OUR WORK, UH, WITHIN WHAT THEIR PRIORITY AREA IS. 
          WHAT ARE THE PROGRAMS THAT ARE GONNA BE IMPLEMENTING A LOT OF THE WORK FOR THAT PRIORITY AREA? UH, IT PUTS IT ALL RIGHT ON THE PAGE. 
          OUR HEALTH EQUITY AND SOCIAL JUSTICE PAGE, UM, EXPLAINS IMPORTANT CONCEPTS SUCH AS INSTITUTIONAL RACISM, SYSTEMIC OR STRUCTURAL RACISM. 
          IT GIVES, IT GIVES AN EXPLANATION AS PART OF A STORY, UM, FOR THE COMMUNITY TO UNDERSTAND WHY THESE THINGS ARE SO IMPORTANT, WHY THESE, UM, THESE ISSUES ARE SO IMPORTANT. 
          UM, IT BASICALLY EXPLAINS THE IMPORTANCE OF MOVING TOWARDS EQUITY AND UNDERSTANDING WHAT THAT MEANS SPECIFICALLY. 
          UM, UH, IT PROVIDES CONTEXTUALIZED DATA, FOR EXAMPLE, AMONG THOSE, UM, WITH A HIGH LEVEL OF EDUCATION, BLACK AND HISPANIC INDIVIDUALS STILL EARN LESS THAN THEIR WHITE COUNTERPARTS. 
          SO THIS IS IMPORTANT CONTEXTUALIZED DATA THAT SPEAKS TO THE EFFECT OF, YOU KNOW, RACISM AND, AND INEQUITIES. 
          AGAIN, OUR, FOR OUR ESSAY, FORWARD ACTION PLAN FOR THIS PRIORITY AREA, AND AGAIN, FOLLOWED TO LINKS AND CROSS CROSSTALKING AND PARTNERING WITH THE WORKS THAT IS GOING ON IN THE CITY OF SAN ANTONIO, LIKE THE OFFICE OF EQUITY, LIKE THE EQUITY ATLAS AND EQUITY SCORE. 
          FINALLY, MENTAL HEALTH AND COMMUNITY RESILIENCE TALKS ABOUT THE IMPORTANCE, THE IMPACT THAT THE C OVID 19 AND THE, YOU KNOW, THE, THE HIGHLY VISIBLE ACCOUNTS OF RACIAL INJUSTICE IN 2020 AND 2021 HAVE HAD ON OUR COMMUNITY. 
          IT HIGHLIGHTS THE IMPORTANCE OF THIS, UM, AMONG YOUTH COUNCILMAN MCKEE MCKEE RODRIGUEZ, YOU, YOU TALKED ABOUT THE EFFECT OF THAT IT HIGHLIGHTS IMPORTANT DATA ABOUT HOW DEPRESSION AND MENTAL HEALTH IS AFFECTING OUR COMMUNITY. 
          UM, ONE THING THAT I WANNA POINT OUT IS, IF YOU LOOK AT THIS FIGURE RIGHT THERE FOR, UM, HOSPITALIZATIONS FOR SELF-HARM, YOU'LL SEE THE UPTICK AT THE, AT THE TOP IN THE YELLOW. 
          THOSE ARE FOR YOUNG GIRLS BEING HOSPITALIZED FOR SELF-HARM IN THE SECOND HALF OF 2020. 
          SO, AGAIN, WE ARE TRACKING THESE ISSUE TO, UM, INFORM OUR PRIORITY AREAS AND THE ACTIONS THAT WE TAKE UNDERNEATH THEM. 
          AND, AGAIN, HIGHLIGHTING A LOT OF THE WORK AND THE PROGRAMS THAT ARE OUT THERE IN THE COMMUNITY, WORKING ON YOUTH MENTAL HEALTH AND ON MENTAL HEALTH AS AN, AS A PRIORITY AREA, UH, WITH EMBEDDED PICTURES AND VIDEOS OF, YOU KNOW, OUR TEAMS OUT IN THE WORLD, UM, IN ACTION, VIOLENCE PREVENTION IS OUR LAST PRIORITY AREA. 
          UM, AGAIN, THIS SPACE SPEAKS TO THE IMPORTANCE OF ADVERSE CHILDHOOD EXPERIENCES. 
          IT TALKS ABOUT THE IMPORTANCE OF UNDERSTANDING THE LINK BETWEEN TRAUMA, VIOLENCE, AND HEALTH. 
          IT HIGHLIGHTS DATA RELATED TO VIOLENCE RELATED TO DOMESTIC VIOLENCE AND RAPE, ET CETERA. 
          UM, AND AGAIN, DISAGGREGATING THE DATA AS MUCH AS POSSIBLE SO THAT THE READER CAN UNDERSTAND HOW THIS AFFECTS, YOU KNOW, OUR COMMUNITIES, UM, IN CERTAIN WAYS. 
          AND FINALLY, OUR ACTION PLAN, UM, EXPLAINED FOR EACH OF OUR ACTION AREAS UNDER THIS ESSAY FORWARD PLAN. 
          SO THAT WAS A REALLY MOUTHFUL OVERVIEW OF OUR, OUR STRATEGIC PLAN ESSAY FORWARD HEALTH DASHBOARD, UH, WHICH IS, AGAIN, SUPPOSED TO BE A COMMUNITY FACING RESOURCE AND PLATFORM. 
          OVER THE NEXT FIVE YEARS, THIS PLATFORM WILL EVOLVE AND GROW AS WE MAKE PROGRESS IN OUR ESSAY FORWARD PLAN AND AS WE REACH MILESTONES. 
          SO, THAT'S IT FOR ME. 
          THANK YOU, DR. 
          AGA. 
          COULD WE JUST GIVE HER A ROUND OF APPLAUSE? AGAIN? THIS WAS REALLY INCREDIBLE WORK. 
          UM, I GOTTA TELL YOU THAT I'M PROUD OF THE WORK OF THE DEPARTMENT. 
          IT'S A LOT OF INFORMATION THAT WE'RE THROWING AT YOU, BUT LET ME JUST END BY SAYING, OH, HOW CAN I, UM, GET BACK TO THE SLIDES? JUST THE LAST COUPLE SLIDES. 
          UM, THIS IS AN INCREDIBLE ENDEAVOR. 
          UM, WHILE IT'S BEEN ALL COVID ALL THE TIME, UH, THIS IS ON TOP OF THE ONGOING WORK, UH, THE DEPARTMENT, BUT THIS IS AN OPPORTUNITY TO SHARE WITH YOU ALL THE TRAILER. 
          UM, JUST SO YOU CAN SEE, OH, IT'S JUST THE LAST ONE. 
          SO I'LL JUST MOVE. 
          [01:20:03]
SO THIS IS JUST AN OPPORTUNITY. 
          SO WE'RE, WE'RE AT THE END OF OUR PRE, WE'RE AT THE END OF OUR PRESENTATION. 
          AND TO EACH AND EVERY ONE OF YOU, I JUST WANNA SAY THANK YOU FOR YOUR AMBASSADORSHIP. 
          I, I CAN'T THANK, UH, THE CITY MANAGER AND HIS TEAM ENOUGH. 
          UM, I GOTTA TELL YOU THAT THIS DID NOT HAPPEN IN ISOLATION. 
          EVEN THE PRODUCT THAT WE SEE ON THE WEBSITE, THE IT DEPARTMENT, THINKING ABOUT OUR RESPONSE EFFORTS AND OUR WORK TIED TO COVID WITH THE HR DEPARTMENT, THINKING ABOUT THE HUMAN SERVICES, POLICE, FIRE, UH, JUST IN GENERAL. 
          SO WITH THAT, UM, WE'LL END. 
          AND, UH, I DID WANT TO AT LEAST SHARE, UH, ONE LAST PIECE, ONE LAST PROJECT, UH, ONE LAST ANNOUNCEMENT, UM, FOR NATIONAL PUBLIC HEALTH WEEK. 
          AS I SHARED AT THE OUTSET, APRIL 4TH THROUGH 10TH, UH, WE ARE CELEBRATING NATIONALLY. 
          THE THEME THIS YEAR IS PUBLIC HEALTH IS WHERE YOU ARE. 
          UH, WE ARE SHARING THE PREVIEW AND THE LAUNCH OF THIS EFFORT TO DOVETAIL WITH NATIONAL PUBLIC HEALTH WEEK. 
          UH, THIS INFORMATION IS BEING MADE AVAILABLE, UH, NATIONWIDE. 
          WE CALL ATTENTION TO THE WORK OF THE GOVERNMENTAL PUBLIC HEALTH ENTERPRISE AT LOCAL, STATE, TRIBAL, AND TERRITORIAL HEALTH DEPARTMENTS. 
          BUT WE'RE ALSO IN THIS ONGOING COVID STORE, AND WE'RE PIVOTING AS WE SPEAK TO THE EXTENT THAT WE ARE SHORING UP OUR LINKAGES ACROSS THE CITY, AND WE'RE SHORING UP OUR LINKAGES, ESPECIALLY WITH OUR ACADEMIC PARTNERS. 
          SO, JUST WANNA SAY THANK YOU FOR THIS OPPORTUNITY IN THIS SPACE, AND NOW WE'LL OPEN IT UP FOR QUESTIONS THAT YOU MAY HAVE ABOUT THE PLAN. 
          THANK YOU, CLAUDE. 
          UM, AND DR. 
          AGA AND EVERYBODY WHO HAS WORKED ON THIS PLAN, UH, I AM TREMENDOUSLY IMPRESSED WITH HOW FAR IT HAS COME SINCE WE SAW, UM, A FEW SLIDES ON IT. 
          I THINK AT OUR LAST BUDGET SESSION, IT WAS, UH, THE CONCEPT WAS INTRODUCED, UM, AND ERIC HAD SHARED SOME OF IT WITH ME. 
          I'M ESPECIALLY IMPRESSED AT THE, THE AREAS YOU'VE DESIGNED, HOW THOROUGHLY YOU'VE WALKED THROUGH THEM IN EACH OF THESE, UH, ONE-PAGERS THAT YOU'VE PROVIDED TO US. 
          UM, AND CLEARLY THEY'RE, THEY'VE THOUGHT THROUGH. 
          I AM PARTICULARLY APPRECIATIVE OF THE FIRST YEAR PROCESS, PROGRESS BEING, UH, IDENTIFIED. 
          UM, I THINK WE, WE WANNA KNOW WHAT'S, WHAT'S HAPPENING, WHAT, WHAT ARE WE GOING TO SEE AT THE END OF, YOU KNOW, A FEW MONTHS OR, OR ONE YEAR. 
          SO THANK YOU VERY MUCH FOR, UH, PROVIDING THAT. 
          UM, I DO WANT TO, UM, SAY REITERATE A POINT THAT YOU MADE. 
          THIS IS ON TOP OF ALL OF THE FUNCTIONS THAT YOU ALREADY DO. 
          SO, UM, VECTOR CONTROL, VACCINATIONS, UM, S T D EDUCATION AND, AND CLINICS, RESTAURANT INSPECTIONS, UH, LACTATION, UH, CLINICS, UM, BABY SHOWERS THAT YOU HOST TOMORROW, I'LL BE, UH, STOPPING BY, UH, ONE OF THOSE. 
          IT IS NOT IN MY HONOR, BUT I WILL BE THERE. 
          . 
          UH, I'M, I'M VERY EXCITED TO, TO PARTICIPATE IN THAT. 
          SO, UH, SO WHAT WE HAVE ARE THE CORE FUNCTIONS OF THE DEPARTMENT AND ON, AND ON TOP OF THAT, YOU'RE, SEE, YOU'RE REALLY SEEING THE ROLE THAT PUBLIC HEALTH CAN PLAY IN, UM, ELIMINATING SOME OF THESE DISPARITIES IN OUR COMMUNITY, AND IT'S HAPPENING ACROSS, ACROSS THE NATION. 
          SO, UH, THANK YOU FOR BRINGING THAT FORWARD. 
          UM, A FEW YEARS AGO, I'D SAT DOWN WITH ERIC AND, UH, A PREVIOUS HEALTH DIRECTOR AND TALKED ABOUT HOW DO WE, HOW DO WE ELEVATE WHAT WE'RE DOING IN THE HEALTH DEPARTMENT? SO IT'S NOT SORT OF JUST IN THE BACKGROUND AND AN AFTERTHOUGHT, BUT SO THAT WE'RE A LEADER, RIGHT? WHAT IS IT A PER CAPITA INVESTMENT THAT WE NEED TO LOOK AT? SOMEBODY TALKED ABOUT THE 3%, YEAH. 
          UH, NUMBER NATIONWIDE. 
          UM, OR IS IT A SPECIFIC GOAL WE NEED TO SEE? SO, UH, THANK YOU. 
          UM, AND I KNOW WE ALSO HAVE COVID TO THANK FOR, FOR THIS, UM, BUT, UH, JUST THANK YOU. 
          I CAN'T THANK YOU ENOUGH FOR, FOR YOUR WORK. 
          UM, A A COUPLE OF QUESTIONS BEFORE WE MOVE ON TO COUNCIL MEMBER COMMENTS. 
          UM, THE, THE DASHBOARD DATA, VERY EXCITED ABOUT IT. 
          UH, WE SPOKE YESTERDAY OR THE DAY BEFORE, CLAUDE, ABOUT, UM, THE DATA FOR, FOR THE COUNTY AND, UH, HAVING THAT AVAILABLE, UH, FOR THE PUBLIC. 
          AS A PUBLIC HEALTH STUDENT, I DID USE THAT TO, TO, FOR ONE CLASS WRITING A REPORT. 
          SO I'M GLAD THAT'S GOING TO BE AVAILABLE. 
          THAT MEANS IT'S, IT'S ALMOST, UM, IT'S PUBLICLY AVAILABLE FOR, SO STUDENTS AT ANY M P H PROGRAM OR IN, IN A BACHELOR'S PROGRAM, CAN TAKE THAT, DO THEIR OWN, UH, ANALYSES. 
          UM, SO MINE WAS IN SPATIAL EPIDEMIOLOGY, AND IT WAS IT, YEAH. 
          AWESOME. 
          SO I'M REALLY GLAD TO SEE ALL THOSE MAPS ON, ON THERE TOO. 
          SO, BUT THE DATA THAT, THAT WE WILL HAVE AVAILABLE IS GENERALLY GOING TO BE AT THE COUNTY LEVEL OR AT THE CITY LEVEL. 
          COME ON, DACA. 
          SO, ON THE VERY FIRST PAGE, IT SORT OF EXPLAINS THAT WE OPERATE AS A CITY COUNTY HEALTH DISTRICT, AND AT THE SAME TIME, MANY OF OUR DIFFERENT DATA SOURCES, UM, COME AT THE CITY 
          [01:25:01]
LEVEL, AND SOME OTHERS COME AT THE COUNTY LEVEL. 
          SO THERE'S, RIGHT AT THE FIRST PAGE, THERE'S AN EXPLAINER THAT SAYS, THROUGHOUT THIS DASHBOARD, YOU WILL SEE DATA ON COUNTY AND CITY INTERCHANGEABLY. 
          SO WE'RE STILL FIGURING OUT IN PLACES WHERE BOTH CITY AND COUNTY IS AVAILABLE, NOT TO OVERWHELM AND CONFUSE IT, UM, BUT FOR A LOT OF THEM, A LOT OF THE DATA, FOR EXAMPLE, HOSPITALIZATIONS, THAT'S ONLY AVAILABLE AT THE COUNTY LEVEL. 
          UM, BUT CERTAIN DATA LIKE PREVALENCE OF DIABETES THAT COMES FROM C'S B R F SS S THAT'S ONLY AVAILABLE FOR SAN ANTONIO. 
          SO WE SORT OF GIVE AN EXPLAINER AND MAKE SURE THAT WITHIN EACH DATA PIECE WE EXPLAIN VERY WELL, WHETHER IT'S SAN ANTONIO CITY OR BEAR COUNTY. 
          SOUND GOOD? YES. 
          THANK YOU VERY MUCH. 
          UM, AND THEN, UH, WELCOME TO OUR NEW GUESTS IN THE, IN THE AUDIENCE. 
          AND THEN, HEY, HEY, . 
          AND THEN IT, UH, YOU AND I TOUCHED ON THIS AS WELL, CLAUDE, BUT, UH, THIS IS A LOT OF WORK COMING IN THE FUTURE. 
          TELL US ABOUT THE WORKFORCE AND PLANS FOR THAT WORKFORCE . 
          UM, SO THE REFERENCE TO, UH, OUR ACADEMIC HEALTH DEPARTMENT, UM, SO WE ARE A NATIONALLY ACCREDITED HEALTH DEPARTMENT AS RECOGNIZED AND DESIGNATED BY THE PUBLIC HEALTH ACCREDITATION BOARD. 
          JUST ABOUT 10 OR 11% OF LOCAL HEALTH DEPARTMENTS NATIONWIDE HAVE MET THESE NATIONAL STANDARDS AND THIS DESIGNATION. 
          AND WE EARNED OURS IN NOVEMBER OF 2019. 
          SO WE'RE HALFWAY THROUGH THE FIVE YEAR CYCLE. 
          UM, AND A A COMPLIMENT TO THAT, ALTHOUGH IT'S NOT A FORMAL DESIGNATION, IT'S TO BE RECOGNIZED AS AN ACADEMIC HEALTH DEPARTMENT. 
          AND IT DOES REQUIRE ROBUST LINKAGES WITH ACADEMIC PARTNERS. 
          WHILE WE ALREADY HAVE CONTRACTS AND WE HAVE A NUMBER OF EFFORTS AND SERVICES, UM, THAT WE'VE BENEFITED FROM, FROM EXISTING PARTNERSHIPS, WE DO HAVE AN OPPORTUNITY, AND THIS HAS BEEN A NATIONAL TREND, UH, TO AMPLIFY THAT, UM, WHAT DR. 
          AGA SHARED IS THE IMPORTANCE AND THE OPPORTUNITY OF HAVING ACCESS TO TIMELY DATA. 
          UM, EVERY THREE YEARS, LOCAL HEALTH DEPARTMENTS ARE SURVEYED AND THEY'RE ASKED A NUMBER OF QUESTIONS, AND TWO OF THEM INVOLVE DATA. 
          SO WHEN ASKED, WELL, HOW MANY OF YOU COLLECT DATA? ABOUT 90% OF HEALTH DEPARTMENTS SAY YES. 
          WE COLLECT A LOT OF DATA. 
          WHEN WE ASK THE NEXT QUESTION, WELL, WHAT PERCENTAGE OF YOU? HOW MANY OF YOU HAVE THE CAPABILITY TO CRUNCH THOSE NUMBERS? WELL, ONLY ABOUT A QUARTER OF THOSE HEALTH DEPARTMENTS ACTUALLY HAVE THE BANDWIDTH. 
          AND SO BY DESIGN, WE ARE MAKING SURE TO SHORE UP OUR WORKFORCE, WE'RE MAKING SURE TO SHORE UP OUR LINKAGES WITH ACADEMIC HEALTH DEPARTMENTS. 
          THE WORKFORCE WRIT LARGE IS EXHAUSTED, ESPECIALLY THROUGH THE LAST COUPLE YEARS, THE ANEMIC AND UNDER RESOURCED, UH, SUPPORT NATIONWIDE TO HEALTH DEPARTMENTS. 
          WE SEE THAT THE FRAGILITY OF OUR INFRASTRUCTURE HAS BEEN EXACERBATED BECAUSE OF COVID. 
          YET NOW THERE'S A NATIONAL BLUEPRINT TO SHORE UP THE WORKFORCE, MAKE SURE WE MAKE BETTER DECISIONS TIED TO DATA, MAKE SURE THAT THERE'S, UH, MORE STABLE FUNDING. 
          BUT ALL THAT TO SAY THAT THE WORKFORCE IN PARTICULAR, SINCE THAT'S THE LION'S SHARE OF THE EXPENSE FOR HEALTH DEPARTMENTS, THAT WE'RE DOING A BETTER JOB TO SUPPORT THE BOOTS ON THE GROUND. 
          AND SO, UH, FOR US, IT'S AN OPPORTUNITY TO AT LEAST LEAN IN AND ENHANCE THE LINKAGES WITH OUR PARTNERS. 
          UM, AND I CAN'T SAY THANKS ENOUGH TO THE TALENT THAT WE HAVE HERE AT METRO HEALTH, BUT ALSO THE INTENTION AND THE LINKAGES THAT WE HAVE FOR PARTNERS HERE ACROSS THE CITY AND THE COUNTY. 
          THANK YOU, CLAUDE. 
          UM, WE WILL MOVE ON TO COUNCIL MEMBER COMMENTS. 
          AND NOW I THINK YOU GUYS CAN UNDERSTAND WHY WE WEREN'T QUITE READY TO GO INTO THE, THE, THE OTHER ITEMS FOUR AND FIVE. 
          UM, WE HAVE, UM, COUNCILWOMAN GERRAN, AND THEN COUNCILMAN MCKEE RODRIGUEZ. 
          UH, COULD WE DO SEVEN MINUTES JUST SO WE CAN THANK YOU. 
          KRU COUNCILWOMAN, PLEASE. 
          THANK YOU. 
          THANK, THANK YOU, CLAUDE, FOR THIS PRESENTATION. 
          I THINK, UM, THIS IS, THIS IS SO IMPORTANT, AND I, I'M SO GLAD YOU PRESENTED AND WE'RE NOT TALKING ARPA, BECAUSE I REALLY WANT THIS TO BE PART OF OUR ARPA DISCUSSION AS WE MOVE FORWARD. 
          THE, THESE SIX PRIORITIES ARE SO INTERTWINED. 
          UM, AND FOR ME, IN THE DISTRICT THREE WITH, UH, ALL OF THEM IMPACT MY DISTRICT, BUT WITH THE, UM, FOOD INSECURITY AND NUTRITION PRIORITY AREA, AND THE MENTAL HEALTH AND COMMUNITY RESILIENCE, I REALLY FEEL THESE ARE CONNECTED BECAUSE MY DISTRICT, MY FAMILY, OUR CULTURE, WE TEND TO EAT OUR FEELINGS. 
          AND THIS IS HOW YOU'RE FEELING SAD. 
          YOUR GRANDMA GIVES YOU SOMETHING TO EAT, YOU'RE FEELING MAD, THEY FEED YOU SOMETHING. 
          THIS IS HOW THEY MANAGE. 
          AND THIS IS WHY, ONE OF THE REASONS I THINK WE HAVE A PROBLEM WITH DIABETES AND OBESITY IN DISTRICT THREE, BECAUSE WE'RE NOT ADDRESSING OUR MENTAL HEALTH AND OUR SOCIAL WELLBEING. 
          SO I, I'M SO EXCITED THAT THESE TWO ARE ON THERE. 
          THE OTHER THING IS, I LOVE THAT SLIDE, AND I THINK YOU KNEW I WAS GONNA LOVE THE SLIDE WHERE IT HAD THE, UM, WAS IT SLIDE FIVE WITH THE UPSTREAM? 
          [01:30:01]
BECAUSE I KEEP ON SAYING UPSTREAM, IT, IT, IT'S SLIDE FIVE. 
          I KEEP ON SAYING UPSTREAM AND DOWNSTREAM. 
          AND I LOVE THAT Y'ALL PUT IT THERE FOR PEOPLE WHO DON'T KNOW WHAT I'M TALKING ABOUT, TO VISUALLY SEE, WHEN I TALK ABOUT ADDRESSING THE UPSTREAM ISSUES, WHERE WE'RE AT VERSUS THE DOWNSTREAM ISSUES WHERE I FEEL LIKE WE, WE KNOW WE'RE, WE'RE GETTING THAT WE CHECK THOSE BOXES FOR THE DOWNSTREAM ISSUES. 
          IT'S THOSE UPSTREAM ISSUES WHERE WE NEED TO FIND THE ORGANIZATIONS TO PARTNER WITH WHERE WE NEED TO CHAMPION. 
          UM, JUST SAYING THE WORD GENDER  AND UNDERSTANDING, WHEN WE TALK ABOUT DOMESTIC VIOLENCE, IT'S VIOLENCE AGAINST WOMEN ALSO. 
          SO I REALLY APPRECIATE YOU, UH, DOING THAT. 
          AND I, I LOOK FORWARD TO SUPPORTING THIS AND HEARING MORE AND SHARING WHATEVER IDEAS Y'ALL NEED FOR RESTAURANTS AND HEALTHY CORNER STORES IN AND AROUND DISTRICT THREE. 
          UM, AND, AND TELLING PEOPLE, HEY, IT DOESN'T TAKE A GYM MEMBERSHIP. 
          YOU CAN JUST TAKE A WALK OUTDOORS AND ACTIVATING THE OUTDOORS. 
          'CAUSE WE HAVE SO MUCH OF IT, AND IT'S ALL SO BEAUTIFUL. 
          UM, BUT THANK YOU FOR THAT. 
          AND I THINK THE ONLY REAL QUESTION I HAVE IS WHEN WE COME TO THE FOOD, WHEN WE TALK FOOD DESERTS, ARE YOU GONNA GO TO EACH DISTRICT SPECIFICALLY? IS THERE GONNA BE A SURVEY WE COULD POSSIBLY DO TO KIND OF TELL YOU WHAT WE'RE HEARING FROM OUR RESIDENTS? SO OUR INITIATIVES ARE TAILORED AT THE DISTRICT LEVEL? I'M GONNA ASK, UM, DENISE TO AT LEAST ELABORATE ON HOW WE ARE IMPLEMENTING THE PROGRAMS, BUT LET ME AT LEAST, UH, ACKNOWLEDGE THAT OUR INTENT IS TO COVER ACROSS THE SPECTRUM OF THE CITY. 
          BUT LET ME ASK DENISE TO ELABORATE. 
          GOOD AFTERNOON COUNCIL MEMBERS. 
          THANK YOU FOR HAVING US. 
          YES, WE ARE DEVELOPING A FOOD INSECURITY WORK GROUP, UM, WITH PARTNERS ACROSS SECTORS WHERE WE'RE HOPING TO GET THAT KIND OF SURVEY DATA IMPLEMENTED. 
          SO WE WILL BE COMING TO THE DISTRICT OFFICES TO BE ASKING FOR ADDITIONAL ASSISTANCE. 
          UM, WE ARE GOING TO THE DISTRICT OFFICES. 
          WE'VE JUST MET WITH, UH, ANNA GALINDO RECENTLY FROM YOUR DISTRICT. 
          AND WE'RE TALKING ABOUT, YOU KNOW, OUR DIABETES RATES. 
          WE'RE TRYING TO GET ALL OF THE FOOD SYSTEM AND, UH, FOOD INSECURITY INFORMATION THAT WE CAN, AND BRINGING THOSE ASSETS TOGETHER, UM, TO DEVELOP WHAT WE'RE CALLING A RESOURCE GUIDE FOR EACH DISTRICT. 
          SO WE'RE REALLY EXCITED ABOUT THAT. 
          AND YES, WE WILL BE COMING TO YOUR DISTRICTS. 
          THANK YOU SO MUCH. 
          AND I'M GLAD YOU MENTIONED ANNA, BECAUSE I THINK ABOUT MY SENIORS AND THE FACT THAT IF I GIVE, IF WE HAVE COFFEE, THEY EXPECT SWEET BREAD OR DONUTS AND TRYING TO, SHE MENTIONED THAT YESTERDAY, . 
          YES. 
          THANK YOU VERY MUCH. 
          THANK YOU. 
          I LOOK FORWARD TO SUPPORTING THIS. 
          THANK, THANK YOU. 
          THANK YOU, COUNCILWOMAN. 
          YOU'RE RIGHT. 
          I EXPECT PANDUCE TOO. 
          UH, COUNCILMAN MKI RODRIGUEZ. 
          THANK YOU. 
          UM, I REALLY DON'T EVEN KNOW WHERE TO START. 
          THAT WAS A, THAT WAS A PRESENTATION WITH VIDEO, LIVE PERFORMANCES, DEMONSTRATIONS,  POETRY. 
          UM, I'LL START BY THE, ONE OF THE THINGS THAT WAS MOST, THAT WAS MOST RECENTLY MENTIONED WAS THE WORK GROUP. 
          UM, I HAVE ENTITIES LIKE GARCIA STREET, URBAN FARM AND OPIA GARDENS, WHO I THINK WOULD JUMP AT THE OPPORTUNITY TO PARTICIPATE IN SOMETHING OF THE SORT. 
          UM, I'LL TALK ABOUT RACE A LITTLE BIT, AND I WANNA BE VERY, VERY SPECIFIC. 
          WE JUST RECEIVED A, UM, A REPORT NOT TOO LONG AGO IN FEBRUARY, A ABOUT THE STATE OF THE BLACK COMMUNITY IN SAN ANTONIO. 
          UM, AND TWO OF THE THINGS THAT WE SAW WAS THAT, UM, BLACK FOLK ARE MORE INCLINED TO BE ON THE LOWER END OF INCOME AND EXPERIENCE HIGHER RATES OF POVERTY, UM, EXPERIENCE GREATER DIABETES MORTALITY RATES. 
          UM, I, I USED TO TEACH AT SAM HOUSTON HIGH SCHOOL ON THE EAST SIDE, AND 91% OF MY, 91% OF ALL THE KIDS THERE ARE ELIGIBLE FOR FREE LUNCH. 
          THE OTHER 9% ARE ELIGIBLE FOR REDUCED LUNCH. 
          THAT'S AN INDICATOR. 
          UM, AND SO I WANT TO, I DON'T KNOW, I JUST WANNA MAKE SURE THAT WHEN WE'RE LOOKING AT THE RESOURCES THAT ARE GOING TO BECOME AVAILABLE TO US, AND I'M NOT GONNA, UM, I'M NOT GONNA TALK ABOUT SOMETHING THAT'S NOT HERE, BUT ARPA AS AN EXAMPLE. 
          UM, I WANT TO SPECIFICALLY KNOW HOW ARE WE GOING TO USE IT TO, TO BETTER THE STATE OF THE BLACK COMMUNITY IN SAN ANTONIO. 
          THAT'S, I, I WANT THAT TO BE A FOCUS. 
          IT NEEDS TO BE A FOCUS, UM, ACCESS TO CARE AND HEALTH EQUITY. 
          I HAVE A QUESTION. 
          UM, HOW MIGHT MEMBERS OF A COMMUNITY, SO SAY A SPECIFIC NEIGHBORHOOD OR A SPECIFIC SIDE OF TOWN, HOW MIGHT THEY ADVOCATE FOR HEALTHCARE FACILITIES IN MORE SPECIFICALLY, LIKE A FULL SERVICE HOSPITAL? HOW WOULD THEY ADVOCATE FOR SOMETHING LIKE THAT TO BE BROUGHT IN? AND WHAT TOOLS DO I HAVE TO SUPPORT THAT, WHETHER IT BE LIKE A ASK REQUESTING AN, I DON'T KNOW, AN R F P PRO? I DON'T KNOW. 
          YEAH. 
          UH, YOU WANT ME TO ANSWER THAT? SO YES, , IT'S, 
          [01:35:01]
UM, SO JUST KNOW THAT, UM, GOOD QUESTION. 
          THERE'S, THERE ARE PROCESSES, RIGHT, FOR IDENTIFYING FACILITIES. 
          I MEAN, IT'S OUT OF MY LINE OF SIGHT HOW THAT HAPPENS HERE. 
          UH, TYPICALLY THERE ARE COLLABORATIONS WITH THE COUNTY, WITH THE CITY, UM, IN TERMS OF THE LENS AND THE PROCESS FOR ENGAGING COMMUNITY PARTNERS, UM, I'LL HAVE TO THINK ABOUT AND AT LEAST CIRCLE BACK TO YOU ABOUT WHAT, HOW THAT HAPPENS. 
          WHAT WE ARE FOCUSED ON IS THE DISRUPTION THAT'S DIRECTLY TIED TO THIS COVID EXPERIENCE. 
          SO WE WILL BE DOING A FORMAL ASSESSMENT TIED TO THAT, WHETHER IT'S THE, UM, COMPROMISE ACCESS TO HEALTHCARE, UH, WHETHER IT'S THE WAY THAT FOLKS EXPERIENCE THE UTILIZATION OF HEALTH SERVICES, BUT IN TERMS OF BRICKS AND MORTAR AND CLINICS THAT ALL DEFERRED TO OTHERS. 
          BUT WE COULD CIRCLE BACK IN TERMS OF A PROCESS, IF THAT'S REALLY AT THE CORE OF YOUR QUESTION AND THE DISTRIBUTION ACROSS THE CITY. 
          THANK YOU. 
          UM, ONE OF THE, I'M REMINDED, ONE OF THE THINGS THAT I REQUESTED OF THE INNER CITY TOURS, UM, THAT WILL HOPEFULLY BE AN ITEM IN THE NEAR FUTURE, UM, IS AN AMENITIES AND NEEDS ASSESSMENT FOR THE DISTRICT. 
          UM, I'LL GIVE AN EXAMPLE OF AN AMENITY. 
          SO LIKE MOVIE THEATERS IN DISTRICT TWO, YOU KNOW HOW BIG DISTRICT TWO IS? IT GOES, IT GOES ALL THE WAY OUT. 
          WE DON'T HAVE A MOVIE THEATER IN DISTRICT TWO EXCEPT FOR THE GALAXY ALL THE WAY IN THE NORTHEAST, WHICH MIGHT AS WELL BE DISTRICT 10. 
          UM, THAT'S THE CASE FOR A LOT OF THINGS. 
          AND IT DOESN'T MATTER WHAT SIDE OF TOWN, WHAT SIDE OF MY DISTRICT I'M ON, THERE'S A, THERE'S A NEIGHBORHOOD SAYING, WHY ARE, YOU KNOW, WHEN CAN I HAVE A HOSPITAL NEAR ME? OR SOME SORT OF FACILITY LIKE THAT. 
          AND SO I'M HOPING THAT, YOU KNOW, AS WE REVEAL THOSE NEEDS THAT WE ALREADY KNOW EXIST, UM, THAT WE CAN, UH, I DON'T KNOW, USE Y'ALL AS A RESOURCES LEVERAGE TO TRY TO GET SOMETHING. 
          I DON'T KNOW WHAT THE, THE OPTIONS ARE LIMITLESS, HOPEFULLY. 
          UM, I ALSO, I'LL TALK ABOUT, UM, FOOD INSECURITY AND NUTRITION FOR A SECOND. 
          UM, SO I KNOW, UH, COUNCILMAN REFERENCED THAT WE'RE GONNA HAVE A C C R COME BEFORE CHECK SOON, UM, ABOUT THE FOOD ACCESS, THE PROPOSING A FOOD ACCESS MASTER PLAN. 
          AND, UM, WHEN I WAS AT GOVERNANCE, I RECOGNIZED, AND, YOU KNOW, DURING THIS PRESENTATION, WE RECOGNIZED THAT THERE IS A LOT BEING DONE, A LOT OF INDIVIDUAL PROGRAMS BEING DONE, UM, TO ADDRESS FOOD INSECURITY. 
          AND I WANT TO, UM, MAKE VERY CLEAR WHAT THE REQUEST IS OR WHAT I HOPE TO SEE OF A PROGRAM LIKE THIS SO AS NOT TO TOUCH ON AN ITEM THAT'S NOT HERE. 
          UM, YOU KNOW, UH, THERE'S A PARK'S GOAL THAT EVERYONE BE WITHIN 10 MINUTES WALKING DISTANCE FROM A PARK. 
          I WANNA SEE A SPECIFIC MEASURABLE GOAL OF HOW FAR IS IT, HOW FAR DOES IT TAKE ANY PERSON IN ANY PART OF TOWN TO GET TO AFFORDABLE QUALITY PRODUCE. 
          UM, I ALSO, I THINK IT WOULD BE LOVELY TO SEE SOMETHING LIKE THE STRATEGIC HOUSING IMPLEMENTATION PLAN, BUT FOR FOOD ACCESS. 
          SO AS WE THINK OF NEEDS, UH, AND THINGS THAT MAY COME BEFORE US, I, THAT'S WHERE I'M THINKING. 
          UM, BUT OTHER THAN THAT, THANK Y'ALL SO MUCH. 
          I ENJOYED THE PERFORMANCE, UH, . 
          Y'ALL BE SAFE. 
          THANK YOU FOR YOUR COMMENTS. 
          REALLY APPRECIATE THE FEEDBACK. 
          UM, IT, THANK YOU. 
          WE ALSO HAVE, UM, OH, FIRST I'M TO RECOGNIZE GIRL SCOUT TROOP 1304. 
          IS THAT WHO WE HAVE WITH US TODAY? 10 30. 
          10 34. 
          SORRY. 
          10 34. 
          WELCOME, . 
          I'M SURE MY STAFF IS ROLLING THEIR EYES AT ME RIGHT NOW. 
          SORRY ABOUT THAT. 
          UM, OKAY, WE HAVE COUNCILWOMAN CASTILLO, AND THEN SHE'LL BE FOLLOWED BY COUNCILMAN BRAVO. 
          THANK YOU. 
          UH, THANK YOU CLAUDE. 
          AND THANK YOU CHAIR. 
          UM, EARLIER THIS WEEK I HAD A CONVERSATION WITH SOME TEXAS, TEXAS TECH MEDICAL STUDENTS WHO ARE LOOKING AT HEALTH DISPARITIES RIGHT HERE IN SAN ANTONIO. 
          AND I'M REALLY HOPING THEY'RE WATCHING TODAY. 
          'CAUSE I THINK Y'ALL JUST WROTE THEIR PAPER, UM, BY PROVIDING ALL THESE RESOURCES, MAPS, AND DATA, UH, ON SAN ANTONIO. 
          AND THEY'RE LOOKING IN PARTICULAR AT INFRASTRUCTURE AND HOUSING AND HOW THAT IMPACTS, UH, THE HEALTH OF OUR, OUR RESIDENTS HERE. 
          UM, AND I'M ALSO GRATEFUL FOR THAT VIDEO THAT Y'ALL PRESENTED AS A HISTORIAN, UH, GROUNDING OURSELVES IN THAT HISTORICAL CONTEXT OF, OF HEALTH DISPARITIES AND PANDEMICS WITHIN SAN ANTONIO. 
          AND HOW WE CONTINUE TO SEE, UH, INJUSTICE TODAY WAS REALLY IMPORTANT. 
          HOWEVER, WITH THESE, UH, CORE INITIATIVES PRESENTED, RIGHT, WE REALLY HAVE AN OPPORTUNITY TO STEER SAN ANTONIO IN A WAY THAT UPLIFTS ALL COMMUNITIES. 
          UM, SO WITH THAT, AGAIN, I'M ALSO GRATEFUL THAT WE AREN'T DISCUSSING ARPA TODAY BECAUSE I WOULD LIKE TO LEARN, YOU KNOW, UH, WITH THESE CORE INITIATIVES, IF WE'VE IDENTIFIED, UM, SOME THAT MAY BE ARPA ELIGIBLE FOR US TO SUPPORT, RIGHT? UM, BECAUSE, UH, I, I KNOW LIKE WITH THE SHIP AND OTHER POL, UM, PROGRAMS THAT HAVE BEEN PRESENTED, RIGHT? THEY, THEY SIT ON A SHELF. 
          UM, BUT I THINK WE HAVE AN OPPORTUNITY WITH THE ARPA CONVERSATION TO PUT MANY OF THESE INITIATIVES INTO ACTION. 
          UH, SO HAS THE METRO HEALTH DEPARTMENT, UH, IDENTIFIED, UH, CORE 
          [01:40:01]
INITIATIVES THAT, UH, YOU ALL WOULD HOPE TO SEE RECEIVE ARPA SUPPORT, UM, WITHIN, UH, THE UPCOMING CONVERSATIONS? GREAT QUESTION. 
          I WOULD JUST SAY THAT THIS IS A MULTI-YEAR PLAN. 
          UH, WE'VE TAKEN ADVANTAGE OF DIFFERENT FUNDING STREAMS. UM, WE DO HAVE A SCHEDULE OVER THE FIVE YEARS, THERE'S STILL A GAP IN TERMS OF THE OUT YEARS MM-HMM. 
          . 
          UM, SO IT'S AN EVOLVING CONVERSATION. 
          WE'RE WORKING IN CONCERT WITH THE CITY MANAGER, WITH THE OFFICE OF MANAGEMENT BUDGET. 
          SO IN TERMS OF A PARTICULAR INITIATIVE, I CAN'T SPEAK TO THAT, BUT JUST KNOW IN BROAD STROKES, WE HAVE THESE CATEGORIES. 
          THESE ARE DEFINED FI PRIORITIES FOR THE NEXT FIVE YEARS. 
          UM, SO IT'S, IT'S AN OPPORTUNITY, BUT I WOULD JUST SAY THAT, UM, WE DO HAVE A SCHEDULE AND WE WANNA MAKE SURE THAT WE TAKE ADVANTAGE OF FUNDING THAT ALLOWS US TO IMPLEMENT ALL THIS THROUGH THE FIFTH YEAR AND BEYOND. 
          GREAT. 
          THANK YOU. 
          AND I KNOW WITH, UM, WITH DISTRICT FIVE IN PARTICULAR, THERE'S A LOT OF CONCERNS ABOUT FOOD INSECURITY, UM, SPEAKING WITH SOME OF OUR SENIOR SERVICE DIRECTORS. 
          UM, YOU KNOW, I'VE, I'VE ASKED LIKE, YOU KNOW, WHAT WOULD BE HELPFUL FOR OUR SENIORS? THEY MENTIONED THAT THEY'VE SEEN AN INCREASE OF SENIORS WANTING TO APPLY FOR A FOOD BANK ASSISTANCE, UM, MANY OF WHICH WHO DON'T QUALIFY FOR THAT FOOD. 
          UM, SO THAT ONE MEAL THEY GET, UH, MANY OF THE SENIORS ARE GRATEFUL FOR. 
          SO, UM, I WOULD HOPE TO SEE, UM, CITY COUNCIL HAVE A LARGER DISCUSSION ON HOW WE CAN EXPAND, UH, URBAN FARMS AND FOOD ACCESSIBILITY, UH, THROUGHOUT SAN ANTONIO. 
          UM, BUT CAN, UM, LOOKING AT THE CORE INITIATIVES ON, UH, PAGE EIGHT, SLIDE 18, RATHER, UM, JUSTICE, JUSTICE INVOLVED PARENTS, CAN YOU HELP ME UNDERSTAND, IS THAT FORMERLY INCARCERATED PARENTS? UM, OR IF YOU COULD HELP ME UNDERSTAND THAT. 
          I'M SORRY, COUNCILWOMAN, COULD YOU REPEAT YOUR QUESTION? YES. 
          FOR THE, THE POINT ON SLIDE FOUR 18 MM-HMM. 
          , UM, WHERE IT SAYS JUSTICE INVOLVED PARENTS, IS THAT, UH, PARENTS WHO ARE FORMALLY FRUSTRATED? OKAY. 
          EXACTLY. 
          YES. 
          GREAT. 
          UH, I, I'M PLEASED TO SEE THAT WE ARE CENTERING FOLKS WHO HAVE BEEN IMPACTED BY THE CRIMINAL JUSTICE SYSTEM AND WITH THE ESTABLISHMENT OF A CITYWIDE CENTER OF EXCELLENCE IN TRAUMA-INFORMED CARE. 
          WOULD THAT BE UNDER METRO HEALTH OR WOULD WE DELEGATE THAT TO THE CENTER FOR HEALTHCARE SERVICES? THAT'S UNDER METRO HEALTH. 
          OKAY. 
          FANTASTIC. 
          MM-HMM. 
          . 
          UM, THERE'S SO MUCH TO COVER. 
          I REALLY VALUE THIS PRESENTATION. 
          IT'S JUST AMAZING AND EXCITING, AND I CAN'T WAIT FOR, UH, MY COUNCIL COLLEAGUES AND I TO PUT THIS INTO WORK AND IDENTIFY THE FUNDING TO ENSURE THAT, UH, THESE, UM, INITIATIVES CAN COME INTO FRUITION. 
          THANK YOU. 
          THANK YOU. 
          I KNOW IT'S OVERWHELMING, RIGHT? HOW , UM, COUNCIL, UH, COUNCILMAN VO. 
          THANK YOU. 
          THANK YOU, CLAUDE, FOR THE PRESENTATION. 
          UM, I ALWAYS APPRECIATE SEEING ANYTHING THAT HAS TO DO WITH FOCUSING ON SOCIAL DETERMINANTS OF HEALTH, SO THAT MAKES ME HAPPY. 
          UM, YOU MENTIONED, WHEN YOU WERE TALKING ABOUT MENTAL HEALTH, YOU SAID THAT WE'VE YET TO SEE THE IMPACTS OF THIS EXPERIENCE, AND I ENTIRELY AGREE, AND I'M EXTREMELY CONCERNED ABOUT THIS. 
          WHAT ARE THE LONG-TERM EFFECTS, MENTAL HEALTH EFFECTS OF, OF THIS PANDEMIC AND WHAT PEOPLE HAVE BEEN THROUGH THESE LAST FEW YEARS? UM, I KNOW OF SCHOOL CHILDREN WHO DON'T HAVE COUNSELORS BECAUSE THERE'S SUCH A SHORTAGE IN, IN LOCAL SCHOOLS. 
          AND MY UNDERSTANDING IS THAT'S LIKE THE FIRST LINE OF DEFENSE WHERE, YOU KNOW, WHERE, WHERE THE PEOPLE LEARN THAT THERE'S AN INDIVIDUAL THAT NEEDS SOME MENTAL HEALTH SUPPORT. 
          UM, I SPOKE WITH THE BAR OWNER THIS WEEK AND HE TOLD ME, YEAH, YOU KNOW, THINGS WERE KIND OF CRAZY AT THE BARS WHEN, UH, WHEN COVID STARTED TO SUBSIDE AND PEOPLE WERE FIRST ABLE TO GO OUT AGAIN. 
          AND HE THOUGHT, HE SAID, YOU KNOW, WE, WE THOUGHT THAT WAS JUST A SURGE BECAUSE PEOPLE WERE STIR CRAZY AND HAD BEEN HOME FOR SO LONG AND THEY CAN FINALLY GO OUT. 
          AND HE SAID, BUT YOU KNOW WHAT? IT HASN'T SUBSIDED. 
          AND LIKE WE'VE WE'RE SEEING BEHAVIOR THAT'S WE'VE NEVER SEEN BEFORE IN OUR BARS. 
          UM, I PERSONALLY HAD TO DO A WELLNESS CHECK ON AN INDIVIDUAL WHO I KNOW WHO, UH, HADN'T SHOWN UP FOR WORK OR RESPONDED TO ANYBODY IN MONTHS, UH, EARLIER THIS WEEK, AND JUST GO CHECK ON THEM AND MAKE SURE THAT THEY'RE OKAY. 
          UM, AND SO I KNOW THAT WE ARE SPEND, WE, WE ARE INVESTING MORE ON MENTAL HEALTH THAN EVER BEFORE, BUT I FEEL LIKE WE'VE ALWAYS UNDERINVESTED IN THE PAST AND THAT WE'RE STILL LOW IN PROPORTION TO WHERE WE NEED TO BE IN COMP COMPARISON TO WHERE THE DEMANDS ARE. 
          AND I'M REALLY HAPPY TO SEE THAT THE CENTER FOR HEALTHCARE SERVICES HAS BEEN CONVENING THESE ROUND TABLE DISCUSSIONS AND BRINGING ALL THE PARTNERS FROM THE COMMUNITY TOGETHER AND SEEING HOW, HOW WE CAN WORK TOGETHER EFFECTIVELY, EFFICIENTLY, YOU KNOW, AND MAKE SURE THAT EVERYBODY'S PLAYING A PART AND, AND THAT WE'RE COORDINATED. 
          BUT I, I REALLY WANT TO SEE HOW WE CAN TAKE IT TO THE NEXT LEVEL IN ANY WAY POSSIBLE IN TERMS OF INVESTING IN, IN SUPPORTING 
          [01:45:01]
OUR COMMUNITY AND MENTAL HEALTH. 
          AND, UH, WOULD APPRECIATE YOUR GUIDANCE IN ANY WAY WE CAN DO THAT. 
          THANK YOU. 
          UM, THANK YOU AGAIN BY DESIGN, GIVEN THE INSIGHTS AND THE EXPERIENCES, UH, WHETHER IT'S THE ADVERSE CHILDHOOD EXPERIENCES OR ADVERSE COMMUNITY EVENTS OR ENVIRONMENTS, DEPENDING ON HOW YOU FRAME THE, THE DECIDE, DEFINE THE FRAMEWORK, UH, WE HAVE AN OPPORTUNITY. 
          UM, MY COMMENT ABOUT WE HAVE YET TO SEE THE IMPACTS, IT'S, IT'S REALLY IN A COUPLE DIMENSIONS. 
          UH, ONE IS STRIPPING AWAY THE STIGMA ASSOCIATED WITH MENTAL HEALTH AND MENTAL ILLNESS. 
          SO WE, WE HAVE TO HAVE A SPACE TO TALK ABOUT THIS STUFF. 
          ON THE FLIP SIDE, AGAIN, IF YOU GO TO THE CLASSIC DEFINITION BY THE WORLD HEALTH ORGANIZATION OF WHAT MAKES FOR A HEALTHY COMMUNITY, IT'S NOT MERELY THE ABSENCE OF DISEASE OR INJURY. 
          IT'S THE STATE OF BEING THIS BALANCE, PHYSICAL, EMOTIONAL AND SOCIAL WELLBEING, SOCIAL SLASH SPIRITUAL WELLBEING. 
          AND SO WE HAVE AN OPPORTUNITY TO AT LEAST CREATE THE SAFE SPACE, LOOK AT OUR ECOSYSTEM, MAKE SURE THAT WE WORK IN CONCERT WITH THE, UH, LOCAL MENTAL HEALTH AUTHORITY OF RECORD, THE CENTER FOR HEALTHCARE SERVICES, BUT ALSO OUR REGIONAL NETWORK AND HEALTHCARE PROVIDERS. 
          AND SO IT'S AN OPPORTUNITY TO MESSAGE THIS DIFFERENTLY. 
          IT'S AN OPPORTUNITY TO LEAN IN, BUT IT'S AN OPPORTUNITY TO BE REAL ABOUT THE TRAUMA THAT COMMUNITIES ARE EXPERIENCING AROUND THE GLOBE AND, UH, DOING SOMETHING ABOUT WHATEVER IT IS THAT WE CAN, UH, TO HELP FOLKS THROUGH THIS EXPERIENCE. 
          SO WE HAVE A, AT LEAST AN ASSET THAT WE'RE BRINGING ONLINE, AND IT'S IN CONCERT WITH OTHER EFFORTS HERE IN THE CITY. 
          THANK YOU, CLAUDE. 
          THOSE ARE ALL MY COMMENTS. 
          UH, THANK YOU, CLAUDE, DR. 
          AGA, THE WHOLE TEAM THAT WAS HERE TODAY. 
          UM, THIS WAS REALLY, UM, KIND OF A, A LUXURY THAT WE WERE ABLE TO, TO DELVE INTO ONE TOPIC, UH, WELL, WHICH IS LIKE A HUNDRED TOPICS. 
          UH, SO, SO MUCH. 
          UM, I, AND JUST A, A COMMENT TO, UH, THE COMMITTEE MEMBERS, UH, WHEN WE, WE, WHEN I FIRST MET WITH YOU, WHEN YOU CAME ON BOARD TO THIS COMMITTEE, I DID ASK WHAT YOU WERE INTERESTED IN, IN HEARING, AND YOU GAVE ME SOME THOUGHTS. 
          PLEASE KNOW THAT THAT INVITATION STANDS OPEN. 
          UM, OBVIOUSLY TODAY WE TOUCHED ON A LOT OF TOPICS. 
          UM, SO FEEL FREE TO, TO TOUCH BASE WITH ME ABOUT OTHER ISSUES THAT YOU'D LIKE TO SEE, UH, BROUGHT FORWARD. 
          UM, AND WITH THAT, UH, WE'LL CONCLUDE OUR MEETING FOR TODAY. 
          THANK YOU VERY MUCH. 
          THANK YOU.
* 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.