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6:00 PM I'M GONNA CALL ROLL, UH, COUNCIL MEMBER MICKEY RODRIGUEZ.
WELCOME EVERYBODY TO OUR OCTOBER 27TH MEETING OF THE COMMUNITY HEALTH ENVIRONMENT AND CULTURE, UH, COMMITTEE.
AND WE'RE GONNA GET A LOT OF ENVIRONMENT AND HEALTH TODAY.
UH, WE'LL SAVE THE CULTURE FOR, FOR ANOTHER, ANOTHER MEETING.
UH, THANK YOU TO ALL OUR GUESTS WHO ARE HERE TO SUPPORT ON THE I VERY IMPORTANT ITEMS THAT WE'RE HEARING TODAY.
AND THANK YOU TO MR. MCCAREY FOR PULLING IT ALL TOGETHER, UH, SEAMLESSLY.
AS, AS ALWAYS, YOU'RE WELCOME AND TO A SPECIAL LITTLE HELPER OVER THERE,
UM, WE ALSO HAVE SPECIAL GUESTS, UH, FROM AUSTIN.
IS THAT RIGHT? IS T C Q HERE IN THE, OKAY.
UM, SO WE'LL BEGIN WITH, UM, A
[Approval of Minutes ]
CONSIDERATION OF THE MINUTES OF THE OCTOBER 4TH MEETING.I MAKE A MOTION TO, I MAKE A MOTION TO APPROVE.
UM, OUR FIRST, UH, ITEM WILL BE, LET'S SEE, UM,
[Briefing and Possible Action on ]
WE'RE GOING TO START WITH THE T C E Q, UH, BRIEFING, BUT I BELIEVE WE'RE GONNA SWITCH, UM, AND DO THE INSULIN COST SHARE PROGRAM FIRST, AND THEN WE'LL DO THE, SORRY, SECOND.AND THEN WE'LL DO THE, UM, HOLD ON.
WE WILL TAKE THE T C E Q ITEM NEXT.
FOLLOWING THAT, WE WILL TAKE THE INSULIN ITEM AND FOLLOWING THAT, WE WILL TAKE THE FOOD ITEM.
UM, SO, UH, CLERK, IF YOU COULD PLEASE READ THE, THE CAPTION AND WE'LL GET GOING.
A BRIEFING BY THE TEXAS COMMISSION ON ENVIRONMENTAL QUALITY ON PLANNING ACTIVITIES FOR BEXAR COUNTY OZONE NON-ATTAINMENT.
GOOD AFTERNOON, MADAM CHAIR COMMITTEE MEMBERS.
MARIO MARTINEZ, ASSISTANT DIRECTOR AT METRO HEALTH.
UM, PRESENTING TODAY'S, UH, SPEAKER FROM T C E Q, ALLISON STOKES, WHO'S BEEN WITH THE T C E Q SINCE 2017, UH, SINCE 2015, AND HAS BEEN WORKING ON STATE IMPLEMENTATION PLANS SINCE 2017.
ALLISON IS THE STATE IMPLEMENTATION PLAN TEAM LEADER IN THE AIR QUALITY SECTION.
SO TODAY SHE'LL BE TALKING, WE'RE SPEAKING TO YOU ABOUT THE PLANNING ACTIVITIES FOR BEXAR COUNTY ON NON OZONE ATTAINMENT.
I'M ALLISON STOKES WITH THE T C E Q, AND TODAY I'LL BE GOING OVER A LITTLE BIT OF OZONE HISTORY WITH BAYER COUNTY AND THEN WHERE WE ARE GOING FORWARD WITH OUR PLANNING.
SO THE 20 15 8 HOUR OZONE STANDARD IS SET AT 0.07 PARTS PER MILLION, MEANING THAT VALUES OF 70 PARTS PER BILLION OR LESS ARE REQUIRED TO ATTAIN THE STANDARD.
THE E P A INITIALLY DESIGNATED BAYER COUNTY AS MARGINAL NON-ATTAINMENT, AND THE DE DESIGNATION BECAME EFFECTIVE IN SEPTEMBER 24TH, 2018.
SEPTEMBER 24TH, 2021 WAS THE INITIAL ATTAINMENT DATE, WHICH MEANT THAT THE AREA HAD TO ATTAIN THE STANDARD BY THE END OF 2020.
SO ONE OF THE FIRST MAJOR REQUIREMENTS FOR A MARGINAL NON-ATTAINMENT AREA IS SUBMITTING AN EMISSIONS INVENTORY SUPERVISION.
THIS EI C P IS DUE TWO YEARS AFTER THE EFFECTIVE DATE OF DESIGN OF THE DESIGNATION.
SO THE T C E Q DECIDED TO SUBMIT A COMBINED SUPERVISION FOR THE HOUSTON GALVESTON, BRAZORIA AND DALLAS-FORT WORTH AREAS ALONG WITH BAYER COUNTY.
THE SIP ESTABLISHES A 2017 BASE YEAR INVENTORY AND WAS SUBMITTED TO THE E P A ON JUNE 24TH, 2020.
AND THE E P A PUBLISHED THEIR FINAL APPROVAL OF THE SIP ON JUNE 29TH.
MS. ALLISON, UM, COULD I ASK YOU TO, UH, EXPLAIN THE, UM, THE ACRONYMS AS YOU GO ALONG? IT'S A NEW TOPIC FOR SOME OF OUR COMMITTEE MEMBERS.
SO THE EMISSIONS, SO THE SIP IS THE STATE IMPLEMENTATION PLAN, AND THEN EMISSIONS INVENTORY IS THE, THE E I C P.
UM, THERE'S, THERE'S A LOT OF ACRONYMS THROWN AROUND IN THIS ONE, SO I'LL
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TRY AND KEEP TRACK.AND THEN E P A ENVIRONMENTAL PROTECTION AGENCY.
SO NATIONAL AMBIENT AIR QUALITY STANDARDS, OR KN, ARE WHAT THE STANDARDS ARE THAT WE ARE FOLLOWING THAT ARE SET BY THE CLEAN AIR ACT.
KN COMPLIANCE IS DETERMINED BY AN AREA'S DESIGN VALUE.
THE DESIGN VALUE IS CALCULATED USING DATA FROM EMISSIONS MONITORS.
THE DESIGN VALUE IS THE AVERAGE OF THE FOURTH HIGH EIGHT HOUR DAILY PEAK FROM A SERIES OF THREE YEARS.
SO YOU CAN SEE THAT WE HAVE ON THIS CHART HERE, THE DESIGN VALUES ON THE RIGHT HAND SIDE, AND THEN THE EIGHT HOUR, THE FOURTH HIGH PEAKS ON THE LEFT THREE COLUMNS THAT MAKE UP THE AVERAGE FOR OUR DESIGN VALUES.
SO YOU CAN SEE OVER THE LAST THREE YEARS, THE BAYER COUNTY DESIGN VALUE HAS BEEN OVER THE 70 PARTS PER BILLION STANDARD FOR THE 2015 OZONE STANDARD.
THIS GRAPH SHOWS LOCAL DESIGN VALUE TRENDS OVER THE LAST 10 YEARS.
AND THEN HERE YOU CAN SEE THE COMPARISON TO THE 2008 STANDARD, WHICH IS A 70 PARTS, 75 PARTS PER BILLION STANDARD.
SO THE COUNTY IS STILL BELOW THAT.
HOWEVER, YOU CAN SEE THAT WHILE THERE'S BEEN A DOWNWARD TREND, WE'VE SOMEWHAT PLATEAUED RIGHT ABOVE THAT 70 PARTS PER BILLION STANDARD BAYER COUNTY, ALONG WITH THE DALLAS-FORT WORTH AND HOUSTON GALVESTON BRAZORIA MARGINAL AREAS DID NOT ATTAIN THE STANDARD BY THE END OF 2020.
ON OCTOBER 7TH, THE E P A PUBLISHED FINAL ACTION RECLASSIFYING THESE AREAS TO MODERATE NON-ATTAINMENT EFFECTIVE.
IN JULY OF 2020, THE T C Q SUBMITTED A SECTION 1 79 B SUPERVISION FOR BAYER COUNTY TO THE E P A.
THIS DEMONSTRATION ARGUED THAT BAYER COUNTY WOULD HAVE ATTAINED THE STANDARD, BUT FOUR EMISSIONS FROM MEXICO, THE E P A DISAPPROVED OF THIS 1 79 B DEMONSTRATION AS A PART OF THEIR RECLASSIFICATION ACTION.
FEDERALLY REQUIRED MODERATE CLASSIFICATION SIPS ARE DUE TO THE E P A BY JANUARY 1ST, 2023, AND THIS INCLUDES AN ATTAINMENT DEMONSTRATION AND THEN A REASONABLE FURTHER PROGRESS SUPERVISION ATTAINMENT IS REQUIRED BY THE END OF 2023 IN ORDER TO MEET A SEPTEMBER 24TH, 2024 ATTAINMENT DATE.
SO THIS FIGURE SHOWS THE CLASSIFICATIONS FOR OZONE.
UH, ONCE AN AREA IS DESIGNATED, IT IS GIVEN A CLASSIFICATION BASED ON HOW FAR OVER THE STANDARD.
IT'S, THIS STARTS WITH THE MOST LENIENT MARGINAL CLASSIFICATION ON THE LEFT, AND THEN IT BECOMES MORE STRINGENT AS YOU MOVE TO THE RIGHT.
AN AREA IS BUMPED UP IN CLASSIFICATION, UM, OR AS AN AREA IS BUMPED UP IN CLASSIFICATION, THE REQUIREMENTS COMPOUND.
SO FOR OUR PURPOSES, WE ARE LOOKING AT THE MODERATE REQUIREMENTS FOR PERMITTING.
UM, YOU HAVE NEW MAJOR SOURCE THRESHOLDS, OR YOU, THE MAJOR SOURCE THRESHOLDS WILL STAY THE SAME.
HOWEVER, THE NON-ATTAINMENT NEWS SOURCE REVIEW OFFSET RATIO WILL CHANGE FROM A 1.1 TO ONE RATIO TO A 1.15 TO ONE RATIO.
SO THESE ARE FOR OUR MAJOR SOURCES, AND THAT'S WHAT THE MAIN CONCERN WITH THEM IS THE REQUIRED ATTAINMENT.
DEMONSTRATION SUPERVISION MUST INCLUDE PHOTOCHEMICAL MODELING AS WELL AS REASONABLY AVAILABLE CONTROL TECHNOLOGY AND REASONABLY AVAILABLE CONTROL MEASURES.
AND THEN OUR REASONABLE FURTHER PROGRESS SUPERVISION WILL REQUIRE A 15% REDUCTION IN VOLATILE ORGANIC COMPOUNDS, THOSE EMISSIONS WITHIN A SIX YEAR PERIOD.
SO FINALLY, MODERATE AREAS MUST IMPLEMENT ALSO A VEHICLE INSPECTION AND MAINTENANCE PROGRAM.
I'M SORRY, UM, ALLISON, THAT, THAT LAST SLIDE, WE DON'T HAVE IT WITHOUT THE, UM, BOX OVER IT.
I, I'LL BE ABLE TO SEND YOU AN UPDATED VERSION.
UM, IT'S JUST WITH AN, AN ANIMATION AND I'LL BE ABLE NO, NO, YEAH, WE'RE GETTING A COPY.
I'M JUST WONDERING IF YOU COULD YEAH, IF YOU COULD, OH YEAH, LEAVE THAT UP FOR A MINUTE.
SO ON THIS SLIDE, UM, YOU HAVE, SOMETIMES THE DETAILS ARE A LITTLE BIT HARD TO READ, BUT YOU HAVE THE CLASSIFICATION NAME AT THE TOP.
THEN THE YEARS IN PARENTHESES ARE THE YEARS THAT THE AREA HAS FROM ITS INITIAL POINT OF DESIGNATION TO MEET THAT CLASSIFICATIONS, UM, TO MEET THE STANDARD WITHIN THAT
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CLASSIFICATION.SO WHEN THE AREA WAS INITIALLY DESIGNATED MARGINAL, IT WOULD'VE HAD THREE YEARS.
HOWEVER, NOW THAT IT'S BEING DESIGNATED MODERATE, YOU SORT OF TACK ON AN ADDITIONAL THREE YEARS FOR A CUMULATIVE SIX YEARS.
AND THEN AT THE BOTTOM YOU HAVE FOR THE PERMITTING PURPOSES FOR MAJOR SOURCES, THE THRESHOLD LEVELS THAT INCREASE IN COMPOUND ON ONE ANOTHER.
SO WHEN THE E P A CLASSIFIES AN OZONE NON-ATTAINMENT AREA AS MODERATE PROGRESS TOWARD MEETING THE STANDARD IS REQUIRED.
THIS PROGRESS IS DEFINED BY THE E P A OR BY THE FEDERAL CLEAN AIR ACT FOR MODERATE NON-ATTAINMENT AREAS AS A 15% REDUCTION IN EMISSIONS BETWEEN A STARTING POINT YEAR, WHICH IS KNOWN AS THE BASE YEAR, AND THEN THE ATTAINMENT YEAR FOR BAYER COUNTY.
THE STARTING YEAR OR THE BASE YEAR IS 2017, AND THEN THE ATTAINMENT YEAR FOR THE 2015 OZONE STANDARD FOR A MODERATE AREA IS 2023.
SO THAT'S THE PERIOD IN TIME IN WHICH THE COUNTY WOULD HAVE TO MAKE THAT 15% REDUCTION.
SINCE IT'S BAYER COUNTY'S FIRST TIME TO BE CLASSIFIED AS MODERATE NON-ATTAINMENT UNDER ANY OZONE STANDARD, THE CLEANER ACT CLEAN AIR ACT REQUIRES THAT BAYER COUNTY, UM, FOCUS ON V O C EMISSIONS, UH, AS OPPOSED TO EMISSIONS FROM ANOTHER OZONE PRECURSOR, WHICH IS NITROGEN OXIDES.
A REDUCTION IN V O C EMISSIONS CAN BE ACHIEVED BY IMPLEMENTING RULES TO CONTROL SOURCES OF V O C EMISSIONS.
THEN AS A FAIL SAFE, IF PROGRESS ISN'T DEMONSTRATED, THEN CONTINGENCY IS AUTOMATICALLY IMPOSED TO ACHIEVE AN ADDITIONAL 3% REDUCTION IN 2024.
SO THIS WOULD'VE BEEN THE YEAR AFTER THAT 2023 ATTAINMENT YEAR
SO THERE ARE FOUR TYPES OF EMISSION INVENTORIES, AND THEN YOU CAN SEE THE BREAKDOWN OF EACH OF THESE EMISSION INVENTORIES INTO EACH OF THESE COLUMNS FOR EACH YEAR, THE THE ONE THAT WE'RE REALLY FOCUSING ON IS THE LARGEST GRAY PORTION, WHICH ARE THE AREA SOURCES.
AND AREA SOURCES ARE SMALLER STATIONARY SOURCES OF EMISSIONS.
AT THE TOP IN THE BLUE, WE HAVE, UM, NON ROAD MOBILE SOURCES, WHICH ARE THINGS LIKE OFFERED EQUIPMENT AND OR CONSTRUCTION AND LAWN EQUIPMENT.
AND THEN IN THE YELLOW WE HAVE ON-ROAD MOBILE SOURCES, WHICH ARE CARS AND TRUCKS.
AND THESE, THOSE SOURCES ARE REGULATED BY THE FEDERAL GOVERNMENT.
AND THEN FINALLY AT THE BOTTOM WE HAVE OUR POINT SOURCES, AND THESE ARE THE LARGE INDUSTRIAL SOURCES LIKE POWER PLANTS AND CEMENT PLANTS.
SO SAN ANTONIO IS UNIQUE FROM OTHER NON-ATTAINMENT AREAS LIKE D F W OR H G B, BECAUSE THAT POINT SOURCE, UM, PORTION IS SO SMALL COMPARED TO YOUR LARGER AREA SOURCES.
SO AS YOU CAN SEE FROM THIS CHART, UH, THE VAST MAJORITY OF V O C COMES FROM AREA SOURCE EMISSIONS, AND THAT IS 74% IN 2020.
SO WHAT IS AN AREA SOURCE? THESE ARE SMALL, INDUSTRIAL, COMMERCIAL AND RESIDENTIAL SOURCES THAT GENERATE EMISSIONS THAT DON'T MEET THE DEFINITIONS FOR LARGER SOURCES LIKE POWER PLANTS OR CEMENT PLANTS.
T C Q STAFF HAVE DEVELOPED AREA SOURCE EMISSIONS INVENTORIES AS COUNTYWIDE TOTALS USING TEXAS SPECIFIC METHODS.
AND WE TRY TO USE TEXAS SPECIFIC METHODS WHENEVER POSSIBLE AS OPPOSED TO THE E P A DEFAULTS.
EXAMPLES OF AREA SOURCES INCLUDE, UM, CONSUMER AND COMMERCIAL PRODUCTS, SURFACE COATING, GAS STATIONS, AND THEN HOUSEHOLD PRODUCTS.
SO THERE ARE HUNDREDS OF SOURCES OF CATEGORIES OF AREA SOURCES THAT GENERATE VOCS OR VOLATILE ORGANIC COMPOUNDS.
SO MANY THAT WE ACTUALLY DON'T HAVE SPACE TO INCLUDE THEM ALL ON THIS CHART.
SO THIS FIRST CHART HERE SHOWS, UM, AREA SOURCE CATEGORIES THAT CONTRIBUTE 5% OR MORE TO THE TOTAL AREA SOURCE VOLATILE ORGANIC COMPOUND EMISSIONS DURING OUR STARTING YEAR FOR THE SUPERVISION, WHICH IS THAT 2017 BASE YEAR.
AND THEN NOT SHOWN IN THIS TABLE ARE THE
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108 CATEGORIES OF AREA SOURCE VIEW C EMISSIONS THAT RANGE BETWEEN 0.0001% AND 4%.UM, SO REALLY THE, THE MESSAGE HERE IS THAT THERE IS, IF WE'RE LOOKING AT V O C AS A A PIE, WE HAVE MANY, MANY TINY, TINY SLICES OF PIE THAT ARE CONTRIBUTING TO THIS ONE LARGE CHUNK OF, OF U O C EMISSIONS.
SO THE T C E Q IS REQUIRED TO ADOPT RULES THAT IMPLEMENT REASONABLY AVAILABLE CONTROL TECHNOLOGY OR RACT IN MODERATE NON-ATTAINMENT AREAS.
THE VOLATILE ORGANIC COMPOUND RULES IMPLEMENTING RACT ARE IN 30 TEXAS ADMINISTRATIVE CODE CHAPTER ONE 15, AND THEY APPLY ON A COUNTY BY COUNTY BASIS.
SO THESE ARE ALREADY IN PLACE FOR THE HOUSTON GALVESTON, BRAZORIA AND D F W COUNTIES.
UM, BAYER COUNTY IS SUBJECT TO SOME CHAPTER ONE 15 REQUIREMENTS, BUT THE APPLICABILITY WILL BE EXPANDED SUCH THAT THESE REQUIREMENTS WILL BE MORE IN LINE WITH THE WHAT'S ALREADY IN PLACE IN HOUSTON, GALVESTON, BRAZORIA, AND THEN THE D F W AREA.
WE CAN COUNT ON REDUCTIONS FROM THE RACKED RULES TOWARDS REASONABLE FURTHER PROGRESS.
HOWEVER, THESE REDUCTIONS ARE RELATIVELY SMALL BECAUSE THEY'RE NOT THE KIND OF LARGE AND INDUSTRIAL SOURCES IN BAYER COUNTY, OR WE DON'T HAVE THE SAME SORTS OF SOURCES IN BAYER COUNTY AS YOU DO IN HOUSTON AND IN DALLAS.
SO RULES WOULD NEED TO BE IMPLEMENTED IN 2023 IN ORDER TO TAKE CREDIT TOWARDS THAT FURTHER PROGRESS.
ADDITIONALLY, MANY OF THE RULES THAT IMPLEMENT RACKED ARE OLDER RULES THAT HAVE BY NOW BEEN SURPASSED IN STRINGENCY BY OTHER REQUIREMENTS SUCH AS NEW SOURCE REVIEW, PERMITTING REQUIREMENTS AND FEDERAL RULES LIKE THE NEW SOURCE PERFORMANCE STANDARDS AND MAXIMUM ACHIEVABLE CONTROL TECHNOLOGY STANDARDS.
AS A RESULT, WE WON'T SEE MANY REDUCTIONS FROM IMPLEMENTING VOLATILE ORGANIC COMPOUNDS RACKED IN SAN ANTONIO, AND WE WILL NEED TO SEEK OUT OTHER REDUCTION STRATEGIES IN ORDER TO MEET THAT 15% REQUIREMENT.
WE ARE ALSO REQUIRED TO IMPLEMENT REASONABLY AVAILABLE CONTROL MEASURES, WHICH IS ANOTHER ONE OF THOSE FUN ACRONYMS WITH RACKHAM.
UM, AND THIS IS TO ENSURE THAT WE CAN MODEL ATTAINMENT IN BAYER COUNTY.
SO BECAUSE OZONE FORMATION IN BAYER COUNTY IS DRIVEN BY NITROGEN OXIDES, THESE STRATEGIES WILL LIKELY BE ADDITIONAL NITROGEN OXIDE CONTROLS FOR CERTAIN SOURCES.
UM, I ACTUALLY HAD TO WORK WITH OUR TECHNICAL STAFF THIS MORNING TO SORT OF WORK THROUGH THIS CHART, BUT, UH, T C Q DID A STUDY TO SEE WHAT WOULD HAPPEN TO OUR DESIGN VALUE IF WE DID A 20% REDUCTION ACROSS THE BOARD OF ALL ANTHROPOGENIC NITROGEN OXIDE EMISSIONS, WHICH IS GOING TO BE THAT BLUE, THOSE BLUE BARS, AND THEN WHAT WOULD HAPPEN WITH A 20% ACROSS THE BOARD REDUCTION OF VOCS OR VOLATILE ORGANIC COMPOUNDS.
AND THAT'S THE SORT OF ORANGE BAR.
AND YOU CAN SEE THAT 20% IS A SUBSTANTIAL AMOUNT OF KNOCKS THAT'S BEING REMOVED, AND THAT 20% WILL ONLY GET US ROUGHLY A ONE PART PER BILLION DECREASE ON THAT DESIGN VALUE VERSUS THE SAME STUDY IN D F W AND HOUSTON WHERE YOU GET SOMETHING LIKE A TWO TO THREE DECREASE IN YOUR PART OR IN YOUR, UM, DESIGN VALUE FOR OZONE.
LUCKILY, THE SAN ANTONIO AREA IS SO CLOSE TO THE STANDARD THAT THAT ONE PER ONE PART PER BILLION DECREASE IS EXTREMELY VALUABLE.
UM, BUT IT SHOWS THAT SMALLER REDUCTIONS IN NOX ARE GOING TO BE MET WITH A SMALLER IMPACT ON THE OVERALL OZONE LEVELS.
THE 15% VOLATILE ORGANIC COMPOUND REDUCTION REQUIREMENT IS GOING TO BE CHALLENGING TO DEMONSTRATE BECAUSE OF THE AREA SOURCES, PARTICULARLY CONSUMER GOODS BEING THE MAIN CONTRIBUTOR TO V O C EMISSIONS.
CURRENTLY, THE T C E Q CANNOT DEMONSTRATE THE
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REQUIRED 15% REDUCTION WITH CONTROL MEASURES THAT WE ARE AWARE OF IN THE COUNTY.SO WE ARE LOOKING AT QUANTIFYING ANYTHING THAT WE CAN BEFORE 2023.
AND THIS IS, WE'VE BEEN QUANTIFYING FEDERAL MEASURES.
WE HAVE BEEN DOING A LOT OF OUTREACH TO INDUSTRY GROUPS TO SEE WHAT MEASURES ARE ON THE BOOKS THAT WE MIGHT NOT HAVE KNOWLEDGE OF THAT WE CAN QUANTIFY AND BRING IN SO THAT WE CAN MEET THAT 15%
EACH OZONE NON-ATTAINMENT AREA IS DIFFERENT, BUT GENERALLY SPEAKING, THE T C E Q ASSESSES THE FOLLOWING ASPECTS WHEN CONSIDERING CONTROL STRATEGIES.
THIS INCLUDES HOW EFFECTIVE THE CONTROL MEASURE WILL BE AT REDUCING OZONE FORMATION.
HOW MUCH WILL THE REDUCTIONS COST? WHO IS THAT COST GOING TO IMPACT? IS IT GOING TO BE INDUSTRY, WILL IT BE CONSUMERS? AND THEN WHEN WILL THOSE REDUCTIONS OCCUR AND CAN WE BRING THOSE REDUCTIONS IN THE AREA? UM, WILL THOSE REDUCTIONS ACTUALLY BRING THE AREA INTO ATTAINMENT BY THE ATTAINMENT DEADLINE OR WILL THEY HELP WITH MEETING THAT REASONABLE FURTHER PROGRESS? 15%.
SO WE'VE, AGAIN, WE'VE BEEN SEEKING INPUT FROM, FROM GROUPS ON V O C REDUCTIONS THAT WE MAY BE ABLE TO IMPLEMENT, UM, AND INCLUDE AND QUANTIFY FOR OUR SIP.
AND THEN THIS IS CONTACT INFORMATION FOR ALL OF OUR TECHNICAL SPECIALISTS THAT ARE CURRENTLY WORKING ON BAYER COUNTY.
WE HAVE BRIAN FOSTER, WHO IS OUR, UM, SAN ANTONIO AREA PROJECT MANAGER, AND THEN JILL DICKEY HALL AND DANIELLE NESS IL, WHO WORK ON THE EMISSIONS INVENTORIES AND REALLY CALCULATING WHERE THOSE EMISSIONS ARE COMING FROM FOR THE AREA AND HOW THAT'S WORKING TO MEET R F P.
AND THEN WE HAVE BOB GIFFORD WHO WORKS IN AIR MODELING AND DATA ANALYSIS AND LOOKS AT HOW, HOW OUR SIP IS STRUCTURED AND HOW WE CAN MODEL OUT THE FUTURE TO SEE WHAT DIFFERENT POTENTIAL RULES OR CONTROL STRATEGIES WILL HELP US MEET OUR END GOALS.
SO DO Y'ALL HAVE ANY QUESTIONS THAT HOPEFULLY I CAN ANSWER, AND IF NOT, I CAN TAKE THEM BACK TO THE OFFICE AND TRY TO FIND ANSWERS FOR YOU.
THANK YOU, ALLISON, FOR YOUR PRESENTATION.
UM, AND THANK YOU TO THE, UH, METRO HEALTH STAFF WHO'S HERE, UH, WHO'VE BEEN WORKING ON THIS ISSUE FOR SUCH A LONG TIME.
UH, THE REASON I HAD REQUESTED THIS BRIEFING FOR THIS PARTICULAR COMMITTEE IS, WELL, IN ONE PART WE ARE THE ENVIRONMENT COMMITTEE, BUT IN THE OTHER PART, WHEN WE GO INTO MODERATE NON NON-ATTAINMENT, THERE WILL BE SOME REQUIREMENTS THAT WE WILL NOT HAVE A CHOICE ON WHETHER OR NOT THEY GET IMPLEMENTED.
AND THESE REQUIREMENTS MAY AFFECT INDIVIDUALS OF LOWER INCOME.
AND I WANT THIS COMMITTEE TO START THINKING ABOUT HOW WE'RE GOING TO ADDRESS THAT.
UM, I DIDN'T SEE ANY MENTION OF THESE.
UH, AND THIS IS THE I N M UH, CONTROLS.
UM, COULD YOU GIVE US A SENSE A OF WHAT THOSE ARE? SO MY UNDERSTANDING IS THAT IT'S EMISSIONS TESTING ON OLDER VEHICLES, BASICALLY.
AND WHEN AND HOW THOSE WOULD BE IMPLEMENTED IN BEXAR COUNTY.
SO EMISSIONS VEHICLE TESTING IS ON ALL VEHICLES.
UM, I KNOW AT LEAST WITH TRAVIS COUNTY, TRAVIS COUNTY VOLUNTARILY ENTERED THE PROGRAM.
UM, BUT THERE IS A FEE ASSOCIATES THAT IS ON TOP OF THE, THE SAFETY INSPECTION THAT, UM, THAT YOU WOULD NORMALLY HAVE WHEN YOU REGISTER YOUR VEHICLE.
SO IT'S AN ADDITIONAL FEE THAT COMES ALONG WITH THE VEHICLE INSPECTION, UM, THE EMISSIONS TEST.
UM, SO IT IS FOR ALL VEHICLES.
I THINK YOU, THERE MAY BE A PROVISION THERE WHERE A VEHICLE, IF IT'S, UM, UNDER TWO YEARS OLD, THOSE DON'T HAVE TO GET TESTED, BUT THEN YOU SORT OF AGE OUT OF THAT.
UM, AND THEN THE VEHICLE I AND M PROGRAM, I DON'T KNOW THE EXACT DATES OF WHEN IT WOULD NEED TO BE IMPLEMENTED.
UM, SO I WILL HAVE TO LOOK AT THAT AND SEE EXACTLY WHEN.
YEAH, WHAT I THINK WHAT WOULD BE HELPFUL FOR, FOR THIS BODY IS KNOWING WHEN THE IMPACTS ARE GOING TO TAKE PLACE AND THEIR EXTENT AND WHO WE COORDINATE WITH, UH, ABOUT THEM.
SO FOR INSTANCE, IF MY VEHICLE DOES NOT PASS INSPECTION, UM, WHAT RECOURSE DO I HAVE TO REPAIR IT? IS THAT ENTIRELY ON MY, ON MY DIME OR IS THERE, UM, IS THERE, ARE THERE PUBLIC FUNDS AVAILABLE FOR THAT? AND WHO MANAGES THOSE?
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DO YOU KNOW?UM, SO THERE HAS BEEN A PROGRAM DESIGNED TO HELP PEOPLE, UM, RETROFIT THEIR VEHICLES IF THEY FAIL INSPECTION.
IT'S JUST NOT IN EFFECT AT THE MOMENT.
SO I GUESS DEPENDING ON THE TIMEFRAME FOR IMPLEMENTATION OF EMISSIONS TESTING, IT MIGHT BE INCUMBENT UPON THIS BODY TO RECOMMEND TO THE, UM, INTERGOVERNMENTAL RELATIONS COMMITTEE OR BEFORE WE APPROVE OUR, UM, OUR STATE LEGISLATIVE AGENDA TO ADVOCATE FOR SOMETHING ALONG THOSE, THOSE LINES.
UM, I'M GONNA OPEN IT UP TO, UH, COUNCIL MEMBER QUESTIONS, UH, BEFORE WE, WE WRAP UP.
SO, UM, ARE THERE ANY QUESTIONS AT THIS TIME? HMM.
OH, YOU'RE STILL REPEATING? OKAY.
YES, IT WAS A VERY TECHNICALLY INTENSE, UH, PRESENTATION.
UM, WHILE YOU'RE READING THAT, I'M JUST GONNA SAY A FEW WORDS.
SO I, I KNOW IT'S TECHNICALLY INTENSE, BUT IT JUST A REMINDER, OZONE IS, UH, A HARMFUL LUNG IRRITANT, AND YOU'VE HEARD ME SAY THIS A BUNCH OF TIMES, RIGHT? IT'S BAD FOR US.
IT, UM, ESPECIALLY FOR, UM, THE ELDERLY PEOPLE WITH, UH, C O P D OR BRONCHITIS AND CHILDREN.
SO, UM, IT'S IMPORTANT FOR US TO GET THIS UNDER, UNDER CONTROL.
UM, ONE OBSERVATION THAT COUNCILWOMAN, YOU HAVE A COMMENT? YEAH.
SO MY, NOW THAT WE'RE IN MODERATE ATTAINMENT AND, UH, COUNCILMAN SANDOVAL, DO Y'ALL HAVE SOMETHING YOU COULD SEND DOWN? WE'RE IN MODERATE YEAH.
THAT WHERE WE COULD KIND OF COMMUNICATE WITH OUR CONSTITUENTS IF THEY HAVE AN OLDER VEHICLE OR, UM, WHAT, BECAUSE WE DO THE OZONE ALERT DAYS AND THINGS LIKE THAT, AND THAT COMES OUT IN AN, UH, ENGLISH AND SPANISH AND THE CITY DOES A GOOD JOB.
BUT IF, IF THERE ARE THINGS THAT WE NEED TO DO, DO Y'ALL PROVIDE THAT FOR THE CITY OR FOR COUNCIL DISTRICTS IN PARTICULAR? SOME MARKETING.
I CAN, I CAN LOOK INTO WHAT RESOURCES WE HAVE, UM, AND I KNOW THAT WE'VE BEEN INCREASING OUR SPANISH OUTREACH AS WELL.
UM, BUT I CAN, I CAN SEE WHAT WE HAVE EXISTING AND WHAT WE WOULD MAKE AVAILABLE IN THE FUTURE FOR YOU, JUST BECAUSE WE PUSH THAT THEY GET THEIR CARS INSPECTED AND IF THEY, IF THEIR EXPECTATION IS TO PAY ONE AMOUNT AND THEN THEY COME AND IT GETS TOLD, I DON'T WANT THEM TO THINK THAT THE, THAT THE PERSON DOING THE INSPECT INSPECTION IS TRYING TO TAKE 'EM FOR A RIDE OR ANYTHING, SO.
AND THEN I, THE TIMEFRAME FOR IMPLEMENTATION OF THE ACTUAL I AND M PROGRAM IS, I, I WANNA SAY IT'S WITHIN FOUR YEARS OF THE, UM, EFFECTIVE DATE OF THIS BUMP UP, UM, OR THE RECLASSIFICATION TO MODERATE.
I JUST, I DON'T HAVE IT IN FRONT OF ME, SO I DON'T WANNA GIVE YOU AN ACTUAL TIMEFRAME WITHOUT HAVING THAT INFORMATION.
IT'S, I, I CAN'T SPEAK TO WHAT'S, WHAT HAS HAPPENED WITH THE RECYCLING PLANS.
I WOULD HAVE TO GO BACK AND AND ASK FOR YOU ON THAT ONE.
'CAUSE I'M TRYING TO, TO MEASURE, RIGHT? UH, HAVING, UH, PEOPLE OF SAN ANTONIO OR ALL THROUGHOUT THE UNITED STATES, THAT'S IMPORTANT TO GO WHEN THEY GO GET THEIR INSPECTION, THAT IT'S NOT REDUCING, UM, RELEASING RATHER A LOT OF EMISSIONS.
BUT, YOU KNOW, THERE ARE THESE LARGER COMMERCIAL BUSINESSES.
I WANNA UNDERSTAND WHAT THOSE STANDARDS ARE FOR COMMERCIAL BUSINESSES AND THE STANDARDS THAT THEY HAVE TO COME AND BE WITHIN COMPLIANCE OF.
DO WE KNOW THAT? OR? I, I DON'T, BUT I CAN, I CAN FIND AN ANSWER FOR YOU.
AND MARIA, IF WE COULD SPEAK AFTERWARD ABOUT POTENTIALLY BRINGING THAT INFORMATION FORWARD.
GO, GO AHEAD, MARIA, IF YOU HAVE ANY COMMENTS.
UM, SO IN THE CITIES, UH, OZONE ATTAINMENT MASTER PLAN, UH, SINCE WE DON'T HAVE REGULATORY, UM, UH, SORT OF THAT AUTHORITY FOR, UM, THOSE TYPES OF BUSINESSES, UM, MOST OF WHAT YOU SEE IN THE PLAN IS, LIKE YOU SAID, UH, EDUCATIONAL, WORKING WITH STAKEHOLDERS ON HOW DO WE REDUCE OZONE IN SAN ANTONIO.
UM, SO IT'S REALLY WORKING WITH T C E Q TO KIND OF LOOK AT, UM, WHAT ARE THE EMISSIONS, WHAT TYPE OF EMISSIONS, AND HOW WE CAN DO BETTER BY WORKING WITH, UH, BY WORKING WITH, UM, T C Q.
SO SPECIFICALLY WHEN, UM, T C Q RELEASES THEIR, UH, STATE IMPLEMENTATION PLAN, THEN THE CITY AND THE OZONE TECHNICAL COMMITTEE WILL LOOK AT THAT AND SEE HOW WE CAN ALIGN OURSELVES TO HELP IMPROVE AND REDUCE OZONE MISSIONS IN SAN ANTONIO.
AND I ASKED, RIGHT, BECAUSE OF THE COMPOUNDING EFFECTS OF
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NOT ONLY THE VEHICLES, BUT THE ACTUAL, UH, PRACTICE AND WORK THAT'S OCCURRING, UH, WITHIN THEIR BUSINESS.BUT THANK YOU, THANK YOU CHAIR.
THEY CALL IT CUMULATIVE EXPOSURE, AND YOU'RE RIGHT.
ALLISON, DID YOU HAVE, UH, OH, WERE THERE ANY OTHER QUESTIONS, COUNCILMAN? YES.
THANK YOU FOR THE PRESENTATION.
I JUST GOT MY WISDOM TEETH TAKEN OUT YESTERDAY AFTERNOON, SO I'M A LITTLE, SO YOU'RE NOT STRUGGLING
UM, UH, THANK YOU FOR THE PRESENTATION AND THANK YOU CHAIR FOR THE, UH, ACKNOWLEDGEMENT OF, YOU KNOW, INDUSTRY JARGON AND ACRONYMS. I HAD A MEETING WITH, UM, ALANA, OUR DIRECTOR OF COMMUN COMMUNITY ENGAGEMENT, IS THAT THE TITLE? THE OFFICE, C E C E? YES.
AND COMMUNICATIONS AND ENGAGEMENT.
AND, UM, SHE HAD MENTIONED HOW ACRONYMS AREN'T, UH, ACCESSIBLE FOR A LOT OF PEOPLE, AND IT'S NOT JUST US RECEIVING THIS PRESENTATION, BUT THERE'S PEOPLE WATCHING AT HOME.
AND SO I WANNA MAKE SURE THAT WE'RE AS ACCESSIBLE AS POSSIBLE, AND WE DON'T MAKE PEOPLE TURN OFF ON VALUABLE INFORMATION.
UM, BASED ON THE PRESENTATION OR MY EXPERIENCES DURING THE PANDEMIC, IS, I WOULD'VE ASSUMED THAT MANY BEHAVIORS CHANGED, UM, BECAUSE MUCH OF THE POPULATION WAS STAYING HOME OR WORKING FROM HOME.
AND I'M WONDERING, IT DIDN'T FEEL LIKE I SAW THAT REFLECTED TOO MUCH IN THE DATA.
SO WHAT DO YOU, WHAT WAS YOUR TAKE ON THAT? I KNOW THAT THIS HAS BEEN LOOKED AT BY, UM, IN AUSTIN, AND I KNOW THAT THE, UM, COUNCIL OF GOVERNMENTS IN THE D F W AREA AND THE HOUSTON GALVESTON BRAZORIA AREA HAVE ALSO BEEN SORT OF RESEARCHING THIS PHENOMENON OF WHAT HAPPENED WHEN EVERYONE STAYED HOME.
AND I KNOW THAT IN SOME CASES, UM, THE TRENDS THAT YOU WOULD HAVE EXPECTED TO SEE DIDN'T HAPPEN BECAUSE YOU, THE SHIFT IN IT WAS REALLY A SHIFT IN WHEN PEOPLE WERE DRIVING MM-HMM.
SO YOU WOULD HAVE, INSTEAD OF NECESSARILY A, UM, AM AND PM RUSH HOUR, IT WAS MORE SPREAD OUT EVENLY THROUGHOUT THE DAY.
AND THEN YOU HAD AN INCREASE IN SHIPPING.
SO FROM PEOPLE STAYING HOME, THE REDUCTIONS THAT YOU MAY HAVE SEEN THERE WERE REPLACED BY AN INCREASE IN DELIVERY TRUCKS.
UM, SO I, I THINK THAT'S KIND OF WHAT THEY HAD SEEN, AT LEAST IN STUDIES IN THE D F W AND HOUSTON, GALVESTON BRAZORIA AREAS.
AND I FOR, FOR MOBILE SOURCE EMISSIONS.
AND I, UM, A LOT OF OUR PRESENTATIONS TODAY ARE, UM, GONNA BE ABOUT THE ENVIRONMENT AND ABOUT, UM, HEALTH DISPARITIES.
AND I THINK ABOUT, UH, WITH THE ENVIRONMENT AND ALL OF THESE THINGS, I THINK ABOUT, UM, THE DECLARATION OF RACISM AS A PUBLIC HEALTH CRISIS, AND THERE ARE PARTS OF TOWN THAT ARE, UM, MORE IMPACTED BY THINGS LIKE, UH, THE POWER PLANTS, UM, ALL THE WAREHOUSES AND THE INDUSTRIAL ZONING.
AND SO I'M WONDERING, IS THERE, I MEAN, THERE'S A BREAKDOWN BY COUNTY OF THESE OZONE VALUES, BUT ARE WE ABLE TO SEE MAYBE A HEAT MAP OF WHERE IN THE COMMUNITY OR WHERE IN THE CITY AND COUNTY, UH, YOU KNOW, THE LEVELS ARE WORSE.
I, I DON'T KNOW IF WE HAVE, UM, A SORT OF TOOL FOR THAT DATA AVAILABLE, UM, TO THE PUBLIC, BUT I CAN LOOK INTO WHAT WE MAY HAVE, WHAT RESOURCES WE DO HAVE, UM, TO REALLY DIVE DOWN INTO THAT.
I WONDER IF, UM, MAYBE A SECOND, MAYBE A FOLLOW UP PRESENTATION COULD BE ABOUT THIS, UH, COULD BE A LITTLE BIT, UH, SOLUTION ORIENTED.
SO I THINK WE SAW A SLIDE THAT HAD, UM, SOME OF THE SOURCES, MAYBE IF YOU COULD COME BACK WITH RECOMMENDATION, IF, IF THE CHAIR WILL ALLOW, UM, MAYBE COME BACK WITH RECOMMENDATIONS ON WHAT CAN THE CITY DO, WHAT SHOULD WE BE PROMOTING, WHAT ARE THE INVESTMENTS THAT WE SHOULD BE MAKING, WHETHER THAT'S, UM, PUBLIC TRANSIT OR, I DON'T KNOW, IT COULD BE ANYTHING.
I THINK BEING AS CREATIVE AS POSSIBLE TO COME UP WITH A PUZZLE PIECE OF A PUZZLE OF SOLUTIONS.
I THINK THAT WOULD BE MY, MY GOAL OF THE CHAIR.
UM, YES, I, UH, I'LL SEE IF WE CAN, UH, BRING SOMETHING BACK LIKE THAT.
AND ALLISON, COULD YOU JUST CLARIFY SOMETHING FOR ME? YOU MENTIONED A 15% REDUCTION IN VOLATILE ORGANIC COMPOUNDS, UM, BUT THEN YOU ALSO MENTIONED THAT ACTUALLY IT'S NITROGEN OXIDES THAT DRIVE OUR OZONE.
SO ARE WE GOING TO BE REQUIRED TO REDUCE BOTH? SO, OZONE IS CREATED INFORMED BY A SORT OF COMBINATION OF OUR CHEMICAL REACTION BETWEEN, UM, BOTH VOLATILE ORGANIC COMPOUNDS AND NITROGEN OXIDES AND SUNLIGHT.
SO WE CALL THE VOLATILE ORGANIC COMPOUNDS AND THE NITROGEN OXIDES
[00:35:01]
OZONE PRECURSORS, AND THOSE ARE WHAT ARE ACTUALLY REGULATED AS OPPOSED TO OZONE ITSELF.UM, THE REASONABLE FURTHER PROGRESS PORTION FOCUSES ON THAT 15% VOLATILE ORGANIC COMPOUND, UM, COMPONENT.
HOWEVER, TO DEMONSTRATE ATTAINMENT, YOU ALSO NEED TO FOCUS ON THE NITROGEN OXIDE PIECE OF IT.
SO IF, I DON'T KNOW IF THIS CHART, SO, SO THERE'S NOT AN EXACT NUMBER FOR REDUCTION IN NITROGEN OXIDES, IT'S JUST THAT THEY WOULD REDUCING THEM IS GOING TO HELP US DEMONSTRATE ATTAINMENT WHEN YOU RUN THE MODEL.
SO REDUCING NO, SPECIFICALLY IN SAN ANTONIO HAS A HIGHER IMPACT ON THE OVERALL REDUCTION OF YOUR DESIGN VALUE, AND THAT'S TOWARDS DEMONSTRATING ATTAINMENT.
AND THEN YOU HAVE THAT SEPARATE PIECE FOR DEMONSTRATING REASONABLE FURTHER PROGRESS, WHICH BECAUSE OF THE WAY THE CLEANER ACT IS STRUCTURED, AND BECAUSE SAN ANTONIO AND BEXAR COUNTY HAVE NOT BEEN MARGIN OR MODERATE NON-ATTAINMENT BEFORE, THEY'RE SORT OF EXCLUSIVELY TIED TO THAT VOLATILE ORGANIC COMPOUND REDUCTIONS.
UM, SO THE NEXT STEPS ARE YOU'RE RECEIVING COMMENTS ON POTENTIAL REDUCTION MEASURES UNTIL THE END OF 2023.
SO WE, WE ARE STILL IN OUR PLANNING PHASES, AND WE ARE CONDUCTING OUTREACH TO INDUSTRY GROUPS TO WORK TOWARDS HOW DO WE BUILD IN CONTROL SOURCES AND CONTROL STRATEGIES INTO OUR MODELS TO DEMONSTRATE ATTAINMENT.
UM, SO WE ARE WORKING ON DEVELOPING THESE CONTROL STRATEGIES AND COMPILING OUR SUPERVISIONS.
UM, AND, BUT SOME OF THEM ARE GOING TO BE BY FOR SURE, RIGHT? LIKE THE EMISSIONS AND, UM, THE EMISSIONS TESTING AND THE, THERE WILL BE A STAFF THAT ARE REQUIRED DISPENSATION.
UH, THANK YOU SO MUCH, VERY MUCH, UH, COMMITTEE MEMBERS FOR, OH, GO AHEAD, COUNCILWOMAN.
OH, I, I DO HAVE ONE LAST QUESTION.
UH, HAS THERE BEEN A RECOMMENDATION BY A METRO HEALTH OR ANY DEPARTMENT ON, UH, A DISTANCE REQUIREMENT OF INDUSTRIAL, UH, RECYCLING PLANTS, UH, A DISTANCE WITHIN RESIDENTIAL, UH, AND INDUSTRIAL HEAVY INDUSTRIAL? UH, IS THERE A RECOMMENDATION THAT METRO HEALTH HAS GIVEN ON WHAT IS HEALTHY, UM, TO BE NEXT DOOR TO RESIDENTIAL? UH, NO MA'AM.
WE, THERE'S NO RECOMMENDATION REGARDING THOSE FACILITIES AND HOW CLOSE THEY ARE TO RESIDENTIAL AREAS.
I, I THINK THAT'S SOMETHING THAT WOULD BE IMPORTANT FOR, UH, US TO EXPLORE AND EVALUATE IS, UM, THE HIGH PERCENTAGE OF ASTHMA NEXT TO THE RECYCLING PLANTS, THE HIGH PERCENTAGE OF CANCER NEXT TO THESE PLANTS.
UM, THAT'S SOMETHING THAT I WOULD LIKE TO SEE.
NOT, NOT THAT THOSE ARE GOOD THINGS, BUT THAT THE, THAT WE WOULD TRY TO ADDRESS THEM, OF COURSE.
WE WILL MOVE ON TO THE ITEM REGARDING THE INSULIN.
UM, CLERK, IF YOU COULD PLEASE READ A CAPTION FOR US, A BRIEFING FROM METRO HEALTH ON COUNCIL CONSIDERATION REQUEST REGARDING THE FEASIBILITY OF AN INSULIN COST SHARE PROGRAM.
UH, CLAUDE JACOB FROM METRO HEALTH.
I'M REPRESENTING THE NASH, NATIONALLY ACCREDITED METRO HEALTH DEPARTMENT.
UH, AGAIN, THIS IS, UH, ITEM FOUR THAT WE'RE DOING FIRST, AGAIN, THIS IS IN RESPONSE TO COUNCIL CONSIDERATION FOR INSULIN COST SHARE PROGRAM.
SO I AM JOINED BY, UH, MEMBERS OF OUR FANTASTIC STAFF.
I DO WANNA THANK JULIUS HUNTER, KATHY SHIELDS, AND DENISE BENOIT MONTEZUMA IN PARTICULAR FOR HELPING TO PUT TOGETHER THIS PRESENTATION.
SO, UH, IN BROAD STROKES, THERE'S A LOT TO COVER HERE.
UM, THIS IS A SECOND PART OF A THREE PART SERIES THAT WE'RE TALKING ABOUT FOR THIS AFTERNOON.
SO WE'LL AT LEAST DO A PRIMER ABOUT DIABETES AND THE IMPACT OF COVID.
UH, WE'LL SHARE WITH YOU FEEDBACK FROM OUR INTERNAL EXTERNAL PARTNERS.
UH, WE'LL TALK ABOUT THE ALIGNMENT OF OUR EFFORT WITH OUR, UH, ESSAY FORWARD PLAN.
AND, UM, WE'LL AT LEAST SHARE WITH YOU THIS PROPOSED, UH, AT LEAST FRAMEWORK AROUND, UH, DIABETES CARE CONTINUUM AND OUR RECOMMENDATION.
SO, JUST, UH, AGAIN, THANK YOU FOR THE OPPORTUNITY TO DISCUSS THIS AND,
[00:40:01]
UM, REALLY IN PARTICULAR, THIS WAS SUBMITTED BY COUNCIL, UM, MEMBERS MCKEE RODRIGUEZ AND ROKA GARCIA BACK ON JANUARY 27TH.THIS IS AN IMPORTANT DISCUSSION FOR THOSE DIAGNOSED WITH DIABETES AND THEIR LOVED ONES.
AS NEARLY 30% OF DIABETICS, OR 7.4 MILLION AMERICANS TAKE INSULIN AS A PART OF THEIR TREATMENT OF THE DISEASE.
INDIVIDUALS WITH DIABETES EXPERIENCE INSULIN RESISTANCE OR AN INSULIN DEFICIENCY, THEY MAY BE DEPENDENT ON INSULIN SUPPLEMENTATION TO LIVE AND MANAGE SYMPTOMS OF THE DISEASE.
UM, THIS MAY BE A LITTLE HARDER TO SEE, BUT JUST KNOW THAT AS WE'VE BEEN TALKING FOR THE LAST COUPLE YEARS ABOUT THE IMPACT OF COVID, THE PANDEMIC HIGHLIGHTED THE NEED TO ADDRESS THE INCIDENT OF DIABETES IN OUR COMMUNITY.
PEOPLE WITH DIABETES ARE MORE LIKELY TO EXPERIENCE SEVERE SYMPTOMS AND COMPLICATIONS FROM C OVID 19.
I'D LIKE TO PROVIDE YOU WITH SOME BACKGROUND ON THE CURRENT STATE OF DIABETES HERE IN BEX COUNTY.
SO, DIABETES IS THE SEVENTH LEADING CAUSE OF DEATH IN BEXAR COUNTY.
OVER 288,000 BEXAR COUNTY RESIDENTS, ALMOST 14 AND A 5% REPORT BEING DIAGNOSED WITH DIABETES.
BEX COUNTY INCIDENTS AND HOSPITALIZATION RATES ARE HIGHER THAN BOTH THE STATE AND NATIONAL AVERAGES OR NATIONAL RATES, AND THE HIGHEST INCIDENTS AND HOSPITALIZATION RATES IN OUR COMMUNITY ARE FOUND AMONG OUR BLACK AND HISPANIC POPULATIONS.
THE HIGHEST INCIDENTS AND HOSPITALIZATION RATES ARE FOUND IN THE NEAR EAST, WEST, AND SOUTH SIDES, PARTICULARLY IN DISTRICTS ONE THROUGH SEVEN, CONSISTENT WITH OTHER RECOGNIZED PATTERNS OF INEQUITIES IN THOSE AREAS.
SO THIS MAP ON THE RIGHT, UH, IS SHOWING THE COVID CASE FATE, RIGHT, UM, CASE, UH, FATALITY RATE, WHICH IS, UH, VERY SIMILAR TO THE MET SHOWING THE DIABETES HOSPITALIZATION RATES ACROSS THE AREA.
THIS IS SIGNIFICANT BECAUSE THOSE WITH UNDERLYING CONDITIONS SUCH AS DIABETES, ARE MORE LIKELY TO EXPERIENCE SEVERE SYMPTOMS OF COVID OR EVEN DEATH.
UH, THEREFORE, IT IS IMPERATIVE TO PREVENT AND OR MANAGE DIABETES IN THESE AREAS IN ORDER TO PREVENT OR AVOID MORE, UH, COVID FATALITY OR ANY OTHER COMMUNICABLE DISEASE IN THE FUTURE.
UM, AGAIN, THIS INFORMATION IS, UH, AVAILABLE THROUGH OUR METRO HEALTH 2020, UH, MORTALITY REPORT.
UH, SO, UH, JUST A QUICK SNAPSHOT IN TERMS OF TYPE ONE, TYPE TWO DIABETES.
ONE KEY TO UNDERSTANDING DIABETES INSULIN THERAPY AND THE NEED WITHIN OUR COMMUNITY IS UNDERSTANDING THE DIFFERENCE BETWEEN TYPE ONE AND TYPE TWO DIABETES.
TYPE ONE DIABETES AFFECTS FIVE TO 10% OF ALL INDIVIDUALS WITH DIABETES.
INDIVIDUALS WITH TYPE ONE DIABETES ARE NOT ABLE TO PRODUCE ANY INSULIN, OR AT ALL ARE VERY LITTLE INSULIN, UH, DUE TO A LACK OF INSULIN, THE BODY IS UNABLE TO PRODUCE THE GLUCOSE IN THE BLOOD FOR USE, UH, BY THE CELLS AS ENERGY.
UH, THOSE WITH TYPE ONE DIABETES MUST HAVE INSULIN SUPPLEMENTATION TO LIVE.
BY CONTRAST, 92, 90 5% OF ALL INDIVIDUALS HAVE DIABETES, THAT HAVE DIABETES, HAVE TYPE TWO DIABETES.
TYPE TWO DIABETES IS WHEN THE BODY DOES NOT RESPOND PROPERLY TO THE INSULIN THAT IS PRODUCED BY THE PANCREAS, THE INDIVIDUAL IS UNABLE TO MAINTAIN PROPER BLOOD GLUCOSE LEVELS.
32, UH, 30% OF TYPE TWO DIABETICS REQUIRE INSULIN TO MANAGE THE DISEASE.
THIS IS USUALLY RECOMMENDED, UH, BY THIS GROUP ONLY IF OTHER TREATMENTS ARE UNSUCCESSFUL.
THE MAJORITY OF THOSE WITH DIABETES, ABOUT 70%, USE OTHER METHODS SUCH AS NUTRITION, PHYSICAL ACTIVITY, AND OTHER MEDICATIONS TO MANAGE THEIR SYMPTOMS. SO I BELIEVE THIS IMPORTANT CONSIDERATION AS WE DEVELOP SOLUTIONS TO THIS POPULATION IN OUR COMMUNITY.
UH, TO ZOOM OUT A BIT, UH, JUST LAST MONTH, THE, UH, US SENATE PASSED THE INFLATION REDUCTION ACT, WHICH INCLUDED ITEMS THAT IMPACT DIABETES CARE.
THE LEGISLATION CAPS THE COST OF INSULIN AT $35 PER MONTH FOR SENIORS WHO HAVE MEDICARE STARTING IN 2023.
IT ALSO CAPS THE COST OF ALL PRESCRIPTION DRUGS AT $2,000 PER YEAR.
FOR SENIORS WHO HAVE MEDICARE PART D IN TIME, THESE MEASURES ARE EXPECTED TO LOWER THE OVERALL INSULIN COST FOR EVERYONE.
THE STATE OF TEXAS HAS ALSO PASSED LEGISLATION TO ADDRESS THE COST OF INSULIN AND DRUG AFFORDABILITY.
TEXAS SENATE BILL 8 27 LIMITS OUT OF POCKET, UH, COPAYS TO $25 FOR EACH INSULIN PRESCRIPTION PER MONTH.
FOR INSURED TEXANS ON STATE REGULATED HEALTH PLANS, THE LAW EXCLUDES THE IN UNINSURED AND INDIVIDUALS WITH PRIVATE INSURANCE TO AID THE UNINSURED TEXAS BILL 18 ESTABLISHED THE TEXAS CARES RX PROGRAM, UH, PRESCRIPTION DRUG SAVINGS PROGRAM THAT COULD POTENTIALLY LOWER INSULIN COSTS BY UP TO 70%.
UH, THE LAW DIRECTS THE TEXAS HEALTH AND HUMAN SERVICES COMMISSION TO NEGOTIATE LOWER PRICES WITH DRUG MANUFACTURERS ON BEHALF OF UNINSURED TEXANS.
THE PROGRAM IS EXPECTED TO BEGIN ALSO IN 2023.
ACCORDING TO THE, UH, AMERICAN, UH, DIABETES ASSOCIATION, ONE OUT OF FOUR INSULIN USERS REPORT THAT COST DOES AFFECT THEIR INSULIN USE AND ADHERENCE TO TREATMENT.
UH, INSULIN PRICES VARY BASED ON THE TYPE OF INSULIN AND HEALTH INSURANCE COVERAGE.
IT CAN RANGE FROM $0 WITH THE SUPPORT OF INSURANCE AND MANUFACTURER DISCOUNTS UP TO $1,500 EACH YEAR.
[00:45:01]
A BIG PART IN WHAT AN INDIVIDUAL WILL PAY FOR THEIR INSULIN PRESCRIPTION.ALMOST 283,000 SAN ANTONIO RESIDENTS ARE UNINSURED.
LACK OF INSURANCE CAN CAUSE INDIVIDUALS TO DELAY OR NEGLECT CARE, CREATING MORE SEVERE COMPLICATIONS DOWN THE LINE WHEN THEIR DIABETES IS LEFT UNTREATED.
SO HEALTH INSURANCE IS CRITICAL FOR INDIVIDUALS WITH DIABETES TO ACCESS SUPPLIES, MEDICATIONS, EDUCATION AND HEALTHCARE, ALLOWING THEM TO MANAGE THEIR, UH, DIABETES AND PREVENT SEVERE COMPLICATIONS.
ENROLLMENT IN THE AFFORDABLE CARE ACT, THE A C A HEALTH INSURANCE PLANS CAN OFFER AN AFFORDABLE OPTION FOR HEALTH INSURANCE.
MANY PHARMACIES HAVE ASSISTANCE PROGRAMS FOR THOSE WHO NEED INSULIN AND CAN'T AFFORD IT.
BOTH H E B AND WALMART OFFER DISCOUNTS AND ASSISTANCE FOR INSULIN AND OTHER DIABETIC CARE PRODUCTS.
UH, THERE ARE ALSO PRESCRIPTION DRUG DISCOUNTS THAT CAN SAVE INDIVIDUALS A HUGE COST OVER THE COST OF THEIR MEDICATIONS, INCLUDING INSULIN.
THE CHALLENGE FOR MANY INDIVIDUALS IS KNOWING HOW TO ACCESS THESE PROGRAMS AND PROVIDING THE INFORMATION NEEDED TO QUALIFY.
SO THIS IS JUST A REMINDER, UH, IN TERMS OF OPTION.
SO, BACK IN, IN MAY, UH, OUR TEAM AT METRO HEALTH, WE PROPOSED THREE OPTIONS TO THE C C R THAT THE GOVERNANCE COMMITTEE, UH, UH, PUT FORTH.
AND SO, UM, UH, OPTION ONE, UH, WAS INCREASED LOBBYING EFFORTS AND SUPPORT FOR LEGISLATION AT THE STATE AND NATIONAL LEVEL THAT WOULD CAP INSULIN PRICES AND EXPAND MEDICAID COVERAGE IN TEXAS.
THIS WOULD BE DONE WITH THE SUPPORT OF CITY COUNCIL AND OUR DEPARTMENT OF GOVERNMENT AND PUBLIC AFFAIRS.
THIS ITEM WOULD BE FORMALLY ADDED TO THE CITY'S, UH, LEGISLATIVE AGENDA.
OPTION TWO WAS TO HIRE DIRECTLY OR SUBCONTRACT THREE PATIENT NAVIGATORS TO HELP INDIVIDUALS ENROLL IN PHARMACEUTICAL DISCOUNT PROGRAMS FOR INSULIN AND ENROLL INTO THE A C A MARKET, UH, MARKETPLACE PLANS.
THIS WOULD NOT ONLY AID INDIVIDUALS IN REDUCING THE COST OF INSULIN, BUT ALSO IN ACCESSING BETTER GENERAL HEALTHCARE AND SPECIFICALLY PREVENTATIVE CARE.
THE THIRD OPTION WAS TO SECURE GENERAL FUNDING FOR DIABETES PREVENTION AND DIABETES SELF-MANAGEMENT EDUCATION, AND A TEAM OF EIGHT DIABETIC, UM, DIABETES HEALTH EDUCATORS.
OUR DIABETES PROGRAM IS CURRENTLY FUNDED THROUGH A COMBINATION OF STATE AND FEDERAL GRANTS.
WE'D LIKE TO ENSURE THAT FUNDING REMAINS CONSISTENT FOR THIS VITAL COMMUNITY PROGRAM, AND IT WILL CONTINUE AFTER THE GRANT TERM IS ENDED.
SO NOW I'LL WALK THROUGH A FEW SLIDES IN TERMS OF, UH, WHAT WE HAVE, UH, BEING PROPOSED THIS AFTERNOON.
SO SINCE THE SPRING, UH, IN THE MONTHS OF JUNE AND AUGUST, FOLLOWING THE GOVERNANCE COMMITTEE, MEETING, OUR TEAM ENGAGED MULTIPLE COMMITTEE STAKEHOLDERS THROUGH, THROUGH MULTIPLE IN-PERSON MEETINGS, VIRTUAL CALLS, UH, AND VIRTUAL CALLS TO GET THEIR FEEDBACK ON AN INSULIN COST SHARE FUND, WHAT THEY SAW AND WHAT WAS THE MOST EFFECTIVE COMPONENTS OF DIABETES CARE, AND HOW THEY WOULD ADMINISTER AN INSULIN FUND.
AND WHAT, UM, WERE THERE PUBLIC PRIOR PUBLIC POLICY PRIORITIES, INCLUDING INSULIN, DIABETES PREVENTION, AND DIABETES CARE ON THE STATE, LOCAL, NATIONAL LEVEL.
THIS FEEDBACK HELPED OUR TEAM THINK THROUGH THE SOLUTIONS THAT ARE MORE COMPREHENSIVE AND SUSTAINABLE.
OUR PARTNERSHIPS HAVE, UH, ALWAYS BEEN CRITICAL TO OUR PROGRAM DEVELOPMENT AND ALLOWING OUR DEPARTMENT TO REACH MORE INDIVIDUALS WITH, WITH MORE RESOURCES.
UM, I'D LIKE TO HIGHLIGHT THAT SOME OF THE CURRENT RELATIONSHIPS HERE, UH, TO STRESS HOW THESE PARTNERS ARE SO VITAL TO THE ONGOING DEVELOPMENT, NOT ONLY IN OUR INITIATIVE, BUT OUR OVERALL DEVELOPMENT OF OUR DIABETES, DIABETES PREVENTION, AND SELF-MANAGEMENT RESOURCES.
UM, OVER THE LAST NINE YEARS, OUR TMM METRO HEALTH HAS HAD A CONTRACT WITH THE Y M C A OF GREATER SAN ANTONIO TO SERVE 300 PARTICIPANTS ANNUALLY THROUGH THE DIABETES PREVENTION AND HEALTHY LIVING WORKSHOPS.
THE Y M C A ALSO HOSTS SICKLE VIA A BIANNUAL C MEDIA EVENT PROMOTING PHYSICAL ACTIVITY AND WELLNESS SINCE ITS START IN 2011.
UH, SO IT'S BEEN OVER 10 YEARS NOW.
SIVIA HAS SEEN OVER A MILLION ATTENDEES FOR OVER 10 YEARS.
THE PARKS AND RECS DEPARTMENT HAS OFFERED THE POPULAR FITNESS IN THE PARK PROGRAM.
LAST YEAR, THEY PROVIDED OVER 3000 FITNESS CLASSES AND SERVED ALMOST 25,000 INDIVIDUALS FROM OUR COMMUNITY.
THE DIABETES PROGRAM COORDINATES FOR WORKSHOPS WITH FITNESS IN THE PARK CLASSES, AND IN THIS, UH, CURRENT FISCAL YEAR, THEY'LL OFFER PARTICIPANTS A FITNESS IN THE PARK CLASS IN THEIR NEIGHBORHOOD AS AN INTEN, AS AN INCENTIVE FOR ATTENDING THE DIABETES WORKSHOPS.
THE SAVE CLINIC IS A NEW PARTNER VOWS, AND THEY SERVED OVER, UH, 4,200 PATIENTS IN, UH, F Y 22.
THE PRIMARY OBJECTIVE OF THIS VASCULAR SURGERY PRACTICE IS TO REDUCE THE NUMBER OF DIABETIC AMPUTATIONS THAT OCCUR DISPROPORTIONATELY IN OUR URBAN CORE ON THE EAST, WEST, AND SOUTH SIDES OF THE CITY.
THE CLINIC REFERS PATIENTS TO OUR DIABETES PROGRAM FOR PREVENTION AND SELF-MANAGEMENT WORKSHOPS, AND IS FOCUSED ON SERVING THE MOST AT RISK UNDERSERVED POPULATIONS.
SO, THROUGH OUR HEALTHY NEIGHBORHOODS PROGRAM, WE PARTNERED WITH THE UT HEALTH INSTITUTE FOR HEALTH PROMOTION RESEARCH TO ESTABLISH A REFERRAL SYSTEM WITH OVER 25 UNIVERSITY WITH MEDICINE ASSOCIATES CLINICS TO REFER TO OUR DIABETES PROGRAM.
THESE PATIENTS CAN ATTEND HEALTH EDUCATION WORKSHOPS
[00:50:01]
AND LEARN HOW TO BETTER MANAGE THE SYMPTOMS OF THEIR DISEASE.AGAIN, IT'S A A LONG LIST OF STAKEHOLDERS.
AGAIN, THIS IS AN ILLUSTRATION OF ESSENTIAL SERVICE NUMBER FOUR, THAT IT IS ABOUT STRENGTHENING AND MOBILIZING PARTNERSHIPS THAT WORK.
AND AGAIN, A SPECIAL SHOUT OUT TO OUR INCREDIBLE STAFFER FOR NURTURING THESE RELATIONSHIPS WITH OUR STAKEHOLDERS AND PARTNERS.
UH, THIS SLIDE, AGAIN, PART OF A NATIONAL FRAMEWORK.
IT MAY BE A LITTLE DIFFICULT TO, UH, TO SEE, BUT JUST KNOW THAT THIS IS THE, UH, BHE MODEL, UM, THE BAY AREA REGIONAL HEALTH INEQUITIES INITIATIVE.
THIS IS A NATIONALLY RECOGNIZED FRAMEWORK USED TO GUIDE PUBLIC HEALTH PROFESSIONALS IN ADDRESSING HEALTH INEQUITIES AND USING SOCIAL DETERMINANTS OF HEALTH IN CREATING HEALTH PROGRAMS AND POLICY.
THIS MODEL HAS INFLUENCED THE COMPREHENSIVE APPROACH THAT HAS BEEN DEVELOPED FOR CONSIDERATION HERE TODAY.
SPECIFICALLY, THE MODEL LOOKS AT BOTH UPSTREAM AND DOWNSTREAM FACTORS.
SO THE RIGHT SIDE OF THE SLIDE WOULD BE FURTHER DOWNSTREAM, THE LEFT SIDE WOULD BE UPSTREAM.
AND THESE LOOK AT, UM, FACTORS THAT NEED TO BE ADDRESSED IN ORDER TO HELP PEOPLE AT RISK OF AND WHO HAVE DIABETES OBTAIN BETTER HEALTH OUTCOMES DOWN THE LINE.
SO, ALIGNMENT, ALIGNMENT, ALIGNMENT, ALIGNMENT.
SO WE WANTED TO ENSURE THAT THE PROPOSAL WAS IN ALIGNMENT WITH OUR METRO HEALTH PRIORITIES AND OUR PUBLIC HEALTH STRATEGIES TO INCLUDE ESSAY FORWARD, METRO HEALTH 2.0, AND, UH, OUR FOUNDATIONAL PUBLIC HEALTH SERVICES.
SO OUR LOCAL STRATEGIC PLAN AS A FORWARD, WHICH, UH, MOST OF YOU'RE VERY FAMILIAR WITH PRIORITIZING PRIORITIZES ADDRESSING FOOD INSECURITY AND CHRONIC DISEASE RATES.
OUR, THE COMPLIMENT IS OUR METROPOLITAN 2.0 PLANS, UH, WHICH WORKS TOGETHER WITH OUR PARTNERS LIKE THE Y M C A AND THE SAFE CLINIC TO CREATE PLACE-BASED SOLUTIONS, ESPECIALLY IN THE HARDEST TO REACH COMMUNITIES.
OUR WORK TO ADDRESS DIABETES ALSO ALIGNS WITH NATIONAL, UH, FRAMEWORKS LIKE THE, UH, PUBLIC HEALTH, UH, THE FOUNDATION, PUBLIC HEALTH SERVICES.
I'VE ALREADY, UH, MENTIONED ESSENTIAL SERVICE NUMBER FOUR, ESSENTIAL SERVICE NUMBER THREE IS ABOUT COMMUNICATING EFFECTIVELY TO INFORM AND EDUCATE INDIVIDUALS ABOUT HEALTH ISSUES THAT INFLUENCE IT AND HOW TO IMPROVE IT.
ESSENTIAL SERVICE NUMBER FIVE IS ABOUT CREATING A CHAMPION TO CREATE CHAMPION AND IMPLEMENT POLICIES, PLANS, AND LAWS THAT IMPACT HEALTH AND ESSENTIAL SERVICE.
NUMBER SIX IS ABOUT UTILIZING OUR, OUR AUTHORITY, UH, DESIGNED TO IMPROVE AND PROTECT THE PUBLIC'S HEALTH.
UM, BASED ON FEEDBACK THROUGH THE SUMMER, UH, THROUGH THE SPRING, THROUGH THE SUMMER, AFTER RECEIVING THIS FEEDBACK FROM INTERNAL AND EXTERNAL PARTNERS, OUR TEAM AT METRO HEALTH DEVELOPED A MODEL THAT WOULD ADDRESS THE COST OF INSULIN AND PROVIDE RESOURCES AND SUPPORT FOR THOSE WHO HAVE DIABETES IN OUR LOCAL COMMUNITY.
SO THIS MODEL IS CALLED THE DIABETES CARE CONTINUUM.
WE DO BELIEVE THAT THIS APPROACH WILL ASSIST AS MANY RESIDENTS AS POSSIBLE TO TAKE ADVANTAGE WITH THE MANY RESOURCES THAT ARE AVAILABLE WITHIN OUR COMMUNITY.
THE DIABETES CARE CONTINUUM HAS FOUR KEY COMPONENTS AND RELIES HEAVILY ON COMMUNITY PARTNERSHIPS.
SO PATIENT NAVIGATORS AND INSULIN SAFETY FUND, HAVING HEALTH, COMMUNITY HEALTH HUBS, AND FAMILY EDUCATION, ONGOING OUTREACH AND EMPOWERMENT, AND DIABETES HEALTH EDUCATION.
SO THIS MODEL WOULD NOT ONLY SUPPORT THOSE WHO HAVE DIABETES, BUT PROVIDE EDUCATION AND ASSISTANCE FOR THOSE WHO WANT TO PREVENT DIABETES, AND FOR CAREGIVERS AND FAMILIES OF THOSE WITH DIABETES.
SO, I'LL JUST QUICKLY HIGHLIGHT EACH OF THESE COMPONENTS.
DON'T WORRY, THERE'S NOT A QUIZ AT THE END OF THIS, SO I JUST WANNA MAKE SURE YOU REST ASSURED.
UM, THE FIRST COMPONENT UNDER COMMUNITY PARTNERSHIPS IS A PATIENT NAVIGATORS AND INSULIN SAFETY FUND.
THE PATIENT NAVIGATORS ARE ESSENTIAL TO OUR PROPOSED MODEL.
THESE INDIVIDUALS WOULD ASSIST RESIDENTS IN COMMUNICATING WITH THEIR, UH, PROVIDERS, UM, TO MAKE SURE WITH THEIR DOCTORS, TO MAKE SURE THAT THEIR PRESCRIPTION IS MOST EFFECTIVE AND AFFORDABLE.
REGISTERING FOR, UH, THE, UH, THE A C A HEALTH INSURANCE PLANS, REGISTERING FOR INSULIN AND MEDICATION ASSISTANCE PROGRAMS, UNDERSTANDING THE DOCUMENTATION NEEDED AND ELIGIBILITY REQUIREMENTS FOR EACH PROGRAM, AND DETERMINING THE ELIGIBILITY FOR THE SAFETY FUND ASSISTANCE IF NO OTHER ASSISTANCE IS AVAILABLE.
THIS MODEL PROPOSES A TEAM OF THREE, UH, NAVIGATORS, A REGISTERED DIETICIAN, AND A SCHEDULER AT EACH OF THE PILOT, UM, HUBS.
SO WHAT WOULD THESE FOLKS DO? SO THE STAFF, SO THE REGISTERED DIETICIAN WOULD BE PRESENT THAT WOULD ALLOW, THAT WOULD ASSIST COMMUNITY MEMBERS ONE-ON-ONE WITH DIETING, DIETING, AND INFORMATION THAT WOULD FURTHER ASSIST THEM IN MANAGING, UH, DIABETES.
AN ADMIN ASSISTANT OR SCHEDULER WOULD BE PRESENT TO HANDLE SCHEDULING OR PROGRAM INQUIRIES.
THE NAVIGATOR'S ROLE WOULD BE TO HELP PARTICIPANTS ASSESS THEIR ELIGIBILITY FOR THE DIFFERENT PROGRAMS AND ENSURE THAT THEY HAVE THE DOCUMENTATION REQUIRED TO REGISTER AND TAKE ADVANTAGE OF THOSE DISCOUNTS.
UH, SO THE FUNDING, UH, WOULD COVER SALARIES TRAINING FOR TEAMS. UH, OUR TEAM AT METRO HEALTH RELIES, UH, ON PARTNERSHIPS WITHIN THE COMMUNITY TO IMPLEMENT, TO IMPLEMENT THE PATIENT NAVIGATION TEAMS. AND SO THAT WOULD BE THE ANCHOR TO THIS EFFORT WOULD BE WITH OUR COMMUNITY PARTNERS.
AS NOTED PREVIOUSLY, DUE TO THE, UH, THE AMOUNT OF PROGRAMS
[00:55:01]
AND ASSISTANCE CURRENTLY AVAILABLE THROUGH INSURANCE PHARMACIES AND DISCOUNT SAVINGS PROGRAMS, MOST RESIDENTS CAN ACCESS INSULIN AT VARIOUS AFFORDABLE RATES AND SOMETIMES AT NO COST.BUT WE DO REALIZE THAT EVEN WITH THIS GREAT NUMBER OF RESOURCES, THERE MAY STILL BE SOME THAT DO NOT QUALIFY, OR AFTER QUALIFYING WILL STILL NEED SOME ASSISTANCE WITH THE REMAINING AMOUNT THAT MUST BE PAID.
UH, SO THEREFORE, WE'RE PROPOSING THAT AN INSULIN SAFETY FUND BE SET UP TO SUPPORT THOSE INDIVIDUALS THAT STILL NEED ASSISTANCE.
THE FUND COULD COVER AT LEAST 2000 RESIDENTS FOR ONE TIME EMERGENCY ASSISTANCE, AGAIN, BASED ON OUR, OUR QUICK READ.
SO THE SECOND COMPONENT, UM, SO THIS IS UNDER COMMUNITY PARTNERSHIPS, UH, WHICH IS, UH, THE COMMUNITY HEALTH HUBS AND EDUCATION AND FAMILY EDUCATION.
SO WE'RE PROUD TO COLLABORATE WITH MULTIPLE COMMUNITY PARTNERS TO PROVIDE RESOURCES FOR DIABETES EDUCATION, PHYSICAL ACTIVITY AND NUTRITION, ACCESS TO CARE AND CRITICAL HEALTH SCREENINGS.
UM, THIS CLEARLY ALIGNS WITH OUR GOALS FOR ESSAY FORWARD AND, AND OUR INTERNAL DOC, UH, PLAN WITH METRO HEALTH 2.0, WHICH IS ABOUT UPGRADING THE LOOK THE FIELD OF THE, THE SOPHISTICATION OF METRO HEALTH.
SO, UH, SOME OF THESE PARTNERS, AS I MENTIONED EARLIER, UH, HAVE, HAVE JOINED US HERE TODAY, AND I'D LIKE TO JUST QUICKLY ACKNOWLEDGE THEM.
UH, WE DID BRING OUR OWN FAN CLUB, NOT ONLY THE STAFF, BUT OUR COMMUNITY PARTNERS.
SO WE DO HAVE CARL NEGLEY FROM THE SAVE CLINIC.
HEY, YOU SIGN AUTOGRAPHS IN THE BACK.
STANDING UP SANDY MORNDER, UH, AND THE Y M C A TEAM.
UM, AND AGAIN, AND YOU KNOW, THE REST OF THE STAFF, AGAIN, YOU CAN GET THEIR AUTOGRAPHS AT THE END OF THE PRESENTATION.
UM, THROUGH PARTNERSHIPS LIKE THESE, WE, WE PROPOSE ESTABLISHING TWO HEALTH HUBS, EAST SIDE AND WEST SIDE.
EACH HEALTH HUB WOULD SERVE UP TO A THOUSAND RESIDENTS ANNUALLY.
UH, IT WOULD PROVIDE A CENTRAL LOCATION WHERE COMMUNITY COULD COME TO MEET WITH PATIENT NAVIGATORS AND ACCESS COMMUNITY RESOURCES.
THE SPACE WOULD HA THE SPACE WOULD HAVE PLACES FOR HEALTH EDUCATION WORKSHOPS, ONE-ON-ONE MEETINGS WITH PATIENT NAVIGATORS OR DIETICIANS, AND POTENTIAL ACCESS TO CARE AND HEALTH SCREENINGS.
WE'VE IDENTIFIED COUNCIL DISTRICTS TWO AND FOUR FOR THE HEALTH HUBS BASED ON HIGH PREVALENCE RATES FOR DIABETES AND HIGH RATES OF DIABETES HOSPITALIZATIONS, AND AS WELL AS THE LACK OF RESOURCES AND ACCESS TO CARE OPTIONS IN COMPARISON TO OTHER DISTRICTS OF HIGH NEED.
MOVING TO THE THIRD COMPONENT, THE THIRD COMPONENT IS OUTREACH AND EMPOWERMENT.
UH, METRO HEALTH OFFICE OF POLICY AND CIVIC ENGAGEMENT, WHICH IS LED BY SEAN GREEN, HAS BEEN WORKING HARD ON THE LEGISLATIVE AGENDA FOR THIS CURRENT FISCAL YEAR.
WE HAVE INCLUDED INSULIN AFFORDABILITY AND DIABETES CARE RESOURCES AS A LEGISLATIVE PRIORITY AND ARE WORKING WITH LIKE-MINDED GROUPS TO SEE THESE PRIORITIES ADVANCED AT THE STATE AND NATIONAL LEVELS.
TO ASSIST IN THESE EFFORTS, WE'D LIKE TO PROPOSE ADDING A SENIOR MANAGEMENT ANALYST, UH, TO OUR TEAM DEDICATED TO DEVELOPING EDUCATION AND ADVOCACY MATERIALS FOR PARTNER AGENCIES AND COMMUNITY MEMBERS ON THE NEEDS OF THOSE WITH DIABETES.
UM, IT ALSO WOULD ALLOW US TO EDUCATE PHYSICIANS AND PRO UH, MEDICAL PROVIDERS ON THE NEEDS AND BARRIERS OF UNDERSERVED POPULATIONS AND THINGS TO CONSIDER WHEN PRESCRIBING INSULIN AND OTHER DIABETES RELATED MEDICATIONS, AS WELL AS PROVIDING GUIDANCE ON OUR, OUR PRIORITY, OUR LEGISLATIVE PRIORITIES FOR ADDRESSING DIABETES.
AND LASTLY, CREATING COMMUNITY CONVERSATIONS IN TARGET DISTRICTS WHERE RESIDENTS CAN LEARN ABOUT DIABETES AND WHERE TO FIND RESOURCES FOR INSULIN, OTHER MEDICATIONS AND DIABETES CARE PRODUCTS.
THE FINAL COMPONENT IS, UH, DIABETES HEALTH EDUCATION.
IN 2013, UH, THE MENTAL HEALTH DEPARTMENT CREATED THE DIABETES PREVENTION AND CONTROL PROGRAM TO ADDRESS THE HIGH RATES OF DIABETES AND DIABETES RELATED HOSPITALIZATIONS HERE IN BEXAR COUNTY USING EVIDENCE-BASED CURRICULA.
THIS PROGRAM PROVIDES PREVENTION AND SELF-MANAGEMENT EDUCATION ACROSS THE CITY.
THESE COMMUNITY WORKSHOPS TAKE PLACE IN BUSINESSES, CLINICS, CHURCHES, AND OTHER ORGANIZATIONS.
THE PROGRAM REACHES BETWEEN FOUR TO 500 INDIVIDUALS ANNUALLY.
THE RESEARCH PROVES THAT PREVENTION AND SELF-MANAGEMENT EDUCATION CAN REDUCE TYPE TWO DIABETES, REDUCE HEALTHCARE COSTS, AND REDUCE HEMOGLOBIN A ONE C SCORES WHILE IMPROVING CLINICAL LIFESTYLE AND PSYCHOSOCIAL OUTCOMES.
RECENTLY, AS PART OF A SA FORWARD INITIATIVE AND FUNDING FROM A FEDERAL GRANT WITH, UH, FEDERAL HEALTH DISPARITIES GRANT, THE PROGRAM HAS EXPANDED ITS REACH.
THEY'VE ADDED, UH, WE'VE ADDED THREE HEALTH EDUCATORS AND ARE TARGETING SPECIFIC COUNCIL DISTRICTS FOR INCREASED ENGAGEMENT BASED ON PREVALENCE AND HOSPITALIZATION RATES.
THE TEAM HAS COMPLETED ITS GOAL OF OFFERING 21, UH, HEALTH EDUCATION WORKSHOPS
[01:00:01]
AND TARGET, AND TARGET, UH, DISTRICTS SINCE THE START OF 2022.IN RESPONSE TO COMMUNITY FEEDBACK, THE DIABETES TEAM WILL BE OFFERING NEW CURRICULA IN THIS CURRENT FISCAL YEAR TO INCLUDE THE VEEVA HEALTH CURRICULUM DEVELOP WITH THE COMMUNITY NUTRITION PROGRAM AND THE DIABETES GARAGE, A CURRICULUM SPECIFICALLY TARGETING, UH, MEN WITH DIABETES.
OUR DIABETES PROGRAM IS CURRENTLY FUNDED THROUGH A COMBINATION OF STATE AND FEDERAL GRANTS.
WE'D LIKE TO ENSURE THAT THE FUNDING REMAINS CONSISTENT FOR THIS VITAL COMMUNITY PROGRAM, AND WE ARE COMMITTED TO SEEKING NEW FUNDING AND HAVING FUTURE DISCUSSIONS, UH, AS WE SUSTAIN THIS PIECE OF THE CONTINUUM.
SO WITH THAT, UM, THIS IS JUST A REMINDER THAT, UH, UM, WHAT WAS ASKED EARLIER IN THE YEAR, WE'D LIKE TO PROVIDE SOME FURTHER CONTEXT AND SUPPORT FOR WHY WE'RE, UH, PROPOSING THIS CONTINUUM OF SERVICES VERSUS A STANDALONE, UH, INSULIN COST SHARE INITIATIVE.
SO, THE BROADER OPTIONS FOR ALL, AS WE NOTED EARLIER, 30% OF DIABETICS USE INSULIN FOR TREATMENT.
A STANDALONE PROGRAM, WHICH IS THE LEFT SIDE, UM, UH, STANDALONE PROGRAM, WOULD SUPPORT JUST A SLIVER OF THE TOTAL NEEDS OF OUR COMMUNITY.
IN RELATION TO DIABETES, A BROADER APPROACH OFFERS SUPPORT FOR DIABETES PREVENTION AND SELF-MANAGEMENT, WHILE STILL SUPPORTING THE 30% OF DIABETICS WHO USE INSULIN.
UH, WE INSULIN IS NOT THE WHOLE CONVERSATION.
UH, THIS AFTERNOON WE CRAFTED A RESPONSE THAT NOT ONLY ADDRESSES INSULIN, BUT ALSO SEEKS TO INCORPORATE THE OTHER EVIDENCE-BASED TOOLS SUCH AS EDUCATION, PREVENTION, OTHER MEDICATIONS, HEALTH INSURANCE, AS WELL AS PATIENT NAVIGATORS.
AND LASTLY, MORE ACCESSIBILITY.
SO WITH THIS, UH, STANDALONE PROGRAM WOULD NOT HAVE THE SAME REACH AS AN OFFERING OF MULTIPLE SERVICES.
SO WE PROPOSED USING TWO HUB LOCATIONS AND HAVE WORKSHOPS THAT ARE CONDUCTED IN MULTIPLE AREAS OF THE CITY TO PROVIDE EDUCATION AND RESOURCES.
THIS SLIDE IS A VIEW OF OUR PRIORITIES WITH THE CONTINUUM BASE ON THE AMOUNT OF PEOPLE AFFECTED AND THE DIRECT IMPACT.
WE DO WANT TO STRESS, AGAIN, THAT EACH COMPONENT RELATES TO THE OTHER AND IS A COMPREHENSIVE APPROACH TO MEET THE MOST NEEDS.
AND WE DO BELIEVE THAT THE HOLISTIC APPROACH IS THE MOST EFFECTIVE WAY TO MEET THE NEEDS OF OUR COMMUNITY FOR DIABETES PREVENTION, CARE AND SUPPORT.
SO, IN WINDING DOWN, JUST KNOW THAT THERE ARE THREE OPTIONS PROPOSED, UM, THAT WE'VE OUTLINED FOR YOUR REVIEW.
THE FIRST OPTION WAS MAINTAIN THE CURRENT EFFORTS TO PROVIDE HEALTH EDUCATION THROUGH NO COST WORKSHOPS ACROSS THE COMMUNITY.
THIS WOULD BE THE CONTINUATION OF OUR DIABETES PREVENTION AND CONTROL PROGRAMMING IN THE HIGHEST AREAS, UH, HEALTH, UH, HIGHEST, UH, HEALTH DISPARITY AREAS ACROSS THE CITY, WHICH IS CURRENTLY BEING FUNDED THROUGH THE 1115 WAIVER.
SOME FUNDING FROM THE STATE HEALTH SERVICES AND THROUGH SOME SUPPORT FROM OUR, OUR FEDERAL GRANT.
SECOND OPTION, UH, SUPPORT INCREASED COMMUNITY PARTNERSHIPS AND INCREASED OUTREACH AND EMPOWERMENT.
SO NEW FUNDING IN THE AMOUNT OF $600 WOULD $600,000 WOULD NEED TO BE IDENTIFIED.
THIS FUNDING WOULD SPECIFICALLY COVER THE PATIENT NAVIGATOR TEAMS, THE INSULIN SAFETY FUND, THE COMMUNITY HEALTH HUBS, AND THE FAMILY EDUCATION COMPONENTS THAT WE HIGHLIGHTED.
THE THIRD OPTION SUPPORT THE COMPREHENSIVE DIABETES CARE CONTINUUM MODEL FOCUSED ON PATIENT NAVIGATORS, INSULIN FUND, HEALTH EDUCATION FOR ADULTS, YOUTH AND FAMILIES, OUTREACH AND ADVOCACY, AND COMMUNITY HEALTH HUBS.
UH, AGAIN, NEW FUNDING AMOUNT WOULD BE REQUIRED IN THE AMOUNT OF $1.6 MILLION THIS WOULD NEED.
UM, THIS WOULD BE AN INVESTMENT TO HELP THOSE AT RISK OF DEVELOPING DIABETES AND THOSE WITH DIABETES TO BECOME HEALTHIER AND PREVENT FURTHER COMPLICATIONS OR HOSPITALIZATIONS.
THE CONTINUUM OF CARE MODEL IS THE IDEAL WAY TO ADDRESS THE ISSUE OF DIABETES FURTHER UPSTREAM AND IS A COMPREHENSIVE APPROACH THAT INVOLVES DIFFERENT SECTOR FROM THE COMMUNITY TO WORK TOGETHER.
SO, SO THIS IS A RECOMMENDATION THEN.
UH, SO THE C C R REQUESTED AT METRO HEALTH DETERMINE THE, UM, UH, FEASIBILITY AND ESTABLISH A FUND TO HELP SAN ANTONIO RESIDENTS COVER THE COST OF INSULIN.
SO, IN CONCLUSION, OUR METRO HEALTH STAFF WOULD LIKE TO RECOMMEND IMPLEMENTING THE PROPOSED DIABETES CARE CONTINUUM AND SUPPORTING THE FULL FUNDING AMOUNT, UH, TO $1.6 MILLION.
THIS, THESE OPTIONS WILL GIVE US BETTER HEALTH OUTCOMES AND FINANCIAL SUPPORT FOR THE GREATEST AMOUNT OF RESIDENTS AND IS AN INVESTMENT IN THE FUTURE OF OUR COMMUNITY.
WE WELCOME ANY SUGGESTIONS OR FEEDBACKS THAT YOU MAY HAVE ABOUT THIS MODEL, AND WE THANK YOU FOR YOUR CONSIDERATION.
UM, CLAUDE, I APPRECIATE THE PRESENTATION AND, UM, WE HAVE A LOT TO DISCUSS.
EVERYBODY'S DYING TO, TO CHIME IN.
UM, FIRST I DO WANNA THANK THE COUNCIL MEMBERS THAT BROUGHT THIS FORWARD.
UH, COUNCILMAN MA RODRIGUEZ AND, UH, R DR.
THIS TO ME, IS ONE OF THE VERY FEW TIMES WE GET TO, UH, WORK ON SOMETHING THAT'S DIRECTLY LIFESAVING FOR, FOR OUR RESIDENTS.
UM, IT IS SO CLOSE TO THE POINT OF WHERE YOU COULD SAVE A LIFE.
[01:05:01]
YOU, UH, FOR BRINGING SOMETHING THAT HAS PLAGUED OUR COMMUNITY FOREVER.AND, UH, AND YOU'RE BRINGING SOMETHING THAT'S, THAT'S TANGIBLE.
UM, SO IT IS, UH, MUCH APPRECIATED.
UM, I BELIEVE WE HAVE MEMBERS OF THE PUBLIC TO COMMENT.
IS THAT CORRECT OR NO? THAT'S THE NEXT ITEM.
WELL, AND THANK YOU TO ALL THE PARTNERS FOR, FOR BEING HERE.
UM, I'M GOING TO TURN THE FLOOR OVER FIRST TO, UH, THE TWO COUNCIL MEMBERS WHO BROUGHT THIS FORWARD, UM, AND, AND LET THEM, UH, SPEAK.
SO COUNCILMAN COUNCILWOMAN, YOU GUYS DECIDE HOW YOU, HOW YOU DO THIS.
ROACH, YOU WANNA GO? THANK YOU.
THANK YOU SO MUCH TO THE MEMBERS, UH, TODAY THAT ARE PRESENT FOR ALLOWING ME TO SHARE, UM, WHY I CHOSE TO CO-AUTHOR WITH COUNCILMAN MAKITA.
I SAID, I'M SO EXCITED, COUNCILMAN.
SO YOU JUST, YOU JUST, IF YOU CAN'T TELL, UM, BUT, UH, I ALSO WANNA SAY THAT IT'S REALLY INTERESTING THAT IT'S EXACTLY NINE MONTHS LATER, SO I FEEL LIKE WE'RE BIRTHING A BABY COUNCILMAN SAND.
SO IT'S, SORRY, I JUST HAD TO, IT WAS THERE.
SO I WAS LIKE, YEAH, THIS IS PERFECT.
SO, UH, BUT I'VE BEEN EAGERLY AWAITING THIS, AND I KNOW THAT THE ARPA DISCUSSIONS IN THE SUMMER CAUSED SOME DELAY, AND I APPRECIATE THAT THIS ITEM WAS DISCUSSED AND THAT METRO HEALTH HAS DONE EXTENSIVE WORK TO PRESENT OPTIONS TO THE COMMITTEE.
I WANT TO, UM, ALSO REMIND EVERYBODY THAT OUR COMMUNITY HEALTH WORKERS REALLY SAVED LIVES, ESPECIALLY DURING THE PANDEMIC.
AND SO THE DEPARTMENT IS FULL OF PASSIONATE AND DEDICATED INDIVIDUALS WHO UNDERSTAND THE IMPORTANCE OF PUBLIC HEALTH AND HOW IT IMPACTS THE QUALITY LIFE THAT OUR RESIDENTS GET TO HAVE LONG BEFORE COVID.
UM, WE WERE ALREADY FACING THESE EFFECTS OF HEALTH DISPARITIES AND DIABETES, AND EVEN PRE-DIABETES IN SAN ANTONIO, WHICH MOST PEOPLE DON'T EVEN KNOW THAT THEY HAVE.
I THINK THE STAT THAT METRO HEALTH GAVE US WAS NINE IN 10.
PEOPLE DON'T EVEN KNOW THAT THEY'RE PRE-DIABETIC.
UM, SO ADDRESSING THESE HEALTH DISPARITIES, ESPECIALLY IN VULNERABLE COMMUNITIES, NEEDS TO BE ONE OF OUR PRIORITIES.
I THINK AS A COUNCIL, UM, I DON'T HAVE A BACKGROUND AND IN PUBLIC HEALTH, BUT MY DOCTORAL RESEARCH DID INCLUDE MARKETING PUBLIC HEALTH INFORMATION TO HARDER REACH POPULATIONS AND HEALTH LITERACY.
SO IT CONTINUES TO BE ONE OF MY PRIORITIES.
AND I KNOW THAT WE HAVE GREAT PARTNERSHIPS WITH LOCAL HEALTHCARE PROVIDERS LIKE UNIVERSITY HEALTH, UT HEALTH, CENTRAL MED, TEXAS, VISTA, THE RESIDENTS IN DISTRICT FOUR, LIKE SOME OF YOUR OTHER, YOUR DISTRICTS AS WELL LACK THE ACCESS TO QUALITY MEDICAL HEALTHCARE, OR THEY ARE EITHER UNINSURED OR UNDERINSURED.
AND SOME OF OUR RESIDENTS HAVE LOW WAGE JOBS THAT DON'T EVEN OFFER TYPES OF MEDICAL INSURANCE.
AND, UM, EVEN AT THAT, THEY HAVE TO DO A COST BENEFIT ANALYSIS THAT FACTORS IN THEIR EARNINGS AND THE COST OF GETTING THIS HEALTHCARE COVERAGE.
AND MANY TIMES OUR RESIDENTS WILL JUST OPT OUT OF GETTING THE COVERAGE BECAUSE THEY CAN'T AFFORD IT.
UM, AND SO, OR THEY CHOOSE TO MAYBE FOCUS ON ONLY COVERING THEIR FAMILIES.
SO YES, SOME WILL QUALIFY FOR CHIP OR MEDICAID, AND WE HAVE SOME, UH, FAMILIES THAT MAY NOT MEET THE ELIGIBILITY CRITERIA FOR PROGRAMS LIKE THIS.
UM, BUT I THINK THAT IT'S STILL OUR RESPONSIBILITY TO DO THIS.
AND WE KNOW THAT THE STATE LEGISLATORS REFUSAL TO EXPAND MEDICAID COVERAGE IMPACTS SEVERAL HUNDREDS OF THOUSANDS OF RESIDENTS IN OUR AREA.
AND TO BE HONEST, EVEN THOUGH I'M AN OPTIMIST, I DON'T SEE THAT CHANGING ANYTIME SOON.
BUT I APPRECIATE THAT WE HAVE IT IN OUR, UM, LEGISLATIVE AGENDA, AND WE MIGHT LOBBY FOR THIS EXPANSION, UM, DURING THE 88 STATE LEGISLATOR PROGRAM AND IN COUNT ME RIGHT IN, BUT I WON'T HOLD MY BREATH.
RIGHT? AND SO, AND I THINK THAT'S IT'S IMPORTANT THAT, THAT WE DO THIS WORK.
WHILE MORE RESIDENTS GET DIAGNOSED WITH DIABETES OR BECOME PRE-DIABETIC, I CANNOT SIMPLY, UM, LEAVE THIS AND SAY THAT IT'S A MATTER OF PERSONAL LIFESTYLE CHOICES, RIGHT? THAT'S KIND OF BEEN THE EXCUSE FOR FAR TOO LONG.
ACCESS TO HIGH QUALITY, FRESH AND NUTRITIOUS FOOD IS FUNDAMENTAL.
AND THERE'S A PROPENSITY OF FOOD DESERTS IN OUR CITY, AND I THINK IT'S NOT SURPRISING TO SEE THAT THE NUMBER OF GROCERS FAR OUTPACED IT BY FAST FOOD, UM, RESTAURANTS IN EVERY PART OF OUR AREA, ALMOST EXCEPT, UM, 1, 1, 1 CERTAIN AREA, UH, IS, IS ADDING TO THIS.
OUR RESIDENTS CHOOSE TO EAT THINGS THAT ARE LARGELY DRIVEN IN PART WHAT, BY WHAT IS AFFORDABLE TO THEM AND WHAT THEY HAVE ACCESS TO.
AND THAT HAS LED TO THIS CREATION OF HEALTH DISPARITIES.
WE'VE ALL SEEN ALSO THE RISING COST OF BASIC COMMODITIES AT GROCERY STORES.
AND THOSE WITH LIMITED BUDGETS, BUDGETS HAVE HAD TO MAKE THESE VERY DIFFICULT CHOICES.
AND SOMETIMES THE MOST AFFORDABLE HEALTH, UH, THE MOST AFFORDABLE FOOD HAPPENS TO BE LIKE THE DOLLAR FOOD, RIGHT? AND SO, AND IT HAS HAPPENS TO BE THE FAST FOOD.
AND THEN SOME PEOPLE WORK MULTIPLE JOBS.
THEY MIGHT NOT BE ABLE TO BUY, UH, FRESH PRODUCE.
THEY MIGHT NOT HAVE TIME TO COOK.
AND FAST FOOD ENDS UP BEING THE MOST TIME EFFECTIVE AND ALSO COST EFFECTIVE, UM, OPTION FOR THEM AND THEIR FAMILIES.
OTHERS MIGHT NOT QUALIFY FOR SNAP.
AND SO THEY HAVE TO STRETCH THEIR DOLLAR AS MUCH AS POSSIBLE.
AND I KNOW THAT YOU ALL HAVE HEARD THIS BEFORE BECAUSE THIS IS A
[01:10:01]
COMMITTEE THAT'S DEDICATED TO IT, BUT I'M THE DAUGHTER OF DIABETIC FATHER, AND I ALWAYS LOOK AT HIS NUMBERS.UM, AT THE START OF THE PANDEMIC, I WAS SO WORRIED ABOUT, UM, THE, THE, THE, WHAT THE MEDICAL PROFESSIONALS WERE WARNING US ABOUT WITH THE COMORBIDITIES, THE IMPACT THAT, UM, IT WAS GONNA HAVE ON FAMILIES THAT WERE ALREADY, UH, GOING THROUGH A LOT OF THESE STRUGGLES.
AND, UM, THE RISE OF INSULIN COSTS NOW AND PRESCRIPTION D DRUGS IMPACTS ALL OF US AT THE END OF THE DAY, RIGHT? AND SO THIS LIFE-SAVING MEDICATION SHOULD REMAIN ACCESSIBLE AND AFFORDABLE.
NO ONE SHOULD HAVE TO TRAVEL TO A DIFFERENT COUNTRY TO GET IT AT A MORE AFFORDABLE RATE.
AND A LOT OF MY RESIDENTS DO THAT.
AND I KNOW COUNCILMAN SANDOVAL, UH, KNOWS THIS AS WELL.
I'M FORTUNATE TO BE ABLE TO ADVOCATE FOR MY DAD AND TO HELP HIM MANAGE HIS DIABETES.
BUT NOT EVERYONE HAS KIDS OR PEOPLE TO HELP HIM.
AND SO, SOMETIMES EVEN LANGUAGE BARRIERS MAKE IT DIFFICULT AND FRUSTRATING FOR SOME.
AND AS MUCH AS I WANT TO EMPOWER MY DAD, OUR HEALTHCARE SYSTEMS CAN BE DIFFICULT TO NAVIGATE.
AND FOR THOSE WITHOUT A FORMAL EDUCATION, THE PROCESS CAN BE INTIMIDATING AND OVERWHELMING.
AND I'M THRILLED ABOUT THE ESSAY FORWARD PLAN.
I BELIEVE THIS IS A SORT OF STRATEGIC VISION AND IMPLEMENTATION THAT HAS BEEN LONG OVERDUE IN SAN ANTONIO.
I COMMEND ALL WHO HAVE PUT THIS PLAN TOGETHER, AND I REALLY WANT TO LEARN MORE ABOUT THE ROLE OF THE PATIENT NAVIGATORS.
I'M SURE THAT, UM, WE WILL, UH, HEAR SOME GREAT IDEAS FROM MY COLLEAGUES HERE IN JUST A LITTLE BIT.
BUT I REALLY HOPE THAT THE SAFETY FUND IS MARKETED ALSO IN A WAY THAT REACHES THOSE WITH MOST IMMEDIATE, OR WHO NEED THE MOST IMMEDIATE ASSISTANCE.
I'M LOOKING FORWARD TO THE DISCUSSION.
UM, AND I ALSO WANNA PUT A PLUG IN FOR, UH, D FIVE AND D FOUR TRYING TO HOST A CICLOVIA TOGETHER.
I MOVE TO SEND THE RECOMMENDATION TO FULL COUNSEL.
IS, IS THAT WHAT YOU'RE ASKING? IS THAT WHAT YOU'RE ASKING US TO DO? IT'S NOT MY MEETING.
UM,
SO YES, THE RECOMMENDATION, THERE ARE THREE OPTIONS, BUT THAT IS THE, UH, RECOMMENDATION.
TO SEND THE THREE OPTIONS TO A B SESSION? NO, THESE ARE THE THREE OPTIONS.
I'D LIKE TO SEND IT TO A B SESSION.
UM, SO I THINK WE HAVE SOME, SOME QUESTIONS FROM COUNCILWOMAN, UH,
IS IT OKAY IF WE GO AHEAD AND GO TO HER? YEAH.
THANK YOU, CLAUDE, FOR THE PRESENTATION.
I, UH, DISTRICT THREE HAS BEEN HERE BEFORE.
UH, WE KNOW HOW DIABETES IMPACTS DISTRICT THREE.
I AM CONCERNED THAT PRICE TAG WITH NO REAL, IF WE JUST DID THE INSULIN I'D AT THE END OF THE DAY, I'D HAVE A NUMBER OF PEOPLE THAT USED THE SERVICES.
I, I, I'M CONCERNED BECAUSE WE'VE HOSTED THE DIABETES FORUM AT MY FIELD OFFICE.
SAVE CLINIC HAS COME TO MY SENIOR CENTER.
IT DIDN'T COST US $1.6 MILLION.
OKAY? THAT, THAT IS, THAT IS MY CONCERN.
THE OTHER THING IS, ANY MARKETING CAMPAIGN THAT DOES NOT ADDRESS THE FACT THAT LATINOS IN PARTICULAR EAT THEIR FEELINGS WILL FAIL.
WE'RE HAPPY WE EAT, WE'RE SAD, WE EAT.
UM, COUNCILMAN ROCHA GARCIA BROUGHT UP SOME GREAT POINTS ABOUT THE FAST FOOD OPTIONS, THE FOOD DESERTS, AND I KNOW YOU'RE GONNA PRESENT ON THE FOOD MAPPING.
IF THIS IS NOT GEARED SPECIFICALLY TO THE NEIGHBORHOODS THAT WE ARE GOING IN AND TRYING TO IMPACT, IT IS NOT GOING TO SEE SUCCESS BECAUSE WE'VE TRIED THIS, THE, WE'VE TRIED DIFFERENT VARIATIONS OF THIS BEFORE YOU CAME HERE, AND THAT FOR, FOR LESS AMOUNT OF MONEY, I THINK.
UM, AND, AND THAT IS WHERE MY CONCERN IS, IS WHAT, WHEN Y'ALL SAY A HOLISTIC APPROACH, WHAT DOES THAT LOOK LIKE? BECAUSE TO ME, THAT LOOKS LIKE HAVING REAL CONVERSATIONS WITH PARENTS OR PEOPLE THAT COME BECAUSE THEY'RE DIABETIC AND TELLING THEM YOU CANNOT TAKE THEM TO THE DRIVE THROUGH AND GET THOSE FRIES.
THE OTHER ISSUE, AND HOW WE NEED TO LOOK AT IT IS IF YOU GO INTO A NEIGHBORHOOD OF MINE AND YOU TELL THEM, OH, Y'ALL, YOU SHOULD WALK MORE.
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I'M GONNA TELL THEM, GO TO THE HARVEY NA GYM AND WALK, BECAUSE I DON'T WANT MY SENIORS UP AND DOWN SOME PARTS OF THE RIVER AT NIGHT BECAUSE IT'S NOT SAFE.AND THEN YOU GET THIS, I CAN'T AFFORD THE Y THIS.
SO I THINK THAT THAT'S THE ONE THING WE NEED TO TAKE INTO CONSIDERATION, OR WHAT I WOULD LIKE TO SEE IS WHAT IS THE HOLISTIC APPROACH FOR THESE COMMUNITIES? HOW ARE WE GOING TO ADDRESS THE, UM, THE REAL MENTAL AND SOCIAL BARRIERS THAT THEY FACE, WHICH IS THEY DON'T HAVE ACCESS TO HEALTHY FOODS.
IT'S AT THE CORNER STORE, OR IT'S AT ONE OF THREE HEBS IN MY AREA, AND I KNOW DISTRICT TWO DOESN'T HAVE THAT MANY HEBS IN SOME OF THE NEIGHBORHOODS.
AND, AND WHAT ARE WE GOING TO ACTUALLY MEASURE AS SUCCESS? UM, IT IS A PROBLEM.
I'M VERY PLEASED WITH WHAT THE Y AND SAVE AND ALL THOSE OTHER PARTNERS HAVE DONE.
BUT BEFORE WE SPEND THIS AMOUNT OF MONEY ON THIS PLAN, I'D REALLY LIKE TO GET A FULL UNDERSTANDING THAT THEY UNDERSTAND THE CULTURE AND COMMUNITY THAT THEY'RE GOING INTO.
BECAUSE THE, HEY, JUST COOK AT HOME OR DO THIS, MAY IT, IT'S NOT GONNA WORK FOR SOME OF 'EM.
AND THE WE'LL JUST GO FOR A WALK IN YOUR NEIGHBORHOOD WHEN THEY HAVE LIKE SIX STRAY DOGS THAT CHASE AFTER 'EM ISN'T GONNA WORK IN THE NEIGHBORHOOD.
SO I THINK THEY HAVE TO HAVE A FULL UNDERSTANDING OF WHAT THE, THE NEIGHBORS ARE.
SO WHEN YOU SAY HOLISTIC APPROACH, WHAT ARE Y'ALL TALKING ABOUT? I AM GONNA TEE IT UP.
AND WHO AM I INVITING? SO EARLIER I TALKED ABOUT LOOKING AT THE CONSTELLATION OF CONDITIONS THAT IMPACT THE QUALITY OF LIFE OF RESIDENTS.
AND SO ZOOMING OUT, I'M GONNA ASK A MEMBER OF OUR STAFF JUST TO WALK THROUGH SOME OF THE EXAMPLES OF WHAT WE DO, UM, THAT BALANCE OUT HOW WE ADDRESS THE QUALITY OF LIFE FOR THESE RESIDENTS.
SO THIS IS SPECIFIC TO THIS, UH, PROGRAM, BUT LET ME AT LEAST ASK WHO'S COMING UP.
OH, KATHY, KATHY'S GONNA COME UP, AT LEAST WALK YOU THROUGH, UH, KATHY'S BEEN OVERSEEING OUR CHRONIC DISEASE SECTION FOR A NUMBER OF YEARS, AND CAN AT LEAST FILL IN A LITTLE BIT OF WHAT WE'VE BEEN DOING ON THE GROUND AND WHAT WE MEAN BY HOLISTIC.
CLAUDE, CAN WE GO BACK TO THIS SLIDE? OH, SURE.
I APPRECIATE THAT JULIUS IS RIGHT BEHIND ME IN CASEY NEEDS TO CHIME IN AS WELL.
SO THIS IS REALLY THE HOLISTIC APPROACH RIGHT HERE.
UM, AND AS CLAUDE MENTIONED EARLIER, THEY ALL GO TOGETHER BECAUSE YOU CAN'T, YOU CAN'T ADDRESS THE PROBLEM APPROPRIATELY WITH JUST ONE OF THESE.
SO WHAT WE'RE DOING RIGHT NOW IN TERMS OF DIABETES, HEALTH EDUCATION, THIS IS WHAT JULIUS'S TEAM IS, IS EMBARKING ON EVERY DAY.
AND OUR PARTNERSHIP WITH THE Y M C A, IT'S FANTASTIC.
UM, WE'RE REACHING, UH, A FRACTION OF THE POPULATION BECAUSE THESE WORKSHOPS ARE A SERIES, SO IT'S NOT A ONE-TIME THING, AND YOU'RE DONE.
IT'S, IN SOME CASES, SIX WEEKS IS THE SHORTEST SERIES, AND A YEAR IS THE LONGEST SERIES.
UM, AND SO THAT IS ONE PIECE OF IT THAT'S HAPPENING THAT WE'RE SUPER PROUD OF, AND WE WILL CONTINUE.
UM, AND WE WANT TO EXPAND THAT ALWAYS.
UM, WE'RE ALWAYS LOOKING FOR, FOR RESOURCES TO EXPAND THAT TOO.
BUT THE OTHER PIECES ARE, I WOULD SAY, UM, NEWER COMPONENTS.
SO THE COMMUNITY HEALTH HUBS AND THE FAMILY EDUCATION PIECE AT THE TOP.
THIS IS REALLY ABOUT THE PARTNERSHIPS THAT WE HAVE IN PLACE AND EXPANDING THEM.
SO THE WORK, THE Y M C A IS DOING, THE, THE PARTNERSHIP THAT WE'RE ENGAGING IN WITH, UM, THE SAFE CLINICS AND THE OTHER PARTNERS THAT ARE PART OF THIS, UH, WE WANNA KIND OF DOUBLE DOWN AND DO MORE OF THAT.
IT'S REALLY ABOUT BRINGING THE RESOURCES TO THE COMMUNITY.
AND SO WE IDENTIFIED TWO DISTRICTS THAT WE THINK ARE IN MOST NEED.
AND SO IT WOULD BE LITERALLY PLACING HUBS IN THOSE COMMUNITIES TO REACH THOSE, THOSE POPULATIONS AS DIRECTLY AS POSSIBLE.
WHAT'S GONNA HAPPEN WITHIN THOSE HUBS? WELL, THE EDUCATION, BUT ALSO THE PATIENT NAVIGATION PIECE, WHICH IS ON THE TOP LEFT AND THE INSULIN SAFETY FUND.
SO WHAT WE KNOW IS MISSING IN A LOT OF CASES IS THAT INDIVIDUALS DON'T HAVE ACCESS TO HEALTH INSURANCE PRESCRIPTION ASSISTANCE OR INSULIN.
WE LEARNED THAT THROUGH TALKING WITH OUR PARTNERS, UH, TALKING WITH THE COMMUNITY, AND TRYING TO GET A BETTER UNDERSTANDING OF WHAT'S HAPPENING.
AND SO WHY IS THAT AND WHAT CAN WE DO ABOUT THAT? WELL, WE ALSO KNOW THAT THERE ARE RESOURCES FOR PEOPLE WHO DON'T HAVE INSURANCE, BUT THERE'S A HUGE CHALLENGE IN, IN BARRIERS IN HELPING PEOPLE, UM, APPLY FOR THOSE RESOURCES.
AND SO WHAT COULD WE DO? WELL, WE COULD PUT NAVIGATORS IN PLACE TO JUST DO THAT, TO JUST HELP THEM APPLY FOR THE
[01:20:01]
RESOURCES, UM, GAIN THE, UH, ACCESS TO THAT INSULIN SAFETY FUND, IF THAT IS WHAT'S NEEDED.OR, UM, YOU KNOW, HELP THEM FIND RESOURCES FOR OTHER MEDICATIONS THAT THEY CAN'T AFFORD.
UH, THAT WE'RE, WE, UH, WE ARE NOT DOING THAT RIGHT NOW IN, IN OUR DIABETES PROGRAM.
THAT WOULD BE AN, AN AMAZING EXPANSION.
AND WHAT WE'RE SAYING IS THAT THAT IS NEEDED, AND THAT, AND IT'S A BIG PRICE TAG RIGHT THERE, BUT IT'S BECAUSE IT REQUIRES STAFF MEMBERS AND IT REQUIRES A LOCATION, AND IT REQUIRES SOME RESOURCES TO DO IT.
AND WE ALSO KNOW THAT BY SETTING UP TWO HUBS, WELL, IDEALLY WE'D WANT SEVEN OR EIGHT HUBS, BUT RIGHT NOW WE NEED TO THINK ABOUT TWO HUBS BEING, BEING MOST TARGETED.
UH, AND THEN LASTLY, THE OUTREACH AND EMPOWERMENT PIECE.
THIS KIND OF ROUNDS OUT THE HOLISTIC APPROACH, AND THIS IS REALLY ABOUT, UM, TRYING TO CHANGE POLICY, UH, HELPING TO EDUCATE AND INFORM, UM, DECISION MAKERS ABOUT POLICIES THAT ARE GOOD FOR THE COMMUNITY IN TERMS OF ADDRESSING DIABETES, AND ALSO TRYING TO REACH OUT TO THE PROVIDERS WHO WE KNOW IN DOING OUR INTERVIEWS WITH, WITH OUR PARTNERS.
UM, SOME PROVIDERS ARE DOING A FANTASTIC JOB OF MAKING INSULIN AVAILABLE OR PROVIDING PRESCRIPTIONS, BUT THEIR PRESCRIPTIONS THAT THE INDIVIDUALS CANNOT AFFORD, COULD NEVER AFFORD.
SO REALLY IT'S ABOUT EDUCATING THE PROVIDERS ABOUT, THERE'S A DIFFERENT, THERE ARE DIFFERENT APPROACHES TO THE INSULIN THERAPY THAT ARE MUCH MORE AFFORDABLE, THAT WOULD WORK AS WELL.
SO I GUESS I WANTED TO GIVE YOU JUST A PICTURE OF THIS, IS, THIS IS THE HOLISTIC APPROACH, UH, LOCATION, EDUCATION, PATIENT NAVIGATION, INSULIN SAFETY FUND, AND THEN NOT TO, NOT TO LEAVE OUT THE OUTREACH, THE POLICY CHANGE, AND, UH, REALLY TRYING TO EMPOWER, UM, INDIVIDUALS.
SO DOES THAT, DOES THAT HELP? YEAH, THAT HELPS.
I'M GONNA NEED TO SEE A BREAKDOWN OF WHAT THIS 1.6 MILLION WOULD GO TO.
I, I, I, I THINK WE CAN DO THIS MORE, UM, EFFICIENTLY WITH LESS MONEY.
UM, CLAUDE, DID YOU HAVE A FOLLOW UP ON THAT? YEAH, NO, NO.
WE, WE CAN PROVIDE THAT BREAKDOWN.
AND WE'LL SEND IT OUT TO THE COMMITTEE.
UM, COUNCILMAN THANK YOU, CHAIR.
UM, I'M GOING TO FIRST PLUG SOMETHING.
SO NOVEMBER 5TH, THE SECOND ANNUAL DIABETES HEALTH FAIR AT DAVIS SCOTT, Y M C A, I'LL BE TEACHING A ZUMBA CLASS.
I AM WHOLEHEARTEDLY IN SUPPORT OF OPTION THREE.
UM, THE THINGS THAT WE'RE TALKING ABOUT DOING WITH THE $1.6 MILLION WE ARE NOT CURRENTLY DOING.
WE ARE NOT CURRENTLY DOING THAT.
IT'S NOT AS SIMPLE AS GOING TO SOMEONE AND TELLING THEM TO FIX THEIR FOOD HABITS.
IT'S NOT ANY OF THE THINGS THAT ARE ACCESSIBLE RIGHT NOW.
I'LL TELL YOU, A LOT OF FOLK IN MY DISTRICT DO NOT HAVE SUPPORT OR DO NOT HAVE, UM, EASY ACCESS TO A NURSE OR A DIETICIAN IN THE WAY THAT THEY WOULD HAVE WITH ONE OF THESE HUBS.
AND SO THAT IS EXCITING TO ME.
AND THE, UM, I'LL, I'LL SAY I WAS A LITTLE BIT DISAPPOINTED WHEN I WENT TO GOVERNANCE, AND, YOU KNOW, I WAS EXCITED, DISAPPOINTED AS WELL, BECAUSE THE INSULIN SAFETY FUND WASN'T INCLUDED.
AND IT, EVEN A LOT OF THIS STUFF REALLY WASN'T EVEN INCLUDED.
AND SO WALK AWAY FEELING LIKE, HEY, WE'RE GONNA HAVE A GREATER FOCUS ON DIABETES, BUT WE DIDN'T GET TO DO ALL THE THINGS I WANTED.
AND SO I APPRECIATE THAT YOU HAD ALL THOSE CONVERSATIONS WITH STAKEHOLDERS AND THE PEOPLE WHO ARE DOING THE WORK, AND THEY ADVISED YOU, HEY, THIS IS THE WAY THAT I WOULD GO.
AND SO I THINK THAT THAT'S, AND THEY'RE THE PEOPLE WHO ARE ALSO, UM, DOING MORE THAN JUST SAYING, OH, FIX YOUR, FIX YOUR DIET AND WALK A LITTLE BIT MORE.
I THINK IT'S IMPORTANT TO ACKNOWLEDGE THE WORK THAT'S BEING DONE THAT'S FAR BEYOND THAT.
AND THIS IS THE RECOMMENDATION THAT THEY'RE MAKING.
I THINK IF WE'RE LOOKING AT $1.6 MILLION IN A MULTI-BILLION DOLLAR BUDGET, WHERE DEPARTMENTS RECEIVE 20 TIMES THIS AMOUNT IN AN INCREASE ALONE TO THEIR BUDGET, I THINK THAT'S SOMETHING TO, TO ACKNOWLEDGE.
AND, UM, METRO HEALTH IS BECOMING AN INCREASING INCREASINGLY, UM, SIGNIFICANT DEPARTMENT AS TIME GOES ON.
AND THE PANDEMIC REALLY, UM, SPEED, UH, SPED THAT UP.
UM, YOU KNOW, LIKE I JUST SAID, I'M EXCITED THAT THE COST SHARE PROGRAM MADE ITS WAY, WAY THROUGH, UM, DUE TO A LARGER EFFORT THROUGH DISCUSSION AND COLLABORATION WITH VARIOUS STAKEHOLDERS.
DIABETES IS A GLOBAL EPIDEMIC, AND INSULIN IS AN ABSOLUTE NECESS, UH, NECESSITY TO SURVIVE FOR MANY.
AND IT'S WITHIN OUR POWER AT ALL LEVELS OF GOVERNMENT, UM, TO RELIEVE SOME OF THAT BURDEN FOR THOSE WITH THIS DISEASE.
WE KNOW, AS INDICATED, UM, IN THE PREVIOUS PRESENTATION, THAT MANY OF OUR CONSTITUENTS HAVE HAD TO MAKE A DIFFICULT CHOICE BETWEEN EXPENSES LIKE RENT, FOOD, UTILITIES, UM, AND ME MEDICAL CARE.
AND SO ACROSS THE COUNTRY, WE'VE HEARD OF THOSE WHO DIE.
AND IN OUR NEIGHBORHOODS, WE HEAR OF THOSE WHO DIE BECAUSE THEY CANNOT AFFORD THEIR INSULIN, AND THEY HAD TO MAKE A CHOICE BETWEEN STAYING HOUSED OR HEALTHY.
[01:25:01]
AND SO, I WANNA THANK COUNCILMAN ROCHA GARCIA.UM, WHEN I FIRST APPROACHED HER WITH THIS IDEA, WE HAD A MINI, A PHONE CALL, UM, AND SHE WAS EAGER, AND SHE HAD A TON OF IDEAS, AND SHE SHARED WITH ME THAT HER FATHER HAS DIABETES, AND SHE VISITS HER PARENTS EVERY DAY TO CARE FOR THEM.
AND I FEEL LIKE I REALLY GOT TO KNOW, UM, HER A LOT DURING THE PROCESS OF CRAFTING AND AUTHORING THE C C R.
AND SO I APPRECIATE HER WILLINGNESS.
I APPRECIATE HER WILLINGNESS TO COLLABORATE WITH A NEWBIE.
UH, I DO ALSO HAVE TO GIVE CREDIT TO MY CHIEF OF STAFF, UH, FRANKIE TKI WHO, UH, WHO GAVE ME THIS IDEA.
SO I GOTTA GIVE HIM, GOTTA GIVE HIM CREDIT FOR THAT.
AND IT'S BECAUSE HIS SISTER HAS DIABETES, AND DIABETES RUNS IN, IN MY FAMILY.
AND SO I JUST THINK, JUST WANTED TO EXPRESS THAT BECAUSE THIS IS AN ISSUE THAT AFFECTS SOMEBODY THAT WE ALL KNOW, SOMEBODY THAT WE ALL KNOW.
AND SO WHATEVER IMPACT WE CAN HAVE, I THINK WE NEED TO BE MAKING THAT IMPACT.
AND SO MY FULL SUPPORT WILL BE GOING TO OPTION THREE.
UM, I, I'M WONDERING, IS THERE CURRENTLY, NO, I WON'T ASK THAT.
BEYOND THIS PLAN, BEYOND THE THINGS THAT ARE, UM, BEING DISCUSSED TODAY, WHAT DOES EXPANSION LOOK LIKE TO ASSIST MORE PEOPLE? I KNOW THAT THE, UM, INSULIN, UH, SAFETY FUND WOULD SUPPORT A THOUSAND, COULD ONLY SUPPORT ABOUT A THOUSAND PEOPLE, BUT WHAT WE'RE TALKING ABOUT IS GONNA BE MORE THAN A THOUSAND.
WHAT DOES THAT LOOK LIKE? AND THEN BEYOND THAT PROGRAM, WHAT WOULD WE NEED TO DO TO GET EVEN MORE PEOPLE IMPACTED? I KNOW I'M THINKING 20 YEARS.
YEAH, NO, AGAIN, AND RIGHT NOW THIS WAS IN RESPONSE TO THE C C R.
SO WHAT WE'RE PROVIDING IS AT LEAST A BETTER, BETTER PLATFORM, A MORE COMPREHENSIVE MODEL.
UM, WE HAVE NOT GOTTEN TO 2040 AND WHAT THAT WOULD LOOK LIKE, OR NOR HAVE WE COSTED THAT OUT.
SO AT LEAST LET'S, UH, ALLOW, UH, US TO BUILD ON WHAT WE HAVE.
WE DO HAVE A MULTI-YEAR PLAN ANCHORED ESSAY FORWARD.
SO YOU'VE MENTIONED THAT IN BEXAR COUNTY, DIABETES IS THE SECOND HIGHEST LEADING CAUSE OF DEATH.
WHAT IS THE FIRST HEART DISEASE? HEART DISEASE.
SO THESE LEADING CAUSES OF DEATH ARE DUE TO CHRONIC HEALTH OUTCOMES, CHRONIC DISEASES.
AND I DON'T THINK THAT AT THE LOCAL LEVEL, WE ARE DOING ENOUGH TO ADDRESS THOSE TWO, THOSE TWO THINGS, AND HEALTH AS A WHOLE, REALLY.
AND THAT'S WHY I FEEL METRO HEALTH HAS BEEN UNDERFUNDED FOR SO LONG, AND I THINK NOW IS A TURNING POINT WHERE WE HAVE AN OPPORTUNITY TO DO SOMETHING ABOUT THAT.
AND SO, UM, I'LL BE FULLY SUPPORTIVE, AND I REALLY, REALLY APPRECIATE THE EVOLUTION OF THIS, UH, OF THIS.
UM, CASTILLO, THANK YOU CLAUDE, FOR THE PRESENTATION.
AND TO, UH, COUNCIL MEMBER JALEN MCKEE RODRIGUEZ AND DR.
ADRIANA, ROD GARCIA FOR, UH, PUTTING THIS C C R OUT, IT'S REALLY IMPORTANT, AS MENTIONED, RIGHT? DISTRICT FIVE DOES HAVE A HIGH PERCENTAGE OF INDIVIDUALS AND FAMILIES WITH DIABETES.
AND YOU KNOW, I RECOGNIZE THAT, YOU KNOW, WE ARE, TEXAS IS IN SHAMBLES RIGHT, WHEN IT COMES TO HEALTHCARE, BUT I DO ENVISION A WORLD IN THE UNITED STATES WHERE WE DO HAVE MEDICARE FOR ALL.
UM, BUT TILL WE GET THERE, RIGHT? UM, THIS C C R AND THE RECOMMENDATION STEP TOWARDS, UH, ENSURING THAT WE'RE TAKING CARE OF OUR COMMUNITY, OUR CONSTITUENTS, AND OUR FAMILIES, RIGHT? UM, AND WHAT THAT LOOKS LIKE, UH, HERE IN SAN ANTONIO IS TO CONTINUE TO CONNECT OUR FAMILIES AND COMMUNITIES TO THAT, UH, KNOWLEDGE AND THOSE RESOURCES.
AND I'M REALLY GRATEFUL FOR, UH, RACHEL ON OUR TEAM AND OUR CONSTITUENT SERVICES TEAM, RIGHT? 'CAUSE OFTENTIMES WE DO HAVE FAMILIES THAT CALL US, UM, TRYING TO NAVIGATE THE BUREAUCRACY OF APPLYING FOR MEDICAID, MEDICARE, UM, TRYING TO ACCESS THAT HEALTH INSURANCE, RIGHT? AND WE TRY TO NOT, YOU KNOW, SEND OUR CONSTITUENTS ALL OVER THE PLACE.
SO IF WE CAN COMPLETE THE APPLICATION WITH THEM, WE WILL, RIGHT? UM, BUT RECOGNIZING THE IMPORTANCE OF HAVING THOSE COMMUNITY HUBS, UM, TO HELP COMMUNITY, TO HELP COMMUNITY WALK THROUGH AND WALK THROUGH AND NAVIGATE THAT PROCESS, UM, WILL MAKE A WORLD OF A DIFFERENCE TO OUR COMMUNITY WHO IS ALREADY DEALING WITH, UH, A NUMBER OF PRESSURES AND STRUCTURES, RIGHT? UM, WE KNOW THAT HAVING UNNEEDED MATERIAL METS ALSO, UM, NEEDS MET.
UH, ALSO IMPACTS, IMPACTS, UH, GLUCOSE LEVELS, UH, HIGH BLOOD PRESSURE, AND ALL THOSE OTHER, UH, HEALTH FACTORS THAT CAN LEAD TO DIABETES, RIGHT? THAT CAN LEAD TO, UM, OTHER HEALTH CONDITIONS.
SO, UM, I, I THINK THIS IS A GREAT START.
I I ALSO BELIEVE THAT, YOU KNOW, WE SHOULD BE INVESTING MORE IN METRO HEALTH, ESPECIALLY GIVEN, UH, THE MAKEUP HERE IN TEXAS.
UM, BUT I, I'M REALLY PLEASED TO SEE, UH, THE WORK OF MY COLLEAGUES AND METRO HEALTH FOR ENSURING THAT, UH, WE'RE MOVING TOWARDS THAT BETTER.
UM, I WANNA JUST ECHO WHAT, WHAT THE COUNCILWOMAN SAID COMPLETELY, UH, AGREE WITH THAT.
I JUST A COUPLE OF QUESTIONS BEFORE, UH, WE MOVE ON TO OUR NEXT ITEM.
[01:30:02]
WHEN WE BROUGHT FORWARD A FEW YEARS AGO, A HOLISTIC APPROACH ON AIDS MANAGEMENT IN SAN ANTONIO, THERE WAS, UH, THERE WAS SOME TARGETS THAT WERE ADOPTED, AND I, I BELIEVE THAT WAS A, THAT'S A NATIONAL CAMPAIGN, RIGHT? THOSE TARGETS WERE SET BY THAT.UM, IS FOR DIABETES, I, I THINK IT WOULD BE GREAT IF WE HAD SOME TANGIBLE TARGETS THAT, THAT WE WERE REACHING.
IS, IS THERE A SIMILAR CAMPAIGN THAT WE CAN LATCH ONTO, OR IS THAT SOMETHING THAT WE CAN SET OUR, ESTABLISH OURSELVES IF THE COUNCIL MEMBERS WHO ARE PUTTING FORWARD, LET'S DO IT.
THIS, UM, IT'S JUST, YOU KNOW, I, I LISTENED TO, TO WHAT THE COUNCILWOMAN SAID, YES, A LOT OF WORK HAS BEEN DONE ON DIABETES.
THERE'S SO MUCH INVESTMENT IN IT, AND YET WE CAN CONTINUE, CONTINUE TO HAVE, UH, COMPLETE FAMILIES, RIGHT? THAT, THAT HAVE, UH, THIS DISEASE.
SO I, I WOULD JUST LIKE TO HAVE A GOAL THAT WE'RE WORKING TOWARD.
SO, UM, THANK YOU FOR THAT QUESTION.
JUST THINKING ABOUT HEALTHY PEOPLE, 2020 OR HEALTHY PEOPLE, 2030, WE'LL GO BACK AND SEE IF THERE'S A SPECIFIC TARGET, UH, REFERENCING DIABETES IN PARTICULAR, BUT, UH, TO THE ALIGNMENT WITH NATIONAL FRAMEWORKS AND TO THE ALIGNMENT OF OUR EFFORTS HERE LOCALLY.
THAT IS A COMMITMENT BY OUR DEPARTMENT.
UM, SO THANK YOU FOR THAT QUESTION.
AND, UM, I GUESS IT WOULD BE SOMETHING THAT, YOU KNOW, WE CAN EITHER TAKE ON FOR OUR OWN PROGRAM OR WORK WITH THESE PARTNERS TO COME TO SOME, SOME TARGET.
AND YOU KNOW WHAT, IT'S OKAY IF WE DON'T MEET IT AT THE A HUNDRED PERCENT LEVEL, BUT I JUST, I WANNA SEE WHERE WE ARE FROM BEFORE TO, TO NOW.
YOU, YOU TALKED ABOUT 283 UNINSURED INDIVIDUALS IN SAN ANTONIO, YET THAT THERE ARE A C A PLANS AVAILABLE AT $10 A MONTH FOR THOSE WHO QUALIFY.
IS THERE A SENSE OF WHAT THAT GAP IS? SO OF THE 283,000, MAYBE THEY ALL CAN'T GET ON THE $10 A MONTH PLAN, BUT YOU KNOW, WHO, WHO, WHO'S STILL VULNERABLE? GO AHEAD.
A ABOUT HALF OF PEOPLE ARE ELIGIBLE FOR SUBSIDIES, UM, DEEP SUBSIDIES UNDER THE, UNDER ARPA FUNDING THAT ARE GOING TO BE CONTINUED NOW FOR THE NEXT THREE YEARS.
AND PEOPLE JUST DON'T KNOW IT.
AND I WANNA MENTION THAT THE, UH, OPEN ENROLLMENT FOR THE A C A STARTS ON NOVEMBER 1ST.
UM, WE'RE, WE'RE OFFERING SOME TRAININGS TO OUR STAFF.
AND I, I THINK, YOU KNOW, YOUR STAFF ARE WELCOME TO JOIN THOSE SO THAT PEOPLE CAN UNDERSTAND THAT WE DO HAVE FREE ONE-ON-ONE HELP HERE IN SAN ANTONIO.
AND, UM, IN TERMS OF THE TARGETING FOR THE FUND ITSELF, UM, HOW WOULD YOU BEGIN THAT? UH, THE PEOPLE WHO ACTUALLY NEED THE, THE ASSISTANCE? I MEAN, PEOPLE CAN COME TO, TO YOU, I IMAGINE THERE'S GONNA BE SOME, SOME MARKETING CAMPAIGN AROUND IT, BUT WHAT ABOUT PEOPLE WHO MAY FREQUENTLY BE EXPERIENCING EPISODES THAT TAKE THEM TO THE EMERGENCY ROOM? IS THAT ALSO GOING TO BE PART OF YOUR TARGET? THAT'S A GOOD QUESTION AS WELL.
SO, UH, THE PLAN IS THAT AS WE'VE ENVISIONED IT, THAT, UH, THE FOLKS THAT COME TO OUR WORKSHOPS ARE, UH, A GREAT REFERRAL SOURCE RIGHT THERE.
SO WE WOULD BE REFERRING PEOPLE FROM OUR WORKSHOPS TO THESE HUBS FOR THAT ENROLLMENT OR HELP MM-HMM.
UM, WE WOULD ALSO ENCOURAGE OUR PARTNERS LIKE THE Y M C A WHO ARE HAVING WORKSHOPS OF THEIR OWN TO DO THE SAME THING.
SO, UH, I THINK THERE'S A, THERE'S AN OPPORTUNITY, AND TO BE FRANK, WE HAVEN'T QUITE THOUGHT THIS THROUGH YET, ABOUT HOW DO WE PROMOTE THAT, UM, BEYOND OUR, THE PEOPLE THAT WE COME IN CONTACT WITH AND WE TOUCH ALREADY.
UH, AND SO WE'LL HAVE TO THINK ABOUT HOW DO WE WANT TO PROMOTE THAT TO THE COMMUNITY.
AND WE ALSO HAVE TO ESTABLISH THE CRITERIA.
SO IT WILL BE VERY IMPORTANT THAT THESE, THIS SAFETY FUND IS A SAFETY FUND.
IT'S A LAST RESORT, BECAUSE WE HOPE THAT BY THIS, BY ENROLLING HERE, BY GETTING THE PRESCRIPTION ASSISTANCE PROGRAM, THAT NOBODY NEEDS A SAFETY FUND.
BUT IF THEY DO, BECAUSE THEY MIGHT, THEN IT'LL BE THERE, BUT IT'S NOT GOING TO BE A COME IN, LET ME WRITE YOU A CHECK FOR THE INSULIN BEFORE WE GO THROUGH ALL THESE OTHER STEPS THAT, UM, COULD ACTUALLY BE A BETTER SOLUTION FOR THEM.
A LONG TERM SOLUTION, HOPEFULLY.
AND THEN LAST QUESTION, PROBABLY THE, THE ONE THAT'S LINGERING ON, ON MANY MINDS IS, OKAY, IF WE SEND THIS FORWARD TO COUNCIL, THAT WE'RE NOT SENDING THE FUNDS FORWARD, WE'RE SENDING THE REQUESTS FOR THE FUNDS FORWARD.
SO, UM, WHAT APPROACH ARE YOU TAKING RIGHT NOW TO LOCATE THAT MONEY? ARE WE TALKING ABOUT NEXT YEAR'S
[01:35:01]
BUDGET AT LIKE, TO, TO HOLD THIS AND, AND PUT IT IN AS A REQUEST FOR NEXT YEAR'S BUDGET? OR HOW ARE YOU GONNA FIND THE MONEY? OR DO WE NEED TO DO THAT? NO, GREAT QUESTION.SO AGAIN, UH, THE LION'S SHARE OF OUR OPERATING BUDGET IS FROM EXTERNAL FUNDS.
SO THAT'S WHAT WE'VE BEEN ABLE TO LEVERAGE.
UH, WE DO HAVE THE STABILIZER AVAILABLE WITH THE SUPPORT OF THE GENERAL FUND.
SO WE'RE SIMPLY ACKNOWLEDGING THAT IT WOULD REQUIRE OTHER FUNDING.
WE HAVE NOT IDENTIFIED WHAT THAT FUND, WHERE THAT WOULD COME FROM.
SO I'M JUST WONDERING IF IT'S APPROPRIATE TO, OH, DO YOU HAVE A COMMENT ON THAT? I, I HAVE A QUESTION.
HOW DO, UH, LIKE THE CARRY FORWARD FUNDING, HOW CAN THAT POTENTIALLY BE USED TO SUPPORT THIS? WOULD IT HAVE TO COME FROM COUNCIL OR RECOMMENDATION FROM METRO HEALTH? MAY MAYBE OUR, GO AHEAD, MR. MCCAREY.
YOU KNOW, WHAT I WOULD RECOMMEND IS THAT YOU ACTUALLY TAKE THIS TO A B SESSION, ALLOW ALL OF COUNCIL TO WEIGH IN.
THIS IS SUCH AN IMPORTANT ENDEAVOR THAT WE WANT TO EXPAND BEYOND, SO THAT WE CAN ALSO HAVE OUR FINANCE COME FORWARD, OUR BUDGET AND MANAGEMENT COME FORWARD.
LET'S PUT EVERYBODY IN THE ROOM AND COME UP WITH THE FUNDING.
I WOULD TAKE THAT APPROACH, THE MOTION.
UH, FINAL COMMENT, COUNCILWOMAN.
I THINK WE NEED TO TAKE IT TO B SESSION.
'CAUSE IF WE'RE SERIOUS ABOUT THIS, WHICH I, I BELIEVE ALL OF US ARE FINDING A WAY WE NEED TO MAKE ROOM FOR THIS DISTRICTWIDE.
AND THAT'S EIGHT TO 10 MILLION, CORRECT? IF WE'RE GONNA TAKE THIS TO THE CITY, AND I THINK WE NEED TO HAVE, UM, HAVE ALL OUR COUNCIL COLLEAGUES WEIGH IN AND, UM, UH, ON THIS ISSUE.
SO I THINK CLAUDE IS HAPPY TO TAKE YOUR EIGHT TO 10 MILLION
NO, THE 1.6 MILLION IS, IS CITYWIDE, RIGHT? NO, IT'S FOR TWO HUBS.
OH, ONLY ESTABLISHING TWO HUBS.
THAT IS YOUR SUGGESTION IS TO, SO THAT'S WHY I'M LIKE, YES, LET'S DO THESE.
IF WE DO THESE TWO HUBS AND, AND WE SEE THE SUCCESS WE WANT, WE MAKE ROOM IN THE BUDGET NEXT YEAR OR THE YEAR AFTER FOR EXPANDING THIS.
CLAUDE, ANY CLOSING COMMENTS? I SEE YOUR HEAD MOVING.
N NO, JUST SIMPLY, UM, SAYING THANK YOU FOR ALLOWING US TO AT LEAST, UM, PUT THIS INTO A BIGGER CONTEXT.
UM, WE ARE MAKING SURE THAT THIS ALIGNS WITH EFFORTS THAT ARE ALREADY ON THE GROUND, WHICH IS WITH A REFERENCE TO ESSAY FORWARD.
BUT AT THE END OF THE DAY, WHAT WE'RE PLAYING BACK IS THE FACT THAT THESE CONDITIONS HAVE GOTTEN WORSE THROUGH THIS C O I D EXPERIENCE THAT WE'VE BEEN HAVING FOR THE LAST COUPLE YEARS.
SO WE'RE TRYING TO AT LEAST, UH, PLAN FOR THE WORST, BUT MAKING SURE THAT WE SUPPORT RESIDENTS.
UH, SO THANK YOU FOR THIS CONVERSATION AND WE'LL, UH, WE'LL BE AVAILABLE FOR THE NEXT STAGE OF THIS.
THANK, UH, IT LOOKS LIKE THERE'S A CLOSING COMMENT, AND THEN WE WILL MOVE ON TO THE NEXT ITEM, WHICH IS YOURS ALSO.
YES, I GUESS, UM, JUST WHAT I MIGHT LIKE TO SEE, UH, BEFORE THIS GOES TO BE SUCH, SO WE WILL HAVE TO TAKE A VOTE ON THAT, I THINK.
UM, I WOULD LIKE FOR US TO HEAR WHAT WOULD BE THE PLAN FOR EXPANSION LATER ON.
SO WHAT WOULD BE THE METRICS WITH, YOU KNOW, THE FIRST TWO DISTRICTS, AND THEN WHO MIGHT BE THE NEXT DISTRICT'S IMPACTED? AND MAYBE A SLOWER, BECAUSE IT MIGHT BE A WHILE BEFORE WE HAVE TO GET TO SAY A DISTRICT NINE OR EIGHT.
SO I, I WOULD JUST LIKE TO KNOW ABOUT
AND, UH, THANK YOU FOR THE REMINDER.
WE DO HAVE A MOTION ON THE FLOOR, UM, AND I CAN SAY, AS YOU SAID, I THINK UNDER THE MOTION, IF THE COUNCIL, UH, COUNCILMAN CAN JUST CLARIFY THE MOTION SO IT'S CLEAR WHAT IT, WHAT IT WAS, BECAUSE THERE'S THREE OPTIONS PRESENTED AND I MOVE TO S PRESENTATION WITH ALL THREE RECOMMENDATIONS TO THE SESSION.
ALL THREE RECOMMENDATIONS, OR THE THIRD RECOMMENDATION.
OKAY, SAY THAT AGAIN, BUT CLEARLY WHICH ONE? I WOULD LIKE TO SEND OPTION THREE AS A B MICROPHONE.
I FORGOT TO TURN MY MICROPHONE ON.
I WOULD LIKE TO, UM, SEND OPTION THREE TO FULL COUNSEL FOR A B SESSION.
AND WE HAVE A SECOND ALREADY FOR THAT.
ALL THOSE IN FAVOR, PLEASE SAY AYE.
UM, OKAY, UH, WE HAVE ONE MORE ITEM, AND I KNOW THERE ARE SOME PEOPLE HERE.
ARE THERE
UM, I THINK WE CAN GET THROUGH THAT ITEM.
WOULD THAT BE SUFFICIENT TIME? OKAY.
THAT MEANS WE ARE GOING TO HAVE TO LIMIT COUNCIL CONVERSATION A LITTLE BIT, SO TAKE IT AWAY.
UM, FOR THIS OPPORTUNITY, AGAIN, THIS IS ON, UH, UM, THE LAST ITEM HAVING TO DO WITH OUR, UH, FOOD ACCESS ROADMAP.
[01:40:01]
QUICKLY, THESE ARE THE POINTS THAT I'LL BE COVERING.QUICK SNAPSHOT BACKGROUND, TALKING ABOUT THE ALIGNMENT OF OUR WORK, UH, AT METRO HEALTH, TALKING ABOUT FOOD ACCESS, GOING FROM TALKING ABOUT FOOD ACCESS TO FOOD INSECURITY, AND THEN BEING MORE INTENTIONAL AS PART OF OUR COLLABORATIVE PROCESS AND OUR RECOMMENDATION.
UM, SO IN BROAD STROKES, AGAIN, THANK YOU FOR THE OPPORTUNITY TO PRESENT OUR RESPONSE AND RECOMMENDATIONS REGARDING C C R.
THAT WAS SUBMITTED ON JANUARY 11TH ON THE ESTABLISHMENT OF A FOOD ACCESS PLAN FOR SAN ANTONIO.
THE C C R WAS SUBMITTED TO ADDRESS THE FOOD INSECURITY THAT MANY RESIDENTS EXPERIENCE IN OUR CITY, AND TO IMPROVE FOOD ACCESS ACROSS THE MOST VULNERABLE AREAS OF THE CITY.
UH, BEXAR COUNTY RESIDENTS HAVE A HARD TIME FINDING FOOD TO EAT ON A DAILY BASIS.
17.6% OF SAN ANTONIO RESIDENTS LIVE IN POVERTY.
14% OF COUNTY, UH, BEXAR COUNTY RESIDENTS EXPERIENCE FOOD INSECURITY 20% OR ONE IN FIVE CHILDREN.
UH, IN SAN ANTONIO EXPERIENCE FOOD INSECURITY.
THESE DISPARITIES AFFECT LATINO AND BLACK HOUSEHOLDS MORE THAN THEIR WHITE COUNTERPARTS.
WE ALSO KNOW THAT SPECIFIC REGIONS, UM, IN SAN ANTONIO, PREDOMINANTLY SOUTHWEST AND EAST SIDE, SEE HIGHER RATES OF FOOD INSECURITY AND OTHER SOCIAL DETERMINANTS OF HEALTH.
UM, AGAIN, YOU KNOW THIS ABOUT, UH, BACK IN JANUARY.
AND JUST IN TERMS OF, UH, ASSETS AND WHAT WE CURRENTLY HAVE IN PLACE, I'M PROUD TO SAY THAT, UM, METRO HEALTH, OUR TEAM AND OUR PARTNERS HAVE SEVERAL SUCCESSFUL EFFORTS CURRENTLY UNDERWAY TO ADDRESS FOOD ACCESS, UM, THAT ARE TAKING PLACE ACROSS COUNCIL DISTRICTS AND TARGET AREAS WHERE HEALTH INEQUITIES EXIST.
SO, COMMUNITY GARDENS, UH, OUR HEALTHY NEIGHBORHOODS PROGRAM SUPPORTS COMMUNITY GARDENS AND TEACHING GARDENS WITHIN PRIORITIZED NEIGHBORHOODS AS A WAY TO CONNECT RESIDENTS TEACH ABOUT NUTRITION AND FOOD SOVEREIGNTY AND SUPPORT OF VIBRANT COMMUNITY.
CURRENTLY, SEVERAL GARDENS ARE SUPPORTED BY THE PROGRAM TO INCLUDE THE PECAN VALLEY WIC TEACHING GARDEN, THE GARDEN CLUB AT VILLARIO ELEMENTARY SCHOOL, AND THE PRESA COMMUNITY CENTER GARDEN.
ADDITIONALLY, COMMUNITY HEALTH WORKERS WITH THE PROGRAM ARE AVAILABLE TO NEIGHBORHOOD ASSOCIATIONS AND RESIDENTS FOR TECHNICAL SUPPORT IN ORGANIZING, UH, GARDEN WORK DAYS AND TEACHING DAYS.
UM, WE ALSO HAVE HEALTHY CORNER STORES.
SO WE STARTED A PILOT PROGRAM IN 2018.
THE HEALTHY CORNER STORES PROJECT WAS CREATED IN PARTNERSHIP WITH THE FOOD POLICY COUNCIL, UH, U I W AND THE HEALTHY NEIGHBORHOODS PROGRAM, AND INCLUDED EIGHT PARTICIPATING STORES.
THE PROGRAM CURRENTLY RESIDES WITHIN OUR HEALTHY NEIGHBORHOODS PROGRAM AND HAS 34 PARTICIPATING STORES.
THE PROGRAM INCENTIVIZES STORE OWNERS IN SELLING FRESH FRUITS AND VEGETABLES AT THEIR STORES, WHICH ARE SELECTED, UH, BASED ON BEING LOCATED WITHIN A FOOD DESERT, UH, AREA, ACCEPTING SNAP BENEFITS AND STORE OWNER INTEREST IN SUPPORTING THE HEALTH OF THE COMMUNITY.
UM, FINALLY, THE, UH, FOOD TREE PROJECT.
UM, OUR, OUR HEALTHY NEIGHBORHOODS PROGRAMS, UH, PROGRAM SUPPORTS COMMUNITY MEMBERS WITH FRUIT TREES IN THE COLLECTION AND DISTRIBUTION OF EXCESS FRUIT TO LOCAL FOOD PANTRIES WITHIN THE NEIGHBORHOOD THAT THE FRUIT WAS GROWN IN.
UH, THIS INITIATIVE ADDRESSES BOTH FOOD WASTE AND FOOD INSECURITY BY CONNECTING EXCESS FOOD WITH THE DISTRIBUTION CENTER DUE TO THE FREEZE LAST YEAR, KNOCKING OUT A LOT OF, UH, THE CITRUS TREES.
THE PROJECT HAS BEEN, UH, ALSO, UH, THEN PROVIDING FRUIT TREES TO RESIDENTS AND TEACHING THEM ABOUT TREE MAINTENANCE.
UM, OTHER EFFORTS, UH, CURRENTLY UNDERWAY.
SO WE'VE DEVELOPED, UH, THROUGH METRO HEALTH, UH, RESOURCE BROCHURE FOR ALL 10, UH, COUNCIL DISTRICTS, BOTH IN ENGLISH AND IN SPANISH, THAT HIGHLIGHT THE AVAILABILITY OF PREVENTION, DIABETES PREVENTION, SELF-MANAGEMENT WORKSHOPS, THE PORT VITA RESTAURANT PARTNERS, THE FREE FITNESS IN THE PARK ACTIVITIES, WIC SERVICES, AND THE HEALTHY QUARTER STORES WITHIN EACH COUNCIL DISTRICT.
THE BROCHURES ARE A VALUABLE ADDITION TO COMMUNITY HEALTH WORKERS AND OUTREACH TEAMS ACROSS OUR DEPARTMENT.
UH, SO OUR STAFF, UH, IMPLEMENT SEVERAL COOKING CLASSES THAT UTILIZE OUR VIVA HEALTH NUTRITION EDUCATION KEY MESSAGES AND TEACH SIMPLE COOKING SKILLS, UH, TEAK TALO FOOD FOREST, WHICH IS INITIATED BY THE FOOD POLICY COUNCIL.
AND THROUGH FUNDING FROM THE CITY'S OFFICE OF INNOVATION, A FOOD FOREST IS BEING DEVELOPED ON THE, UH, COUNTY'S PADRE PARK, UH, LOCATED ON THE SOUTH SIDE OF THE CITY.
THE HEALTHY NEIGHBORHOODS COMMUNITY HEALTH WORKERS HAVE FACILITATED A CRITICAL ROLE IN, UH, ENSURING COMMUNITY ENGAGEMENT THROUGH, UM, THROUGHOUT THE VISIONING PLANNING AND IMPLEMENTATION STEPS OF THE PROJECT.
THE PROJECT ITSELF BRINGS INDIGENOUS COMMUNITY MEMBERS AND ORGANIZATIONS TO THE PROJECT TO PLAY A CENTRAL ROLE IN DETERMINING THE PURPOSE OF THE SPACE AS A WAY TO TEACH THE YOUTH ABOUT NATIVE CULTURE AND LOCAL FOOD AND MEDICINE PRODUCING PLANTS.
THE NAME LON MEANS FIRE SPIRIT AND HONORS THE CONNECTION BETWEEN THE SACRED CEREMONIAL FIRE AND THE SUN, WHICH PROVIDES ENERGY AND WARMTH FOR OUR PEOPLE AND THE PLANTS WE GROW.
[01:45:03]
SO VACANT LOTS, UH, USING VACANT LOTS FOR GROWING FOOD HAS BEEN AN INTEREST OF THE FOOD POLICY COUNCIL FOR MANY YEARS.A GREAT DEAL OF RESEARCH HAS BEEN DONE BY THE FOOD POLICY COUNCIL TO FIGURE OUT WHAT'S NEEDED HERE IN THE CITY TO MAKE THAT A REALITY.
THERE ARE MANY CHALLENGES TO MOVING AN INITIATIVE LIKE THIS FORWARD, HOWEVER, UM, THE, UH, UH, URBAN AGRICULTURE WORK WORK GROUP WITHIN THE FOOD POLICY COUNCIL HAS DEVELOPED A LIST OF RECOMMENDATIONS AND JUST WANTED TO QUICKLY HIGHLIGHT THEM.
SO, CONVENING A POLICY GROUP HERE IN THE CITY, CONDUCTING SOIL SAMPLE TESTS, UH, STAYING TUNED FOR A PILOT OF URBAN, UH, INVEST, WHICH IS A DATA TOOL FOR, UM, FROM STANFORD UNIVERSITY THAT WILL ENABLE URBAN PLANNERS TO PROJECT, UH, THE ENVIRONMENTAL MENTAL, PHYSICAL, UH, HEALTH VALUE OF CHANGING LANDS, UH, TO USE GREEN SPACES.
UM, THERE, THERE'S A RECOMMENDATION ABOUT EXPANDING THE GOAL BEYOND VACANT LOTS TO CITY OWNED PROPERTY.
THAT IS, UH, UH, UM, HAS A LARGE OPEN SPACE FOR FOOD PRODUCTION, UH, LOOKING AT EXPANDING THE CITY'S, UH, TOOL LIBRARY, UH, AND LOOKING AT SUPPORTING, UH, UH, CODE CHANGES PROPOSED BY THE FOOD POLICY COUNCIL.
UM, AGAIN, BY RECOGNIZING THAT COMMUNITY FOOD SECURITY AS A PUBLIC GOOD REMOVES VIOLATIONS FOR HAVING ITEMS ON THE PROPERTY RELATED TO FARMING.
GARDENING SUCH AS SHEDS AND COMPOST PILES AND CHANGES THE, UH, CERTIFICATE OF DETERMINATIONS TO REMOVE THE PLATTING REQUIREMENTS, UM, FOR URBAN FARMS AND FOOD REDUCTION.
SO THIS IS A, A QUICK, UH, SNAPSHOT JUST OF OUR EVOLUTION OVER, OVER THE LAST, UH, THIS YEAR.
SO OUR TEAM AT, UH, METRO HEALTH HAS WORKED ON INITIATIVES THAT ADDRESS FOOD ACCESS.
UH, WE HAD NOT FORMALLY IDENTIFIED FOOD INSECURITY AS A PRIORITY UNTIL THIS YEAR WITH THE ROLLOUT OF OUR ESSAY FORWARD PLAN.
SO THE PANDEMIC, UM, UH, WE'VE LEARNED A LOT, UM, AND WE RECOGNIZE THAT THE NEED TO ADDRESS FOOD INSECURITY AND THAT WE NEED TO, UM, UH, LEVERAGE OUR EXISTING FUNDING FOR THAT.
SO WE DO HAVE A HEALTH DISPARITIES GRANT, UH, FROM THE FEDS, AND WE'VE ALIGNED THIS WITH OUR SA FORWARD PLAN, AND WE HAVE RESOURCES TO PUSH THIS PROCESS FORWARD.
SO BACK IN JANUARY OF THIS YEAR, WE ESTABLISHED, UH, THE PACE OFFICE, THE OFFICE OF POLICY AND CIVIC ENGAGEMENT AT METRO HEALTH, AND THERE ARE THREE PRIORITY AREAS THAT THE PACE STAFF, SO LED BY SEAN GREEN AND HIS TEAM.
UM, SO THOSE AREAS HAVE TO DO WITH HEALTH AND HOUSING, ACCESS TO CARE AND FOOD INSECURITY.
UM, ALSO IN JANUARY, AS YOU HEARD, UM, THIS IS C C R WAS FILED BY, UH, COUNCIL MEMBERS, UH, MCKAY RODRIGUEZ AND, UH, COUNCILWOMAN SANDOVAL.
AND SO JUST KNOW THAT THIS WAS, IS TO DIRECT US TO ESTABLISH A, A, A BROADER PLAN BACK IN MARCH.
UM, WE DID RECEIVE, UM, WE, OUR TE WE USED OUR C D C FUNDING TO HIRE A NUTRITION POLICY LEAD AND A REGISTERED DIETICIAN DEDICATED TO ADVANCING AND ADVOCATING FOR POLICIES THAT INCREASED ACCESS TO HEALTHY AND CULTURALLY REV RELEVANT FOODS.
UM, YOU SAW AND HEARD THE SPLASH WHEN WE, UH, LAUNCHED SA FORD BACK IN THE SPRING.
AND WITHIN THAT, ONE OF OUR FIRST GOALS WAS TO DEVELOP AND CONVENE A FOOD INSECURITY WORK GROUP THAT INCLUDES A BALANCE OF INTERNAL PARTNERS, GRASSROOTS AND GRASSTOPS ORGANIZATIONS IN THE COMMUNITY, AND COMMUNITY MEMBERS WHO HAVE LIVED EXPERIENCE WITH FOOD INSECURITY.
UM, ALSO IN THE SPRING, UM, WE BEGAN CONVENING WEEKLY TO LAY THE GROUNDWORK FOR, UM, NOT ONLY CONVENING THE FOOD INSECURITY WORK GROUP, BUT ALSO EXECUTING, UH, BROADER ASSESSMENT.
SO WITH THAT, UM, THE SUMMER, UH, WE STARTED KEY INFORMANT INTERVIEWS AND OUR IN THE THROES OF DEVELOPING AN R F P TO CONDUCT THIS ASSESSMENT.
SO YOU'VE SEEN THIS, UH, BEFORE, SO I'LL JUST, UH, MOVE TO, UM, OUR STRUCTURE NOW.
SO JUST KNOW THAT THIS SLIDE OUTLINES THE STAFF WORKING TO ADVANCE THEIR STRATEGIES AND GOALS.
UM, SO HAVING, UH, UH, 10 STAFF CONVENE BACK IN THE SPRING TO SERVE AS, UH, THIS INTERNAL PLANNING TEAM.
UM, WITHIN THE PACE OFFICE, AS I'VE REFERENCED, WE DO HAVE NOW A FOOD POLICY COORDINATOR.
THE TEAM FOCUSES ON ESTABLISHING THIS, THIS WORK GROUP AND OVERSEEING THE WORK TIED TO OUR FOOD ASSESSMENT, THE COMPLEMENT OF THE PACE OFFICE, THE OFFICE OF POLICY AND CIVIC ENGAGEMENT.
IT'S OUR COMMUNITY NUTRITION TEAM.
AGAIN, THIS IS IN ALIGNMENT WITHIN METRO HEALTH.
SO THE COMPLIMENT OF THE STAFF WITHIN THE, THE COMMUNITY NUTRITION TEAM IS TO EXPLORE, UH, NUTRITION POLICIES TO INCREASE ACCESS TO HEALTHY FOODS AND TO ASSIST, UH, SAN ANTONIO ORGANIZATIONS ACROSS THE CITY TO IMPLEMENT POLICIES OR STANDARDS IN IMPROVING, UH, NUTRITION, UH, THE NUTRITION ENVIRONMENT.
SO, AGAIN, YOU'LL HEAR REFERENCE ABOUT OTHERS THAT WE'VE IDENTIFIED TO HELP US SUPPORT THIS MOVEMENT.
SO, LOOKING AT THE ALIGNMENT WITH SA TOMORROW PLAN, WORKING IN COLLABORATION WITH THE OFFICE OF SUSTAINABILITY, THE WORLD HERITAGE OFFICE, AND THE FOOD POLICY COUNCIL.
SO WITH THAT, UH, WE DEVELOPED A SET OF QUESTIONS TO PROBE INFORMANTS AND
[01:50:01]
LEARN ABOUT DIVERSE PERSPECTIVES OF FOOD INSECURITY HERE IN THE CITY.WE INTERVIEWED KEY STAKEHOLDERS FROM THE OFFICE OF SUSTAINABILITY.
UM, WE ALSO INTERVIEWED INFORMANTS FROM, UH, KEY INFORMANT INTERVIEWS, UH, UH, FROM THE WORLD HERITAGE OFFICE, THE HEALTHY NEIGHBORHOODS PROGRAM, TRINITY UNIVERSITY, AND THE, UM, FOOD BANK.
ALTHOUGH THE RESPONSES WERE UNIQUE TO THE INFORMANT, WE IDENTIFIED IN COMMON THEMES, AND THIS IS WHAT YOU SEE REFLECTED ON THE SLIDE.
SO JUST KNOW THAT, UM, UH, WE HEARD THAT FOOD INSECURITY IS NOT JUST AN ACCESS ISSUE.
THAT FOOD INSECURITY IS COMPLEX, THAT INDIVIDUALS FACING FOOD INSECURITY OFTEN MAKE TRADE-OFFS.
AND WE SHOULD INCLUDE DIVERSE SECTORS IN THE FOOD INSECURITY WORK GROUP, A BOTTOM-UP APPROACH, WHICH IS CRITICAL.
AND, UH, CONSIDER THE POLICY AROUND UNIVERSAL BASIC INCOME OR INCREASED MINIMUM WAGES.
SO WITH THAT, UH, WE HAVE TO ASK OURSELVES, WHAT CAUSES FOOD INSECURITY? SO POVERTY, LOW INCOME UNEMPLOYMENT, LACK OF AFFORDABLE HOUSING, MEDICAL COSTS OR LACK OF ACCESS TO HEALTHCARE AND SYSTEMIC RACISM ARE KNOWN AS FACTORS OF FOOD INSECURITY.
DECADES OF EVIDENCE SHOW THAT FOOD INSECURITY INCREASES THE RISK FOR CHRONIC DISEASES, SUCH AS TYPE TWO DIABETES, AND WE WERE TALKING ABOUT THAT EARLIER, AND HEART DISEASE, MAKING IT AGAIN, A PUBLIC HEALTH ISSUE.
SO IN TURN, THESE DISEASES ARE THE SAME UNDERLYING CONDITIONS THAT WE SAW SIGNIFICANTLY INCREASE THE RISK OF C OVID 19 HOSPITALIZATIONS AND DEATH.
SO INDIVIDUALS EXPERIENCING FOOD INSECURITY, AS I'VE MENTIONED, OFTEN MAKE THESE TRADE-OFFS AS A COPING STRATEGY TO DEAL WITH OTHER FINANCIAL OBLIGATIONS.
SO FOOD TRENDS TEND TO BE ON THE MOST FLEXIBLE BUDGET ITEM, AND IT MAY BE EASIER FOR SOMEONE TO FORGO A MEAL OR PURCHASE AN INEXPENSIVE FOODS IN ORDER TO STAY ON TOP OF RENT, UTILITIES, HOUSING, PAYMENTS, AND OTHER MEDICAL BILLS.
SO FEEDING AMERICA A NETWORK WITH OVER 200 MEMBER, UH, FOOD BANKS, UH, ACROSS THE UNITED STATES, CONDUCTED A STUDY AND COLLECTED DATA FROM CLIENTS WHO REPORTED HAVING TO MAKE THESE TRADE-OFFS OFTEN TO MAKE ENDS MEET THE FINDING STRESS THAT FOOD INSECURITY IS NOT AN ISOLATED ISSUE.
SO, FOR EXAMPLE, 69% OF HOUSEHOLDS REPORTED HAVING TO CHOOSE BETWEEN PAYING FOR FOOD AND OR PAYING FOR UTILITIES, 67%, UH, TRANSPORTATION, 66% MEDICAL CARE, OR 57% HOUSING AT SOME POINT DURING THE YEAR, ONE THIRD, WHO REPORTED HAVING TO MAKE THESE TRADE-OFFS REPORTED HAVING TO DO SO EVERY SINGLE MONTH.
79% OF HOUSEHOLDS REPORTED PURCHASING INEXPENSIVE, UNHEALTHY FOODS AS THEIR MAIN FOOD SOURCE.
AND, UH, 55% OF HOUSEHOLDS REPORTED USING THREE OR MORE COPING STRATEGIES JUST IN THE PAST YEAR.
SO THESE TRADE-OFFS SIGNAL TO US THE NEED FOR, AGAIN, A HOLISTIC APPROACH TO ADDRESSING FOOD INSECURITY.
WE NEED A CONCENTRATED EFFORT WITH OUR EXTERNAL PARTNERS AND OTHER COSA DEPARTMENTS TO TACKLE, TACKLE THE UNDERLYING FACTORS THAT LEAD TO FOOD INSECURITY.
SO, AS I'M WINDING DOWN HERE, WHAT WE HEARD THEMATICALLY, SO FOR THE KEY INFORMANT INTERVIEWS AND INFORMAL GATHERINGS, THAT FOOD INSECURITY IS A BYPRODUCT OF SEVERAL COMPLEX FACTORS.
THIS IS IN LINE WITH NUMEROUS FOOD SECURITY STUDIES INDICATING THAT ACCESS IS ONLY ONE PIECE OF THE PUZZLE.
FOOD INSECURITY IS DEFINED AS A LACK OF CONSISTENT ACCESS TO SUFFICIENT SAFE AND NUTRITIOUS FOOD, WHICH MEETS DIETARY NEEDS AND FOOD PREFERENCES FOR AN ACTIVE, HEALTHY LIFE.
IT'S ALSO A HOUSEHOLD LEVEL ECONOMIC, SOCIAL, AND ENVIRONMENTAL CONDITION OF UNLIMITED OR OF LIMITED OR UNCERTAIN ACCESS TO ADEQUATE FOOD THAT MEETS CULTURAL OR PERSONAL NEEDS.
FOOD INSECURITY MAY BEGIN WITH WORRYING ABOUT WHERE THE NEXT MEAL WILL COME FROM AND CAN LEAD TO MISSED MEALS AND POOR POORER HEALTH OUTCOMES.
SO THE THREE CONDITIONS THAT LEAD TO FOOD IN INSECURITY, UM, UH, INCLUDE ACCESS, AVAILABILITY, UM, UH, OR THAT LEAD TO FOOD SECURITY INCLUDE ACCESS, AVAILABILITY, AND QUALITY OF FOOD AND NUTRITION AND UTILIZATION OF FOOD.
SO WHEN THESE CONDITIONS ARE MET, WE ACHIEVE FOOD SECURITY AS REFLECTED IN THE MIDDLE PART OF THE VENN DIAGRAMS. SO OUR TEAM IS WORKING IN SEVERAL AREAS.
WE RECOGNIZE THE NEED TO ALIGN WITH DIVERSE SECTORS, AND WE RECOGNIZE THE VALUE OF THESE PARTNERSHIPS, UM, AS, UH, WE ADDRESS THIS BURDEN HERE.
SO WITH THAT, UM, ABOUT 10 YEARS AGO, OUR TEAM FUNDED A FOOD INSECURITY ASSESSMENT IN PARTNERSHIP WITH THE, UH, FOOD POLICY COUNCIL AND U T S A, UH, RESEARCHERS ATTEMPTED TO DESCRIBE THE POPULATION LEVEL PATTERNS OF FOOD INSECURITY RISK.
UH, WE CONSTRUCTED A SPATIAL DATABASE OF FOOD RESOURCES AND CONDUCTED A SURVEY OF INDIVIDUAL HOUSEHOLDS OF FOOD INSECURITY ACROSS BEAR HERE IN BEXAR COUNTY.
WE KNOW THAT BETWEEN 2010 AND 2022, AND THIS YEAR, THE POPUL OR SAN ANTONIO POPULATION GREW BY OVER A HUNDRED THOUSAND INDIVIDUALS.
AND THE COVID PANDEMIC, UH, DRAMATICALLY INCREASED THE NUMBERS OF INDIVIDUALS EXPERIENCING, UH, FOOD INSECURITY HERE IN THE CITY.
SO WE'VE, UH, CRAFTED, UH, AN R F P, UH, WHICH REFERENCES THIS PROJECT BACK IN IN 2012.
AND, UH, THERE ARE JUST THREE DIMENSIONS TO THE RECOMMENDATIONS.
SO LOOKING AT, UM, AN ASSESSMENT OF LAWS AND REGULATIONS THAT CREATE OR PERPETUATE FOOD INSECURITY, UH, LOOKING
[01:55:01]
AT A, UH, PHOTO VOICE, UM, UH, PROJECT USING COMMUNITY PARTICIPATORY ACTION RESEARCH MODEL.AND, UH, LOOKING AT ESTABLISHING A DATA DASHBOARD THAT TRACKS FOOD INSECURITY TRENDS HERE IN SAN ANTONIO.
SO WITH THAT, OUR BENCHMARKS, BEFORE WE INVITE EXTERNAL PARTNERS TO THE TABLE, WE RECOGNIZE THE IMPORTANCE OF CONVENING, UH, KAL INTERNAL LEADERS TO DISCUSS COMMON GOALS AND ALIGNMENT AROUND FOOD INSECURITY AND AROUND OUR WORK.
UH, THIS WILL TAKE AN INTENTIONAL COLLABORATIVE PROCESS, AND WHAT YOU SEE HERE ARE THESE DIFFERENT PHASES.
SO I'M MINDFUL OF THE TIME HERE, BUT I JUST WANTED TO SHARE WITH YOU THAT WE DO HAVE THIS AS OUR DEFINED BENCHMARK.
SO WHAT WILL IT TAKE? UM, CLEARLY HAVING CAPACITY.
SO PERSONNEL ARE FUNDED IN OUR COMMUNITY NUTRITION TEAM AND THE PACE OFFICE, UM, THROUGH OUR FEDERAL HEALTH DISPARITIES GRANT.
UM, AND AGAIN, THESE GRANT CYCLES WE KNOW ARE SCHEDULED TO EXPIRE, UH, NEXT FALL.
WE WILL NEED CONTINUED SUP, UM, SUPPORT TO SUSTAIN THIS WORK.
UH, IF THE WORK EXPANDS, THEN WE'LL NEED ADDITIONAL STAFF, UM, UH, TO SUPPORT THE EFFORTS MOVING FORWARD.
SO THE FOOD INSECURITY WORK GROUP WILL CONVENE LATER THIS YEAR, BUT THE FUNDING TO SUSTAIN THE COLLABORATION WITH PARTNERS, OVERSEEING THE ASSESSMENT AND IDENTIFYING STRATEGIES, WE HAVE THAT AT LEAST THAT SUPPORT THROUGH SEPTEMBER 30TH, 2023.
WE ANTICIPATE AND ARE AT LEAST PURSUING ADDITIONAL FUNDING.
BUT JUST KNOW THAT, UM, THIS IS AN EFFORT THAT IS ANCHORED TO OUR CURRENT PLAN WITH THE PACE OFFICE AND WELL SUPPORTS OUR COMMUNITY NUTRITION TEAM.
SO AT THE END OF THE DAY, RECOMMENDATIONS ARE THAT IT'S NOT ONE SINGLE DEPARTMENT OR ORGANIZATION THAT ADDRESSES FOOD INSECURITY.
THIS WORK, UH, WILL REQUIRE SUSTAINED COMMUNITY ENGAGEMENT AND LOTS OF COORDINATION ACROSS THE COAST ENTERPRISE AND OUR EX EXTERNAL STAKEHOLDER GROUPS.
UM, WE ARE RECOMMENDING THESE, THESE, UH, THESE BUCKETS THAT BUILDING ON EXISTING PARTNERSHIPS AND EFFORTS TO EXPAND THE FOCUS FROM FOOD ACCESS TO FOOD SECURITY, UH, PLANNING AND ADMINISTERING THIS FOOD INSECURITY ASSESSMENT, FORMALLY CONVENING, UH, DEPARTMENTS, AGAIN HERE IN THE CITY, STAKEHOLDER ORGANIZATIONS AND COMMUNITY RESIDENTS WITH LIVED EXPERIENCE TO DEVELOP STRATEGIES THAT ADDRESSED THE DRIVERS OF FOOD INSECURITY HERE IN THE CITY.
AND, UH, UH, DEVELOPING SHARED METRICS AND SUPPORTING, UH, COORDINATED ACTION ACROSS DIFFERENT SECTORS.
SO AT THE END OF THE DAY, BASED ON THE RESULTS OF THE FOOD INSECURITY ASSESSMENT AND THE COLLECTIVE WISDOM OF THE FOOD INSECURITY WORK GROUP WILL DEVELOP THIS ROADMAP.
UM, THIS WILL BE A LONG RANGE PLAN TO ADDRESS FOOD INSECURITY, INCLUDING FOOD ACCESS IN SAN ANTONIO.
IT ALSO INCLUDES METRICS AND STRATEGIES TO IMPROVE, IMPROVE FOOD INSECURITY.
THE FIRST STEP, THOUGH, IS TO BUILD A STRONG WORK GROUP OF COMMITTED PARTNERS AND STAKEHOLDERS, AND THAT'S WHAT YOU SEE PRESENTED HERE IN RESPONSE TO THE C C R.
AND I'LL STOP THERE, AND I THANK YOU FOR, FOR YOUR TIME THIS AFTERNOON.
UH, UM, MADAM CLERK, DO WE HAVE ANYBODY FROM THE PUBLIC HERE TO SPEAK? WE HAD TWO MEMBERS SIGN UP TO SPEAK.
UH, JOVANNA LOPEZ, STEVEN LUCKY.
OKAY, WELL, WE'LL MOVE ON TO COUNCIL MEMBER COMMENT.
UH, COUNCILMAN MICKEY RODRIGUEZ.
I THINK IT'S, UM, ALMOST POETIC IN A SENSE THAT BOTH, BOTH THE UM, INSULIN CROSS SHARE PROGRAM AND THE DIABETES CARE CONTINUUM, UM, AND THE FOOD ACCESS MASTER PLAN, UH, CCRS BOTH CAME AT THE SAME TIME.
UM, THERE ARE TWO ISSUES THAT, UM, FEED HEAVILY INTO ONE ANOTHER.
AND JUST LIKE I SAID, WITH, UM, YOU KNOW, THE, OUR IMPACT ON DIABETES PREVENTION AND CARE, UM, YOU KNOW, WE HAVE RESPONSIBILITY THERE.
WE ALSO HAVE A RESPONSIBILITY AS IT RELATES TO FOOD ACCESS.
AND, UM, I FORGET IF THIS WAS A PART OF THE C C R THAT THAT MADE IT TO THE FINAL DRAFT, BUT DESERTS ARE NATURALLY OCCURRING ECOSYSTEMS, WHEREAS FOOD DESERTS ARE NOT.
UM, I WANTED TO THANK, UH, STEVEN LUCKY WAS HERE, UM, AS WELL AS JOANA LOPEZ FROM GARCIA STREET URBAN FARMS. UH, BUT THEY GOT TO SEE THE OTHER PRESENTATIONS WHERE THEY HAD TO STEP OUT.
BUT I REALLY APPRECIATE THEM FOR ATTENDING AND FOR BEING A PART OF THE CONVERSATION.
UH, SOMETHING THAT WAS IMPORTANT THAT WE JUST MET, UH, TUESDAY AND DISCUSSED THIS, AND ONE OF THE THINGS THAT I THINK WE, WE AGREED ON IS THAT THIS ROADMAP SHOULD BE FORMED WITH AND FOR THE COMMUNITY FROM THE BEGINNING TO ENSURE ITS SUCCESS.
AND I HEARD WHAT I WANTED TO HEAR, WHICH WAS THAT, AND I THINK IT WAS IN 20, STARTING IN 2025, A PLAN WOULD BE ANNOUNCED AND THERE WOULD BE A LONG-TERM ONE.
DO WE HAVE AN IDEA OF IS IT GONNA BE A 10 YEAR PLAN OR WHAT ARE WE THINKING LONGER THAN A FIVE YEAR PLAN? HOW ABOUT,
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HOW ABOUT I SAY THAT THAT'LL WORK FOR NOW.UM, YOU KNOW, IDEALLY IT WOULD RESULT IN A 10 YEAR GOAL THAT IS BOLD VISIONARY.
IT COULD BE A, YOU KNOW, A TRUE NORTH STAR.
WE SHOULD KNOW WHAT OUR GOALS FOR, WHAT OUR GOALS ARE FOR THAT PERIOD OF TIME, HOW EFFECTIVE OUR EXISTING PROGRAMS ACROSS AGENCIES AND DEPARTMENT, UH, DEPARTMENTS, AS WELL AS MAJOR OPPORTUNITIES THAT WE SHOULD START PREPARING FOR, UM, IN 2025, SUCH AS GRANT OP, FEDERAL, UH, GRANT OPPORTUNITIES OR INFRASTRUCTURE DOLLARS OR FUTURE BOND PROGRAMS. I DON'T THINK, I THINK THERE'S OPPORTUNITY TO MAKE, UM, MAKE SOME GROUND IN THE 2027 BOND.
SO I THINK THIS PLAN SHOULD ACCOUNT FOR ALL OF THOSE OPPORTUNITIES.
SO I MOVED TO SEND THE RECOMMENDATION TO A B SESSION, SIMPLE.
SECOND IS, IS THAT THE RECOMMENDATION THAT STEPH IS THIS BIT? THIS? OH, OKAY.
BASICALLY THE WHOLE PRESENTATION WOULD GO TO B SESSION, RIGHT? THAT IS CORRECT.
JUST MAKING SURE THAT'S WHERE WE'RE GOING.
AND, UM, THANK YOU VERY MUCH, CLAUDE.
WE ARE THANK YOU, DISTRICT TWO