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>> WE'VE GOT OUR BVMENTD SESSION READY TO START.
>> CLERK: WELCOME TO THE CITY COUNCIL B SESSION OF APRIL THE 10TH.
>> CLERK: MAYOR, WE DO HAVE A IMOR -- QUORUM.
THE MAYOR, OF COURSE, WILL NOT BE HERE TODAY.
>> MAYOR PRO TEM: AND SO THE MAYOR ASKED ME TO BRING REGARDS TO EVERYONE.
HE'S ADVOCATING FOR THE CITY IN
[1. Briefing by the San Antonio Metropolitan Health District on the development of its new strategic plan for fiscal year 2020 - 2023 [Colleen M. Bridger, MPH, PhD, Interim Assistant City Manager; Jennifer Herriot, Interim Director, Health]]
AUSTIN AND SO WE'LL LOOK FORWARD TO HAVING HIM TOMORROW.WE HAVE OUR BRIEFING TODAY BY THE SAN ANTONIO METROPOLITAN HEALTH DISTRICT ON THE DEVELOPMENT OF ITS NEW STRATEGIC PLAN FOR FISCAL YEAR 2020 TO 2023.
>> DR. BRIDGER: GOOD AFTERNOON, EVERYBODY.
THANK YOU FOR THE OPPORTUNITY TO TALK TO YOU THIS AFTERNOON ABOUT THE DEVELOPMENT OF OUR STRATEGIC PLAN.
THIS IS A BITTERSWEET PRESENTATION FOR ME BECAUSE THIS WILL BE MY LAST PRESENTATION AS YOUR HEALTH DIRECTOR, AS I'M TRANSITIONING INTO MY NEW ROLE.
SO IN ORDER TO MAKE THIS A LITTLE LESS PAINFUL FOR ME, I'M DOING HALF AND JENNIFER'S DOING HALF.
THAT WILL HELP US DO THIS TRANSITION PERIOD.
SO THOSE OF YOU WHO ARE IN COMMUNITY HEALTH AND EQUITY HAVE SEEN PORTIONS OF THIS PRESENTATION.
I'M GOING TO TRY TO GO THROUGH THAT PART PRETTY QUICKLY.
AND THEN THERE'S A BUNCH OF NEW STUFF THAT JENNIFER WILL BE PRESENTING TO YOU AS WELL.
SO JUST TO GIVE YOU A SENSE OF HOW WE'RE GOING TO LAY THIS PRESENTATION OUT, SO WE'RE GOING TO HIGHLIGHT ALL THE FOLKS WHO WE INTERACTED WITH, HOW WE DID THAT, WHAT THEY TOLD US AND HOW WE'RE GOING TO USE THEIR INPUT.
SO BIG PICTURE, WE STARTED WITH ABOUT 25 DIFFERENT MAJOR HEALTH ISSUES FOR BEXAR COUNTY, AND WE SURVEYED BEXAR COUNTY RESIDENTS.
WE NARROWED THAT DOWN TO THE TOP 10.
WE THEN WORKED WITH A GROUP OF COMMUNITY STAKEHOLDERS TO NARROW THAT DOWN TO FOUR.
SO I'M GOING TO GO INTO A LITTLE BIT MORE DETAIL ABOUT WHAT THAT LOOKED LIKE.
SO FIRST, WHEN WE DID THE SURVEY TO GO FROM 25 TO 10.
YOU CAN SEE THIS IS A MAP OF WHAT THE SURVEY RESPONSE LOOKED LIKE.
WE DID GET OVER 4,000 SURVEY RESPONSES TO -- ASKING PEOPLE TO LOOK AT THE 25 ISSUES, THEY PICKED THEIR TOP THREE, AND THAT RESULTED IN US HAVING THE TOP 10.
THE MAJORITY OF THE RESPONDENTS WERE FEMALE.
YOU CAN SEE HOW THE DEMOGRAPHIC BREAKOUT WORK, AND IT WAS SKEWED PRETTY YOUNG, WHICH IS NICE, BECAUSE THAT ISN'T ALWAYS THE CASE WHEN WE SEND OUT SURVEYS FOR FOLKS.
SO HOW DID WE DO THIS? WE DID IT A COUPLE OF DIFFERENT WAYS.
WE STARTED THIS PROCESS THIS TIME LAST YEAR DURING THE BUDGET EVENT SPONSORED BY SA SPEAK UP.
SO WE HAD THIS BOARD THAT YOU CAN SEE IN THE PICTURE AT EVERY SA SPEAK UP EVENT, AND INTERACTED WITH THE PUBLIC AS THEY CAME TO THOSE EVENTS.
EVERYBODY WHO CAME TO THE BOARD GOT THREE STICKERS, AND THEY GOT TO PUT ON THIS BOARD WHAT THEIR TOP THREE PRIORITIES WERE FOR THEIR NEIGHBORHOOD.
WE ALSO HAD A LOT OF INFORMATION OUT THROUGH THE REGULAR MEDIA, THROUGH SOCIAL MEDIA.
I DID A NUMBER OF PRESENTATIONS, ALL OF THIS DRIVING PEOPLE TO THE SURVEY MONKEY SURVEY.
AND WE ALSO DID PAPER SURVEYS.
SO ULTIMATELY, WE ENDED UP WITH ABOUT 60% OF OUR RESPONDENTS RESPONDED THROUGH THE SURVEY MONKEY AND ABOUT 40% OF OUR RESPONDENTS RESPONDED THROUGH THE PAPER SURVEY, SO WE -- AND LIKE 4% DID THE SA SPEAK UP EVENTS.
BUT WE HAD A LOT OF DIFFERENT OPPORTUNITIES FOR PEOPLE TO WEIGH IN AND LET US KNOW WHAT THEY THOUGHT SHOULD BE THESE TOP 10 AREAS.
SO WHAT DID THEY TELL US? WELL, BASICALLY THESE ARE OUR TOP 10 ISSUES.
THEY -- YOU CAN CIAC SESTO HEALTH, AGING, DENTAL, DIABETES, SUBSTANCE ABUSE, HOUSING, MENTAL HEALTH, NUTRITION.
OF COURSE, MY FAVORITE, ADVERSE
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CHILDHOOD EXPERIENCE, AND THEN VIOLENCE.SO HOW DID WE USE THEIR INPUT? WELL, WE TOOK THIS TOP -- IN AUDIO] -- LIST AND WE WENT THROUGH A PROCESS OF NARROWING DOWN THE 10 TO FOUR.
AND IN ORDER TO DO THAT, WE CREATED FACT SHEETS FOR EACH OF THE TOP 10 HEALTH ISSUES.
AND, I BELIEVE THAT ON YOUR -- YOUR LAPTOP, TABLET THINGS, THERE IS -- TOP 10 PRIORITY HEALTH ISSUES FACT SHEETS.
IT'S ONE PAGE, FRONT AND BACK.
AND IT COVERS -- AUDIO] -- KIND OF PARTICULAR HEALTH ISSUE AND THINGS THAT THE COMMUNITY IS ALREADY DOING IN ORDER TO ADDRESS IT.
SO AS WE GATHERED THESE 30 -- DEPTH SYNOPSIS OF WHAT WAS GOING ON FOR EACH OF THOSE HEALTH ISSUES.
THE OTHER THING WE DID WAS WE GOT A LITTLE WONKY AND WE CREATED A HEALTH IMPACT INDEX FOR EACH OF THOSE TOP 10 ITEMS. WE MODIFIED AN EXISTING NATIONAL PRIORITIZATION INDEX CALLED THE HANLAN METHOD TO HAVE IT WORK FOR US IN WHAT WE WERE DOING, AND THAT ALLOWED US TO CALCULATE A SCORE TO HELP MAKE THE DECISION ABOUT HOW TO PRIORITIZE THINGS A LITTLE BIT MORE OBJECTIVE.
SO I WON'T GO INTO A TON OF DETAILS.
HAPPY TO ANSWER ANY QUESTIONS ABOUT THAT, BUT THAT WAS A REALLY CRITICAL PIECE TO BE ABLE TO HAVE PEOPLE THINK THROUGH OBJECTIVELY WHAT SHOULD WE BE FOCUSING ON.
SO WE HAD A MEETING ON A SATURDAY MORNING, AND OVER 30 PEOPLE CAME.
VARIOUS STAKEHOLDERS OUT IN THE COMMUNITY, WE RELIED HEAVILY ON OUR HEALTHY NEIGHBORHOODS PROGRAM TO BRING IN LAY HEALTH ADVISERS, TO HELP US REALLY HEAR FROM THE BOOTS ON THE GROUND, WHAT'S GOING ON, AS WELL AS SOME SUBJECT MATTER EXPERTS FOR EACH OF THOSE TOP 10 ISSUES.
WE WENT -- ITEM, AND WE CONVERTD THAT OVER TO A HOT DOTS EXERCISE.
SO FOLKS WERE ABLE TO VISUALLY SEE WHERE EVERYBODY WAS, AND AFTER WE DID THAT, WE ENDED UP WITH THESE FOUR THINGS.
SO THESE ARE THE PRIORITY HEALTH ISSUES FOR METRO HEALTH: ACCESS TO CARE, ADVERSE CHILDHOOD EXPERIENCES AND TLDRAUMA INFORMD CARE, NUTRITION AND VIOLENCE.
SO JENNIFER'S GOING TO TALK TO YOU ABOUT WHAT WE DID AFTER WE NARROWED IN ON THOSE TOP FOUR ITEMS.
THE NICE THING ABOUT PRESENTING -- COPRESENTING WITH DR. BRIDGEER IS THAT SHE TOLD ME SHE WOULD TAKE ALL THE HOT QUESTIONS, SO...
>> SO THE NEXT THING THAT WE DID WAS WE ACTUALLY SENT OUT A SURVEY TO ALL OF THE METRO HEALTH EMPLOYEES, SO THAT THEY COULD HELP US -- WE PROVIDED THEM WITH THE FOUR PRIORITY HEALTH ISSUES THAT HAD BEEN IDENTIFIED, THAT DR. BRIDGER JUST MENTIONED, AND THEN WE ASKED THEM, AFTER GIVING THEM A MENU OF WHAT WE CALLED FOCUS AREAS, WE ASKED THEM TO IDENTIFY TWO TO THREE FOCUS AREAS THAT WE SHOULD SPEND OUR TIME ON IN EACH OF THOSE PRIORITY AREAS.
OBVIOUSLY, VIOLENCE, ACCESS TO CARE, NUTRITION AND TRAUMA-INFORMED CARE ARE VERY BROAD, SO WE NEEDED TO THINK ABOUT WHERE SPECIFICALLY DOES THE HEALTH DEPARTMENT NEED TO FOCUS.
WE HAD OVER 150 RESPONSES, AND IT WAS REALLY PRETTY -- IN AUDIO] -- ABLE TO SEE VERY CLEARLY WHERE WE SHOULD SPEND
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OUR TIME.SO -- REALLY BEEN WORKING ON GETTING STAKEHOLDER AND COMMUNITY -- IDENTIFY GAPS AND DRAFT SOME ACTION STEPS.
SO, AGAIN, BEFORE WE DIVE INTO THESE FOUR AREAS, WE'VE GOT A LOT OF PARTNERS THAT ARE WORKING IN THESE AREAS ALREADY.
WE WANTED TO MAKE SURE THAT THE SERVICES THAT -- AUDIO] -- IN OUR COMMUNITY.
SO TO DO THAT, WE FORMED FOUR WORK GROUPS MADE UP OF SUBJECT MATTER EXPERTS WITHIN METRO HEALTH.
WE INITIATED MEETINGS WITH KEY STAKEHOLDERS.
WE'VE GOT MORE OF THOSE SCHEDULED.
AND WE ALSO HELD AN INITIAL LISTENING SESSION IN MARCH AND ADDITIONAL COMMUNITY INPUT OPPORTUNITIES ARE ALSO BEING PLANNED.
SO THE FIRST FOCUS AREA THAT CAME OUT UNDER ACCESS TO CARE IS PREVENTING DEPRESSION AND ANXIETY.
IMPACT ON [INDISCERNIBLE] ABUSE AND POTENTIALLY ON DOMESTIC VIOLENCE AND GUN VIOLENCE.
THOSE ARE FOCUS AREAS THAT YOU'LL SEE LATER ON IN THE PRESENTATION.
SO WE'VE IDENTIFIED THREE POTENTIAL STRATEGIES AROUND PREGNANT AND POSTPARTUM MOMS, TEENS AND ADULTS.
AND AS I'M SHARING -- AUDIO] FOCUSING ON IS IN ADOLESCENCE.
IT'S A PROGRAM OUT OF NEW YORK THAT IS CALLED GROWTH MINDSET.
THE INTERVENTION WOULD BE THE FIRST OF ITS KIND IN TEXAS, AND IT'S SHOWN TO CUT DEPRESSION SYMPTOMS BY HALF IN NINE MONTHS.
AND THE LAST ONE THAT WE'RE LOOKING AT IS RELATED TO WORKING WITH OUR FAITH-BASED COMMUNITY, AND THAT'S REALLY TO AMPLIFY AND SUPPORT THE WORK BEING DONE BY PARTNERS TO ASSIST FAITH-BASED LEADERS TO DECREASE STIGMA AND CONNECT PEOPLE TO HELP.
FOCUS AREA 2 UNDER ACCESS TO CARE IS ENSURING IMMIGRANT-FRIENDLY SERVICES.
SO IMMIGRANTS ARE A GROUP THAT ARE LESS LIKELY THAN MANY OTHER GROUPS TO HAVE HEALTH INSURANCE, AND ARE MORE LIKELY TO EXPERIENCE BARRIERS IN ACCESSING HEALTH.
IN THE MEDICAL CENTER ALONE, IF YOU THINK ABOUT IT, THERE ARE 20 DIFFERENT LANGUAGES SPOKEN.
SO FIGURING OUT HOW TO MAKE SURE THAT OUR SERVICES ARE ACCESSIBLE AND FRIENDLY TO IMMIGRANTS IS SOMETHING THAT'S INCREDIBLY IMPORTANT TO US.
TWO OF THE INITIATIVES THAT WE ARE LOOKING AT CURRENTLY TO CONSIDER IS THE IMPLEMENTATION OF A CARE ACROSS COMMUNITIES.
THIS IS A ROBERT WOOD JOHNSON FOUNDATION INITIATIVE, WHICH FOSTERS INNOVATIVE PARTNERSHIPS AMONG SCHOOLS, MENTAL HEALTH SERVICE PROVIDERS AND IMMIGRANT AND REFUGEE COMMUNITY ORGANIZATIONS.
THE OTHER ONE IS AN INITIATIVE OUT OF PITTSBURGH CALLED HELLO NEIGHBOR, AND IT'S BASED ON PROGRAMS THAT MATCH NEW IMMIGRANT FAMILIES WITH LOCAL MENTORS.
THE NEXT PRIORITY AREA IS ASIS AND TRAUMA-INFORMED CARE AND IN THIS AREA WE IDENTIFIED THREE FOCUS AREAS.
THE FIRST ONE IS INCREASING COMMUNITY AWARENESS.
THE SECOND IS ENSURING HEALTHY TEEN RELATIONSHIPS, AND THE THIRD IS INSURING PARENT SUPPORT SYSTEMS. WE'RE INTERESTED IN RAISING A COMMUNITY-WIDE FOCUS ON ADDRESSING TRAUMA IN CHILDHOOD.
ALSO DEVELOPING A LOCALLY SUPPORTED WEBSITE TO SHARE ONLINE TRAININGSES, RESOURCES AND ACTIVITIES.
THE SECOND FOCUS AREA, ENSURING HEALTHY TEEN RELATIONSHIPS, WE'RE LOOKING AT IMPLEMENTING A PROGRAM CALLED TOO GOOD FOR VIOLENCE.
THIS VIOLENCE PREVENTION AND CHARACTER EDUCATION PROGRAM FOR STUDENTS K THROUGH 12 AND IT BUILDS SKILLS AROUND RESPECT, CELEBRATING DIVERSITY AND
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UNDERSTANDING FEELINGS AND ACTIONS.AND THAT LAST ONE I HAD MENTIONED WAS ENSURING PARENT SUPPORT SYSTEMS. SO ONE OF THE THINGS THAT WE'RE REALLY INTERESTED IN DOING IS IMPLEMENTING A NATIONALLY RECOGNIZED CURRICULUM CALLED PPP.
IT'S A COMPREHENSIVE EVIDENCE-BASED PARENTING AND FAMILY SUPPORT SYSTEM THAT PROVIDES SUPPORT IN A VARIETY OF WAYS.
IT INCREASES PARENTS' CONFIDENCE AND COMPETENCE IN RAISING CHILDREN.
IT IMPROVES THE QUALITY OF PARENT/CHILD RELATIONSHIPS, IT DESTIGMATIZES PARENTING INFORMATION AND FAMILY SUPPORT, AND IT MAKES EVIDENCE-BASED PARENTING INFORMATION WIDELY AVAILABLE TO PARENTS.
OUR THIRD AREA -- PRIORITY AREA IS NUTRITION.
AND WITHIN THE AREA OF NUTRITION, WE'RE INTERESTED IN FOCUSING ON CHILDHOOD NUTRITION SPECIFICALLY, REALLY THE ISSUE OF CHILDHOOD OBESITY.
SO SOME OF THE AREAS THAT WE'RE LOOKING AT IN THIS AREA IS TO ENGAGE WITH EARLY CHILDCARE PROVIDERS TO IMPLEMENT POLICIES AIMED AT IMPROVING MEALS, SNACKS AND BEVERAGES SERVED IN CHILDHOOD SETTINGS.
WE'RE ALSO LOOKING AT IMPLEMENTING POLICIES DESIGNED TO IMPROVE FOOD SELECTIONS LIKE AMUSEMENT PARKS, AND ALSO LOOKING AT EXPANDING THE PROGRAM OF CHEF.
WE'RE ALREADY WORKING HERE IN SOME SCHOOLS AND WE THINK IT'S AN OPPORTUNITY TO EXPAND.
THE SECOND AREA IS ACCESS TO AFFORDABLE HEALTHY FOOD AND BEVERAGES.
SO WITHIN THE CITY OF SAN ANTONIO WE JUST PASSED AN ADMINISTRATIVE DIRECTIVE IN WHICH WE'VE IDENTIFIED SOME CLEAR GUIDELINE, SOME HEALTHY FOODS THAT WILL BE ABLE TO BE PROCURED WITH CITY DOLLARS.
WE'VE ALREADY DONE THAT HERE WITHIN THE CITY AND WE'D LIKE TO EXPAND THAT TO OTHER WORK SITES AND POTENTIALLY SCHOOLS THAT MAY BE INTERESTED IN IMPLEMENTING AN INITIATIVE LIKE THAT.
THE OTHER THING WE'D LIKE TO CONSIDER IN TERMS OF ACCESS TO AFFORDABLE HEALTHY FOOD AND BEVERAGES POTENTIALLY EXPANDING THE HEALTHY CORNER STORE INITIATIVE, IF WHEN WE GET OUR PILOT RESULTS BACK WE FIND IT TO BE SUCCESSFUL.
WE ALSO WANT TO WORK OUT LINKING FARMERS' MARKETS WITH WIC AND SNAP.
A LOT OF FARMER'S MARKET DOLLARS GO UNSPENT.
SO IF WE MAKE SURE THAT PEOPLE ARE AWARE THAT THEY CAN ACCESS THOSE SERVICES BY GOING TO A FARMER'S MARKET AND THEY ACTUALLY GET DOUBLE BUCKS, THAT'S A GREAT OPPORTUNITY TO INCREASE ACCESS TO FRUITS AND VEGETABLES.
AND ANOTHER AREA WE'RE INTERESTED IN WORKING IN IS INSTALLING WATER HYDRATION STATIONS IN WORK SITES, SCHOOLS AND PUBLIC PLACES.
IT'S GREAT FOR THE ENVIRONMENT AND IT'S GREAT FOR THE HEALTH OF ALL OF US TO HAVE AK AT THE TIME TO POTABLE WATER.
THE THIRD ACCESS IN NUTRITION IS ADDRESSING COMMUNITY NUTRITION STANDARDS.
SO THIS IS ANOTHER AREA IN WHICH WE WOULD WORK WITH WORK SITES TO IMPLEMENT HEALTH -- AUDIO] -- HEALTHY FOOD OPTIONS IN PLACES OF EMPLOYMENT.
THE OTHER THING WE'D LIKE TO DO IS EXPAND PARTICIPATION IN OUR HEALTHY WORKPLACE RECOGNITION PROGRAM.
SO MANY TIMES PEOPLE THINK, OH, WELL, WHY DO WE NEED TO KEEP RECOGNIZING EMPLOYERS, BUT REALLY IT'S A VERY COMPLETE APPLICATION THAT THEY HAVE TO GO THROUGH, AND THEY'RE REALLY WORKING VERY HARD AT IMPROVING ACCESS TO HEALTH WITHIN THE WORK SITES.
SO IT'S A REALLY ROBUST PROGRAM, AND WE'D LIKE TO SEE IT EXPANDED HERE LOCALLY.
AND THEN LAST IS DEVELOP AND DISSEMINATE HEALTHY PACKAGED SNACKS AND BEVERAGE GUIDELINES.
AND, AGAIN, THERE'S SO MUCH INFORMATION -- OR LACK OF INFORMATION ABOUT WHAT'S HEALTHY AND NOT HEALTHY.
SO HELPING PEOPLE UNDERSTAND THAT WHEN THEY'RE CHOOSING A PACKAGED SNACK, THAT FINDING ONE THAT'S LOW IN SALT AND LOW IN SUGAR AND LOW IN FIGHT AND HIGHER IN PROTEIN AND FIBER IS ALWAYS A GOOD CHOICE.
THE LAST AREA THAT I'M GOING TO TOUCH ON IS VIOLENCE.
AND SO IN THE AREA OF VIOLENCE, WE'RE FOCUSING ON THREE AREAS.
ONE OF THOSE IS PREVENTION OF CHILD ABUSE.
ANOTHER IS PREVENTION OF DOMESTIC VIOLENCE.
SO PREVENTION OF GUN VIOLENCE.
SO IN THE AREA OF CHILD ABUSE, WE'RE ALSO LOOKING AT IMPLEMENTING PPP.
SO PPP STRENGTHENS PARENTING SKILLS FOR MOMS AND DADS AND OTHER CAREGIVERS, AND INCREASES PARENTS' ABILITY TO MANAGE STRESS AND ANGER.
SO WHILE THAT WILL ALSO ADDRESS SOME OF THE WORK WE WANT TO DO IN ASES IN TERMS OF STRENGTHENING PARENTING CAPACITY TO DEAL WITH CHALLENGING ISSUES WITH CHILDREN AND FAMILIES, THIS ALSO WILL HAVE AN IMPACT ON ADDRESSING CHILD ABUSE.
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THE OTHER INTERESTING POSSIBILITY THAT WE'RE JUST LOOKING INTO IS RESEARCHING THE FEASIBILITY OF ESTABLISHING A CRISIS NURSERY.THIS WAS NOT SOMETHING I HAD HEARD OF BEFORE, BUT BASICALLY, IT'S A DROP-IN CENTER THAT'S OPEN 24 HOURS FOR PARENTS TO DROP OFF THEIR CHILDREN AGES BIRTH TO 12 IN A CRISIS.
WHEN THEY JUST REALIZE THAT THEY REALLY NEED A TIME -- THEY NEED TO PUT THEIR CHILD IN A SAFE PLACE.
THIS IS BEING IMPLEMENTED IN LOTS OF COMMUNITIES THROUGHOUT THE COUNTRY.
OTHER AREA THAT WE'RE GOING TO BE WORKING ON RELATED TO VIOLENCE IS PREVENTION OF DOMESTIC VIOLENCE.
SO CURRENTLY WE'RE ALREADY WORKING WITH THE DEPARTMENT OF HUMAN SERVICES AND THEY'VE BEEN VERY INVOLVED IN KIND OF REESTABLISHING THE DOMESTIC VIOLENCE TASK FORCE.
SO WE'RE VERY -- AUDIO] -- AND THEN THE LAST BULLET IS RELATED TO REACHING OUT TO THE LGBTQ COMMUNITY TO IDENTIFY NEEDS TO IMPROVE AWARENESS AND ACCESS TO DOMESTIC VIOLENCE SERVICES.
SO THAT ALSO HAS BEEN IDENTIFIED AS A POTENTIAL PLACE THAT WE COULD -- WE COULD WORK.
AND THEN MY LAST ONE -- FOCUS AREA IS TO REDUCE GUN VIOLENCE.
SO WE ARE PLANNING ON WORKING ON VIOLENCE PREVENTION RESOURCES AND WORK BEING DONE IN PHILADELPHIA, DR. BRIDGER WAS JUST ABLE TO BE THERE A FEW WEEKS AGO AND BROUGHT BACK SOME EXCELLENT RESOURCES.
SO WE'RE JUST STARTING TO HAVE THOSE CONVERSATIONS.
AND THEN, OF COURSE, WE'LL CONTINUE TO IMPLEMENT OUR STAND UP SA PROGRAM, WHICH WAS ESTABLISHED, I THINK YOU ALL ARE A LITTLE BIT FAMILIAR WITH IT, TO INTERRUPT VIOLENCE AND CHANGE BEHAVIORS AND COMMUNITY NORMS. THE SECOND TO LAST SLIDE -- I'M ALMOST DONE -- IS WE DEFINITELY HAVE BEEN WORKING ON DEVELOPING COMMUNITY OUTREACH PLANS, SO WE'VE ALREADY HAD AN OPPORTUNITY TO ENGAGE COMMUNITY, BUT WE WILL CONTINUE TO DO SO AS WE GO THROUGH THIS PROCESS, WHETHER THAT BE THROUGH SOCIAL MEDIA, RADIO, COMMUNITY LISTENING SESSIONS.
WE'VE GOT A NUMBER OF DIFFERENT HEALTH FAIRS, WE KNOW THE COMMUNITY WILL BE THERE, SO WE'LL TAKE AN OPPORTUNITY TORO SPEAK WITH THEM AT THAT TIME.
SOME OF THE WORK GROUPS ARE THINKING ABOUT DOING SOME FOCUS GROUPS AND, OF COURSE, DOING ONE-ON-ONE CONVERSATIONS WITH COMMUNITY MEMBERS AS WELL.
SO WE'LL ALSO BE CONTINUING WITH OUR KEY STAKEHOLDERS AND PARTNERS BECAUSE IT'S ALWAYS IMPORTANT TO HEAR WHAT THEY HAVE TO SAY AND WHERE WE CAN BEST WORK TOGETHER.
AND THEN WE'LL ALSO CONTINUE TO GATHER INPUT FROM HEALTH AND OTHER CITY EMPLOYEES, PARTICULARLY OUR HEALTH DEPARTMENT EMPLOYEES.
I THINK WE'VE GOT OVER 400 OF THEM, AND THEY ALWAYS APPRECIATE WHEN THEY GET TO BE PART OF A PROCESS LIKE THIS.
AND SO NOT ONLY DID WE INCLUDE THEM WHEN WE WERE IDENTIFYING THE FOCUS AREAS -- AUDIO] -- BUT WHAT WE PLAN ON DOING, AS YOU CAN SEE, THIS IS ALL A PROCESS.
WE'LL CONTINUE TO GATHER FEEDBACK AND INPUT EACH STEP ALONG THE WAY.
OUR INTENT IS TO HAVE A PROPOSED -- PROPOSED ACTION STEPS/STRATEGIES SOLIDIFIED AND BUDGETS DEVELOPED FOR REVIEW AND DISCUSSION WITH EACH OF YOU PRIOR -- IT WILL BE HERE BEFORE WE KNOW IT, BUT THOSE ARE THE PLANS IN TERMS OF GETTING THE STRATEGIC PLAN PUT TOGETHER.
AND NOW DR. BRIDGER'S AVAILABLE FOR QUESTIONS.
WELL, THANK YOU, JENNIFER AND THANK YOU DR. BRIDGER FOR ALL OF YOUR WORK -- BOTH OF YOUR WORK AND YOUR TEAM.
AND CONGRATULATIONS, AGAIN, DR. BRIDGER.
I THINK YOUR RECENT NEW POSITION OR NEW ROLE IS TESTAMENT TO THE GREAT WORK THAT YOU CONTINUE TO DO FOR THE CITY OF SAN ANTONIO.
WHAT I FIRST REVIEWED LISTENING TO THE PRESENTATION IT WAS INTERESTING FOR ME TO SEE THE INDEX VERSUS HOW OUR CITIZENS RANKED THE ISSUES.
FOR EXAMPLE, THE NUMBER ONE ON THE INDEX WAS NUMBER FOUR ON OUR LIST, BUT AT THE END OF THE DAY, IT LOOKED LIKE WE GRAVITATED TOWARD THE INDEX THAT MATCHES KIND OF THE NATION, WHICH IS INCLUSIVE OF A LOT OF THE OTHER ISSUES AS WELL.
SO I'M GLAD THAT WE SAW THAT EXPLANATION.
AND THEN THE OTHER POINT THAT I WILL MAKE IS I WAS ABLE TO MEET
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WITH CHIEF MCMANUS EARLY ON ABOUT THE APPROACH -- THE NEW APPROACH TO TREATING VIOLENCE AS A HEALTH ISSUE.AND I THINK THAT'S INNOVATIVE.
I THINK IT'S -- I THINK IT'S -- [INDISCERNIBLE] WE'VE HAD FOUR OR FIVE SHOOTINGS IN THE LAST, YOU KNOW, FIVE TO 10 DAYS.
AND, YOU KNOW, WE CAN -- WE CAN DEAL WITH THE IMMEDIATE ISSUES, WE CAN DEAL WITH THE PERPETRATORS, BUT AT THE END OF THE DAY, WE'VE GOT TO GET AHEAD OF IT.
AND, YOU KNOW, THE APPROACH TO PUBLIC SAFETY AND VIOLENCE AS A HEALTH ISSUE, GETTING AHEAD OF THAT EARLY ON, I THINK IS -- I THINK IT'S GREAT.
SO I APPRECIATE THE WORK THAT YOU ALL ARE DOING WITH THE CHIEF ON THAT.
WE DO HAVE A COUPLE COUNCILMEMBERS, COUNCILWOMAN SANDOVAL.
>> SANDOVAL: THANK YOU, MAYOR PRO TEM.
THANK YOU VERY MUCH, JENNIFER AND DR. BRIDGER FOR YOUR PRESENTATION.
JUST -- I THINK IT'S REALLY EXCITING THAT WE'RE GOING IN THIS DIRECTION, AND THAT YOU FOUND A NEW WAY TO DEVELOP THE PLAN AND YOU BROUGHT THESE PARTNERS IN TO HELP YOU DEVELOP IT.
JUST SOME CLARIFYING QUESTIONS, SO YOU SAID "WE" A LOT, WE'RE GOING TO DO A, B AND C.
SO DO YOU REALLY SEE, I GUESS, THE HEALTH DEPARTMENT TAKING ON MOST OF THE WORK FOR -- THAT'S IN HERE, OR WILL WE -- I GUESS COULD YOU JUST TALK ABOUT THAT A LITTLE BIT.
SO THESE INITIATIVES ARE REALLY WHAT THE HEALTH DEPARTMENT WILL FOCUS ON OVER THE NEXT FOUR YEARS.
SO THAT DOESN'T MEAN WE WON'T CONTINUE TO DO ALL THE WORK THAT WE NORMALLY DO, BUT IN IDENTIFYING THESE HEALTH PRIORITIES, WE RECOGNIZE THAT THE COMMUNITY FEELS LIKE WE NEED TO BE ADDRESSING SOME ADDITIONAL ISSUES.
AND SO WE'RE TAKING THAT VERY SERIOUSLY AND FIGURING OUT HOW WE'RE GOING TO ADDRESS IT BY IDENTIFYING THESE STRATEGIES.
I WILL SAY THAT WE -- PART OF THIS IS ALSO IDENTIFYING FUNDING TO GO ALONG WITH IT.
SO IT MAY BE THAT IF FUNDING IS NOT READ LY -- READILY AVAILABLE, THAT THE FIRST YEAR OF THE PLAN WILL BE ABOUT IDENTIFYING SOURCES OF FUNDING, WHETHER THAT BE GRANT APPLICATIONS AND SUCH.
>> DR. BRIDGER: THE OTHER THING I'D ADD, THE HEALTH DEPARTMENT IS THE CHIEF HEALTH CATALYST FOR THE COMMUNITY.
AND WE RARELY DO ANYTHING WITHOUT -- GOING TO CHANGE THAT MODEL WITH THE STRATEGIC PLAN.
EVERYTHING WE DO WILL PROVIDE -- WHO'S WORKING ON THIS AND RELATED ISSUES TOGETHER TO HELP -- HELP US MOVE THAT FORWARD.
AND I GUESS WHEN YOU -- WHENEVER WE GET AN UPDATE LATER, WILL WE BE ABLE TO SEE KIND OF THE SCALE OF THE PLAN? YOU KNOW, HOW MANY PEOPLE ARE WE TALKING ABOUT ADDRESSING.
WE'LL BE PUTTING TOGETHER ESSENTIALLY A ONE- TO TWO-PAGE DOCUMENT ON EACH OF THE PRIORITY AREAS THAT WILL WALK US THROUGH EACH OF THOSE STRATEGIES THAT WE'VE IDENTIFIED THAT WE'RE GOING TO BE IMPLEMENTING, ALONG WITH HOW MUCH PEOPLE ARE WE GOING TO REACH, WHAT WOULD THIS COST, WHAT THE STAFFING COMPLEMENT LOOKS LIKE.
>> AND WHAT WE HOPE THE OUTCOMES TO BE AS WELL.
SO ANOTHER CLARIFYING QUESTION, WHEN WE LOOK AT THAT LIST OF THE TOP HEALTH ISSUES THAT WERE -- THAT WERE VOTED ON, I SEE NUTRITION AND DIABETES, AND TO ME THOSE ARE, YOU KNOW, PRETTY LINKED.
SO IF YOU WORK ON NUTRITION, YOU WILL IDEALLY, RIGHT, PREVENT DIABETES IN THE FUTURE AND HELP EVEN MANAGE DIABETES.
BUT I ALSO CIAC SESTO -- SEE ACCESS TO HEALTH SERVICES AND THEN I CEMENT L HEALTH.
I IMAGINE THERE -- I SEE MENTAL HEALTH, I GUESS THERE'S SOME OVERLAP, BUT I WANTED TO ASK YOU, IN THE FOCUS AREAS FOR ACCESS TO HEALTH, THERE WERE TWO AND ONE OF THEM HAD TO DO WITH IMMIGRANT POPULATIONS AND ONE OF THEM REALLY SEEMED TO BE ABOUT MENTAL HEALTH.
SO I GUESS I'D JUST LIKE TO KNOW HOW YOU NARROWED DOWN TO THOSE TWO PARTS OF HEALTHCARE?
>> SO WHAT WE DID WAS WE ESSENTIALLY DEVELOPED A MENU OF THINGS THAT FALL UNDER ACCESS TO CARE.
AND THEN WE ASKED OUR PARTNERS AND OUR STAFF WHO WORK EVERY DAY WITH MEMBERS OF THE COMMUNITY WHAT FOCUS AREAS THEY FELT WE REALLY NEEDED TO FOCUS ON AND WHERE THERE WERE GAPS IN SERVICES CURRENTLY.
AND THAT'S HOW THOSE WERE IDENTIFIED.
>> DR. BRIDGER: BUT YOU'RE RIGHT, WE DID, WHERE POSSIBLE, TRY TO INTEGRATE SOME OF THOSE TOP 10 INTO OUR FINAL FOUR.
SO THAT'S WHY YOU DO SEE, FOR EXAMPLE, SOME MENTAL HEALTH FOCUS AREAS WITHIN ACCESS TO CARE, BECAUSE THAT ALLOWED US TO INCORPORATE MENTAL HEALTH, WHICH WAS ON THE TOP 10 -- AUDIO]
>> SANDOVAL: I GUESS THE ONLY SLIGHT CONCERN I HAVE IS THAT I THINK THERE IS A LOT OF NEED FOR ACCESS TO HEALTHCARE BEYOND THOSE TWO AREAS, AND OBVIOUSLY YOU CAN'T DO IT ALL AT ONCE.
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>> SANDOVAL: YEAH, A BUNCH OF OTHER BARRIERS, RIGHT? LIKE ACTUALLY HAVING INSURANCE, HAVING MONEY TO PAY FOR THAT, TRANSPORTATION BARRIERS, SO I JUST WISH THERE WERE SOMETHING THAT WERE ALSO ADDRESSING THAT, BUT I KNOW THAT THAT MEANS IT WOULD BE STRETCHING YOU MUCH THINNER THAN YOU ARE ALREADY.
AND THEN YOU TALKED ABOUT YOU'LL BE DEVELOPING THE BUDGET AND WE'LL KNOW THAT WHEN WE GO INTO -- INTO THE NEXT YEAR.
>> SANDOVAL: THANK YOU VERY MUCH FOR THE PRESENTATION.
>> MAYOR PRO TEM: THANK YOU, COUNCILWOMAN.
I THINK COUNCILWOMAN SANDOVAL EXPRESSED SOME OF THE SAME CONCERNS I HAD, PARTICULARLY ABOUT DIABETES AND -- AND ACCESS TO HEALTH.
AND REALLY WHEN I LOOK -- IN AUDIO] -- THREE OUT OF THESE FOUR ISSUES ALL TRULY REVOLVE AROUND MENTAL HEALTH, BECAUSE WHEN YOU'RE TALKING ABOUT TEEN PREGNANCY OR DEPRESSION OR YOU'RE TALKING ABOUT, YOU KNOW, TRAUMA, AND THEN YOU'RE TALKING ABOUT ACES AND YOU'RE TALKING ABOUT VIOLENCE, ALMOST ALL OF THESE HAVE MENTAL HEALTH COMPONENTS THAT WE NEED TO HAVE SERVICES AVAILABLE FOR PEOPLE TO BE ABLE TO GET THAT KIND OF HELP.
AND I THINK THAT WOULD REALLY AFFECT THREE OF THESE FOUR AREAS, OTHER THAN NUTRITION, WHICH IS REALLY AN EDUCATIONAL THING, MORE THAN ANYTHING ELSE.
>> DR. BRIDGER: AND I THINK WHAT YOU HAVE HIT ON IS THE CRUX OF THE CONVERSATION THAT WE'VE BEEN HAVING WITH THE COMMUNITY OVER THE LAST SEVERAL YEARS, WHICH IS MENTAL HEALTH IS AN ISSUE.
IT'S AN ISSUE THAT'S NOT BEING ADDRESSED AS WELL AS THE COMMUNITY WISHES IT WOULD BE, AND THE ROLE FOR PUBLIC HEALTH IN MENTAL HEALTH IS UPSTREAM.
HOW CAN WE PREVENT THE CRISES FROM HAPPENING.
>> DR. BRIDGER: HOW CAN WE TRY TO DECREASE THE NUMBER OF PEOPLE WHO ARE ENDING UP IN OUR EMERGENCY ROOMS IN A MENTAL HEALTH CRISIS? SO NOT ONLY DO YOU SEE A STRONG MENTAL HEALTH COMPONENT IN HERE BECAUSE THAT'S WHAT THE COMMUNITY SAID THEY WANTED, BUT YOU ALSO SEE PUBLIC HEALTH'S APPROACH TO PROBLEM-SOLVING, WHICH IS GET IN FRONT OF IT AS FAR AS YOU CAN AND TRY TO PREVENT IT.
WELL, I HOPE THAT THERE'S A LOT OF EMPHASIS IN THAT.
>> MAYOR PRO TEM: THANK YOU, COUNCILMAN.
THANK YOU FOR THAT PRESENTATION.
I -- YOU KNOW, I GUESS I'M -- WHAT I'M HOPING WOULD ALSO HAPPEN, TOO, AND WE'VE TALKED ABOUT THIS A LOT IS SOME OF THE ENVIRONMENTAL SORT OF BUILT ENVIRONMENT ISSUES AROUND -- AND YOU'VE IDENTIFIED HOUSING ISSUES AND VIOLENCE AND ACCESS TO HEALTH SERVICES.
IT SEEMS LIKE THERE'S A WAY TO TIE THIS INTO A LOT OF OUR OTHER EFFORTS AS WELL, DIFFERENT DEPARTMENTS IN TERMS OF HOW HEAT IMPACTS, YOU KNOW, THE UPTICK IN VIOLENCE, FOR EXAMPLE, AND WHAT WE CAN DO TO HELP SORT OF SHORE UP ALL THE OTHER THINGS THAT WE'RE DOING WITH OUR RESOURCES ELSEWHERE TO ACKNOWLEDGE THAT THESE HAVE COMPOUNDING AFFECTS.
>> DR. BRIDGER: SO I WOULD SAY THE SINGLE MOST APPEALING PART OF MY NEW JOB IS THE ABILITY TO INFLUENCE HEALTH ACROSS THE CITY.
IT'S NOT JUST THE HEALTH DEPARTMENT THAT'S RESPONSIBLE FOR IMPROVING THE HEALTH OF THE COMMUNITY.
IT'S -- IT'S REALLY A CORE PILLAR OF EVERYTHING THAT WE DO HERE IN THE CITY.
BUT SOMETIMES WE DON'T THINK ABOUT IT THAT WAY, AND SO, YES, I WOULD LOVE TO BE ABLE TO FIGURE OUT HOW TO MAKE THOSE CONNECTIONS ACROSS EVERYTHING THAT WE DO, BECAUSE, YOU KNOW, PEOPLE MAY NOT THINK OF TREES AS BEING A HEALTH ISSUE, BUT THEY REALLY ARE ON A NUMBER OF LEVELS.
AND SO THE WORK THAT WE'RE DOING WITH PARKS IS INCREDIBLY IMPORTANT TO THE WORK THAT METRO HEALTH IS DOING AROUND OZONE AND AIR QUALITY, FOR EXAMPLE.
>> TREVINO: THANK YOU, DR. BRIDGER, I LOOK FORWARD TO WORKING WITH YOU IN YOUR NEW CAPACITY.
THANK YOU GUYS, AGAIN, WE APPRECIATE EVERYTHING YOU'RE DOING AND KEEP IT UP.
[Executive Session]
WE'LL NOW GO INTO EXECUTIVE SESSION.THE TIME IS NOW 2:50 P.M. ON WEDNESDAY, APRIL 10TH, 2019.
THE EXECUTIVE SESSION SCHEDULED FOR TODAY WILL BE CARRIED OVER TO TOMORROW AND WILL BE HELD DURING THE CITY COUNCIL A SESSION THAT BEGINS NO EARLIER THAN 9:00 A.M.
THE CITY COUNCIL WILL NOW RECESS TODAY'S MEETING AND RECONVENE ON THURSDAY, APRIL 11, 2019 IN THE
[00:35:03]
CITY COUNCIL CHAMBERS AT 9:00 A.M.* This transcript was compiled from uncorrected Closed Captioning.