[Approval of Minutes  ] [Public Comments  ] [00:02:23] ... AND THEY MAKE A TREMENDOUS DIFFERENCE IN THE COMMUNITY, AND THEY'RE DOING A GREAT JOB, AND SO WE'VE DEVELOPED SOME REAL PARTNERSHIPS, SO THEY COME, THEY HELP US IN ALL AREAS OF THE COMMUNITY, AND WE'RE LOOKING FORWARD TO CONTINUING TO DO GREAT THINGS. WE'RE BUILDING GARDENS, SO I'M ACTUALLY WITH SAN ANTONIO MILLION GARDEN PROJECT, AND SO WE BUILT GARDENS ALL OVER THE COMMUNITY, AND WE CONTINUE TO BUILD THEM. WE'RE GROWING FOOD, AND WE'RE GETTING HELP FROM THE COMMUNITY HEALTH WORKERS, AND FROM THE HEALTH DEPARTMENT, AND SO WE'RE JUST THANKFUL FOR THE STUDENTS AND FOR WHAT IT MEANS WHEN THE CITY ACTUALLY PARTICIPATES IN PROMOTING HEALTH IN THE COMMUNITY AND HELPING THE COMMUNITY TO BECOME HEALTHY . I THINK THAT IS A TREMENDOUS ASSET, WE'RE THANKFUL FOR ALL THEY DO AND ALL THAT IS TAKING PLACE AND WE HOPE THAT IT CONTINUES AND EXPANDS AS WE GO FORWARD, THANK YOU. >> GALVAN: THANK YOU FOR THE COMMENT. YOU HAVE THREE MINUTES. >> WHEN DOES MY TIME START? GOOD MORNING. SINCE IT HASN'T STARTED YET, I'LL GO AHEAD AND START. GOOD MORNING. I'M GRATEFUL FOR THIS OPPORTUNITY TO COME AND BE ABLE TO SPEAK ON BEHALF OF THE COMMUNITY HEALTH WORKERS, I KNOW I HAVE THREE MINUTES. I'M PRIOR MILITARY, SERVED 30 YEARS IN THE ARMY, RETIRED HERE IN SAN ANTONIO. I'M ALSO A FORMER MEMBER OF THE COMMUNITY HEALTH WORKERS TEAM WITH HEALTHY NEIGHBORHOODS, AND SO I UNDERSTAND THE IMPORTANCE OF WHAT COMMUNITY HEALTH WORKERS DO, AND WHAT IT ALSO DOES, IT PROVIDES AN OPPORTUNITY FOR US TO BE ABLE TO COMMUNICATE WITH THOSE THAT ARE OUT IN VARIOUS COMMUNITIES. WE DO FOCUS OUR AREA THEN THE EAST SIDE OF SAN ANTONIO, WHERE A LOT OF THE DEMOGRAPHICS THERE ARE PEOPLE WHO REALLY ARE IN NEED OF HEALTHY FOOD, AND THOSE AREAS IN WHICH THEY LIVE ARE FOOD DESERTS, ONE OF THE THINGS I DID AS PART OF COMMUNITY HEALTH WORKER TO GO IN AND HELP PROVIDE HEALTHY FOODS EACH AT THE GROCERY STORE, WHERE THEY HAVE THE INITIATIVE WHERE THEY TRIED TO PUT HEALTHY FRUITS AND VEGETABLES WITHIN THOSE DEPARTMENT STORES NOT JACKING IT UP AS THEY TYPICALLY DO IN COMMUNITY GROCERY STORES. ONE THING THAT IS IMPORTANT FOR US TO KNOW IS THAT FOOD IS MEDICINE. SO WHEN WE CAN PROVIDE THEM, HELP THEM TO HAVE HEALTHY FOOD, WHERE THEY CAN GO [00:05:03] OUTSIDE THEIR HOMES, THEIR DOORS AND PULL OUT OF THEIR GARDENS THINGS THEY CAN COOK, VERSUS HAVING TO RUN TO THE STORE AND OTHER THINGS, WE KNOW THAT THE THINGS WE GROW IN OUR GARDENS ARE HEALTHIER THAN WHAT WE GET IN SOME OF THESE STORES, FOR CHWS TO BE ABLE TO PROVIDE THOSE OPTIONS FOR THEM DEFINITELY MAKES A DIFFERENCE. SO THE INITIATIVE THAT HAS BEEN MADE WITH THE PROJECT THEY'RE HAVING REALLY MAKES A DIFFERENCE, AGAIN, IN THE CITY CAN SUPPORT THOSE EFFORTS IT DOES MAKE A DIFFERENCE. WE TALK ABOUT COVID, HOW THE IMPACT OF THOSE WHO WERE -- LOST THEIR LIVES, THEY WERE BASED ON THE MOBILITIES THAT THEY HAD, AND HEALTHY FOOD CAN HELP TO OFFSET SOME OF THOSE HEALTHY IMPACTS THAT THEY'VE HAD. SO WE LOOK FORWARD TO WHAT WILL TAKE PLACE AND WE PRAY THAT YOU GUYS WILL HELP TO INCREASE WHAT'S BEING DONE. THANK YOU. >> THANK YOU FOR YOUR COMMENTS. SUSIE SCHUMAN. >> MY NAME IS SUSIE, I SERVE AS THE SAFETY NET DIRECTOR AT THE UNITED WAY OF SAN ANTONIO AND BEXAR COUNTY. TOGETHER, WE'RE WORKING TO ENSURE CHILDREN ARE READY FOR SCHOOL, YOUTH ARE SUCCESSFUL, INDIVIDUALS AND FAMILIES ARE SELF-SUFFICIENT IN OUR COMMUNITY IS SUPPORTED IN TIMES OF CRISIS, OUR SAFETY NET IMPACT AREA SERVES AS A FOUNDATION OF OUR WORK AND THE SUPPORT SYSTEM FOR THE OTHER THREE IMPACT AREAS ENSURING THAT ESSENTIAL NEEDS ARE MET. WE PROVIDE FOCUS IN THREE AREAS, ECONOMIC STABILITY, FOOD SECURITY, AND HOUSING. AND ECONOMIC STABILITY, WE'RE PROVIDING ESSENTIAL NEEDS BOTH DIRECTLY ABDOMINAL LONGSIDE CASE MANAGEMENT. IN FOOD, ENSURING ACCESS TO FOOD THROUGH FOOD PANTRY, AND COMMUNITY DISTRIBUTIONS, AND PROVIDING SAFE SHELTER AND SUPPORT FOR VULNERABLE POPULATIONS, WE ARE GRATEFUL FOR OUR STRONG PARTNERSHIP WITH METRO HEALTH, TO STRENGTHEN THE FOOD SYSTEM THROUGH COLLABORATION, PARTNERSHIP IN ACTION, SERVED AND CONTINUED TO SERVE AS ADVISORS ACROSS OUR IMPACT AREAS, A SPECIAL ACKNOWLEDGMENT TO ANNA AND DAN IN ATOR CONTRIBUTIONS TO OUR SAFETY NET. THEY'VE ALSO PARTICIPATED IN A FILM THAT WILL INFORM OUR NEXT REQUEST FOR PROPOSAL, THEY'VE INTRODUCED LEAH'S PANTRY TO TWO OF OUR FOOD PARTNERS, THEY'VE LED MEANINGFUL CONVERSATIONS WITH OUR PARTNERS REDUCING FOOD WASTE, THE FOOD CENTER AT CORONADO AND THE UNITED WAY NETWORK WORK CLOSELY TOGETHER, VIA CORONADO ALSO PARTICIPATED IN OUR EVENTS AND CONSISTENTLY BRINGS FRESH FRUIT. DURING THE RECENT GOVERNMENT SHUT DOWN, FORT SAM REQUESTED EXPECTING AND POSTPARTUM MOTHERS. AND THE FRC PROVIDED BABY HYGIENE ITEMS, MANY IN OUR COMMUNITY ARE ONE EMERGENCY AWAY FROM A CRISIS, IT COULD BE A COWORKER, FRIEND OR NEIGHBOR, HELP LINE IS ONE OF ONLY THREE, 24-7 CALL CENTERS IN THE STATE OF TEXAS, WE INVITE YOU TO VISIT OUR OFFICE AND LISTEN TO CALLS, 21 IS A POWERFUL RESOURCE FOR YOUR OFFICE AND YOUR CONSTITUENTS, VISIT TX DOT 21 COUNTS.ORG TO SEE THE TOP NEEDS IN YOUR DISTRICT, IN 2024, THE TOP THREE NEEDS IN BEXAR COUNTY, WERE HOUSING, FOOD AND UTILITIES. JOIN US AT THE HOMELESS PERSON'S MEMORIAL SERVICE ON SUNDAY, SEPTEMBER 21, AT 7 P.M., AS WE HONOR THE LIVES LOST IN 2025, WE REAFFIRM OUR COMMITMENT TO MAKE SURE EVERYONE HAS A SAFE PLACE TO CALL HOME, OUR DATA IS AVAILABLE ON OUR WEBSITE AND WE APPRECIATE THE RECENT CONVERSATIONS WE'VE HAD WITH YOUR STAFF, UNITED WAY IS HERE TO SUPPORT YOU AND YOUR CONSTITUENTS. THANK YOU FOR YOUR TIME AND COMMITMENT TO A STRONGER MORE RESILIENT COMMUNITY. >> GALVAN: THANK YOU FOR YOUR COMMENTS. ALFREDO ORTIZ? >> HELLO. THANKS FOR RECEIVING, OR LETTING ME BE HERE. MY NAME IS ALFREDO ORTIZ, UNIVERSITY OF THE INCARNATE WORD, AND I DIDN'T COME FROM THE WORD OF ACADEMIA, I DO SOMETHING CALLED COMMUNITY BASED RESEARCH, ACTION RESEARCH, WHERE WE TRY TO WORK WITH PEOPLE TO BECOME THEIR OWN RESEARCHERS OR ADDRESS THEIR OWN CHALLENGES. I WAS FORTUNATE TO MEET COMMUNITY HEALTH WORKERS AND THE BROADER TEAM WITH HEALTHY NEIGHBORHOODS BACK IN 2017. WE EVEN -- TIMING IS GOOD BECAUSE WE HAD THANKSGIVING TOGETHER WHERE WE HAD ONE CLASS WITH MY PH.D. STUDENTS AT HEALTHY NEIGHBORHOODS AND THEN HEALTHY NEIGHBORHOODS COMMUNITY HEALTH WORKERS CAME TO OUR CLASS FOR ANOTHER EXCHANGE, AND MY GOAL IS ALWAYS TO GET THE COMMUNITY INTO THE CLASSROOM AND TAKE THE CLASSROOM IN THE COMMUNITY, AND I FOUND NO MORE IDEAL PARTNER THAN HEALTHY NEIGHBORHOODS TO BE ABLE TO DO THAT OVER THE YEARS. FAST FORWARD A LITTLE BIT TO 20 -- RIGHT AROUND WHEN THE PANDEMIC STARTED, AND WE HAD AN OPPORTUNITY AT THE INCARNATE WORD TO PURSUE A GRANT WITH THE JOHNSON FOUNDATION, COMMUNITY HEALTH AND WELL-BEING, AND WE PARTNERED WITH HEALTHY NEIGHBORHOODS AGAIN. THEY BROUGHT IN THEIR OWN RESOURCES AND TIME, WE BROUGHT -- AND THEY LEVERAGED A LOT OF RESOURCES THAT WE HAD, AND WE WORKED TOGETHER FOR ABOUT THREE YEARS, WORKING WITH COMMUNITIES TO DO JUST THAT, TO BECOME THEIR OWN RESEARCHERS TO TRY AND ADDRESS CHALLENGES THAT ARE [00:10:02] IMPORTANT TO THEM AND THEIR BROADER COMMUNITIES. A GREAT EXAMPLE THAT I LOVE IS WE WORKED WITH BREAST FEEDING MOTHERS, SOUTH -- SOME OF THE NEIGHBORHOODS, HEALTHY NEIGHBORHOODS WORKS, AND WE WENT THROUGH A PROCESS OF TELLING STORIES, HEARING THEIR EXPERIENCES, BREAST FEEDING DURING THE PANDEMIC, AND AT A CERTAIN POINT IN THIS PROCESS, WE WERE USING A PHOTO VOICE PROCESS, TAKING PICTURES, IT'S A WAY THAT ALLOWS COMMUNITY MEMBERS TO REPRESENT THEIR KNOWLEDGE IN SOPHISTICATED WAYS WITHOUT HAVING TO NECESSARILY DO THROUGH TRADITIONAL RESEARCH PROCESSES. THEY SHARED THEIR PICTURES, WE WERE TRYING TO FIGURE OUT WHAT ARE THESE RESILIENT BREAST FEEDING STRATEGIES DURING THE PANDEMIC, AND AT A CERTAIN POINT, WE REALIZED THE PICTURES WEREN'T DOING THE TRICK, SO WORKING WITH HEALTHY NEIGHBORHOODS, THEY WERE VERY KEEN TO SAY, HEY, WE NEED TO GO SLOWER, WE NEED TO PAY MORE ATTENTION TO WHAT THE COMMUNITY WANT TO SAY, WE NEED TO ASK THEM WHAT SHOULD WE DO NEXT, AND WHAT WE DID WAS HE ENDED UP DOING A DEEPER STORYTELLING PROCESS CARTOONING AND THINGS ALLOWED COMMUNITY EXPERTS AS WE CALLED THEM TO REPRESENT THEIR KNOWLEDGE IN SUCH HIGH LEVEL WAYS THAT THEY'RE INFLUENCING MULTIPLE OTHER SPACES. WE PRESENTED THE RESULTS OF THAT WITH THE COMMUNITY EXPERTS IN MULTIPLE CONFERENCES AND OTHER SPACES AND THIS BEAUTIFUL CARTOON FILLED ACADEMIC ARTICLE IS ABOUT READY TO COME OUT IN ABOUT A MONTH WE'RE HAPPY TO SHARE WITH YOU AS WELL. I ALLEGING JUST CONCLUDE BY SAYING HEALTHY NEIGHBORHOODS ISN'T JUST MEETING THE COMMUNITY WHERE THEY ARE, THEY'RE DEFINITELY DOING THAT, THEIR STRATEGIES ARE COMMUNITY FIRST, COMMUNITY CENTERED AND NOT HELL STRATEGY CENTERED, BUT RATHER WHERE DO YOU START, HOW CAN WE MEET YOU WHERE YOU ARE, AND SECONDLY, THEY'RE PRODUCING KNOWLEDGE ALONG THE WAY, THEY'VE LEARNED SO MUCH ABOUT THE INTERSECTION BETWEEN COMMUNITY, HEALTH, CITY, THEY'RE PART OF THE FABRIC OF THE CITY, AND WE NEED TO INVEST WAY MORE IN THOSE KIND OFFAL PERHAPS AND NOT LESS. THANK YOU. >> GALVAN: THANK YOU FOR YOUR COMMENTS. OUR FINAL SPEAKER IS MOLLY. MOLLY? >> THANK YOU FOR THE -- IT COMES IN GOOD HANDY, IT'S LIKE REALLY COLD OUTSIDE. SO I'M NOT REPRESENTING INCARNATE WORD. I'M ACTUALLY CALLING AND SPEAKING ABOUT PEOPLE THAT ARE DIEING IN THE STREETS RIGHT NOW. THEY'RE FIGHTING TO STAY ALIVE. AND IT DOES NOT GET COLD UNTIL 32°. IT ACTUALLY DOES GET COLD IN THE 50S. IT KIND OF GETS COLD IN THE 60S, BUT REALLY HYPOTHERMIA STARTS IN THE 60S, Y'ALL HAVE THIS STRANGE RULE ABOUT NOT OPENING UP WARMING 24 HOUR SHELTERS UNTIL 32°, AND THAT PRETTY MUCH TELLS ME THAT THE CITY WANTS PEOPLE TO DIE ON THE STREETS. PLEASE PROVE ME WRONG. OPEN UP THE 24 HOUR WARMING CENTERS. WE HAVE TONS OF COMMUNITY CENTERS. I'M JOBLESS. IF YOU WANT TO GO AHEAD AND STAFF SOMEONE, I NEED A JOB. YOU CAN STAFF ME. I'LL GLADLY TAKE THE NIGHT SHIFT. BUT WE NEED A WARMING CENTER FOR THESE FOLKS THAT ARE FIGHTING TO STAY ALIVE. THEY'RE DYING ON THE STREETS. I DON'T KNOW HOW ELSE TO BEG. THE ONLY THING THAT Y'ALL ARE DOING IS A SILLY LITTLE -- I THINK SOMEONE ALREADY MENTIONED IT. SOMEONE IS GOING TO DO A MILAM PARK, RECITE ALL THE PEOPLE THAT DIED ON OUR STREETS, LIKE REALLY? THAT IS ALL SAMMINISTRIES AND THE CITY IS GOING TO DO, RECITE PEOPLE'S NAMES LEFT AND RIGHT. OH, WE FEEL SO SAD THAT YOU DIED. PATRICIA LAWRENCE, I'M SO SAD YOU JUMPED OFF THE BUILDING BECAUSE YOU DIDN'T WANT TO FACE ANOTHER TIME OF COLD. IS THAT REALLY WHAT THE CITY OF SAN ANTONIO IS GOING TO DO? DONATING MONEY TO A DRUG CITY THAT PEOPLE DON'T WANT TO GO TO HAVEN FOR HOPE, THAT'S NOT ANSWER. SAMM MINISTRY STAFF TOLD ME THEMSELVES ON LOOP 410 THAT THEY ARE NOT TAKING NEW INTAKES. THAT'S WHAT THE STAFF AT SOCIAL MEDIA MINISTRIES TOLD ME. YOU HAVE A HOLIDAY INN HOTEL THAT HAS AN OCCUPANCY LEVEL OF WHAT, 500, 400, AND THEY'RE ONLY AT ABOUT A HUNDRED, 150, AND THE TWO LADIES AT SAMMINISTRIES TOLD ME THEMSELVES THAT THEY ARE NO LONGER TAKING NEW INTAKES. WHAT'S THAT ABOUT? WHAT IS THAT ABOUT? I DON'T UNDERSTAND. SO Y'ALL ARE DONATING MONEY TO AGENCIES, YOU'RE PAYING MONEY TO SAMMINISTRIES TO PAY FOR THE HOLIDAY INN HOTEL RENT, AND YET YOU'RE NOT TAKING IN NEW INTAKES. I'M NOT SURE -- I'M NOT UNDERSTANDING WHAT THAT'S ABOUT. WHAT CAN ONE DO TO GET Y'ALL'S ATTENTION? I MEAN I KNOW COUNCILMAN MARC WHYTE AND COUNCILMANGA [00:15:09] VITO, I KNOW Y'ALL DON'T CARE, BECAUSE YOU SIGNED A CRR TO ASK E ERIK WALSH FOR MORE HUMAN SWEEPS. HUMAN SWEEPS ARE NOT TO ANSWER. PEOPLE ARE NOT GETTING SHELTER FROM HUMAN SWEEPS. THAT IS ALL THAT RESULTS FROM YOUR CCR THAT Y'ALL SIGNED, WITH MANNY PALÁEZ, IS DEATH, YOU HAVE A ANNUAL CITY RICH URAL AT MILAM PARK. IS THAT REALLY WHAT YOU WANT. TELL ME THE TRUTH. THAT'S WHAT I WANT TO KNOW. DO YOU WANT THEM TO DIE. >> GALVAN: THANK YOU FOR YOUR COMMENTS. ANYBODY ELSE SIGNED UP TO SPEAK? GREAT. [Briefing and Possible Action on  ] WE'LL NOW MOVE ON TO ITEM NUMBER 1, METRO HEALTH, UPDATING NEIGHBORHOOD PROGRAMS, I BELIEVE -- >> GOOD MORNING, MEMBERS OF THE COMMITTEE. THANK YOU FOR THIS OPPORTUNITY, I'M DR. CLAUDE JACOB, ALONG WITH THE DEPARTMENT OF HUMAN SERVICES, WE WILL PROVIDE TWO BRIEFINGS TODAY, FIRST ON METRO HEALTH HEALTHY NEIGHBORHOODS PROGRAM, AND THEN ON THE TEEN MENTAL HEALTH SURVEY. TO KICK OFF, I HAVE SOME EXCITING NEWS TO SHARE, I'M PROUD TO ANNOUNCE THAT THE SAN ANTONIO METRO HEALTH DISTRICT HAS RECEIVED OFFICIAL NOTICE OF ITS REACT CREDIT ACCOMMODATION STATUS, WHOO, WHOO, AS RECOGNIZED BY THE HEALTH ACCREDITATION BOARD, THIS NATIONAL DESIGNATION AFFIRMS THE DEPARTMENT'S CONTINUED COMMITMENT TO MEETING THE HIGHEST STANDARDS FOR PUBLIC HEALTH PRACTICE AND STANDARD DELIVERY. JUST KNOW THAT NATIONALLY ONE IN FOUR LOCAL HEALTH DEPARTMENTS ACROSS THE UNITED STATES IS ACCREDITED. CURRENTLY, THERE ARE A TOTAL OF 8 LOCAL HEALTH DEPARTMENTS IN TEXAS ACCREDITED OUT OF 73 STATEWIDE. I REALLY WANT TO THANK THE CITY MANAGER, COUNCILMAN -- COUNCILMEMBERS GALVAN AND CASTILLO FOR PARTICIPATING IN THE SITE VISIT HELD AT THE END OF OCTOBER, I WANT TO SEND A SPECIAL SHOUTOUT TO OUR FANTASTIC TEAM, ESPECIALLY AVILA, WHO SERVES AS OUR ACCREDITATION COORDINATOR FOR HELPING TO ANCHOR THIS AT THE DEPARTMENT. NOW, WITH THAT, I'LL INTRIEWRS TODAY'S PRESENTATION. DURING OUR OCTOBER 23RD PRESENTATION, WE PROVIDED AN OVERVIEW OF MEDICAID 1115 WAIVER PROGRAM AND HIGHLIGHTED CONSTRAINTS EXPECTED AT THE END OF THIS FISCAL YEAR. WE ALSO PROVIDED AN OVERVIEW OF THE DIABETES PROGRAM WHICH IS AN EXAMPLE OF A KEY PROGRAM THAT WILL BE IMPACTED BY THE LAPSE IN FUNDING AT THE END OF THIS FISCAL YEAR. WITH THE EXPIRATION OF THIS FUNDING TREATMENT, THE ECONOMIC IMPACT TO METRO HEALTH WILL BE THE LOSS OF APPROXIMATELY $8 MILLION, AND ABOUT 80 STAFF BY THE END OF SEPTEMBER, 2026. THERE ARE 8 DIFFERENT PROGRAMS AND A NUMBER OF CROSS CUTTING TEAMS THAT HAVE BEEN IMPLEMENTED FOR OVER A DECADE, AND TODAY WE'LL FEATURE ONE OF THOSE PROGRAMS. SO THE HEALTHY NEIGHBORHOODS PROGRAM HAS BEEN OPERATING SINCE 2012 AND REMAINS ONE OF OUR STRONGEST COMMUNITY BASED INITIATIVES, THIS PROGRAM IS FUNDED THROUGH THE FUND, THE 1115 WAIVER, THE CENTERS FOR DISEASE CONTROL AND PREVENTION, AND USDA GRANTS. DESPITE FUNDING CHALLENGES, HEALTHY NEIGHBORHOODS CONTINUES TO BE NATIONALLY RECOGNIZED INCLUDING EARLIER THIS YEAR, THE 2025 DESIGNATION AS A PROMISING PRACTICE AS RECOGNIZED BY THE NATIONAL ASSOCIATION OF COUNTY AND CITY HEALTH OFFICIALS. THE SECOND PRESENTATION WILL FEATURE THE TEAM MENTAL HEALTH SURVEY, COADMINISTERED BY THE DEPARTMENT OF HEALTH AND HUMAN SERVICES, THIS BEGAN IN 2021, DURING THE PANDEMIC, WHEN THE YOUTH AND PROJECT WORTH TEAM AMBASSADORS CAME TOGETHER TO BETTER UNDERSTAND HOW THE PANDEMIC WAS AFFECTING YOUTH MENTAL HEALTH, THE SURVEY PROVIDES VALUE INSIGHTS INTO SERVICES OF 12 TO 15-YEAR-OLDS, RESOURCE ALLOCATIONS, AT THIS TIME I'LL INTRODUCE OUR ASSISTANT DIRECTOR MARJORIE WHITE TO PRESENT AN UPDATE, FOLLOWING ADMINISTRATOR AT DHS WILL PRESENT A UPDATE AND WILL BE ABLE TO ANSWER ANY QUESTIONS FOLLOWING THE PRESENTATIONS. THANK YOU. MARJORIE? >> GOOD MORNING. AS DR. JACOBS STATED, MY NAME IS MARJORIE WHITE. I SERVE AS THE ASSISTANT DIRECTOR FOR THE COMMUNITY HEALTH AND SAFETY DIVISION. IT IS SUCH A DELIGHT TO SHARE WITH YOU ONE OF OUR MOST INNOVATIVE PROGRAMS AT THE HEALTH DEPARTMENT HEALTHY NEIGHBORHOODS. IN THIS PRESENTATION, I WILL PROVIDE AN OVERVIEW OF THE BACKGROUND OF THIS PROGRAM INCLUDING WHERE AND HOW WE WORK, HOW WE USE THE ASSET BASED COMMUNITY DEVELOPMENT MODEL TO DRIVE MEANINGFUL HEALTH IMPROVEMENTS AND THE CHALLENGES AND OPPORTUNITIES WE'VE ENCOUNTERED ALONG THE WAY. OUR WHY. HEALTHY NEIGHBORHOODS BEGAN IN 2013 UNDER THE 1115 MEDICAID WAIVER AS A HEALTH PROMOTION INITIATIVE. WHAT MADE IT UNIQUE FROM THE [00:20:04] START IS OUR COMMITMENT TO HIRING FROM COMMUNITIES THAT WE WERE GOING TO SERVE. TOGETHER, THESE TEAM MEMBERS DEVELOPED THEIR GUIDING WHY WHICH STATES WE BELIEVE THAT ALL FAMILIES DESERVE HEALTHY NEIGHBORHOODS, AND THEY POSSESS THE ASSETS NEEDED TO CREATE POSITIVE CHANGES. THIS GUIDING PRINCIPLE CENTERS THE WORK AROUND COMMUNITY INCLUSION AND RECOGNIZING THAT RESIDENTS ARE THE TRUE EXPERTS OF THEIR LIVED EXPERIENCES. THE HEALTHY NEIGHBORHOODS BECAME THE FIRST METRO HEALTH PROGRAM TO FULLY EMBRACE THE IDEA OF COMMUNITY HEALTH WORKERS, AS THE IDEAL MODEL FOR ENGAGING COMMUNITIES ON HEALTH TOPICS. TODAY THIS PROGRAM REMAINS THE LARGEST CHW PROGRAM WITH ABOUT 18CHWS, THE PROGRAM IS STRUCTURED INTO THREE INTERCONNECTED BRANCHES, LEVERAGING THEIR UNIQUE STRENGTH TO SERVE THE COMMUNITY MORE EFFECTIVELY. FIRST BEGINNING WITH COMMUNITY CONNECTORS. THIS TEAM IS COMPRISED OF NEIGHBORHOOD BASED CHWS, WHERE EACH ARE DESIGNED WITH NEIGHBORHOODS, THESE NEIGHBORHOODS WERE SELECTED BASED ON HISTORICAL DISINVESTMENTS AND THE PRESENCE OF STRONG COMMUNITY ASSETS, SUCH AS THE PEOPLE, THE PLACES, AND ORGANIZATIONS READY FOR COLLABORATIVE AND HELP FOCUSED INTERVENTIONS. OUR REACH PROGRAM, RACIAL AND ETHNIC APPROACHES TO COMMUNITY HEALTH. THROUGH FUNDING THROUGH THE CENTERS FOR DISEASE CONTROL AND PREVENTION, WE WERE ABLE TO EXPAND THIS TEAM TO INCLUDE REACH, THIS ADDED A TEAM FOCUS ON POLICY, SYSTEMS AND ENVIRONMENTAL CHANGE ACROSS THE EAST, SOUTH AND WEST CORRIDORS OF THIS COMMUNITY. THEIR WORK INCLUDES IMPROVING NUTRITION STANDARDS AND FOOD PANTRIES, OFFERING INCENTIVES LIKE DOUBLE UP FOOD BUCKS TO MAKE HEALTHIER OPTIONS MORE ACCESSIBLE, THROUGH THE HEALTHY CORNER STORE INITIATIVE, ENHANCING PHYSICAL ENVIRONMENTS TO PROMOTE ACTIVITY, SUPPORTING EARLY CHILD CARE CENTERS AND ADOPTING EVIDENCE-BASED HEALTH GUIDELINES AND ALSO OUR RESOURCE CENTER AT VIA CORONADO. IN 2023, HEALTHY NEIGHBORHOODS LAUNCHED A FIRST OF ITS KIND ROW SEARCH CENTER LOCATED ON THE SOUTH SIDE OF SAN ANTONIO. THIS CENTER ADDRESSES BOTH IMMEDIATE SAFETY NET NEEDS AND LONG TERM FOOD SECURITY WHILE ALSO SUPPORTING CHRONIC DISEASE PREVENTION. TOGETHER, THESE BRANCHES REPRESENT A COMPREHENSIVE COMMUNITY-LED APPROACH TO PUBLIC HEALTH WITH CHWS LEADING THE WAY. HOW WE WORK. OUR COMMUNITY CONNECTOR SERVE THREE ESSENTIAL ROLES. THEY SERVE AS COMMUNITY ORGANIZERS, THEY IDENTIFY AND CONNECT ENGAGE RESIDENTS HELPING THEM TO COCREATE HEALTH PROMOTIONAL INITIATIVES. FOR EXAMPLE, IN THE CAMELOT NEIGHBORHOOD, THIS LED TO FAMILY YOGA WHERE PARENTS LEARN SELF-REGULATION TOOLS, AT THE VALERO ELEMENTARY, FRIENDSHIP, FITNESS, AND SELF ESTEEM BUILDING. AND ON THE SOUTH SIDE, THE COMMUNITY CAME TOGETHER TO CREATE THE CITY'S FIRST FOOD FOREST, WHICH GROWS FOOD YEAR ROUND AND FOSTERS DEEP COMMUNITY CONNECTIONS. THEY ALSO SERVE AS HEALTH EDUCATORS, CHWS, MEET PEOPLE WHERE THEY ARE IN THE COMMUNITY, WHETHER IT'S COMMUNITY CENTERS, CHURCHES, OUTDOOR SPACES, BUT THEY OFFER EDUCATIONAL NUTRITION, FITNESS, FOR ALL ABILITY LEVEL, THEY ALSO SERVE AS COMMUNITY LIAISON, THE CHWS TAKE THE PULSE OF THE COMMUNITY AND SERVE AS A BRIDGE BETWEEN RESIDENTS AND PUBLIC HEALTH. ONE EXAMPLE IS DURING THE COVID RESPONSE. IT WAS THE HEALTHY NEIGHBORHOODS TEAM THAT PLAYED A VITAL ROLE IN EVERY ASPECT OF THAT RESPONSE. WHILE ALSO PROVIDING CRITICAL FEEDBACK TO THE DEPARTMENT ABOUT COMMUNITY PERCEPTIONS, CONCERNS AND INNOVATIONS. OUR CHWS ROLE MAY DIFFER FROM TRADITIONAL ROLES SUCH AS CLINICAL EXTENDERS OR PATIENT NAVIGATORS. OUR CHWS, HAVE THE AUTONOMY TO COCREATE PUBLIC HEALTH INTERVENTIONS IN PARTNERSHIP WITH COMMUNITY, BRINGING RESIDENTS IDEAS TO LIFE. SO WHERE WE WORK. HERE IS A SNAPSHOT OF WHERE OUR COMMUNITY CONNECTORS WORK. EACH OF 12 NEIGHBORHOODS SPANNING FROM THE EAST, SOUTH AND WEST SIDE HAVE ONE DEAD CADEED CHW. THESE ARE LONG-TERM INVESTMENTS WHERE CHWS ARE EMBEDDED IN THE COMMUNITY, ATTENDING THE NEIGHBORHOOD MEETINGS, SUPPORTING VENTS, AND BRINGING IN RESOURCES AND EDUCATION IDENTIFIED BY HE'S RESIDENTS, THE YELLOW STARS ON THE MAP INDICATE LOCATIONS WHERE OUR TEACHING GARDENS ARE LOCATED. THESE SERVE AS REGIONAL HUBS FOR HEALTH PROMOTIONAL CLASSES THAT PROTECT EDUCATION WITH GARDENING. [00:25:03] THEY'RE LOCATES AT THE SALINAS WICK CLINIC, VILLA CORONADO CENTER AND PECAN VALLEY. ANOTHER UNIQUE ASPECT OF HEALTHY NEIGHBORHOODS IS THE USE OF ASSET-BASED COMMUNITY DEVELOPMENT FRAMEWORK. ON THE LEFT, YOU SEE A NEEDS BASED APPROACH, WHICH FOCUSES PRIMARILY ON PROBLEMS AND DEFICITS, AS YOU SEE HERE, CHILD ABUSE, TEAM MOTHERS, GANG MEMBERS, CLEAN GWENCY, ADDICTION, ALL OF THE ABOVE. IN CONTRAST, RECOGNIZES THE STRENGTHS ALREADY PRESENT IN THE COMIEBT. IT'S PEOPLE, IT'S PLACES AND ORGANIZATIONS. RESIDENTS ARE SEEN AS COLLABORATORS AND AGENTS OF CHANGE, WITH PUBLIC HEALTH PLAYING A SUPPORTIVE ROLE TO AMPLIFY THEIR IDEAS. TO WORK TOGETHER, WE MUST FIRST BUILD TRUST, AND THAT BEGINS BY RECOGNIZING AND HONORING THE GOOD THAT IS ALREADY PRESENT. ASSET MAPPING IS A KEY STEP TO ASSET BASED COMMUNITY DEVELOPMENT FRAMEWORK, THE HANDS ON PROCESS OF DISCOVERING WHO IS PRESENT IN THE COMMUNITY AND WHAT MOTIVATES THEM TO TAKE ACTION. THE IMAGE ON THE RIGHT IS A REAL ASSET MAP FROM THE LOS HARDINNAS COMMUNITY BETWEEN DISTRICT 5 AND 6, IT SHOWS THE PEOPLE, THE COMMUNITY HEALTH WORKS CONNECTED TO AND HOW RESIDENTS ARE CONNECTED TO ONE ANOTHER. OUR CHWS ARE TRUSTED IN THE COMMUNITY. LINKING PEOPLE WITH SHARED INTERESTS AND GOALS. WE ALSO HAVE RESIDENT LEADERS. THESE INDIVIDUALS WITH BROAD SOCIAL NETWORKS WHO ARE ESPECIALLY SKILLED AT SPREADING INFORMATION, AND THEN OUR RESIDENTS WHO ALSO BECOME CHANGE AGENTS, USE IG THEIR RELATIONSHIPS, TALENTS AND LIVED EXPERIENCES TO DRIVE TRANSFORMATION. THIS INTERCONNECTEDNESS IS ALSO KNOWN AS SOCIAL NETWORK. HEALTHY NEIGHBORHOODS ACTUALLY RECENTLY COMPLETED A STUDY LOOKING AT A SOCIAL NETWORK ANALYSIS TO EXPLORE HOW THESE CONNECTIONS INFLUENCE HEALTH OUTCOMES, THE FINDINGS CONFIRM WHAT WE ALREADY KNEW, A CONNECTED COMMUNITY IS A HEALTH INJURY COMMUNITY. PEOPLE WILL MORE RELATIONSHIPS IN THEIR NEIGHBORHOOD ARE STATISTICALLY MORE LIKELY TO REPORT BETTER HEALTH THAN THOSE WITH FEW OR NO CONNECTIONS. AND NOW FOR THE REACH PROGRAM. WITH ADDED A POWERFUL LAYER OF EVIDENCE-BASED, SUSTAINABLE AND COMMUNITY DRIVEN STRATEGIES, FOE KISSED ON POLICY, SYSTEMS AND ENVIRONMENTAL CHANGE WHICH GOES BEYOND THESE ONE-TIME EVENTS OR PROGRAMS. THESE TYPE OF PROGRAMS ARE FOUNDATIONAL TO LONG-TERM HEALTH IMPROVEMENTS, SUSTAINABLE, EVEN WHEN KEY INDIVIDUALS MOVE ON, LOGICALLY LINKED TO MEASURABLE HEALTH OUTCOMES AND CAPABLE OF INFLUENCING BOTH INDIVIDUAL BEHAVIORS AND THE PHYSICAL ENVIRONMENT. THE IMAGES HERE HIGHLIGHT OUR WORK AND EARLY CHILD CARE CENTERS SUPPORTING HEALTHY DEVELOPMENT FROM THE START, PUBLIC ENGAGEMENT TO IMPROVE SPACES FOR SAFE PHYSICAL ACTIVITY, OUR FRUIT AND VEGETABLE VOUCHER PROGRAMS, FOOD PANTRY ENHANCEMENTS WHICH PROMOTE CLIENT CHOICE AND DIGNITY. THESE EFFORTS CLAIM TO REDUCE HEALTH DISPARITIES IN COMMUNITIES ACROSS SAN ANTONIO'S EAST, WEST, AND SOUTH SIDE. OUR SPECIAL SAUCE. THE COMBINATION OF THE COMMUNITY CONNECTED BRANCH AND THE REACH GRANT IS WHAT THE TEAM LIKES TO CALL THE SPECIAL SAUCE. THIS UNIQUE BLEND THAT MAKES HEALTHY NEIGHBORHOODS SO EFFECTIVE IN CREATING COMMUNITY LED NEIGHBORHOOD SPECIFIC EVIDENCE BASED LONG LASTING POSITIVE CHANGE. ONE POWERFUL EXAMPLE IS THE GARDEN AT THE CHURCH LOCATED GIST STEPS FROM THEIR FOOD PANT TRION THE EAST SIDE. THIS GARDEN WIZ INSTALLED TOGETHER BY (INDISCERNIBLE) AND HEALTHY NEIGHBORHOODS PROGRAM. THE FOOD GROWN HERE GOES DIRECTLY TO THE COMMUNITY, SHOWCASING THE STRENGTH OF THE LOCAL FOOD SYSTEM AND THE MANY HANDS THAT COME TOGETHER TO NURTURE AND CARE FOR THEIR NEIGHBORHOODS. OUR RESOURCE CENTER AT VILLA CORONADO, THIS ALSO CAME OUT OF THAT SAME SPECIAL SAUCE WE TALKED ABOUT EARLIER. THIS WAS ONCE A VACANT BUILDING. IT WAS PRESERVED BY COMMUNITY MEMBERS WHO ENVISION WHAT IT COULD BE. WE ARE SO GRATEFUL THAT THE COMMUNITY ENTRUSTED OUR HEALTHY NEIGHBORHOODS PROGRAM TO HELP BRING THIS VISION TO LIFE. TODAY THE CENTER PROVIDES IMMEDIATE FOOD ASSISTANCE, A WELCOMING SPACE FOR COMMUNITY GATHERINGS, CLASSES AND PREVENTATIVE HEALTH SERVICES THAT SUPPORT LONG-TERM FOOD AND HEALTH SECURITY. CURRENTLY, THE CENTER SERVES AROUND 300 UNIQUE INDIVIDUALS PER MONTH. IT'S A TESTAMENT OF BOTH WHAT TRUST BUILT OVER TIME AND THE ON GOING NEED FOR SUPPORT AND SERVICES IN THE COMMUNITY. IN TERMS OF OUTCOMES, HERE IS A BRIEF OVERVIEW OF THE [00:30:05] MANY PEOPLE THAT THE PROGRAM HAS SERVED THIS LAST FISCAL YEAR. AS YOU CAN SEE, 1087 CHILDREN WERE ENROLLED IN CENTERS WHERE BEST PRACTICE FOR HEALTH PROMOTION THAT OUR HEALTHY NEIGHBORHOODS PROGRAM ASSISTED WITH. 17,160 RESIDENTS SERVED -- WERE SERVED BY FOOD PANTRIES WITH ENHANCED NUTRITION POLICIES AND PRACTICES. WE HAVE MORE THAN 50 CORNER STORES RECOGNIZED AS OUR HEALTHY CORNER STORE INITIATIVE FOR STOCKING FRESH FRUITS AND VEGETABLES. AND FOR ONE OF THE HEALTHY CORNER STORES, WE OFFER DOUBLE UP FOOD BUCKS DISCOUNT AND WE HAD 19,127 TRANSACTIONS. FOR OUR RESOURCE CENTERVILLE "LA CORRIDA" NADO THIS PAST YEAR, WE SERVED 1240 UNIQUE PERSONS, AND OFFERED 447 HEALTH EDUCATION CLASSES, JUST TO NAME A FEW. BEYOND THE DATA, THERE'S STORIES BEHIND ALL OF THIS, IN CHRONIC DISEASE PREVENTION, IT'S OFTEN DIFFICULT TO MEASURE HOW MANY HEART ATTACKS WE PREVENTED, HOW MANY PEOPLE WE PREVENTED THE ONSET OF DIABETES, BUT WHAT WE CAN MEASURE IS BEHAVIOR CHANGES. THIS DATA IS FROM THE CAMELOT NEIGHBORHOOD, WHICH WAS THE CHW THAT WAS PART OF THIS WAS MS. CANTU, WHO RECENTLY RETIRED. SHE WORKED IN THIS NEIGHBORHOOD FOR APPROXIMATELY 12 YEARS, AND AS YOU CAN SEE FROM THE DATA, THERE WAS POSITIVE HEALTH OUTCOMES FROM THE WORK THAT WAS INVESTED HERE. AMONG THE INDIVIDUALS SHE REGULARLY ENGAGED WITH, MOST REPORTED ADOPTING BEHAVIORS KNOWN TO REDUCE THE RISK OF HEART DISEASE AND DIABETES, WHICH ARE BOTH LEADING CAUSES OF DEATH. MANY ALSO SHARED PERSONAL STORIES ABOUT HOW THE CLASSES POSITIVELY IMPACTED THEIR ENTIRE FAMILIES. THIS SLIDE ALSO SHOWS THE VOICES OF OUR COMMUNITY MEMBERS IN REGARDS TO THE WORK. SO ONE SAYS. CONFIDENT WITHS LISETTE'S TEACHINGS, MY FAMILY AND I ARE HEADING FOR A BETTER FUTURE. WE ALSO RECEIVED QUOTES FROM SOME YOUTH. ONE SAID THE FOOD DEMOS MAKE ME LOVE COOKING AND NOW I COOK HEALTHY DISHES FOR MY FAMILY. LISETTE HELPED TO GET BOYS OUT THERE. SHE CONNECTED US WITH RESOURCES THAT HELPED MY FAMILY. JUST TO GI YOU AN IDEA OF THE IMPACT OF THIS WORK BY THIS TEAM. THE HEALTHY NEIGHBORHOODS PROGRAM HAS RECEIVED NATIONAL RECOGNITION. OFFICIALS IN 2019. IN 2025, VERY RECENT, OUR RESOURCE CENTER AT VILLA CORONADO WAS RECOGNIZED AS A PROMISING PRACTICE. THESE HONORS PROTECT THE PROGRAM'S INNOVATION, EFFECTIVENESS AND COMMITMENT TO COMMUNITY-LED PUBLIC HEALTH. AND NOW FOR THE CHALLENGES AND THE OPPORTUNITIES. SIMILAR TO THE PRESENTATION WITH THE DIABETES PROGRAM IMPACTED BY OUR WAIVER PROGRAM, THIS PROGRAM IS ALSO BEING IMPACTED AS WELL. ON THE LEFT SIDE YOU SEE WHAT OUR CURRENT FUNDING IS, AS WELL AS STAFFING AND CAPACITY. AS CLAUDE INDICATED PREVIOUSLY, THE 1115 MEDICAID WAIVER WE EXPECT TO EXHAUST ALL OF THOSE FUNDS BY SEPTEMBER 30TH, 2026, SO AS YOU CAN SEE FOR THIS PROGRAM, THEIR BUDGET WOULD GO FROM A LITTLE OVER 2.1 MILLION, TO 1.3 MILLION, WHICH IS A FUNDING REDUCTION OF ABOUT 36%. THE STAFFING WILL GO FROM 23 TO 16, BUT PLEASE NOTE THAT THIS REDUCTION ALSO INCLUDES MAJORITY OF THE LEADERSHIP OF THIS PROGRAM. IN ADDITION, THIS WILL ALSO IMPACT THE CAPACITY, THE NUMBER OF NEIGHBORHOODS WE SERVE, THE NUMBER OF CLASSES WE'RE ABLE TO OFFER, AS WELL AS THE NUMBER OF PEOPLE WE WOULD REACH. AND WE ESTIMATE THAT THE REDUCTION WOULD BE BETWEEN 35 AND 50%. AND WHAT'S NOT LISTED HERE IS THE INSTITUTIONAL KNOWLEDGE THAT WILL BE LOST, BECAUSE MANY OF THESE INDIVIDUALS HAVE OVER A DECADE DOING THIS WORK IN THE COMMUNITIES. OPPORTUNITIES. SO WE ARE WORKING TO PRESERVE THE CORE ELEMENTS OF THE PROGRAM TO REMAIN VIGILANT FOR FUTURE GROWTH. SUCH AS USING ASSET BASED COMMUNITY DEVELOPMENT MODEL, USING OUR COMMUNITY HEALTH WORKERS AS ORGANIZERS, EDUCATORS AND LIAISONS, WHICH IS UNIQUE, EFFECTIVE AND WORTH PROTECTING. BY MAINTAINING THIS FOUNDATION, WENT SHIRE THAT WHEN FUNDING DOES BECOME [00:35:01] AVAILABLE AGAIN, THAT WE ARE IN POSITION TO APPLY. IN THE MEANTIME, THE PROGRAM IS WORKING TO ALIGN WITH OTHER CITY INITIATIVES TO REMAIN RELEVANT. THE RESOURCE CENTER MODEL IS ALSO BEING EXPLORED AS A WAY TO MAINTAIN DEEP TIES IN SELECTED NEIGHBORHOODS, SHOULD WE NEED TO SCALE BACK IN OTHERS. OUR PARTNERSHIPS, MANY ARE ALSO HERE TODAY WITH US. IN ADDITION TO THE PARTNERS THAT ARE LISTED ON THIS SLIDE, THERE ARE MANY OTHER PARTNERS THAT ARE NOT PICTURED WHICH INCLUDE OUR NEIGHBORHOOD HOUSING ASSOCIATION, INFORMAL COMMUNITY GROUPS AND TRUSTED LOCAL LEADERS. EVERYONE IS REALLY FEELING THE STRAIN OF THE NATIONAL DISINVESTMENT OF PUBLIC HEALTH. CITIES AND STATES ACROSS THE COUNTRY ARE GRAPPLING WITH BUDGET SHORTFALL, AND WE KNOW WHAT HAPPENS WHEN THERE'S A DISINVESTMENT OF PUBLIC HEALTH. THE BURDEN OFTEN SHIFTS TO THE INDIVIDUAL AS WELL AS HEALTHCARE SYSTEMS. AND OUR HEARTS GOES TO ALL OF US WHO ARE WORKING WITH LESS. YOU FOR THE OPPORTUNITY TO LET YOU KNOW THE GREAT WORK THAT'S HAPPENING IN OUR HEALTHY NEIGHBORHOODS PROGRAM. HERE IN THE AUDIENCE, WE HAVE SEVERAL MEMBERS OF THE LEADERSHIP TEAM AS WELL AS OUR STAFF. IF YOU ALL CAN ALL PLEASE STAND. HERE IN THE AUDIENCE TODAY ARE KATHY SHIELDS, OUR PUBLIC HEALTH ADMINISTRATOR, ANNA, OUR HEALTH PROGRAM MANAGER, NORA VARGAS, OUR OUTREACH SUPERVISOR FOR THE COMMUNITY CONNECTORS. CHONG MIN WHO IS OUR GRANT COORDINATOR, AND DANIEL JIMINEZ, OUR RESOURCE CENTER COORDINATOR, AND MANY OF OUR CHWS THAT SERVE THIS COMMUNITY. CAN YOU GIVE THEM A ROUND OF APPLAUSE? IT IS AN HONOR TO BE THEIR ASSISTANT DIRECTOR. THIS CONCLUDES OUR PRESENTATION. THANK YOU. >> THANK YOU SO MUCH, MARJORIE, FOR THE PRESENTATION. THANK YOU FOR EVERYONE FOR ALL THE WORK YOU DO DAY IN AND DAY OUT FOR THIS PROGRAM. FOR MY COLLEAGUES WANT TO START WITH QUESTIONS OR COMMENTS. COUNCILMAN WHYTE, IF YOU WANT TO START. >> WHYTE: SURE. IF YOU'RE READY, YOU'RE UP. COME ON, YOU KNOW YOU WANT TO GO FIRST. >> OKAY. I'LL GO FIRST. THANK YOU, CHAIR. THANK YOU SO MUCH FOR THIS PRESENTATION. I THOUGHT YOU WERE SPOT ON IN THAT RESIDENCE . WE KNOW OUR NEIGHBORHOODS BEST, I KNOW, NOT ONLY ON THE NEEDS OF IT, BUT WE KNOW WHO SPEEDS ON OUR STREETS. WE KNOW WHO THE CONNECTORS WERE LIKE YOU WERE MENTIONING EARLIER, AND WE ALSO KNOW THE PEOPLE WHO MAY NEED SOME HELP. SO THANK YOU SO MUCH FOR ALL OF THAT RESEARCH THAT YOU ALL WERE DOING. I HAD A QUICK -- SOME QUICK LOGISTICAL QUESTIONS. WHY WERE THESE NEIGHBORHOODS SELECTED? AND ALSO KIND OF A DOUBLE QUESTION, ARE THERE PLANS TO EXPAND TO OTHER NEIGHBORHOODS? I KNOW THE LAST SLIDE TALKING ABOUT SOME OF THE BUDGET CONSTRAINTS, BUT JUST CURIOUS. >> NO, ABSOLUTELY. THE ORIGINAL NEIGHBORHOODS WERE SELECTED BECAUSE OF HEALTH OUTCOMES IN THESE COMMUNITIES, SO THAT WAS THE ORIGINAL WAY THAT WE APPROACHED THE COMMUNITIES THAT WE WORKED WITH EVENTUALLY. OVER TIME, AS WE WERE ABLE TO GET MORE FUNDING TO EXPAND, WE WERE ABLE TO EXPAND TO OTHER COMMUNITIES AS WELL, BUT LOOKING AT HEALTH OUTCOMES, THESE ORIGINAL TEN NEIGHBORHOODS HAD VERY POOR HEALTH OUTCOMES, AS WELL AS HISTORICAL DISINVESTMENTS, FOR A VARIETY OF REASONS, IN THESE COMMUNITIES, AND ALSO THERE ARE PEOPLE THERE WHO ARE -- WANTED TO HAVE CHANGE. AND SO THAT IS VERY HELPFUL WHEN WE'RE ABLE TO PARTNER WITH THE COMMUNITY TO ADDRESS WHAT THEIR NEEDS ARE, BUT ALSO THE ASSETS AND FIGURE OUT WAYS TO EXPAND UPON THAT. >> ALDERETE-GAVITO: YEAH, AND THANK YOU FOR THAT, SO BASICALLY WHAT I'M HEARING IS EXPANSION IS DEPENDENT ON BUDGET. >> ABSOLUTELY. AS YOU SAW FROM THAT ONE SLIDE, ONCE WE GET TO OCTOBER 1, IF WE ARE UNABLE TO SUSTAIN FUNDING OR FIND ADDITIONAL PROGRAM FOR THIS FUNDING, WE WILL FACE A REDUCTION IN THE NUMBER OF NEIGHBORHOODS, CAPACITY, ET CETERA. >> ALDERETE-GAVITO: ESPECIALLY THROUGH THE IMPACT STORIES, ESPECIALLY LIKE THE FOOD DEMOS MADE ME LOVE COOKING AND SHOW, YOU KNOW, HOW SHE CAN MAKE A HEALTHY -- OR THIS PERSON, I'M NOT SURE IF HE OR SHE, CAN MAKE HEALTHY DINNERS FOR THEIR FAMILY, THAT'S WHERE THE RUBBER MEETS THE ROAD, I USED TO LIVE ON THE NORTH SIDE, NOW I LIVE IN WOODLAWN LAKE. YOU HAVE THE LUXURY OF BEING ABLE TO DRIVE TO OTHER [00:40:02] PLACES, FOR PEOPLE WHO DON'T HAVE THOSE OPTIONS, YOU SEE THE STARK REALITY OF LIVING IN CERTAIN NEIGHBORHOODS IN THE CITY. I HAVE A QUESTION ON THE PARTICIPATING IN CORNER STORE PROGRAMS, WHAT DOES THAT LOOK LIKE. >> THE HEALTHY CORNER STORES? SO WE WORK IN COMMUNITIES WHERE THERE'S FOOD SWAMPS, GOOD DESERTS AS WELL, WE PARTNER WITH THE CORNER STORE TO PROVIDE FRESH VEGETABLES AND FRUITS IN THAT CORNER STORE. RECENTLY WE'RE TRY TRANSITIONING TO DO DOUBLE UP FOOD BUCKS, WHERE INDIVIDUALS WHO SNAP, DOUBLE UP FOOD BUCKS MATCH IT DOLLAR FOR DOLLAR, GIVE MORE FOR THEIR MONEY, THAT IS ENSURING THAT WE HAVE ACCESS TO HEALTHY OPTIONS IN THESE CORNER STORE, THAT MAY BE THE GROCERY STORE FOR THE COMMUNITY. >> ALDERETE-GAVITO: NICE, I LOVE THAT. IT REMINDS ME WHEN I USED TO WORK AT USAA, YOU KNOW, YOU HAVE YOUR SPENDING, BUT YOU COULD LITERALLY GET A SALMON SALAD FOR THE SAME COST AS TWO TACOS, YOU KNOW, SO I THINK INCENTIVIZING HEALTHY FOOD LIKE THAT GOES A LONG WAY. ON THE IMPACT STORIES, HOW ARE WE TRACKING LONG-TERM OUTCOMES TO SEE HOW WE'RE MOVING THE NEEDLE THROUGH GENERATIONS? >> I'LL BRING UP UP ANNA WHAT IS THE PROGRAM MANAGER. >> WE DO A VARIETY OF RESEARCH PLETHS IN ORDER TO SEE HOW THE PROGRAM IS DOING, WE DO A LOT OF STORIES. WE'VE DONE A LOT OF VIDEOS IN THE PAST TO SHOW IMTHE PACT OF THE WAYS WE'RE DOING DIFFERENT PROGRAM IN PARTNERSHIP WITH COMMUNITY MEMBERS. THE LONG, LONG-TERM HEALTH OUTCOMES IS A CHALLENGE TO MEASURE, BUT WE'RE HOPING THAT THE RESOURCE CENTER AT VILLA CORONADO WILL GIVE US THE OPPORTUNITY AS MANY PEOPLE ARE COMING BACK TO THE SAME SPOT. EACH YEAR WE DO A VARIETY OF QUALITATIVE AND QUANTITATIVE MEASURES TO CHECK IN TO MAKE SURE THEY'RE ON THE RIGHT TRACK AND MEETING THE COMMUNITY'S NEEDS. >> AND WE CAN TAKE THIS OFFLINE, BUT I WOULD LOVE TO SORT THROUGH T THAT DATA WITH YOU, I'M CURIOUS WHAT THAT LOOKS LIKE, AND HOW WE CAN SUSTAIN IT, YOU KNOW, GOING TO SLIDE 16 AND 17, I UNDERSTAND HOW REDUCTIONS ARE TOUGH, AND, YOU KNOW, WE WANT TO CONTINUE AGAIN TO ME THIS IS A LOT OF WHERE THE RUBBER MEETS THE ROAD ON MOVING THE NEEDLE FOR SAN ANTONIO. IS THERE WAYS THAT WE'RE EXPLORING PARTNERSHIPS WITH NONPROFITS, OR COMMUNITY ORGS TO CONTINUE TO DO THIS WORK? OUR BUDGET CONSTRAINTS ARE OUR BUDGET CONSTRAINTS, I'M WONDERING IF THERE'S WAYS WE CAN PARTNER WITH GARDEN, OTHER NONPROFITS WHO CAN HELP WITH SOME OF THIS STUFF. >> NO, ABSOLUTELY. WE'RE ACTUALLY IN THE PROCESS OF OUR STRATEGIC PLANNING FOR ALL OF OUR WAIVER FUNDED PROGRAMS, AND THAT IS PART OF IT. WHAT ARE THE PARTNERS? IF THIS GOES AWAY, WHO -- OR HOW CAN WE BETTER COLLABORATE TO EXPAND REACH, IN SOME SHAPE OR FORM, SO WE ARE IN THE PROCESS OF DOING THAT. >> ALDERETE-GAVITO: OKAY, SOUNDS GOOD. AND I KNOW OUR COUNCIL OFFICES OBVIOUSLY HAVE ACCESS TO -- SO DO YOU ALL -- A LOT OF NONPROFITS, BUT IF THERE'S WAYS WE CAN PUT OUR HEADS TOGETHER AROUND THAT, AGAIN, THIS WORK IS DRIEWCIAL. THANK YOU SO MUCH. THANK YOU. THANK YOU, CHAIR. >> GALVAN: COUNCILMEMBER WHITE? >> WHYTE: YEAH, THANKS, CHAIR. COUNCILWOMAN TOUCHED ON IT A LITTLE BIT. LONG-TERM SUCCESS, SHORT-TERM SUCCESS, HOW ARE WE MEASURING THE SUCCESS OF THE PROGRAM? >> I DEFINITELY WOULD SAY THROUGH OUR ENGAGEMENT WITH OUR COMMUNITY PARTNERS. WHAT WE ALSO LOOK AT ARE LIKE WHAT ARE SOME OF THE RESIDENT PROJECTS THAT THE FOLKS ARE WORKING ON, THAT'S PROMOTING HEALTH IN THEIR DIFFERENT COMMUNITIES. WE LOOK AT HEALTHY CORNER STORES, HOW ARE WE EXPANDING THAT? HOW MANY FOLKS ARE ACTUALLY USING DOUBLE UP FOOD BUCKS TO INCREASE THE NUMBER OF HEALTHY OPTIONS THAT THEY'RE PURCHASING. QUALITATIVE WORK, FROM SURVEYS AND FOCUS GROUPS THAT ALSO HELPS US TO DETERMINE WHETHER OR NOT WE'RE BEING EFFECTIVE. BUT I'M GOING TO TURN IT OVER TO -- >> DO WE HAVE DATA, DO WE HAVE NUMBERS ON SOME OF THESE THINGS AS TO HOW MANY PEOPLE ARE BEING SERVED? >> YEAH, WE SHARED A LOT OF THE NUMBERS ABOUT HOW MANY PEOPLE ARE BEING SERVED, AND THEN WE USE A VARIETY OF METHODS TO SEE HOW DIFFERENT PIECES OF OUR PROGRAM IS IMPACTING THE COMMUNITY. BECAUSE OF THE VARIETY OF WORK THAT WE'RE DOING, WE'LL HONE IN ON DIFFERENT AREAS. FOR EXAMPLE, WE RECENTLY DID A STUDY ON THE DOUBLE UP FOOD BUCKS PARTICIPANTS EXPERIENCE, TO LEARN HOW [00:45:01] DOUBLE UP FOOD BUCKS IMPACTS FAMILIES. IT REALLY SHEDS LIGHT ON THE POWER OF BEING ABLE TO PROVIDE THOSE EXTRA FUNDS FOR ADDITIONAL FRUITS AND VEGETABLES, IMPACTS THE VARIETY OF FRUITS AND VEGETABLES BEING PURCHASED, THE QUANTITY OF FRUITS AND VEGETABLES BEING PURCHASED AND THINKING ABOUT THOSE TRADEOFFS PEOPLE ARE MAKING WHEN THEY'RE THINKING ABOUT BUYING FOOD OR OTHER RESOURCES OR UTILITIES, IT SHOWED A VERY POSITIVE RESULT. I DEPENDS ON WHICH ASPECT OF THE PROGRAM, BUT EVALUATION IS ALWAYS A PART OF WHAT WE'RE DOING, AND HAPPY TO PROVIDE ANY ADDITIONAL DOCUMENTATION ON THAT. >> IT LOOKS LIKE WE'VE GOT BUDGETED A LITTLE OVER 640 GRAND FOR THE PROGRAM IN FISCAL YEAR 2027, RIGHT WHICH IS ABOUT HALF OF THE -- A LITTLE LESS THAN HALF OF THE PROGRAM'S TOTAL FUNDING. >> CORRECT. >> WHYTE: IS THERE -- IS THERE A PLAN TO GET LESS DEPENDENT ON THE GENERAL FUND MOVING FORWARD, OR IS THIS PROGRAM ALWAYS GOING TO REQUIRE SIGNIFICANT GENERAL FUND FUNDING? >>> THANK YOU, COUNCILMAN. I WOULD SAY THAT THISSEN -- WHAT WE OFFER HERE IS AT LEAST A SNAPSHOT OF THE PROGRAMS THAT WILL BE DISRUPTED BY THE LAPSE OF THE MEDICAID 1115 WAIVER, I WOULD SAY THAT EACH PROGRAM IS UNIQUE, FOR THIS ONE IN PARTICULAR, IT'S NOT ONLY THE GENERAL FUND, IT'S ALSO THE OFFSET FROM THE MEDICAID 1115 WAIVER, THE CDC, AS WELL AS THE USDA GRANT, WE'RE ASSESSING THIS. WE WANT TO LET YOU KNOW ABOUT THE FRAGILITY OF THESE PROGRAMS, THE IMPACT OF WHAT WE'VE SEEN OVER THE LAST DECADE. BUT THIS IS NOT UNIQUE. WHAT WE'VE OFFERED HERE AT AT LEAST THROUGH THESE DIFFERENT SCENARIOS IS JUST SO YOU'RE AWARE -- MORE AWARE OF SOME OF THE PROGRAMS AND WHAT EWE'VE WE'VE DONEOVER THE LAST FEW YEAE UNDERSTAND THE CONSTRAINTS OF THE GENERAL FUND. >> WHYTE: SURE. AND WOULD YOU SAY -- WE'RE LOOKING AT ALMOST 1.4 MILLION THAT'S GOING TO BE SPENT ON THE PROGRAM IN 2027. WHAT PERCENTAGE OF THAT IS DIRECT COMMUNITY IMPACT VERSUS ADMINISTRATIVE? >> WE CAN PROVIDE SOME MORE DETAIL ABOUT THE BREAK DOWN. >> WHYTE: OKAY. I THINK THAT'S REALLY IT. I APPRECIATE -- I APPRECIATE Y'ALL'S WORK, AND OBVIOUSLY THIS HELPS A BUNCH OF FOLKS, AND SO THANK YOU FOR THE PRESENTATION. >> GALVAN: THANK YOU, COUNCILMEMBER CASTILLO? >> CASTILLO: THANK YOU, CHAIR, THANK YOU, DR. JACOB, MARJORIE AND THE ENTIRE HEALTH TEAM, AS WELL AS MEMBERS OF THE PUBLIC WHO GAVE COMMENT TODAY, AN IMPORTANCE OF THE IMPACT OF THIS PROGRAM. WHAT WE KNOW AND STATED BY ONE OF THE PUBLIC COMMENTERS, RIGHT, WE KNOW THE PEOPLE ON THE GROUND ARE THE ONES WITH THE SOLUTIONS AND WE SHOULD FOLLOW OUR LEAD, THAT'S WHAT IS IMPORTANT ABOUT COMMUNITY HEALTH WORKER, WORKING FROM ASSET MIND SET RATHER THAN A DEFICIT MIND SET, IT HELPS ME THINK ABOUT THE WEST SIDE HISTORIC NEIGHBORHOOD, WHICH IS MY NEIGHBORHOOD, CITY'S MOST ECONOMICALLY DIVESTED ZIP CODE AND COMMUNITIES, WHAT WE START OFF IS WHAT I LOVE ABOUT THE HISTORIC WEST SIDE. OFTENTIMES FOLKS COME IN WITH NEGATIVE PERCEPTIONS, WE HAVE PUBLIC HOUSING, LOW INCOME HOUSING, WORKING CLASS FAMILIES, WE START OFF WITH WHAT WE LOVE ABOUT OUR COMMUNITY, BECAUSE WE KNOW WE ARE AN ASSET, WE NEED SUPPORT AND INVESTMENT AND CARE FROM FOLKS BEYOND OUR NEIGHBORHOOD. BUT WITH THA THAT BEING SAID, I THINK WHAT Y'ALL HAVE HIGHLIGHTED IN TERMS OF THE POTENTIAL REDUCTIONS, HAS METRO HEALTH HAD CONVERSATIONS IN TERMS OF WHAT ARE THE NONNEGOTIABLES? WHAT ARE THE AREAS IN WHICH WE DON'T INTEND TO REDUCE, IF WE DON'T IDENTIFY ADDITIONAL FUNDING SOURCES TO HELP SUPPORT THE PROGRAM? >> THANK YOU, COUNCILWOMAN, AGAIN, WE'RE GOING THROUGH THAT EXERCISE NOW. AND WHAT WE'RE SHARING HERE BUT IS A PREMIER ABOUT SOME OF THE MOST IMPACTED PROGRAMS, SO WE FEATURED THE DIABETES PROGRAM IN OCTOBER. YOU'RE HEARING ABOUT HEALTHY NEIGHBORHOODS. JUST KNOW THAT WE'RE ANALYZING THE IMPACTS NOW. WE ALREADY HAVE PLACE HOLDERS IN TERMS OF OUR BUDGET PLANNING PROCESS FOR FY27, SO THIS IS INTENDED TO BE A DATAPOINT FOR THIS GROUP, AS WE HAVE AND ACKNOWLEDGE THE ON GOING CONSTRAINTS IMPACTING OTHER PROGRAMS AT THE DEPARTMENT. >> CASTILLO: WHAT I OFFERED TO MY COLLEAGUES IN TERMS OF HOW WE CAN IDENTIFY OPPORTUNITIES, I THINK THERE'S VALUE IN REVISITING OUR CPS POLICY, AND THE WAYS IN WHICH WE CAN FUND THESE REALLY IMPORTANT VITAL PROGRAMS TO OUR COMMUNITY MEMBERS. AS YOU MENTIONED IN YOUR PRESENTATION, MARJORIE, RIGHT, WE KNOW WE'RE GOING TO SEE DRASTIC IMPACTS ALL THROUGHOUT THE COMMUNITY, HOW THAT IS GOING TO OVERALL IMPACT WORKING FAMILIES, ECONOMICALLY, IF YOU DON'T HAVE ACCESS TO HEALTHY FOOD, [00:50:02] FITNESS PROGRAMMING, HYPERTENSION SO MUCH MORE, BUT SOMETHING TO HIGHLIGHT WITHIN THE PRESENTATION, ARE SOME OF THE IMPACT STORIES, RIGHT, AND HOW THIS PROGRAM HAS IMPROVED HEALTH BEHAVIORS, PARTICULARLY AROUND REDUCING ACCESS TO SUGAR INTAKE AT 60%, WHICH IS HUGE, LESS ADDED SALT, 58%, WHICH IS ALSO HUGE AS WELL, LESS SATURATED FATS, AND SO ON AND SO FORTH, WITH WAYS THIS PROGRAM HAS HELP IMPROVED THE HEALTH FOR SAN ANTONIO FAMILY, EXTREMELY GRATEFUL FOR THAT WORK. I DON'T THINK IT'S SOMETHING WE CAN AFFORD TO DIVEST IN. I UNDERSTAND THERE'S FINANCIAL CONSTRAINTS AND THERE'S FEDERAL FUNDING THAT IS OUT OF OUR HANDS, BUT WE DO HAVE A RESPONSIBILITY TO WORK A BUDGET THAT REFLECTS THE NEEDS OF SAN ANTONIO RESIDENTS, I BELIEVE THAT CONTINUING TO INVEST IN THIS PROGRAM HELPS REFLECT THE NEEDS OF OUR COMMUNITY MEMBERS. AND IN TERMS OF SOMETHING I WOULD LIKE TO LEARN MORE ABOUT, RIGHT, IS I REALLY VALUE THE EXAMPLE PRESENTED IN TERMS OF THE VACANT LOT AND COMMUNITY TAKING OWNERSHIP, AND THEN PARTNERING WITH METRO HEALTH TO ACTIVATE IT AND TURN IT INTO A FARM. I'D LIKE TO LEARN MORE ABOUT THAT. AND I THINK THAT GOES HAND IN HAND WITH OUR CRIME PREVENTION PLAN AS WELL, SO I'D LIKE TO SEE HOW WE CAN CONTINUE TO SUPPORT THE IMPLEMENTATION OF THAT COMPONENT AS WELL. BECAUSE NOT ONLY IS IT HELP EGG TACKLING THE COMMUNITY PUBLIC HEALTH COMPONENT, BUT ALSO AS I KNOW, THE INTERSECTION WITH PUBLIC SAFETY AS WELL. SO THOSE ARE ALL MY COMMENTS AND QUESTIONS AND I THINK COUNSEL HAS A HUGE TASK TO ENSURE WE DON'T SEE THE REDUCTION THE COMMUNITY HEALTH WORKERS OUT IN OUR DISTRICTS, BECAUSE WITH THAT BEING SAID, RIGHT, THIS IS A PROGRAM THAT IS HIRING EVERYDAY PEOPLE WITH EXPERTISE AND RELATIONSHIPS WHICH IS REALLY HARD TO FIND IN RÉSUMÉ. SO I DON'T THINK WE CAN AFFORD TO LOSE ANY COMMUNITY HEALTH WORKERS. >> THANK YOU, AGAIN. WHAT YOU SEE HERE IS AN EXAMPLE OF LOOKING AT THE GLASS BEING HALF FULL, SO IT'S REALLY ABOUT THE ASSETS, THE RESOURCES IN COMMUNITY, AND HOW WE CAN DO A BETTER JOB PROTECTING ALL OF THOSE IN THAT JURISDICTION, THAT NIGHBORHOOD, OR THAT PART OF THE CITY, JUST KNOW I APPLAUD THE DEAN, OVER THE DECADE, AND THIS IS ONE OF MANY PROGRAMS THAT WILL BE IMPACTED, SO FOR THIS MORNING, WE WANTED TO GIVE YOU A LITTLE BIT MORE INSIGHT WHAT WE'VE DONE, WHAT THE TEAM HAS DONE ON THE GROUND, WITH THE PARTNERS ON THE GROUND, BUT AT THE SAME TIME, SIGNAL TO YOU ABOUT OUR FRAGILITY. WE KNOW THAT THIS FUNDING STREAM IS ON BORROWED TIME, THIS IS ONE EXAMPLE, AND THE ANALYSIS CONTINUES. >> CASTILLO: THANK YOUR TEAM FOR THE DIABETES FAIR OVER AT MONTERREY PARK. THERE WAS SO MANY FAMILIES, HE GOT THE DANCING START AND GOT ME OUT THERE, IT WAS A LOT OF FUN AND GREAT TO HEAR POSITIVE FEEDBACK FROM THE COMMUNITY, BUT WHEN IS THE NEXT ONE, RIGHT? REALLY GRATEFUL FOR YOUR TEAM AND EVERYBODY OUT ON THE GROUND DOING THE WORK. THANK YOU, CHAIR. >> GALVAN: THANK YOU. I HAD A COUPLE OF QUICK "S AND CONVERSATION ABOUT THIS. ONE OF THE THINGS I THINK IS REALLY IMPORTANT IS -- WE TALKED ABOUT WHAT COULD HAPPEN WITH FUNDING IS NOT THERE NEXT YEAR, WHERE FOLKS WILL GO, INSTITUTIONAL KNOWLEDGE THAT CAN BE LOST, EMPLOYEES DOING THIS WORK EVERY SINGLE DAY, WHERE DO THEY END UP, THAT'S STERL GOING ON, I DON'T KNOW, DO THE EXERCISE SO FAR, WE HAVE IDENTIFIED WHAT OPPORTUNITIES ARE AVAILABLE, BECAUSE MY CONCERN, AND CONSTANT CRITIQUE IS THAT IF THE JOB OPPORTUNITIES ARE NOT THERE IN THE COMMUNITY, IF THE PAY RATE IS NOT THE SAME, IF THE EMPLOYMENT BENEFITS ARE NOT THE SAME, DO WE LOSE THOSE FOLKS COMPLETELY? AND IF SO, I THINK IT'S JUST CRITICAL THAT OUR CITY DOES CONTINUE TO DO THAT WORK, TO BE THAT FACILITY, TO BE THAT HOME BASE FOR THE FOLKS TO DO THIS WORK EVERY DAY, IF THERE'S NOT VALID OR EQUAL OPPORTUNITY OUT IN THE COMMUNITIES, DO WE HAVE ANY DATA ON THAT, OR IDENTIFY OF THAT SO FAR ABOUT WHAT OPPORTUNITIES THERE ARE? >> THANK YOU, COUNCILMAN, NOT AT THIS TIME. AGAIN, THIS IS ANALYSIS IN PROGRESS. SO WE APPRECIATE THE COMMENTARY, WE'LL MAKE A NOTE, BUT LIGHT ANYTHING ELSE, THIS DOVETAILS WITH CONVERSATIONS AROUND FISCAL IMPACTS OVER THE COURSE OR THE COMING YEAR. >> THANK YOU FOR THAT. THAT IS THE IMPORTANT PART THAT STAYS IN MY HEAD ABOUT, YOU KNOW, WE CAN ALWAYS TAKE A PART OF TEXAS ON, IF THERE'S INABILITY FOR THE PARTNERS TO DO SO, INABILITY TO PAY THE BENEFITS WE OFFER HERE IN THE CITY, LOSE THOSE FOLKS DOING THE WORK, THIS IS THE PLACE WHERE IT CAN BE DONE, IN PARTNERSHIP, YES, BUT ALSO WITH THE DELIBERATE FUNDING EFFORT, I THINK ABOUT OTHER CITIES DOING PUBLIC HEALTH WORKFORCE CORES, RIGHT, TO BUILD THOSE KIND OF TEAMS, I KNOW THAT WORK IS DONE HERE IN DIFFERENT WAYS, THE PURPOSE THERE IS THAT THE CITY IS ABLE TO TAKE IT ON, RIGHT? WE'RE ABLE TO DO THE SOCIAL SERVICES COMPARED TO OTHER ENTITY HERE, NATIONALLY, TOO, SO I'LL LEAVE THAT THERE. I DO APPRECIATE THE COMMENT ABOUT SOME OF REQUESTS FOR DATA AS WELL. I KNOW DIFFERENT KIND OF [00:55:04] QUALITIES WE'RE LOOKING AT, SOMETHING THAT I WOULD LIKE TO SEE IS THE -- WHAT KIND OF CASE WORK OR KIND OF REQUESTS FOR SUPPORT FROM THE COMMUNITY IS REQUESTED, WHETHER IT'S RELATED TO FOOD SECURITY OR RELATED TO PUBLIC SAFETY, OR VACANT LOTS, WHAT KIND OF THINGS ARE BEING ASKED ABOUT AND HOW ARE THINGS BEING ADDRESSED BY COMMUNITY HEALTH WORKERS AND OTHER PARTNERS, SAY CAN'T LOT, THEREFORE WE HAVE A DELIBERATE EFFECT ON ILLEGAL DUMPING OR WHATEVER IT IS, WE HAVE A CHANGE HERE ON FOOD ACCESS, MAKING SURE HEALTHY ACCESS, WE'RE SEEING SUGAR, HOW DOES IT AFFECT THE YOUTH AND THE HOUSEHOLD, WHO ARE ABLE TO FOCUS MORE, WHATEVER THE DATAPOINT IS THERE, I THINK IT'S AENING LOTSER KIND OF ANALYSIS THAT HAS TO BE DONE, BUT I WOULD LOVE TO SEE SOME OF THOSE THINGS, IT'S HELPFUL FOR US TO KIND OF PUT IN PERSPECTIVE A BIT OF HOW IMPACTS LIFE LONG, LESS SUGAR, GREAT, WE KNOW THAT'S GREAT, ALSO WE CAN SEE THE MULTIPLIER AFTER THAT, KIDS GOING TO SCHOOL MORE, FOLKS ABLE TO GET JOB PLACEMENT, WHATEVER IT IS, LESS HOSPITALIZATION VISITS, I THINK THOSE WOULD BE HELPFUL TO SHOW AS WELL, NOT ONLY IN THE NOW, BUT THE FUTURE TOO. WHAT WOULD IT BE LIKE, COULD WE EXPECT TO SEE SIGNIFICANT REDUCTION IN HOSPITAL VISITS, COST SAVINGS ON OUR END, AND COMPLETELY ARE UNIVERSITY HEALTH VISITS TOO. THAT'S A LONG WAY TO SAY, I WOULD LOVE TO SEE SOME OF THOSE, ESPECIALLY IN TERMS OF THE COST SAVINGS, ALWAYS THE UPSTREAM, WE SAVE MONEY DOWN IN HEALTHCARE OUTCOMES, AND IN TAXPAYER OUTCOMES. LAST THING I WANT TO ASK IS ABOUT SPECIFIC PROGRAMMING IN EACH NEIGHBORHOOD. DO WE HAVE A PROGRAMMING OF WHAT IS BEING DONE IN EACH NEIGHBORHOOD? >> WILFORD>> WE HAVE COMPOSITES. WE'LL SEE WHAT WE CURRENTLY HAVE, SUBJECT TO THE HEALTHY NEIGHBORHOODS PROGRAM, WE CAN PUT SOMETHING MORE ROBUST TOGETHER. >> GALVAN: THAT WOULD BE GREAT. LAST LAST THING. WOULD LIKE TO SEE ALSO THE DEMOGRAPHICS IF POSSIBLE, FOLKS BEING TOUCHED BY THE COMMUNITY HEALTH WORKERS, SENIORS, JOT, BOTH, FAMILIES WITH DISABILITIES, WHATEVER IT IS, IF THERE'S SOME OF THAT INFORMATION, THAT WOULD BE INTERESTING TO SEE TOO TO KIND OF REVIEW. >> OKAY, WE CAN WORK ON THAT AS WELL. >> GALVAN: THANK YOU FOR THE WORK YOU DO, I APPRECIATE GOING TO THE MEETINGS AND SEEING COMMUNITY HEALTH WORK, INCREDIBLE WORK EVERY SINGLE DAY, AND BEEN DOING IT A LONG TIME TOO, THE COMMUNITY IS EXCITED TO TALK WITH YOU ABOUT WHAT IS GOING ON, THANK YOU FOR WHAT EVERYONE DOES ON THE TEAM, ESPECIALLY THE FOLKS ON THE WEST SIDE OF DISTRICT 6. THANK YOU SO MUCH. >> ALL RIGHT, THANK YOU. >> GALVAN: ANY LAST QUESTIONS OR COMMENTS FROM COLLEAGUES? GREAT. MOVING ON TO ITEM NUMBER 2, METRO HEALTH AND DHS BRIEFING ON THE TEAM (E) TEEN MENTAL HEALTH SURVEY. WHO IS COMING? REBECCA FLORES AND JESSE HIGGINS. >> GOOD MORNING, I'M REBECCA FLORES, THE EDUCATION PROGRAM ADMINISTRATOR. WE HAVE SOME SPECIAL GUESTS, BUT BEFORE I CALL THEM UP, I JUST KIND OF WANT TO BRIEFLY GO OVER THE AGENDA FOR TODAY. SO OUR SPECIAL GUEST, WE HAVE REPRESENTATIVES FROM THE SAN ANTONIO YOUTH COMMISSION, AND THE PROJECT WORTH TEAM AMBASSADORS, I'M GOING TO GIVE A SUMMARY OF 2022 TO 2024 TEEN MENTAL HEALTH SURVEYS, THEN I'M GOING TO TURN IT OVER TO JESSE, AND SHE'S GOING TO DO A DEEPER DIVE OVER THE DATA WHAT WE'RE SEEING IN THE COMMUNITY, AND MENTAL HEALTH INITIATIVE. WITH THAT, I WOULD LIKE TO TURN IT OVER TO OUR SPECIAL GUEST. >> HIR HI, MY NAME IS ROBERT JIMINEZ, REPRESENTING DISTRICT 7, ON THE SAN ANTONIO YOUTH COMMISSION, I'M A SENIOR AT TMI EPISCOPAL, I'M HERE TO TALK ABOUT THE IMPORTANCE OF THE TEEN MENTAL HEALTH SURVEY AND YOUTH MENTAL HEALTH IN SAN ANTONIO. WE CAN ALL AGREE THAT MENTAL HEALTH IS A REFLECTION OF OUR ENVIRONMENT, AND THE TEEN MENTAL HEALTH SURVEY, REALLY GIVES A GOOD REPRESENTATION OF HOW THE CITY IS DOING WITH MENTAL HEALTH AMONG TEENS. AND IT BRINGS TO LIGHT THE OFTEN OVERLOOKED CAUSES, SYMPTOMS, AND COPING MECHANISMS OF WHAT TEENS ARE GOING THROUGH. WITH THE INFORMATION PROVIDED IN THE SURVEY, THE CITY CAN ASSESS WHAT RESOURCES THEY NEED TO ALLOCATE TO BETTER SUPPORT THE YOUTH IN SAN ANTONIO. AS A TEEN, I SEE THROUGH NOT ONLY MYSELF, BUT IN OTHER PEOPLE MY AGE THE EFFECTS OF PEER PRESSURE, BULLYING, POLITICAL, AND ECONOMIC STRESS. THE SURVEY IS NEEDED NOW MORE THAN EVER WITH INCREASING STRESSES IMPACTING EVERYONE, BUT ESPECIALLY THE YOUTH. [01:00:01] >> GOOD MORNING, AND THANK YOU FOR GIVING ME THE OPPORTUNITY TO SPEAK TODAY. MY NAME IS NATALIE SAW SATO, I'M HERE WITH TEEN AMBASSADORS, I AM A TEEN AMBASSADOR, SORRY, I'M HERE REPRESENTING DISTRICT 6 TO SHARE WHY THE VARY AND THE TOPIC OF MENTAL HEALTH MATTERS TO SO MANY IN OUR CITY. FIRST ABOUT THE SURVEY, THE SURVEY IS IMPORTANT BECAUSE IT GIVES YOUNG PEOPLE A REAL VOICE. A LOT OF THE TIMES DECISIONS ABOUT YOUTH ARE MADE WITHOUT FULLY UNDERSTANDING WHAT WE'RE ACTUALLY SPECIOUSING, BY COLLECTING HONEST FEEDBACK DIRECTLY FROM US, THE SURVEY HELPS IDENTIFY WHAT IS WORKING, WHAT IS MISSING, AND WHAT THE STUDENTS FEEL THEY NEED. IT TURNS EXPERIENCES INTO DATA THAT ADULTS AND LEADERS CAN USE TO MAKE INFORMED CHOICES. SECOND, WHY MENTAL HEALTH RESOURCES MATTER FOR TEENS. SO MANY TEENS ARE DEALING WITH STRESS, ANXIETY AND DEPRESSION, PRESSURE BOTH IN AND OUT OF SCHOOL, NOT EVERYONE HAS ACCESS TO THE SUPPORT THEY NEED. MENTAL HEALTH RESOURCES AREN'T JUST ABOUT TREATING PROBLEMS. THEY HELP US BUILD HEALTHY COPING SKILLS, STAY CONNECTED AND FEEL SUPPORTED. WHEN TEENS FEEL SAFE AND CARED FOR, WE DO BETTER ACADEMICALLY, SOCIALLY AND PROFESSIONALLY, HAVING THESE ROW SOURCES MAKES THE DIFFERENCE IN OUR ABILITY TO SUCCEED, AS CITY LEAD FORTUNATES, YOUR SUPPORT MAKE SURE FINDINGS ARE FROM THIS SURVEY TURN INTO REAL CHANGES, PROMOTING MENTAL HEALTH EDUCATION. EVEN SMALL AT STEPS CAN HAVE A HUGE IMPACT ON PEOPLE IN DISTRICT 6 AND ACROSS THE CITY. THANK YOU FOR YOUR TIME AND LISTENING TO THIS PERSPECTIVE OF YOUNG PEOPLE. WE APPRECIATE YOUR SUPPORT AND HELPING PRIORITIZE TEEN MENTAL HEALTH. >> GALVAN: JUMP IN REALLY QUICK SAY THANK YOU TO THE FOLKS, THE SPECIAL GUESTS WE HAVE HERE TODAY, EVERY SINGLE DAY, ANY MEMBERS OF YOUR FAMILY HERE TODAY OR ANYONE -- AWESOME, SAY TO THE PARENTS, THANK YOU FOR RAISING INCREDIBLE READERS HERE, FOR THE PARENTS WHO ARE NOT HERE, THEY FOR RAISING UNCREDIBLE LEADERS OBVIOUSLY. THE WORK I STARTED DOING PERSONALLY STARTED IN HIGH SCHOOL TO GET INVOLVED IN SOME OF THIS WORK WE DO EVERY SINGLE DAY, YOU MAY NEVER KNOW WHERE YOU END UP. THE WORK YOU'RE DOING NOW WILL CONTINUE TO GROW, PEOPLE WILL LOOK TO YOU FOR THE ANSWERS, FOR THE SOLUTIONS, THANK YOU FOR THE DEPARTMENTS TO INVESTING IN THE YOUTH IN OUR CITY, THANK YOU. >> WELL, THANK YOU, NATALIE AND ROBERT. I'M KIND OFNER US HAVE TO DO AFTER THEM BECAUSE THEY DID SUCH A GOOD JOB. LUCKILY, THEY'RE GOING TO BE WITH US, IF Y'ALL HAVE QUESTIONS FOR THEM AFTER THE END OF OUR PRESENTATION. BEFORE I BEGIN DISCUSSING WHAT WE LEARNED FROM THE SURVEY, I WANT TO SHARE A LITTLE BIT ABOUT HOW THE IDEA STARTED, IT WAS THE FALL OF 2021, WE WERE HAVING NORMAL SATURDAY YOUTH COMMISSION MEETING. NORMALLY WE HAVE LIKE ZERO PROBLEMS GETTING OUR YOUTH TO TALK. BUT SOMETHING -- MY FORMER TEACHER HAT CAME INTO PLAY AND WE NOTICED THAT SOMETHING WAS OFF WITH OUR YOUTH THAT SATURDAY. SO INSTEAD OF STICKING TO THE AGENDA, SO COVER YOUR EARS, CITY CLERK'S OFFICE, WE ALLOWED THE COMMISSION MEMBERS TO SHARE WITH US WHAT WAS ON THEIR MINDS. ALTHOUGH IT WAS CONCERNING TO HEAR ALL OF THE CHALLENGES THEY WERE FACING, AS A PERSON WHO WAS BROUGHT UP DURING A TIME TALKING ABOUT MENTAL HEALTH WAS TABOO, IT WAS REFRESHING TO HEAR THE COMMISSION MEMBERS BEING SO HONEST ABOUT WHAT THEY AND THEIR FRIENDS WERE EXPERIENCING DURING THE PANDEMIC. AND THAT IS HOW BASICALLY THE IDEA CAME ABOUT OF HOW THE MENTAL -- WE WANTED TO BETTER UNDERSTAND WHAT THE HEALTH CHALLENGES WERE IN TEENS IN SAN ANTONIO. THE SAN ANTONIO YOUTH COMMISSION JOINED FORCES WITH PROJECT WORTH AMBASSADORS TO CREATE THE FIRST SURVEY MADE BY YOUTH FOR YOUTH, RELEASED ON THE CITY'S SA SPEAK UP PLATFORM. I ALSO WANT TO ADD BESIDES CAPTURING WHAT THEY WERE HEARING AND FEELING, THEY ALSO WANTED TO BETTER UNDERSTAND WHAT RESOURCES YOUTH 12 TO 19 WANTED TO SEE IN OUR COMMUNITY. THE SURVEY WAS REVIEWED BY MENTAL HEALTH EXPERTS, TRANSLATED INTO FIVE LANGUAGES, IT WAS ALSO REVIEWED TO ENSURE THE LITERACY LEVEL OF THE APPROPRIATE FOR THE AUDIENCE, THIS MAY HAVE BEEN THE FIRST SURVEY WRITTEN BY TEENS, BUT I DARE SAY IT WAS AS PROFESSIONAL AS ANY OTHER SURVEY WE HAVE PUBLISHED ON THE SA SPEAK UP PLATFORM. IN 2022, WE RECEIVED A TOTAL OF 1047 RESPONSES TO THE SURVEY. I WILL GIVE A HIGH LEVELING NATIONAL OF THE SURVEY. PARTICIPANTS NOTED SEVERAL CHALLENGES WITH MENTAL HEALTH, WHEN ASKED ABOUT A VARIETY OF DEPRESSIVE TRAIT, 37% STATED AN INABILITY TO PERFORM DAY TO DAY TASKS. 49% STATED FEELING HELPLESS, HOPELESS, NUMB, OR LIKE NOTHING MATTERS. AND 24% INDICATED SMOKING, VAPING OR USING DRUGS. [01:05:08] FEMALES REPORTED HIGHER STRUGGLES COMPARED TO THEIR MALE COUNTERPARTS. WHILE LGBTQ PLUS AND GENDER 24% HIGHER COMPARED TO THEIR HETEROSEXUAL COUNTERPARTS WHEN REPORTING THE INABILITY TO PERFORM DAY TO DAY TASKS, FEELING HELPLESS, HOPELESS, NUMB, OR LIKE NOTHING MATTERS. WHEN EXAMINING BY RACE, ETHNICITY, WE DIDN'T HAVE ENOUGH RESPONSES TO BE STATISTICALLY SIGNIFICANT, ASIAN-AMERICANS REPORTED THE HIGHEST RATES OF INABILITY TO PERFORM DAY TO DAY TASKS AND FEELING HELPLESS, HOPELESS, NUMB, OR LIKE NOTHING MATTERS. WHICH AS YOU MAY RECALL, WE WERE IN THE MIDDLE OF THE PANDEMIC, AND THE ANTI-ASIAN SENTIMENTS AND HATE CRIMES WERE PREVALENT, AND OBVIOUSLY THEY WERE HAVING IMPACT ON ASIAN MESH YOUTH. WHEN ASKED ABOUT WHETHER THEY HAVE JEW CIDAL IDEATIONS, LGBT, GENDER, ASIAN-AMERICAN YOUTH REPORTED HIGHER THAN THEIR POPULATIONS. OVER 50% IN LGBT, AND 45% OF ASIAN-AMERICAN YOUTH 25% IN COMPARED. IN ADDITION THEY PRESENTED HIGHER PERCENTAGES OF HARMING THEMSELVES. ON AVERAGE, 26% OF YOUTH REPORTED THESE TENDENCIES. SO STILL VERY HIGH IN OUR GENERAL POPULATION. A STAGGERING 17% OF YOUTH REPORTED THEY DID NOT FEEL COMFORTABLE TALKING TO ANYONE ABOUT THEIR MENTAL HEALTH CHALLENGES. MOST YOUTH REPORTED THEY DID NOT HAVE A TRUSTED ADULT AT SCHOOL TO TALK ABOUT THEIR MENTAL HEALTH CHALLENGES. WHEN ASKED WHERE THEY GO FOR MENTAL HEALTH SUPPORT, OVERWHELMING YOUTH REPORTED A PREFERENCE TO TALK TO THEIR FRIENDS. THE SURVEY ALSO REVEALED THAT BESIDES THEIR FRIENDS, THE TOP TEN MENTAL HEALTHOUT LETS WERE MUSIC, HEALTH, GAMING AND ARTS. THE TEENS WANTED MORE RESOURCES IN SCHOOL, THAT'S NOT SURPRISE, BECAUSE THAT'S WHERE THEY SPEND MOST OF THEIR TIME. THE SURVEY COULD NOT HAVE COME AT A BETTER TIME. CITY COUNCIL AND CITY LEADERSHIP WERE DEVELOPING PLANS ON HOW OUR COMMUNITY WOULD INVEST IN THE AMERICAN RESCUE PLAN ACT FUNDS DURING THIS PERIOD. AFTER HEARING FROM PROJECT WORTH MEMBERS, THE COMMUNITY HEALTH AND ENVIRONMENT COMMITTEE I WITH US WITH A PRECURSOR TO THIS COMMITTEE, RECOMMENDED $18 MILLION BE ALLOCATED TO YOUTH MENTAL HEALTH PROGRAMS. THE COMMITTEE ALSO ALLOCATED HUNDRED THOUSAND DOLLARS TO THE SAN ANTONIOOUT COMMISSION WITH THE ONLY GUIDANCE FROM COUNCIL, THE FUNDS BE USED TO POSITIVELY IMPACT TEEN MENTAL HEALTH AND LEARNING ENVIRONMENTS. THEY WENT TO WORK AND KEPT US VERY BUSY. WITH THEIR 100,000 INVESTMENT, MEMBERS SUPPORTED TEAM MENTAL HEALTH FIRST AID TRAINING WHICH FOCUSES ON HELPING IDENTIFY SUPPORT MENTAL HEALTH CHALLENGES IN THEIR FRIENDS, THIS SUGGESTS THE SURVEYS FINDINGS THAT A MAJORITY TURNED TO THEIR FRIENDS FOR MENTAL HEALTH SUPPORT. AN EVENT HELD IN THE SPRING THAT BROUGHT TOGETHER YOUTH ORGANIZATIONS THROUGHOUT SAN ANTONIO AND PROVIDED OUTLETS FOR YOUTH TO LEARN MORE ABOUT MENTAL HEALTH RESOURCES AND OFFERED FUN ACTIVITIES YOUTH HAD IDENTIFIED AS DESTRESSORS IN THE SURVEY. PERHAPS THE MOST IMPACTFUL, OFFERED TEACHERS, COUNSELORS AND STUDENT GROUPS AN OPPORTUNITY TO APPLY FOR UP TO $3,000 FOR PROJECTS TO POSITIVELY IMPACT TEEN MENTAL HEALTH AND LEARNING ENVIRONMENTS. THEY RECEIVED 147 PROPOSALS, THEY CREATED A COMMITTEE THAT REVIEWED EVERY SINGLE ONE OF THEM. ALTHOUGH THEY DEDICATED MOST OF THEIR $100,000 TO SUPPORTING THESE MICRO GRANTS, THEY WERE ONLY ABLE TO AWARD 27 PROJECTS AND FUNDED ONE PROJECT IN ALMOST EVERY SINGLE COUNCIL DISTRICT. AS YOU CAN SEE FROM THE SLIDE, I HAVE SOME PHOTOS THERE. I KEPT ADDING MORE AND MORE AND MORE. SO THANK YOU TO WHOEVER HELPED CLEAN THAT UP. BUT YOU CAN KIND OF SEE SOME OF THE PROJECTS THEY FUNDED. SCHOOL GARDENS. ANIMAL THERAPY BEFORE STANDARDIZED TESTIFIES COVERING THE COST OF COUNSELORS TO ATTEND THE AMERICAN COUNSELING ASSOCIATION CONFERENCE, SO THEY COULD BETTER SUPPORT THEIR STUDENTS AT SCHOOLS. ART PROJECTS WITH PROFESSIONAL ARTISTS. I COULD GO ON AND ON AND ON AND ON. LET'S JUST SAY AFTER THIS PROCESS, I WAS READY TO TURN OVER THE KEYS OF THE CITY AND HAVE THE YOUTH KIND OF RUN IT FOR US. IT WAS JUST AN AMAZING PROCESS. PROJECT WORTH MEMBERS DECIDED THIS FIRST, SA SPEAK UP YOUTH SURVEY SHOULD SERVE AS A BASELINE TO TRACK THE MENTAL HEALTH OUTCOMES OF YOUTH IN SAN ANTONIO, IN 2023, THE SECOND SURVEY WAS [01:10:02] ISSUED. IS SLIDE SAYS THE DATA WAS INCONCLUSIVE. THAT'S A NICE WAY TO SAY WE EXPERIENCED TECHNICAL DIFFICULTIES ON THE BACK END OF THE SURVEY, UNFORTUNATELY, WE WERE UNABLE TO VERIFY WHICH RESPONSES WERE VALID. IN 2024, WE ADDRESSED THE TECHNICAL ISSUES AND ISSUED THE THIRD SURVEY. WE RECEIVED 1,550 RESPONSES TO THE SURVEY. AND 1455 WERE VALID, WHICH IS QUITE AN IMPRESSIVE NUMBER. AS WITH THE SURVEY IN 2022, ALL TEN COUNCIL DISTRICTS WERE REPRESENTED IN THE SURVEY RESULTS. ALTHOUGH PARTICIPANTS CONTINUED TO EXPERIENCE CHALLENGES WITH MENTAL HEALTH, THERE WAS PROMISING DECREASES IN STATED STRUGGLES WHEN COMPARED TO 2022 SURVEY, AND THIS INDICATED THAT THE INVESTMENT THE CITY, COUNTY, AND YOUTH MENTAL HEALTH PROGRAMS WAS HAVING AN IMPACT. WHEN ASKED ABOUT A VARIETY OF DEPRESSIVE TRAITS, 25% STATED AN INABILITY TO PERFORM DAY TO DAY TASKS, DOWN FROM 2022. 36% STATED THEY FELT HELPLESS, HOPELESS, NUMB, OR LIKE NOTHING MATTERS, DOWN FROM 47%. 10% STATED THEY SMOKED OR USED DRUGS, DOWN FROM 24% IN 2022. WHILE A HIGHER PERCENTAGE OF LGBTQ PLUS KIDS REPORTED EXPERIENCING DEPRESSIVE TRAITS, THERE WAS A DECREASE IN ALL CATEGORIES FOR THEM. WHEN EXAMINING RACE AND ETHNICITY, ALL CATEGORIES REPORTED A DECREASE ALSO. EXCEPT THOSE WHO SELECTED ANOTHER OPTION NOT LISTED HERE OR I PREFER NOT TO ANSWER. >>> >>> SAYCY AND PROJECT WORTH MEMBERS CURRENTLY WORKING ON DEVELOPING THE 2026 TEEN MENTAL HEALTH SURVEY TARGET DATE OF ISSUING IT ON MARCH 2ND. AS WITH PREVIOUS SURVEYS THEY'RE PLANNING ON HOSTING A PRESS CONFERENCE AT CITY HALL AND I'M SURE THAT THEY WOULD LOVE TO HAVE Y'ALL JOIN THEM AND SHOW YOUR SUPPORT FOR THIS PROJECT. SO I'M FINISHED WITH MY REMARKS AND WE'RE NOW GOING TO TURN IT OVER TO JESSE HIGGINS, WHO WILL DISCUSS WHAT MENTAL HEALTH PROFESSIONALS ARE ACTUALLY SEEING AND HOW THE CITY CONTINUES TO SUPPORT MENTAL HEALTH FOR YOUTH. THANKS. >> GOOD MORNING, CHAIR AND MEMBERS OF THE COMMUNITY HEALTH COMMITTEE. ANY NAME IS JESSE HIGGINS AND I'M THE CHIEF MENTAL HEALTH OFFICER. I'M HAPPY TO BE HERE TODAY WITH YOU ALONGSIDE REBECCA, ROBERT AND NATALIE. ONE OF THE BEST PARTS OF MY JOB IS GETTING TO BEAR WITNESS TO THE AMAZING WORK THAT'S DONE IN OUR COMMUNITY AND I HAVE A GREAT PICTURE OF LIKE THIS PROUD AUNT MOMENT THAT I JUST TOOK OF THESE TWO WHILE THEY'RE PRESENTING TO YOU ALL. IT'S TRULY A PRIVILEGE TO BE HERE. I'M INCREDIBLY PROUD OF THE CARE, THOUGHTFULNESS AND EFFORT OF PROJECT WORTH OF THE YOUTH COMMISSION AND CITY STAFF PUT INTO THE TEEN MENTAL HEALTH SURVEY. THE RESPONSE RATE ALONE IS IMPRESSIVE. WE HAVE SOME OTHER COMMUNITY DATA THAT I'D LIKE TO SHOW YOU SO THAT WE CAN BETTER UNDERSTAND THE LANDSCAPE OF OUR COMMUNITY. I WANT TO ACKNOWLEDGE THAT THESE SLIDES WILL TALK ABOUT SELF-INJURY AND SAW SIDE ATTEMPTS FOR ADULT AND CHILDREN, AND WHILE THIS INFORMATION IS HEAVY, THERE ARE GLIMMERS OF HOPE. THIS SLIDE COMES FROM THE TEXAS DEPARTMENT OF STATE HEALTH SERVICES AND SHOWS THE EMERGENCY DEPARTMENT VISITS FOR FEMALES AND MALES UNDER THE AGE OF 18 IN BEXAR COUNTY. YOU CAN SEE THAT SELF-HARM OR SELF-INJURY IS A DIAGNOSIS EXPERIENCED MORE FREQUENTLY BY GIRLS AND THAT THERE WAS A LARGE INCREASE IN 2021. THE GOOD NEWS IS THAT IN 2023 THE RATE FOR BOTH BOYS AND GIRLS WAS LOWER THAN IT WAS IN 2019. WE FIND ENCOURAGEMENT IN THESE NUMBERS TRENDING DOWNWARD. ON THIS SLIDE WE HAVE SPECIFIC DATA FROM 2022 AND 2023. THIS DATA IS HOSPITAL DISCHARGE RATES FOR SUICIDAL IDEATION AND ATTEMPTS IN BEXAR COUNTY FOR ALL AGES. AND THEN SOOMS IN ON YOUTH AGES 14 THROUGH 18. YOU CAN SEE THAT COMPARED TO THE FIRST COLUMN OF ALL AGES, TEENS AGE 14 THROUGH 18 IN BEXAR COUNTY HAVE A MUCH HIGHER RATE OF SUICIDAL IDEATION AND SUICIDE ATTEMPTS. ALTHOUGH WE ARE SEEING SOME COMMUNITY WIDE INDICATORS AND INDICATORS IN THE TWO TEEN MENTAL HEALTH SURVEYS TRENDING IN A BETTER DIRECTION, WE STILL RECOGNIZE THAT SELF-HARM, SUICIDAL IDEATION AND SUICIDE ATTEMPTS ARE THE REALITY THAT MANY YOUNG PEOPLE IN OUR COMMUNITY ARE STRUGGLING WITH. WE ALSO KNOW THAT FOR CHILDREN, SUICIDE IS THE SECOND HIGHEST CAUSE OF DEATH AFTER ACCIDENTS MUCH WE'VE GOT TO KEEP UP THE LIFE-SAVING WORK OF TALKING ABOUT MENTAL HEALTH AND PROVIDING TO SERVICES -- PROVIDING ACCESS TO SERVICES. ONE MORE INDICATOR THAT I LIKE FOR US TO KEEP OUR EYE ON, THIS SLIDE SHOWS SAPD'S MENTAL HEALTH 911 CALLS FROM 2019 TO 2024. [01:15:01] THROUGH THE PANDEMIC WE HAD A PRETTY SIGNIFICANT INCREASE IN 911 MENTAL HEALTH CALLS AND AS WE CONTINUE TO DESTIGMATIZE MENTAL HEALTH NEEDS AND OFFER A RESPONSE LIKE SA-CORE, I THINK THAT WE'LL CONTINUE TO HAVE A HIGH CALL VOLUME. THESE NUMBERS SEEM TO HAVE STABILIZED AND ARE ACTUALLY DECREASING SLIGHTLY. FOR 2025 WE ARE TRENDING CLOSER TO 29,000. I'M HOPEFUL THAT THIS DATA POINT IS FINDING ITS FOOTING AND BASELINE AND PERHAPS PEOPLE ARE BECOMING AWARE OF PROGRAMS THAT CAN HELP THEM IN A CRISIS AND ALSO BEFORE IT BECOMES A CRISIS. I'D LIKE TO POINT OUT THAT THERE'S MANY DIFFERENT WAYS TO SHOW DATA LIKE THIS AND THIS IS PURE CALL VOLUME, WHICH SHOWS THE WAIT ON OUR 911 CALL CENTER. THIS DOES NOT SHOW CALLS IN LIGHT OF POPULATION INCREASE WE'VE SEEN OVER THE LAST FEW YEARS, AND WITH THAT POPULATION INCREASE IN MIND THESE NUMBERS WOULD ACTUALLY SHOW A STEEPER DECREASE. SO WHAT DO WE DO ABOUT THIS? WE'VE HEARD THE NEED FROM OURER COMMISSIONERS AND AMBASSADORS. WE'VE HEARD FROM THE YOUTH IN THE COMMUNITY AND WE HAVE ACCESS TO DATA THAT WE CANNOT IGNORE. ONE RESOURCE THAT IS BECOMING INCREASINGLY IMPORTANT IS THE TWO SCHOOL-BASED MENTAL HEALTH SERVICE CONTRACTS THAT WE HAVE THROUGH THE GENERAL FUND. THESE CONTRACTS ARE AWARDED TO COMMUNITIES IN SCHOOLS AND THE MOBILE WELLNESS COLLABORATIVE. THESE CONTRACTORS PROVIDE COUNSELING, CASE MANAGEMENT, BASIC NEEDS, LEADERSHIP PROGRAMMING AND STAFF PROFESSIONAL DEVELOPMENT TO THE DISTRICTS THEY SERVE. THEY SERVE THE DISTRICTS OF EAST CENTRAL, EDGE WOOD, HAIR LYNDELL, JUDSON, NORTHEAST, NORTHSIDE, SAN ANTONIO, SOUTH SAN AND SOUTHSIDE. AND WE EXPECT THAT THEY WILL SERVE AT LEAST 650 CLIENTS IN FISCAL YEAR 2026. WE ARE THANKFUL THAT COUNCIL ALLOCATED AN INITIAL '21 TWIST THOUSAND IN ADDITIONAL FUNDING FOR 2026 AND 2027. THE RELATIONSHIP WILL CHANGE THIS YEAR AS ALL OF ARPA FUNDS IN THE COMMUNITY WILL BE EXHAUSTED. WE ARE WORKING WITH COMMUNITY PARTNERS AND BEXAR COUNTY TO MONITOR THE IMPACT OF THIS FUNDING ENDING. THE SCHOOL COMMUNITY IS ALSO IN THE MIDST OF WORKING OUT THE IMPLEMENTATION OF TEXAS SENATE BILL 12, WHICH WENT INTO EFFECT ON SEPTEMBER 1ST OF THIS YEAR. THIS IMPACT THE SERVICES STUDENTS CAN BE PROVIDED WITHOUT PARENTAL CONSENT. WE ARE HEARING THAT THERE IS CONFUSION AND CONSISTENCY IN HOW SCHOOLS ARE UNDERSTANDING THIS BILL. ONE MORE INITIATIVE THAT I WANT TO MAKE SURE YOU'RE AWARE OF IS THE BEXAR AREA SCHOOL SAFETY AND MENTAL HEALTH SUMMIT. AS WE WERE THINKING ABOUT THE IMPACT OF THE RELATIONSHIPS BUILT THROUGH THE CONTRACTS AND THE NEEDS OF THE COMMUNITY, LAST YEAR WE HOSTED THE FIRST ANNUAL BEXAR AREA SCHOOL SAFETY AND MENTAL HEALTH SUMMIT. THIS WAS A COLLABORATIVE EFFORT WITH METRO HEALTHY, BEXAR COUNTY, REGION 20 AND COMMUNITIES IN SCHOOLS. AT THE SUMMIT LAST YEAR WE HAD OVER 150 PEOPLE IN ATTENDANCE REPRESENTING SCHOOL DISTRICTS, CHARTER SCHOOLS, NON-PROFITS, HOSPITALS, PHILANTHROPY, LAW ENFORCEMENT, CRIMINAL JUSTICE, ELECTED OFFICIALS, THE TEXAS SCHOOL SAFETY CENTER, HHSC, THE OFFICE OF HOMELAND SECURITY, THE FBI AND THE SECRET SERVICE. THIS YEAR ON NOVEMBER 3RD WE HOSTED THE SECOND ONLY SCHOOL SAFETY AND MENTAL HEALTH SUMMIT WITH OVER 200 PEOPLE REGISTERED. THE OBJECTIVES OF THE SUM SUMMIT ARE TO UNDERSTAND THAT MENTAL HEALTH OF SCHOOL AGE CHILDREN IS A PUBLIC HEALTH PRIORITY. TO STRENGTHEN SCHOOL SAFETY BY INCLUDING COMPREHENSIVE CARE WHICH INCLUDES MENTAL HEALTH AND IDENTIFY NEXT STEPS. ONE OF THE NEXT STEPS IDENTIFIED FROM THE FIRST SUMMIT WAS A TEXAS CAPITOL ADVOCACY DAY WHICH WE ATTENDED AND SPOKE AT THIS YEAR IN FEBRUARY. WE WERE PLEASED TO SEE THAT THE SCHOOL SAFETY ALLOTMENT WAS ESTABLISHED, BUT NOT FUNDED IN 2023, WAS FUNDED THIS YEAR IN 2025, AND MOST IMPORTANTLY, IT ALSO INCLUDES PSYCHOLOGY SAFETY, WHICH ACKNOWLEDGES THAT MENTAL HEALTH SERVICES, TRAINING AND AWARENESS ARE KEY TO STUDENTS FEELING SAFE IN SCHOOLS. HIGHLIGHTS FROM A SUMMIT THIS YEAR INCLUDED A PANEL OF STUDENTS, A LEGISLATIVE POLICY REVIEW, WHICH DID A DEEP DIVE INTO SETBACK 12 AND OTHER POLICY CHANGES OUT OF THE 89TH LEGISLATURE, A DATA REVIEW AND SPOTLIGHTS ON COLLABORATIONS IN OUR COMMUNITY THAT ARE SUCCESSFUL. WE'RE ALREADY WORKING ON PLANS FOR THE THIRD ANNUAL SUMMIT NEXT YEAR. THANK YOU SO MUCH FOR GIVING US THE OPPORTUNITY TO PRESENT TO YOU TODAY. I TRULY BELIEVE THAT ANYTHING WE DO FOR YOUTH, EVEN IF IT'S CRISIS SERVICES, IS WORK IN A SACRED UPSTREAM SPACE. WORKING WITH CHILDREN TO HELP THEM BETTER UNDERSTAND THEMSELVES AND THE WORLD AROUND THEM IS A BEAUTIFUL WAY TO INVEST IN THE FUTURE OF OUR COMMUNITY. WE'RE ALL AVAILABLE TO ANSWER ANY QUESTIONS THAT YOU HAVE. THANK YOU. >> THANK Y'ALL SO MUCH. LET'S MOVE TO COUNCIL CONVERSATION. COUNCIL MEMBER ALDERETE GAVITO. >> GAVITO: THANK YOU, CHAIR. THANK YOU SO MUCH TO THE YOUTH COMMISSION AND ALL THE WORK AROUND HERE. IT'S OBVIOUSLY AN IMPORTANT TOPIC AND ALSO IMPORTANT TO [01:20:01] SEE US ORGANIZED IN THIS PASSION AND REALLY HELPING US ARTICULATE WHAT THE STATUS IS FOR THE YOUTH IN OUR CITY. I WANTED TO GIVE A QUICK SHOUT-OUT TO ROBERT HIM MEN KNOWS. YOU WERE QUICKLY APPOINTED AND JUMPED TO A LEADERSHIP ROLE AND ALL OF YOUR EFFORTS THERE. IT'S AWESOME THAT YOU'RE REPRESENTING D7. AND THE SECOND QUICK NOTE IS SOMETHING THAT WE'VE BROUGHT UP AGAIN AND AGAIN, AND I FEEL IT'S APPLICABLE TO THIS CONVERSATION AND THAT IS WHEN WE CALL 911, ANY RESIDENT CALLS 911, WE SHOULD HAVE A MENTAL HEALTH OPTION. THIS IS DONE IN OTHER CITIES. YOU KNOW, WE'RE OBVIOUSLY -- THE SA-CORE TEAM DOES GREAT WORK, BUT WE WANT TO MAKE SURE THAT IF TEENS OR ANY RESIDENT IS EXPERIENCING A MENTAL HEALTH CRISIS THAT THEY'RE CONNECTED TO HELP QUICKLY. AND SO I JUST AGAIN WANT TO PUSH FOR US TO FIGURE OUT WHAT LOGISTICS WE NEED TO DO TO MAKE A MENTAL HEALTH OPTION WHEN REGULAR R RESIDENTSE CALLING 911 A REALITY. >> WHYTE: QUICKLY, ON THE SURVEY SUMMARY THIS LOOKS LIKE IN 2024 SOME OF THE DEPRESSIVE TRAITS R. DOWN, RIGHT? SO ARE WE -- IS THE CONCLUSION THERE THAT IT WAS COVID THAT MADE THESE THINGS SPIKE AND NOW WE'RE GETTING BACK TO NORMAL. ARE THESE PRE-COVID NUMBERS? >> THEY'RE NOT AT PRE-COVID NUMBERS. AND I THINK ONE OF THE THINGS, THAT'S WHY I CALLS BRING UP THAT 911 CALL VOLUME SLIDE, IS THAT WHEN WE DESTIGMATIZE MENTAL HEALTH AND SAY IF YOU NEED HELP, ASK FOR IT AND WE HAVE SERVICES FOR YOU. WE'RE GOING TO SEE AN INCREASE IN TALKING ABOUT IT, AN INCREASE IN SORT OF ADMITTING THAT WE'RE STRUGGLING AND AN INCREASE IN ACCESS OR ASKING FOR SERVICES. SO WE DO SEE -- WE KNOW THAT CHILDREN ARE RESILIENT, MORE RESILIENT THAN ADULTS, AND WE DO SEE FOLKS RECOVERING AND GETTING A LITTLE BIT BETTER, BUT I WOULD SAY IT'S ALSO A TESTAMENT TO WHAT THE CITY AND COMMUNITY AND SERVICES HAVE BEEN INVESTED IN OVER THAT COURSE. SO IT'S NOT TO PRE-COVID NUMBERS, BUT IT IS GETTING A LITTLE BIT BETTER. >> WHYTE: HOW MUCH HIGHER THAN PRE-COVID NUMBERS ARE WE? >> WE'LL HAVE TO GO BACK AND LOOK. WE WON'T HAVE THE EXACT SAME DATA POINTS BECAUSE WE DON'T HAVE THE TEEN MENTAL HEALTH SURVEY FROM BEFORE COVID, BUT WE CAN DEFINITELY DO A DEEPER DIVE INTO PRE-COVID AND POST COVID NUMBERS. >> WHYTE: IT WOULD BE INTERESTING TO SEE WHAT IT WAS BEFORE. >> WE ALWAYS STRUGGLE WITH CHILDREN DATA. WE DON'T HAVE AS MUCH ACCESS TO DATA ON KIDS AS WE DO ADULTS. >> WHYTE: YEAH. AND YOU SAY THESE ARE DOWN OVER THE LAST TWO YEARS DUE TO EFFORTS OF THE CITY. SO WE HAVE, I GUESS, METRICS SO THAT WE CAN SAY THAT? >> SURE I HAVE -- LET ME SHOW YOU OUR OVERALL RESULTS. SO THIS IS THE RESULTS OF THE OVER 6,000 KIDS. AND YOU CAN SEE THAT OF THE 54% OF THE 6,000 THAT GOT FOUR OR MORE SESSIONS, WE SAW 52% REPORTING A DECREASE IN DID HE PRESS SUV SYSTEMS AND 40% REPORTING AN INCREASE IN WELL-BEING. SO THE SERVICES DO AND DID HELP PEOPLE FOR SURE. >> WHYTE: OKAY. MY LAST QUESTION IS THE MEMO ON THIS ONE SAYS DATA HAS BEEN UTILIZED TO ALLOCATE RESOURCES, BUT IT DOESN'T SAY WHAT RESOURCES, HOW MUCH MONEY OR WHAT WE'VE CHANGED BECAUSE OF THE SURVEY. DO YOU HAVE ANY OF THAT INFORMATION? >> SURE. SO ONE OF THE THINGS THAT HOW THE ARPA -- IT LARGELY SHAPED HOW THE ARPA DOLLARS WERE SPENT. THAT FIRST SURVEY DID. IT ALSO -- WE CONCENTRATED ON COMMUNITY-BASED SERVICES. WE ALSO CONCENTRATED ON A FEW -- SOME OF THESE CONTRACTS HELPED TRAIN TEENS TO BE ABLE TO BETTER UNDERSTAND WHAT THEIR PEERS WERE GOING THROUGH, THAT IMPORTANT DATA POINT THAT TEENS WANT TO TALK TO TEENS. AND TO MAKING SURE THAT A TENTH GRADER CAN UNDERSTAND THAT INFORMATION THAT THEY MAY BE BEING TOLD BY THEIR PEER AND KNOWING WHEN TO BRING IN AN ADULT AND HOW TO ADDRESS THAT WITH THEIR PEER. WE ALSO, THE MINI GRANTS THAT THE YOUTH COMMISSION GAVE OUT, THAT WAS A HUGE PART. AND ALSO THE CHANGE IN THIS YEAR'S BUDGET I THINK LARGELY NOT JUST FROM THE TEEN MENTAL HEALTH SURVEY, BUT CAME OUT OF THE YOUTH TOWN HALL WHERE MENTAL HEALTH WAS IDENTIFIED AS ONE OF THE PRIORITIES FOR TEENS IN OUR COMMUNITY. >> WHYTE: ALL RIGHT. THANKS, CHAIR. >> GALVAN: THANK YOU. COUNCIL MEMBER CASTILLO. >> CASTILLO: THANK YOU, CHAIR AND JESSE AND REBECCA [01:25:03] FOR THE PRESENTATION AND TO OTHERS FOR YOUR LEADERSHIP. I'M ALWAYS GRATEFUL TO SEE YOUNG FOLKS AT THE PODIUM EXPRESSING WHATNOT JUST WHAT YOUR GENERATION NEEDS, BUT WHAT THE CITY OF SAN ANTONIO SHOULD BE ADVOCATING FOR. THANK YOU SO MUCH. VERY PROUD OF YOU ALL. AT YOUR AGE I COULD NEVER HAVE STOOD UP AT A IPADIUM AND TALKED TO FOLKS. WE'RE REALLY PROUD OF YOU ALL. IN TERMS OF THE PRESENTATION TODAY THERE'S A COUPLE OF ALARMING METRICS IN HERE, PARTICULARLY AROUND THE SUICIDAL IDEATION, SELF HARM, PARTICULARLY FOR LBGTQ YOUTH AND TRANSGENDER YOUTH. I BELIEVE IT'S MORE THAN A CRY FOR HELP, I BELIEVE IT A CALL FOR ACTION FOR THE CITY OF SAN ANTONIO TO STAND ALONGSIDE OUR LBGTQ YOUTH BEYOND PARK & RIDE PRIDE MONTH. WHAT THAT LOOKS LIKE I THINK IS BEYOND CONVERSATION WITH THE YOUTH COMMISSION AND THE ORGANIZATIONS DOING THE WORK TO SEE HOW WE CAN CONTINUE TO BETTER SUPPORT OUR LBGTQ YOUTH. WITH THAT I HAD AN OPPORTUNITY ABOUT TWO YEARS AGO TO DO A RIDE-ALONG WITH EMS, AND ONE OF THOSE VISITS WAS A RESPONSE TO A SUICIDE, RIGHT? SO IT'S SOMETHING THAT WE KNOW FOLKS IN PUBLIC SAFETY ARE RESPONDING TO, BUT THERE'S A NEED, AS JESSE MENTIONED, TO DESTIGMATIZE THE NEED FOR -- ASKING FOR HELP AND ALSO PRESENTING WHAT RESOURCES ARE AVAILABLE TO FOLKS. ANOTHER METRIC WORTH HIGHLIGHTING, AND I THINK SOMETHING THAT COUNCIL SHOULD HONE IN ON IS THE FOUR IN FOUR TEENS WHO HAVE SAID THAT THEIR FAMILY STRUGGLES COVERING THEIR BASIC NEEDS SOMETIMES IS SOMETHING THAT SITS WITH THEM. I THINK WHEN WE'RE HAVING CONVERSATIONS ABOUT AFFORDABLE HOUSING, UTILITY RATES, LOCAL WAGES WITH CITY-SUPPORTED CONTRACTS, THAT WE HAVE A RESPONSIBILITY TO MAKE SURE THAT WE'RE SUPPORTING SAN ANTONIO FAMILIES WITH EACH OF THOSE PILLARS, BECAUSE IT'S OUR YOUTH THAT ARE GOING TO SCHOOL, NOT GOING TO SCHOOL, GOING TO COURT OR TRUANCY COURT THAT ARE SITTING WITH THEM, THOSE STRUGGLES THAT THEIR PARENTS ARE FACING. NOW, AN AREA THAT I'M PROUD OF IS WORKING WITH THE JUDGE CONNECTING OUR FAMILIES TO RESOURCES, MAKING SURE THAT'S TAKING A HOLISTIC APPROACH CONNECTING OUR FAMILIES TO THE RESOURCES THAT THEY NEED. BUT ALSO THE WORK OF THE YOUTH COMMISSION, IN THE PUBLIC SAFETY COMMISSION WITH MELODY WE HAD A CONVERSATION ABOUT HOW WE CAN MITIGATE YOUTH VIOLENCE AND SUPPORT YOUTH HERE IN THE CITY AND SOME OF THE RECOMMENDATIONS IS THE WORK THAT THE YOUTH COMMISSION HAS INITIATED THROUGH THE 100,000-DOLLAR PILOT, RIGHT, WHICH IS CREATING THESE CALMING CENTERS WITHIN THEIR SCHOOLS AND CONNECTING OUR KIDS TO MEDITATION RESOURCES, OUR TEACHERS. SO YOU ALL ARE REALLY LEADING THE WAY AND IT'S UP TO COUNCIL TO INVEST AND IMPLEMENT THOSE RECOMMENDATIONS. BUT THERE'S PLENTY OF WORK. GRATEFUL FOR THE WORK,, REBECCA AND JESSE AND THIS REALLY IMPORTANT ISSUE. WHEN WE LOOK AT THE TRENDS CONNECTING TO YOUTH VIOLENCE IN PARTICULAR WE'RE SEEING AN INCREASE SO I THINK WE HAVE A RESPONSIBILITY TO INVEST IN THIS PILLAR BECAUSE IT'S OUR FUTURE WORKFORCE. AND THEN IF WE'RE ALLOWING FOLKS TO ENTER THE JUSTICE SYSTEM THERE'S MORE BARRIERS TO HOUSING, WORKFORCE OPPORTUNITIES, SO ON, SO FORTH. I BELIEVE THAT'S WHERE THE WORK IS AND THANK YOU SO MUCH FOR LEADING IN THIS INITIATIVE. THOSE ARE ALL MY COMMENTS. THANK YOU, CHAIR. >> GALVAN: THANK YOU, COUNCIL MEMBER. AND AT 11:29 A.M. ON DECEMBER 2ND, WE WILL NOW ADJOURN THE COMMUNITY HEALTH MEETING. THANK YOU. * This transcript was compiled from uncorrected Closed Captioning.