[00:00:11] WE'LL OFFICIALLY CALL THE MEETING TO ORDER. MADAM CLERK, WILL YOU PLEASE CALL THE ROLL. [Approval of Minutes  ] QUORUM. >> GALVAN: GREAT. DO YOU HAVE ANY CHANGES OR ADJUSTMENTS TO THE MINUTES? GREAT. CAN I GET A MOTION TO APPROVE? ALL OF THOSE IN FAVOR OF APPROVING. ANY OPPOSED? ANY ABSTENTIONS? [Public Comments  ] BEAUTIFUL. WE'LL MOVE INTO PUBLIC COMMENT. WE HAVE ONE SPEAKER SI SIGNED UP AND A COUPLE FOLKS WHO SENT PUBLIC COMMENT THROUGH SPEAK UP SA. EVERYONE IN THE COMMUNITY GOT THEIR WRITTEN NOTES, WE'LL KEEP THOSE IN THE REC RECORD. THANK YOU NADIA, EMILY, AND GRACIE FOR SENDING IN YOUR COMMENTS. OUR PERSON HERE TO SPEAK IN PERSON IS JAIME GONZALEZ FROM THE FOOD COUNCIL. COME UP, AND YOU'LL HAVE THREE MINUTES TO SPEAK. >> I WAS ABOUT TO SAY, NOBODY BROUGHT A STOOL FOR ME TO STANDS ON. SO GOOD MORNING, EVERYONE. I'M JAIME GONZALEZ, EVERYBODY KNOWS ME AS THE PRODUCE LADY OF SAN ANTONIO, AND I REPRESENT THE FOOD POLICY COUNCIL AND RIVER CITY PRODUCE AND CHICHO BOYS. I CAME IN TO M MAKE A PUBLIC COMMENT ABOUT THE CONVERSATIONS ABOUT THE BUDGET AND HEALTHY NEIGHBORHOODS PROGRAM AND OTHER PROGRAMS AND PUBLIC HEALTH PROGRAMS THAT ARE POTENTIALLY BEING IMPACTED BY THE DECREASED BUDGET NEXT YEAR. I HAVE HAD THE PRIVILEGE FOR SPENDING -- OF SP SPENDING THE LAST TEN YEARS WORKING WITH MANY OF THE COMMUNITY HEALTH WORKERS IN THIS COMMUNITY THROUGH THE FOOD POLICY COUNCIL, THROUGH THE VARIETY OF PROGRAMS WITH METRO HEALTH, ESPECIALLY THE HEALTHY NEIGHBORHOODS PROGRAM, AND WHILE I KNOW THAT THE CITY IS FACING DEEP DEFICITS OVER THE NEXT COUPLE OF YEARS, I WANTED TO COME AND SPEAK TO SOME OF THE WORK, AND BEHIND THE SCENES WORK THAT THE HEALTHY NEIGHBORHOODS TEAM AND OUR ARMY OF COMMUNITY HEALTH WORKERS DO IN THIS COMMUNITY. IF IT WAS NOT FOR HEA HEALTHY NEIGHBORHOODS AND THE WORK OF THE MANY COMMUNITY HEALTH WORKERS I'VE ENGAGED WITH OVER THE YEARS, THERE ARE SO MANY PROGRAMS AND INITIATIVES THAT WOULD HAVE NOT MOVED AS FAR ALONG AS THEY HAVE. THESE ARE PEOPLE WHO ARE NOT JUST SHOWING UP FOR WORK WITH A CITY BADGE FROM 9:00 TO 5:00 GOING TO MEETINGS THAT THEY'RE PAID TO GO TO. IT'S THE EVENINGS, THE WEEKENDS, THE NIGHTS, THE TIME THAT THESE PEOPLE SPEND OF THEIR OWN TIME VOLUNTEERING IN THE COMMUNITY ALONGSIDE THE PEOPLE THAT ARE EMBEDDED IN THE COMMUNITY. WHEN I THINK ABOUT DIALING BACK THE FUNDING FOR THESE TYPES OF PROGRAMS, THIS IS THE SAFETY NET THAT WE HAVE CREATED IN THE CITY, AND ONE, WHERE WE'RE GOING TO LEAVE A LARGE GAP AS WE LOSE THIS TYPE OF WORKER IN THE COMMUNITY AND THE IMPACT OF THE HEALTHY NEIGHBORHOODS PROGRAM. THIS IS NOT JUST COMMUNITY HEALTH WORKERS DOOR KNOCKING AND ME MEETING WITH THE COMMUNITY, BUT THEY ARE THE MOST TRUSTED PEOPLE IN THESE NEIGHBORHOODS. WHEN THERE IS A NEW INITIATIVE, WHEN THERE IS A PROJECT, WHEN THERE IS A PROGRAM, WHEN A CITY COUNCILMEMBER WANTS TO HAVE AN EVENT LIKE A COMMUNITY PLATIKA, THESE ARE THE PEOPLE HELPING TO SPREAD THE WORD AL ALONGSIDE OF US. THESE ARE ALSO THE DEPARTMENTS WHO HAVE U UPLIFTED PRIVATE PUBLIC PARTNERSHIPS IN THE COMMUNITY FOR MANY YE YEARS, BUT IMPACTFULLY FOR THE BETTER PART OF THE LAST FIVE YEARS. WE WOULD NOT HAVE ST STARTED AND GROWN THE HEALTHY CORNER STORE PROGRAM WITHOUT THE HELP OF THE COMMUNITY HEALTH WORKERS AND THEIR PARTICIPATION WITH THE FOOD POLICY COUNCIL, AND AS THAT PROGRAM PHASES OUT, THE EXPANSION OF THE DOUBLE UP FOOD BUCKS PROGRAM AND JUST BR BRINGING THAT PROGRAM TO SAN ANTONIO HAPPENS IN THE HEART OF THE HEALTHY NEIGHBORHOODS TEAM. THIS IS WHERE V VIA COR CORNADO GETS ITS LEGS AND WHERE COMMUNITY MEMBERS GO TO WHEN THEY'RE STRUGGLING. WE KNOW THEY GO TO CITY COUNCIL AND OFFICES BUT THE PEOPLE THEY TRUST MOST AND CALL AND THE PEOPLE PICKING UP CHILDREN, TAKING THEM TO PRACTICE AND MAKING SURE THEY KNOW ABOUT FOOD DISTRIBUTIONS, THIS IS YOUR HEALTHY NEIGHBORHOODS TEAM, THIS IS THE HEART OF THE CI CITY. I WORRY, AND THE FOOD POLICY COUNCIL WORRIES THAT AS THIS DEPARTMENT IS DIALED BACK AND THE OTHER DEPARTMENTS IN METRO HEALTH, HOW DO WE CONTINUE THE BRIDGE AND FILL THE GAP OVER THE NEXT TWO YEARS THAT WILL OCCUR IN PUBLIC HEALTH IN THIS COMMUNITY. AND THAT IS NOT JUST HEALTHY NEIGHBORHOODS IT'S COMMUNITY DISEASE PREVENTION AND STI TE TESTING PROGRAMS AS WE WELL. THE VITAL RESOURCES THAT WE HAVE, THAT THE COMMUNITY DOESN'T -- [00:05:03] OFTEN DOESN'T KNOW ENOUGH ABOUT, AND I WILL SAY ONE MORE THING THAT'S GOING TO BE A LITTLE BIT MORE OF AN U UNPOPULAR COMMENT. AS WE LOOK TO TIGHTEN THE CITY'S BUDGET AND FIND MONEY WHERE MONEY DOES NOT EXIST, I CHALLENGE YOU TO LOOK DEEPER WITHIN SOME OF YOUR OTHER PROCESSES, ONE IS YOUR RFP PROCESS, AND I'VE SPOKEN PUBLICALLY ABOUT THAT MANY TIMES IN FRONT OF CITY COUNCILMEMBERS, THE COST OF THAT, THE GAPS IN THE FINANCE DEPARTMENT, AND THE WAY THAT THEY'RE ASSIGNED TO DIFFERENT DEPARTMENTS AND OFFICES AND THE ARBITRARY WAY THAT THEY PAY MONEY, COLLECT MO MONEY, NEED A PO, DON'T NEED A PO, ALL OF THIS, BECAUSE IT IS ACTUALLY NOT SYNCED IT BECAUSE THOSE PROCESSES ARE NOT CONSISTENT ACROSS DEPARTMENTS. THAT CREATES A HUGE GAP AND CREATES MONEY LAWS THAT COULD BE USED FOR PUBLIC PROGRAMMING, AND THE LAST ONE I WILL MENTION IS THE MARKETING DEPARTMENT OF THE CITY OF SAN ANTONIO AND METRO HEALTH. WHILE I'VE ENJOYED WO WORKING WITH THE MAR MARKETING TEAM OVER THE YEARS, I WILL TELL YOU THAT I'VE SEEN MORE PERFORMATIVE WORK DONE FROM THE MARKETING DEPARTMENT OF THE CITY OF SAN ANTONIO THAN ANYONE ELSE THAT I'VE EVER WORKED OR BEEN A PART OF. I LOVE THAT WE LIKE OUR CITY. I LOVE THAT WE WANT TO PROMOTE IT, BUT WE DON'T WANT WATER BOTTLES WITH CITY LOGOS ON THEM. WE DON'T NEED THAT. WE DON'T WANT THE GIM GIMMICKY THINGS, WE DON'T WANT THE TOWELS OR CONTAINERS, PEOPLE NEED HELP, NEED FOOD. NEED CONSISTENT ACCESS TO QUALITY AFFORDABLE FOOD, HOUSING, AND HEALTHCARE. I DON'T CARE HOW MANY BILLBOARDS YOU PUT UP. HOW MANY TIMES YOU HAVE FIVE PEOPLE SHOW UP INTO A ROOM THAT ARE OFTEN THE RELATIVES OF THE MARKETING DEPARTMENT. THOSE EFFORTS ARE NOT REACHING THE COMMUNITY. THE PEOPLE DEEPLY EM EMBEDDED WITHIN THE MARKETS IN METRO HEALTH ARE THE PEOPLE CON CONNECTING WITH THE COMMUNITY. THOSE ARE PLACES TO LOOK FOR MONEY, AREAS TO TIGHTEN THE BUDGET. >> GALVAN: THANK YOU. >> AND I DO CHALLENGE YOU GUYS TO MAYBE LOOK AT THAT A LITTLE BIT MORE. I APPRECIATE THAT TIME. >> GALVAN: I APPRECIATE YOUR COMMENTS AND WANT TO GIVE YOU A LITTLE BIT MORE TIME BECAUSE I KNOW YOU DO A LOT OF WORK IN TH COMMUNITY AND I APPRECIATE IT. BUT THANK YOU FOR THE COMMENTS TODAY. >> ABSOLUTELY. [Briefing and Possible Action on  ] THANK YOU. >> GALVAN: ALL RIGHT. WE'LL MOVE TO ITEM NUMBER 2. METRO HEALTH MATERNAL HEALTH PROGRAMS. WE HAVE A BIG STACKED AGENDA WITH METRO HEALTH PROGRAMMING, SO I'M EXCITED TO JUMP INTO IT. GO AHEAD. >> GOOD MORNING. MY NAME IS MARGORIE WHITE, I SERVE AS THE ASSISTANT DIRECTOR WITH THE COMMUNITY HEALTH AND SAFETY DIVISION WITHIN METRO HEALTH. TODAY'S PRESENTATION WILL HIGHLIGHT OUR MATERNAL HEALTH PROGRAM IN THIS DIVISION WHICH CONSISTENT OF OUR WOMEN, INFANT, AND CHILDREN PROGRAM KNOWN AS WIC. OUR SAN ANTONIO LACTATION SUPPORT CENTER AS WELL AS OUR HEALTHY START PROGRAM. A COMMON THEME YOU'LL SEE IS WE PROVIDE SERVICES THROUGHOUT THE FULL MATERNAL HEALTH CONTINUUM FROM P PRECONCEPTION TO PREGNANCY, TO DELIVERY, TO POST PARTUM, AS WELL AS INTERCONCEPTION, WHICH ARE ALL CRITICAL TO A SUCCESSFUL PREGNANCY. THE WOMEN, INFANT, AND CHILDREN PROGRAM RECENTLY CELEBRATED 50 YEARS OF EXISTENCE, IT WAS ESTABLISHED IN 1975 AND CAME TO METRO HEALTH AGRICULTURE. HERE IN SAN ANTONIO WE HAVE TEN METRO HEALTH WIC CLI CLINICS, WHICH MAKES US THE LARGEST WIC PROVIDER IN THIS COMMUNITY, AS WELL AS ONE OF THE LARGEST IN THE STATE OF TEXAS. OUR SERVICES INCLUDE FOOD BENEFITS TO BRIDGE DIETARY GAPS AND IMPROVE ACCESS TO HEALTHY FOODS, NUTRITION EDUCATION THROUGH 101 COUNSELING AND CLASSES DO HELP FAMILIES MAKE INFORMED DECISION AND ASSIST WITH DIETARY NEEDS, ESPECIALLY WITH CHILDREN WITH ALLE ALLERGIES, BREAST-FEEDING SUPPORT AND PROVIDING REFERRALS TO HEALTHCARE PROVIDERS AS WELL AS SOCIAL SERVICES WHEN THERE'S A NEED WITHIN THAT HOUSEHOLD. OUR OTHER SERVICES INCLUDE PROVIDING WIC SERVICES AT LOCAL HOSPITALS, COORD COORDINATING WITH THE SAN ANTONIO FOOD BANK TO PROVIDE SUMMER FEEDING AS WELL AS HOSTING DIETIC INTERNS THROUGHOUT THE YEAR. TO QUAFF FOR WIC PROGRAM, A PARTICIPANT MUST BE PREG PREGNANT, POST PARTUM UP TO SIX MONTHS AFTER DELIVERY, BE BREAST-FEEDING A YEAR AFTER DELIVERY, BE EITHER PARENTS, STEP PARENTS, GU GUARDIANS OF SOME SORTS OF A CHILD UNDER THE AGE OF FIVE, MEET THE WIC INCOME GUIDELINES BASED ON THE SIZE OF THE HOUSEHOLD AS WELL AS THE GROSS MONTHLY INCOME. PLEASE NOTE THAT IF A CLIENT IS RECEIVING MEDICAID, SNAP, TANIF, THEY DO QUALIFY FOR WIC, ALTHOUGH THOSE ARE NOT THE ONLY QUALIFIERS FOR THE PROGRAM. [00:10:01] FOR THE PROGRAM YOU MUST ALSO LIVE IN TEXAS AND WE ALSO WANT TO NOTE THAT U.S. CITIZENSHIP IS NOT A REQUIREMENT FOR ELIGIBILITY, MAKE SURE WE'RE REDUCING THAT BARRIER TO CARE. THERE ARE FIVE GOALS AND OBJECTIVES FOR THE WIC PROGRAM, ONE IS TO IMPROVE BIRTH OUTCOMES DEFINITELY CENTERED AROUND INFANT MORTALITY, LOW BIRTH WEIGHTS AS WELL AS PREMATURE BIRTHS WHEN YOU LOOK AT THE COMMUNITY'S DATA, YOU'LL FIND WE HAVE A HIGH INFANT MORTALITY RATE. LOW BIRTHRATE AND PREMATURE BIRTH WE'RE AS IN THE STATE OF TEXAS AS WELL AS NATIONAL RATES. WE WANT TO ENSURE HEALTHY DEVELOPMENT BY ADDRESSING NUTRITIONAL AND FOOD NEEDS, PROMOTE HEALTHY BEHAVIORS NOT JUST NOW BUT THROUGHOUT THE LIFE SPAN OF THAT FAM FAMILY. PREVENT NUTRITIONAL ANIME M MAS, WE CHECK FOR IRON DEFICIENCY AND WHEN WE FIND THAT HAPPENS WE REFER THEM TO A HEALTHCARE PROVIDER, WE ALSO SUPPORT BREAST-FEEDING, WHICH PROVIDES VITAL NUTRIENTS TO A BABY UPON BIRTH. IN FISCAL YEAR 2025, WE DECIDED TO MOVE OUR SAN ANTONIO LACTATION SUPPORT CENTER UNDERNEATH THE UMBRELLA OF THE WIC PROGRAM FOR FINANCIAL STABILITY. THIS PROGRAM HAS INTERNATIONAL BOARD CERTIFIED LACTATION CONSULTANTS WHO ARE THERE TO PROVIDE 101 CONSULTATION TO OUR FAMILIES NEEDING ASSISTANCE WITH BREAS BREAST-FEEDING. AS YOU CAN SEE FROM THE SLIDE, WE PROVIDE CLINICAL ASSESSMENT AND MANAGEMENT. WE DO INDIVIDUALIZED CARE, NOT JUST FOR WHEN THEY'RE WITH US, BUT ALSO TO SUSTAIN THEIR PLANS AND GOALS. MATERNAL HEALTH SCREENINGS, SUCH AS DEPRESSION. WE MAKE SURE WE'RE CON CONNECTING FOLKS TO SERV SERVICES. CARE COORDINATION AND REFERRALS SIMILAR TO WHAT WE DO IN OUR OTHER PROGRAMS WHEN WE FIND THAT A FAMILY HAS OTHER SOCIAL SERVICES NEED, WHETHER FOOD I INSECURITY, HOUSING I INSECURITY, ET CETERA, AS WELL AS EDUCATION AND COUNSELING, BY REMOVING COST BARRIERS AND IMPLEMENTING EXPERTISE WITH COMMU COMMUNITY-BASED CONSUL CONSULTATION, THIS PROGRAM SERVES AS A CRITICAL BRIDGE BETWEEN HEALTHCARE SYSTEMS THE IMPACT OF THIS PROGRAM. AS OF APRIL TO DATE, THE WIC PROGRAM HAS SERVED 35,923 INDIVIDUALS. AS YOU CAN SEE, OUR FISCAL YEAR 26 TARGET IS 36,924, SO WE'RE DEFINITELY ON TARGET TO MEET THAT GOAL. TO DATE, WE'VE ALSO E EXPENSIONED ABOUT $3.7 MILLION OF FOOD BENEFITS TO OUR CLIENTS. IF YOU LOOK AT THAT TABLE, YOU'LL SEE THERE'S DEFI DEFINITELY A JUMP FROM WHAT WE'VE BEEN SPENDING IN THE PAST YEARS, BUT DUE TO CO COST -- INCREASED COST IN FOOD AS WELL AS INCREASED COST OF FOOD BENEFITS, THAT'S WHY THE COST PER CLIENT HAS INCREASED TO DATE AS WELL AS WE'RE VERY PLEASED TO SEE THAT THERE'S BEEN AN INCREASE IN BREAST-FEEDING INITIATION RATES. BEFORE PROGRAM, I DEFINITELY WANT TO HIGHLIGHT A FEW THINGS REGARDING WIC. ONE, LAST YEAR, OUR WIC PROGRAM PARTICIPATED IN AN AUDIT BY THE TEXAS WIC PROGRAM, AND THERE WERE NO FINDINGS. THIS IS THE FIRST TIME EVER FOR ANY WIC PROGRAM OF THIS SIZE. IN ADDITION, WE CONTINUE TO EXCEED OUR CUSTOMER SATISFACTION SCORES, AND NEXT WEEK, THIS TEAM WILL ALSO BE RECOGNIZED FOR THE CITY MANAGER'S EXCELLENCE AWARD FOR THE PARTICIPATION IN THE FEEDING SAN ANTONIO INITIATIVE. VERY PROUD OF THIS TEAM. AS WE TRANSITION TO OUR OTHER WONDERFUL TEAM, OUR HEALTHY START PROGRAM, THE MISSION OF HEALTHY START IS THRIVING COMMUNITIES, STRONG FAMILIES, AND HEALTHY BAB BABIES. THIS PROGRAM IS FUNDED UNDERNEATH THE HEALTH R RESOURCE AND SERVICES ADMINISTRATION, AND IT WAS ORIGINALLY FUNDED IN 2001 AND IT HAS SERVED FAMILIES IN OUR COMMUNITY FOR OVER T25 YEARS. WE'RE ONE OF OVER 115 HEA HEALTHY START SITES ACROSS THE COUNTRY AND ONE OF SIX TO COLLABORATE WITH THE TEXAS HEALTHY START ALLIANCE HERE IN TEXAS. WITHIN THE PROGRAM, WE HAVE A COMMUNITY ACTION CONSORTIUM WHICH IS THE HEALTHY FAMILIES NETWORK, AND WITHIN THAT IS A SUBSET OF THE AFRICAN AMERICAN COUNCIL AS W. THEY PROVIDE BOTH IN HOME AND VIRTUAL CASE MANAGEMENT BASIS, SCREENING ASSESSMENT AS WELL AS CARE COORDINATION AND REFERRALS, LA YOU HAVE OUR STAFF ARE ALSO TRAINED TO BE DUE LAS, TO HELP A MOTHER PRE-- DURING [00:15:01] PREGNANCY, POST PREGNANCY, AS WELL AS WE PROVIDE LACTATION SUPPORT AND ALSO DO COMMUNITY HEALTH EDUCATION CLASSES FOR OUR CLIENTS AS WELL AS THE COMMUNITY. OTHER ROLES DEFINITELY INCLUDE CONDUCTING THE CONSORTIUM AS WELL AS THE WORK GROUPS IN ADDITION TO PARTICIPATING IN THE INFANT DEATH REVIEWS THROUGH THE CHILD FATALITY REVIEW TEAM TO SEE WHAT ARE SOME OF THE MAJOR CAUSES OF DEATH FOR CHILDREN AS WELL AS PRO PROMOTING EDUCATION BASED CURRICULUM, TRAUMA INFORMED CARE, CLASSES, AS WELL AS POSITIVE PARENTING. TO BE ELIGIBLE FOR THIS PROGRAM, IT'S OPEN TO ADULT AND TEENS PREPARING TO HAVE A CHILD, EXPECTING A BABY, OR PARENTING A CHILD UNDER 18 MONTHS OLD. WITH THIS PROGRAM YOU MUST RESIDE IN ONE OF THE 11 ZIP CODES. THESE ZIP CODES WERE IDENTIFIED BECAUSE THEY WERE HIGHER INFANT MORTALITY RATES COMPARED TO THE NATIONAL RATE, AND SO AS YOU CAN SEE HERE, THESE ARE THE 11 ZIP CODES, AND THEY TOUCH ABOUT EVERY COUNCIL DISTRICT IN THIS COMMUNITY. THE DATA REFLECTED HERE ARE HEALTH RI START PERFORMANCE MEASURES THAT ADDRESSES LE LEADING CAUSES OF INFANT AND MATERNAL MORTALITY AND MORBIDITY. FOR EXAMPLE, INDIVIDUALS RECEIVING FIRST TRIMESTER PRENATAL CARE. WE KNOW THE IMPORTANCE OF THAT FOR EARLY DETECTION OF ANY CONCERNS, PERCENTAGE OF INFANTS BEING BREAST-FED. PARTICIPANTS PRACTICING SAFE INFANT SLEEP, IDENTIFIED AS A TOP REASON FOR INFANTS DYING IN THE FIRST YEAR AS WELL AS RECEIVING PROPER R REPRODUCTIVE LIFE PLANNING, AS WELL AS THE WHEN THERE'S NEEDS SUCH AS MENTAL HEALTH CONCERNS MAKING SURE WE'RE REFERRING FOLKS TO THE PROPER HEALTHCARE PROVIDERS. THIS SLIDE PROVIDES AN OV OVERVIEW OF OUR BUDGET FOR THESE PROGRAMS. AS YOU CAN SEE, WE RECEIVE APPROXIMATELY $1.9 MILLION IN GRANTS FOR BOTH, I'LL NOTE FOR HEALTHY START AT THE MOMENT WE'VE ALSO RECEIVED A PARTIAL INS INSTALLMENT, SO THIS IS NOT A TRUE REFLECTION OF THE TRUE BUDGET BUT WHAT WE'VE RECEIVED SO FAR. OPPORTUNITIES AND NEXT ST STEPS. OUR GOAL IS DEFINITELY TO ALWAYS INCREASE PARTICIPATION FOR OUR PROGRAMS. THE MORE FOLKS THAT WE CAN HELP, THE BETTER. IMPLEMENT E-WIC CARDS WHICH HELP TO MAKE STREAMLINING THE DISTRIBUTION OF OUR WIC BENEFITS, MAKES IT MORE SUFFICIENT AND EASIER FOR OUR CLIENTS, INCREASE VISIBILITY OF THE HEALTHY START PROGRAM, IT IS A SM SMALLER PROGRAM, AND IT IS FOCUSED ON SPECIFIC ZIP CODES, HOWEVER, ENSURING THAT THOSE WHO QUALIFY ARE AWARE OF THIS PROGRAM. ALSO, CONTINUE TO ENGAGE WITH A WIDE RANGE OF COMMUNITY PARTNERS. WHAT WE'RE FINDING WHEN WE'RE MEETING WITH OUR CLIENTS, ALTHOUGH WE'RE THERE FOR MATERNAL HEALTH NEEDS, THERE'S A PLETHORA OF OTHER HEALTH CHANNELS THAT FAMILY MAY BE FACING AND WE WANT TO MAKE SURE WE'RE ABLE TO PROPERLY CONNECT THEM. BEFORE I CONCLUDE, MATERNAL HEALTH MATTERS BECAUSE IT DIRECTLY IMPACTS THE SURVIVAL AND WELL BEING OF A MOTHER AS WELL AS THEIR BABIES, ESPECIALLY GIVEN THAT APPROXIMATELY 80% OF PREGNANCY DEATHS ARE PREVENPREVENTABLE. I WOULD LIKE TO THANK THE LEADERSHIP OF OUR MATERNAL HEALTH PROGRAMS, SOME ARE PRESENT TODAY. OUR WOMEN, INFANT, AND CHILDREN PUBLIC HEALTH ADMINISTRATOR, OUR WIC LEADERSHIP PROGRAM MANAGER, MS. MARÍA SADANA WHO COULDN'T BE HERE TODAY AS WELL AS JANUA JANET BURGET, M MS. COR LA EVERILY, SUSAN, PROGRAM COORDINATOR, WHO'S OUR HEALTHY FAMILIES CONSORTIUM COORDINATOR AND ALL OF OUR STAFF AND PAR PARTNERS WHO HELP TO ADDRESS MATERNAL HEALTH ISSUES IN THIS COMMUNITY EVERY DAY. THANK YOU SO MUCH FOR YOUR TIME. >> GALVAN: THANK YOU SO MUCH FO THE PRESENTATION AND THANK YOU FOR ALL THE METRO HEALTH EMPLOYEES WHO MAKE THESE PRO PROGRAMS RUN. I TRY TO BE A LITTLE THEMATIC LOOKING AT FAMILY PLANNING AND OVERALL FAMILY HEALTH AND OF COURSE STARTING OFF WITH MATERNAL HEALTH AND CRUCIAL HERE, SO I APPRECIATE YOU GOING THROUGH BOTH PROGRAMS, HEALTHY START AND THE WIC PROGRAM. AND LACTATION CENTER AND HOW THEY ALL INTERTWINED OF COURSE. WOULD ANYBODY LIKE TO START WITH ANY COMMENTS OR QUESTIONS? COUNCILMEMBER ALDERETE GAVITO? >> ALDERETE GAVITO: THANK YOU, CHAIR. THANK YOU FOR THIS PRESENTATION, IT WAS REALLY GREAT. YOU KNOW, THESE PROGRAMS ARE EXTREMELY IMPORTANT, SO THANK YOU SO MUCH FOR THE CRUCIAL WORK YA'LL ARE DOING FOR SO MANY MOTHERS AND THEIR BAB BABIES. I DEFINITELY APPRECIATE IT. ON SLIDE NUMBER 3 -- I JUST HAVE A FEW QUESTIONS. ON SLIDE NUMBER 3, YOU MENTIONED THE INCOME GUIDELINES. WHAT ARE THEY AGAIN? THE INCOME GUIDELINES FOR THEM TO GET ON TO WIC? >> YEAH. SO IT'S BASED OFF OF THE [00:20:02] GROSS MONTHLY INCOME IN THE HOUSEHOLD. WE CAN SEND YOU THE TABLE SO THAT YOU CAN SEE THAT. WE CAN PROVIDE THAT IN A MEMO. >> ALDERETE GAVITO: PERFECT. YEAH. I'M CURIOUS ABOUT THAT. ALSO, WHAT TYPE OF FOODS ARE AVAILABLE TO WIC U USERS? >> IT'S EGGS, PEANUT BUTTER, MILK, BREAD, HEALTHY OPTIONS FOR THE FAMILY. ALSO, FORMULA, THAT'S A BIG THING. AND FRESH PRODUCE. VEGETABLES AND FRUITS, AND CEREAL. >> ALDERETE GAVITO: OKAY. THANK YOU. THANK YOU FOR THAT INFORMATION. ON SLIDE 6, YOU KNOW, WE'RE SEEING THAT THE DOLLAR AMOUNT IS -- FOR THIS YEAR IS ABOVE TARGET. WHY IS THAT? OR WHAT ARE WE DOING ABOUT THAT? OR IS THAT BY DESIGN? >> IT'S OKAY. THE WIC PROGRAM DID PROVIDE ADDITIONAL FOOD BENEFITS FOR US TO BE ABLE TO SERVE THIS CLIENTELE, SO I BELIEVE ACROSS THE COUNTRY THEY'RE SEEING AN INCREASE, AS WE KNOW THE COST OF LIVING IS GOING UP ACROSS THE BOARD, AND THIS PROGRAM -- THE WAY WE GET THE REVENUE IS BASED OFF OF THE NUMBER OF CLIENTS WE DO SERVE, AND SO WE DO HAVE SUFFICIENT FUNDING TO PROVIDE THIS. >> ALDERETE GAVITO: OKAY. AND THE FUNDING COMES FROM . >> THIS IS THE U.S. DEPARTMENT OF AGRICULTURE. >> ALDERETE GAVITO: OKAY. GOT IT. THANK YOU. ON SLIDE NUMBER 10, WAS IT THE SAN ANTONIO HEALTHY START OBVIOUSLY IS A GREAT PROGRAM SURPASSING NEARLY ALL OF THE TARGETS. SO. SO WHEN WE'RE LOOKING AT THIS, WHAT ARE SOME OF THE BEST PRACTICES THAT YA'LL HAVE SEEN THAT HAVE -- THAT HAVE ATTRIBUTED TO THE SUCCESS? >> I THINK IT'S THE PERSONALIZED TOUCH THAT WE DO. WE GO TO INDIVIDUALS HOMES, WE TRY LOOKING AT TRANSPORTATION AREAS, PROVIDING SERVICES VIRTUALLY, ALSO CON CONNECTING FOLKS TO SERVICES, I THINK WHEN WE'RE CONSISTENT WITH OUR EFFORTS AND ENG ENGAGEMENT WITH OUR CLIENTS, AND THEY'RE S SEEING THE OUTCOME, JUST LACK WEEK, WE HAD A MOTHER -- UNFORTUNATELY, SHE'S PREGNANT AND ON METH, AND IT TOOK A WHILE FOR US TO ENGAGE WITH THAT CLIENT, BUT ONCE WE BUILT THAT RAPPORT WE WERE ABLE TO WORK WITH SAN ANTONIO HEALTHCARE SERVICES TO GET HER CONNECTED. AND WALKING PEOPLE THROUGH A SYSTEM, ESPECIALLY IF THERE'S A NEED, I THINK THAT HELPS US TO BUILD CREDIBILITY WITH OUR STAFF, AND AS I SAID BEFORE, SOME OF OUR STAFF ARE DOULA TRAINED, AND SO SOME ARE IN THE DELIVERY ROOM. AND SO I THINK BUILDING THE TRUST AND RAPPORT WITH OUR CLIENTS BUILD THE SUCCESS. >> ALDERETE GAVITO: GOOD TO K KNOW. THANK YOU. ON SLIDE 11 -- SO BOTH OF THESE PROGRAMS -- THEY'RE FULLY FUNDED BY GRANTS; RIGHT. >> CORRECT. >> ALDERETE GAVITO: AND ARE W WE -- HAVE THEY BEEN FAIRLY SECURE? ARE WE NERVOUS ABOUT DISTURBANCES IN FUNDING. WHAT ARE OUR THOUGHTS THERE? >> GOOD QUESTION. SO THE WIC PROGRAM IS MOST SECURE. THE HEALTHY START PROGRAM IS ONE THAT CONTINUES TO FACE VULNERABILITY ON A FEDERAL LEVEL, AND SO EVEN THIS PAST YEAR, WE WERE UNSURE WHETHER OR NOT THIS PROGRAM WAS GOING TO CONTINUE. WE DID RECEIVE A NOTICE OF AWARD IN MARCH, AND WE JUST RECEIVED AN ADDITIONAL ONE, JUST THIS WEEK, AND SO WE'RE WAITING TO SEE WHETHER OR NOT THE FEDERAL GOVERNMENT WILL PUT IT IN THE BUDGET FOR THE UPCOMING YEAR, AND SO THE HEALTHY START PROGRAM IS THE ONE THAT'S MOST VULNERABLE. >> ALDERETE GAVITO: THAT'S GOOD TO KNOW. THANK YOU. YEAH. AND, YOU KNOW, IF THERE'S WAYS THAT WE CAN HELP SPREAD THE WORD ABOUT, LIKE, THE HEALTHY START PROGRAM TO OUR DISTRICTS, LET US KNOW SO THAT WAY WE CAN BE PARTNERS IN THAT. BUT THANK YOU AGAIN. I MEAN, I THINK, YOU KNOW, WE WERE TEXTING, I MEAN, EVEN MOTHERS WHO HAVE ALL THE RESOURCES IN THE WORLD, THIS IS STILL SUCH A TOUGH TIME. PREGNANCY, AFTER BABIES, I MEAN, IT'S A REALLY TOUGH TIME IN PEOPLE'S LIVES. SO THANK YOU FOR BEING THERE FOR SO MANY IN OUR COMMUNITY DURING THAT TIME. THANK YOU. >> THANK YOU. >> GALVAN: THANK YOU COUNCILMEMBER. ANYBODY ELSE WANT TO -- COUNCILMEMBER MEZA GONZALEZ. >> GONZALEZ: THANK YOU. THANK YOU FOR THE PRESENTATION AND FOR ALL THE WORK THAT METRO HEALTH IS DOING AND THEIR EMPLOYEES AND ALL THE PARTNERS THAT THEY WORK WITH. THIS IS REALLY BOOTS ON THE GROUND; RIGHT? SO JUST A COUPLE OF QUESTIONS ON -- I THINK SLIDE 10. THE GOAL IS 700, I BELIEVE IT WAS. YEAH. 700. ARE WE ON TARGET TO MEET THAT GOAL? >> YES. [00:25:03] WE ARE. WE'RE CONTINUING TO INCREASE OUR OUTREACH EFFORTS, BUT YES. OVUM. >> GONZALEZ: AND WHERE -- I THINK WE TALKED ABOUT FEDERAL DOLLARS AND MAKING SURE THEY'RE IN TACK, SO HOPEFULLY THAT'S SOMETHING WE COULD GET AN UPDAT ON FROM OUR IGR COMMITTEE SOON. ON THE OUTREACH TOO, I DON'T KNOW IF THIS IS -- AND I APPRECIATE YOU WALKING THEM THROUGH THE SYSTEM BECAUSE THAT'S WHAT SO MUCH OF THIS IS WITH A LOT OF PROGRAMS WE OFFER, WHETHER IT'S READY TO WORK OR OUR HEALTHY START PROGRAM, IT'S WALKING FOLKS THROUGH A SYSTEM THAT HASN'T ALWAYS MET THEM WHERE THEY NEED TO BE, SO I -- I JUST APPRECIATE THE THO THOUGHTFULNESS IN THAT. MY QUESTION IS AROUND OTHER SERVICES THAT WE ALSO SHARE, LIKE THAT WE SUPPORT. SO ARE WE TALKING TO THESE CLIENTS AS WELL ABOUT READY TO WORK OR ABOUT PRE-K FOR SA? WHAT DOES THAT LOOK LI LIKE? >> SO OUR PROGRAM DOES HAVE A SOCIAL SERVICES SHEET OF DIFFERENT R RESOURCES, ALSO THE HO HOMELESS DIVISION, MAKING SURE WE'RE CONNECTING FOLKS TO THE CONNECTIONS HOTLINE, READY TO WORK UTILITY ASSISTANCE TOO. WE DO WORK TO ENSURE OUR PROGRAM STAFF ARE AWARE OF THESE DIFFERENT R RESOURCES TO OFFER, AND IF THEY DON'T KNOW, WE CAN HELP FACILITATE THAT ON AN ELT LEVEL AS WELL AS THEIR ADMINISTRATIVE LEVEL. >> GONZALEZ: CAN YOU PROVIDE MAYBE IN A REPORT JUST KIND OF THE BREAKDOWN OF THE DEMOGRAPHICS OF FOLKS COMING THROUGH? >> YOU WANT IT FOR HEALTHY START? ALL OF THAT? >> GONZALEZ: YEAH. I'M CURIOUS ABOUT AGE RANGE, AND NUMBER OF CHILDREN, ALL OF THAT. >> ABSOLUTELY. ABSOLUTELY. >> GONZALEZ: THANK YOU SO MUCH. THOSE ARE ALL OF MY QUESTIONS. THANKS AGAIN. >> THANK YOU. >> GALVAN: COUNCILMEMBER CASTILLO. >> CASTILLO: THANK YOU CHAIR AN MARGORIE FOR THE PRESENTATION. IN TERMS OF THE HEALTHY NEIGHBORHOODS PRESENTATION AND THE IMPACT AND JUST LOOKING AT THE OVERALL PRESENTATIONS WE'LL GET TODAY; RIGHT, KEY IS ACCESS TO QUALITY FOODS, AND I THINK IN TERMS OF THE FUNDING THAT MAY BE AT RISK, I THINK THAT'S SOMETHING THAT WE SHOULD IDENTIFY WITHIN OUR CURRENT BUDGET TO CONTINUE TO SUPPORT THAT PROGRAMMING BECAUSE OF THE IMPACT TO OUR CHILDREN. I DID HAVE A QUEST QUESTION; RIGHT? I'M THINKING -- AGAIN, LO LOOKING AT ALL THE PRESENTATIONS WE'RE GOING TO RECEIVE TODAY AS A WHOLE IS A BIT FRUSTRATING IN TERMS OF, YOU KNOW, THIS IS FU FUNDING THAT WE HAVE TO FIGHT TO KEEP OUR IDENTIFY, AND I THINK IN TERMS OF LOBBYING AT THE FEDERAL LEVEL AND STATE LEVEL, AND THINKING ABOUT OUR TRIPS TO SA -- TO D.C. IS THERE -- AND I SEE ON SLIDE 7, THERE'S ORGANIZATIONS THAT DO SOME OF THAT ADVOCACY, BUT AS METRO HEALTH, WHEN WE GO FROM SA TO D.C., IS THERE AN AGENDA IN WHICH IS DRAFTED AND WE WORK WITH BUSINESS PARTNERS TO GO AND ADVOCATE FOR, AND CAN YOU WALK ME THROUGH A LITTLE BIT WHAT THAT LOOKS LIKE? >> I CAN SPEAK A LITTLE BIT REGARDING THE TEXAS HEALTHY START ALLIANCE. SO -- AND OUR STAFF ALSO ATTENDS THE CONFE CONFERENCE -- NATIONAL CONFERENCE IN D.C. AS WELL, BUT THERE'S A LOT OF TALK ABOUT, YOU KNOW, HOW DO WE SUSTAIN THIS, WHO ARE THE PARTNERS WHO CAN HELP SUPPORT IT? SO I THINK THERE IS LOBBYING HAPPENING AT THAT LEVEL. IN REGARDS TO OTHER FORUMS, I AM NOT FAMILIAR, BUT I CAN, YOU KNOW, SPEAK TO CLAUDE, MAYBE WHEN HE GOES TO D.C., MAYBE THERE'S OTHER OPPORTUNITY. >> THANK YOU, COUNCILWOMAN FOR THE QUESTION. I WOULD SAY IN STAFF, SO WE DON IN ISOLATION, SO DEP DEPENDING ON THE PRO PROJECT, WE'RE MEMBERS OF NATIONAL ORGANI ORGANIZATIONS AND NETWORKS, AND SO, AGAIN, WE CAN TALK MORE BROADLY IN TERMS OF OTHER INITIATIVES, BUT SPECIFICALLY TO THIS, WE WORK WITH PARTNERS ON THE GROUND AND CLINICAL PROVIDERS. >> CASTILLO: YEAH. I'M THINKING IN TERMS -- I THINK IN THE FRAMEWORK OF HOUSING AND OFTENTIMES FOLKS ASSUME LOW INCOME IS LOWER T TAXED AND A LOT IS. WE KNOW RURAL COMMUNITIES RELY ON AFFORDABLE HOUSING AND RELY ON WIC AND THESE PROGRAMS, SO I THINK THERE'S OPPORTUNITY WHETHER WITH COUNCIL MEETING WITH LARGER DELEGATION TO TALK ABOUT THE IMPACT NOT JUST URBAN AREAS BUT RURAL COMMUNITIES AS WELL TO POTENTIALLY HELP TO MAKE THE CASE ON WHY WE SHOULD CONTINUE TO P PRESERVE THIS FUNDING. >> THAT'S RIGHT. POINTS WELL TAKEN AND WE WORK WITH COSA AND OTHER COMMUNITY PARTNERS TO MAKE THE CASE FOR SUPPORTING OUR PROGRAMS. >> CASTILLO: THANK YOU. >> GALVAN: THANK YOU. ANYBODY ELSE HAVE QUESTIONS OR COMMENTS ON THIS PROGRAM? ALL RIGHT. WELL THANK YOU SO MUCH. I HAVE A COUPLE QUICK THINGS, A COUPLE OVERLAP WITH MY COLLEAGUES, OF COURSE SUPPORTIVE OF FINDING WAYS TO MAINTAIN THESE PROGRAMS AND ADVOCATE FOR THEM AND SEEING IF WE COULD ALIGN WITH ANY CHAMBERS FOR THE SADC WORK WE DO THERE. WHEN WE TALK ABOUT ANY OF THESE PROGRAMS, AND I KNOW COUNCILMEMBER MEZA GONZALEZ TALKED ABOUT THEM AS THEY WORK TO WORK FORCE DEVELOPMENT, EDUCATION AS WELL, ALL ALIGN THERE, MAKING SURE KIDS ARE WELL FED, WELL TAKEN CARE OF, THEIR PARENTS TOO, WE TALK ABOUT IN THE HEAD START WORLD LOOKING AT [00:30:06] HOLISTIC CARE BECAUSE IT'S NOT ENOUGH TO SAY IS THIS KID BEING TAKEN CARE OF. LOOKING AT THE HOUS HOUSEHOLD. YOU GET THAT. UNDERSTANDING HOW WE COULD BRIDGE THE GAP WITHIN THE ECONOMIC DEVELOPMENT WORLD IS CRITICAL WITHIN A COMMUNITY. IT'S GREAT TO GET SOMEONE A JOB. YES, MAKING SURE WE HAVE ACCESS THERE, THE PA PATHWAYS TO THE CAREER, BUT ACTUALLY BEING ABLE TO GET THERE, USUALLY THIS. MAKING SURE SOMEONE HAS CHILD CARE, HAS WHAT THEY NEED, HAS CONNECTION TO NAVIGATE THROUGH THE SERVICES THAT THEY MAY NOT BE A TABLEABLE TO GO THROUGH ON THE OWN IS CRITICAL. SO SUPPORTIVE OF THOSE COMMENTS MADE. APPRECIATE THE CLARIFICATIONS ON THE FUNDING FOR EACH OF THESE PROGRAMS. ONE OF THE THINGS I WA WANTED TO ASK WAS SO SOME -- I GUESS THINKING ABOUT THE EDUCATIONAL ASPECT TOO, RIGHT, TH THINKING ABOUT HEAD START, THINKING ABOUT EVEN THE DOMESTIC VIOLENCE PROGRAMS, WHAT OTHER PROGRAMS OVERLAP FOR DUPLICATED CLIENTS, I DON'T KNOW IF DUPLICATION IS RIGHT TO SAY, BUT WHAT WE'RE GI GIVING TO THEM AND S SEEING WHAT THE NEXT STEPS ARE FOR A LOT OF THEM. I THINK WE LOOK AT SOME OF THESE PROGRAMS, THEY'RE NOT IN ISOL ISOLATION, THEY SHOULDN'T BE CONSIDERED IN ISOLATION BECAUSE IT'S EASY FOR SOMEONE TO FALL OFF WHATEVER KIND OF FORM IT IS OF SUCCESS WITHOUT THE SUPPORT THERE, SO INTERESTED IN THE MEMO THAT'LL BE FOR FOR ALDERET COUNCILMEMBER'S REQUEST AND THE HUMAN SERVICES PROGRAM, WHATEVER THEY MAYBE, IT WOULD BE HELPFUL THERE ALONG WITH THE HHSC READY TO WORK, ET CET CETERA, I THINK ALL OF MY THINGS AS WELL. SO THANK YOU ALL SO MU MUCH. >> THANK YOU SO MUCH AS WELL. HAVE A GREAT DAY. >> GALVAN: ALL RIGHT. MOVING TO ITEM NUMBER 3, REPRODUCTIVE JUSTICE D DR. WOO. >> IS THIS THE MAGIC BUTTON? YES. OKAY. I FOUND THE BUTTON. SO THANK YOU. THIS IS US REPORTING BACK ON THE REPRODUCTIVE JUSTICE FUNDING THAT WAS APPROVED BY COUNCIL. AND THAT'S WHAT WE'RE GOING TO TALK ABOUT. SO REPRODUCTIVE JUSTICE, YOU SEE THE DEFINITION, ONE OF THE DEFINITIONS UP THERE, THIS WAS A MOVEMENT AND FRAMEWORK CREATED BY BLACK WOMEN IN 1984, IT'S THE RIGHT TO HAVE CHILDREN, NOT TO HAVE CHILDREN, TO NURTURE THE CHILDREN WE HAVE IN A SAFE AND HEALTHY ENVIRONMENT. COUNCIL ALLOCATED 500,000 FOR THIS IN SEPTEMBER OF 23 WE HAD THE RFP GO OUT AND METRO HEALTH CREATED THE FRAMEWORK -- A PREVENTATIVE FRAMEWORK BECAUSE THAT'S OUR PUBLIC HEALTH FRAMEWORK, SO IF, FOR INSTANCE, IT WENT UPSTREAM TO DOWNSTREAM, SO IF FOR INSTANCE YOUR ULTIMATE OUTCOME IS PREGNANCY, THAT'S DOWNSTREAM, THEN UPSTREAM OF THAT WOULD BE A HEALTHY RELATIONSHIPS, STABLE ECONOMIC -- ECONOMICS IN THE HOME, AND MIDSTREAM MIGHT BE SOMETHING LIKE TRAINING DOULAS. SO WE HAD 10 RESPONSIVE PROPOSALS, AND FOUR VENDORS SELECTED THAT YOU CAN SEE THERE, AND I ALSO WANT TO THANK METRO HEALTH WHO DID A LOT OF THIS WORK, NONE OF THE SELECTED VENDORS OFFERED ABORTION RELATED SER SERVICES. COUNCIL APPROVED THE VENDORS IN NOVEMBER OF 24, AND THE CONTRACTS RAN FROM NOVEMBER OF 24 TO NOVEMBER OF '25, AND THE EVALUATION PANEL E ENDED UP AWARDING JUST UNDER 500,000, $499,179. SO WHEN WE LOOK AT THE WORK UPSTREAM WE SEE EVIDENCE-BASED SEX EDUCATION IN SCHOOLS IN ISD AND NORTH SIDE ISD FOR 5,000 YOUTH, A NUMBER OF COMMUNITY WORKSHOPS YOU CAN SEE, SOME OF WHICH ARE STILL CONTINUING NOW UNDER A DIFFERENT FUNDER, AND A LOT OF DIFFERENT TOPICS, AND INFORMATION ON THE FAIRNESS WORKERS ACT IN MULTIPLE WORKSHOPS AND YOU CAN SEE A QUOTE FROM ONE OF OUR PARTICIPANTS, AND THAT IS A PICTURE OF A YWCA WORKSHOP, I BELIEVE. IN THE MIDSTREAM CATEGORY, WE HAD 30 DOULAS NOW ADDED TO OUR COMMUNITY CERTIFIED TO SERVED AS TRUSTED PROVIDERS IN HIGH NEEDS ZIP CODES, YOU CAN SEE A GRADUATING CLASS FROM LATCH THERE ON THE RI RIGHT, AND A QUOTE, 189 PEOPLE WHO GOT NAVIGATED TO STI CARE AND TREATMENT, 25 PEOPLE NAVIGATED TO BENEFITS, AND 50 LONG-TERM REVERSAL CONTRACEPTION DEVICES, IUDS THAT WERE PROVIDED AT NO CHARGE. AND THEN FINALLY, DOWNSTREAM, WE HAVE 240 PEOPLE RECEIVING DIRECT NO COST MATERNITY SUPPORTS, SO DOULAS, THERAPIES, ACCESSORY CUE [00:35:04] PUNCTURE, ASSISTANCE, AT NO COST DURING PREGNANCY AND POST PARTUM AND 800 PEOPLE RECEIVING STI TESTING RESULTING IN 113 INFECTIONS THAT WERE TREATED. THERE'S OUR SUMMARY. SO THAT'S 12,509 PEOPLE, AND IF YOU DIVIDE THAT INTO THE 500,000, IT'S JUST UNDER $40 PER PERSON BECAUSE PUBLIC HEALTH IS A GOOD VALUE. AND THAT'S WHAT I GOT. THANK YOU. >> GALVAN: THANK YOU. I LIKE THAT LAST COM COMMENT. ANYONE LIKE TO START THE CONVERSATION TODAY? COUNCILMAN WHYTE? >> WHYTE: THANK YOU, CHAIR. WELL, I'M HAVING FL FLASHBACKS TO MY FIRST YEAR ON COUNCIL. THIS SEEMED TO TAKE UP ALL THE OXYGEN IN THOSE FIRST -- THOSE FIRST FEW MONTHS. OBVIOUSLY, I HAD SERIOUS CONCERNS ABOUT THIS FUND WHEN IT WAS -- WHEN IT WAS PROPOSED DUE TO POTENTIAL LEGAL EXPOSURE AND ALL OF THAT, BUT I'M GLAD ULTIMATELY THE DOLLARS, YOU KNOW, WEREN'T DIRECTED TOWARDS ANY OUT OF STATE ABORTION CARE, AND IT WAS FOCUSED ON THE IS ISSUES THAT WE SEE HERE IN THE SLIDE SHOW. I DO WANT TO ASK THIS. IT LOOKS LIKE -- AND TELL ME IF I'M READING THIS WRONG, DR. WOO, BUT 12,500 PEOPLE SERVED, AND WE SPENT $500,000. SO MY ROUGH MATH IS TE TELLING ME THAT'S SOMEWHERE AROUND $40,000 A PERSON? >> $40. >> WHYTE: HUH? FORTY DOLLARS. HO DO$40 PER PERSON IS WHAT WE SPENT HERE? >> YES, SIR. >> WHYTE: RIGHT. RIGHT. FORTY DOLLARS PER PER PERSON, AND IT WAS ON THE COUNSELING THAT -- THE IUDS, AND SOME OF THIS -- THE STUFF ON THE DOWNSTREAM WAS WHERE MOST OF THE DOLLARS WERE SPENT. WERE WE ALWAYS GOING TO FOCUS MOST OF THE DOLLARS ON THE DOWNSTREAM? >> IN MY PUBLIC HEALTH DREAM WORLD, NO. WHAT WE TOOK IS WHAT THE VENDORS PROPOSED. LIKE, EACH OF THE VEN VENDORS PROPOSED A SUITE OF SERVICES THAT THEY WANTED TO PROVIDE, AND THEN THROUGH THE PRO PROCUREMENT PROCESS, YOU KNOW, YOU MAY REMEMBER WE HAD TO LOOK AT EXPERIENCE, AND, YOU KNOW, BACKGROUND, AND THEN WE ALSO HAD TO LOOK AT WHAT THEIR ACTUAL PROPOSAL WAS AND THEN PROCUREMENT, LOOK AT THE COST, AND THEN, YOU KN KNOW, WHEN YOU PUT THAT ALL THE IN THE SNOW GLOBE AND SHAKE IT OUT, THIS IS WHAT WE ENDED UP WITH. >> WHYTE: RIGHT. AND THAT WAS MY QUESTION BECAUSE I THOUGHT WHEN WE ORIGINALLY PROPOSED IT, THE MORE MONEY WOULD BE SPENT UP TOP. >> IT'S TRUE. WE GO WITH THE PROPOSAL, THAT'S PART OF THE P PROCUREMENT PROCESS, YEAH. >> WHYTE: OKAY. ALL RIGHT. SO IT WAS JUST SORT OF BASED ON WHAT WAS FOUND TO BE NEEDED? >> YES. >> WHYTE: YEAH. OKAY. MY SECOND QUESTION IS -- YOU KNOW, BEFORE WE SPEND -- IF WE'RE CONSIDERING SPENDING ANY FUTURE GENERAL FUND DOLLARS HERE, CAN STAFF GET US A LIST OF WHERE SOME OF THE SERVICES PROVIDED BY THIS FUND ARE ALREADY PROVIDED IN DIFFERENT PROGRAMS THROUGH BEXAR COUNTY AND OTHER AREAS? OTHER PROVIDERS? >> SO RIGHT NOW -- I MENTIONED THAT THE -- SOME OF THE CLASSES WERE PICKED UP BY UNITED WAY SA, BUT THE IDEA WAS THAT THESE ARE THINGS THAT ARE NOT ACTUALLY BEING DONE ELSEWHERE. WE REALLY LOOKED HARD FOR THAT -- I WOULD SAY THE SELECTION COMMITTEE LOOKED FOR THAT. SO EVEN FOR INSTANCE -- WHERE DID IT GO? THE SEX EDUCATION -- YOU KNOW, THE SAN ANTONIO AIDS FOUNDATION DOES DO SEX EDUCATION IN OUR SCHOOLS, BUT SPECIFICALLY, THIS ALLOWED THEM TO BOLSTER EDUCATION THAT WAS NOT BEING COVERED BY OTHER FUNDING THAT THEY HAD, YOU KNOW, THAT THEY WOULD HAVE HAD TO PULL BACK ON, IT ALLOWED THEM TO MAINTAIN SOMETHING. SO -- >> WHYTE: SO WIC AND HEALTHY START AND SOME OF THESE OTHER PLPLACES DON'T PROVIDE SOME OF THESE SERVICES? >> SO EVIDENCE-BASED SEX EDUCATION IN SCHOOLS IS NOT COMMONLY PROVIDED, UNFORTUNATELY, BUT N NONPROFITS. AND THEN THE WORKSHOPS. I -- WE -- THEY'RE NO NOT -- WE CAN LOOK UP -- I KNOW THESE WORKSHOPS WERE CREATED UNDER REPO JUSTICE. SO WHETHER THEY'RE CONTINUING NOW -- YOU KNOW, IT COULD BE WE LAID THE SEEDS AND THEY'RE CONTINUING UNDER THE ORGANIZATIONS TH THAT -- ONE OF THESE FOUR ORGANIZATIONS. [00:40:10] AND THEN THESE OTHERS I'M NOT AWARE -- THE DOULAS -- YOU KNOW, LATCHED WILL CONTINUE TO TRAIN DOULAS NOT UND UNDER -- BUT, YOU KNOW, WITHOUT THE LEVEL OF FUNDING THAT WE PROVIDED FOR SOME OF -- SO SOME PEOPLE COULD GET TRAINED AT NO COST. AND THEN SOME OF THESE DOWNSTREAM SERVICES, UNLESS THEY GET OTHER FUNDING, I DO NOT SIGH SEE THAT CONTINUING. >> WHYTE: OKAY. SO THESE ARE SERVICES THAT YOU DON'T BELIEVE ARE PROVIDED ELSEWHERE. >> I DON'T BELIEVE THAT THEY'RE PROVIDED AT NO COST. >> WHYTE: THAT WAS MY QUESTION. >> I DON'T BELIEVE THEY'RE PROVIDED AT NO COST. >> COUNCILMEMBER, WE COULD DO THAT ANALYSIS TO SEE WHERE THEY'RE SIMILAR, POTENTIALLY, AND OTHER AREAS IF THEY HAVE CONTINUED THESE SERVICES, WE CAN LOOK AT THAT AND GET BACK TO Y YOU. >> WHYTE: GOT IT. GOT IT. YEAH. THAT'S JUST WHAT I WANT TO CHECK ON. AND OTHER THAN THAT -- I MEAN, THOSE ARE REALLY MY QUESTIONS ON WHETHER THE -- YOU KNOW, THE $40 PER PERSON WE WERE HELPING, YOU FOUND TO BE IN LINE WHY MOST OF THE MONEY WAS DOWNSTREAM, AND IF THERE'S ANY OVERLAP WITH OTHER -- WITH OTHER PROVIDERS. SO I APPRECIATE THE PRESENTATION. >> GALVAN: THANK YOU COUNCILMAN. AND JUST REALLY QUICKLY, I SHARED SOME SIMILAR THOUGHTS THERE ABOUT JUST KIND OF WHAT'S THIS WORK SUPPLEM SUPPLEMENTING; RIGHT? THAT'S THE BIGGER POINT, HOW DOES THE WORK SCALE UP THESE PROGRAMS, THAT'S MY PERSPECTIVE OF IT, AND THAT'S WHAT'S CLEAR WITH THE PROGRAMS THAT THEY WERE MEANT TO ADD INTO THAT WORK, NOT REPLACE, SOME EXTRA SUPPORT HERE AND THERE, AND SO I WOULD BE INTERESTED IN SEEING, YOU KNOW -- AND IF IT'S JUST THIS, THEN THAT'S GREAT TO KNOW BUT IF 800 PEOPLE RECEIVE STI TE TESTINGINGS FROM THIS FUND WHO WOULDN'T HAVE RECEIVED IT AT ALL, THAT'S THE KEY POI POINT; RIGHT. >> YEAH. THAT'S A GOOD EXAMPLE. SO FOR INSTANCE THAT IS FOR THE SAN ANTONIO AIDS FOUNDATION, AND THEY GET FUNDING FROM DIFFERENT STREAMS LIKE ALL OF US DO; RIGHT? SO THE WAY FUNDING IS RIGHT NOW, IT COVERS SPECIFIC POPULATIONS, SO THEY HAD A STREAM THAT WAS NOT COVERED, SPECIFICALLY HETERO SEXUAL WOMEN AND NEEDED TESTING FOR CHLAMYDIA AND GONORRHEA FOR HETEROSEXUAL WOMEN NOT COVERED BY THEIR FUNDING STREAMS SO THAT WAS THE ANALOGY NOT EXPLAINING WELL FOR ALL OF THESE. WE WERE FILLING GAPS, NOT ADDING -- NOT DUPLICATING. >> GALVAN: THAT'S THE BIGGEST THING. WHEN LOOKING BACK, AND I THINK IT'S HELPFUL TO GET THE PARTNER GROUPS TO UNDERSTAND WHERE THE FULL ECOSYSTEM IS IN THE WORLD, BUT STI TESTING AND OTHER GENERAL PROGRAMS, AND I KNOW THE MAIN FOUR WE HELP FUND AS WELL, BUT IT'S HE HELPFUL TO UNDERSTAND OKAY THIS IS THE WORK THEY CAN DO AT THIS MOMENT AND THEY'LL SEE IMPACTS TO THEIR FUNDING BUT WHERE DO WE AS A CITY STEP IN, THE CONVERSATIONS WE BEEN HAVING AT BUDGET, MAYBE THEORETICAL, WHERE DOES THE GOVERNMENT STEP IN, AND FOR ME, THIS IS WHERE WE JUMP IN, THIS CAN BE DONE OTHERWISE HERE IS HOW WE SUPPORT THESE PUBLIC HEALTH CONCERNS BUT I WANTED TO ADD TO THAT CONVERSATION THERE. COUNCILMEMBER ALDERETE GAVITO. >> ALDERETE GAVITO: THANK YOU. THANK YOU FOR THIS PRESENTATION, AND ALSO THANK YOU FOR THE WORK THAT YOU ALL HAVE DONE FOR MANY AS WELL. JUST, YOU KNOW, I HAD A QUICK QUESTION OR WHOEVER. I REMEMBER THERE WAS TWO REPRODUCTIVE JUSTICE FUND THINGS. ONE -- AND I'M SORRY. CORRECT ME IF I'M WRONG. I THINK THE FIRST ONE WAS INITIATED BY COUNCILWOMAN CASTILLO, AND THAT WAS THE USE OF AND THEN THE SECOND ONE INITIATED BY COUNCILWOMAN WHAT ARE SIMILAR DID A THAT ENDED UP GOING NOWHERE. >> RIGHT BECAUSE THERE WAS A STATE LAW WENT INTO EFFECT THAT WE COULDN'T USE THAT FUND. >> ALDERETE GAVITO: RIGHT. BUT THAT $100,000 DID NOT HELP A SINGLE WOMAN. >> CORRECT. WE DIDN'T USE THAT. >> ALDERETE GAVITO: OKAY. GOT IT. SO TALKING ABOUT THE FIRST $500 FROM THE OFF SYSTEM SALES; RIGHT. >> CORRECT. >> ALDERETE GAVITO: AND WE KNEW GOING INTO IT THAT WOULD BE A ONE-TIME THING, THERE WAS NO TALKS OF THIS BEING REOCCURRING IN THE GENERAL FUND. >> CORRECT. A ONE TIME $500,000. BECAUSE OF THAT AMENDMENT. IT WAS AN AMENDMENT. >> ALDERETE GAVITO: RIGHT. YES. BY THE WAY, I SUPPORT I IT, AND, YOU KNOW, I WILL ALSO REITERATE BECAUSE I'M GOING TO REITERATE ALL THE TIME, I AM PRO-CHOICE. I HAVE TWO DAUGHTERS. I DO BELIEVE THAT THIS IS ESSENTIAL FOR A WO WOMAN'S HEALTH, BUT, YOU KNOW, I THINK WE DO RAISE A STRONG CONCERN WHEN WE TALK ABOUT THIS MONEY COMING IN FROM OUR GENERAL FUND BECAUSE THEN WE'RE RISKING A LOT OF OTHER FUNDS NOT COMING IN, AND THEN HOW DO WE FUND OUR NONP NONPROFITS AND HOW DO WE FUND OUR STREETS AND HOW DO WE FUND ALL OF THESE OTHER THINGS THAT THE COMMUNITY NEEDS. SO WE ALL KNOW -- I ME [00:45:04] MEAN, I'M NOT BEING POLITICAL HERE, BUT WE ALL KNOW THAT WE ARE IN A STATE THAT IS NOT KIND TO WOMEN AND NOT KIND TO WOMEN'S HEALTH, AND WE'RE GOING TO HAVE TO WORK AROUND THAT, BUT I THINK THAT IF WE'RE STRATEGIC ABOUT IT, IT IS THROUGH FUNDING N NONPROFITS WHO CAN DO THE WORK WITHOUT THE RISK. IF WE FUND -- IF THIS MONEY COMES IN THROUGH THE CITY, WE RISK G GETTING PENALIZED, AND THEN WE WILL BE WITH LESS POTS OF MONEY FOR OTHER NONPROFITS WHO DO SO MUCH GREAT WORK. SO I JUST WANT TO MAKE SURE THAT WE'RE ALL LEVEL SET ON THAT. AND I DO JUST WANT TO MAKE SURE THAT WE'RE -- THE NONPROFITS WHO WERE PART OF THE UPSTREAM, MIDSTREAM, AND DOWNSTREAM, NO DOUBT THEY DO AMAZING WORK, BUT THE EXPECTATIONS WERE SET THAT THIS WAS GOING TO BE JUST A ON ONE-TIME FUND. AND SO I JUST WANT TO MAKE SURE -- AND LISTEN, YOU KNOW, I WAS A N NONPROFIT EXECUTIVE DIRECTOR, I KNOW HOW HARD IT IS BUT IF THE EXPECTATIONS WERE SET CLEARLY, WE JUST NEED TO MAKE SURE THAT THAT IS PROCESSED, IS -- YOU KNOW, IS -- AND ALSO, TWO, THAT THE COMMUNITY KNOWS HEY, THEY'RE NO LONGER GETTING FUNDS FROM THE CITY SO HOW DOES THE REST OF THE CITY COME IN AND HELP SUPPORT? HOW DO WE AS INDIVIDUAL CONTRIBUTORS GO IN AND FUND THE NONPROFITS BECAUSE ONE OF THEIR FUNDING SOURCES IS GONE. THAT'S I THINK THE LARGER CONVERSATION WE NEED TO HAVE BECAUSE I THINK THE CITY JUST -- OBVIOUSLY WE'RE TALKING ABOUT OUR BUDGET DEFICIT AND TALKING ABOUT HOW WE HAVE TO TIGHTEN THE BE BELT, AND THEN WHEN WE PUT THE REST OF THE FUNDS AT RISK, THEN WE'LL BE IN MORE DIRE CONVERSATIONS. SO I THINK THE LARGER CONVERSATION, THE LARGER POINT IS WE KNEW THIS WOULD END, THE EXP EXPECTATIONS WERE CLEAR FROM THE GIT-GO, AND NOW AS A COMMUNITY, WE NEED TO SAY AS INDIVIDUAL CONTRIBUTORS NOT IN THE CITY ROLE, HOW DO WE KEEP THIS -- THESE FUNDS -- THE NONPROFITS DOING GREAT WORK ALIVE, AND HOW DO WE KEEP THEM FUNDED TO CONTINUE DOING THE GREAT WORK THEY NEED TO DO. SO THOSE ARE ALL OF MY COMMENTS. THANK YOU. >> GALVAN: THANK YOU. ANYONE ELSE? COUNCILMEMBER MEZA GONZALEZ. >> GONZALEZ: THANK YOU. THANK YOU FOR THE PRESENTATION AND ALL THE WORK THAT YOU'RE DOING WITH YOUR TEAM, DR. WOO. JUST A COUPLE OF QUESTIONS. YOU KNOW, I THINK OBVIOUSLY PARTNERING WITH THESE COMMITTED GROUPS WHO ARE ALREADY DOING THE WORK IS IMPORTANT TO DELIVER ON OUR GOAL AS A CITY, TO MAKE SURE THAT RESIDENTS HAVE ACCESS TO CARE BECAUSE THOSE RESIDENTS HAVE ACCESS TO CARE AND WILL CONTINUE HOPEFULLY TO BE PRODUCTIVE MEMBERS OF OUR COMMUNITY, THAT'S WHAT WE ALL WANT AT THE EARNED OF THE DAY, AND WHATEVER CONNECTIONS WE CAN PROVIDE, AND SUP SUPPORT, I THINK, IS IMPORTANT. AND SO ON THE -- THE FOUR SELECTED VENDORS, ARE EACH OF THEM PROVIDING UPSTREAM AND DOWNSTREAM OR SPECIALITIES IN THAT? OR . >> IT DEPENDS. SO SOME OF THEM -- SOME OF THE PROVIDED THINGS IN A COUPLE OF CATEGORIES, SOME OF THEM PROVIDED THINGS IN ONLY ONE CATEGORY. FOR INSTANCE, LATCH JUST TRAINED DOULAS, BUT ON THE OTHER HAND, THE YWCA DID PRESENTATIONS AND WORKSHOPS AND ALSO PROVIDED THE IUDS. SO IT DEPENDS. GONE GONE AND IS THERE CROSS COLLABORATION BETWEEN THE VENDORS? >> ABSOLUTELY THERE WAS. >> GONZALEZ: DO YOU HAVE AN EXAMPLE? >> THE CLASSES, I MENTIONED THOSE WERE N NEW, SO THE YWC, AND THE YWCA AND POWERHOUSE C COCRECREATED THOSE WORKSHOPS OTHER THAN SEPARATELY CREATING THEM FROM SCRATCH. >> GONZALEZ: OKAY. I THINK -- BECAUSE FU FUNDING IS AT RISK, I THINK IT'S IMPORTANT FOR US, WE'RE LOOKING AT COLLABORATIONS AND PARTNERSHIPS YOU'LL HEAR US SAY THAT A MILLION TIMES IN THE NEXT COUPLE OF MONTHS, WE'VE BEEN SAYING THAT, BUT MORE SO WHEN WE'RE IN A DEFICIT LIKE THIS, AND SO MEDICAL CENTERS, I'M LOOKING AT METHODIST, U UTSA HEALTH, PARTNERS HAVE YOU ENGAGED WITH THEM AT ALL? IS THERE OPPORTUNITY TO? >> SO AS PART OF THE CENTER FOR POLICY AND HEALTH IMPROVEMENT, ABSOLUTELY. THEY'RE PART OF THE WORK IN -- I'M TRYING TO THINK OF WHETHER THEY GO ACROSS ALL OF THE CATEGORIES OF THE COMMUNITY HEALTH IMP IMPROVEMENT PLAN, DEFINITELY THEY'RE INVOLVED WITH FOOD SECURITY. THEY ARE -- AND THEN HOUSING STABILITY IS AN OFFSHOOT OF THE FOOD STABILITY GROUP, ABSOLUTELY INVOLVED WITH BEHAVIORAL HEALTH AND MENTAL WELL BEING, AND I KNOW WE'VE GOT UNIVERSITY -- OH, YEAH, UTSA IS ALSO WORKING WITH US WITH PRENATAL CARE. SO YES. >> GONZALEZ: WONDERFUL. WELL THANK YOU FOR ALL THE WORK YOU'RE DOING AND TO YOUR TEAM. THANK YOU. >> GONZALEZ: THANK YOU, COUNCILWOMAN CASTILLO. >> CASTILLO: THANK YOU, CHAIR AND DR. WOO FOR THE PRESE PRESENTATION. I WANTED TO EMPHASIZE THE GREAT WORK OF ROUTINE WITH RFP PROCESS AND WORKING THROUGH AND DISPERSING FUNDS TO MAKE SURE THERE'S GREAT [00:50:03] IMPACT. I'M LOOKING AT PARTICULARLY FOR THE EVIDENCE-BASED SEX EDUCATION FOR OVER 5,000 YOUTH AND JUST THE OVERALL IMPACT THAT THAT HAS HAD IN OUR COMM COMMUNITY, AND AS YOU HIGHLIGHTED IN YOUR COMMENT, THIS ISN'T SOMETHING THAT WE NECESSARILY -- ESPECIALLY IN THE STATE OF TEXAS RECEIVE PUBLIC FUNDS TO HELP SUPPORT BUT WE KNOW THE IMPACT THIS HAS IN OUR COMMUNITIES. I DID HAVE A QUESTION FOR OUR CITY ATTORNEY. FOR EXAMPLE, WITH THE MIDSTREAM FUNDING THAT WE SEE ON SLIDE SIX, IF WE WERE TO REINSTATE THIS FUNDING, WOULD YOU SEE ANY LEGAL RISK WITH WHAT'S LAID OUT ON SLIDE SIX? SO IF FUNDING WERE TO BE REINSTATED THROUGH A BUDGET AMENDMENT AND THEN WE WORK THROUGH WHAT THE FUNDING SOURCE, WOULD THERE BE ANY LEGAL RISK ASSOCIATED WITH WHAT WE SEE ON SIX? >> TO BE HONEST, I'D HAVE TO LOOK AT THAT A LITTLE BIT MORE CLOSELY. I JUST -- THE INITIAL ANALYSIS, CROSS A I DON'T SEE A PROBLEM, BUT THIS HAVE TO RUN THROUGH THE REGULAR BUDGET PROCESS WHETHER IT'S ACCEPTABLE OR NOT. >> CASTILLO: I APPRECIATE THAT. BUT I WANTED TO RECOGNIZE WHAT'S GOING OUT IN TERMS OF THIS RFP AND WHAT'S BEING DISPERSED, I DON'T BELIEVE OUR CITY WOULD PUT US AT RISK BY UTILIZING THESE FUNDS. SO I WANT TO MAKE SURE THERE'S NOTHING RISKY ABOUT THE NONPROFITS WE'VE SERVED, AND IF WE WERE TO REINSTATE THE FUNDING I WOULD ASSUME WITH LEGAL ANALYSIS THAT IT WOULD NOT POSE A RI RISK, BUT I JUST WANTED TO EMPHASIZE, AGAIN, WE KNOW THAT PUBLIC HEALTH IS PUBLIC PRIORITY, IT'S NOT A NICE TO HAVE, AND WE HAVE A RESPONSIBILITY TO MAKE SURE THAT OUR COMMUNITY MEMBERS HAVE ACCESS TO SEX EDUCATION, HEALTHCARE, SO ON AND SO FORTH BECAUSE THAT'S HOW WE HAVE HEALTHY COMMUNITIES. IF WE WANT -- IF WE WANT A STRONGER ECONOMY, YOU HAVE TO HAVE A HEALTHY WORKFORCE. SO I JUST WANT TO HIGHLIGHT THAT IN INTERSECTION, AND OF COURSE MY MESSAGE TODAY WHETHER IT'S WITH THE SECOND ITEM, THIRD OR FOURTH, WE SHOULD BE R REINSTATING FUNDING TO SUPPORT OUR COMMUNITY FOR ACCESS TO HEALT HEALTHCARE, AND THEN OF COURSE IF IT IS AT RISK, WE SHOULD BE WORKING WITH OUR BEXAR COUNTY DELEGATION TO LOBBY AND ADVOCATE FOR SECURED FUNDING, BUT I WANTED TO THANK THE TEAM FOR THE WORK THEY'VE DONE ON THIS. THANK YOU, CHAIR. >> GALVAN: THANK YOU SO MUCH. ANY OTHER COMMENTS OR QUESTIONS ON THIS ITEM? WELL, GREAT. THANK YOU DR. WOO FOR THE PRESENTATION AND FOR THE ENTIRE TEAM, AND OF COURSE ALL OF OUR PARTNERS DOING THIS I INCREDIBLE WORK AND THE FOLK WHO IS ADVOCATED FOR THIS AS WELL. I DON'T THINK I HAVE TOO MANY OTHER QUESTIONS ON THIS. ONE OF THE THINGS I REALLY APPRECIATE FROM PUBLIC COMMENT EARLIER WAS THE CONVERSATION AROUND THE SOCIAL SAFETY NET WE HAVE LOCALLY, AND A LOT OF THAT IS EXACTLY THIS. AND WE CAN TALK ABOUT TIES TO ECONOMIC U UNCERTAINTY, IT'S PROGRAMS LIKE THESE THAT KEEP PEOPLE ALIVE, FRANKLY, KEEP PEOPLE SAFE, KEEP PEOPLE HEA HEALTHY, EDUCATED, READY TO STAY IN THE WORK WORKFORCE, ALL OF THE DIFFERENT THINGS COMING BACK TO THE SOCIAL SAFETY NET WE DO OUR BEST TO PROVIDE IN MOMENTS WHERE OTHER ENTITIES WON'T PROVIDE THAT, AND SO I THINK THAT'S SOMETHING THAT'S HELPFUL FOR OTHER COMMUNITY MEMBERS IN A LOT OF WAYS. NOT JUST THE DIRECT SUPPORT BUT THE HOLISTIC CARE FOR THE REST OF THEIR LIVES RIGHT. WHEN WE LOOK AT HOW WE OPERATE A CITY GOVERNMENT WE HAVE TO LOOK AT A LARGER SCALE AND NOT A ONE-OFF THING THAT WE WANT TO INVEST LONGER THAN THIS PERSON GOT AN STI TEST, NO, MAKE SURE THEY'RE HEA HEALTHY THEIR ENTIRE LIVES, HAVE BETTER RELATIONSHIPS, AND BETTER RELATIONSHIPS WITH THEIR KIDS IF THEY HAVE KIDS LATER ON, CHOOSE NOT TO. WHATEVER IT MAY BE, A LOT OF EXTERNAL FACTORS THAT COME INTO THIS, AND ULTIMATELY SUPPORT OUR ENTIRE PUBLIC HEALTH, AND THEREFORE OUR LARGER SOCIETY. SO I APPRECIATE THE WORK UP FRONT, IT'S PART OF THE LARGER PART HERE TO SUPPORT. ALL OF OUR FOLKS HERE. THANK YOU FOR THAT. THE ONLY THING I HAD WAS IF WE COULD GET THE ZIP CODES OF WHO WAS SERVED THROUGH THESE, I KNOW THIS IS -- SOME BARRIERS HERE AND THERE WITH THE REPORTING, BUT IF IT COULD BE A LARGE SCALE THAT WOULD BE HELPFUL OR HIGH LEVEL, THAT WOULD BE HELPFUL TO SEE WHO'S SERVED THROUGHOUT THE CITY FOR THIS FUNDING. YEAH. THAT'S IT. THANK YOU SO MUCH. AND INTO ITEM NUMBER 4 -- NO. FIVE. NO. FOUR. OKAY. SORRY. ITEM 4. MEDICAID 1115 UPDATE. CLAUDE, TAKE US AWAY. >> GOOD MORNING. AND THANK YOU FOR THE OPPORTUNITY TO PROVIDE THIS UPDATE REGARDING THE MEDICAID 115 WAIVER RESE RESERVES, THIS PRESENTATION IS PART OF A SERIES OF U UPDATES WE PROVIDED SINCE LAST OCTOBER, TODAY'S BR BRIEFING IS INTENDED TO SHARE PRELIMINARY REPRESENTATIONS ABOUT OUR PROGRAMS AND SOLICIT YOUR I INPUT AS WE PROVIDE OUR FY27 BUDGET PACKET. SO FOR REORIENTING FOR THIS PROCESS. KNOW THAT THE L THAT WAS [00:55:05] ESTABLISHED BACK IN 2011 IN ORDER TO HELP CONTROL COST AND IMPROVE THE STATE'S HEALTHCARE STRUCTURE, WITH COMMUNITY HEALTH, MENTAL AGENCIES WERE ENGAGED IN THE PROJECT. THE INITIAL FUNDING WE RECEIVED AND WITH COUNCIL'S APPROVAL BACK IN FY13, IT RAISED THE ANNUAL OPERATING BUDGET MORE THAN THEREUPON TO SUPPORT SIX NEW EXPANDED PROGRAMS ALIGNED WITH PRIORITIES ESTABLISHED THROUGH COMMUNITY HEALTH ASSESSMENT, IMPROVEMENT, PLAN AND SUPPORTED BY OUR DEPARTMENT OF STRATEGIC PL PLAN. KNOW THAT ALTHOUGH THE FU FUNDING HELPED TO ACCELERATE THE DEPARTMENT'S POPULATION BASED PREVENTION EFFORTS, THE PROJECT ITSELF ENDED IN SEPTEMBER OF 2021. SO IF YOU FAST FORWARD, OTHER THE YEARS, THE CITY HAS BUILT RESERVES FROM INCENTIVE PAYMENTS, WHICH ALLOWED THE PROGRAM TO CONTINUE OVER THE LAST FEW YEARS, WHICH INCLUDE THE PEAK YEARS OF THE PANDEMIC, WE'VE BEEN CONCERNED ABOUT THE FUND INITIALLY ABLE TO CONTINUE OVER THIS YEAR. OUR STAFF HAS BEEN TAKING A DEEPER DIVE INTO THE PRO PROGRAMS IN THIS RESERVE FUND. AS MENTIONED UNTIL THE FY26 MID YEAR FORECAST, ADDITIONAL RESERVES HAVE BEEN IDENTIFIED TO SUPPORT THE DEPARTMENT'S OPERATIONAL NEEDS WITHOUT MOVING TO THE GENERAL FUND. CURRENTLY, THE AMOUNT IS ESTIMATES AT $20 MILLION D DUED TO ACCRUED INTEREST, ACCRUED SINCE 2013, OUTAGES AND REDUCED PROGRAM EXPE EXPENSES. KEEP IN MIND THAT THERE ARE SEVERAL VARIABLES THROUGHOUT THIS PLANNING PROCESS, INCLUDING THE RIGHT SIZING OF PROGRAM ACCOUNTS AND EXPENSES WHICH ARE ONGOING, KNOW THAT THE PROPOSED FY27 DEPARTMENTAL BUDGET WILL BE PRESENTED TO FULL COUNCIL LATER THIS SUMMER. THIS MORNING'S DISCUSSION PROVIDES AN OPPORTUNITY TO SOLICIT YOUR INPUT AS WE DEVELOP OUR DEPARTMENTAL BUDGET. SO THIS SNAPSHOT, THIS SLIDE PROVIDES A QUICK SNAPSHOT OF OUR MEDICAID 1115 WAIVER R RESERVES AND THE ALLOCATION BUDGETED FOR THIS CURRENT FISCAL YEAR, IT AMOUNTS TO $8 MILLION, SUPPORTING DIFFERENT PROGRAMS AND A VARIETY OF CROSS CUTTING TEAMS AND FUNCTIONS AND AMOUNTS TO ABOUT 10% OF OUR OPERATING BUDGET THIS YEAR. SINCE LAST FALL, WE HIGHLIGHTED THE CHALLENGES EXPERIENCED BY SOME OF THE MOST IMPACTED PROGRAMS, YOU'VE HEARD. AND WE DID FORMAL PRESENTATIONS ON HEALTHY NEIGHBORHOODS, ORAL HEALTH, DIABETES. IN ADDITION THIS BUDGET SUPPORTS SOME INNOVATIVE PROGRAM TIED TO DISEASE, TRAUMA INFORMED CARE, VIOLENCE PREVENTION PROGRAM AS WELL AS CRITICAL OPERATION SUPPORT THAT INCLUDE THE REQUIREMENTS FOR MAINTAINING NATIONAL PUBLIC HEALTH AND AUGMENTS OUR CAPABILITIES RELATED TO CAPACITY TO MONITOR DISEASE PATTERNS. OVER THE NEXT FEW SLIDES, I'LL HIGHLIGHT A FEW EXA EXAMPLES OF THE NEWFECTION PROGRAMS AND SHARE FUNDING FRAMEWORK FOCUSED ON DISCUSSIONS HELD IN LAST WEEK'S GOAL SETTING SESSIONS SINCE LAST FALL. AGAIN, FOR YOUR CONSIDERATION THE CONSOLATION OF MANDATED PROGRAMS, PRIORITY PROGRAMS AND PROGRAMS PREVIOUSLY FU FUNDED BY THE GENERAL FUND, ADDITIONAL FACTORS FOR CONVERSATION WOULD INCLUDE PROGRAM OUTCOMES, HAVING A MULTIYEAR STRATEGY, LOOKING AT OUR COLLABORATIONS ON THE GROUND WITH OUR COMMUNITY PARTNERS, AND CITY MANDATES AS WELL AS POLICY PRIOR PRIORITIES. FOR THE REST OF THE PRESENTATION, I'M GOING TO HIGHLIGHT WHAT WE HAVE, AT LEAST TIED TO PROGRAMS. STAND UP SA, HIV PREVENTION AS WELL AS DIABETES PREVENTION EFFORTS. IT'S IMPORTANT TO UNDERSCORE THE NEED, THOUGH AS WE SEE THAT THERE'S A REFERENCE TO OUR SUPPORT FUNCTIONS, WHAT'S LESS VISIBLE TO THE WORK OF THE DEPARTMENT, EVEN THOUGH IT'S NOT LESS VALUABLE, JUST KNOW THAT THERE ARE OPERATIONAL NEEDS AND SUPPORTS AND CRITICAL FUNCTIONS THAT UNDERSCORE OUR ONGOING CAPACITY TO MONITOR DISEASES EFFEC EFFECTIVELY. IT SPEAKS TO THE ONGOING INVESTMENTS AND THE TRAUMA INFORMED CARE TRAINING, AND SPEAKS TO THE INVESTMENTS AND CONTINUED COMPLIANCE WITH REQUIREMENTS TO MAINTAIN OUR DESIGNATION AS A NATIONALLY ACCREDITED HEALTH DEPARTMENT, AGAIN ONLY EIGHT OTHER ACCREDITED HEALTH DEPARTMENTS HERE IN TEXAS. SO WITH THIS, YOU MAY RECALL -- AGO WE PROVIDED A BRIEFING ABOUT THE ORAL HEALTH IN FEBRUARY, JUST KNOW THAT OUR DEPARTMENT BEGAN THESE SERVICES MANY YEARS AGO, OVER 50 YEARS AGO, AND AT THAT TIME, THE SUPPORT WAS ANCHORED TO THE GENERAL FU FUND. KNOW THAT THE PROGRAM'S OPERATING BUDGET IS $2.5 MILLION AND SUPPORTS NEARLY 40 STAFF, AGAIN, A MIX OF TEMP STAFF AND CLINICAL STAFF AND PROGRAMMATIC STAFF, AND KNOW IF YOU FAST TOWARDS, OUR CURRENT SUPPORT, THE LINE SHARE OF THE PROGRAMS SUPPORTED BY THE MEDICAID 1115 WAIVER AND EXTERNAL GRANTS $2 MILLION WITH NOMINAL SUPPORT FROM THE GENERAL FUND ABOUT $400,000. TODAY THE ORAL HEALTH PROGRAM'S PURPOSE IS TO IMPROVE OVERALL HEALTH BY PROVIDING ORAL HEALTH SERVICES, INCREASING ACCESS TO DENTAL CARE FOR UNINSURED AND UNDERINSURED FAMILIES [01:00:04] AND PROVIDING EVIDENCE-BASED ORAL HEALTH EDUCATION. WE CURRENTLY DO THIS THROUGH A DELIVERY OF THREE INITIATIVES THAT INCLUDE HEAD START AND EARLY HEAD START OR HEALTH SERVICES, MILES TO SMILES, AND THE DENTAL ASSISTANCE PROGRAM. EACH YEAR WE SERVE OVER 17,000 CHILDREN AT NO COST TO FAMILIES, AND JUST KNOW THE COMPLIMENT TO THE MOBILE DENTAL HEALTH CLINICS, THE TEAM PROVIDES ORAL HEALTH EVALUATIONS TO CHILDREN AND ADMINISTERED FLOOR RIDE APPLICATION AND SEAL HASN'TS FOR CAVITIES AT NO COST FOR FAMILIES AND IN ADDITION TO THAT, WE PROVIDE CASE MANAGEMENT SERVICES TO PARTICIPANTS IN NEED AS WELL AS REFERRALS AND ASSISTANCE WITH COORDINATING DENTAL CARE AND ORAL HEALTH EDUCATION. AGAIN, THE IMPACTS. A LAPSE OF THIS FUNDING WOULD RESULT, BASICALLY IN THE ELIMINATION OF THIS PROGRAM, AND CRITICAL FUNCTIONS AND DOING THIS SERVICE, THEREFORE WE RECOMMEND CONTINUING THE FUNDING FROM THE MEDICAID 1115 RESERVES TO BE ALLO ALLOCATED TO SUPPORT THIS PROGRAM FULLY. SO THE NEXT EXAMPLE -- AG AGAIN, THIS PROGRAM, THE STAND UP SA ESTABLISHED BACK IN 2015 IS -- THIS IS A VIOLENCE PREVENTION -- VIOLENCE INTERVENTION AND PREVENTION PROGRAM. AGAIN, USING AN ASSET-BASED MODEL, SPEAKS TO THE INV INVESTMENTS, A LOT OF COMMUNITY HEALTH WORKERS OUT IN COMMUNITY, AND DEDICATED TO SUPPORTING INDIVIDUALS AND FAMILIES AFFECTED BY GUN VIOLENCE. IT HAS AN OPERATING BUDGET OF $15.5 MILLION WITH HALF COMING FROM THE GENERAL FUND AND SUPPORTS STAFF, MOST IMPACTED BY VIOLENCE, BUILD TRUST, PROVIDE MENTORSHIP AND RESIDENTS WITH CRITICAL SUPPORT AND RESOURCES. THEY FOCUS ON DE-ESCALATING CONFLICTS AND PREVENTING VIOLENCE BEFORE IT OCCURS. STANDUP SA PROVIDES SUPPORT TO VICTIMS OF SHOO SHOO SHOOTIN STABBINGS WITH HOSPITAL VISITSES AND ENCOURAGES POSITIVE LIFE CHOICES, AND MAINTAINS A STRONG PRESENCE IN THE COMMUNITY AND BU BUILDING MEANINGFUL RELATIONSHIPS, THE PROGRAM STRIVES TO CREATE SAFER NEIGHBORHOODS AND LONG-TERM POSITIVE CHANGE. STANUP SA OPERATES THROUGH THREE DISTINCT TEAMS, THE EAST SIDE TEAM, WEST SIDE TEAM, AND HOSPITAL INITIATIVE TEAM. LAST YEAR, THE PROGRAM EXPANDED EFFORTS BY ENGAGING YOUTH AT THE JUVENILE DETENTION CENTER AND AIMED AT FOSTERING PERSONAL GROWTH AND REDUCING FUTURE INV INVOLVEMENT IN VIOLENCE. THE HIGHLIGHTS INCLUDE FROM THE PAST FISCAL YEAR OVER 500 ALTERCATIONS INTER INTERRUPTED, 100 HOSPITAL PATIENTS SERVED, AND 100 YOUTH ENGAGED. AGAIN, THE EAST SIDE STEAMS SUPPORTED BY THIS PROGRAM, WE RECOMMEND CONTINUING FU FUNDING FROM THE MEDICAID 11125 WAIVER RESERVES BE ALLOCATED TO SUPPORT THE STANDUP SA PROGRAM. THE NEXT EXAMPLE, AGAIN, THIS IS NOT AN EXHAUSTIVE LIST, BUT INTENDED TO SHARE WITH YOU THE MOST IMPACTED PROGRAM SUPPORTED BY THE MEDICAID 1115 RESERVES, THE STI CONTROL AND PREVENTION PROGRAM HAS AN OVERALL OPERATING BUDGET AT $9.5 MILLION AND INCLUDES A MIX OF THE GENERAL FUND GRANTS AND MEDICAID WAIVER FUNDS AND SUPPORTS 58 STAFF AND PROGRAM. THERE ARE FOUR COMPONENTS TO THIS PROGRAM THAT ARE FUNDED WITH THE MEDICAID 1115 FU FUNDING SPECIFICALLY, IT'S THE STI CLINIC, MOBILE O OUTREACH TEAM, THE SYPHILIS TEAM, AND THE HEALTHY BEATS PROGRAM. THE STI -- CONTROL AND CLINIC IS CRUCIAL TO PROVIDE A WAY FOR PATIENTS TO IDENTIFY THROUGH PUBLIC HEALTH INVESTIGATIONS CONDUCTED BY METRO HEALTH TO BE SCREENED QUICKLY AND OFFICER PREVENTIVE TREATMENT EXPOSURE. THE MOBILE OUTREACH TEAM, ANOTHER COMPONENT, PROVIDES SCREENING AND TREATMENT OPPORTUNITIES THROUGHOUT THE COMMUNITY AT DIFFERENT EVENTS, TA TARGETED SCREENINGS OF HIGH RISK POPULATIONS OR IN RESPONSE TO INVESTIGATION FINDINGS CONDUCTED BY DISEASE INTERVENTION SPECIALIST. THE HEALTHY BEATS COMPONENT IS ONE THAT PROVIDES CASE MANAGEMENT ON A VOLUNTARY BASIS TO ANYONE WHO IS PREGNANT AND HAS BEEN DIAGNOSED WITH SYPHILIS OR AT RISK OF BEING EXPOSED TO SYPHILIS THROUGH PREGNANCY. AND FINALLY THE TEAM REVIEWS AND INVESTIGATES ALL REPORTS OF BABIES BORN WITH POSITIVE SYPHILIS TO SEE IF THEY WERE BORN WITH CONGENITAL SYPHILIS. AGAIN, WHAT WE SERVED OVER THE PAST FISCAL YEAR. OVER 14,000 INDIVIDUALS SERVED, AND 3600 TREATED WITH SYPHILIS. WE CONDUCT OVER 6,000 SYPHILIS INVESTIGATIONS AND WE FOUND THAT 161 CONGENITAL SYPHILIS INVESTIGATIONS WERE CONDUCTED BY OUR TEAM. FOR THIS, THE RECOMMENDATION IS TO SUPPORT THE MANDATED COMPONENTS OF THIS PROGRAM. AGAIN, IF YOU LOOK AT OUR FUNCTION SPECIFIC TO THE CLINICAL SERVICES AND OUR CCONGENITAL SYPHILIS INVESTIGATIONS, THEREFORE WE RECOMMEND CONTINUED FUNDING [01:05:04] FROM THE MEDICAID 1115 WAIVER RESERVES BE ALLOCATED TO SUPPORT THE CLINICAL SERVICES AND THE CONGENITAL SYPHILIS INVESTIGATIONS. AND LASTLY, AGAIN, BY WAY OF THIS UPDATE, THIS PROGRAM, THE DIABETES PROGRAM WAS LAUNCHED BACK IN 2013. IT'S ANCHORED TO OUR DIABETES -- OUR CHRONIC DISEASE SECTION AT OUR DEPARTMENT, AND IT PROVIDES FREE DIABETES PREVENTION AND SELF-MANAGEMENT EDUCATION WORKSHOPS ACROSS THE CITY. THE PROGRAM ITSELF IS CURRENTLY FUNDED BY A NUMBER OF DIFFERENT STREAMS THAT INCLUDE THE MEDICAID 1115 WAIVER, THE GENERAL FUND, AND THE STATE GRANT. ABOUT ONE DOZEN STAFF SUPPORTED BY THIS -- BY THESE DIFFERENT FUNDING STREAMS, JUST KNOW THAT MOST OF THE STAFF ARE SUPPORTED BY THE MEDICAID 1115 WAIVER. THE PROGRAM OFFERS NO COST TO DIABETES PREVENTION AND SELF-MANAGEMENT EDUCATION WORKSHOPS ACROSS THE CITY. AGAIN, WORKSHOPS ARE HELD AT COMMUNITY CENTERS, SENIOR CENTERS, PLACES OF WORSHIP. BUSINESSES, LIBRARIES, AND A WHOLE HOST OF COMMUNITY SI SITES, IT'S IMPORTANT TO ACKNOWLEDGE THIS UNIT ANCHORS THE INSULIN ASSISTANCE PROGRAM WHICH IS SUPPORTED BY OUR GENERAL FUND. WITH THIS IN MIND, WE RECOMMEND FUNDING THE MEDICAID THAT -- THE MEDICAID 1115 WAIVER RES RESERVES SUPPORT THE EDUCATIONAL AND OUTREACH COMPONENT OF THIS PROGRAM. THIS ALLOWS US TO FOCUS ON OUR PRIMARY PREVENTION EFFORTS AND OUR ONGOING COLLABORATIONS WITH CLINICAL AND NONPROFIT LIKE YMCA, SAVE CLINIC, AND METHODIST HEALTHCARE MINISTRIES. SO FOR THIS MORNING, IN CLOSING, JUST KNOW THAT OUR GLOBAL RECOMMENDATION IS TO ESTABLISH A GLIDE PATH THAT ALLOWS US TO CONTINUE FU FUNDING CERTAIN FRAMEWORKS BASED ON FRAMEWORK THAT WAS DISCUSSED DURING LAST WEEK'S GOAL SETTING SESSION, KNOW THE FUNDING WILL ALLOW US TO CONTINUE SELECTED PROGRAMS AND CRITICAL CROSS CUTTING FUNCTIONS THAT INCLUDE AUGMENTS OUR DATA ANALYTICS, MAINTAINING OUR DESIGNATION AS NATIONALLY ACCREDITED HEALTH DEPARTMENT AND ENS ENSURING THAT WE'RE IN COMPLIANCE WITH ALL THE FUNCTIONS AS REQUIRED AND MANDATED BY LAW. OUR NEXT STEPS WOULD INCLUDE INCORPORATING TODAY'S FE FEEDBACK AS WE DEVELOP OUR BUDGET FOR THE NEXT FISCAL YEAR TO BE PRESENTED TO FULL COUNCIL LATER THIS SUMMER, SO YOUR COMMENTS TODAY ALLOW US TO FACTOR IN KEY CONSIDERATIONS AS WE PRIORITIZE PROGRAMS AND FUNCTIONS AT THE DEPARTMENT TO MITIGATE BURNOUT AND TO MINIMIZE A DISRUPTION OF SERVICES. SO FOR THAT, I WANT TO THANK YOU FOR ALLOWING US TO BRING YOU UP TO SPEED. AND OPEN IT UP FOR QUES QUESTIONS. >> GALVAN: THANK YOU SO MUCH. DR. JACOB. REALLY APPRECIATE THE PRESENTATION. I KNOW WE HAD A LITTLE SNAPSHOT LAST FRIDAY ABOUT THIS PARTICULAR ITEM. AND SO THIS WAS HELPFUL TO GET INTO MORE OF THE WEEDS OF IT. JUST A QUICK NOTE FOR THE COMMITTEE, OF COURSE WE HAD DIABETES PROGRAM AND ORAL HEALTH COME TO BE PRESENTED HERE -- OR LATE LAST YEAR. STANDUP SA AND THE HIV SYPHILIS PREVENTION PROGRAMS WE'LL BE LO LOOKING INTO THE NEXT COUPLE MONTHS FOR MORE DETAIL ON THOSE. ONE QUICK THING I WANTED TO ASK BEFORE I OPEN IT UP WAS ON THE DEEP DIVE PORTION, I KNOW WE TALKED A LITTLE BIT ON FRIDAY ABOUT WHAT THAT FULLY ENTAILS. COULD YOU TALK MORE ABOUT HOW THESE PROGRAMS WERE SELECTED, WAS IT BASED ON FUNDING, WAS IT BASED ON PRIORITY BY THE COUNCIL, OR WHAT WAS THE KIND OF BACKGROUND WITH THAT? WHAT GOES INTO A DEEP DIVE? >> SURE. COUNCILMEMBER THANK YOU SO MUCH. SO JUST TO RECAP, IN THE BEGINNING -- AS WE ST STARTED THIS YEAR, WE ANTICIPATED THE FUNDING WOULD RUN OUT ON SEPTEMBER 30, SO WE STARTED LOOKING AT WHAT PROGRAMS -- YOU KNOW, HOW -- WHAT PROGRAMS ARE FUNDED THROUGH THE MEDICAID WAIVER, AND THEN AS PARKING LOT OF, THAT WE WENT BACK AND LOOKED -- DID A FULL RECONCILIATION OF THE PROGRAM, AND WE'RE STILL FINALIZING THAT, SO I WANT TO BE CLEAR THAT WE'RE -- THE NUMBERS MAY CHANGE SLIGHTLY. BUT WHAT WE DID IS AS PART OF THAT, BASED ON WHAT COUNCIL DISCUSSED LAST WEEK, IN TERMS OF WHAT OUR MANDATED SERVICES, WHAT ARE PRIORITY SERVICES, WE LOOKED AT THOSE FUNC FUNCTIONS, AT THOSE PROGRAMS BEING FUNDED OUT OF MEDICAID WAIVER, AND CAME UP WITH THESE RECOMMENDATIONS, WE SAW OUR HIV, SYPHILIS, A MANDATED PROGRAM, WE WANT TO FUND PORTIONS OF THAT PROGRAM, STANDUP SA AS WELL AS THE ORAL HEALTH PROGRAM BECAUSE BASED ON OUR CONVERSATION WITH THIS COMMITTEE LAST -- WHEN WE DID THE ORAL HEALTH, WE UNDERSTOOD THAT THIS WAS A PRIORITY AS WELL. DOES THAT HELP ANSWER YOUR QUESTION? >> GALVAN: IT'S A MIXTURE TOO RIGHT. PRIMARILY PRIORIT PRIORITIZATION, WHAT FUNDING IS AVAILABLE IN THIS BUDGET, I KNOW A LOT IS REIMBURSEMENT DOLLARS, BUT THE COST. >> YES. SO THESE -- THIS IS A LITTLE BIT DIFFERENT BECAUSE IT'S INCENTIVE PAYMENTS WE RECEIVED BECAUSE WHEN WE RECEIVED THE MONEY IN 2013, IT ALLOWED US TO -- AS PART OF THIS PROGRAM, WE EXPANDED PROGRAMS OR CREATED NEW PROGRAMS TO ADDRESS HEALTH NEEDS IN THE COMMUNITY. >> GONZA >> GALVAN: GOT IT. [01:10:02] >> SO WE'RE LOOKING AT WHAT ARE THE PROGRAMS THAT WE HAVE THAT ARE MANDATED PRIORITY OR FUNDED TO THE GENERAL FUND PRIOR TO 2013, WHICH IS THE ORAL HEA HEALTH. >> GALVAN: GOT IT. THAT'S HELPFUL. THAT WAS ONE OF THE BIGGEST POINTS, I WANTED TO MAKE SURE HOW THAT PROCESS WENT THROUGH AND WHAT THE NEXT STEPS ARE. SO GLAD TO HEAR WE HAVE A LITTLE BIT OF FLEXIBILITY AND OPTIONS AVAILABLE THROUGHOUT THE SUMMER, BUT ALSO THOSE WILL BE WORKED ON. DON'T WANT TO GET AHEAD OF OURSELVES. >> SURE. AND ONE THING WE LOOKED AT WAS HOW TO CONTINUE THE PROGRAMS ON A MU MULTIYEAR, FOR AS LONG AS A GLIDE PATH AS WE CAN. SO THAT'S WHY WE'RE RECOMMENDING TO SUNSET SOME OF THE PROGRAMS, BUT THAT WILL ALLOW US TO FUND SOME OF THESE PRIORITY AND MANDATED PROGRAMS IF ARE A LONGER PERIOD OF TIME. >> GALVAN: GOT IT. >> WITHOUT THE GENERAL FUND SUPPORTING IT. >> GALVAN: RIGHT. THANK YOU, JUSTINA. ANYONE WANT TO START THE COUNCIL CONVERSATION? COUNCILMAN WHYTE. >> WHYTE: THANK YOU FOR THE PRESENTATION. THESE PROGRAMS. STANDUP SA, CHILDREN'S ORAL HEALTH, ALL OF THEM DO GREAT WORK AND SERVE A LOT OF PEOPLE IN THE COMMUNITY. MOVING FORWARD, I OF COURSE WANT TO MAKE SURE WE'RE BEING GOOD STEWARDS OF TAXPAYER DOLLARS. SAME QUESTION I SORT OF ASKED A MINUTE AGO ON THE REPRODUCTIVE JUSTICE STUFF, ARE THERE ANY OTHER ORGANIZATIONS, BEXAR COUNTY, UNIVERSITY HEALTH, NONPROFITS OR OTHER DEPARTMENTS DOING SIMILAR WORK THAT COULD POTENTIALLY ABSORB THESE SERVICES? >> WE WORK -- THANK YOU FOR THE QUESTION, WE DO WORK WITH A NUMBER OF COMMUNITY PARTNERS, AND IT DEPENDS ON THE PROGRAM OR INITIATIVE, WE HAVE DIFFERENT COLLABORATIONS ON THE GROUND, SO I RATTLED OFF AT LEAST SOME OF THE N NONPROFITS, SO WORK WITH THE CENTER OF HEALTH EMPOWERMENT, THE SAVE CLINIC, THE SCHOOL DISTRICTS, THE COMMUNITY PROVIDERS, THE FEDERALLY QUALIFIED HEALTH CEN CENTERS, SO DEPENDING ON THE DISEASE PATTERN OR PROGRAMMING, WE DO HAVE DIFFERENT PARTNERSHIPS ON THE GROUND, INCLUDING THE COUNTY. >> WHYTE: OKAY. AND OTHER GRANT OPPORTUNITIES AND MODELS WE CAN LOOK AT AS THIS PHASES OUT. >> TRUE. AND OVER THE LAST YEAR AND A HALF, THE BIGGEST CONCERN HAS BEEN ABOUT THE INSTABILITY OF THE FEDERAL GRANTS TO SUPPORT THIS WORK, SO THIS WAS SPECIFIC TO THE MEDICAID 1115 REZ SERVES UNIQUE IN AND OF ITSELF, SO LOOKING AT IMPACTS OF PROGRAMS ON THE GROUND. >> WHYTE: THANKS. >> GALVAN: ANYONE ELSE HAVE THOUGHTS OR QUESTIONS ON THIS? >> THANK YOU FOR THE PRESENTATION. I AGREE THESE PROGRAMS ARE SO IMPORTANT FOR OUR COMMUNITY AND DISTRICT 8 IS PROBABLY THE MOST DIVERSE DISTRICT IN THE CITY, SO MAKING SURE ESPECIALLY ON THE ORAL HEALTH SIDE, MAKING SURE FOLKS COMING INTO OUR COMMUNITY WHO DON'T HAVE AS MANY PREVENTIVE OPTIONS HAVE THEM HERE, SO THAT WE'RE SUPPORTING AND CONNECTING THEM TO THOSE RESOURCES IS IMPORTANT. I JUST HAD A QUESTION ON THE RESERVES BECAUSE WE HAVE TALKED ABOUT THE DEEP DIVE AND IT'S COME UP A LOT RECENTLY. WE HAD RESERVES, I DON'T WANT TO READ THE SLIDE DIRECTLY, BUT THE RESERVES, WE WERE USING THOSE FROM '22 TO '26, A SET OF RESERVES, RIGHT? THEN WE HAVE TAKEN A DEEP DIVE INTO FINDING MORE RESERVE FUNDING. SO WHERE ARE WE, WHERE DO WE FIND THAT EXACTLY? >> JACOB: OKAY. SO JUST KNOW THAT THERE ARE -- WE FOCUS ON PROGRAM EXPENSES YEAR OVER YEAR WHICH IS WHAT WE PRESENT AND GETS ADOPTED EACH YEAR. WE DO KNOW THERE'S BEEN AN INTEREST-BEARING ACCOUNT THAT HAS BEEN ACCRUING INTEREST OVER THE COURSE OF THE LAST 12 OR 13 YEARS. BESIDES SALARY SAVINGS, WE WERE ABLE TO COBBLE THIS DOLLAR AMOUNT WHICH IS WHY IT'S AN ESTIMATED AMOUNT, THE $20 MILLION THAT WAS ANNOUNCED A FEW WEEKS AGO. SO IT'S NOT IN ONE FUND. IT'S NOT IN ONE CENTER. IT'S LITERALLY TIED TO PROGRAMS THIS WERE APPROVED BY THE STATE. SO BECAUSE OF THE INCENTIVE PAYMENT STRUCTURES, THERE ARE NUANCES TO THE FINANCING. WE DON'T HAVE ANY OTHER FUND LIKE THIS BUT YES, WE HAVE BEEN DOING OUR DUE DILIGENCE AND -- >> GONZALEZ: IF ONLY WE DID. >> JACOB: I GOT YOU. >> GONZALEZ: JUST FOR MORE CONTEXT, WHEN WE WERE, IN 2013 WHEN WE DID APPROVE THIS, WHAT WAS THE BIGGER GOAL OR I MEAN, THAT'S A HARD QUESTION BUT WAS THERE SOMETHING HAPPENING AT THE STATE LEVEL? >> JACOB: AGAIN, WE WERE ONE OF A NUMBER OF PARTNERS, LOCAL HEALTH DEPARTMENTS, MENTAL HEALTH PROVIDERS, THAT WERE INVITED TO PARTICIPATE IN THE DEMONSTRATION, WHICH ENDED YEARS AGO. >> GONZALEZ: YEAH. >> JACOB: SO WE HAVE BEEN MANAGING THESE RESERVES, THIS ONE FUND, AND IT'S ALLOWED US TO NOT ONLY EXPAND BUT ADD NEW PROGRAMS LIKE THE EXPANSION OF STANDUP SA. >> GONZALEZ: AS PART OF THE PROGRAM, WE ARE REALLY [01:15:01] LOOKING AT INNOVATIVE WAYS TO PROVIDE HEALTH SERVICES. THEY LOOKED AT HEALTH PROVIDERS IN GENERAL AND HOW WE COULD EXPAND SERVICES, MAKE THEM BETTER, INNOVATIVE WAYS, SO WE WERE GETTING THOSE PAYMENTS AS WE LOOKED FOR WAYS WE COULD BETTER PROVIDE HEALTH SERVICES TO THE COMMUNITY. ONE LAST QUESTION, ON STANDUP SA, I'M INTERESTED IN THE HOSPITAL INITIATIVE TEAM. CAN YOU SHARE A LITTLE MORE ABOUT THAT? >> JACOB: SURE. IT'S ONE OF THE SMALLEST TEAMS THAT WE HAVE. IT'S A RELATIVELY NEW INITIATIVE. WE DO WORK WITH THE PROVIDERS ON THE GROUND. THIS WAS, BASED ON OBSERVATIONS FROM OUR CLINICAL PROVIDERS THAT WE NEEDED TO HAVE BETTER NEXUS WITH PATIENTS WHO ACCESS THE HEALTH CARE SYSTEM. SO I WOULD SAY THAT THE MORE ROBUST TEAMS ARE THE EAST AND WEST SIDE TEAM BUT THE HOSPITAL TEAM IS A SMALLER UNIT AND IT'S JUST A COUPLE YEARS IN THE MAKING, AND IT'S TIED TO THE HOSPITAL NETWORKS HERE IN THE CITY. >> GONZALEZ: IS IT PUTTING OURSELVES IN THE HOSPITAL? >> JACOB: SO THE MECHANICS OF IT, HAVING A DEDICATED STAFF PERSON IN THE EMERGENCY DEPARTMENT BUT ALSO WORKING WITH THE PROVIDERS IN TERMS OF SOME OF THE CLIENTELE THAT COME IN THAT ARE VICTIMS OF WHETHER IT'S A SHOOTING OR ANY OTHER ACUTE INJURY. IT'S SOMETHING THAT WE'VE IDENTIFIED AS AN OPPORTUNITY AND A GAP BUT AGAIN, IT'S THE SMALLEST OF THE THREE TEAMS THAT WE HAVE. >> GONZALEZ: OKAY. THANK YOU SO MUCH. APPRECIATE IT. >> JACOB: SURE. >> GALVAN: COUNCIL MEMBER CASTILLO? >> CASTILLO: THANK YOU, CHAIR. THANK YOU, DR. JACOB, FOR THE PRESENTATION. ALSO WANTED TO EXPRESS MY GRATITUDE FOR JAMIE AND THE FOLKS WHO GAVE PUBLIC COMMENT, WRITTEN COMMENT, RATHER, NADIA, EMMA AND GRACIE, IN TERMS OF THE IMPACT OF THESE PROGRAMS. I APPRECIATE HOW THESE PRIORITIES WERE IDENTIFIED BASED OFF OF PAST CONVERSATION AND I'M LOOKING AT THE LIST AND THEY ARE VERY VITAL TO OUR COMMUNITIES, PARTICULARLY THE INNER WEST SIDE. JUST WANTED TO HIGHLIGHT AND EXPRESS MY GRATITUDE TO DR. JULIUS WITH THE DIABETES PREVENTION CONTROL PROGRAM, SEEING THERE'S BEEN A 62% OF PARTICIPANTS WHO COMPLETED THE PROGRAM SAW REDUCTION OF THEIR RISK OF DEVELOPING DIABETES WHICH IS VERY IMPACTFUL. I'M HOPEFUL WITH SOME OF THE CHANGES THAT WE'VE SEEN IN TERMS OF WHAT YOU CAN PURCHASE WITH SNAP BENEFITS WILL SEE BETTER OUTCOMES AS WELL AND THE INTERSECTION OF DENTAL CARE WE SEE WITH OUR YOUTH. PLEASED TO SEE THOSE ARE PRIORITIZED. AGAIN, AS JAMIE ARTICULATED WELL IN HER PUBLIC COMMENT JUST THE OVERALL IMPACT TO HAVING ACCESS TO HEALTH IN OUR COMMUNITIES. IT IS, NOII KNOW THIS IS Y'ALL'S JAM, I'M PREACHING TO THE CHOIR, BUT WANTED TO REEMPHASIZE THE IMPORTANCE OF THAT WORK. I WAS ALSO INTERESTED WITH THE STANDUP SA PROGRAM, SOMETHING THAT OUR TEAM CONTINUES TO ADVOCATE FOR. I WAS INTERESTED TO SEE THE WORK THAT Y'ALL DO WITHIN THE JUVENILE AND IF THERE'S OPPORTUNITY I WOULD LOVE TO JOIN YOUR TEAM TO SEE SOME OF THAT RELATIONSHIP BUILDING AND WHAT THAT WORK LOOKS LIKE. BUT JUST SUCH IMPACTFUL WORK. PLEASED TO SEE THAT FUNDING HAS BEEN IDENTIFIED TO SUPPORT THE CONTINUATION OF THIS WORK. BUT MY ONLY QUESTION IS CAN YOU REMIND US HOW MANY EMPLOYEES ARE SUPPORTED THROUGH THIS FUND? >> JACOB: STANDUP SA SPECIFICALLY? >> CASTILLO: WITH EVERYTHING SUPPORTED. >> JACOB: WE BUDGETED OVER 80 STAFF FOR THE CURRENT FISCAL YEAR. WE CURRENTLY HAVE ABOUT 75, 76 STAFF. WE HAVE A FEW VACANCIES BUT THAT'S GLOBALLY FOR OUR SUPPORTED BY THE MEDICAID 1115 WAIVER. AGAIN, IT'S IMBEDDED, INTEGRATED AS PART OF OUR OPERATING BUDGET BUT $8 MILLION WAS BUDGETED AND OVER 80 STAFF FOR THIS CURRENT FISCAL YEAR. >> CASTILLO: THANK YOU FOR THAT CLARIFICATION. I THINK THE 75 AND THE TOTAL OF 80, THESE ARE POSITIONS THAT WE CAN'T AFFORD TO LOSE. IT'S NOT ABOUT HOW CAN WE AFFORD TO COVER THE COST. IT'S LIKE WE CAN'T AFFORD TO LOSE THESE POSITIONS IN OUR COMMUNITY. BUT THOSE ARE ALL MY COMMENTS. THANK YOU, DR. JACOB. THANK YOU, CHAIR. >> GALVAN: COUNCIL MEMBER ALLED RET GAVITO? >> GAVITO: THANK YOU, CHAIR. THANK YOU FOR THE PRESENTATION. THE YES. I KNOW THE ORAL HEALTH PROGRAM, I THINK WE ALL MENTIONED HAS A HUGE IMPACT ON THE COMMUNITY. SO HAVE THESE OTHERS. SO BUT I DO WANT US TO BE CLEAR. IF WE ARE GOING TO CONTINUE FUNDING THESE PROGRAMS, THEN WHAT IS NOT GOING TO GET FUNDED? WHAT PROGRAMS ARE NOT GOING TO BE FUNDED? >> JACOB: AGAIN, WE ARE DOING OUR ANALYSIS ACROSS A SPECTRUM OF THESE DIFFERENT PROGRAMS BUT WE WOULD END UP FORFEITING THE NON-MANDATED COMPONENTS, FOR EXAMPLE. OUR ALGORITHM IS LOOKING AT WHAT WE HAD HISTORICALLY INVESTED IN. THE ORAL HEALTH PROGRAM IS PROBABLY THE CLEANEST TO TALK ABOUT, THE LION'S SHARE, OVER 85% OF THAT BUDGET IS ANCHORED TO THE MEDICAID 1115 WAIVER. IF YOU IMAGINE LOSING ALL THAT CAPACITY, BASICALLY UNDERCUTS THAT ENTIRE PROGRAM. >> JUST TO CLARIFY. WHAT WE WOULD BE RECOMMENDING IS ELIMINATING PIECES OF THE MOBILE OPERATIONS TEAM FOR THE STI CLINIC, ALSO HEALTHY NEIGHBORS. THOSE ARE THE TWO MAIN [01:20:03] PROGRAMS. AND SOME OF THE SUPPORT OPERATIONS AS WELL. >> GAVITO: THAT MAKES SENSE, THANK YOU. ALSO, WHAT IS THE PLAN FOR NEXT YEAR IF AND WHEN THE RESERVES RUN OUT? >> JACOB: RIGHT NOW, BASED ON WHAT WE HAVE ESTIMATED, WE ARE LOOKING AT A MULTI-YEAR, AGAIN, GLIDE PATTERN WHICH IS WHY THE REFERENCE TO SUNSETTING COMPONENTS STRETCHING THE DOLLARS AS MUCH AS WE CAN WITHOUT ADDING MORE DURESS TO STAFF BUT ALSO CURTAILING CERTAIN SERVICES LIKE MOBILE OUTREACH TEAM. THIS IS ONGOING ANALYSIS AND THAT'S WHAT WE WOULD BE PRESENTING TO FULL COUNCIL THIS SUMMER, OUR ENTIRE BUDGET COMPLEMENT. >> GAVITO: OKAY. THANK YOU. THANK YOU FOR THAT. THAT HELPS. THOSE ARE ALL MY COMMENTS. >> GALVAN: THANK YOU. ANYONE ELSE HAVE ANY QUESTIONS OR COMMENTS ON THIS? GREAT. WELL, THANK YOU FOR THE PRESENTATION. THANK YOU FOR ALL THE WORK TO GET US TO THIS POINT. I KNOW IT'S A REALLY INCREDIBLE PROGRAM THAT I KNOW MYSELF, I'M EAGER TO SEE HOW WE CONTINUE TO MAINTAIN. I KNOW A LOT OF COUNCIL MEMBERS ARE. I HAVE ONE LAST QUESTION. ON THE MENTAL HEALTH COMPONENT, ON SLIDE FOUR, WHAT GOES INTO THAT? WAS THAT MORE INTERNAL FOR STAFF, THE KIND OF TRAUMA-INFORMED CARE? >> JACOB: YES. WE DO HAVE A DEDICATED STAFF OR TEAM HELPING TO DO THE TRAININGS FOR THE LEVEL ONE TRAUMA-INFORMED CARE CERTIFICATION, SO THAT'S WHAT THIS FUNDING SUPPORTS. YOU PROBABLY ARE AWARE OF THE MINI GRANTS WE PROVIDE THROUGH COMMUNITIES AND SCHOOLS SO THAT'S NOT TIED TO THIS FUNDING STREAM. THIS IS SPECIFIC TO OUR CAPACITY TO CONDUCT THESE TRAININGS HERE WITHIN COSA. >> GALVAN: OKAY. >> WE WOULD LOOK TO MOVE SOME OF THESE TRAININGS ONLINE. SO THAT WOULD ALLOW US TO FREE UP CAPACITY IN THE MEDICAID WAIVER. >> GALVAN: OKAY. GOT IT. THE TEEN PREGNANCY ONE, IS THAT DIFFERENT FROM THE HEALTHY START? >> JACOB: THAT IS CORRECT. THIS WAS, AGAIN, TIED TO OUR CONTRACTS WITH COMMUNITIES AND SCHOOLS BUT ALSO TIED TO PROJECT -- WE HAVE TRANSITIONED FROM THAT PROGRAMMING. DIFFERENTIAL INDICATION. >> GALVAN: DO ANY OF THE FUNDING -- TRYING TO GET THE RIGHT WORD. ANY OF THESE PROGRAMS THAT POTENTIALLY AT RISK, ARE THEY FUNDED THROUGH IS IT SUPPLEMENTARY WORK OR DIFFERENT? >> JACOB: YEAH. THIS IS A SNAPSHOT OF THE MOST IMPACTED PROGRAMS. WE CAN AT LEAST LOOK AT THE CROSSWALK WITH WHAT WE HAVE SUPPORTED BY DELEGATE AGENCIES. >> GALVAN: I WOULD BE INTERESTED IN THAT ANALYSIS OR EVALUATION, LITTLE BIT OF ANALYSIS OF WHAT'S THE BEST WAY TO GO AS FAR AS WE CAN WITH IT. IF IT'S MORE DELEGATE AGENCY FUNDING TOWARDS A SPECIFIC INITIATIVE THAT'S TIED TO MENTAL HEALTH OR TEEN PREGNANCY, I'M INTERESTED IN SEEING WHAT THAT ADDITIONAL FUNDING FOR THAT MAYBE AGENCY WOULD BE AND COULD LOOK LIKE IN TERMS OF THE LARGER IMPACT AND SCALE OF IT VERSUS, RIGHT, POTENTIALLY USING THAT FUNDING FOR SUPPLEMENTING THESE PROGRAMS TO STAY MAINTAINED. JUST INTERESTED IN SEEING THE SCALE OF IMPACT WE HAVE ON THE COMMUNITY OVERALL. THAT WILL ALREADY BE DONE DURING THE SUMMER BUT INTERESTED IN SEEING THAT SPECIFIC KIND OF COMPARISON. >> JACOB: GOT IT. THAT'S GOOD TO KNOW. >> GALVAN: I THINK THAT'S IT. THANK YOU ALL SO MUCH. AT 11:24 A.M., WE WILL OFFICIALLY ADJOURNED THE COMMUNITY HEALTH COMMITTEE MEETING. * This transcript was compiled from uncorrected Closed Captioning.