* This transcript was created by voice-to-text technology. The transcript has not been edited for errors or omissions, it is for reference only and is not the official minutes of the meeting.
          [00:00:02]
           GOOD AFTERNOON, AND WELCOME TO COMMUNITY HEALTH AND EQUITY COMMITTEE MEETING TODAY'S JANUARY 23RD, AND WE'LL GET STARTED WITH THE ROLE. 
          MADAM CHAIR SANDOVAL HERE. 
          COUNCIL MEMBER TREVINO HERE. 
          COUNCIL MEMBER ANDREW SULLIVAN. 
          HERE. 
          COUNCIL MEMBER ADRIANA GARCIA. 
          ROCHA GARCIA HERE. 
          COUNCIL MEMBER PE MADAM, WE HAVE A QUORUM. 
          THANK YOU. 
          THANK YOU VERY MUCH. 
          UH, NANCY? YES, MA'AM. 
          UH, THE FIRST ITEM ON THE 
          [1. 20-1422 Approval of the Minutes for the December 13, 2019 Community Health and Equity Committee Meeting.]
AGENDA IS THE APPROVAL OF THE MINUTES FOR THE DECEMBER 13TH MEETING. 
          I ALSO WANNA CALL YOUR ATTENTION TO ONE MORE THING. 
          UM, WE HAD SOME QUESTIONS FOR FOLLOW UP, UH, DURING OUR LAST MEETING. 
          STAFF HAS, UH, GONE AHEAD AND GIVEN US THE SUMMARY OF THOSE QUESTIONS AND THE FOLLOW UP ANSWERS. 
          THANK YOU VERY MUCH FOR, FOR PROVIDING THIS. 
          UM, IF, UH, IF ANYBODY ELSE WOULD LIKE A COPY, THEY'RE UP ON THE COUNTER, BUT ALL THE COUNCIL MEMBERS SHOULD HAVE ONE AT THEIR PLACE. 
          UM, ALRIGHT, SO, UH, IS THERE A MOTION FOR ITEM NUMBER ONE? MOTION TO APPROVE. 
          SECOND. 
          ALL IN FAVOR? AYE. 
          ANY OPPOSED? MOTION CARRIES. 
          THANK YOU. 
          UH, ON PUBLIC 
          [Public Comments]
COMMENTS, WE HAVE, UH, TWO CITIZENS OR TWO PEOPLE SIGNED UP TO SPEAK, UM, ON ITEMS, NOT ON THE AGENDA. 
          THAT IS, UM, MARIO BRAVO, FOLLOWED BY SANDRA MONTALVO. 
          YOU'LL EACH HAVE THREE MINUTES IF YOU WANNA GO AHEAD AND GO FORWARD. 
          THANK YOU. 
          GOOD AFTERNOON. 
          MY NAME IS MARIA BRA BRAVO, AND I CURRENTLY SERVE AS CHAIR OF THE C P S ENERGY ENVIRONMENTAL STAKEHOLDERS GROUP. 
          AND JUST SO YOU KNOW, THAT GROUP IS A GROUP OF MEM MADE UP OF MEMBERS OF THE BROADER ENVIRONMENTAL ADVOCACY COMMUNITY HERE IN SAN ANTONIO, WHO MEET WITH C P S ENERGY SENIOR STAFF ON A QUARTERLY BASIS TO, UH, DISCUSS ISSUES RELATED TO SUSTAINABILITY AND, UH, ASK QUESTIONS, UM, PROVIDE FEEDBACK, WHATNOT. 
          UM, I, I AM HERE TO TALK TO YOU ABOUT AN AGENDA ITEM FROM THAT WAS POSTED LAST NIGHT. 
          IT'S FOR C P S, I MEAN, FOR CITY COUNCIL'S. 
          A SESSION, UM, IT'S FOR A SESSION NEXT WEEK. 
          SO YOU'RE BEING ASKED TO VOTE TO EXTEND THE, UM, THE STEP PROGRAM, THE SAVE FOR TOMORROW ENERGY, UH, PLAN PROGRAM. 
          SO YOU'RE BEING ASKED TO VOTE TO, TO ALLOW C P S ENERGY TO SPEND $70 MILLION OF OUR MONEY NEXT WEEK. 
          UM, SO ENVIRONMENTAL STAKEHOLDERS HAVE ALWAYS BEEN SUPPORTIVE OF THIS PROGRAM. 
          IT'S GREAT BECAUSE WHAT YOU DO, YOU KNOW, YOU CAN, OUR, OUR COMMUNITY USES ELECTRICITY AND SO SUPPLY HAS TO MEET DEMAND. 
          AND SO ONE THING YOU CAN DO IS IF THERE'S MORE DEMAND, YOU CAN INCREASE YOUR SUPPLY, RIGHT? BUT YOU CAN ALSO INCENTIVIZE PEOPLE TO REDUCE THEIR ENERGY CONSUMPTION, RIGHT? AND SO IF YOU DO THAT, THEN YOU DON'T HAVE TO INCREASE THE SUPPLY. 
          SO WE CAN BE MORE ENERGY EFFICIENT AND THEY HAVE DIFFERENT REBATES AND DIFFERENT INCENTIVES FOR THAT. 
          SO THIS PROGRAM WAS APPROVED AND HAS BEEN IN PLACE FOR 10 YEARS. 
          IT'S BEEN EXTREMELY SUCCESSFUL. 
          UH, THANK YOU. 
          IT'S BEEN AN EXTREMELY SUCCESSFUL PROGRAM. 
          UM, HOWEVER IT NEEDS TO BE UPDATED. 
          IT'S, IT'S OUT OF DATE. 
          AND, UM, SO OVER THE LAST YEAR AND A HALF, THE ENVIRONMENTAL STAKEHOLDERS HAVE BEEN MEETING WITH C P S ENERGY. 
          AND WE'VE BEEN ASKING THEM, CAN WE PROVIDE INPUT ON WHAT THAT SHOULD LOOK LIKE? WE'D LIKE TO HAVE MEANINGFUL CONVERSATIONS WITH THE UTILITY THAT WE OWN AND, AND PROVIDE INPUT ON, ON WHAT THIS PROGRAM CAN LOOK LIKE GOING FORWARD. 
          I HAVE COPIES OF PROPOSED AGENDAS THAT WE HAVE SENT TO C P S ENERGY ASKING TO DO THIS IN AUGUST OF 2018. 
          IN AUGUST OF 2019. 
          IN NOVEMBER OF 2019, WE NEVER WERE AFFORDED THAT OPPORTUNITY. 
          WE WERE REPEATEDLY TOLD, YES, THERE WILL BE PLENTY OF CHANCES FOR YOU TO WEIGH IN ON THIS. 
          AND YET LAST WEEK THE BOARD APPROVED, UM, BOARD APPROVED IT WITH NO INPUT FROM US. 
          AND NOW YOU'RE BEING ASKED TO VOTE TO APPROVE THE $70 MILLION SPEND OF OUR MONEY, UM, AGAIN, WITH NO INPUT. 
          AND SO THEY'RE A, THEY'RE ALSO LOOKING TO, TO PUT TOGETHER A NEW PROGRAM. 
          AND WHAT, I GUESS WHAT I'M HERE TO ASK YOU TODAY IS WE WANT TO BE A, WE, WE WANT TO BE ABLE TO, TO PARTICIPATE WITH OUR PUBLIC UTILITY. 
          WE WANT TO BE ABLE TO PROVIDE, IT'S A PUBLIC UTILITY. 
          WE WANT TO BE ABLE TO PROVIDE INPUT. 
          AND SO GOING FORWARD, WE WOULD LIKE TO MAKE SURE THAT THERE IS SOME KIND OF, THERE, THERE'S SOME KIND OF, UH, BODY IN PLACE TO BE ABLE TO PROVIDE THAT INPUT. 
          UM, AND SO THAT'S, THAT'S WHAT WE'RE HERE TO POINT OUT, THAT WE C B S ENERGY HAS LACKED ACCOUNTABILITY, TRANSPARENCY, AND OPPORTUNITIES FOR PUBLIC PARTICIPATION. 
          THANK YOU. 
          THANK YOU, MR. BATTLE. 
          UH, MS. SAND, 
          [00:05:01]
WHO I KNOW FROM HIGH SCHOOL, MARIACHI, THANK YOU VERY MUCH, . 
          OKAY, SO I, I APOLOGIZE. 
          I'M GONNA GO AHEAD AND READ THIS STATEMENT 'CAUSE I LIKE TO KEEP IT BRIEF. 
          SO, FIRST OF ALL, I WANNA THANK YOU FOR, UH, ALLOWING US THIS TIME TO SPEAK. 
          MY NAME IS SANDRA MONTALVO, AND I SERVED ON THE CLIMATE ACTION, UH, AND ADAPTATION PLAN REPRESENTING A I SAN ANTONIO. 
          I'M ALSO A MEMBER OF THE ENERGY STAKEHOLDERS GROUP. 
          SO, AGAIN, NOT TO, YOU KNOW, COMPOUND WHAT MARIO WAS SAYING, BUT WE UNDERSTAND THAT THE STEP PROGRAM HAS REQUESTED AN EXTENSION FOR A 10 YEAR PLAN THAT TO THE TUNE OF, UH, $70 MILLION. 
          AND WHILE WE THINK THAT IT WAS A GREAT EFFORT, IT'S CONTINUING TO FEED OUR DEPENDENCES ON FOSSIL FUELS. 
          AND WE BELIEVE THAT IT IS AN OUTDATED PROGRAM. 
          UM, IF, AND I SAY IF C P S IS TRULY A MUNICIPALLY OWNED UTILITY COMPANY, THEN THEY CANNOT CONTINUE TO MAKE DECISIONS IN A BUBBLE. 
          SO THE BOARD MEETINGS ARE POSTED ON THE WEBSITE FOR ALL THE PUBLIC TO ATTEND ONCE A MONTH. 
          THIS MEETING, I BELIEVE, WAS ANNOUNCED, UH, VERY QUICKLY. 
          AND, UM, AGAIN, UNLESS YOU'RE GOING DIRECTLY TO THE WEBSITE AND THE AVERAGE CUSTOMER PROBABLY DOESN'T EVEN KNOW THAT THIS EXISTS, HOW WOULD YOU KNOW THAT THESE BOARD MEETINGS ARE BEING HELD? SO, UM, WE WOULD ASK THAT C P S POST NOTICE OF THE BOARD MEETINGS ON SOCIAL MEDIA NOTIFYING THE PUBLIC, AND ALSO TO NOTIFY THE KEY STAKE, UH, STAKEHOLDER GROUPS THAT THEY BE NOTIFIED AT LEAST, UH, ONE WEEK PRIOR, SO THAT WE MAY ALSO HAVE INPUT. 
          UM, LAST WE ASKED THAT C P S , I KNOW THAT I MYSELF WOULD HAVE TO PRODUCE SOME SORT OF A REPORT IF I WAS ASKING FOR $70 MILLION. 
          BUT WE ASKED THAT C P S COMPILE A REPORT WITH NUMBERS TO SHOW, UM, THAT THEY'RE BEING MINDFUL OF HOW THIS IS GOING TO DOVETAIL WITH THE CAP PLAN ITSELF. 
          I HAVEN'T HEARD ANY DISCUSSION AS TO WHETHER OR NOT THIS IS, UH, GOING TO BE A ONE YEAR TEMPORARY OR HOW THAT'S PROCEEDING FORWARD. 
          I THINK THE PUBLIC WOULD LIKE TO KNOW THAT. 
          SO THANK YOU VERY MUCH. 
          THANK YOU, MICHAEL. 
          WE'LL MOVE ON TO, UH, ITEM NUMBER TWO, AND THANK YOU FOR BRINGING THOSE ITEMS TO OUR ATTENTION. 
          THEY'RE NOT ON THE AGENDA, SO WE CAN'T DISCUSS THEM TODAY, BUT WE CAN CERTAINLY DISCUSS AFTERWARD. 
          THANK YOU. 
          UM, WE'LL MOVE ON TO ITEM NUMBER TWO, 
          [2. 20-1373 A briefing by the San Antonio Metropolitan Health District on the Communicable Disease Division and infectious disease reporting in Texas. [Colleen Bridger, MPH, PhD, Assistant City Manager; Jennifer Herriott, MPH, Interim Director, Health]]
BRIEFING BY, UH, METRO HEALTH ON COMMUNICABLE DISEASE DIVISION AND INFECTIOUS DISEASE REPORTING IN TEXAS. 
          UM, THIS ITEM CAME ABOUT FOR A COUPLE OF REASONS, BUT ALSO A COUNCILMAN ELIAS HAD REQUESTED, UH, SPECIFICALLY A CONVERSATION ON, UH, VACCINATIONS. 
          IS THERE ANYTHING YOU'D LIKE TO ADD, COUNCILMAN? UM, YEAH. 
          UH, THE, I BELIEVE THAT ONE OF THE ROLES, THE MOST BASIC ROLE OF GOVERNMENT IS TO MAKE SURE THAT THERE'S FEWER, UH, DEAD PEOPLE RIGHT AT THE END OF THE DAY, UH, ON OUR WATCH. 
          AND, UH, YOU KNOW, WE, WE SPEND A LOT OF TIME TALKING ABOUT A WHOLE BUNCH OF OTHER PROJECTS, BUT THIS IS ONE OF THOSE MOST BASIC, UH, SERVICES THAT WE OFFER, WHICH IS EDUCATING FOLKS ON, UH, INFECTIOUS DISEASES AND THEN DOING SOMETHING ABOUT IT WHEN WE DISCOVER THEM. 
          AND SO, UH, THAT'S WHY I REQUESTED A COUNCILMAN, BECAUSE I THINK IT'S ONE OF THE ESSENTIAL FUNCTIONS OF METRO HEALTH. 
          THANK YOU. 
          THANK YOU. 
          SO I'D LIKE TO INTRODUCE DR. 
          ANITA. 
          IAN. 
          SHE IS AN ASSISTANT DIRECTOR AT METRO HEALTH OVERSEEING COMMUNICABLE DISEASE. 
          UM, SHE'S GOING TO COVER NOT JUST VACCINE PREVENTABLE ILLNESSES, BUT ALL COMMUNICABLE DISEASES BECAUSE COUNCILMAN ELIAS AND I ALSO HAD A SCINTILLATING CONVERSATION ABOUT HANSEN'S DISEASE AND TUBERCULOSIS. 
          UM, SO SHE'S GOING TO COVER THAT, AND WE ANTICIPATE THAT THERE MAY BE SOME QUESTIONS ABOUT THE CORONAVIRUS. 
          SO SHE IS ALSO PREPARED TO ADDRESS THOSE QUESTIONS. 
          SO, I JUST WANNA CLARIFY, UM, THIS PRESENTATION IS NOT ABOUT, CORONAVIRUS PRESENTATION WAS PUT TOGETHER LONG BEFORE THE INCIDENT HAPPENED. 
          SO, AND, AND IF YOU DON'T FIND THIS PRESENTATION, UM, TO BE ANSWERING ALL YOUR QUESTIONS, WE'LL BE HAPPY TO COME BACK. 
          SO ESSENTIALLY, THE PRESENTATION TODAY IS A BRIEF OVERVIEW OF HOW INFECTIOUS DISEASES GET REPORTED TO US METRO HEALTH DEPARTMENT, THE LOCAL PUBLIC HEALTH DEPARTMENT, AND OUR RESPONSE TO EACH OF THESE INFECTIOUS DISEASES. 
          UM, SO MOVING ON, METRO HEALTH, AS YOU'RE ALREADY FAMILIAR, UM, A DIVISION AT METRO HEALTH IS TO HAVE HEALTHY PEOPLE THRIVE IN HEALTHY COMMUNITIES. 
          AND WE ACHIEVE THIS MISSION THROUGH, UH, THE WORKS OF THE THREE BIG DEPARTMENTS AT, UH, DIVISIONS AT METRO HEALTH, WHICH IS COMMUNICABLE DISEASE, COMMUNITY HEALTH, ENVIRONMENTAL HEALTH AND OPERATIONS. 
          AND ALL THESE THREE DIVISIONS WORK COLLABORATIVELY TO PREVENT ILLNESS, UH, PROMOTE HEALTHY BEHAVIOR, AND PROTECT, UH, OUR RESIDENTS, UH, AGAINST ENVIRONMENTAL AND HEALTH HAZARDS. 
          SO I PRIMARY, I OVERSEE THE COMMUNICABLE DISEASE DIVISION. 
          WE HAVE A STAFF OF 145 IN THIS DIVISION, UH, CONSISTS OF FIVE BIG PROGRAMS, EPIDEMIOLOGY, SORRY, BEAR WITH ME. 
          FIVE BIG PROGRAMS, WHICH IS EPIDEMIOLOGY, IMMUNIZATIONS, UM, PUBLIC HEALTH LAB, S D CONTROL PREVENTION, 
          [00:10:01]
AND TB CONTROL AND PREVENTION. 
          AND I HAVE, I DO HAVE SOME OF THE TEAM MEMBERS HERE. 
          I JUST WANNA SHED SOME LIGHT. 
          UH, RITA ESP ESPINOZA, UH, IS A PROGRAM MANAGER FOR, UH, EPIDEMIOLOGY DIVISION. 
          SHE'S THE CHIEF EPIDEMIOLOGIST. 
          STEP UP TO THE FRONT. 
          R UM, UH, MS. UH, IAN ELMORE IS A PROGRAM MANAGER FOR S T D, UH, CONTROL AND PREVENTION. 
          AND COLLECTIVELY, BETWEEN THESE PROGRAM MANAGERS AND ME, WE HAVE ROUGHLY ABOUT, UH, WHAT WOULD YOU SAY OVER, OVER A CENTURY OF PUBLIC HEALTH EXPERIENCE HERE IN THIS ROOM. 
          NOW, MANY OF YOU KNOW THAT PUBLIC HEALTH, UH, OR INFECTIOUS DISEASE KNOW NO JURISDICTIONS. 
          THIS TEAM HERE, WE CAN VOUCH THAT THEY ALSO DO NOT RESPECT THE TIME OF THE DAY, UH, OR A WEEKEND OR A HOLIDAY, BECAUSE MOST OF THESE PUBLIC HEALTH, UH, EMERGENCIES HAPPEN ON A FRIDAY EVENING, LONG WEEKEND HOLIDAYS. 
          UH, SO WE ARE, UH, ON CALL 24 7 RESPONDING TO THESE INFECTIOUS DISEASE REPORTS. 
          SO THE APPROACH WE TAKE IN MY DIVISION FOR ANY PROBLEM, ANY INFECTIOUS DISEASE, WE FOLLOW FOUR MAIN STEPS. 
          ONE IS TO UNDERSTAND WHAT THE, WHAT THE DISEASE IS, WHAT THE PROBLEM IS, AND WE DETECT OR WE ANSWER THE QUESTION AS TO WHAT THE CAUSE IS OR WHAT THE DIS WHAT THE ISSUE IS BASED ON THE SURVEILLANCE DATA THAT WE COLLECT. 
          THE NEXT STEP, ONCE WE IDENTIFY THE CAUSE, IS TO IDENTIFY WHAT THE, UM, WHAT, ONCE THE PROBLEM IS IDENTIFIED, THEN THE NEXT STEP IS TO IDENTIFY WHAT THE CAUSE OF THE PROBLEM IS. 
          BECAUSE EVERYTHING WE DO IN MY DIVISION, THE PRIMARY GOAL OF EVERY SINGLE INVESTIGATION IS TO FIND THE DISEASE THAT'S CAUSING THE PROBLEM, STOP THE SPREAD OF THE DISEASE IN THE COMMUNITY, AND PREVENT NEW CASES FROM OCCURRING. 
          SO THIS IS ONE OF THE STEP TOWARDS ACHIEVING THAT GOAL. 
          THE NEXT STEP IS ONCE WE IDENTIFY WHAT THE COST IS, UM, WHAT, WHAT ARE, WHAT ARE SOME OF THE INTERVENTIONS THAT WE CAN FORMULATE TO DO JUST THAT FINE STOP, PREVENT. 
          ONCE INTERVENTIONS ARE IDENTIFIED, THEN WE GO ABOUT IMPLEMENTING THIS INTERVENTIONS COMMUNITYWIDE TO SPREAD THE FURTHER SPREAD OF THE DISEASE. 
          SO SURVEILLANCE IS THE CORNERSTONE OF ALL OUR INFECTIOUS DISEASE ACTIVITY, AND WE RELY PRIMARILY ON THREE BIG SURVEILLANCE SYSTEMS TO DO THIS. 
          ONE IS THE TEXAS NOTIFIABLE CONDITIONS. 
          THIS IS THE FOCUS OF THE PRESENTATION TODAY. 
          I'LL BE TALKING ABOUT THIS IN A BIT IN, IN DETAIL IN A BIT. 
          SECOND IS THE SENTINEL SURVEILLANCE SYSTEM. 
          HERE WE HAVE A NETWORK OF DOCTOR'S OFFICES, HOSPITALS THAT WE'VE RECRUITED ON VOLUNTARY BASIS TO PROVIDE US WITH THE DATA ON A SPECIFIED HEALTH EVENT. 
          UM, SO WE USE THIS SYSTEM PRIMARILY AT METRO HEALTH TO TRACK THE INFLUENZA ACTIVITY DURING A INFLUENZA SEASON. 
          AND HOW MANY OF YOU HAVE SEEN OUR SURVEILLANCE REPORTS? IT GETS PUT OUT DURING FLU SEASON EVERY FRIDAY ON OF, FROM OCTOBER THROUGH MAY. 
          YEAH. 
          AND THEN THE THIRD SURVEILLANCE SYSTEM, WHICH IS A RELATIVELY NEW SYSTEM, IS CALLED THE SYNDROMIC SURVEILLANCE SYSTEM, WHERE WE COLLECT CHIEF, UH, COMPLAINT DATA FROM OUTPATIENT AND EMERGENCY DEPARTMENTS. 
          SO THE SYSTEM WE USE HERE IS CALLED ESSENCE. 
          SO ESSENCE HAS INBUILT ALGORITHMS THAT COLLECT ALL THIS CHIEF COMPLAINT DATA AND CATEGORIZES INTO FIVE BIG SYNDROMES. 
          EACH OF THESE SYNDROMES HAVE AN INBUILT, WELL-ESTABLISHED THRESHOLD. 
          SO EVERY TIME A SYNDROME GOES ABOUT THE THRESHOLD THAT TRIGGERS US, UM, TO, TO INVESTIGATE THAT PARTICULAR SYNDROME. 
          SO WE DON'T WAIT FOR AN ACTUAL INFECTIOUS DISEASE DIAGNOSIS TO BE MADE, WHICH COULD PROBABLY TAKE SEVERAL DAYS TO SOMETIMES WEEKS. 
          SO THIS SYSTEM HELPS US, THIS TIME SAVING ASPECT OF THIS SYSTEM HELPS, HELPS US, ESPECIALLY IN THE CONTEXT OF BIOTERRORISM, WHERE TIMING IS OF ESSENCE, WE NEED TO MAKE AN EARLY DETECTION FOR IMPROVED SURVEILLANCE, UH, FOR IMPROVED SITUATIONAL AWARENESS. 
          UM, SO WE WILL BE USING THIS SYSTEM FOR TRACKING CORONAVIRUS. 
          SO SAY FOR INSTANCE, JUST MORNING, WE MADE THE REQUEST TO THE HOSPITALS TO SAY, ANY PERSON COMING INTO YOUR EMERGENCY DEPARTMENT WITH FEVER, LOWER RESPIRATORY SYMPTOMS, GO AHEAD AND ASK OR INCLUDE THE WORD WUHAN CITY OR TRAVEL TO CHINA. 
          SO THAT WAY, EVEN THE PRO, IF THE PROVIDERS MISS DIAGNOSING THIS PARTICULAR PATIENT OR COLLECT MIS COLLECTING SPECIMENS, WE AT THE HEALTH DEPARTMENT CAN THEN REVIEW THE SYNDROMIC SURVEILLANCE DATA TO TO, AND WE ARE PRIMARILY LOOKING FOR THOSE KEYWORDS. 
          AND ONCE WE SEE PATIENTS SHOWING UP AT WUHAN CITY, WE WILL BE CONTACTING THOSE PATIENTS TO MAKE SURE THAT THEY'RE APPROPRIATELY TESTED AND ISOLATED AND TREATMENT, ET CETERA. 
          ALL THE GOOD STUFF. 
          SO THIS IS WHAT IS THE FOCUS OF THIS PRESENTATION. 
          WHAT YOU SEE UP THERE IS THE TEXAS NOTIFIABLE NOTIFIABLE CONDITIONS LIST FOR THE STATE OF TEXAS. 
          THIS IS A LIST OF ABOUT 78 CONDITIONS. 
          UM, EVERY STATE HAS ITS OWN STATE SPECIFIC LIST. 
          SO EVERY YEAR, EPIDEMIOLOGISTS ACROSS THE STATE, ACROSS THE NATION COME TOGETHER, REVIEW THEIR STATE SPECIFIC LIST IN COLLABORATION WITH C D C, AND PICK 
          [00:15:01]
CERTAIN CONDITIONS TO BE PUT ON THIS LIST. 
          SO THIS IS UPDATED ANNUALLY, UM, AND REVIEWED AND UPDATED ANNUALLY. 
          SINCE IT'S A STATE SPECIFIC, YOU MAY NOT FIND, UH, SAY THINGS LIKE OXIDATIVE MYCOSIS, WHICH IS A PRIORITY FOR, UH, THE STATE OF ARIZONA OR NEVADA ON THE STATE OF TEXAS LIST. 
          SO EVERY STATE HAS ITS OWN STATE SPECIFIC LIST. 
          THE SECOND COLUMN THAT YOU SEE IS, IS THE REPORTING TIMEFRAME. 
          SO WHAT IT MEANS IS THAT EVERY PROVIDER, AND YOU'LL SEE WHO ARE REQUIRED TO REPORT THIS TO THE LOCAL PUBLIC HEALTH DEPARTMENT. 
          SO ALL THOSE REPORTING ENTITIES WHO MAKE A DIAGNOSIS OF ANY OF THESE CONDITIONS ON THE LIST ARE REQUIRED BY LAW TO REPORT IT TO THE LOCAL PUBLIC HEALTH DEPARTMENT WITHIN THOSE DESIGNATED REPORTING TIMEFRAMES. 
          SO IN ADDITION TO THOSE, ANY OUTBREAKS, EXOTIC DISEASES OR UNUSUAL GROUP OF DISEASES THAT MAY BE OF PUBLIC HEALTH CONCERN IS ALSO REQUIRED BY LAW TO BE REPORTED TO THE LOCAL PUBLIC HEALTH DEPARTMENT. 
          BY MOST EXPEDITIOUS MEANS AVAILABLE. 
          SO WHO SHALL REPORT, I ALLUDED TO THIS EARLIER. 
          A MULTITUDE OF ENTITIES ARE REQUIRED TO REPORT THIS TO THE LOCAL PUBLIC HEALTH DEPARTMENT, DOCTOR'S OFFICES, HOSPITALS, LABS, MEDICAL EXAMINERS, SCHOOLS, UNIVERSITIES. 
          ANYBODY WHO MAKES A DIAGNOSIS OF ANY OF THOSE CONDITIONS ON THE LIST ARE REQUIRED TO REPORT IT TO THE LOCAL PUBLIC HEALTH DEPARTMENT WITHIN THOSE REPORTING TIMEFRAMES. 
          AND AGAIN, IT IS STATE LAW. 
          UH, FAILURE TO REPORT, UH, ANY OF THOSE NOTIFIABLE CONDITIONS TO THE HEALTH DEPARTMENT WITHIN THOSE DESIGNATED TIMEFRAME IS A CLASS B MISDEMEANOR AND CAN RESULT IN SUSPENSION OF LICENSE TO PRACTICE FOR SIX MONTHS FOR MEDICAL CARE PROVIDERS. 
          UH, BUT IN MY 17, ALMOST 18 YEARS OF EXPERIENCE, WE'VE NEVER DONE THAT. 
          SO WHAT SHOULD BE REPORTED, WE ASK THAT THE PROVIDERS REPORT, CONTACT INFORMATIONS, DEMOGRAPHICS, RACE, AGE, GENDER OF THE PATIENT, ALL MEDICAL RECORDS, HISTORY, PHYSICAL EXAMINATION RESULTS, AND THE ALL PERTINENT LABS. 
          AND JUST WANNA POINT OUT, THIS REPORTING OF THIS INFORMATION FROM HEALTHCARE PROVIDERS TO LOCAL PUBLIC HEALTH DEPARTMENT IS EXEMPT FROM HIPAA. 
          SO WHAT DO WE DO ONCE THESE CONDITIONS GET REPORTED TO US? WE USE STANDARDIZED CONDITION, SPECIFIC CASE QUESTIONNAIRE TO COLLECT ADDITIONAL INFORMATION TO DO WHAT I SAID EARLIER, FINE, STOP AND PREVENT THE FURTHER SPREAD OF THE DISEASE. 
          AND YOU'LL SEE AN EXAMPLE OF THIS, UM, TOWARDS THE END OF MY SLIDE WHEN I WALK YOU THROUGH THE MEASLES INVESTIGATION. 
          HERE'S A DISEASE REPORTING CHANGE. 
          SO ONCE WE COLLECT ALL THE INFORMATION, WE'VE COMPLETED INVESTIGATIONS, WE IMPLEMENTED CONTROL CON, UH, CONTROL AND CONTAINMENT MEASURES, THEN ON DAILY BASIS, THIS INFORMATION IS TRANSMITTED TO DEPARTMENT OF STATE HEALTH SERVICES USING STATE MAINTAINED SECURE ELECTRONIC DATABASES. 
          AND THE STATE THEN VERIFIES, VALIDATES ALL THE INFORMATION WE LOCAL SUBMIT. 
          AND THEN THAT DATA AT THE STATE LEVEL IS COMPILED AND THEN TRANSMITTED TO C D C AGAIN USING SECURE ELECTRONIC DATABASES ON, UM, WEEKLY BASIS. 
          AND THEN ONCE C D C GETS ALL THIS INFORMATION, THEY PUT OUT NATIONAL ESTIMATES OF EACH OF THESE INFECTIOUS DISEASES. 
          AND THIS FLOW OF INFORMATION IS BIDIRECTIONAL. 
          C D C THEN REPORTS THOSE INFORMATION BACK TO THE LOCALS THROUGH THE STATE HEALTH DEPARTMENT. 
          SO IN 2018, SO TYPICALLY IN A GIVEN YEAR, WE HAVE, UH, WE GET ANYWHERE FROM 55 TO ABOUT 60 INFECTIOUS DISEASES. 
          SO YEAH, 45 TO 55 INFECTIOUS DISEASES REPORTED TO US. 
          WE GET ANYWHERE FROM 35,000 TO 50,000 INDIVIDUAL CASE REPORTS REPORTED TO US. 
          SO IT'S, THE STAFF IS QUITE BUSY AROUND. 
          SO IN 2018, WE HAD 49 DIFFERENT, WHICH IS THE MOST RECENT DATA. 
          2019 IS BEING FINALIZED. 
          IT SHOULD BE UP ON OUR WEBSITE BY JUNE OF THIS YEAR. 
          UM, SO IN 2018, WE HAD 49 DIFFERENT COMMUNICABLE DISEASES THAT WERE REPORTED TO US. 
          WE HAD A TOTAL SLIGHTLY OVER 17,000 UNDUPLICATED CASES REPORTED IN 2018. 
          THREE OF THE TOP FIVE CONDITIONS THAT WERE REPORTED TO US WERE STIS, SEXUALLY TRANSMITTED INFECTIONS, CHLAMYDIA TOPPED THE LIST. 
          GONORRHEA WAS NUMBER TWO, AND H I V WAS NUMBER FIVE. 
          TYPICALLY, WE TEND TO SEE TOP FOUR INFECTIOUS DISEASES TO BE STIS. 
          WE ALSO SEE SYPHILIS ON THE LIST. 
          WHAT HAPPENED IN 2018 TO GET SYPHILIS DISPLACED FROM THE LIST? WE HAD THE BIGGEST FOODBORNE OUTBREAK HERE IN THE HISTORY OF SAN ANTONIO THAT WAS ASSOCIATED WITH A LOCAL FOOD ESTABLISHMENT. 
          SO SALMONELLA GOT ON THAT TOP FIVE DISPLAY SYPHILIS TO POSITION NUMBER SIX,  AND, AND, AND . 
          THIS THIS TREND THAT WE SEE HAVING S STIS PREDOMINANTLY AS THE TOP FIVE FAIRING 
          [00:20:01]
IN THE TOP FIVE. 
          THIS IS NOT UNIQUE TO BAYER COUNTY. 
          WE SEE THIS TREND ACROSS VARIOUS JURISDICTIONS ACROSS THE NATION. 
          ALRIGHT, SO MOVING ON. 
          WE ALL WOKE UP TO THIS HEADLINE IN MARCH OF 2019. 
          FIRST CASE OF MEASLES DETECTED IN 12 YEARS IN BAYER COUNTY. 
          WELL, IN FACT, THAT THAT HEADLINE IS NOT ACCURATE. 
          WE DID HAVE THREE CASES OF MEASLES IN 2007. 
          BUT REGARDLESS, THIS WAS A HEADLINE IN MARCH OF 2019. 
          AND HERE'S THE STORY BEHIND THE HEADLINE. 
          SO, PUBLIC HEALTH WAS NOTIFIED OF A MEASLES CASE ON MARCH 1ST, WHICH HAPPENED TO BE A FRIDAY AFTERNOON. 
          SO THERE, THERE IS A SENSE OF URGENCY WHEN MEASLES IS REPORTED TO US, BECAUSE IN MY OPINION, MEASLES IS THE MOST INFECTIOUS OF ALL INFECTIOUS DISEASES. 
          'CAUSE, 'CAUSE IT CAN, 90% OF FOLKS WHO ARE UNVACCINATED, WHO COME IN CONTACT WITH MEASLES CASES WILL BREAK DOWN WITH THE DISEASE. 
          AND THE MEASLES VIRUS IS AIRBORNE. 
          IT TENDS TO BE SUSPENDED IN THE AIR FOR UP TO TWO HOURS AFTER THE CASE HAS LEFT THE ROOM AND CAN INFECT FOLKS WHO ENTER THE ROOM WITHIN TWO HOURS AFTER THE PATIENT HAS LEFT. 
          SO IT IS ONE OF THE MOST INFECTIOUS OF ALL INFECTIOUS CONDITIONS. 
          SO THAT IS A SENSE OF URGENCY TO CONTACT THIS PATIENT AS SOON AS POSSIBLE TO GET ALL THE INFORMATION WE NEED TO PUT IN THOSE CONTROL CONTAINMENT MEASURES. 
          SO THE PATIENT WAS CONTACTED AND THE HISTORY WE GOT WAS HE HAD HIS SYMPTOMS BEGAN ALMOST 10 DAYS PRIOR TO WHEN IT WAS NOTIFIED TO US, BEGAN ON 2 21. 
          THE SYMPTOMS. THE SYMPTOMS YOU HAVE MEASLES, USUALLY IN THE INITIAL STAGES, THEIR PRODROMAL SYMPTOMS, PATIENT MAY PRESENT WITH FEVER, UH, COUGH, RUNNY NOSE, REDNESS OF EYES. 
          SO THOSE ARE THE SYMPTOMS THAT MEASLES BEGIN WITH. 
          AND WITHIN THREE TO FIVE DAYS OF PRODROMAL SYMPTOMS, PATIENT MAY BREAK DOWN WITH RASH. 
          AND THE MEASLES RASH ARE PRETTY CHARACTERISTIC. 
          YOU CANNOT MISS THOSE RASHES. 
          THEY'RE MACULAR PAPULAR RASHES THAT BEGIN ON ALONG YOUR HAIRLINES SPREAD TO YOUR NECK, TRUNK AND YOUR EXTREMITIES AND DISAPPEAR IN THE SAME WAY IT APPEARS. 
          SO PATIENT HAD RASH ONSET, AND THIS IS IMPORTANT BECAUSE, SORRY, I CAN'T SEE THIS. 
          AND THE, THE, THE DATE OF RASH ONSET IS VERY IMPORTANT FOR US BECAUSE THAT'S HOW WE DETERMINE HOW LONG OR WHEN DID, WHEN DID THE PATIENT BECOME INFECTIOUS? MEANING WHEN DID THE PATIENT DEVELOP THE CAPABILITY OF TRANSMITTING THE ILLNESS TO OTHERS? SO TYPICALLY MEASLES, A PATIENT WITH MEASLES IS INFECTIOUS FOUR DAYS BEFORE TO FOUR DAYS AFTER RASH ONSET. 
          SO BY THAT TOKEN, THE PERSON WAS INFECTIOUS ON TWO 18. 
          SO IF YOU LOOK CLOSELY, WHAT HAPPENED ON 2 21, HE HAD A FLIGHT EXPOSURE. 
          THIS WAS AN INTERNATIONAL TRAVELER WHO CAME FROM A REGION WHERE WE KNEW WAS HAVING THE BIGGEST MEASLES OUTBREAK THAT TIME. 
          SO WE KNEW WE HAD FLIGHT EXPOSURE ON OUR HAND. 
          THAT IS A PUBLIC HEALTH NIGHTMARE. 
          SO WHAT WE DO IS IMMEDIATELY CONTACT F A A TO GET THE PASSENGER MANIFESTO. 
          WE GET THOSE MANIFESTOS SENT TO US THROUGH THE CDC D'S QUARANTINE STATION. 
          SO THERE ARE THREE QUARANTINE STATIONS HERE IN THE STATE OF TEXAS. 
          UH, WE HAVE ONE IN D F W, ONE IN HOUSTON, EL PASO. 
          WE FALL UNDER BAY COUNTY FALLS UNDER THE EL PASO JURISDICTION. 
          SO THE EL PASO QUARANTINE STATION OFFICER WAS CONTACTED AND, UH, THE PASSENGER MANIFESTO WAS REQUESTED. 
          WE GOT THE PASSENGER MANIFESTO AND THE, WHAT WE DO IS LOOK AT THE PATIENT'S RESIDENCE. 
          WE GET THE PATIENT'S NAME, ADDRESS, CONTACT INFORMATION, AND WE BASED ON THE, THE JURISDICTIONAL RESPONSIBILITIES ARE DECIDED BASED ON THE PATIENT'S RESIDENCE. 
          SO WE HAVE JURISDICTION EARLY OVER BAY COUNTY RESIDENTS. 
          SO THERE WERE FOUR BAY COUNTY RESIDENTS ON THAT FLIGHT. 
          AND THEN WE PASS ON THE REMAINING CONTACT INFORMATIONS TO THE APPROPRIATE JURISDICTIONS FOR THE, FOR THE, UM, LOCAL HEALTH DEPARTMENTS FROM OTHER JURISDICTIONS TO DO EXACTLY WHAT WE PLAN TO DO, WHICH IS IMPLEMENT CONTROL CONTAINMENT MEASURES. 
          SO THE PATIENT WAS INFECTIOUS FROM TWO 18 TO 2 26. 
          SO LET'S SEE, WHERE DID HE GO? WHILE HE WAS STILL INFECTIOUS, HE SHOWED UP IN AN URGENT CARE FACILITY. 
          HE WAS SICK. 
          2 21, HE THOUGHT HE, HE SELF-MEDICATED HIMSELF, TOOK SOME OVER THE COUNTER MEDICATION, FEVER, COUGH, RUNNY NOSE OVER THE COUNTER MEDICATION, DIDN'T IMPROVE RASH ONSET THE SUBSEQUENT DAY, DECIDED TO SHOW UP IN AN URGENT CARE 2 24 WHILE HE WAS STILL INFECTIOUS. 
          THE URGENT CARE, THIS IS ONE OF THOSE MISSED OPPORTUNITIES WE TALK ABOUT ALL THE TIME. 
          THE URGENT CARE PHYSICIAN DID NOT ASK THE TRAVEL HISTORY, DID NOT DIAGNOSE MEAS EVEN THOUGH THE PATIENT HAD CLASSIC MEASLES SYMPTOMS. SEND THE PATIENT BACK HOME TREATING HIM SYMPTOMATICALLY. 
          PATIENT DIDN'T FEEL BETTER. 
          WHERE DOES HE DECIDE TO SHOW UP THE NEXT DAY? THE EMERGENCY DEPARTMENT. 
          SO WE HAD A WHOLE LIST OF EXPOSURES THERE. 
          PATIENT WAS WAITING IN THE EMERGENCY DEPARTMENT. 
          AND SO NOW THE URGENT URGENCY IS TO CONTACT EMERGENCY DEPARTMENTS AND THE URGENT CARE ON THE DAY THAT THE PATIENT VISITED 
          [00:25:01]
AND REQUEST A LIST OF ALL THE PATIENTS WHO ARE WAITING WITH THIS PATIENT IN THE WAITING ROOM UP TO TWO HOURS AFTER THE PATIENT LEFT, THEM LEFT THE WAITING ROOM. 
          SO WE HAD ABOUT 18 CONTACTS WE IDENTIFIED IN THE URGENT CARE. 
          WE HAD 35 EXPOSURES IN EMERGENCY DEPARTMENT. 
          SO NOW WE HAVE A LIST OF 35 PLUS 18 FOOT FORWARD EXPOSURES. 
          HOW MUCH IS THAT? 53, 4 57 EXPOSURES THAT WE HAD TO FOLLOW UP. 
          SO WHAT WE DO IS CALL EACH SINGLE PERSON ON OUR LIST AND SEE IF THEY'RE SYMPTOMATIC. 
          IF THEY'RE SYMPTOMATIC, THEN OUR RECOMMENDATION, THIS IS THE, THIS IS THE MOST IMPORTANT RECOMMENDATION WE GIVE OUT, IS PLEASE DO NOT SHOW UP IN AN URGENT CARE AND EMERGENCY DEPARTMENT. 
          WE MAKE SURE WE CALL THE FACILITY OF CHOICE OF THEIR CHOICE AHEAD OF TIME. 
          MAKE SURE THE FACILITY HAS ALL AIRBORNE PRECAUTIONS IN PLACE, AND MAKE SURE THE PATIENT IS SEEN IN ISOLATION AWAY FROM THE GENERAL PATIENT POPULATION. 
          SO IF THE PATIENT IS SYMPTOMATIC, WE DO THAT. 
          WE COORDINATE SPECIMEN COLLECTION BECAUSE CONFIRMATORY RESULTS, CONFIRMATORY TESTING FOR MEASLES IS NOT AVAILABLE IN COMMERCIAL LABS. 
          IT'S NOT AVAILABLE IN IN HOSPITAL LABS. 
          ONLY PUBLIC HEALTH LABS CAN TEST THAT. 
          SO WE COORDINATE SPECIMEN COLLECTION, SHIP THE ASSESSMENT TO OUR PUBLIC HEALTH LAB FOR TESTING. 
          NOW, IF THE PATIENT IS NOT SYMPTOMATIC, WE LET THEM KNOW. 
          WE EDUCATE THEM ON WHAT THE SIGNS AND SYMPTOMS OF MEASLES ARE, MONITOR THEM FOR A PERIOD OF THEIR EXPOSURE BECAUSE THAT'S THE TIME THAT IF THEY WERE TO BREAK DOWN WITH INFECTION, THEY, THEY WILL DO SO. 
          SO IF THEY DO NOT HAVE ANY, ANY, ANY SIGNS AND SYMPTOMS FOR 21 DAYS AFTER THE DATE OF EXPOSURE, IT'S SAFE TO ASSUME THAT THEY ARE NOT GOING TO BREAK DOWN WITH THIS INFECTION AS THIS INFECTION. 
          AS A RESULT OF THIS EXPOSURE, WE ALSO DO A VACCINATION STATUS ASSESSMENT. 
          UM, IF THE PATIENT IS NOT VACCINATED, THEN WE DO OFFER VACCINES TO MAKE SURE THAT THE PATIENT DOESN'T BREAK DOWN WITH DISEASE. 
          SO WE DID COLLECT SPECIMENS ON THAT PATIENT THAT WAS, UH, REPORTED TO US. 
          P C R CONFIRMED THAT IS THE TESTING. 
          CONFIRMATORY RESULTS FOR MEASLES WAS CONFIRMED TO BE A CASE OF MEASLES. 
          WE MONITORED ALL THE EXPOSURES UNTIL THREE 18 ON THREE 14, WHICH IS DURING THE MONITORING PERIOD. 
          ONE OF THE EXPOSURES WHO WAS NOT A PRIORITY FOR ME ON BOTTOM OF MY LIST BECAUSE HE WAS VACCINATED. 
          AND THIS IS NOT UNUSUAL BECAUSE IF YOU ARE COMPLETELY VACCINATED WITH MEASLES TWO MAX VACCINES, YOU SHOULD BE 95% PROTECTED AGAINST GETTING 97% PROTECTED AGAINST GETTING MEASLES. 
          BUT THREE OF THE THREE OF HUNDRED PATIENTS WHO ARE VACCINATED CAN ALSO BREAK DOWN WITH DISEASE. 
          AND HE HAPPENED TO BE ONE OF THOSE. 
          BUT, BUT IT'S, IT'S A GOOD THING BECAUSE FOLKS WHO ARE VACCINATED BREAK DOWN WITH DISEASE, THEY CANNOT TRANSMIT THE ILLNESS THAT THE TRANSMISSIBILITY IS NOT AS HIGH AS AN UNVACCINATED PATIENTS. 
          THAT'S ONE THING. 
          AND THEN THE PATIENT ALSO TEND TO RUN A PRETTY MILDER COURSE. 
          BUT REGARDLESS, WE CONTACTED THE PATIENT AND WHAT WE FOUND OUT WAS HE WAS SYMPTOMATIC THREE EIGHT, THAT WAS THE LAST DAY OF HIS CLASS. 
          SO HE DID HAVE ABOUT 13 EXPOSURES. 
          AND THIS WAS MIND YOU BEFORE SPRING BREAK. 
          SO AGAIN, MATT DASH TO CONTACT ALL THESE 13 EXPOSURES BEFORE SPRING BREAK. 
          SO WE CAN, AGAIN, GIVE OUT THE SAME RECOMMENDATIONS WE DID WITH CASE B. 
          WE FOLLOWED ALL OF THOSE EXPOSURES ALL THE WAY UNTIL 3 31, WHICH WAS THE END OF THE 21 PERIOD MONITORING PHASE. 
          SO WE DIDN'T HAVE ANY MORE CASES. 
          THIS, I JUST PUT THIS UP THERE FOR YOU GUYS TO SEE. 
          THIS IS WHAT WE IN THE EPI WORLD CALL IT AS NETWORK OF CONTACTS. 
          EVERY EPIDEMIOLOGIST WHO'S INVOLVED IN ANY PUBLIC HEALTH INVESTIGATION HA WILL HAVE ONE OF THESE. 
          WE TRACK OUR PLACES OF TRANSMISSION, OUR EXPOSURES, OUR MONITORING PHASE IN USING THIS, THIS, THIS SCHEMATIC DIAGRAM. 
          SO IF YOU ASK ME THE HEADLINE INSTEAD, ONE CASE DETECTED IN BAYER COUNTY SHOULD HAVE BEEN, UM, WHAT, 70, 71 CASES PREVENTED BY METROHEALTH. 
          BUT I GUESS THAT IS NEVER SENSATIONAL ENOUGH. 
          SO IT DIDN'T MAKE THE HEADLINES . 
          SO HERE'S OUR, HERE'S OUR REPORTING TIME, UH, REPORTING NUMBERS. 
          WE DO WORK 24 7. 
          THAT'S OUR EMERGENCY CONTACT INFORMATION FOR AFTER HOURS. 
          AND THOSE ARE OUR DISEASE REPORTING NUMBER, REPORTING NUMBERS FOR FOLKS CAN FAX THEIR MEDICAL RECORDS. 
          THAT IS A SECURE FAX LINE FOR US. 
          THAT'S THE END OF OUR PRESENTATION, AND THANK YOU FOR YOUR TIME. 
          THANK YOU SO MUCH DR. 
          KRAN. 
          THAT WAS A FASCINATING, UH, DISCUSSION. 
          I KNOW YOU KIND OF HAD A RUSH THROUGH THAT. 
          WE COULD BE HERE ALL DAY, RIGHT? TALKING ABOUT EVERYTHING ELSE YOU DID. 
          UM, I'LL START WITH QUESTIONS FROM COUNCILWOMAN, UH, ANDREW SULLIVAN, AND SHE'LL BE FOLLOWED BY COUNCILMAN BELI. 
          THANK YOU CHAIR. 
          UH, THANK YOU DR. 
          KRAN. 
          THIS IS REALLY INFORMATIVE AND, AND VERY HELPFUL FOR 
          [00:30:01]
A LOT OF PEOPLE. 
          UM, I DO HAVE A FEW QUESTIONS THAT ARE RELATED TO, UM, THE S T D UH, PROGRAM. 
          I KNOW, UM, ABOUT MAYBE FIVE YEARS AGO WAS WHEN THE PUSH FOR H P V CAME ON THE SCENE AND THE VACCINATION WAS CREATED, AND NOW YOU REALLY DON'T HEAR ANYTHING. 
          BUT WE HAVEN'T HAD ANY FOLLOW UP ON SINCE THE VACCINE WAS CREATED AND KIND OF MADE MANDATORY, UM, WHERE WE STAND AS FAR AS THE AGE RANGE. 
          ARE WE SEEING A DECREASE IN THE TRANSMISSION? UM, IS THE VACCINE REALLY HELPING TO PREVENT? UM, SO I DON'T KNOW WHERE THAT FALLS. 
          I KNOW IT'S STILL CONSIDERED A A S T D AND CAN BE CONTRACTED. 
          SO DO WE HAVE ANY KIND OF FOLLOW UP ON HOW THAT'S WORKING OUT? SO H P V IS STILL CONSIDERED AND S C I AND IT CAN STILL BE TRANSMITTED SEXUALLY. 
          AND YES, IT IS STILL A RECOMMENDED VACCINE. 
          WE RECOMMEND, UH, TWO DOSES OF H P V FOR, UH, CHILDREN, NINE TO 12 YEARS OF NINE TO 11 YEARS OF AGE. 
          UM, UNFORTUNATELY, BECAUSE THIS IS NOT ONE OF THOSE REQUIRED VACCINES FOR SCHOOL AGE ENTRIES, SEVENTH GRADERS, THEY'RE REQUIRED BY LAW TO HAVE T D A AND MENINGOCOCCAL. 
          H P V IS NOT A REQUIRED VACCINE. 
          IT'S A RECOMMENDED JUST LIKE FLU. 
          SO WE ARE WORKING, UH, CLOSELY WITH, UH, ALL THE IMMUNIZATION COALITIONS LOCALLY HERE TO CHANGE THAT AND SEE IF WE CAN MAKE THAT, UH, UH, A REQUIRED VACCINE. 
          SO THAT'S ONE WAY WE ARE TRYING TO, UM, HAVE AN UPTICK IN THE VA IN, IN THE, IN THE H P V VACCINATIONS. 
          SO OUR RATES AS WELL AS, AS FAR AS LOCALLY GO, WE ARE DOING GOOD WITH INITIATION. 
          IT IS STILL LOW. 
          IT IS STILL LOW. 
          THE RIGHT, THE HEALTHY PEOPLE, 2020 OBJECTIVE WAS TO HAVE 80% OF THE FOLKS VACCINATED. 
          SO THE INITIATION RATE FOR US, BAYER COUNTY IS, UH, JUST OVER 40%. 
          BUT REMEMBER THEY NEED TO HAVE TWO DOSES, TWO TO SIX MONTHS APART. 
          SO THE COMPLETION IS NOT PRETTY GOOD. 
          UM, SO WE ARE WORKING ON THAT. 
          BUT I, I STILL NEED TO POINT OUT, EVEN THOUGH WE ARE DOING, UH, OUR RATES ARE LOWER THAN HEALTHY PEOPLE 2020, WE ARE DOING MUCH BETTER THAN THE STATE. 
          AND HERE, HERE LOCALLY, UM, GLAD YOU BROUGHT THIS UP, WE ARE WORKING CLOSELY WITH SCHOOLS, UM, AND WITH THE HOSPITAL SYSTEMS TO CHANGE HOW THEY HAVE THIS DIALOGUE WITH THE PARENTS. 
          SO MAINLY IF YOU GO INTO A DOCTOR'S OFFICE, YOU TAKE YOUR KID TO YOUR DOCTOR'S OFFICE, A DOCTOR SAYS, OKAY, YOUR CHILD IS DUE, UM, YOUR THIRD DOSE OF SECOND DOSE OF M M R, YOUR THIRD DOSE OF, UH, D P T AND, YOU KNOW, KNOW OR, UM, OR MENINGOCOCCAL VACCINE. 
          AND BY THE WAY, UM, WOULD YOU LIKE TO HAVE H P V FOR YOUR CHILD TOO? SO WE ARE TRYING TO MAKE THOSE CONVERSATIONS, UM, HAPPEN IN A DIFFERENT WAY. 
          DON'T MAKE THAT DISTINCTION. 
          SO WHAT WE TEACH THE HEALTHCARE PROVIDERS DON'T, DON'T MAKE THAT DISTINCTIONS BETWEEN REQUIRED AND RECOMMENDED. 
          WHEN A CHILD WALKS IN, JUST LIST ALL THE VACCINES THAT ARE AGE APPROPRIATE AND DUE FOR THAT CHILD AT THAT VISIT. 
          BECAUSE RIGHT THEN AND THERE, AS A HEALTHCARE PROVIDER, IF I SAY, OKAY, THIS IS REQUIRED AND THIS MAY BE, YOU CAN HAVE IT IF YOU WANT, YOU ARE GIVING THE WRONG MESSAGE TO THE PARENTS. 
          SO WE ARE WORKING CLOSELY, WE SIT ON THE REGIONAL ADVISORY BOARD FOR SCHOOLS. 
          WE ARE WORKING CLOSELY WITH NORTH SAID ISDS, WHERE THEY DO SEND OUT LETTER EVERY SCHOOL, EVERY I S D SENDS OUT RIGHT ABOUT THE SCHOOL, BACK TO SCHOOL SEASON. 
          THEY SEND OUT LETTERS SAYING, YOUR CHILD HERE ARE THE REQUIRED VACCINE YOUR CHILD SHOULD HAVE. 
          SO WE ARE WORKING CLOSELY WITH THE SCHOOLS TO SAY, OKAY, DON'T ALSO, CAN YOU ALSO ADD SAYING, AND HERE ARE THE RECOMMENDED VACCINES THAT YOUR CHILD IS DUE AS WELL, AND SEE IF THIS IS GOING TO IMPROVE THE VACCINATION RATE. 
          SO I DON'T KNOW IF THAT ANSWERED YOUR QUESTION, BUT IT DOES. 
          IT DOES. 
          AND THEN, UM, THE NEXT QUESTION I HAD IS, WHEN IT COMES TO THE STDS AND, AND H P V, I KNOW A LOT OF TIMES WE LOOK AT THE YOUNGER GENERATIONS, BUT WE HAVE A HIGH RATE OF MORBIDITY, MORBIDITY AND INFANT MORTALITY. 
          AND I KNOW DURING PREGNANCY, A LOT OF PEOPLE ARE NOT TESTED PARTICULARLY FOR MAYBE H P V, AND I WANTED TO KNOW IF THERE'S ANY CORRELATION WITH, UM, SOMEONE WHO HAS BUT HAS NOT BEEN TREATED OR HAS NOT BEEN TESTED AND NOT HAVING THE PROPER PRENATAL CARE. 
          UM, IF, IF THERE'S A CORRELATION IN, IN THAT ASPECT. 
          WE DON'T HAVE ANY LOCAL STUDIES DONE, JUST JUST TO ESTIMATE THAT JUST YET. 
          BUT I COME FROM TARRANT COUNTY. 
          SO, SO BEFORE I GO TO THE TARRANT COUNTY STORY HERE, WHAT WE ARE DOING IS WE HAVE A FEMUR, WHICH IS FETAL INFANT MORTALITY REVIEW BOARD, WHERE WE REVIEW EVERY SINGLE INFANT DEATH, UH, TO ASSESS WHAT WAS THE CAUSE FOR THIS, THIS, THIS ADVERSE EVENT TO HAPPEN. 
          [00:35:01]
SO WE ARE NOT YET READY TO RESULT, UH, RELEASE THE RESULTS OF THAT REVIEW, BUT BASED ON RESULTS FROM OTHER JURISDICTIONS OR FEMA REVIEWS, WHAT WE FOUND OUT, WHAT WAS THAT? S STIS IS THE NUMBER ONE REASON WHY WE HAVE INFANT DEBTS IN A COMMUNITY. 
          SO IT REMAINS TO BE SEEN IF WE ARE ABLE TO DETECT THE SAME TREND. 
          UM, SO YEAH. 
          YES, S T SS ARE VERY IMPORTANT AND WE HAVE A BIG, UH, PROGRAM CALLED HEALTHY BEATS WHERE WE ARE NOT H P V TESTING DURING PREGNANCY IS NOT STATE MANDATED. 
          UM, BUT SYPHILIS TESTING IS. 
          SO WE HAVE A HEALTHY BE PROGRAM, WHICH IS A CASE MANAGEMENT FOR PREGNANT WOMEN, WHERE WE ENSURE THAT ALL PREGNANT WOMEN ENROLL IN OUR PROGRAM, GET THEIR REQUIRED, UH, FIRST TRIMESTER AND THIRD TRIMESTER TESTING, UH, FOR SYPHILIS. 
          SO HOPEFULLY WE CAN PRESENT THAT SOMETIME IN THE FUTURE. 
          AWESOME, THANK YOU. 
          AND THEN MY LAST AND FINAL QUESTION, UM, I KNOW WHEN I WAS SENDING MY CHILDREN OFF TO COLLEGE, THERE WAS ONE REQUIRED, UH, VACCINATION THEY HAD TO HAVE YES. 
          TO ENROLL. 
          HAVE WE SEEN THE, THE REPORTS ON HOW IS THAT NOW? BECAUSE BEFORE IT WAS REQUIRED, WE KIND OF HAD, IT'S STILL REQUIRED. 
          IT'S STILL REQUIRED, RIGHT? HOW IS THE NUMBER OF PEOPLE THAT ARE NOW INFECTED, HOW HAS IT DECREASED WITH THE REQUIREMENT OF THE VACCINATION? IT CERTAINLY IS, AND AGAIN, MENINGOCOCCAL MENINGITIS IS ANOTHER ONE OF THOSE INFECTIOUS DISEASES YOU DO NOT WANNA HAVE BECAUSE IT CAN RESULT IN SERIOUS MORBIDITY. 
          IT HAS SERIOUS COMPLICATIONS, CAN RESULT IN DEATH AS WELL. 
          SO WE HAVEN'T HAD ONE OF THOSE CASES REPORTED TO US IN A LONG TIME. 
          SO, SO THE VACCINATION IS WORKING, VACCINATION IS ABSOLUTELY THE REASON TO KEEP THAT DISEASE RATE DOWN. 
          AWESOME. 
          THANK YOU SO MUCH. 
          AND THANK YOU CHAIR. 
          THANK YOU COUNCILWOMAN. 
          COUNCILMAN ELIAS. 
          UH, EXCELLENT PRESENTATION. 
          I REALLY APPRECIATE YOU PUTTING THE WORK AND, AND BRINGING YOUR TEAM OUT. 
          UH, UH, I WANNA GO BACK TO, YOU KNOW, A FEW YEARS BACK WHEN THE AVIAN FLU WAS ALL THE RAGE AND, UH, EVERYBODY WAS TALKING ABOUT IT, RIGHT? AND I, I REMEMBER THAT, UM, I WAS, I GOT TO SEE IT PLAY OUT AS AN IN-HOUSE ATTORNEY AT A BIG COMPANY IN OUR HUMAN RESOURCES DEPARTMENT NATIONWIDE REALLY TOOK IT ON, RIGHT? AND I LEARNED THAT IT WAS SOMETHING THAT HUMAN RESOURCES MANAGERS ALL OVER THE NATION AT LARGE COMPANIES WERE TAKING THIS VERY SERIOUSLY. 
          UM, AND I'M WONDERING, TO WHAT EXTENT DO YOU SPEAK TO LOCAL HUMAN RESOURCES DEPARTMENTS OR DECISION MAKERS ABOUT, YOU KNOW, ANNUALLY ABOUT THE FLU OR I DON'T KNOW, CORONAVIRUS OR WHATEVER, RIGHT? UM, TO MAKE SURE THAT THEY'RE IN SYNC WITH YOU AND THAT THEY KNOW HOW TO CONTACT YOU AND OR YOU GIVE THEM INFORMATION. 
          OKAY. 
          SO OUR CONTACT INFORMATION IS WIDELY PUBLICIZED. 
          UM, DO WE, DO I ACTIVELY CALL EACH OF THESE COMPANIES TO SEE, CAN WE COME OUT AND MAKE PRESENTATIONS? NO. 
          BUT THEY ALL KNOW WE ARE HERE, SHOULD THEY, SHOULD THEY NEED OUR ASSISTANCE? YEAH. 
          UM, TOM, BUT HAVING SAID THAT, FROST BANK VERY ENGAGED WITH PUBLIC HEALTH. 
          UM, THEY HAVE ASKED ME TO COME OUT TWICE TO GIVE A END OF THE YEAR FLU SUMMARY. 
          AND SOMETIMES WHEN THE FLU SEASON IS TERRIBLE, LIKE 2017, WE HAD A BAD SEASON, THEY WILL ASK US TO COME IN AND MAKE SURE THEY HAVE ALL THOSE, UH, RIGHT PROTOCOLS IN PLACE TO PROTECT THEIR, THEIR, THEIR, UH, STAFF. 
          SO IF THERE WERE MORE THAN 24 HOURS IN THE DAY, AND ASSUMING YOU HAD THE RESOURCES AND TIME, DO YOU SEE A BENEFIT IN RECRUITING THE HELP NOW OF, YOU KNOW, UH, ORGANIZED HUMAN RESOURCES MANAGERS? AND LEMME TELL YOU, THERE'S AN ORGANIZATION IN TOWN CALLED SHRM OR SHERMA, RIGHT? WHERE ALL THE HUMAN RESOURCES MANAGERS BELONG AND IT'S, UH, IT'S A GROUP WHERE THEY ALL SHOW UP TO UPDATE EACH OTHER ON TRENDS AND NEWS AND, YOU KNOW, AND DO TRAINING, UH, IN ORDER TO GET CERTIFIED MM-HMM. 
           AND, UH, YOU KNOW, THE, UH, IT'S, EVERY MAJOR CITY HAS ONE OF THESE, RIGHT? MM-HMM. 
          , AND IT WOULD, IT SEEMS TO ME LIKE A LOW HANGING FRUIT OPPORTUNITY TO, TO GO TALK TO THEM AND MAYBE EVEN GIVE THEM A PRESENTATION ON WHO Y'ALL ARE, RIGHT? BECAUSE I MEAN, I KNOW THAT YOUR, YOUR CONTACT INFORMATION IS WIDELY PUBLICIZED, BUT GOING TO THE CUSTOMER BEFORE DISASTER HITS, RIGHT? UM, AND FORGING THAT PARTNERSHIP EARLY ON MIGHT MIGHT BE HELPFUL. 
          AND I'M NOT GONNA TELL YOU HOW TO DO YOUR JOB, I'M JUST SUGGESTING YEAH, NO, NO, NO, ABSOLUTELY. 
          AND YOU'RE RIGHT. 
          I MEAN, WE NEED TO BE DOING MORE OF THAT. 
          AND THANK YOU FOR BRINGING THIS TO OUR ATTENTION. 
          WE WILL ALL, WE'LL CERTAINLY REACH OUT TO THIS ORGANIZATION NEXT WEEK AND SEE IF THEY'RE WILLING TO ENGAGE WITH US AND WORK CLOSELY WITH US. 
          OKAY. 
          NO, THAT'S ALWAYS, I NEVER CONSIDER REDUNDANCY IN, IN POINTS OF DISSEMINATION AS A BAD THING. 
          YOU KNOW, THE MORE PEOPLE WE CAN TALK TO, THE BETTER FOR PUBLIC HEALTH. 
          [00:40:01]
AND, AND THE REASON IT WORRIES ME IS, 'CAUSE I READ RECENTLY THAT WAS IT NINE IN 10 PEOPLE REPORT THAT THEY'LL SHOW UP TO WORK WITH FLU SYMPTOMS. MM-HMM. 
          , UH, YOU KNOW, 'CAUSE THEY GOTTA GO TO WORK AND OR THEY'VE USED UP THEIR SICK DAYS OR THEY JUST THINK IT'S A COLD. 
          AND, UH, YOU KNOW, I MEAN, IF, IF COMMUNICABLE DISEASES ARE COMMUNICABLE JUST BECAUSE OF PROXIMITY MM-HMM. 
          , UH, IT SEEMS TO ME THAT, YOU KNOW, EVERYBODY GOES TO WORK. 
          RIGHT. 
          AND, UM, SO ANYWAY, SO THAT'S ONE. 
          AND THEN THE SECOND THING I WANTED TO ASK YOU ABOUT, UM, WAS SCHOOLS, I, I IMAGINE THAT Y Y'ALL HAVE A, A VERY GOOD RELATIONSHIP WITH THE SCHOOL NURSES AND THE SCHOOL HEALTH OFFICERS OR WHATEVER AT THE PUBLIC SCHOOLS. 
          HOW DOES THAT WORK, YOU KNOW, TRANSLATE TO IN, IN PRIVATE SCHOOLS? SAME THING. 
          UH, OKAY, SO, SO, AND IS THERE A, YOU KNOW, A LOT OF THESE PRIVATE SCHOOLS ARE FAITH-BASED, YOU KNOW, ATTACHED TO A CHURCH PROGRAM OF SOME SORT. 
          DO YOU, UH, FIND THAT THEY'RE JUST AS WILLING TO TAKE YOU GUYS IN AND WORK WITH YOU OR? YES. 
          OKAY. 
          ALRIGHT. 
          YES. 
          AND ONE THING I WANNA POINT OUT ABOUT SCHOOLS TOO. 
          SCHOOL AND HEALTHCARE FACILITIES ARE TWO PLACES WHERE WE JUST, WE SEE WE ARE THE PUBLIC HEALTH AGENCY. 
          WE ARE NOT A REGULATORY ENFORCEMENT AGENCIES. 
          WE CAN MAKE RECOMMENDATIONS, BUT IN THESE TWO INSTANCES, SAY FOR INSTANCE, HAD WE HAD A MEASLES CASE IN A SCHOOL AND EXPOSURES REFUSE TO BE VACCINATED, WE CAN'T SCHOOL OFFICIALS WHO ARE CLOSELY WITH US AND EXCLUDE THOSE PEOPLE WHO ARE NOT GETTING VACCINATED FOR, FOR THE REST OF THEIR MONITORING PERIOD, WHICH IS 21 DAYS. 
          SO, UM, YEAH. 
          SO SOMETHING I, AND MOST PEOPLE I THINK, THINK, DON'T KNOW ABOUT IT, AND IF YOU CAN TALK ABOUT IT, IS THE PEOPLE WHO CHOOSE NOT TO VACCINATE THEIR CHILDREN, THERE IS A, A PROCESS FOR THAT, RIGHT? THERE'S PAPERWORK TO FILL OUT. 
          YES. 
          UH, AND YOU HAVE TO INFORM THE SCHOOL. 
          UM, AND IS THAT PAPERWORK THAT'S SENT TO YOU TO THE TEXAS DEPARTMENT OF STATE HEALTH SERVICES? SO TEXAS IS ONE OF THOSE 16 STATES WHICH YOU'RE PLANNING, WE'RE TRYING HARD TO CHANGE WHERE WE DON'T ONLY, WE NOT ONLY HAVE MEDICAL EXEMPTIONS FOR VACCINES, BUT THEY ALSO ALLOW CONSCIENTIOUS EXEMPTIONS. 
          RIGHT? SO THOSE PEOPLE WHO THINK THAT THOSE ARE THE PEOPLE AND THEY CAN, THOSE ANTI-VAXXERS YES. 
          YEAH. 
          ANTI-VAXXERS. 
          AND IT IS SO EASY TO GET THOSE CONSCIENTIOUS EXEMPTIONS IN PLACE. 
          ALL YOU NEED IS A SIGNED AFFIDAVIT IT, GET IT NOTARIZED, SUBMIT IT TO THE STATE, AND YOU'RE GOOD TO GO. 
          BUT DO THEY INFORM YOU? YES. 
          UH, THEY KNOW TEXAS DEPARTMENT OF STATE HEALTH SERVICES, AND WE GET THOSE INFORMATIONS FROM THE TEXAS DEPARTMENT OF STATE HEALTH SERVICES. 
          OKAY. 
          SO STATE IS THE ONE WHO HAS THE AUTHORITY TO GRANT THOSE EXEMPTIONS. 
          SO JUST FOR THE BENEFIT OF MY, MY COLLEAGUES, UM, I WAS LOOKING AT A, SOMEBODY COMPILED A MAP OF SORT OF THE HOTSPOTS WHERE THE MOST, WHAT IS IT, UM, REFUSALS TO VACCINATE BASED ON CONSCIOUS CASES HAPPEN. 
          RIGHT. 
          AND IT TURNS OUT THAT THEY'RE IN DISTRICT A, THE N I SS D SCHOOLS ARE THE ONES WHERE YOU HAVE THE MOST REFUSALS TO VACCINATE BASED ON CONSCIOUS AND, UH, THE, THE, YOU KNOW, THE ANTI-VAXXER PHENOMENON. 
          AND, UH, I, I WAS SURPRISED. 
          AND, UM, YOU KNOW, ONE OF THE THINGS WE DO IS WE, WE TALK ABOUT IT SOMETIMES WITH PARENTS AT OUR, OUR TOWN HALLS AND ALL THAT, BUT, UH, MANY OF THEM WERE IN DISTRICT SEVEN. 
          UH, AND SO IT'S, BUT, BUT I APPRECIATE YOU GUYS DOING THIS PRESENTATION. 
          THANK YOU FOR ANSWERING MY QUESTIONS. 
          AND THANK YOU CHAIRWOMAN, FOR ENTERTAINING THIS TODAY. 
          THANK YOU. 
          COUNCILMAN, UH, COUNCILWOMAN ROCHE GARCIA. 
          THANK YOU, CHAIR. 
          THANK YOU FOR THAT PRESENTATION THAT WAS, UH, TERRIFYING. 
          UH, BUT WONDERFUL TO LEARN ALL ABOUT. 
          I HAVE A QUESTION. 
          UM, I TOLD MANY, I THINK I'M LIKE ITCHING OR SOMETHING RIGHT NOW, BUT, UM, HOW DO WE PREPARE FOR SOMETHING LIKE, UH, YES. 
          THE, ANY TYPE OF FLU EPIDEMIC OR YES. 
          UH, CORONAVIRUS, OR IS THERE, I I DON'T WANNA ASSUME THAT THERE'S LIKE A PLAN ON SOME SHELF IN PLACE THAT TELLS YOU HOW TO WORK, YOU KNOW, ACROSS THE CITY AND, AND MAYBE TO HELP YOUR ELECTED OFFICIALS REASSURE THEIR FOLKS THAT THEY'RE, THAT EVERYTHING'S GONNA BE OKAY. 
          BUT DO WE HAVE, WE, I'M ASSUMING THERE'S BEEN, UM, A PROCESS BEFORE AND YOU PROBABLY, OR DR. 
          BRIDGER HAD SET UP OR SOMETHING. 
          CAN YOU JUST HELP ME A LITTLE BIT? YOU WANT ME TO ANSWER? YOU WANNA ANSWER? SURE. 
          I LOVE TO PUT MY PUBLIC HA HEALTH HAT BACK ON. 
          UM, SO USING THE CORONAVIRUS AS AN EXAMPLE, YESTERDAY AFTERNOON WE HAD A PHONE CALL OF APPROXIMATELY 25 TO 30 DIFFERENT ORGANIZATIONS AND PARTNERS WHO WOULD BE INVOLVED IF THIS BECAME A SIGNIFICANT EVENT HERE IN SAN ANTONIO. 
          SO WE MADE SURE THAT EVERYBODY HAD THE LATEST AND GREATEST INFORMATION. 
          UM, WE MADE SURE THAT EVERYBODY UNDERSTOOD THE NEED FOR HEIGHTENED AWARENESS AND HEIGHTENED SCREENING AND FOR EVERYBODY TO CHECK AND MAKE SURE THAT THEY HAD THE RIGHT AMOUNT OF THE RIGHT KINDS OF SUPPLIES. 
          UM, SO THAT WAS A PRELIMINARY CONVERSATION. 
          WE THEN HAD A PHONE CALL WITH 
          [00:45:01]
HOSPITALS TODAY. 
          UM, WE HAVE ANOTHER PHONE CALL TOMORROW, UH, WITH THE STATE. 
          AND SO RIGHT NOW WE'RE IN THIS KIND OF SURVEILLANCE AND MONITORING PHASE OF THE RESPONSE. 
          UM, EVERY EVENT IS DIFFERENT BECAUSE EVERY INFECTION HAS A DIFFERENT SET OF RULES. 
          UM, BUT WE USE A SIMILAR TEMPLATE, WHICH IS THAT REGULAR COMMUNICATION OF ALL OF OUR PARTNERS, MAKING SURE WE'RE ALL ON THE SAME PAGE. 
          AND THAT COMMUNICATION IS, UM, HAPPENING A LOT REDUNDANTLY VERY CLEARLY. 
          AND AS A MATTER OF FACT, WE JUST WROTE UP A, UM, SUMMARY FOR CITY COUNCIL, UH, TO GO OUT IN ERIC'S END OF WEEK REPORT FOR TOMORROW TO KEEP Y'ALL IN THE LOOP AS WELL. 
          GREAT. 
          THANK YOU DR. 
          BRIDGER. 
          AND I DO WANNA, UM, GIVE A NICE SHOUT OUT TO ACOG BECAUSE YESTERDAY I GOT, UM, A NICE PRESS RELEASE SAYING, HEY, YOU KNOW, HERE'S THE STATUS OR WHATEVER IT WAS. 
          AND SO I APPRECIATED THEN THEY'RE KEEPING OUR LOCAL AND IN RURAL COMMUNITIES AS WELL INFORMED. 
          SO THANK YOU. 
          AND THEN MY NEXT QUESTION IS, I KNOW THAT, UM, IT SOUNDS LIKE EVERYTHING'S DONE ELECTRONICALLY AND RECORDS ARE, UM, TRANSMITTED SO THAT, YOU KNOW, TO BE EFFICIENT. 
          I'M ASSUMING THAT THERE'S SOME SORT OF A BACKUP PLAN IN CASE THE TECHNOLOGY WOULD ALSO BE IN JEOPARDY. 
          LIKE IF WE CAN'T USE TECHNOLOGY TO FIND OUT, FIND THE, THESE RECORDS OF THESE PATIENTS THAT MIGHT HAVE BEEN INFECTED. 
          LIKE WHAT'S THE BACKUP PLAN? IS IT MEDICAL CHARTS? FAX, FAX MACHINES? THEY STILL EXIST. 
          YES. 
          PHONE CALLS, FAX MACHINES. 
          AND SINCE WE ARE SO CLOSE TO AUSTIN, WE HAVEN'T HAD TO DO THAT, BUT WE ARE WILLING TO DO THAT TOO. 
          JUMP IN THE CAR AND TAKE IT TO AUSTIN. 
          YES. 
          SORRY, I'M ALWAYS LOOKING FOR A PLAN B, SO THANK YOU. 
          THANK YOU. 
          CHEER. 
          THANK YOU VERY MUCH MS. KION. 
          AND THEN WE'LL HAVE ANOTHER PRESENTATION NEXT MONTH, I BELIEVE, ON THE ROLE OF THE HEALTH DEPARTMENT. 
          UM, I DID HAVE ONE QUICK QUESTION ACTUALLY. 
          UM, YOU TALKED ABOUT BEING THE AUTHORITY FOR THE COUNTY, NOT JUST FOR THE CITY. 
          IS THAT, UM, AND THAT'S, SO FOR ALL THE SUBURBAN CITIES AS WELL, HOW DOES THAT WORK? SO IF YOU LOOK CLOSELY AT THE NAME OF THE HEALTH DEPARTMENT, IT'S ACTUALLY THE METROPOLITAN HEALTH DISTRICT. 
          THE REASON WE'RE CALLED A HEALTH DISTRICT IS BECAUSE WE ARE RESPONSIBLE FOR BOTH THE COUNTY AND THE CITY. 
          UM, WHEN IT COMES TO ESPECIALLY COMMUNICABLE DISEASES, UM, FOR THE OTHER JURISDICTIONS, THEY CAN OPT OUT OF THAT IF THEY WANT TO HAVE THEIR OWN. 
          BUT, UM, NONE OF THEM DO. 
          THEY LIKE TO RELY ON US. 
          UM, SO WE, WE ARE THE GO-TO PLACE FOR ANYBODY WHO LIVES WITH BEXAR COUNTY TO DEAL WITH COMMUNICABLE DISEASES. 
          OKAY. 
          CAN YOU TALK INTO THE MIC? THANK YOU. 
          I WAS JUST GONNA SAY, BECAUSE THE COMMUNICABLE DISEASES, UH, THE REPORTING, NOTABLE CONDITIONS, REPORTING IS A STATE LAW. 
          UM, CITIES CAN OPT OUT IF THEY HAVE A HEALTH DEPARTMENT TO CARRY OUT THESE FUNCTIONS. 
          NOW, IN THE ABSENCE OF THAT, THEY DON'T HAVE A CHOICE. 
          THEY'RE REQUIRED BY PROVIDERS PRACTICING IN THEIR JURISDICTION OR REQUIRED BY LAW TO REPORT TO US. 
          OKAY, GREAT. 
          UM, HOLD ON, WE'VE GOT TWO, TWO MORE QUESTIONS, UH, COMING UP. 
          UM, IS THAT HOW, UH, SO IN TERMS OF THE METROPOLITAN HEALTH DISTRICT, IS THAT HOW IT FUNCTIONS IN OTHER COUNTIES AS WELL? IT DEPENDS. 
          UH, HOUSTON FOR EXAMPLE, HAS A COUNTY HEALTH DEPARTMENT AND A CITY HEALTH DEPARTMENT. 
          MM-HMM. 
          , UM, AUSTIN, FOR EXAMPLE, IS THE CITY AND THE COUNTY TOGETHER. 
          YEAH. 
          SO IT'S, IT'S EVERY, BASICALLY, LIKE DR. 
          CURIAN SAID, IF THE CITY DECIDES THEY WANT TO HAVE THEIR OWN HEALTH DEPARTMENT, THEN THEY CAN, AND THEY CAN BE IN CHARGE OF THEIR WORLD HERE IN SAN ANTONIO. 
          UM, WE COVER THE ENTIRE COUNTY. 
          SO WE'RE NOT YOUR ONLY BOSSES. 
          THE COUNTY IS ALSO YOUR BOSS. 
          NO, ED, YOU SOUND, YOU LOOK REALLY EAGER. 
          I WANT YOU TO GO TO THE FRONT AND TAKE THE MIC. 
          . 
          YEAH, I CAN GIVE YOU A LITTLE BACKGROUND FOR THAT. 
          SO THE GOOD AFTERNOON. 
          HI EVERYONE. 
          UM, AND FOR ANYONE WHO DOESN'T KNOW, THIS IS THE ATTORNEY. 
          YES, I'M, I'M THE ATTORNEY. 
          SO, UH, YEAH. 
          SO IN THE 1960S, THE CITY AND COUNTY CONSOLIDATED HEALTH SERVICES INTO THE CITY. 
          WE HAVE A COOPERATIVE AGREEMENT WITH THE COUNTY THAT ACTUALLY ALLOWS IT TO FUNCTION ESSENTIALLY AS A DEPARTMENT OF THE CITY UNDER THE CONTROL OF THE CITY. 
          SO THE COUNTY DOESN'T COME INTO PLAY WITH ANY SORT OF, UH, OWNERSHIP OR LEADERSHIP OF THE HEALTH DISTRICT. 
          AND IT APPLIES TO THE CITY LIMITS AND TO UNINCORPORATED AREAS OF THE COUNTY. 
          GREAT. 
          ANYTHING ELSE, DR. 
          BRIDGER? NO. 
          OKAY. 
          WE HAVE A FOLLOW UP FROM, UH, COUNCILWOMAN. 
          YES. 
          SO IN THE CO-OP AGREEMENT, OR DOES BEAR COUNTY ALSO 
          [00:50:01]
HELP FUND SAN ANTONIO METRO HEALTH? THE COUNTY PROVIDES A LITTLE UNDER $200,000 A YEAR TO COVER THE COST OF RESIDENTS, UM, IN UNINCORPORATED BEAR COUNTY. 
          UM, WE HAD THE SUPER EXCITING ANNOUNCEMENT WITH OUR BUDGET THAT THE HOSPITAL WAS CONTRIBUTING $600,000 TOWARDS OUR INSTITUTE FOR TRAUMA-INFORMED CARE. 
          UM, THAT WAS ALSO A WAY TO, UM, HAVE THE COUNTY CONTRIBUTE MORE TO THE WORK OF THE HEALTH DEPARTMENT, UM, BUT IN A MORE TARGETED AREA. 
          SO I, I NEED TO START TALKING ABOUT THAT $600,000. 
          WHEN I TALK ABOUT THAT 200, THE 200 GOES MORE TOWARDS THE CORE SERVICES THAT WE PROVIDE. 
          THE 600 GOES TOWARDS SPECIFICALLY TO THE INSTITUTE. 
          SO MY NEXT QUESTION IS GONNA BE HOW LONG DID THEY FUND 200,000 OR WAS IT SINCE THE INCEPTION OR WHEN WAS IT REVISITED? BUT IT SOUNDS LIKE YOU ANSWERED MY QUESTION WITH THE 600,000 ADDITIONAL. 
          YES. 
          AND THAT 200,000 HAS BEEN FOR AT LEAST 10 YEARS. 
          OKAY, GREAT. 
          THANK YOU. 
          DR. 
          RICHARD SAID THANK YOU, CHAIR. 
          UH, COUNCILMAN T THANK YOU CHAIR. 
          UM, YOU KNOW, JUST OFTEN, UH, IT IT COMES TO MIND, YOU KNOW, WHEN WE TALK ABOUT REPORTING, UM, AND WE ALWAYS WANT TO TAKE DOWN THESE NUMBERS BECAUSE THE, THEY'RE CRITICAL, BUT I'VE BEEN ASKING THIS A LOT LATELY, IS WHY DO WE NOT EXPAND OUR 3 1 1 SYSTEM TO, TO PROVIDE MORE CONNECTIVITY TO THESE NUMBERS MORE EFFECTIVELY? I MEAN, THERE SHOULD REALLY BE TWO MAJOR NUMBERS. 
          EVERYBODY SHOULD KNOW ABOUT 9 1 1 AND 3 1 1. 
          AND, UH, AND I WOULD ASK THAT WE CAN TAKE A LOOK AT HOW 3 1 1 COULD POTENTIALLY, UH, BE, UH, UH, UTILIZED SO THAT, UH, YOU DON'T HAVE TO NECESSARILY MEMORIZE ALL THESE NUMBERS, BUT YOU CAN EASILY MEMORIZE 3 1 1. 
          SO THAT'S MY REQUEST. 
          THANK YOU CHAIR. 
          AND JUST FOR THE RECORD, IF ANYBODY CALLS 3 1 1 AND SAYS, I NEED TO REPORT THIS, THEY HAVE THAT INFORMATION. 
          THE QUESTION THAT YOU'RE ASKING IS WHY DON'T WE JUST DIRECT THEM TO 3 1 1? BUT I DID WANT TO CLARIFY THAT. 
          WELL, SO I, I AND I, I NEED TO CLARIFY TOO. 
          I'M, I'M ALSO TALKING ABOUT THE 3 1 1 ESSAY APP. 
          MM-HMM. 
          . 
          'CAUSE IT'S NOT IN THERE. 
          UH, YEAH. 
          AGAIN, THESE ARE MEDICAL PROVIDERS WHO ARE REPORTING THE COMMUNICABLE DISEASES, NOT THE, UM, AVERAGE PUBLIC. 
          AND, AND THERE'S THE ISSUE OF HIPAA AS WELL. 
          SO THESE INFORMATION, MEDICAL INFORMATION CANNOT BE TRANSMITTED TO OTHERS EXCEPT FOR PUBLIC HEALTH DEPARTMENT. 
          THEN WE HAVE TO DEAL WITH HIPAA ISSUES. 
          YES. 
          OKAY. 
          SO I MISUNDERSTOOD. 
          I THOUGHT THESE ARE NUMBERS FOR PEOPLE TO, TO BE REPORTING, BUT OKAY. 
          I STAND CORRECT. 
          NO, THAT'S, THAT'S CONFUSING BECAUSE LIKE, WHY WOULD I NEED THOSE NUMBERS? RIGHT. 
          , I DON'T RUN A CLINIC, SO, OKAY. 
          SO, SO GENERAL, OH, SORRY. 
          BECAUSE I'M THE CHAIR, I NEED, I NEED ALL THOSE NUMBERS. 
          , UH, YES. 
          PUBLIC CAN ALSO CALL THESE NUMBERS AND REPORT. 
          THEY CAN ALSO CALL 3 1 1 AND JUST REPORT THAT I AM, I'M AWARE OF SOMEBODY IN MY OFFICE WHO'S BEEN DIAGNOSED WITH LET'S SAY MENINGITIS. 
          THEY CAN DO THAT. 
          AND THOSE 3 1 1 CALLS GET ROUTED TO US. 
          WE CONTACT THE PATIENT, THE, THE CALLER BACK TO GET ADDITIONAL INFORMATION AND THEN, BUT, BUT THIS IS PRIMARILY FOR PROVIDERS TO REPORT HIPAA INFORMATION TO US. 
          UM, COUNCILMAN? NO, YOU, YES, YOU HAVE IT. 
          YEAH, I DO ACTUALLY. 
          I, YOU KNOW, THERE'S SOMETHING THAT, THAT I LEFT OFF AT THE VERY BEGINNING OF THE PRESENTATION. 
          UH, DR. 
          BRIDGER SAID THAT SHE AND I HAD HAD A SCINTILLATING CONVERSATION ABOUT, UH, TUBERCULOSIS AND HANSEN'S DISEASE. 
          AND I LEARNED LATER THAT HANSEN'S DISEASE IS A THING, IT'S ON YOUR LIST AND THAT IT'S, UH, IT'S LEPROSY AND, UH, THAT LEPROSY STILL EXISTS AND THAT IT'S SOMETHING THAT YOU ALL MONITOR FOR AND THAT YOU ARE, YOU KNOW, ALWAYS ON THE ON GUARD ABOUT. 
          BUT DID, IF I REMEMBER CORRECTLY, YOU TOLD ME THAT THERE'S LIKE A LEPROSY INSTITUTE HERE IN SAN ANTONIO OR IS LIKE A FOUNDATION, IS THAT RIGHT? NOT . 
          WILL YOU SAY A LITTLE BIT ABOUT THE, UM, THE HOSPITAL, THE, THE T C I D HOSPITAL? OKAY. 
          SO WE DO HAVE A CHEST CLINIC, UH, THAT'S A STATE RUN HOSPITAL, UM, WHERE IT'S AN INPATIENT FACILITY FOR, UM, MULTI-DRUG RESISTANT, EXTREMELY DRUG RESISTANT TB IN CASES OF LEPROSY TOO. 
          'CAUSE LEPROSY AND TB, THEY'RE BOTH HIGHLY INFECTIOUS. 
          IT'S, IT'S ONE OF THOSE, UH, CONDITIONS THAT ARE AUTHORIZED FOR FEDERAL ISOLATION AND QUARANTINE. 
          SO, UH, FORTUNATELY FOR US, WE DON'T SEE CASES OF LEPROSY. 
          I DON'T THINK WE'VE HAD A CASE OF LEPROSY HERE IN BAYER COUNTY IN THE LAST MAYBE 30 YEARS. 
          UH, MOST OF THOSE CASES ARE IMPORTED THAT WE SEE IN THE NATION. 
          SO, UH, WE DON'T TAKE THE FOOT OFF THE GAS PEDAL. 
          WE ARE CONSTANTLY MONITORING THAT. 
          BUT WE DON'T HAVE A 
          [00:55:01]
CASE HERE AT BAY COUNTY JUST YET. 
          MOST OF THOSE CASES ARE IMPORTED CASES. 
          ALRIGHT, THANK YOU VERY MUCH. 
          UM, IT'S GREAT TO TALK ABOUT HEALTH FINALLY AT THE, AT THE HEALTH COMMITTEE MEETING. 
          SO, . 
          ALRIGHT. 
          UH, I DO HAVE TO SAY THE BEST PART OF THE PRESENTATION WAS WATCHING THE ECONOMIC DEVELOPMENT STAFFS FACE WHEN , WHEN THE MEASLES SYMPTOMS WERE BEING DESCRIBED. 
          UM, ALRIGHT, UH, WE'LL MOVE ON TO THE 
          [3. 20-1273 Briefing and possible action on the San Antonio Senior Services Assessment conducted by The University of North Texas, Department of Public Administration. [Colleen M. Bridger, MPH, PhD, Assistant City Manager; Melody Woosley, Director, Human Services]]
NEXT ITEM, WHICH IS THE, UH, SENIOR SERVICES ASSESSMENT. 
          OH, SHOULD I INTRODUCE YOU, JESSICA? SORRY. 
          IT'D BE NICE. 
          UM, JESSICA DOLINA IS AN ASSISTANT DIRECTOR AT OUR DEPARTMENT OF HUMAN SERVICES AND OVERSEES, UM, SENIOR SERVICES EVEN THOUGH WE'RE GONNA LEARN A NEW WAY TO TALK ABOUT SENIOR SERVICES AT SOME POINT, UM, BECAUSE I LEARNED THAT I'M QUICKLY APPROACHING THAT AGE GROUP AND I DON'T WANT TO BE REFERRED TO AS A SENIOR. 
          UM, SO JESSICA, TAKE IT AWAY. 
          THANK YOU, DR. 
          BRIDGER. 
          UM, SO TODAY, AS DR. 
          BRIDGER MENTIONED, WE'LL BE PROVIDING A HIGH LEVEL OVERVIEW OF OUR RECENTLY COMPLETED SENIOR SERVICES STRATEGIC PLAN, ALONG WITH RECOMMENDATIONS AND NEXT STEPS. 
          AND JUST AS BACKGROUND BEFORE WE BEGIN ON OUR PROGRAM, WE OPERATE 10 COMPREHENSIVE SENIOR CENTERS CURRENTLY THROUGHOUT THE CITY AND ALSO 42 PART-TIME NUTRITION SITES THAT ARE OPERATED BOTH BY THE DEPARTMENT OF HUMAN SERVICES AND OUR COMMUNITY PARTNERS. 
          AND WE HAVE AN OVERALL BUDGET OF ABOUT 13.7 MILLION, OF WHICH 2 MILLION IS GRANT FUNDED. 
          SO IN 2011, UH, SOME OF YOU MIGHT REMEMBER THAT WE COMPLETED A SENIOR SERVICES STRATEGIC PLAN WITH K G B T TEXAS. 
          FROM THAT PLAN, THERE WERE ABOUT 86 RECOMMENDATIONS, 90% OF WHICH WE IMPLEMENTED FULLY IN FISCAL YEAR 2018. 
          AND THOSE, THOSE RECOMMENDATIONS REALLY FOCUSED AROUND FOUR KEY AREAS, OPTIMAL SERVICE, DELIVERY, FOOD SERVICE, OUR LOCATIONS OF SENIOR CENTERS AND TRANSPORTATION. 
          AND SO IMPLEMENTATION OF THOSE RECOMMENDATIONS ACTUALLY FORM THE MODEL THAT WE SEE TODAY. 
          SINCE 2011, OUR PARTICIPATION FROM SENIORS IN THE COMMUNITY HAS GROWN FROM 9,000 TO MORE THAN 24,000 ACTIVE PARTICIPANTS. 
          AT THE SAME TIME, THE NUMBER OF COMPREHENSIVE SENIOR CENTERS HAS GROWN FROM SIX TO 10, AND WE HAVE TWO MORE PLANNED IN 2022 IN COUNCIL DISTRICT FOUR AND COUNCIL DISTRICT NINE. 
          AND REALLY BASED ON THESE CHANGES AND THE CHANGES IN OUR OPERATIONAL MODEL, THE OVERALL GROWTH IN THE COMMUNITY. 
          IN MARCH OF 2019, WE ASKED AND CITY COUNCIL APPROVED A RECOMMENDATION TO, UH, ENGAGE IN AN INTER-LOCAL AGREEMENT WITH THE UNIVERSITY OF NORTH TEXAS TO COMPLETE A SENIOR SERVICES STRATEGIC PLAN UPDATE. 
          AND THE FIRST THING THAT THE STUDY REALLY LOOKED AT IS OUR OVERALL SENIOR POPULATION IN THE COMMUNITY RELATIVE TO THE SERVICES AND PROGRAMMING THAT WE'RE OFFERING AT OUR CENTERS. 
          SO IN SAN ANTONIO, THE TOTAL POPULATION THAT'S ESTIMATED TO BE 60 AND OVER IS ROUGHLY 17%. 
          AND BY 2040 IT'S EXPECTED TO GROW TO 20% OF THE POPULATION. 
          YOU'LL SEE HERE A MAP. 
          AND THIS ACTUALLY SHOWS THE POPULATION OVER 60 BY CENSUS BLOCK GROUP THAT'S ESTIMATED BY 2024. 
          AND THE DARKER SHADED AREAS ARE ANTICIPATED TO HAVE A HIGHER DENSITY OF SENIOR, SENIOR RESIDENTS. 
          RIGHT NOW, OVER 95% OF SENIORS IN SAN ANTONIO LIVE WITHIN A FIVE MILE RADIUS OF EITHER A COMPREHENSIVE SENIOR CENTER OR A PART-TIME NUTRITION SITE. 
          AND YOU'LL, YOU'LL REMEMBER THAT I MENTIONED WE HAVE 24,000 ACTIVE PARTICIPANTS. 
          ABOUT 79% OF THOSE PARTICIPANTS ACTUALLY ATTEND A COMPREHENSIVE CENTER WITH THE REMAINDER ATTENDING A PART-TIME NUTRITION SITE. 
          SO THE STRATEGIC PLAN ACTUALLY FOCUSED ON THREE KEY AREAS FOR US. 
          IT LOOKED AT WHAT ARE THE EVOLVING DEMANDS FOR NOT ONLY OUR SENIOR CENTERS BUT SERVICES CITYWIDE. 
          WHAT ARE SOME, UH, LOCATION DECISIONS THAT THEY CAN HELP US WITH TO DETERMINE FUTURE SENIOR CENTER PLACEMENT? AND HOW DO WE INTEGRATE AGE-FRIENDLY, UH, ACTION POLICY CITYWIDE? SO YOU'LL SEE HERE THE WORLD HEALTH ORGANIZATIONS AGE-FRIENDLY COMMUNITY FRAMEWORK, WHICH ACTUALLY SERVED AS A GUIDING PRINCIPLE AS WE COMPLETED THE SENIOR SERVICES STRATEGIC PLAN. 
          AND IN 2014, THE CITY OF SAN ANTONIO ACTUALLY ADOPTED THE AGE-FRIENDLY, UH, COMMUNITIES, NETWORK IDEAS, AND, UH, THROUGH A A R P TEXAS. 
          AND WE REAFFIRMED THAT COMMITMENT IN 2017. 
          SO, AS I MENTIONED, THE FIRST PHASE OF THE STUDY WAS LOOKING AT THE EVOLVING DEMAND IN OUR SENIOR CENTER SERVICES, BOTH, NOT, NOT ONLY JUST FROM CURRENT PARTICIPANTS, BUT ALSO THOSE SENIORS THAT ARE IN THE COMMUNITY THAT ARE MAYBE NOT PARTICIPATING IN PROGRAMMING. 
          IN TOTAL, MORE THAN 1500 SURVEYS WERE COMPLETED, AND THEY REALLY REPRESENTED 
          [01:00:01]
THE DIVERSITY IN OUR COMMUNITY. 
          AND THEY WERE ANALYZED IN CONJUNCTION WITH LOOKING AT BEST PRACTICE RESEARCH AND LITERATURE REVIEW TO FRAME THE RECOMMENDATIONS THAT ARE PROVIDED IN THE REPORT FROM THE SURVEYS. 
          94% OF THOSE SURVEYED INDICATED THAT THEY VISIT A SENIOR CENTER EVERY DAY, AND DURING THOSE VISITS, THEY STAY FOR TWO OR MORE HOURS. 
          THE OTHER THING WAS THAT REGARDLESS OF INDIVIDUAL CHARACTERISTICS OF PARTICIPANTS UNIVERSALLY APPEALING TO ALL SENIORS WHERE THE MEAL PROGRAM, EXERCISE CLASSES AND GAMES. 
          HOWEVER, THE STUDY DID FIND THAT THERE WERE SIGNIFICANT DIFFERENCES IN PREFERENCES BASED ON AGE, GENDER, INCOME, AND CULTURE. 
          SO SOME SPECIFIC EXAMPLES REGARDING THAT, SENIORS AGED 75 AND OLDER HAD A HIGHER THAN ANTICIPATED NEED FOR SOCIAL SERVICES. 
          MEN HAD A HIGHER THAN ANTICIPATED INTEREST IN GAMES AND OTHER RECREATIONAL ACTIVITIES COMPARED TO WOMEN. 
          WOMEN HAD A HIGHER THAN EXPECTED INTEREST IN ARTS AND CRAFT AND DANCE CLASSES. 
          ASIAN AMERICANS HAD A HIGHER INTEREST IN FIELD TRIPS THAN OTHER, UH, DEMOGRAPHIC GROUPS. 
          AND THEN EVEN MORE INTERESTINGLY, INTEREST IN OUR VOLUNTEERING INCREASED AS A PARTICIPANT'S INCOME LEVEL INCREASED. 
          SO THOSE ARE JUST A FEW OF THE VARIATIONS. 
          THERE WERE MANY MORE IN THE REPORT. 
          AND WHAT WE'RE DOING IS WE'RE ACTUALLY USING THOSE VARIATIONS TO HELP US INFORM WHAT KIND OF PROGRAMMING ADJUSTMENTS WE NEED TO MAKE TO MAKE SURE THAT WE'RE BEING RESPONSIVE TO THE NEEDS AND DESIRES OF OUR SENIOR MEMBERS AND THE LARGER COMMUNITY. 
          AND WE WILL ASSESS THAT ON AN ANNUAL BASIS. 
          SO JUST A FEW OF THE KEY RECOMMENDATIONS IDENTIFIED IN THE REPORT. 
          THERE ARE OTHERS THAT ARE NOT IDENTIFIED HERE THAT THE DEPARTMENT OF HUMAN SERVICES HAS INCLUDED IN OUR IMPLEMENTATION PLAN. 
          AND WE WILL, UH, IMPLEMENT THOSE THROUGH EXISTING RESOURCES AND COMMUNITY PARTNERSHIPS. 
          THESE THAT ARE IDENTIFIED HERE HAVE A FINANCIAL IMPACT THAT ARE ASSOCIATED WITH THEM, AND WE'VE GROUPED THEM INTO SEVEN CATEGORIES THAT YOU SEE. 
          THE FIRST IS REBRANDING OUR SENIOR CENTERS. 
          SO, AS DR. 
          BRIDGER MENTIONED, THE TERMINOLOGY SENIORS IS NOT VERY APPEALING TO OLDER ADULTS. 
          AND SO HOW DO WE LOOK AT SOMETHING LIKE AN AGING WELLS CENTER OR A 50 STRONG AS A WAY OF TALKING ABOUT OUR SENIOR CENTERS AS OPPOSED TO CALLING THEM SENIOR CENTERS? ALSO LOOKING AT EXPANDING OUR EQUITY-BASED PROGRAMMING DECISIONS SO THAT WE ATTRACT MEMBERS WHO HISTORICALLY WE HAVE NOT SERVED IN THOSE CENTERS AND HAVE HISTORICALLY BEEN UNDERSERVED IN GENERAL, INCLUDING MEMBERS OF THE L G B T Q COMMUNITY. 
          ALSO LOOKING AT PROVIDING ONSITE SOCIAL AND FINANCIAL RESOURCES AND SERVICES. 
          SO HOW DO WE HELP SENIORS WITH FUTURE PLANNING FINANCIALLY? HOW DO WE HELP THEM WITH EMERGENCY ASSISTANCE IF THEY NEED THAT? AND THEN ONCE THEY GET READY TO TRANSITION TO THE NEXT PHASE OF THEIR LIFE, HOW DO WE HELP THEM IDENTIFY CAREGIVERS AND RESOURCES TO SUPPORT THAT? WE ALSO INCLUDED THE, RATHER, THE STUDY INCLUDED RECOMMENDATIONS TO EXTEND OPERATIONAL HOURS TO LOOK AT EXPANDING OUR SERVICE ELIGIBILITY TO SENIORS THAT ARE OLDER ADULTS THAT ARE AGE 50 TO 59, EXCUSE ME,  PEOPLE. 
          WE'RE JUST PEOPLE  MM-HMM. 
          . 
          AND THEN INCREASING MANAGEMENT SUPPORT IN LINE WITH THE GROWTH IN THE NUMBER OF SENIOR CENTERS, THE NUMBER OF PARTICIPANTS THAT WE'RE SERVING AND THE LEVEL OF SERVICE THAT WE'RE PROVIDING. 
          AND LASTLY, EXPANDING OUR MEDICAL SERVICES TO MAKE SURE THAT WE'RE USING EVIDENCE-BASED PRACTICES THAT ENHANCE COGNITIVE AND PHYSICAL HEALTH DEVELOPMENT IN A MORE COMPREHENSIVE WAY THAN WHAT WE CURRENTLY PROVIDE AT THE CENTERS. 
          SO WE ARE RECOMMENDING, IMPLEMENTING THESE RECOMMENDATIONS. 
          WE'RE PROPOSING THAT THEY BE PHASED IN OVER FOUR YEARS, AND AS PART OF THAT STRATEGY, WE WANNA IDENTIFY FOUR REGIONAL HUBS THAT WILL OFFER THOSE EXTENDED HOURS AND EXTENDED ELIGIBILITY SERVICES. 
          WE WOULD BE BASING THAT ON AN ANALYSIS OF FACILITY CAPACITY, COMMUNITY INPUT, COMMUNITY INTEREST INPUT FROM THE SENIORS, AND ALSO INPUT FROM CITY COUNCIL. 
          THE SECOND PHASE OF THE STUDY LOOKED AT FUTURE SENIOR CENTER LOCATIONS, REALLY TO GIVE US SOME GUIDANCE ON HOW DO WE DETERMINE WHERE TO PLACE SENIOR CENTERS IN THE FUTURE IN A MORE METHODICAL WAY. 
          AND IT LOOKED AT DEVELOPING AN INDEX THAT LOOKED AT A NUMBER OF FACTORS, INCLUDING SENIOR POPULATION DENSITY IN THE AREA, BOTH THE CURRENT POPULATION AND FUTURE PROJECTED POPULATIONS, LOOKING AT THE FEASIBILITY OF A SENIOR SENATE IN THE AREA. 
          SO IS THERE LAND AVAILABLE? ARE THERE ZONING ISSUES? THOSE TYPES OF CONSIDERATIONS. 
          THE LIKELINESS THAT RESIDENTS IN THAT AREA WOULD UTILIZE SENIOR SERVICES AND THEN SURROUNDING AMENITIES IN THE AREA THAT WOULD MAKE IT A GOOD FOCAL POINT OR HUB FOR SENIOR SERVICES OVERALL. 
          AS A PART OF THIS ANALYSIS, THEY ALSO LOOKED AT OUR EXISTING SENIOR CENTERS IN ORDER TO IDENTIFY IF THERE WERE GAPS OR AREAS THAT WERE UNDERSERVED IN THE COMMUNITY. 
          YOU'LL SEE ON THAT MAP, THE DARKER AREAS ARE AREAS WHERE THEY SAID THAT THERE MAY BE NEED FOR ADDITIONAL SENIOR CENTERS. 
          COINCIDENTALLY, THE TWO NEW SENIOR CENTERS THAT ARE PROPOSED TO OPEN IN 2022 IN COUNCIL DISTRICT FOUR AND COUNCIL 
          [01:05:01]
DISTRICT NINE ARE WITHIN THOSE HIGH NEED AREAS. 
          THE THIRD ASPECT OF THE REPORT, REALLY THROUGH INTERVIEWS AND THROUGH BEST PRACTICE RESEARCH AND LITERATURE REVIEW, AS WELL AS GOING BACK TO THE AGE-FRIENDLY DOMAINS, LOOKED AT HOW DO WE IMPLEMENT AGE-FRIENDLY POLICY CITYWIDE, SO OUTSIDE OF THE DEPARTMENT OF HUMAN SERVICES OR OTHER SPECIFIC, UM, DEPARTMENTS THAT OFFER SENIOR SERVICES, HOW DO WE LOOK AT ON A MORE, UH, GLOBAL SCALE? AND IT REALLY WORKED AT IDENTIFYING SEVEN ADDITIONAL CITY DEPARTMENTS THAT COULD PROVIDE SOME TARGETED EFFORTS IN THOSE AREAS, WHICH INCLUDES T C I, NEIGHBORHOODS AND HOUSING SERVICES, LIBRARY PARKS AND RECREATION PLANNING DEVELOPMENT SERVICES, AND METRO HEALTH. 
          THESE RECOMMENDATIONS, AS I STATED, ARE ALIGNED WITH THE AGE-FRIENDLY DOMAINS, AND MANY OF THESE SAME RECOMMENDATIONS ARE ALSO INCLUDED IN THE HUMAN SERVICES IMPLEMENTATION PLAN. 
          TO GIVE YOU SOME EXAMPLES IN THE AREAS OF OUT OUTDOOR, UM, SERVICES AND BUILDINGS, IMPROVING WALKABILITY FOR SENIORS, UH, TRANSPORTATION INCREASING OR ALTERNATIVE ACCESS TO TRANSPORTATION. 
          SO LOOKING AT THINGS LIKE UBER, LYFT, AND OTHER OPTIONS THAT MIGHT BE AVAILABLE AND IN HOUSING OR PUBLIC TRANSPORTATION. 
          , RIGHT?  MM-HMM. 
          . 
          UM, AND THEN IN HOUSING, LOOKING AT INCREASING NEW AND EXISTING AFFORDABLE HOUSING STOCK FOR OLDER ADULTS. 
          AND SO SOME OF THESE THEMES MAY SOUND FAMILIAR. 
          THERE ARE THINGS THAT CITYWIDE OTHER DEPARTMENTS ARE ALREADY WORKING ON, AND SO WE WILL BE INTEGRATING WITH THAT WORK. 
          UM, AND WE WILL BE ALSO BE WORKING WITH THEM TO REVIEW DIFFERENT ASPECTS OF THE REPORT AND DEVELOP IMPLEMENTATION PLANS. 
          LASTLY, THIS IS A HIGH LEVEL OVERVIEW OF OUR NEXT STEPS. 
          SO BEGINNING IN DECEMBER, WE STARTED WORKING WITH INTERNAL AND EXTERNAL STAKEHOLDERS TO REVIEW REPORT FINDINGS AND REALLY SOLIDIFY THE DEPARTMENT OF HUMAN SERVICES IMPLEMENTATION PLAN. 
          THROUGH AUGUST, WE'RE GONNA CONTINUE THESE CONVERSATIONS AND ENHANCE THEM WITH OTHER DEPARTMENTS TO ALSO PREPARE FOR THE UPCOMING BUDGET PROCESS. 
          IN OCTOBER OF 2020, WE'RE ANTICIPATING THAT WE WILL BE BEGIN THE DEPARTMENT OF HUMAN SERVICES MULTI-YEAR IMPLEMENTATION PLAN, AND THAT OUR PARTNERING CITY DEPARTMENTS WILL LOOK AT HOW THEY COLLECT AND DISAGGREGATE OLDER ADULT USAGE OF THEIR SERVICES TO HELP INFORM THEIR OWN PLAN DEVELOPMENT. 
          AND THEN FOR FISCAL YEAR 2022, RECOMMENDATIONS FOR AGE FRIENDLY POLICY ACTION CITYWIDE WOULD ACTUALLY BE BROUGHT TO COUNCIL BY INDIVIDUAL DEPARTMENTS THROUGH THE ANNUAL BUDGET ADOPTION PROCESS. 
          AND THAT, THAT CONCLUDES THE PLAN PRESENTATION THAT WE HAD. 
          BOTH MELODY AND I ARE HERE TO ANSWER ANY QUESTIONS YOU ALL MIGHT HAVE. 
          UH, THANK YOU VERY MUCH. 
          EVERYONE HAS QUESTIONS? UH, SO I'LL START WITH COUNCILWOMAN. 
          ANDREW SULLIVAN. 
          THANK YOU CHAIR. 
          UM, THANK YOU JESSICA FOR THE PRESENTATION. 
          THANK YOU, MELODY, UM, FOR ALWAYS BEING OPEN TO LISTEN TO US ABOUT OUR SEASON, UH, POPULATION AS THEY CONTINUE TO AGE IN PLACE. 
          UM, A LOT OF THINGS THAT I HEAR WHEN WE HAVE OUR, OUR BREAKFAST IS IN DISTRICT TWO, WE HAVE A STOREFRONT, SO THEY FEEL VERY DISRESPECTED TO BE JUST PLACED IN A, IN A CORNER SOMEWHERE, UM, WHICH DOESN'T REALLY OPEN UP TO A LOT OF THE THINGS THAT THEY WOULD LIKE TO SEE HAPPEN, UM, AS THEY AGE IN PLACE. 
          UM, ANOTHER ONE OF THE CONCERNS IS ABOUT THE TRANSPORTATION, BECAUSE A LOT OF THEM CANNOT GET TO THE SENIOR CENTERS BECAUSE EITHER THE PERSON THAT DRIVES THE VAN DOESN'T COME IN, OR THE PERSON THAT'S SUPPOSED TO BE THERE JUST DOESN'T SHOW UP. 
          UM, SO THEY MISS A LOT OF THE ACTIVITIES THAT THEY WOULD LIKE TO, TO TO SEE. 
          UM, SOME OTHER CONCERNS WERE THEY, WE HAVE, UM, A PLANET FITNESS THAT'S, THAT'S CLOSE MM-HMM. 
          . 
          AND BECAUSE OF THEIR FIXED INCOME, A LOT OF THEM ARE STILL PAYING TO GO TO THIS FITNESS CENTER BECAUSE BEING IN THE LITTLE CORNER THAT THEY'RE STUFFED IN, THEY DON'T REALLY GET THE ACTIVITIES THAT THEY'RE USED TO. 
          SO IT FEELS LIKE THEY'RE AN AFTERTHOUGHT. 
          MM-HMM. 
           AFTER THEY LOOK AROUND AND SEE OTHER DISTRICTS THAT ARE GETTING THE SENIOR CENTERS, UM, AS FAR AS DOING AQUATICS THAT WE KNOW ARE VERY IMPORTANT TO THEM, HAVING JOINT LIFE AND BEING ABLE TO MOVE, THERE'S NOWHERE IN THE DISTRICT FOR THEM TO TRULY TAKE PART IN THAT. 
          UM, I KNOW THE POOLS AT THE Y M C A AND THE BOYS AND GIRLS CLUB HAVE BEEN CLOSED BECAUSE OF, UM, FILTRATION ISSUES OR, UM, BECAUSE THEY'RE SO OLD, THEY JUST DON'T WORK AS WELL AS THEY THEY USED TO. 
          AND SO A LOT OF THE THINGS I'M SEEING THAT'S GREAT TO HAVE SERVICES GO INTO THE CENTER. 
          THEY JUST DON'T SEEM TO, TO THINK YOU GUYS SEE THEM, UM, FOR THE THINGS THAT THEY NEED. 
          AND SO WE WOULD REALLY LOVE TO SEE IF WE'RE TALKING ABOUT EQUITY THAT TRULY BE THE CONVERSATION THAT WE HAVE. 
          [01:10:01]
SO I APPRECIATE ALL THAT YOU DO, BUT I WOULD REALLY LOVE IT TO HAPPEN IN EVERY DISTRICT. 
          SO THANK YOU. 
          UH, THANK YOU COUNCILWOMAN. 
          UM, I'VE ALSO HEARD, UH, COMMENTS IN MY DISTRICT ABOUT THE TRANSPORTATION NOT ALWAYS COMING, UH, ON, ON TIME FOR, FOR EVENTS OR SOMETHING LIKE THAT. 
          AND, AND WHOLE GROUPS OF SENIORS AT A, LIKE, AT A NUTRITION SITE MISSING MM-HMM. 
          , UH, AN ANNUAL EVENT THAT WE MIGHT HAVE FOR SENIORS. 
          SO, UM, I'LL MOVE ON TO COUNCILMAN, UH, TREVINO, WHOSE COMMITTEE, UH, WILL ACTUALLY BE HEARING SENIOR, UH, ISSUES IN THE FUTURE. 
          SO THANK YOU. 
          YEAH. 
          WE, WE, WE CERTAINLY LOOK FORWARD TO IT. 
          AND, AND THANK YOU, UH, CHAIR TO, TO RECOGNIZE THAT BECAUSE IT IS COMPLEX. 
          AND, UM, I WANNA DOVETAIL, UH, OFF OF THE TRANSPORTATION PIECE AND JUST, UH, ASK THAT, THAT WE TAKE A LOOK AT SOME OF THE RIDESHARE COMPANIES. 
          I KNOW LYFT HAS OFFERED TO, TO BE, UH, PROACTIVE IN HELPING TO SUPPORT SOME OF THE, THE TRANSPORTATION OF SENIORS MM-HMM. 
          . 
          AND I THINK IT, THAT GIVES US A LOT OF FLEXIBILITY. 
          SO IF, IF WE CAN, I KNOW, UH, WE'VE ASKED BEFORE ABOUT, UH, USING SOME OF THE, THE, THE FUNDS OR RESOURCES AVAILABLE AND SEE HOW CAN WE MAYBE, UH, PILOT A PROGRAM THAT THAT COULD INCORPORATE, UH, LYFT PARTICULARLY, BECAUSE I KNOW THEY HAVE A MM-HMM. 
           THIS PARTICULAR PROGRAM THAT COULD HELP. 
          SO I'D LIKE TO FOLLOW UP ON THAT. 
          UM, AND THANK YOU FOR RECOGNIZING, UH, L G B T Q NEEDS. 
          SO I'M GLAD THAT WAS IN THE PRESENTATION. 
          AND YOU KNOW, ONE OF THE THINGS THAT, THAT IS BROUGHT UP A LOT WHEN, WHEN TALKING ABOUT, UH, L G B T Q CENTER IS, IS, IS MAKING IT A, A PLACE THAT MAYBE IS, UH, MAYBE TO DR. 
          BRIDGER'S POINT, IS NOT JUST ENTIRELY SENIORS. 
          AND YOU, YOU EVEN MENTIONED MAYBE MORE LIKE A COMMUNITY CENTER AND, UM, YOU KNOW, I'D LIKE FOR US TO EXPLORE THIS IDEA THAT, THAT MAYBE THERE, THERE'S OPPORTUNITIES AND, AND, AND GAPS IN, IN OTHER AGE RANGES. 
          AND I, I'LL GIVE YOU A SMALL EXAMPLE. 
          WE'VE BEEN TRYING FOR A LONG TIME TO, TO GET A A, A BOYS AND GIRLS CLUB IN, IN DISTRICT ONE. 
          WE DON'T HAVE ONE. 
          AND, UH, WE KNOW THEY'RE A GREAT RESOURCE TO OUR ENTIRE COMMUNITY, BUT, YOU KNOW, THEY, THEY CAN'T NECESSARILY BE EVERYWHERE. 
          AND, AND SO THIS IDEA COULD BE THAT MAYBE THERE'S OPPORTUNITIES WHERE, YOU KNOW, SOME, SOME YOUNGER KIDS COULD, COULD BENEFIT FROM RESOURCES THAT WE COULD SHARE AND DRIVE, YOU KNOW, CONNECTION BETWEEN SENIORS AND, AND, AND CHILDREN. 
          UH, WHICH AT LEAST I THINK I'VE READ, UH, IS, IS A VERY, VERY POSITIVE, UH, GOOD, HEALTHY SOLUTION, UH, IN TERMS OF COMMUNITY AND CONNECTION. 
          AND MORE AND MORE COMMUNITIES ARE DOING THAT, AND I'D LIKE TO SEE US EXPLORE THAT. 
          UM, AND THEN LASTLY, JUST AS, AS THE CHAIR MENTIONED, WHICH WE WILL TALK A LITTLE BIT MORE IN MY COMMITTEE, IS I DO WANT US TO LOOK AT THE FACILITIES, UH, AND, AND TAKE A LOOK AT, YOU KNOW, INNOVATIVE WAYS TO, TO MAKE THOSE FACILITIES MORE MULTIPURPOSE. 
          MM-HMM. 
          , UH, MORE FLEXIBLE. 
          THE ISSUE THAT I HAVE, I, I HAVE AT LEAST IN, IN THE, IN TWO SENIOR CENTERS THAT THE, WELL, THREE SENIOR CENTERS THAT, UM, SENIOR, UH, FACILITIES IS SORT OF THE IMMOBILITY AND THE SORT OF LACK OF, OF, OF CHANGING, UH, YOU KNOW, THE, THE ABILITY TO, TO, TO DO DIFFERENT PROGRAMMING AND DIFFERENT THINGS WITH THE SPACE. 
          KENWOOD, FOR EXAMPLE, BECAUSE EVEN SOME OF THE INTERIOR WALLS ARE ACTUALLY BUILT OUT OF CONCRETE BLOCK. 
          MM-HMM. 
           INCREDIBLY DIFFICULT TO, TO ADJUST AND MOVE. 
          AND WE JUST SHOULDN'T BE BUILDING THEM LIKE THAT. 
          IN FACT, THAT'S HOW, THAT'S HOW YOU BUILD PRISONS. 
          UM, AND WE SHOULDN'T BE BUILDING SENIOR CENTERS LIKE THAT. 
          UM,  THINK IT EASY, AND SO, WELL, I, I'M, YOU KNOW, YOU GOTTA BE, YOU GOTTA BE, UH, UPFRONT ABOUT THIS. 
          'CAUSE IT'S, YOU KNOW, THE, THE, THE SENIORS AT KENWOOD FEEL THIS WAY MM-HMM. 
          , THEY FEEL LIKE WE'RE, WE'RE NOT GIVING THEM THE SPACE THEY DESERVE. 
          AND, AND SO, UH, YOU KNOW, I THINK ALL OF US UP HERE, HERE FROM, FROM, FROM OUR SENIORS, UH, THEY'D LIKE TO REALLY HAVE SOME OF THESE GREAT MODERN, UH, AMENITIES AND, AND, AND WE CAN TRY TO PROVIDE, UH, A MORE ADAPTABLE, INCLUSIVE SPACE. 
          AND I THINK IT GOES ALONG WITH WHAT I SAID PREVIOUSLY ABOUT SORT OF THE DIFFERENT AGE RANGES AND HOW WE CAN MM-HMM. 
          , IF WE CAN MAKE FACILITIES, UH, MORE ADAPTABLE, THEN THEY COULD BE USED FOR A VARIETY OF THINGS AND, AND, AND ACTIVATE 'EM MORE THROUGHOUT THE ENTIRE DAY. 
          WHICH IS ALSO ANOTHER COMPLAINT, WHICH IS, YOU KNOW, SOMETIMES THEY'RE NOT OPEN LONG ENOUGH. 
          RIGHT? OR WE CREATE SOME OF THESE ISSUES, UH, JUST BECAUSE OF THE WAY THE BUILDING IS SH UH, DESIGNED. 
          SO, YOU KNOW, I WANNA EXPLORE THAT. 
          AND I THINK THAT THIS IS SORT OF DOVETAILS INTO THE KIND OF SERVICES THAT WE DO PROVIDE. 
          AND, 
          [01:15:01]
UH, WE'VE BEEN HEARING IT CONSISTENTLY, UH, I THINK THROUGHOUT THE CITY. 
          SO I HOPE WE CAN TAKE A LOOK AT THAT AS WE START LOOKING AT SOME OF THE NEXT STEPS. 
          ABSOLUTELY. 
          AND JUST TO ADD, UH, UNDER DR. 
          BRIDGER'S DIRECTION, BOTH D UH, D H S AND PARKS AND RECREATION ARE LOOKING AT EXPLORING HOW DO WE ENHANCE INTERGENERATIONAL PROGRAMMING THAT'S HAPPENING IN THE CENTERS AND LOOKING AT SITES WHERE YOU HAVE, UM, A COMPLEX WITH A SENIOR CENTER THAT'S LOCATED ADJACENT TO A YOUTH ACTIVITY CENTER, SUCH AS YOU HAVE AT WEST END. 
          AND SO THAT'S SOMETHING THAT WE'RE EXPLORING MOVING FORWARD. 
          UM, AND YES, WE RECOGNIZE THE SENIOR CENTERS, ESPECIALLY IN THE INNER CITY, ARE SOMETIMES LEND CONSTRAINED. 
          AND SO THERE'S SOME CHALLENGES ASSOCIATED WITH THAT, BUT WE ARE LOOKING AT THAT AS WE MOVE FORWARD. 
          THANK YOU. 
          THANK YOU, CHAIR. 
          THANK YOU. 
          COUNCILMAN COUNCILWOMAN. 
          ROCHE GARCIA. 
          THANK YOU, CHAIR. 
          AND THANK YOU FOR THE PRESENTATION. 
          I, UM, I WAS JUST HAVING CONVERSATION ABOUT MULTI-GENERATIONAL CENTERS JUST A FEW HOURS AGO WITH DR. 
          GARZA FROM PALO ALTO COLLEGE AND THE NEED FOR MULTI-GENERATIONAL CENTERS. 
          AND SO, UM, I, I DEFINITELY THINK THAT THAT'S THE MODEL GOAL TO GO, UM, PARKS AND REC, UH, AND D H SS WORKING TOGETHER FOR THE HERITAGE CENTER THAT'S OPENING IN D FOUR IS IMPORTANT TO ME. 
          UM, CHARLES BUTT SENT US A BOOK, AND I DON'T KNOW IF ANY OF MY COLLEAGUES HAVE STARTED READING IT, BUT I HAVE, IT'S CALLED NO APPARENT DISTRESS. 
          AND I DON'T KNOW, I'M, I'M SURE YOU GUYS HAVE HEARD OF IT BECAUSE Y'ALL ARE IN THIS BUSINESS, BUT I HADN'T HEARD OF IT. 
          SO I STARTED READING IT, UM, AS I'M, I'M GOING THROUGH MY PHYSICAL THERAPY AND I'M NOTICING ALL THESE THINGS THAT THE BOOK TALKS ABOUT. 
          AND SO IT'S BROUGHT ME VERY IN TUNE WITH SOME OF THE ISSUES, THE, UM, DIVERSITY ISSUES, UM, THAT, THAT, THAT WE'RE FACING IN OUR COMMUNITIES. 
          AND SO, UM, I, IN, IN D FOUR, UH, OUR POPULATION, ONE THIRD OF OUR POPULATION ABOUT IS 55 PLUS. 
          SO I NEED TO MAKE SURE THAT WE START THINKING ABOUT THAT POPULATION. 
          BUT ONE THIRD OF MY POPULATION, DISTRICT FOUR IS ALSO UNDER 18 ABOUT. 
          SO THEN HOW DO WE BRIDGE THAT AND HOW DO WE MAKE THOSE CONNECTIONS? I THINK IT'S VERY IMPORTANT. 
          UM, ALSO, UH, YOU KNOW, AND JUST SOME OF THE, THE CON OR SOME OF THE THINGS THAT ARE MENTIONED IN THE BOOK. 
          SO I KEEP GETTING DISTRACTED WITH LIKE THEIR, THEIR MENTION OF N I H STUDIES, AND SO THEN I GO AND LOOK 'EM UP MYSELF, OR I LOOK AT THE FOOTNOTES, AND THEN I'M JUST GOING DOWN ALL THESE RABBIT HOLES, WHICH IS I'M ASSUMING WHY MR. BUT DID THAT BECAUSE HE WANTED US TO MAKE SURE THAT WE STARTED THINKING OF ALL THESE OTHER THINGS, WHICH I THOUGHT WAS BRILLIANT OF HIM TO JUST DO. 
          UM, BUT IN, IN, IN THAT, I ALSO, UM, I WAS INTERESTED, I DON'T SEE IT IN THIS REPORT, AND I KNOW THAT IT'S THE DRAFT, BUT YOU ALL MENTIONED THAT THERE WAS A THOROUGH LITERATURE REVIEW, AND I'M JUST SO INTERESTED IN IT THAT I'D LOVE TO SEE, UM, THE LITERATURE REVIEW, BECAUSE I'D LOVE TO SEE SOME ADDITIONAL STUDIES AND JUST KIND OF REALLY PLAN FOR, UH, FOR THIS DEMOGRAPHIC. 
          MY PARENTS ARE IN THEIR EIGHTIES, SO I'M STARTING TO DO A WHOLE LOT OF THINGS THAT I WOULDN'T HAVE TYPICALLY THOUGHT OF BEFORE. 
          AND I KNOW THAT, THAT THE RESIDENTS IN D FOUR ARE GOING TO NEED THIS AS WELL. 
          SO I'M STARTING TO THINK FROM A DIFFERENT LENS, NOT ONLY AS AS A DAUGHTER, BUT OBVIOUSLY AS A COUNCIL PERSON FOR FOLKS THAT ARE 55 PLUS. 
          UM, SO, UH, ONE OF THE THINGS THAT DR. 
          GARZA AND I TALKED ABOUT EARLIER WERE VOLUNTEERISM AND EMPLOYMENT OPPORTUNITIES AND PARTNERING WITH A A R P. 
          AND SO MY FIRST QUESTION, UH, SO I, I KNOW YOU GUYS CALL IT TARGETED RECRUITMENT, WHICH IS GREAT BECAUSE I'M IN MARKETING, SO I LOVE THIS, RIGHT? BUT ARE WE, UH, I'M ASSUMING THAT WE'RE ALSO WORKING WITH INFORMATION FROM OUR LOCAL A A R P, UM, WHEN WE DO OUR OWN KIND OF STUDIES AND FIGURING OUT WHAT AREAS HAVE THE MOST NEED. 
          YES. 
          AND ACTUALLY IN COMPLETING THIS, UH, STRATEGIC PLAN ANALYSIS, DR. 
          KEYS, THE LEAD RESEARCHER DID LOOK AT A ARPS COMPLETED STUDY, AND ALONG WITH SOME OTHER CITY DOCU COMPREHENSIVE PLANS IN DEVELOPING THAT. 
          AND WE CAN ABSOLUTELY PROVIDE THE LITERATURE REVIEW SO THAT YOU CAN, UH, TAKE A LOOK AT THAT, PLEASE. 
          I'D JUST LIKE TO NERD OUT ON THOSE. 
          UM, AND SO I'M EXCITED ABOUT THE REBRANDING OPPORTUNITY. 
          MM-HMM. 
          , I THINK THAT IT IS IMPORTANT, ALTHOUGH I KNOW SOME OF MY RESIDENTS ARE SURPRIS, I, LET'S JUST MAKE IT, CALL IT A BINGO HALL, AND YOU'LL GET MORE PEOPLE IN HERE. 
          I'M SURE THAT'S WHAT THEY WOULD SAY. 
          UM, BUT WE CAN'T DO THAT. 
          BUT ANYWAY, SO I'M EXCITED ABOUT THE REBRANDING OPPORTUNITY. 
          ALSO WONDERING, UH, SO THE SUBCOMMITTEES, I KNOW IT'S GONNA BE PRESENTED TO, TO THE NEWLY CREATED CULTURE AND COMMUNITY SERVICE COMMITTEE OR, OR WHATEVER THE NAME OF IT IS. 
          UM, HAS THIS PRESENTATION ALSO BEEN BEGINNING OF OUR REGULAR UPDATES GIVEN TO THE JOINT COMMISSION ON ELDERLY AFFAIRS? IT HAS. 
          SO WE ACTUALLY PRESENTED AN INITIAL, UM, WE'VE WORKED WITH THEM AS WE MOVE FORWARD IN ACTUALLY PROCURING THE SERVICES TO COMPLETE THE SENIOR SERVICES STRATEGIC PLAN. 
          THEY'VE BEEN INVOLVED IN LOOKING AT THE UPDATES THAT WE'VE MADE FROM THE 2011 PLAN, AND THEN HAVE ALSO RECEIVED UPDATES ON THIS PLAN AND THE RECOMMENDATIONS. 
          AND WE'VE SCHEDULED A FOLLOW-UP SESSION WITH THEM IN FEBRUARY TO BE, TO REVIEW IN MORE DETAIL. 
          GREAT. 
          ON THE 2011 PLAN SINCE, UH, A LOT OF US WEREN'T HERE, IS THERE SOMETHING THAT SHOWS US LIKE WHAT THE RECOMMENDATIONS WERE AND IF THOSE WERE ACHIEVED OR, OR WHAT THE PROGRESS OR WE HAVE MADE ON THOSE RECOMMENDATIONS? WE CAN ABSOLUTELY PROVIDE THAT. 
          OKAY. 
          GREAT. 
          [01:20:01]
AND THEN LAST BUT NOT LEAST, I KNOW MY COLLEAGUES ARE, ARE TALKING ABOUT RIDE SHARING AND, AND LYFT WAS MENTIONED, BUT VIA ALSO HAS A GREAT SERVICE THAT THEY PROVIDE PRACTICALLY DOOR TO DOOR. 
          AND SO, UM, I DON'T KNOW THAT IF BEFORE WE REACH OUT TO SOMEBODY WHO'S BENEFITING, UM, JUST REGULAR BUSINESS, LIKE, I THINK THAT, I'M SURE THAT YOU ALL HAVE BEEN TALKING TO VIA AND, AND BEING STRATEGIC AND, AND SOMETHING THAT WE KIND OF ALREADY PAY FOR MM-HMM. 
          . 
          SO, UM, SO I JUST WANTED TO ASK ABOUT THAT OR, OR PUT IN MY, UM, OR MY PITCH FOR VIA AS WELL TO BE CONSIDERED IF IT HASN'T. 
          SO, AND THAT'S ACTUALLY SOMETHING THAT THE REPORT IDENTIFIED. 
          WE DIDN'T NECESSARILY HIGHLIGHT IT IN TODAY'S PRESENTATION, BUT ALSO LOOKING AT HOW CAN WE PROMOTE SERVICES THAT ARE HAPPENING IN THE COMMUNITY THAT, UM, ARE OFFERED THROUGH OTHER PARTNERS, LIKE VIA. 
          AND SO THAT'S SOMETHING THAT WE'RE LOOKING AT. 
          WE'RE ALSO LOOKING AT UBER AND LYFT. 
          ONE OF THE, THE THINGS THAT WE'RE ENCOUNTERING, HOWEVER, IS SOME RESISTANCE FROM SENIORS, UM, REGARDING THE SAFETY. 
          AND SO WE'RE WORKING THROUGH THAT AND PROVIDING PRESENTATIONS TO HELP ALLEVIATE SOME OF THOSE CONCERNS. 
          RIGHT. 
          AND I THINK THAT, UM, AND, AND SO LIKE MY PARENTS WOULD SHARE THAT CONCERN WITH, WITH UBER AND LYFT MM-HMM. 
          , BUT THEY'RE LOCAL, SO THEY HEAR VIA AND THEY TRUST VIA. 
          YES. 
          AND SO I THINK THAT'S WHY WE SHOULD PROBABLY, UH, INVEST A LITTLE BIT MORE TIME AND EFFORT INTO MAKING SURE THAT, THAT WE DO LET THEM KNOW THAT, THAT VIA HAS THIS TYPE OF SERVICE. 
          UM, IN THE CONVERSATION ALSO WITH DR. 
          GARZA THIS MORNING, WHEN WE WERE TALKING ABOUT MULTI-GENERATIONAL CENTER, I WAS TALKING ABOUT WRAPAROUND SERVICES MM-HMM. 
          . 
          SO I LIKE THE FACT THAT THERE'S NONPROFIT ORGANIZATIONS THAT YOU ALL ARE ALREADY LOOKING AT THAT WE WOULD HAVE ACCESS, UM, YOU KNOW, OR, OR GIVE THEM AT LEAST INFORMATION TO HAVE ACCESS TO, AND JUST MAKE IT, UM, A TRULY, UM, ONE-STOP SERVICE CENTER ALMOST. 
          SO, UM, BUT THANK, THANK YOU FOR THE WORK YOU'RE DOING. 
          I LOOK FORWARD TO, TO READING THE, THE, THE REPORT AND SOME OF THE ADDITIONAL INFORMATION ON THE LITERATURE REVIEW. 
          SO THANK YOU. 
          THANK YOU. 
          THANK YOU, CHAIR. 
          THANK YOU. 
          COUNCILMAN BELI. 
          THANK YOU VERY MUCH. 
          UM, UH, A COUPLE OF THINGS. 
          THE ONE, I, I ALWAYS REMIND PEOPLE THAT THE, THERE'S TWO THINGS THAT EVERY SAN ANTONIAN HAS IN COMMON, AND I MEAN, UBIQUITOUS, RIGHT? MM-HMM. 
           ACROSS THE BOARD IS THAT ONE, WE'RE ALL STUCK IN TRAFFIC. 
          UH, AND TWO, WE'RE ALL GONNA BE SENIORS. 
          MM-HMM. 
          , UM, AND THIS CITY IS, UM, I, I THINK, UH, BEHIND THE EIGHT BALL, OR AT LEAST BEHIND THE CURB ON, ON CATCHING UP TO THIS AGING PHENOMENON THAT WE'RE EXPERIENCING, RIGHT? I, I REMEMBER WHEN, I MEAN, IT WASN'T TOO LONG AGO, SOMEBODY WOULD TELL YOU, OH, MY GRANDMOTHER PASSED AWAY. 
          REALLY? HOW OLD WAS SHE? OH, SHE WAS 80. 
          AND YOU'D GET FLOORED. 
          YOU'D BE LIKE, WHOA, 80. 
          THAT'S SO OLD. 
          I CAN'T BELIEVE SHE LIVED THAT LONG. 
          AND NOW SOMEBODY TELLS YOU THEY'RE 80 AND THEY'RE LIKE, OH, ARE THEY STILL WORKING? DO THEY STILL HAVE A JOB? RIGHT. 
          I MEAN, AND SO, UM, I, UH, UH, YOU KNOW, WE ARE, WE'RE NOW SEEING PEOPLE, YOU KNOW, LIVE INTO THEIR NINETIES, AND THAT'S NOT EVEN SURPRISING ANYMORE. 
          RIGHT. 
          UM, AND THOSE PEOPLE LIVE LONGER AND LONGER, AND I BELIEVE THAT THE OLDER THEY GET, UM, AND LIVE INTO THOSE AGES, THE LESS RELEVANT WE ARE TO THEM. 
          RIGHT. 
          UH, OR LESS. 
          AND I THINK WE'VE GOT SORT OF A CRISIS ON OUR HANDS HERE, BECAUSE WE'VE SPENT SO MUCH TIME TALKING ABOUT MAKING SURE THE CITY IS READY FOR MILLENNIALS, THIS AND MILLENNIALS THAT. 
          RIGHT. 
          AND WE'RE, YOU KNOW, UH, WE FOCUS SO MUCH OF OUR ENERGY, RIGHT. 
          MAKING SURE THE MILLENNIALS SEE US SO THAT THEY LOVE BEING HERE. 
          BUT, UM, YOU KNOW, MY DAD, FOR EXAMPLE, IS PUSHING 80, UM, AND MY DAD IS A RADIOLOGIST, UM, WITH VERY LIMITED MOBILITY. 
          UM, MY DAD CAN PROGRAM, YOU KNOW, ANY NEWFANGLED M R I MACHINE, MY DAD DOES SOME AMAZING TECHNOLOGICAL WORK MM-HMM. 
          , YOU KNOW, BUT I'LL TELL YOU RIGHT NOW THAT THERE ISN'T A SENIOR CENTER IN SAN ANTONIO THAT WOULD BE ATTRACTIVE TO HIM. 
          UM, AND HE'S NOT A CUSTOMER OF YOURS. 
          AND YET, I I MY HEAD AND WONDER, WELL, WHY NOT? RIGHT? I MEAN, UH, AND I UNDERSTAND, YOU KNOW, THE MAJORITY OF YOUR POPULATION IS, UH, YOU KNOW, LOWER INCOME, UM, YOU KNOW, SENIORS. 
          BUT IS THAT BY DESIGN OR, UH, I MEAN, DO WE WANT TO CAPTURE ALL SENIORS? AND IF SO, YOU KNOW, IS THAT WHY WE'RE DOING THIS REBRANDING? BECAUSE I, I WOULD, I WOULD TELL YOU RIGHT NOW THAT THE WORD SENIOR CENTER ALONE MAKES ME FEEL OLD. 
          MM-HMM. 
          , YOU KNOW, AND IF I WOULD BE OFFENDED IF THE DAY MY KIDS COME TO ME AND SAY, HEY, MOM, HOW, OR DAD, HOW ABOUT A, A NICE DAY AT THE SENIOR CENTER? I'LL, YOU KNOW, I'LL GROUND THEM. 
          I DON'T CARE HOW OLD THEY ARE, . 
          AND SO, UM, I, I, UM, I, I, THAT'S WHAT I WORRY ABOUT, RIGHT? AND THAT IS THAT WE HAVE CREATED THESE SENIOR CENTERS, AND I WALK IN THERE AND I'M LIKE, YOU KNOW, THERE'S NOTHING, THERE'S NOTHING HERE THAT SPEAKS TO THE NEXT GENERATION OF SENIORS. 
          AND SO, I, I ALWAYS TELL MY KIDS THAT, YOU KNOW, I ASPIRE TO REACH, YOU KNOW, A CERTAIN AMOUNT OF AFFLUENCE, YOU KNOW, OR TO AMASS A CERTAIN AMOUNT OF AFFLUENCE TO WHERE MY KIDS CAN AFFORD A NURSING HOME WITH AT LEAST SCREAMING FAST WIFI. 
          RIGHT. 
          AND, UH, AND, YOU KNOW, ACCOMMODATE MY NEEDS. 
          MM-HMM. 
          , UH, YOU KNOW, AND MY NEEDS WHEN I'M GONNA BE 70 OR 80 ARE GONNA BE, YOU KNOW, A, A PLACE, YOU KNOW, THAT IS SMART, INTELLIGENT, YOU KNOW, THAT IS AN INTELLIGENT BUILDING THAT SPEAKS TO THE DEVICE MM-HMM. 
           THAT I HAVE CHOSEN TO, UH, USE 
          [01:25:01]
TO BE SPOKEN THROUGH. 
          AND SO ALONG THOSE LINES, I, I SAW THE, THE RECOMMENDATIONS. 
          YOU GUYS HAVE THOSE, THE THIRD BULLET POINT, IF YOU GUYS CAN GO TO THAT SLIDE, PLEASE. 
          UM, YEAH. 
          SO EXPAND SOCIAL AND FINANCIAL SERVICES. 
          UH, AND I'LL, I'LL READ FOR YOU WHAT IT SAYS IN THE REPORT. 
          I, I DID READ THE REPORT AND I LIKED IT, UM, TO EXPAND RESOURCES TO ASSIST WITH FINANCIAL PLANNING, BENEFITS, ENROLLMENT, EMERGENCY SUPPORT, AND CAREGIVER RESOURCES. 
          AND THEN IN THAT SECTION, THERE'S NO MENTION OF TECHNOLOGY AT ALL. 
          UM, AND I KNOW THAT THE WORD TECHNOLOGY APPEARS TWICE IN THE REPORT. 
          UM, AND, UH, THE LAST AND MOST IMPORTANT TIME, IT, IT, UH, APPEARS, I THINK, UM, WE'RE TALKING ABOUT, YOU KNOW, HELPING THEM, YOU KNOW, WITH TECHNOLOGY SO THAT, UM, THEY CAN PARTICIPATE, UM, YOU KNOW, DO CIVIC ENGAGEMENT OR, YOU KNOW, UH, AND, AND IT'S MORE THAN THAT, RIGHT? MM-HMM. 
          , IT'S, IT'S NOT JUST A WAY FOR THEM TO ACCESS MEDICARE BENEFITS, AND IT'S NOT A WAY FOR THEM TO FIGURE OUT HOW TO SEND, YOU KNOW, UH, THE APPLICATION TO RIGHT. 
          YOU KNOW, UH, GET THEIR S S I OR WHATEVER. 
          I MEAN, THIS IS THE WAY THAT PEOPLE CONNECT WITH OTHER HUMAN BEINGS NOW, RIGHT? AND IT'S THE WAY THAT, I MEAN, YOUR INABILITY TO, TO USE THIS WEAPON OF MASS DESTRUCTION, RIGHT, UM, TO ITS FULLEST IS, IS A DISABILITY IN MANY WAYS, RIGHT? AND SO, UM, I, I WANT, I WISH THE REPORT WAS MADE WITH A WHOLE SECTION ON WHAT IT IS WE CAN DO TO, TO BE CUTTING EDGE, RIGHT. 
          AND INNOVATIVE IN THAT WAY. 
          UM, ANYWAY, I'LL PUT THAT, I DON'T, I DON'T KNOW WHAT, WHAT YOU CAN DO WITH, YOU KNOW, THAT CHALLENGE THAT I'M, I'M PUTTING OUT THERE FOR YOU. 
          WELL, IF I CAN'T, SO, UM, THE REPORT REALLY IS ARRANGED AROUND, ALONG THOSE EIGHT DOMAINS THAT WE MENTIONED, UM, UP HERE. 
          AND SO WITHIN THESE DOMAINS THERE, THEY'RE FOCUSING ON THINGS THAT WE NEED TO DO TO IMPROVE CERTAIN AREAS, BUT IT'LL BE UP TO STAFF AND OTHER CITY DEPARTMENTS TO LOOK AT HOW DO WE INTEGRATE, INTEGRATE TECHNOLOGY AND OTHER THINGS TO MAKE SURE THAT WE ARE BEING AS FORWARD THINKING AS WE NEED TO BE TO ADAPT TO THE POPULATION THAT WE'RE SERVING. 
          SO THE RECOMMENDATIONS ARE REALLY MORE GENERAL THINGS THAT WE NEED TO FOCUS ON. 
          THEY'RE NOT A PRESCRIPTION AS TO HOW TO ACCOMPLISH THAT. 
          RIGHT? SO I, I, I GET THAT, AND I APPRECIATE THAT, AND THAT'S THE RIGHT ANSWER. 
          UM, ALRIGHT. 
          UM, I, I WOULD URGE YOU THAT COMMUNICATION AND INFORMATION OR SOMEWHERE, I MEAN, THE WORD TECHNOLOGY NEEDS TO BE BECAUSE IT IS A BOX THAT NEEDS TO BE CHECKED OFF. 
          IT'S NOT A MEANS TO AN END, RIGHT? BUT IT'S, IT'S THE END IN MANY WAYS, RIGHT? MM-HMM. 
          . 
          AND SO I HAVE A, I I WANT TO THROW THAT OUT THERE. 
          THE O THE OTHER THING TOO IS, UM, TO WHAT EXTENT DO Y'ALL WORK WITH OUR FAITH COMMUNITY? I KNOW THAT, UM, REVEREND HELMKE, YOU KNOW, SORT OF FALLS UNDER Y'ALL'S UMBRELLA, BUT WHAT IS HER INVOLVEMENT WITH THIS INITIATIVE? SO, REVEREND UH, HELMKE ACTUALLY HAS A WORKING GROUP THAT'S FOCUSED ON SENIOR ISSUES, AND THEY WORK WITH OUR PROGRAMMING. 
          SO THIS IS EXTERNAL COMMUNITY LEADERS, UH, FAITH-BASED LEADERS THAT ARE LOOKING AT ISSUES THAT OUR SENIORS ARE FACING, AND WORK WITH OUR PROGRAM STAFF TO HELP ADDRESS THOSE ISSUES IN OUR SENIOR CENTERS BY BRINGING IN ADDITIONAL RESOURCES, ADDITIONAL PERSPECTIVES, UM, AND DIFFERENT POINTS OF VIEW, RIGHT? BECAUSE WE CAN, WE ALWAYS TALK ABOUT LIVE, WORK, PLAY, LIVE, WORK, PLAY. 
          BUT I, I REALLY THINK THE MORE ACCURATE THING TO SAY IS THAT WE WANNA BE A CITY WHERE, YOU KNOW, PEOPLE LIVE, WORK, PLAY WORSHIP, RIGHT? MM-HMM. 
          , AND, UH, THAT WE, THAT WE PAY ATTENTION TO THAT REALLY IMPORTANT COMPONENT OF THE WAY THAT THESE PEOPLE, YOU KNOW, CARRY OUT THEIR HUMANITY. 
          UH, AND SO I'M APPRECIATIVE OF THAT, UH, WHICH BRINGS ME TO, UH, A REQUEST COUNCIL, UM, BECAUSE THE FAITH COMMUNITY IS SUCH AN IMPORTANT COMPONENT OF, YOU KNOW, THESE FOLKS DAY TO DAY. 
          UM, AND BECAUSE I THINK THE FAITH IS PART OF EQUITY AND COMMUNITY AND HEALTH AND ALL THAT, UM, MAYBE AT SOME POINT WE COULD INVITE, UM, REVEREND HELMKE TO COME TALK TO US ABOUT WHAT SHE DOES. 
          I HAVE NO IDEA WHAT THAT, I MEAN, SHE'S A FANTASTIC, BRILLIANT LADY, BUT I HAVE NO IDEA WHAT SHE DOES. 
          AND, UH, IT SOUNDS TO ME FROM HAVING HEARD ABOUT HER, THAT SHE HEARD ABOUT HER, THAT SHE'S INTO A LITTLE BIT OF EVERYTHING MM-HMM. 
          , BUT I, I DO THINK WE, WE WOULD PROBABLY BENEFIT FROM SOME KIND OF UPDATE ON OUR FAITH INITIATIVES HERE IN THE CITY. 
          AND I CAN'T THINK OF ANOTHER COMMITTEE THAT WOULD BE AN APPROPRIATE PLACE FOR THAT. 
          SO I SHALL PUT IT ON THIS LIST. 
          THANK YOU. 
          THANK YOU. 
          AND THEN LASTLY, I, I'LL, I'LL REMIND EVERYBODY, I KNOW IT SOUNDS GOOFY, BUT I'M NOT KIDDING. 
          UH, THE ELEPHANT AT THE ZOO, UH, LIKE OUR ONE ELEPHANT LUCY, I THINK SHE TURNED 60 THIS YEAR, UH, IN MARCH. 
          UM, SHE'S GONNA, SHE'S ABOUT TO BECOME ONE OF YOUR CUSTOMERS . 
          UH, AND, UH, YOU KNOW, I, I, IF I, I MET WITH THE ZOO AND I THINK THEY'RE TALKING TO THE A A R P ABOUT IT, HOW TO CELEBRATE HER BIRTHDAY, BUT IT SOUNDS LIKE A NEAT OPPORTUNITY TO EXPOSE SENIORS TO INTRODUCE 'EM TO THE NEWEST SENIOR IN TOWN, BUT WE'LL INCLUDED IN OUR IMPLEMENTATION PLAN. 
          YEAH. 
          GREAT. 
          THANK YOU SO MUCH. 
          ALL RIGHT. 
          THANK YOU. 
          NOW, IS THIS AN ACTION ITEM OR JUST A BRIEFING? OKAY. 
          IS THE NEXT ITEM AN ACTION ITEM? OKAY. 
          I, OKAY. 
          UH, JUST A COUPLE OF COMMENTS REAL QUICK BEFORE WE MOVE ON TO, UH, THE 
          [01:30:01]
NEXT ITEM. 
          UM, BEFORE THERE IS IMPLEMENTATION, DOES THIS NEED TO GO TO COUNSEL FOR APPROVAL? I, I'M JUST NOT CLEAR. 
          IT SEEMS LIKE A LITTLE VAGUE TO ME. 
          IS IT A WORK PLAN? IS IT A STRATEGIC PLAN? WHAT? IT'S A WORK PLAN. 
          AND SO WHAT WE'LL BE DOING IS WE'LL BE BRINGING YOU RECOMMENDATIONS THAT HAVE A FINANCIAL IMPACT FOR APPROVAL DURING THE BUDGET ADOPTION PROCESS. 
          OKAY. 
          UH, DURING THE BUDGET ADOPTION PROCESS. 
          AND THEN IT SAYS HERE THAT BETWEEN NOW AND AUGUST, UH, YOU WILL HAVE, UH, PRESENTATIONS AND PLANNING SESSIONS WITH, UH, THE JOINT COMMISSION INTERNAL CITY DEPARTMENTS, AND IT SAYS EXTERNAL STAKEHOLDERS. 
          UM, THAT ALSO SOUNDS REALLY VAGUE TO ME. 
          CAN YOU TELL ME WHAT THE PLANS ARE FOR THAT? SURE. 
          WE ACTUALLY ARE INVOLVED IN A NUMBER OF GROUPS THAT ARE LOOKING AT AGING ISSUES CITYWIDE. 
          AND SO ONE OF THOSE GROUPS IS THE SUCCESSFULLY AGING AND LIVING IN SAN ANTONIO. 
          THAT'S, UH, THROUGH THE SAN ANTONIO AREA FOUNDATION. 
          SO THAT'S ONE OF THOSE EXTERNAL STAKEHOLDERS AS WELL AS OTHER PROVIDERS THAT ARE PROVIDING SENIOR PROGRAMMING IN OUR COMMUNITY. 
          MM-HMM. 
          . 
          OKAY. 
          UH, GREAT. 
          I, I WOULD INVITE YOU TO COME TO MY COMMUNITY AND, UM, WE CAN, UH, I DON'T, I THINK THIS APPLIES PROBABLY FOR ALL OF US. 
          WE DON'T RE, THERE'S NO SHORTAGE OF REQUESTS AND COMMENTS THAT WE GET ABOUT SENIOR SERVICES. 
          AND I THINK, UH, YOU'RE PROBABLY THE PERSON THAT THEY NEED TO BE TALKING TO. 
          AND THOSE ARE THE TYPES OF FOLKS I, UM, YOU MAY WANT TO, TO HEAR FROM. 
          I'D BE HAPPY TO COLLABORATE WITH YOU ON A JOINT, UH, MEETING WHERE WE CAN INVITE SOME OF THEM TO, TO PROVIDE, UH, COMMENTS. 
          UM, I DON'T KNOW IF ANY OF THE OTHER COUNCIL MEMBERS WANT TO, UH, PERHAPS DO SOMETHING SIMILAR IN, IN THEIR COMMUNITY. 
          SO, UM, ALRIGHT. 
          CAN WE, UH, CAN WE WORK ON THAT? YES. 
          AFTERWARD, OR YOU'LL JUST CONTACT, UH, THE COUNCIL MEMBERS? I, I'VE ALREADY GOT LIKE 10 PEOPLE IN MY MIND THAT I KNOW WILL SHOW UP FOR, FOR THAT 50. 
          OH, WELL YOU'VE GOT YOUR BREAKFAST SESSION. 
          THAT'S WONDER. 
          THAT'S ALREADY SET TO GO. 
          OKAY. 
          UM, AND THEN, UH, ANOTHER QUESTION IS, UH, IN TERMS OF, UH, RESIDENTS THAT DON'T LIVE IN THE CITY OF SAN ANTONIO, BUT MAYBE THERE IN BACO HEIGHTS, LEON VALLEY, WHAT IS THEIR ABILITY TO USE OUR, UH, OUR SENIOR SERVICES? SO WE ACTUALLY RUN THE MEAL PROGRAM FOR ALL OF BEXAR COUNTY. 
          AND SO WE HAVE SOME SITES THAT ARE IN THE COUNTY AS WELL, ABOUT FOUR LOCATIONS THAT ARE IN BEXAR COUNTY. 
          THEY'RE PART-TIME NUTRITION SITES, BUT THEY ALSO OFFER PROGRAMMING AC RIGHT. 
          AND, AND ACOG DOES, BUT IN TERMS OF, UH, SAY I LIVE IN LEON VALLEY, BUT I WANNA GO TO THE DORIS GRIFFIN CENTER. 
          CAN I DO THAT? CAN I TAKE A MEMBERSHIP THERE? OKAY. 
          AND IS THAT AT A DIFFERENT RATE? UH, IS MY MEMBERSHIP RATE DIFFERENT? ACTUALLY, NO. 
          MEMBERS PAY ANY FEES TO PARTICIPATE. 
          OKAY. 
          ALL SERVICES ARE PROVIDED FREE OF CHARGE. 
          OKAY. 
          UM, NO APPLICATION FEE? NO. 
          OKAY. 
          ALRIGHT. 
          UH, WELL THANK YOU, UH, VERY MUCH APPRECIATE IT. 
          AND WE'LL 
          [4. 20-1397 A briefing on the Property Assessed Clean Energy (PACE) Act, the proposed City PACE Program, and the proposed Interlocal Agreement with the Alamo Area Council of Governments for program administration. [Carlos Contreras, Assistant City Manager; Alejandra Lopez, Director, Economic Development Department]]
MOVE ON TO THE LAST ITEM. 
          YOU GUYS HAVE BEEN WAITING VERY, VERY PATIENTLY FOR THIS. 
          THANK YOU VERY MUCH, PLEASE. 
          MM-HMM. 
          ? YEAH. 
          UM, MICHAEL, PLEASE GO AHEAD. 
          MM-HMM. 
          , WELL, GOOD AFTERNOON TO ALL THE MEMBERS OF THE COMMUNITY HEALTH AND EQUITY COUNCIL COMMITTEE. 
          MY NAME IS MICHAEL SEND, AND I'M AN ASSISTANT DIRECTOR AT THE CITY'S ECONOMIC DEVELOPMENT DEPARTMENT. 
          TODAY I WILL BE PRESENTING AN OVERVIEW ON A NEW PROPOSED CITY PROGRAM CALLED THE PROPERTY ASSESSED CLEAN ENERGY PROGRAM OR PACE. 
          AS PART OF THE PRESENTATION, I WILL WALK YOU THROUGH THE TEXAS PACE ACT, HOW THE PROGRAM WILL OPERATE, WHO BENEFITS FROM THE PROGRAM, THE VARIOUS CITY COUNCIL ACTIONS NEEDED TO ESTABLISH A PACE PROGRAM IN SAN ANTONIO, AND A PROPOSED INTERLOCAL AGREEMENT WITH THE ALAMO AREA COUNCIL OF GOVERNMENTS, UH, OR ACOG TO SERVE AS THE PROGRAM'S THIRD PARTY ADMINISTRATOR. 
          AND ACOG'S HERE WITH US TODAY, BOTH DIANE WRATH AND JOHN CLAMP. 
          LET'S GET STARTED WITH SOME BACKGROUND INFORMATION. 
          THE TEXAS LEGISLATURE APPROVED THE PACE ACT IN 2013, ESTABLISHING AN INNOVATIVE FINANCING TOOL THAT ALLOWS COMMERCIAL, INDUSTRIAL, NON-PROFIT AND MULTI-FAMILY RESIDENTIAL PROPERTY OWNERS ACCESS TO LOW COST LONG-TERM LOANS TO CONDUCT ENERGY EFFICIENCY AND WATER CONSERVATION IMPROVEMENTS THAT ARE FIXED TO REAL PROPERTY. 
          HOWEVER, IN ORDER FOR SAN ANTONIO PROPERTY OWNERS TO ACCESS THIS FINANCING TOOL, THE TEXAS PACE ACT REQUIRES CITY COUNCIL TO DESIGNATE AN AREA WITHIN ITS LEGAL JURISDICTION, WHICH IN THIS ESSENCE IS THE SAN ANTONIO CITY LIMITS WHERE PACE LOANS CAN BE ASSESSED. 
          ULTIMATELY, THE GOALS AND INTENTIONS OF THE TEXAS PACE ACT 
          [01:35:01]
WERE DESIGNED TO PROMOTE ECONOMIC DEVELOPMENT EFFORTS THROUGH INCREASED INVESTMENT AND BUSINESS ACTIVITY, WHILE ALSO BOOSTING SUSTAINABILITY EFFORTS THROUGH WATER AND ENERGY CONSERVATION. 
          SINCE THE PA, SINCE THE PACE A WAS PASSED IN 2013, OVER 35 TEXAS CITIES AND COUNTIES HAVE ADOPTED A PACE PROGRAM, WHICH HAS RESULTED IN OVER 25 PROJECTS BEING COMPLETED, UM, THAT LED TO OVER A HUNDRED MILLION DOLLARS IN INVESTMENTS. 
          THE NEXT SLIDE DEMONSTRATES HOW INELIGIBLE PROPERTY OWNER WOULD SECURE A PACE LOAN. 
          ONCE A PACE PROGRAM IS ESTABLISHED IN SAN ANTONIO. 
          FIRST, THE ELIGIBLE PROPERTY OWNER WOULD IDENTIFY WATER AND ENERGY IMPROVEMENTS THAT ARE FIXED TO RURAL PROPERTY AND THEN IDENTIFY A CONTRACTOR AND A LENDER OF THEIR CHOOSING TO COMPLETE THE PROJECT. 
          ONCE THE IDENTIFIED IMPROVEMENTS MEET ALL PACE REQUIREMENTS AND ARE VALIDATED BY A MANDATORY THIRD PARTY REVIEWER, THE PROPERTY OWNER WILL SIGN A CONTRACT WITH THE PACE PROGRAM ADMINISTRATOR, WHICH PACES A PLACES A SENIOR LIEN ON THE PROPERTY. 
          NEXT, THE LENDER WILL SIGN A CONTRACT WITH THE PACE PROGRAM ADMINISTRATOR TO FUND THE IMPROVEMENTS FOR THE PROPERTY OWNER, WHICH WILL ALLOW THE CONTRACTOR TO BEGIN WORK ON THE BUILDING LAST, THE PROPERTY OWNER WOULD START SENDING THEIR MONTHLY PAYMENTS TO THE LENDER UNTIL THE LOAN IS ACTUALLY COMPLETED. 
          NEXT, I WANNA FOCUS ON THE BENEFITS OF ADOPTING A CITY OF SAN ANTONIO PACE PROGRAM. 
          ONE PRIMARY BENEFIT OF ADOPTING A PACE PROGRAM IS THAT THE TOOL IS STRUCTURED IN A WAY THAT ENCOURAGES AND INCENTIVIZES PROPERTY OWNERS TO UNDERGO BUILDING RETROFITS THAT MAY HAVE BEEN PREVIOUSLY DELAYED DUE TO PREVIOUS FINANCIAL BARRIERS. 
          THE UPFRONT FUNDING AND LONG-TERM REPAYMENT PERIOD ALLOWS PROPERTY OWNERS TO COMPLETE BUILDING RETROFITS THAT ARE CASHFLOW POSITIVE FOR MERE ONE, AS THE MONTHLY SAVINGS FROM ENERGY AND WATER BILLS WILL EXCEED THE MONTHLY COST OF THE LOAN. 
          THIS BENEFIT OF COMPLETING PROPERTY IMPROVEMENTS THAT ARE CASHFLOW POSITIVE FROM YEAR ONE IS WHAT SETS PACE LOANS APART FROM TRADITIONAL LOANS WHERE IMPROVEMENTS MAY NOT RESULT IN A POS, UH, CASH POSITIVE OR NEUTRAL FLOW FOR A NUMBER OF YEARS. 
          AS STATED ON THE PREVIOUS SLIDE, TO ENSURE THE BUILDING IMPROVEMENTS ARE CASHFLOW POSITIVE, THE PROJECTED SAVINGS MUST BE VALIDATED BY AN INDEPENDENT THIRD PARTY REVIEWER BEFORE THE LOAN CAN BE COMPLETED AND CONSTRUCTION BEGINS, WHICH FURTHER ENSURES THERE WILL BE COST SAVINGS ON THE PROJECT. 
          LAST, ANY PROPERTY OWNER WHO SECURES A PACE LOAN WILL HAVE THE REPAYMENT OBLIGATION AUTOMATICALLY TRANSFERRED TO THE NEXT OWNER IF THAT PROPERTY IS SOLD. 
          THE FINANCING DESIGN AND SAFEGUARDS OF THE PACE PROGRAM, UH, MAKE THE TOOL PARTICULARLY ATTRACTIVE TO PROPERTY OWNERS WHO HAVE DELAYED ENERGY AND WATER CONSERVATION IMPROVEMENTS. 
          AND NOT ONLY DO PROPERTY OWNERS BENEFIT FROM A REDUCTION IN THEIR MONTHLY UTILITY BILLS AND A PROJECT THAT IS CASHFLOW POSITIVE, OTHERS INVOLVED IN PACE, THE PACE PROJECT WILL BENEFIT AS WELL. 
          CONTRACTORS AND LENDERS WILL SEE AN INCREASE IN BUSINESS ACTIVITY AND THE SAN ANTONIO COMMUNITY WILL SEE AN INCREASE IN ECONOMIC DEVELOPMENT ACTIVITY, IMPROVE BUILDING INFRASTRUCTURE, IMPROVE AIR AND WATER CONSERVATION, AND A REDUCTION IN PEAK ENERGY DEMAND. 
          IN FACT, THESE BENEFITS THAT THE SAN ANTONIO COMMUNITY WILL EXPERIENCE IF ADOPTING A PACE PROGRAM DOES ALIGN WITH RECENT CITY ADOPTED PLANS AND MEMORANDUMS OF UNDERSTANDING THE SAN ANTONIO. 
          TOMORROW SUSTAINABILITY PLAN SUPPORTED THE ADOPTION OF A PACE FINANCING PROGRAM. 
          THE SAN ANTONIO CLIMATE AND ADAPTATION PLAN CALLED TO ANALYZE A FINANCING ENERGY EFFICIENCY MECHANISM, SUCH AS PACE AND THE AMERICAN CITY'S CLIMATE CHALLENGE. 
          MEMORANDUM OF UNDERSTANDING LISTED PACE AS ONE OF THE EIGHT CHALLENGE STRATEGIES FOR THE CITY OF SAN ANTONIO. 
          IN ORDER TO IMPLEMENT A PACE PROGRAM IN SAN ANTONIO, PER THE TEXAS PACE ACT, CITY COUNCIL HAS TO TAKE A FEW ACTIONS TO INFORM THE PUBLIC ON THE PROGRAM, GATHER PUBLIC INPUT, AND SELECT A THIRD PARTY ADMINISTRATOR TO OVERSEE THE PROGRAM. 
          FIRST ON FEBRUARY 20TH, DURING CITY COUNCIL A SESSION, THE ECONOMIC DEVELOPMENT DEPARTMENT IS RECOMMENDING CITY COUNCIL ADOPT A RESOLUTION OF INTENT TO ESTABLISH A PACE PROGRAM AND CALL FOR A PUBLIC HEARING TO GATHER FEEDBACK ON THE PROGRAM. 
          IN ADDITION TO THE CALL FOR A PUBLIC HEARING, THE ECONOMIC DEVELOPMENT DEPARTMENT WILL POST A PUBLICLY FACING REPORT ON THE PACE PROGRAM THAT OUTLINES HOW THE PROGRAM WILL OPERATE, AS WELL AS THE VARIOUS CONTRACTS THAT PROPERTY OWNERS AND LENDERS WOULD SIGN WHEN EXECUTING A PACE LOAN. 
          SECOND, ON MARCH 5TH, DURING CITY COUNCIL A SESSION, THE ECONOMIC DEVELOPMENT DEPARTMENT IS RECOMMENDING CITY COUNCIL HOLD THE PUBLIC HEARING REGARDING THE PACE PROGRAM AND ADOPT A RESOLUTION TO ESTABLISH A PACE PROGRAM IN THE CITY OF SAN ANTONIO. 
          IN ADDITION, THE ECONOMIC DEVELOPMENT DEPARTMENT IS RECOMMENDING CITY COUNCIL AUTHORIZE AN INTERLOCAL AGREEMENT WITH ACOG TO SERVE AS THE CITY'S PACE PROGRAM ADMINISTRATOR TO FACILITATE MANY OF THE PACE FUNCTIONS I DESCRIBED EARLIER IN THIS PRESENTATION. 
          ACOG IS THE RECOMMENDED 
          [01:40:01]
AS ACOG IS RECOMMENDED AS THE PACE PROGRAM ADMINISTRATOR, AS THEY HAVE EXPERIENCE SERVING AS A THIRD PARTY ADMINISTRATOR FOR PACE PROGRAMS, AS THEY HAVE MULTIPLE INTERLOCAL AGREEMENTS WITH VARIOUS CITIES AND COUNTIES IN THE REGIONS THEY SERVE BY SERVING AS THE THIRD PARTY ADMINISTRATOR. 
          THE INTERLOCAL AGREEMENT WITH ACOG WILL INCLUDE THE FOLLOWING PROVISIONS, SUCH AS ALL PROJECTS MUST ADHERE TO THE TEXAS PACE ACT. 
          NO COST OR LIABILITIES WILL BE INCURRED BY THE CITY. 
          FEES TO COMPLETE A PACE LOAN WILL BE LISTED PUBLICLY AND EASILY ACCESSIBLE ONLINE. 
          PROPERTY OWNER DEMOGRAPHIC INFORMATION WILL BE SHARED WITH THE CITY REGARDING POTENTIAL AND COMPLETED PACE LOANS, WHICH WILL ALLOW US TO UNDERSTAND BOTH WHO IS INTERESTED IN A PACE LOAN VERSUS WHO IS ACTUALLY ACCESSING THEM TO IDENTIFY ANY POTENTIAL DISPARITIES. 
          UM, THEY WILL BE REQUIRED TO SUBMIT ANNUAL REPORTS TO THE ECONOMIC DEVELOPMENT DEPARTMENT. 
          AND THEN ONE OTHER THING I WANTED TO TOUCH ON IS THAT ACOG DOES HAVE A HISTORY OF SECURING A PARTNERSHIP TO HELP IN THE ADMINISTRATION OF THEIR PACE PROGRAMS IN THE OTHER CITIES AND COUNTIES IN WHICH THEY HAVE AN INTERLOCAL AGREEMENT FOR THIS PROGRAM. 
          WHO IS THE TEXAS PACE AUTHORITY? A NONPROFIT ORGANIZATION FOR THE PURPOSES OF ADMINISTERING THE PACE PROGRAM IN SAN ANTONIO. 
          WHILE THE TEXAS PACE AUTHORITY MAY ULTIMATELY BE SELECTED, ACOG HAS AGREED TO CONDUCT A PUBLICLY COMPETITIVE SOLICITATION PROCESS TO SELECT A RESPONDENT WHO DEMONSTRATES THE BEST QUALIFICATIONS, EXPERIENCE, AND PROPOSED PLAN TO ASSIST IN THE MANAGEMENT OF THE CITY'S PACE. 
          PROGRAM. 
          EMPHASIS WILL BE PLACED ON RESPONDENTS WHO DEMONSTRATE ENGAGEMENT WITH UNDERSERVED COMMUNITIES AS WELL AS OTHER FACTORS SUCH AS THE FEES THAT ARE ASSESSED FOR THE LOANS TO ENSURE WE ARE REACHING AS MANY ELIGIBLE PROPERTY OWNERS, CONTRACTORS, AND LENDERS AS POSSIBLE. 
          THE ECONOMIC DEVELOPMENT DEPARTMENT WILL ALSO BE WORKING JOINTLY WITH ACOG TO SPREAD AWARENESS IN OUR LOCAL COMMUNITY ABOUT THE PROGRAM. 
          THIS INCLUDES INCORPORATING PACE INFORMATION INTO SMALL MINORITY WOMEN AND VETERAN-OWNED BUSINESS OUTREACH, UH, AND EVENTS SUCH AS OUR VENDOR ORIENTATIONS AND THINGS LIKE OUR NEWSLETTERS. 
          UM, IT INCLUDES HOSTING TECHNICAL WORKSHOPS FOR PROPERTY OWNERS, CONTRACTORS AND LENDERS, INCORPORATING PACE INFORMATION INTO EXISTING INCENTIVE PROGRAM GUIDES THAT BUSINESSES REVIEW, AND WORKING WITH PARTNERS SUCH AS THE SAN ANTONIO ECONOMIC DEVELOPMENT FOUNDATION TO PROMOTE THE PROGRAM'S BENEFITS DURING BUSINESS RELOCATION RETENTION AND EXPANSION VISITS. 
          NOW, BEFORE WE OPEN UP FOR QUESTIONS, I'D LOCK LIKE TO WALK YOU THROUGH A COUPLE OF PACE PROJECTS THAT WERE COMPLETED HERE IN TEXAS. 
          THIS EXAMPLE HIGHLIGHTS THE BARFIELD BUILDING IN THE CITY OF AMARILLO THAT HAD AN, THAT WAS UNOCCUPIED FOR A NUMBER OF YEARS WITH SUPPORT FROM PACE FINANCING. 
          THE BUILDING IS BEING REACTIVATED AND RENOVATED TO BECOME A BOUTIQUE HOTEL. 
          IMPROVEMENTS INCLUDE BOTH WATER AND ENERGY CONSERVATION WITH SIGNIFICANT SAVINGS THAT ARE INTENDED TO BRING THE BUILDING UP TO CODE. 
          BUT PACE FINANCING ISN'T ONLY LIMITED TO LARGE PROJECTS HERE WE HAVE A SMALL PAINT AND BODY SHOP IN DALLAS, WHICH A MUTS WITH A MUCH SMALLER LOAN THAT WAS USED TO LOWER THEIR ENERGY CONSUMPTION. 
          IT IS OUR INTENTION AND PARTNERSHIP WITH ACOG THAT WE PROMOTE THE PROGRAM IN SAN ANTONIO SO WE CAN SEE BOTH PROJECTS LIKE THESE BECOME REALITY. 
          THANK YOU. 
          THANK YOU MICHAEL. 
          AND TO THE WHOLE TEAM FOR ALL THE WORK ON THIS. 
          CARLOS, ALEX AND YOUR, YOUR OTHER COLLEAGUE OVER THERE. 
          SORRY, I DON'T KNOW YOUR, YOUR NAME. 
          THAT'S ISAAC BERNAL. 
          ISAAC, UH, ISAAC. 
          UH, THANKS FOR YOUR WORK ON THIS. 
          I CAN'T WAIT TO SEE YOU GUYS BLOCK WALKING DOWN CULEBRA AND BANDERA AT ALL OUR AUTO REPAIR SHOPS TO SEE SOMETHING LIKE, LIKE THIS HAPPEN FOR SURE. 
          YEAH. 
          YEAH, WE HAVE A LOT OF THOSE. 
          UM, I'M GONNA START WITH COUNCILWOMAN ANDREW SULLIVAN. 
          THANK YOU. 
          THANK YOU CHAIR. 
          UM, THANK YOU SO MUCH FOR THE PRESENTATION. 
          THANK YOU FOR BRIEFING US PRIOR TO THIS PRESENTATION TO HELP US UNDERSTAND EXACTLY WHAT THIS PROGRAM DOES AND HOW IT WORKS. 
          UM, I ONLY HAVE A, A FEW QUESTIONS. 
          I KNOW IN THE PRESENTATION YOU SAID THAT, UH, INCORPORATING PACE INFORMATION INTO EXISTING, UM, INCENTIVE PROGRAM GUIDES. 
          WHAT DOES THAT ENTAIL WHEN IT COMES TO, UM, TS PROJECTS THAT WE HAVE THROUGH A LOT OF THE DEVELOPMENT OF THE MULTI-FAMILY HOUSING AND, AND MM-HMM. 
           INNOVATIVE ZONES? HOW, HOW DOES THIS WORK? SO NOT ONLY ARE WE GONNA BE INCORPORATING THIS INFORMATION INTO THE PROGRAMS THAT ECONOMIC DEVELOPMENT, OVERSEE ANY OTHER DEPARTMENT THAT WOULD POTENTIALLY BE ABLE TO UTILIZE A PACE LOAN, OUR CENTER CITY DEVELOPMENT DEPARTMENT, UH, NEIGHBORHOOD AND HOUSING SERVICES. 
          OUR INTENTION IS ALSO CONNECT THIS PROGRAM WITH THEM, CONNECT ACOG WITH THEM SO THAT WE CAN ALSO PUSH OUT THIS PROGRAM THROUGH THOSE MECHANISMS AS WELL TO CAST THE WIDEST NET POSSIBLE. 
          AWESOME. 
          THANK YOU SO MUCH. 
          MM-HMM. 
          . 
          THANK YOU CHAIR. 
          UM, OKAY. 
          THANK YOU. 
          BUT I, I KIND OF THINK WHAT YOU'RE GETTING AT IS MAYBE WHEN THE TS UH, PROJECTS COME FOR OUR APPROVAL, WE CAN, UH, OR BEFORE THEY COME TO OUR APPROVAL, MAYBE WE CAN PROMOTE IT AND SEE WHAT WE CAN DO TO, TO TRY TO GET THAT, UH, MECHANISM USED. 
          THAT WOULD BE, THAT WOULD BE GREAT FOR SURE. 
          UM, COUNCILWOMAN, UH, ROCHE GARCIA, THANK YOU CHAIR. 
          UM, AND THANK YOU ALSO TO, UH, TO E D D 
          [01:45:01]
AND TO ACOG. 
          I APPRECIATE, ESPECIALLY THAT YOU ALL ADDED THE PUBLIC SOLICITATION PROCESS. 
          I THINK IT, UH, IT IMPROVES OUR TRANSPARENCY AND ACCOUNTABILITY. 
          AND I KNOW YOU GUYS ALREADY PARTNERED WITH SOMEONE, BUT YOU ALL WENT ABOVE AND BEYOND WHEN WE WERE CONCERNED AND WE ASKED, WELL, CAN I GO THROUGH A FORMAL, UH, PROCESS? SO THANK YOU VERY MUCH FOR MAKING THAT HAPPEN. 
          UM, I KNOW, UH, FORMER COUNCILMAN CLAMP WAS INSTRUMENTAL IN THAT, SO THANK YOU. 
          AND DIANE, UM, I KNOW THERE'S GONNA BE A LOT OF, I, I, I KEEP, UH, REMEMBERING I'VE GOTTEN MULTIPLE CALLS FROM THE ARCHDIOCESE, UH, ABOUT, YOU KNOW, PARTICIPATING SO THEY'RE READY TO MOVE THIS ALONG. 
          SO I'M EXCITED THAT I'LL FINALLY BE ABLE TO, UH, TALK TO MY COUNCIL COLLEAGUES AND SAY, HEY, THERE'S PEOPLE OUT THERE THAT CAN REALLY BENEFIT FROM THIS. 
          UM, AND ALSO JUST, UH, I KNOW THAT WORKFORCE AND ECONOMIC DEVELOPMENT IS WORKING THROUGH THAT COMMITTEE. 
          YOU GUYS ARE WORKING ON THE POSSIBLE ESTABLISHING THE SMALL BUSINESS COUNCIL, AND THIS WOULD BE THE TYPE OF THING THAT I THINK WOULD BE GREAT TO BRING UP TO THOSE SMALL BUSINESS OWNERS. 
          SO I'M LOOKING FORWARD TO, UM, A REPORT THAT, UH, THAT YOU GUYS WILL BE SHOWING, YOU KNOW, A YEAR FROM NOW OR WHENEVER IT IS TO SHOW HOW MANY PEOPLE HAVE TAKEN ADVANTAGE OF IT. 
          SO THANK YOU SO MUCH. 
          AND, UH, THANKS CHAIR. 
          THANKS. 
          UH, THANK YOU VERY MUCH. 
          I CAN'T WAIT FOR US TO GET STARTED ON THIS. 
          I THINK SLIDE FIVE IS MY ABSOLUTE FAVORITE. 
          IT'S GOT BENEFITS FOR, FOR EVERYONE. 
          I'M REALLY EXCITED ABOUT OUR LOCAL LENDERS AND OUR LOCAL CONTRACTORS. 
          HOPEFULLY, I KNOW WE CAN'T REQUIRE THAT THEY BE LOCAL, BUT, UH, THAT, THAT, UH, THEY SEE SOME INCREASED ECONOMIC ACTIVITY, SO, FOR SURE. 
          UH, THANK YOU VERY MUCH MADAM, MADAM CHAIR. 
          IT WOULD BE HELPFUL TO US TO HAVE A RESOLUTION OF THIS COMMITTEE RECOMMENDING COUNCIL APPROVAL OF THIS. 
          MM-HMM. 
          , UH, I THINK THE, THE LAWYER TO ME STARTED ASKING WHY WE CAN'T ENTER INTO THE INTERLOCAL AGREEMENT ONCE YOU ESTABLISH THE, UH, BOUNDARIES, THAT FIRST STEP, UH, SO THAT ACOG CAN GET STARTED ON THEIR PROCESS. 
          ALL OF THIS SUBJECT TO COUNCIL, THAT SECOND STEP, YOU KNOW, THE PUBLIC HEARING AND COUNCIL APPROVAL OF THAT. 
          SO IF WE COULD GET A RECOMMENDATION THAT WE MOVE THIS THING FORWARD, UM MM-HMM. 
           TO THE A SESSION, I WOULD APPRECIATE THAT. 
          UH, WE HAVE A MOTION BY COUNCILMAN ELIAS AND A SECOND BY COUNCILWOMAN, UH, ROCHA GARCIA. 
          ALL IN FAVOR? AYE. 
          AYE. 
          ANY OPPOSED? MOTION PASSES. 
          THANK YOU CARLOS. 
          THANK YOU EVERYONE. 
          UH, WE ARE NOW ADJOURNED. 
          YOU.
* This transcript was created by voice-to-text technology. The transcript has not been edited for errors or omissions, it is for reference only and is not the official minutes of the meeting.