[2024 Budget Workshop: Houston Health Department]
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HOUSTON HEALTH DEPARTMENT PROPOSED BUDGET.
MR. WILLIAMS, THE FLOOR IS YOURS.
I'M STEVEN WILLIAMS, DIRECTOR OF THE HEALTH DEPARTMENT.
I'LL START ON PAGE TWO, WHICH IS ACT, UH, SLIDE TWO, WHICH IS REALLY THE TABLE OF CONTENTS FOR, UH, THE PRESENTATION THIS AFTERNOON.
ON SLIDE THREE, YOU'LL SEE OUR ORGANIZATION CHART.
IT SHOWS HOW OUR ORGANIZATION IS STRUCTURED.
UH, JUST FOR YOUR INFORMATION, WE'RE CURRENTLY RECRUITING FOR AN ASSISTANT DIRECTOR OF ENVIRONMENTAL SERVICES BECAUSE PATRICK KEY, WHO'S IN THE OFFICE IN THE, UH, AUDIENCE TODAY, TOLD ME HE WANTED TO RETIRE.
UH, ALSO WE'RE RECRUITING FOR A DEPUTY DIRECTOR AND MBK, UH, UH, DIRECTOR ALSO, JUST FOR YOUR INFORMATION.
ALSO, THREE OF OUR, UH, ADS ARE, UH, AND OUR IT, UH, DIRECTOR ARE RELATIVELY NEW TO THE ORGANIZATION, SO WE'VE EXPERIENCED SOME TURNOVER IN OUR EXECUTIVE LEADERSHIP WITH ME IN THE AUDIENCE, AND I'LL LET THEM RAISE THEIR HAND, AS I CALL THEM.
JANINA WHITE, WHICH IS OUR DEPUTY HEALTH AUTHORITY.
UH, ROGER SEALEY, WHO'S THE ASSISTANT DIRECTOR FOR LAB AND EPI SERVICES.
UH, YOU HAVE DARREN ASHER WITH ME, OUR CHIEF FINANCIAL OFFICER, MARK SEALS, WHO IS OUR CHIEF TECH CHIEF TECHNOLOGY OFFICER.
I MENTIONED PATRICK, WHO'S ABANDONING US, WHO'S, UH, OVER ENVIRONMENTAL SERVICES.
OUR NEW DEPUTY ASSISTANT DIRECTOR FOR COMMUNICATIONS, TOOKER WILSON.
AMBER HANK, UH, DEPUTY ASSISTANT DIRECTOR, UH, WHO WORKS WITH THEIR, AND ALSO, UH, DEPUTY CHIEF OF STAFF, AND JIMMY ANG, WHO'S A SENIOR STAFF ANALYST WORKING ON BUDGET.
AND YOU ALL PROBABLY KNOW PORTFOLIO OF VI LL THE PUBLIC INFORMATION OFFICER.
ON SLIDE FOUR, YOU'LL SEE, UH, HOW OUR PROGRAMS ACTUALLY ALIGN WITH THE CITY'S PILLARS.
UH, YOU WILL SEE MOST OF THE, UH, SERVICES OR PROGRAMS ACTUALLY ALIGN WITH, UH, PUBLIC SAFETY.
I ACTUALLY CALL THAT PUBLIC HEALTH AND SAFETY.
UH, JUST BE, UH, BECAUSE OF THE ROLE THAT WE PLAY, CERTAINLY IN ENVIRONMENTAL SERVICES, DISEASE PREVENTION AND, AND, AND CONTROL.
AND IT'S OBVIOUS THAT REENTRY AND YOUTH VIOLENCE GOES IN THAT TOO.
UH, I THINK THE PANDEMIC PRETTY MUCH DEMONSTRATED THE IMPORTANCE OF, UH, OF PUBLIC HEALTH AND ENSURING THE HEALTH AND SAFETY OF, OF OUR COMMUNITY.
ON SLIDE FIVE, UH, THIS BASICALLY SHOWS OUR EXPENDITURES BY PROGRAM AREAS.
UH, I PRETTY MUCH CHARACTERIZED THE PROGRAM AREAS AND, AND, AND CATEGORIES THAN, RATHER THAN SOME OF THE INDIVIDUAL PROGRAMS. SOME I WILL TALK ABOUT LATER.
THE LARGEST REDUCTION OF NOTE IS THE ALLOCATION OF FUNDS FOR DISEASE PREVENTION AND CONTROL SAFETY NET SERVICES, AND THAT WAS PRIMARILY RESULTING FROM VACANCIES AND PLAN REDUCTIONS DUE TO REDUCE REVENUE.
IN OUR 1115 WAIVER, YOU WILL SEE INCREASES IN ENVIRONMENTAL HEALTH, WHICH ARE DUE TO DEBT SERVICE AMOUNT FOR CONSUMER, UH, HEALTH PERSONNEL, AND THE NEW APARTMENT INSPECTION INITIATIVE THAT HAVE ABILITY PROGRAM THAT WAS INTRODUCED LAST YEAR.
YOU'LL SEE INCREASES IN ADMINISTRATIVE SERVICES, WHICH IS DUE TO, UH, INCREASES IN FTES FOR IT AND INCREASES IN OTHER RESTRICTED ACCOUNTS, UH, FOR 2024.
FAMILY HEALTH AND HUMAN SERVICES INCLUDES ABOUT $3.1 MILLION IN VACANCIES THAT ARE, ARE, ARE, ARE FILLED, UH, PRIMARILY IF WE EXPERIENCE A, A, A LONG TERM EMERGENCY, BUT WE ARE ALSO USING THOSE FUNDS TO CONTINUE THE LIFESPAN OF A NUMBER OF PROGRAMS THAT ARE FUNDED BY OUR 1115 WAIVER.
OTHER INCREASES ARE DUE TO HOPE PENSION AND HEALTH INSURANCE INCREASES.
ON SLIDE SIX, UH, ADMINISTRATIVE SERVICES, UH, OF THE 200, UH, OF THE 24 MILLION IN ADMINISTRATIVE SERVICES, APPROXIMATELY 9.9 MILLION IS IN RESTRICTED ACCOUNTS.
THIS LEAVES ABOUT 15 MILLION TO PROVIDE CRITICAL SUPPORT SERVICES TO THE DEPARTMENT'S OPERATIONS.
JUST TO PUT THIS IN CONTEXT, OUR GENERAL FUND IS 55.8 MILLION.
OUR SPECIAL FUND IS 41 MILLION.
OUR GRANT FUNDS IS 172 MILLION.
UH, 72 OF THOSE MILLION ARE ROUTINE GRANTS.
A HUNDRED MILLION ARE RELATED TO COVID, SO OUR TOTAL BUDGET IS $269 MILLION.
WHEN YOU LOOK AT THE ADMINISTRATIVE SUPPORT
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SERVICES, YOU'LL SEE THAT THAT IS JUST UNDER 10% OF OUR TOTAL BUDGET, OR 5.6%, UH, IF YOU EXCLUDE THE RESTRICTED ACCOUNTS.THAT'S SOMETHING THAT WE'VE BEEN MAINTAINING, UH, FOR ALMOST TWO DECADES THAT I'VE BEEN HERE, UH, IN ORDER TO PROVIDE ADEQUATE ADMINISTRATIVE SUPPORT SERVICES, AND WE'RE TALKING ABOUT IT, WE'RE TALKING ABOUT, UH, UH, QUALITY ASSURANCE AND COMPLIANCE, LOGISTICAL SUPPORT, CONTRACT AND PROCUREMENT.
WE'VE HAD TO ADD A, A 1115 WAIVER SUPPORT TO THOSE FUNCTIONS IN ORDER, UH, FOR THEM TO BE AT AN ADEQUATE LEVEL TO PROVIDE SUPPORTS TO THAT $260 MILLION.
I WANT TO ALSO NOTE THAT WE PROVIDE SIGNIFICANT IT SUPPORT THROUGH GRANT FUNDS, UH, AND, AND LOOKING TO THE FUTURE OUT YEARS, WE'RE GONNA NEED TO FIGURE OUT HOW WE, UH, CONTINUE SOME OF THESE SUPPORT SERVICES.
WE'VE LEARNED, CERTAINLY DURING COVID, BECAUSE WE WERE IN CRISIS, THAT WE DIDN'T HAVE SUFFICIENT COMMUNICATIONS, SUFFICIENT QUALITY ASSURANCE, THE ABILITY TO BUY GOODS AND SERVICES THAT WE WILL BE SEVERELY HAMPERED IN OUR RESPONSE.
ON SLIDE SEVEN AND ENVIRONMENTAL SERVICES, OF COURSE, YOU UNDERSTAND THAT THESE ARE MANDATED PUBLIC HEALTH SERVICES THAT GENERATE QUITE A LOT OF REVENUE, BUT WE HAVE BEEN RELYING HEAVILY ON COMMUNITY CONSUMER HEALTH SPECIAL FUNDS, THAT'S FOG AND OUR FUND 2002, WHAT WE CHARACTERIZE AS MIGHT FUND TO FUND ALL OF ENVIRONMENTAL HEALTH OPERATIONS.
OUR EXPENDITURES HERE HAVE EXCEEDED THE DEPARTMENT'S PORTION OF THE REVENUE GENERATE REGENERATE ON THE SPECIAL FUND SIZE SIDE.
SO CONSEQUENTLY, WHAT YOU'RE GONNA SEE IS A 2.1 MILLION ALLOCATION AND DEBT SERVICES ACCOUNT TO SUBSIDIZE THE REVENUE SHORTAGE THAT WE ARE EXPERIENCING IN ENVIRONMENTAL HEALTH.
AND THAT, AS I SAID EARLIER, THIS BUDGET ALSO INCLUDES AN $800,000, UH, FUND TO SUPPORT HAVE ABILITY, THE HAVE ABILITY PROGRAM.
ON SLIDE EIGHT, UH, JUST FOR CONTEXT AND DISEASE PREVENTION AND CONTROL AND SAFETY NET SERVICES, WE'RE THE DESIGNATED ENTITY BY LAW FOR REPORTABLE DISEASES, AND THERE ARE SOME EIGHTIES, UH, MORE THAN 80 REPORTABLE DISEASES THAT PROVIDE US HAVE TO REPORT TO US.
UH, MOST OF THE ACTIVITIES OUTSIDE OF OUR CLINICAL ACTIV UH, ACTIVITIES ARE ACTUALLY FUNDED BY GRANTS.
OF THE 260 MILLION THAT'S SPENT ON COMMUNICABLE DISEASES IN THE DEPARTMENT, ONLY ABOUT 16.3% IS PROVIDED BY THE GENERAL FUND.
ALMOST ALL OF OUR EPIDEMIOLOGY SUPPORT IS ON GRANT, AND WE HAVE EXPANDED EPI AND DATA SURVEILLANCE WITH COVID FUNDING.
AND AS YOU KNOW, NEXT YEAR, A LOT OF THAT FUNDING WILL BE GOING AWAY.
SIGNIFICANT SUPPORT FOR OUR TB PROGRAM IS PROVIDED BY THE 1115 WAIVER DUE TO A REDUCTION IN THE 1115, UH, WAIVER REVENUE.
WE EXPECT TO REDUCE TV'S OVERALL BUDGET BY ONE POINT, UH, $5 MILLION, UH, THIS YEAR.
HAVING A CLINICAL STAFF, COMMUNICABLE DISEASE PROGRAM STAFF AND EXISTING OPERATIONAL PROCESSES WERE KEY FACTORS, WHICH ALLOWED US TO SUCCESSFULLY, UH, RESPOND TO THE COVID PANDEMIC.
AND ALSO I IMPACTS, I THINK IT'S IMPORTANT THAT WE RECOGNIZE THAT THERE HAS TO BE A BASE LEVEL OF, OF, OF SERVICE PROVIDERS AS WELL AS INFRASTRUCTURE IN PLACE IF WE'RE GONNA BE RESPONSIVE WHEN WE ARE CONFRONTED WITH PUBLIC HEALTH CHALLENGES.
ON SLIDE NINE, REENTERING IN YOUTH VIOLENCE.
MY BROTHERS KEEPER AND COMMUNITY REENTRY NETWORK ARE PROJECTS THAT ARE DESIGNED TO ADDRESS, UH, THE NEGATIVE INTERACTIONS WITH LAW ENFORCEMENT AND HOPEFULLY SET, UH, YOUNG MEN ON A POSITIVE PATH.
THERE ARE NO GENERAL FUND MONIES ALLOCATED TO THESE INITIATIVES.
ALL OF OUR REV REENTRY AND VIOLENCE PREVENTION INITIATIVES ARE FUNDED BY THE 1115 WAIVER ARE GRANT FUNDS, WHICH MEANS THAT WHEN THOSE 1115 WAIVER DOLLARS RUN OUT, THESE PROGRAMS WILL NO LONGER EXIST UNLESS WE FIND ANOTHER FUNDING SOURCE FOR 'EM.
JUST TO PUT THAT IN CONTEXT, WE'RE PAYING FOR MY BROTHER'S KEEPER INFRASTRUCTURE.
UH, THE OUR REDIRECT PROGRAM, WHICH WERE, UH, JUDGES AND FOLKS FROM JUVENILE PROBATION REFER, UH, AND YOUNG PEOPLE TO OUR STAFF FOR OUR WRAPAROUND SERVICES, OUR COMMUNITY REENTRY NETWORK, OUR COMMUNITIES AND SCHOOLS, UH, YOUTH LEADERSHIP PROGRAM, WHICH WE CALL XY ZONES, OUR MBK SYSTEMS OF CARE, WHICH IS A CONTRACT WITH HARRIS COUNTY RESOURCES FOR CHILDREN AND, AND ADULTS, AND NOW URBAN SCHOLARS PROGRAM, WHICH IS OPERATED THROUGH A CONTRACT WITH THE SOCIAL JUSTICE LEARNING INSTITUTE.
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I I WANNA ALSO NOTE THAT THE SOCIAL JUSTICE LEARNING INSTITUTE ALSO PROVIDES MONEY FROM A FOUNDATION IN, IN CALIFORNIA TO RUN THAT PROGRAM HERE.THESE ARE THINGS THAT I'M JUST HIGHLIGHTING THAT ARE SUPPORTED BY THE 1115 WAIVER PROGRAM IN 2020 FY 24.
OF COURSE, OUR CREDIBLE MESSENGER PROGRAM, COUNCIL MEMBER JACKSON, HOPEFULLY, AND OUR YOUTH VIOLENCE INTER PROGRAMS, WERE WE FUNDED WITH OPERA DOLLARS, AND WE HOPE TO LAUNCH THEM THIS YEAR.
UH, AS I SAID EARLIER, ALL PROGRAMS THAT I TALKED ABOUT EARLIER ARE AT RISK, UH, ONCE THE 1115 WAIVER PROGRAMS, UH, ARE, ARE, ARE DIMINISHED.
ON SLIDE 10 MULTI-SERVICE CENTERS, MOST OF YOUR FAMILIAR WITH THESE, UH, THESE, THESE CENTERS ACTUALLY PROVIDE A, A, A STAGING AREA FOR A, A VARIETY OF PROGRAMS, SOME THAT ARE PROVIDED BY US, SOME THAT ARE PROVIDED BY OTHER FOLKS.
FOR EXAMPLE, IN SOME OF OUR CENTERS, WE HAVE HEAD START, WE HAVE DAYCARES.
UH, WE'RE CO-LOCATED WITH LIBRARIES IN SOME CASES, OUR WIC PROGRAM, OUR MAYOR'S OFFICE OF SPECIAL EVENTS, AND OUR DIABETES AWARENESS NETWORK, AND, UH, ARE LOCATED WITHIN OUR MULTI-SERVICE CENTERS.
AS YOU KNOW, UH, THESE SERVICE CENTERS ALSO PROVIDE A MEETING PLACE FOR COMMUNITY MEETINGS, AND ALSO A NUMBER OF THEM SERVE AS KEY VOTING LOCATIONS IN, UH, SOME OF OUR NEIGHBORHOODS.
JUST NOTE, EACH ONE OF OUR MULTI-SERVICE CENTERS HAS EXERCISE EQUIPMENT TO PROMOTE ACCESS TO PHYSICAL ACTIVITY.
THE $3.1 MILLION THAT YOU'VE SEEN IS PRIMARILY SPENT ON PERSONNEL.
THERE'S NO FUNDING FOR THE PROGRAMS ASSOCIATED WITH OUR MULTI-SERVICE CENTERS OTHER THAN AN ALE, UH, WHICH HOUSES OUR DIABETES AWARENESS NETWORK.
THAT IS THE FIRST TIME THE GENERAL FUND HAS ACTUALLY, UH, FUNDED, UH, THAT, UH, PREVENTIVE HEALTH PROGRAM.
ON SLIDE 11, FAMILY HEALTH AND HUMAN SERVICES, THE GENERAL FUND PRIMARILY SUPPORTS CLIENT ACCESS AND CARE COORDINATION.
AS YOU KNOW, THE NUMBER OF UNINSURED PEOPLE IN, UH, TEXAS AND HOUSTON IS QUITE HIGH.
WE DON'T PROVIDE PRIMARY CARE SERVICES, BUT WE PUT AN EMPHASIS ON PROVIDING PEOPLE ACCESS TO CARE.
AND WHAT THAT MEANS IS THAT WE ACTUALLY PROVIDE ELIGIBILITY SERVICES FOR HARRIS HEALTH, BUT WE ALSO SCREEN INDIVIDUALS, UH, FOR ELIGIBILITY FOR OTHER PROGRAMS. UH, WE ALSO IN OUR A, A CLIENT ACCESS PROGRAM, UH, HAVE WORKED EXTENSIVELY WITH, UH, COVENANT HOUSE, WHERE WE HAVE, UH, PROVIDED, UH, THIS SERVICE TO THOSE INDIVIDUALS TO ENSURE THAT THOSE KIDS DON'T FALL OUT OF CARE.
UH, THAT PROGRAM ACTUALLY SAVES AN INORDINATE AMOUNT OF MONEY, UH, BECAUSE THE KIDS DON'T REALLY HAVE TO BE CAUGHT UP ONCE THEY'RE, THEY'RE LOST TO CARE.
ON SLIDE 12, UH, WE, YOU WILL SEE IN CHRONIC DISEASE, WELLNESS AND EDUCATION, I MENTIONED THE DIABETES AWARENESS NETWORK.
UH, WE, THAT PROGRAM, UH, WE HAVE INVESTED SIGNIFICANT AMOUNTS OF 1115 WAIVER FUNDING, UH, FOR CHRONIC DISEASE PROGRAM.
OF COURSE, AS I MENTIONED EARLIER, THE NEW DAWN CENTER IN ALE IS ACTUALLY FUNDED BY THE GENERAL FUND.
UH, THIS IS TRUE, ALTHOUGH CHRONIC DISEASE IS THE LEADING CAUSE OF DEATH AND DISABILITY.
UH, DURING THE COVID-19 PANDEMIC, UH, AS WE HAD THOSE PRESS CONFERENCES, YOU NOTED THAT THE HIGHEST MORTALITY RATE FOR COVID WAS AMONGST THOSE INDIVIDUALS WITH UNDERLYING HEALTH CONDITIONS.
MOST OF THESE CONDITIONS, UH, WERE CHRONIC CONDITIONS.
THEY WEREN'T ACUTE CONDITIONS, THINGS THAT PEOPLE HAD BEEN DEALING WITH FOR, UH, ALONG A LONG LENGTH OF TIME.
LET'S GO TO SLIDE 13, DEBT SERVICE.
THIS IS OUR $2 MILLION TO COVER THE EXPENDITURE SHORTFALL FOR APPROXIMATELY 15 PEOPLE IN FUND 2020, WHICH IS CONSUMER HEALTH SERVICE.
I HAVE REFER TO THAT SHORTFALL IN A PREVIOUS SLIDE ON SLIDE 14, EXPENDITURES BY FUND.
THE GENERAL FUND EXPENDITURE REDUCTION IS DUE TO REMOVING THE 1115 WAIVER INTERGOVERNMENTAL TRANSFER FUND.
I SMILED WHEN I SAW THE ARTICLE IN THE CHRONIC CHRONIC CHRONICLE THAT SAID THAT WE WERE, MY BUDGET WAS CUT BY $10 MILLION.
OF COURSE, I CALLED WILL AND ASKED HIM FOR THE $10 MILLION BACK.
THAT WASN'T A $10 MILLION CUT.
THE NEW CHARITY CARE PROGRAM THAT WE'RE INVOLVED IN
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NOW DOES NOT REQUIRE THAT MATCH.THAT'S WHY THERE'S NOT THAT TRANSFER INTO THE GENERAL FUND.
THE 1115 WAIVER FUNDS DID REQUIRE A, SO IT'S PRETTY MUCH A WASH.
YOU WILL SEE A, A SPECIAL FUND INCREASE, UH, IN, IN INCLUDES THE HOUSTON CENTER FOR TRANSFORMATIVE, UH, HEALTH INITIATIVE, WHICH WE'RE IN PARTNERSHIP WITH TSU, WITH, UH, YOU, THAT IS ALSO VEHICLE CARRYOVER AND FRINGE BENEFIT INCREASES SWIMMING POOL AND SPECIAL WASTE INCREASES INCLUDE VEHICLE CARRYOVER AND FRINGE BENEFITS.
YOU KNOW, DURING COVID, THERE WAS AN ABSENCE OF CHIPS, AND SO THEREFORE, WE WERE NOT ABLE TO BUY OUR VEHICLES ON TIME.
SO IT JUST ROLLED OVER, UH, TO, TO THE NEXT FISCAL YEAR.
THE ESSENTIAL SERVICES CONTINGENCY FUND 1115 WAIVER WILL BE USED TO PROVIDE MBK REENTRY, SEE TO SUCCEED IN CHRONIC DISEASE SERVICES.
I'VE TALKED ABOUT THAT THROUGHOUT THE PROPOSAL, UH, HOPING THAT WE CAN FIND, UH, UH, ADDITIONAL DOLLARS IN THE NEXT, UH, THREE TO FOUR, FOUR YEARS TO KEEP THESE PROGRAMS GOING.
IT ALSO SUPPORTS IT AND, AND COMMUNICATIONS.
FROM A STAFFING STANDPOINT, WE HAVE 173 FULL-TIME POSITIONS THAT'S COVERED BY OUR 1115 WAIVER DOLLARS.
ON SLIDE 15, PERSONNEL VERSUS NON-PERSONNEL.
AS YOU CAN SEE, RESTRICTED ACCOUNTS REPRESENT NEARLY HALF OF OUR NON-PERSONNEL OPERATIONS FOR THE GENERAL FUND.
OF COURSE, FOG HAS A LARGER CONTRIBUTION TOWARDS EQUIPMENT, VEHICLE PURCHASES AND CONTRACTS WITH SPECIAL WASTE DISPOSAL VENDORS.
ON SLIDE 16, PERSONNEL VERSUS NON-PERSONNEL.
THESE FUNDS ARE RESTRICTED AND DEDICATED FOR SPECIFIC HEALTH RELATED PROGRAMS BY THE FUNDERS.
UH, REVENUE IS USED PRIMARILY FOR CONTRACTS, SUPPLIES, AND EQUIPMENT.
THIS FUND CONTRIBUTES TO SEVERAL OF OUR PROGRAM OPERATIONS SEARCHES, VITAL TO STATISTICS, ENVIRONMENTAL HEALTH, UH, VETERAN SERVICES PROGRAM, WHICH IS IN OUR AREA, AGENCY ON AGING, AND THE MEDICAID EX ADMINISTRATIVE CLAIMING TO NAME AFR FEW.
IN SUMMARY, IT'S BASICALLY A FUND, UH, THAT WE USE FOR OUR PROGRAMS. ACTUALLY EARN, EARN SOME LEVEL OF REIMBURSEMENT OF INCOME FOR SPECIAL PURPOSES.
WE CAN'T JUST SPEND IT FOR ANY, ANY REASON.
ON 17 A FUND 2009 OR THE SWIMMING POOL, IT DOES HAVE SOME PERSONNEL CONTRACTS AND VEHICLE EQUIPMENTS.
UH, FUND 2010 OR ESSENTIAL PUBLIC HEALTH SERVICES IS PRIMARILY PERSONNEL AND CONTRACTS ON 18.
WE NO LONGER RECEIVE REVENUE FROM 1115 WAIVER.
I WON'T BE TALKING ABOUT THAT NEXT YEAR, HOPEFULLY.
UH, SO THERE'S A REDUCTION IN THE FAMILY, UH, HEALTH BUDGET OF 10.8 MILLION.
AND, AND SINCE I MENTIONED EARLIER THAT SINCE, UH, THERE ARE NO LONGER FUNDS, THERE ARE NO, THERE'S NO LONGER A MATCH REQUIREMENT.
AND, AND, AND SO THERE'S NO INTERGOVERNMENT OR TRANSFER, UH, WHICH IS SHOWN, SHOWN IN THE CLINICAL HEALTH AS PART OF THE $9.9 MILLION THAT YOU SEE ON THIS CHART.
WE COULD GO TO CHART 19, BUT, AND LOOK AT IT.
BUT THE, THE EXPLANATION IS ACTUALLY ON CHART ON ON SLIDE NUMBER 20 FOR THAT.
UH, WE ARE GOING FROM APPROXIMATELY $20 MILLION IN REVENUE FROM THE ORIGINAL 1115 WAIVER PROGRAM TO EIGHT TO 10 MILLION WITH THE CHARITY CARE PROGRAM.
I HAVE TO ACKNOWLEDGE THE STAFF THAT DID SIGNIFICANT WORK, BOTH ON THE LEGISLATIVE LEVEL AND ACTUALLY WORKING WITH THE STATE, UH, UH, MEDICAID OFFICE TO ENSURE THAT THERE WAS MONEY SET SET ASIDE FOR HEALTH DEPARTMENTS TO ACCESS.
UH, AFTER THE 1115 WAIVER DRIED UP, WHAT THE LEGISLATURE DID WAS SET ASIDE $500 MILLION FOR NOT ONLY HEALTH DEPARTMENTS, BUT ALSO FOR MENTAL HEALTH AGENCIES TO ACCESS BECAUSE OF HEALTH DEPARTMENTS INEXPERIENCED IN ACTUALLY MEDICAID AND, AND, AND MEDICARE REIMBURSEMENTS.
THE TOTAL DRAW DOWN OUT OF THAT 500 MILLION FOR HEALTH DEPARTMENTS ACROSS THE STATES WAS LESS ACROSS THE STATE, WAS LESS THAN $15 MILLION.
HOUSTON HEALTH DEPARTMENT DREW DOWN 10 OF THOSE $15 MILLION BECAUSE OF THE, THE, THE, ACTUALLY, BECAUSE OF THE COMPETENCY AND THE AGGRESSIVENESS OF, OF OUR STAFF JUST FIGURING OUT HOW TO DO THAT.
SO I REALLY WANT TO ACKNOWLEDGE THAT ACTUALLY NEXT, UH, MONTH, MY, MY
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STAFF IS GOING TO AUSTIN, AND WE'RE HOLDING A WORKSHOP WITH OTHER HEALTH DEPARTMENTS BECAUSE THERE'S ABOUT 60 MILLION OF THAT, UH, $500 MILLION THAT WASN'T DRAWN DOWN.AND WE'RE TRYING TO FIGURE OUT HOW HEALTH DEPARTMENTS CAN ACTUALLY ACCESS THAT.
SO MY END GOAL WILL PROBABLY, IT WILL BE TO TRY TO DRAW DOWN AS MUCH OF THAT MONEY FOR A CHARITY CARE, WHICH IS REALLY UNCOMPENSATED CARE AS, AS WE CAN, UH, AND YOU MIGHT NOT REMEMBER, BUT ALSO WE WERE ABLE TO, UH, WORK WITH THE LEGISLATURE AND, AND THE STATE MEDICAID OFFICE TO ESTABLISH A SPECIFIC PROVIDER TYPE FOR PUBLIC HEALTH DEPARTMENTS, HOPING THAT SOME OF THE CRITERIA, UH, SOME OF THE, THE, THE THRESHOLDS THAT THEY'RE ESTABLISHING FOR REGULAR PROVIDERS, UH, THAT WAS NOT APPROPRIATE FOR HEALTH DEPARTMENTS, UH, WILL, WILL ACTUALLY DIMINISH.
AND ACTUALLY THEY HAVE, FROM AN ADMINISTRATIVE STANDPOINT, WE'RE GONNA SEE, UH, WHAT THE FUTURE LOOKS LIKE WITH THAT.
BUT ACTUALLY, AS A HEALTH DEPARTMENT, ME AND MY STAFF WE'RE ACTUALLY LEADING THE STATE AND TRYING TO FIGURE OUT HOW WE CAN MAXIMIZE RESOURCES, UH, RELATED TO DRAWING DOWN, UH, MEDICAID DOLLARS FOR UNCOMPENSATED CARE, BUT ALSO FOR SOME OF THE PROGRAMS, FOR SOME OF THE SERVICES THAT WE PROVIDE.
WHAT YOU SEE IS THAT A LOT OF OUR CRITICAL SERVICES WITHIN THE HEALTH DEPARTMENT ARE FUNDED BY GRANTS.
WE WANT TO COME UP WITH A MORE LOCALIZED, UH, FUNDING STRUCTURE FOR THOSE ESSENTIAL SERVICES BE BECAUSE AS YOU, YOU, YOU, YOU KNOW, THE TIDE CHANGES IN WASHINGTON DC BUT THE PROBLEMS HERE IN HOUSTON DO NOT.
AND SO WE REALLY NEED TO BE STRATEGIC IN OUR APPROACH FOR THAT.
WELL, THANK YOU, DIRECTOR, UH, TO YOU AND YOUR ENTIRE STAFF FOR, UH, THE WORK AND EFFORTS YOU PUT IN FOR THE PRESENTATION.
UH, WHEN YOU'RE SPEAKING OF SOME OF THE PROGRAMS LIKE MY BROTHER'S KEEPER THAT HAS LIMITED DOLLARS, UH, WHAT'S THE STRATEGY FOR THE HEALTH DEPARTMENT WHEN WORKING WITH OUTSIDE NONPROFITS THAT DO SIMILAR WORK TO ENSURE THAT, UH, THOSE IN NEED OF CERTAIN PROGRAMS STILL HAVE ACCESS TO A WIDE RANGE OF PROGRAMS? WELL, IF, IF YOU LOOK AT OUR STRATEGY IN MY BROTHER'S KEEPER, IT'S NOT JUST A PROGRAM.
UH, WHAT WE'VE ASSEMBLED ARE KEY EXECUTIVES FROM VARIOUS ORGANIZATIONS AND A AND A NUMBER OF THOSE ORGANIZATIONS HAVE RESOURCES.
WE ALSO HAVE NONPROFITS THAT ARE SITTING AROUND, AROUND, AROUND THE TABLE.
AND BASICALLY WE'RE, WE'RE IN THE PROCESS OF REVISING OUR, OUR, OUR STRATEGIC PLAN RELATED TO MY, MY BROTHER'S KEEPER.
THE, UH, MBK ALLIANCE HAS COME UP WITH NEW CRITERIA FOR OUR AFFILIATING WITH THEM NATIONALLY.
AND WE'RE IN THE PROCESS OF, OF, OF GOING THROUGH THAT PROCESS TOO.
BUT WE DO HAVE SOME CORE PROGRAMS THAT WE EITHER FUND OR WE, UH, WE, WE ACTUALLY OPERATIONALIZE OURSELVES.
I, I MENTIONED, UH, THE URBAN SCHOLARS PROGRAM.
I ACTUALLY, UH, WAS AT A HIGH, I WAS ACTUALLY AT NORTH HIGH SCHOOL THIS MORNING TALKING TO THE PRINCIPAL AND THE ASSISTANT PRINCIPAL ABOUT HAVING, UH, THAT PROGRAM INITIATED THERE PRIMARILY BECAUSE THE, THE, THE, THE COUNCIL MEMBER HAS, UH, CISNEROS HAS ACTUALLY, UH, SENT SOME MONEY OVER THAT WE'RE GONNA MATCH SO THAT THAT PROGRAM CAN EXIST WITH WITHIN THAT HIGH SCHOOL.
UH, BUT WE ARE WORKING WITH NONPROFITS.
UH, ONE OF OUR GOALS ACTUALLY, UH, IS TO LOOK AT A MINI-GRANT PROCESS THAT I WOULD LIKE TO, UM, INVOLVE UP TO TWO TO THREE DOZEN NONPROFITS, UH, TO HELP THEM CONTINUE THEIR WORK, BUT ALSO TO GET THEM IN A POSITION WHERE THEY CAN ACTUALLY CARRY OUT SOME HEALTH MESSAGES TOO.
THANK YOU CHAIR, AND THANK YOU DIRECTOR.
ON SLIDE SEVEN, THE, THE REVENUE SHORTAGE IN ENVIRONMENTAL HEALTH ARE FEES NOT KEEPING UP WITH OUR COSTS.
I MEAN, WHAT'S THE, WHAT'S, WHY, WHY, UM, ARE, WHAT'S THE STORY THERE? OKAY, I'LL EXPLAIN IT AND THEN DARREN WILL RE-EXPLAIN IT.
WE ACTUALLY,
YOU NOT, YOU'RE NOT KEEPING IT ALL.
THAT'S SO, SO YOU GET 2 MILLION FROM DEBT SERVICE, LIKE THAT'S JUST EXTRA MONEY.
YOU DON'T HAVE TO PAY DEBT DOWN, OR, OR WHAT, WHAT'S DEBT SERVICE ON THAT? I'M GONNA LET DARREN EXPLAIN THAT PART.
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TO NOT INCREASE FTES, BUT THEY DID REALIZE THAT WE WERE OVERSPENDING IN THAT SPECIAL FUND UHHUH.AND SO TO COVER THAT, THEY JUST MOVED MONIES INTO A DEBT SERVICE, AND WE TRANSFERRED THAT ONCE THE FISCAL YEAR STARTS.
UM, I WAS A LITTLE CONFUSED ON, ON SLIDE, UM, AT EIGHT, UM, THE TB PROGRAM, YOU SAID YOU WERE HAVING A REDUCTION IN TB, UM, SPENDING, BUT, BUT, BUT WE DID APPROVE SOMETHING TODAY.
WAS THAT RELATED? THE HARMONY HOUSE DEAL? THAT WAS, THAT, THAT'S 1 MILLION FOR TB.
I MEAN, I'M, WELL, HARMONY HOUSE WE'VE BEEN CONTRACTING WITH, UH, THEY ACTUALLY PROVIDE HOUSING FOR PEOPLE, UH, WITH ACT, ACT, ACT ACTIVE TV.
YES, IT IS TB, IT'S PART OF THE TB PROGRAM.
AND IF I CUT TB, THAT'S NOT ONE OF THE OKAY.
PROGRAMS THAT WE'RE GONNA CUT.
BUT THE REALITY IS, IT'S THAT WE'VE BEEN SUBSIDIZING NOT ONLY SUPPORT SERVICES LIKE IT COMMUNICATIONS, UH, AND SOME CLINICAL SERVICES WITH 1115 WAIVER MONEY, BUT WE'VE ALSO FUNDED SUBSIDIZED FUNDING FOR, IN THIS CASE, TB, TO THE 2.1 $0.5 MILLION.
I KNOW THAT THE 11TH OUR, THAT, THAT POOL IS RUNNING OUT.
AND SO WE WILL HAVE TO REDUCE RESOURCES FROM THE, THAT POOL GOING TO TB SERVICES.
THAT AMOUNT IS ABOUT $1.5 MILLION.
NOW, QUITE FRANKLY, 'CAUSE I DON'T WANT MY BUREAU CHIEF THINKING THAT HE'S GONNA GET THIS MONEY BACK, UH, PART OF IT IS LOOKING AT WAYS TO BE MORE EFFICIENT IN, IN TB, THIS IS SOMETHING THAT I'VE BEEN LOOKING AT FOR MORE, MORE THAN A YEAR.
UH, FOR INSTANCE, OUR FOLKS GO OUT, UH, AND DO DIRECTLY OBSERVE THERAPY, AND WE'RE THINKING OF WAYS TO DO THAT, YOU KNOW, UH, THROUGH TELEHEALTH METHODS.
I HAVE ONE MORE, BUT YOU CAN PUT ME BACK IN.
THANK YOU SO MUCH FOR EVERYTHING THAT ALL OF Y'ALL DO, AND REALLY GOOD WORK.
A COUPLE QUESTIONS, UM, HAVE WE COME UP WITH, I'M SURE YOU HAVE, BUT A STRATEGIC PLAN OR FORECASTING IN TERMS OF WHEN WE LOSE THE 1115, HOW ARE WE GOING TO, 'CAUSE, SO THIS IS WHAT MY CONCERN IS BECAUSE NOW WE'RE DOING OUTCOME-BASED BUDGETING.
IF WE LOSE A PROGRAM THAT WE REALLY NEED, BUT WE DON'T PUT IT IN THERE BECAUSE WE DON'T HAVE THE FUNDS FOR IT, HOW DO WE THEN PUT IT BACK IN AS A LINE ITEM? BECAUSE, YOU KNOW WHAT I'M SAYING? MM-HMM
DOES THAT MAKE SENSE? WELL, WE'VE BEEN ABLE, THIS YEAR WE WERE ABLE TO RECOUP NINE OF THOSE MILLION DOLLARS, $9 MILLION FROM UNCOMPENSATED CARE, FROM CH FROM THE CHARITY CARE PROGRAM.
UH, THERE IS A GAP OF AT, AT AT LEAST, YOU KNOW, FOUR OR $5 MILLION FROM, TO MAINTAIN OUR, OUR CURRENT SERVICES.
AND SO REALLY WE'RE MAKING DECISIONS EACH YEAR AS TO WHAT CAPACITY WILL EXIST IN EACH ONE OF THE PROGRAMS THAT'S FUNDED BY THE 1115 WAIVER.
SO WE'RE AGGRESSIVELY TRYING TO FIND OTHER REVENUE SOURCES TO SUPPORT THE PROGRAM.
RIGHT NOW, OUR, OUR RECIDIVISM RATE AND REENTRY IS AROUND 8%.
AT THE STATE LEVEL, IT'S RIGHT AT 20%.
IT MAKES NO SENSE TO NOT DO THAT PROGRAM.
BUT ACTUALLY FROM A POLICY STANDPOINT, Y'ALL HAVE TO DECIDE WHETHER OR NOT YOU WANT THAT PROGRAM TO CONTINUE.
OF COURSE, MY RECOMMENDATION WOULD BE TO CONTINUE IT.
WE'RE DOING EVERYTHING THAT'S FUNDED BY THE 1115 WAIVER THAT I BELIEVE BRINGS SOME VALUE TO, UH, SOME OF THE CRITICAL ISSUES THAT WE'RE FACING HERE IN HOUSTON.
I MEAN, MY BROTHER'S KEEPER IS ANOTHER, OUR VISION PROGRAM.
UH, EVEN WE'VE ALMOST RECOVERED AFTER THE PANDEMIC, WE SAW 900, WE SAW 9,984 KIDS THIS YEAR, 540 SOMETHING ACTUALLY NEEDED REFERRALS FROM MEDICAL TREATMENT.
I THINK 40 OF THOSE CHILDREN, ACTUALLY, THEIR CASES WERE SERIOUS ENOUGH TO REFER IMMEDIATELY.
I MEANT, THOSE ARE THE KINDS OF THINGS THAT WE'RE FUNDING.
I MEANT WHEN I SEE THAT AS A DIRECTOR, I MEANT I'M GONNA DO ALL WE CAN TO CONTINUE THAT.
BUT AT SOME POINT, I THINK FROM A POLICY STANDPOINT, YOU'RE GONNA HAVE TO DECIDE WHETHER OR NOT THAT IS SOMETHING THAT SHOULD BE.
I'M DIRECTOR WILLIAMS AND YOUR ENTIRE TEAM FOR BEING GREAT PARTNERS.
UM, YOU KNOW, I'VE BEEN ABLE TO MOVE A LOT OF PROJECTS, UM, IN DISTRICT B, UM, BECAUSE OF YOUR SUPPORT.
UM, I, I KNOW WE SAID, UM, PUBLIC SAFETY IS ONE OF OUR PRIORITIES, AND SO JUST
[00:30:01]
ONE QUESTION.WHEN I FIRST CAME IN OFFICE IN 2021, I SUBMITTED THAT $500,000 BUDGET AMENDMENT, UM, ON THE CREDIBLE MESSENGER PROGRAM THAT WILL PASS UNANIMOUSLY, UM, WITHOUT COUNSEL.
AND SO WE ARE HERE IN 2023, AND WE HAVE YET TO GET THOSE RESOURCES.
AND SO I THINK IT'S IMPORTANT IF WE'RE PUTTING OUT PROGRAMS, WE KNOW THAT THERE'S PROGRAMS THAT'S EFFECTIVE, THAT'S GONNA, YOU KNOW, HELP IMPROVE PUBLIC SAFETY AND THE LIVES OF OUR YOUTH.
WHAT ARE, WHY IS IT SUCH A CHALLENGE TO GET THOSE RESOURCES ONCE IT'S PASSED BY COUNCIL? I THINK THE CHALLENGE IS ADMINISTRATIVE IN NATURE.
OUR PROCESSES AND ARE, YOU KNOW, IN GOVERNMENT ARE, ARE SLOW.
I, I THINK THAT WE PROBABLY NEED TO LOOK AT THOSE YEAH.
TO FIGURE OUT HOW WE CAN EXPEDITE INITIATIVES LIKE THAT.
BECAUSE I KNOW THE MAYOR, EVEN WITH THE MAYORS ONE, SAFE HOUSTON, UM, HE DID HIS, UM, ANNOUNCEMENT IN 2022, AND WE STILL LIKE 2023.
WE JUST, I THINK THE RFP JUST CAME OUT, UM, ON THAT INITIATIVE.
SO I WOULD JUST LIKE TO SEE, YOU KNOW, WHEN WE DO SEE PROGRAMS THAT WILL BENEFIT OUR COMMUNITIES, THAT WE KIND OF LIKE, WE MOVE FORWARD, UM, COME UP WITH A PROCESS THAT WHERE WE CAN MM-HMM
EXPEDITE, UM, THESE PARTICULAR INITIATIVES.
BUT THANK YOU FOR EVERYTHING THAT YOU'RE DOING BECAUSE WE'RE ABLE TO, YOU KNOW, WE GOT 52 CREDIBLE MESSENGERS TRAINED.
WE GOT SOME WORKFORCE DEVELOPMENT STUFF THAT'S MOVING IN THE DISTRICT, AND IT'S ALL BECAUSE OF THE SUPPORT OF THE HEALTH DEPARTMENT.
IF YOU LOOK AT SLIDE SEVEN, UM, I FEEL LIKE WE GET A LOT OF CALLS AND WE'VE MET WITH THE HEALTH DEPARTMENT AND THEY'VE BEEN EXTREMELY HELPFUL, UH, WITH THIS.
BUT IT HAS THE NUMBER OF FATS, OIL AND GREASE, UH, THOSE INSPECTIONS GOING DOWN.
WHY ARE WE SEEING A DECREASE IN THOSE INSPECTIONS? I, I KNOW EARLY ON, UH, IT, IT WAS A STAFFING SHORTAGE THAT AFFECTED THE NUMBER OF INSPECTIONS I, GOING FORWARD, THOSE SHOULD GO UP.
PATRICK SAYS, YES, OTHERWISE I'LL MAKE HIM WORK LONGER.
IF HE DOESN'T
I'LL MAKE HIM GO INSPECT ONE OF THOSE.
ACTUALLY, IT'S AN INTERESTING PROCESS TO WATCH WHAT THEY DO.
IT REALLY IS COUNCIL MEMBER ALCORN.
UM, IN FEBRUARY, AS YOU KNOW, DIRECTOR, WE APPROVED THE, UH, INTERLOCAL WITH HARRIS COUNTY, WHICH I WAS VERY EXCITED ABOUT, UM, TO DO SOME, SOME CO COORDINATION AND COLLABORATION.
CAN YOU KIND OF GIVE ME AN UPDATE ON WHERE WE ARE ON THAT AND IF IT COULD LEAD TO ANY EFFICIENCIES? ACTUALLY, I WAS GONNA SURPRISE YOU, BUT, UH,
WE'RE ACTUALLY ENGAGED WITH HARRIS COUNTY ON A NUMBER OF LARGER INITIATIVES.
ONE IS WE ARE LOOKING AT ACTUALLY OUTSOURCING THE MANAGEMENT OF OUR, UM, PHARMACY.
WHAT WE FOUND IS THAT, AND THIS IS HAPPENING ALL OVER, ESPECIALLY SINCE THE, UM, THE, THE PANDEMIC THAT WE NEED A, A DEEPER BENCH, UH, IN ORDER TO ENSURE THAT, UH, SOME OF THOSE FUNCTIONS CONTINUE.
IT CAN'T, WE CAN'T RELY ON JUST ONE OR TWO PEOPLE TO ENSURE THAT A FUNCTION IN A CITY THIS LARGE CONTINUES.
AND SO WE HAD CONVERSATIONS, UH, WITH THE COUNTY, AND THEY'RE LOOKING AT, UH, THEY, WELL, THEY'VE AGREED, BUT WE'RE GOING THROUGH THE, THE CONTRACTING PROCESS TO MAKE THAT HAPPEN.
THE OTHER THING THAT WE'RE ALSO ENTERTAINING IS, UH, HAVING THEM HOST OUR EPIC SYSTEM, WHICH IS OUR, UH, RIGHT.
I HEARD A LITTLE BIT ABOUT THAT.
YOU KNOW, INTERESTING ENOUGH, THEY AGREED TO HOST OUR SYSTEM BEFORE WE GOT A EPIC, BUT WHEN WE GOT READY TO TURN THE SWITCH, THEY SAID, NO, WE CAN'T DO IT.
AND SO WE HAD TO GO OUT AND, AND, AND, AND FIND A CO-OP TO GET ACCESS TO EPIC.
IT WASN'T IDEAL DURING THE PANDEMIC BECAUSE WE COULD NOT MAKE THE CHANGES THAT WE WANTED TO MAKE.
AND SO NOW, UH, THEY HAVE A NEW IT MANAGER, UH, A NEW CEO, AND THEY'RE OPEN TO IT.
THEY'RE ALSO, EPIC IS ALSO ACTUALLY, UH, ENCOURAGING, UH, SYSTEMS TO BE FORMED LIKE THAT.
THEY ARE HOSTING, UH, THE COUNTY HEALTH DEPARTMENT.
THEY'RE ALSO HOSTING HARRIS CENTER.
SO WE'RE REALLY CREATING A SYSTEM.
SO IS THAT THE RESULT OF, OF THIS, OR WAS THAT ALREADY IN THE WORKS? WHAT, WHAT IS WHAT WE DID IN FEBRUARY? WHAT IS THAT SUPPOSED TO LEAD TO? WHAT THAT, WHAT THAT OUTLINE IS? HOW WE WOULD WORK SPECIFICALLY WITH THE COUNTY HEALTH DEPARTMENT.
UH, THERE ARE SOME THINGS THAT WE'RE LOOKING AT WITH THEM, BUT TO BE CANDID WITH YOU, WE, WE'VE, WE'VE HAD A LONG-TERM RELATIONSHIP SURE.
WITH A NUMBER OF DEPARTMENTS WITHIN THE COUNTY.
LIKE, UH, JUVENILE PRO PROBATION, UH, WE WE'RE TALKING ABOUT MBK EARLIER.
WE HAD A A, AN EXECUTIVE TEAM MEETING WITH FOR MBKA WEEK BEFORE LAST.
THE DISTRICT ATTORNEY WAS SITTING IN MY CONFERENCE ROOM WHERE WITH OTHER PARTNERS WHERE WE'RE TALKING ABOUT STRATEGIES AND WHAT WE NEEDED
[00:35:01]
TO DO.I UNDERSTAND YOU HAVE A LOT OF ONGOING THINGS.
I'M JUST ASKING SPECIFICALLY ABOUT THIS MEASURE IN FEBRUARY, IF THAT EFFORT HAS KICKED OFF FORMALLY.
HAS THIS, THE THING THAT THEY HAVE INTRODUCED AND WE'RE OPEN TO IS, HAS THE COMMUNITY WIDE COORDINATING COUNCIL, HAS THAT BEEN SET UP? WE HAVEN'T SET THAT UP YET.
BUT THE THING THAT WE HAVE TALKED SPECIFICALLY ABOUT BOTH ORGANIZATIONS ARE ACCREDITED THROUGH THE PUBLIC HEALTH ACCREDITATION BOARD.
ONE OF THE REQUIREMENTS IS THAT WE DO A COMMUNITY HEALTH ASSESSMENT OR A COMMUNITY HEALTH PLAN.
UH, WHAT THE DIRECTOR AND I HAVE TALKED ABOUT IS ACTUALLY DOING THAT JOINTLY.
WHICH IS, WHICH IS A BIG START, WHICH IS SOMETHING THAT ACTUALLY I PROPOSED YEARS AGO, SO, OKAY.
ONE FINAL QUESTION JUST TO FOLLOW UP, UM, WITH EPIC AND THE COLLABORATION, DO YOU THINK THAT'S GOING TO DECREASE EXPENSES BECAUSE WE'LL HAVE MORE OF A CONSTANT WORKFLOW.
SO A PATIENT GOES TO ONE LOCATION AT THE CITY, THE INFORMATION IS ABLE TO BE SEEN AT THE COUNTY, SO MAYBE THEY DON'T HAVE TO GO TO MAKE TWO DIFFERENT OFFICE VISITS.
I CAN TELL YOU THAT THE COST WOULD BE LESS.
I DON'T KNOW THAT IT'S DUE TO WORKFLOW THOUGH.
IT'S JUST THE MEMBERSHIP IN THE CO-OP IS MORE EXPENSIVE THAN, UH, HARRIS HEALTH ACTUALLY HOUSING OUR INSTANCE OF EPIC.
WELL, AGAIN, DIRECTOR, UH, THANK YOU TO YOU AND YOUR ENTIRE TEAM FOR YOUR PRESENTATION AND YOUR DISMISS.
WE ARE NOW AT THE PUBLIC COMMENT PERIOD WHEN YOUR NAME IS CALLED.
PLEASE MAKE YOUR WAY TO THE PODIUM.
WE ARE USING THE LIST OF PUBLIC SPEAKERS WHO SIGNED UP BY 3:00 PM YESTERDAY.
YOU WILL HAVE TWO MINUTES TO SPEAK.
THE FIRST NAME IS CHRIS VALDEZ.
CHRIS VALDEZ, MAXIMO CORTEZ, SARAH SAEED.
UH, I NOTICED A FEW NEW FACES.
I SERVE AS THE SENIOR COMMUNITY ORGANIZER AT JUNTOS IN THE SPRING BRANCH AREA.
UM, TODAY WE WILL BE JOINED LIMITED BY THREE PEOPLE.
UM, FOR SOME OF OUR OBSERVATIONS, UM, FOR THE HOUSTON HEALTH BUDGET VIEWS ARE EXPRESSLY THEIR OWN AND THEY HOPE TO HAVE ANY INSTITUTIONAL KNOWLEDGE FROM CITY COUNCIL TO HELP FILL ANY GAPS.
UM, TODAY YOU'LL HEAR FROM OUR, THE EXECUTIVE DIRECTOR AT WOODY JUNTOS AND AN IMPACTED COMMUNITY MEMBER.
UH, WE APPRECIATE THE EXPANSIVE FEEDBACK THAT AND EXPLANATION FROM THE HOUSTON HEALTH DEPARTMENT TODAY.
UM, WE ARE LOOKING FORWARD TO REVIEWING THE UPDATED STRATEGIC PLAN OF THE HOUSTON HEALTH DEPARTMENT AND HOPE THAT THIS INCLUDES AN UPDATED PLAN FOR LANGUAGE ACCESSIBILITY.
UH, MY OBSERVATION IS THAT THERE IS A SIGNIFICANT DECREASE IN REVENUE DUE TO THE END OF 1115, WHICH INEVITABLY TO THE COUNCIL MEMBER'S POINT, WILL LEAD TO LOSS OF PROGRAMS UNLESS WE ALLOCATE REPLACEMENT FUNDS.
UH, WHICH PROGRAMS? I NOTICED THERE WAS NO LIST ARE AT RISK DUE TO THE LOSS OF 1115, THE WAIVER AND WHICH ONES WILL YOU WORK TO PROTECT, IS MY QUESTION.
IF YOU WANT TO SUBMIT THAT IN WRITING TO YOUR COUNCIL MEMBER, WE WILL GET IT UPLOADED TO SHAREPOINT AND THE DEPARTMENT WILL PROVIDE A RESPONSE.
I HAVE ONE MORE THING I'D LIKE TO ADD.
UM, WITH THE FUNDS THAT ARE BEING, UH, DESIGNATED FOR EPIC, UM, I ALSO WANNA POINT OUT THAT WHEN YOU DO USE EPIC, THERE IS STILL INSTITUTIONAL KNOWLEDGE THAT HAS TO BE LEARNED, AND THAT DOES NOT REDUCE THE CLERICAL BURDEN, UH, TO OUR POINT OF LIKE WORKFLOW, UM, OF PHYSICIANS OR MID-LEVELS THAT CONTINUE TO USE THAT EMR SYSTEM.
I HOPE THERE IS, AND THIS IS JUST A COMMENT, I HOPE THERE IS A COMMITMENT TO ADDING MORE STAFF, UM, AND PEOPLE WHO ARE EQUIPPED AND, AND PEOPLE WHO ARE KNOWLEDGEABLE TO HELP WITH THIS.
BECAUSE I THINK PATIENTS DESERVE MORE FACE TIME WITH THEIR PROVIDERS.
UM, I THINK THERE SHOULD BE, UH, A WORKFLOW ADJUSTMENT TO CONSIDER, UH, CLERICAL BURDEN.
THE NEXT SPEAKER IS JAJA NORMAN.
I'M THE EXECUTIVE DIRECTOR OF AVEN, LOCATED IN THE K COMMUNITY CENTER IN SPRING BRANCH.
I HAVE BEEN A HOMEOWNER FOR MORE THAN 20 YEARS IN HARRIS COUNTY.
MY COMMENT IS THE LANGUAGE BARRIERS, PRESENTER CHALLENGES IN ACCESSING MANY RESOURCES SUCH AS HEALTHCARE RELATED SERVICES.
[00:40:01]
THE HOUSTON DEPARTMENT, UH, HEALTH DEPARTMENT BUDGET AND LISTENING TO THEIR DEPARTMENT TODAY, MY OBSERVATION IS THAT NOWHERE DOES IT DISCUSS LANGUAGE ACCESS IN THE SHORT TERM OR LONG TERM GOALS.TERRA ARE PERFORMANCE METRICS INCLUDED THE POOR HEALTH, EDUCATION AND OUTREACH AND HUMAN SERVICES.
HOWEVER, WE ARE LIMITED IN OUR UNDERSTANDING OF WHERE AND HOW DID OUTCOME IMPACT OUR COMMUNITIES.
IN THE HUMAN SERVICE SECTION, YOU STATE UNDER THE CALL SECTION THAT YOU WOULD LIKE TO COLLABORATE WITH COMMUNITIES, WITH THE, UH, COMMUNITIES TO ELIMINATE HEALTH DISPARITY.
UH, OUR COMMUNITY IS BEING REACHED BY, UH, HEALTH, THIS OUTREACH PROGRAM IN THIS CRITICAL PROGRAM.
MY SUGGESTION IS TO HAVE MORE FUND ALLOCATED FOR COMMUNITY OUTREACH AND INCLUDE LANGUAGE ACCESS OR EVEN, UH, STUDY FOR NEIGHBORHOOD WITH BARRIERS TO ACCESS.
BUT WE, WE'VE HEARD YOUR COMMENT, UH, AS WE SAID TO THE, SOME OF THE OTHER SPEAKERS THAT WE UNDERSTAND THAT LANGUAGE BARRIERS ARE A REAL CONCERN.
UM, YOU ALL HAVE BROUGHT THAT EVEN MORE HIGHLIGHTED TO US TODAY, AND WE WILL TAKE THAT INTO CONSIDERATION MOVING FORWARD.
I'M A CLIENT OF JUNTOS LOCATED HOUSTON COMMUNITY CENTER IN SPRING BRANCH AREA.
I AM 65 YEARS OLD AND I'M A FIRST GENERATION U US CITIZEN.
MY COMMENT IS THAT PREVIOUSLY I WOULD GO TO LOCAL HOSPITAL WITHOUT WORRYING BECAUSE I WAS A GOLD CARD, UM, CARRIER OR HOLDER.
BUT NOW I HAVE A MEDICARE ONLY.
SO IT IS DIFFICULT BECAUSE COSTS ARE VERY HIGH.
I WAS RECENTLY SEEN IN THE, UH, EMERGENCY ROOM AND I RECEIVED SEVERAL EMAILS ASKING ME TO PAY FOR THE HOSPITAL BILL, AND I WAS UNABLE TO PAY.
I HAVE BEEN IN AND OUT OF THE HOSPITAL FOR OVER TWO YEARS AND UNABLE TO WORK.
SO IT HAS BECOME A HUGE BURDEN FINANCIALLY.
I HAVE, UH, LIVING EXPENSES ON TOP OF HOSPITAL AND MEDICINE, UH, COSTS.
I HAVE RECEIVED HELP FROM MY DAUGHTER, BUT NOW, UM, SHE'S, UH, UM, SHE MOVED, UH, OUT OF STATE THEN I LIVE ALONE WITHOUT HELP.
AND THE SOCIAL SECURITY BENEFITS I RECEIVE CANNOT COVER THE APARTMENT COSTS.
THE HOSPITAL HAS MADE IT CLEAR THAT ONLY MEDICAID CAN BE USED TO COVER COSTS FOR THE HOSPITAL
[00:45:01]
OR ANY MEDICATIONS.MY OBSERVATION IS THAT I WAS NOT ABLE TO REVIEW THE BUDGET PRESENTATION BEFOREHAND BECAUSE IT WAS NOT AVAILABLE.
I WOULD LIKE TO KNOW WHERE FUNDS ARE BEING SPENT TO PEOPLE LIKE ME WHEN WE TRY REACH OUT, UH, TO OUR COUNCIL MEMBERS.
UM, THEY DO NOT SPEAK KOREAN LANGUAGE, AND I HAVE TO DEPEND ON ORGANIZATIONS LIKE JUNTOS TO HELP ME NAVIGATE.
MY SUGGESTION IS HAVING MORE INVESTMENT INTO COMMUNITY ORGANIZATIONS TO HELP US WITH LANGUAGE BARRIERS, ESPECIALLY WITH, UH, WHEN IT COMES TO FINANCIAL ASSISTANCE IN HEALTHCARE.
THANK YOU, MA'AM, FOR YOUR COMMENT.
AND, UM, IF YOU DO REACH OUT TO YOUR COUNCIL MEMBERS, I'M CONFIDENT THAT WE WILL FIND A WAY TO GET THE INFORMATION BACK TO YOU AND A LANGUAGE THAT YOU CAN BE RECEPTIVE TO, UH, AS IT PERTAINS TO, UH, THE GOLD CARD THAT IS A, A FUNCTION OF THE COUNTY.
SO I WOULD, UM, ENCOURAGE YOU ALL TO PLEASE ADVOCATE TO YOUR COUNTY COMMISSIONER ON THAT.
UH, AND THEN YOU CAN ALSO REACH OUT TO YOUR COUNCIL MEMBERS TO HELP YOU FACILITATE THAT CONVERSATION IF NEEDED.
OF COURSE, MEDICAID IS A FEDERAL PROGRAM.
UH, WE CAN'T SPEAK FOR EVERY SINGLE MEDICAL FACILITY AND PROVIDER THAT'S OUT THERE, BUT WHAT WE CAN, UH, COMMIT TO YOU IS YOU REACH OUT TO OUR OFFICE, WE WILL FIND A WAY TO TRY, UH, TO ADDRESS YOUR ISSUE.
COUNCIL MEMBER PECK, THANK YOU.
YES, PLEASE REACH OUT TO MY OFFICE.
WE WILL GET A TRANSLATOR, UM, TO MAKE SURE THAT WE CAN GET THE INFORMATION TO YOU IN THE RIGHT LANGUAGE.
SO I, I WANT TO UPLIFT A QUESTION THAT, SORRY.
I'M JASON OLIVER AT DISTRICT G.
UH, I WANNA UPLIFT A QUESTION THAT SARAH ASKED THAT WAS POSED TO YOU ALL AND NOT THE DEPARTMENT THAT WAS SPECIFICALLY ABOUT, WE, WE'VE KNOWN ABOUT THE 1115 WAIVER DECLINE AND, AND LOSS FOR SEVERAL YEARS NOW, WHICH PROGRAMS THAT ARE AT RISK DUE TO THE LOSS OF THIS WAIVER, WILL YOU WORK TO PROTECT AND HOW, SO WHAT, WHICH PROGRAMS ARE YOU ALL LOOKING TO PRIORITIZE AND PROTECT THAT WE'RE LOSING DUE TO THIS WAIVER? I'M ALSO WONDERING WITH THE, WITHOUT THE REQUIRED, UH, 1115 WAIVER MATCH, WE'RE FREEING UP SOME GENERAL FUNDS SINCE PUBLIC SAFETY IS THE CITY'S TOP PRIORITY.
WOULD ANY OF YOU BE SUPPORTIVE OF ALLOCATING THOSE SAVINGS TO REENTRY AND YOUTH VIOLENCE PREVENTION? I THINK THAT'S AN IMPORTANT NEED THAT WE HAVE IN OUR CITY.
AND THEN LAST, THE RECIDIVISM RATE OF, OF NINE OF 8% THAT WE HEARD FROM THE DIRECTOR AND PROGRAMMING SEEMS LIKE A GREAT MEASURABLE OUTCOME SHOWING HOW OUR CITY IS, IS BEING MADE SAFER THROUGH THIS WORK.
UH, SAFETY IS SOMETHING THAT'S REALLY IMPORTANT TO ME.
HOW ARE YOU COMPARING THE IMPACT OF THESE VIOLENCE PREVENTION AND PUBLIC SAFETY PROGRAMS ACROSS CITY DEPARTMENTS? YEAH, I GUESS I CAN'T SPEAK FOR EVERY SINGLE COUNCIL MEMBER, BUT FEEL FREE TO CHIME IN.
I THINK ALL OF THE PROGRAMS ARE, ARE VITAL.
I WOULDN'T PUT ONE ABOVE THE OTHER.
UH, BUT I ALSO WANT TO STRESS THAT I BELIEVE THAT WE SHOULDN'T ALWAYS BE DEPENDENT ON, UH, THESE WAIVER DOLLARS OR OUTSIDE DOLLARS THAT ARE TIED TO, UH, CERTAIN CONTINGENCIES.
WE HAVE A LOT OF PROGRAMS AND BOOTS ON THE GROUND AND NONPROFITS RIGHT HERE IN THE CITY THAT DO EXCELLENT WORK.
AND WHAT I WOULD LIKE TO SEE IS A CONTINUED, UM, STRATEGY TOWARDS ENSURING THAT WE IDENTIFY THESE PROGRAMS THAT ARE IN THESE COMMUNITIES THAT DO SIMILAR WORK AND MAKE SURE THAT, UH, WE'RE WORKING IN COLLABORATIVE, IN A COLLABORATIVE WAY WITH THEM SO THAT THE PEOPLE WHO NEED THOSE SERVICES ARE STILL RECEIVING THOSE SERVICES.
SO, SO IN TERMS OF RETAINING SOME OF THESE 1115 WAIVER PROGRAMS, WHICH PROGRAMS, 'CAUSE AGAIN, THIS IS NOT A SUDDEN, THIS ISN'T A REVEAL FOR TODAY.
LIKE, WHICH OF THESE PROGRAMS DO YOU SEE US BEING ABLE TO RETAIN? OR DO YOU EXPECT TO WORK TO RETAIN AS, AS WE'RE EXPECTING TO LOSE? I MEAN, VIOLENCE PREVENTION, RIGHT? LIKE THAT'S A CLEAR PUBLIC SAFETY PRIORITY AND WE KNOW IT'S TAKING A WHILE TO GET SOME OF THESE PROGRAMS OFF THE GROUND.
IT TAKES SOME TIME TO START THINGS, BUT THESE ARE THINGS THAT WE ALREADY HAVE EXISTING, RIGHT.
THAT WE KNOW ARE EFFECTIVE, THAT WE HAVE OUTCOMES TIED TO.
SO HOW ARE WE MAKING SURE THAT WE BOTH MAINTAIN AND THEN SCALE UP, RIGHT? THAT WE SCALE UP THESE THINGS THAT, THAT WE KNOW ARE EFFECTIVE.
SO THAT, THAT'S, UH, REALLY WHAT I'M, WHAT I'M HOPING TO HEAR FROM YOU ALL.
[00:50:01]
AGREE.I MEAN, WE DON'T NEED TO LET GO OF ANY OF THE PROGRAMS. I, I DO BELIEVE ONE, ONE THING THAT, THAT THE DIRECTOR MENTIONED WAS THE, UM, THE, UM, THE MAKE GRANT TO REALLY TRY TO DO THAT.
'CAUSE THAT'S A LARGE CHUNK OF MONEY THAT YOU CAN GRAB AND MULTIPLE NONPROFITS THAT ARE ALREADY DOING THE WORK CAN BE A PART OF IT.
I THINK THAT'S A REALLY GREAT SOLUTION, UM, TO THIS.
BUT HAVING THE CONVERSATION OF LOSING THESE PROGRAMS, I DON'T THINK ANYONE HERE WOULD WANT TO DO THAT.
I MEAN, THEY'RE ALL REALLY IMPORTANT.
COUNCIL MEMBER ALCORN, THANK YOU.
I MEAN, THESE ARE, WE HAVE BEEN FOLLOWING THIS FOR MANY YEARS.
I'VE BEEN HERE A LONG TIME, AND WE'VE, LIKE HE SAID, I DON'T KNOW IF I'M GONNA BE TALKING ABOUT 1115 WAIVER NEXT YEAR.
WE'VE BEEN HEARING IT IN BUDGET, UH, AFTER BUDGET, AFTER BUDGET.
UM, THE FAMILY HEALTH, THE NURSE FAMILY HEALTH THING, ALL THOSE THINGS ARE SUPER IMPORTANT.
SO YEAH, IT IS ON US TO FIND MONEY AND, AND YOUR, YOUR, UM, YOUR COMMENT ABOUT GENERAL FUND MATCH.
I MEAN THE, THE REENTRY PROGRAM HAS, UH, AS COUNCIL MEMBER JACKSON HAS BEEN SO INVOLVED IN, IS, IS SUPER IMPORTANT AND SOMETHING I BELIEVE IN.
SO THAT'S ONE PROGRAM I DEFINITELY WANNA SEE CONTINUE ON.
AND I THINK THE, THE, UH, MATERNAL HEALTH, THE, THE NURSE FAMILY PARTNERSHIP THAT FOLLOWS MOTHERS AND, AND CHILDREN FOR THE, YOU KNOW, THE FOLLOWING YEAR IS SUPER IMPORTANT.
I MEAN, YEAH, WE DON'T WANNA SEE, I MEAN, IT'S PRETTY SHOCKING TO SEE THE REVENUES GOING FROM 65 MILLION TO 45 MILLION.
RIGHT? AND SO WE, WE HAVE TO BE COGNIZANT OF THAT.
AND YOU'RE RIGHT, IT ALL HAS A, IT ALL HAS A PUBLIC SAFETY IMPACT.
ANYONE, ANYONE ELSE, UH, IN TERMS OF THESE, THESE PRIORITIES? UH, AND, AND, UM, THIS QUESTION THAT I ASKED ABOUT COMPARING VIOLENCE PREVENTION, MR. OLIVER PROGRAMMING ACROSS THE CITY DEPARTMENTS.
WELL, I, THAT WAS A QUESTION THAT I HAD ASKED AS WELL.
SO I WANTED TO MAKE SURE I GET A RESPONSE.
IF ANYONE HAS A RESPONSE THERE, YOU PUT IT, PUT IT INTO THE SHAREPOINT.
UM, SO I'M REALLY, UM, EXCITED ABOUT ALL THE WORK THAT THE HEALTH DEPARTMENT IS DOING IN CASHMERE GARDEN.
ANOTHER THING, IT'S, IT'S DISCOURAGING FOR ME SOMETIMES BECAUSE, UM, I AM A RESIDENT IN THE OSC SOUTH UNION NEIGHBORHOOD AND IT LIES BETWEEN TWO COMMUNITIES WHO ARE PART OF THE COMPLETE COMMUNITIES.
AND IT'S DISCOURAGING TO SEE THAT A COMMUNITY THAT LIES BETWEEN THESE TWO COMMUNITIES IS NOT RECEIVING THE RESOURCES THAT THEY NEED TO ADDRESS COMMUNITY CONDITIONS.
WE HAVE A ENVIRONMENTAL SITE THAT IS LOCATED ON GRIGGS ROAD IN OSC SOUTH UNION.
UH, ARE THERE ANY OPPORTUNITIES FOR FUNDING TO ENGAGE THE PUBLIC, UM, PUBLIC HEALTH OFFICIALS THAT WORK WITHIN THE, UM, HEALTH DEPARTMENT TO GO OUT AND COLLECT SAMPLES AND THOSE TYPE OF THINGS TO ENSURE THAT, YOU KNOW, SOMETHING THAT THE, WHAT HAPPENED IN FIFTH WARD? OH, I KNOW IT WAS OVER A HUNDRED YEARS OF CONTAMINANTS, BUT THAT IS ALSO SOMETHING THAT COULD POTENTIALLY BE A PROBLEM AT SOME POINT IN OSC SOUTH UNION.
IS THERE OPPORTUNITY FOR A PARTNERSHIP OR FUNDS AVAILABLE TO DO THAT? COUNCIL MEMBER PLUMMER.
AND THANK YOU FOR THAT QUESTION.
I'M WORKING REALLY CLOSELY WITH THE HEALTH DEPARTMENT WITH EPA, WITH TCQ, SO IF YOU DON'T MIND EMAILING ME THE LOCATION THAT YOU'RE REFERRING TO, AND LET ME LOOK INTO IT A LITTLE BIT AND SEE HOW, WHAT INFORMATION I CAN GIVE YOU.
COUNCIL MEMBER JACKSON, ARE YOU REFERRING TO THE CES PLANT? YES, MA'AM.
ON GREEKS ON, IT'S BEEN SHUT DOWN FOR A WHILE, BUT STILL, YOU KNOW, GOING UNDER THE GROUND AND, YOU KNOW, IT HASN'T BEEN COMPLETELY REMEDIATED, MA'AM.
AND I KNOW MA'AM, THAT, UM, A DEVELOPER RIGHT NOW IS TALKING ABOUT DOING A TRUCKING SCHOOL AT THAT PARTICULAR LOCATION.
I WAS ACTUALLY PART OF THE, UM, THE ACT, THE, THE ORGANIZING TO GET THAT, UM, LOCATION CLEANED DURING A NIECE PARKER, UM, ADMINISTRATION.
COME TO FIND OUT THE CITY WAS BASICALLY PROVIDING WATER, BUT THERE WAS NO OVERSIGHT OF THIS.
IT STARTED OUT AS A CLEANING COMPANY.
THEY CLEANED TRUCKS AND THEN BEFORE YOU KNOW IT, THEY STARTED STORING ALL TYPE OF CHEMICALS.
AND SO, UM, IT'S DISCOURAGING THAT, YOU KNOW, EPA CAME IN AND GAVE $2 MILLION FOR THE CLEANUP.
AND YOU WANT ME TO SHUT UP? OKAY.
AND SO IT'S BEEN GOING ON FOR QUITE SOME TIME.
EXPLOSIONS THERE, PEOPLE DIED AT THE PARTICULAR LOCATION.
SO I'M GLAD YOU BROUGHT THIS UP.
AGAIN, I'LL SAY GET WITH TEXAS ORGANIZING PROJECT AS WELL, BECAUSE THEY WERE THE LEAD ORGANIZATION IN TEXAS, LOW INCOME HOUSING ON ORGANIZING AROUND THAT.
[00:55:01]
COMPLETES OUR PUBLIC SPEAKER COMMENT PERIOD, AND THAT COMPLETES OUR HOUSTON HEALTH DEPARTMENT BUDGET WORKSHOP.WE WILL NOW ADJOURN AND TAKE A FIVE MINUTE BREAK WHILE SETTING UP FOR THE SOLID WASTE MANAGEMENT DEPARTMENT BUDGET WORKSHOP.