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PLEASED TO HAVE STEVEN WILLIAMS HERE WITH THE CITY HEALTH DEPARTMENT.AND DARREN, TELL ME YOUR LAST NAME.
THANK YOU SO MUCH FOR BEING HERE.
I'D LIKE TO WELCOME MY COLLEAGUES IN ATTENDANCE.
WE HAVE COUNCIL MEMBER TWILA CARTER, VICE MAYOR, PRO TEM, AMY PECK, COUNCIL MEMBER JULIAN RAMIREZ, COUNCIL MEMBER ABBY CAYMAN AND STAFF WITH VICE CHAIR COUNCIL MEMBER RAM MARIO'S CASTILLO'S OFFICE AND COUNCIL MEMBER TIFFANY THOMAS'S OFFICE, AND I'M SURE OTHERS WILL BE JOINING.
BUT, UH, WITH THAT, I WILL, THE FLOOR IS YOURS, DIRECTOR.
YOU HERE? I AM HERE PRESENTING MY 20TH BUDGET PRESENTATION,
AND WE ARE VERY LUCKY TO HAVE YOU.
IT WILL PROBABLY BE MY LAST, BUT
UH, I'M GONNA START OFF BY, UH, WITH THE ORGANIZATION CHART, JUST TO INTRODUCE MY STAFF BECAUSE I'M REALLY PROUD OF THEM.
UH, OF COURSE YOU HAVE DARREN ASHTON, WHO'S, UH, OUR, OUR FINANCE PERSON.
BUT, UH, DAVID PURSE IS NOT HERE.
UH, THEY'RE, THEY'RE DOING TESTING ACTUALLY IN THE FIRE DEPARTMENT.
UH, BUT WE DO HAVE OUR DEPUTY HEALTH AUTHORITY, OUR AUTHORITY, DR.
UH, ALSO MY DEPUTY DIRECTOR AND CHIEF OF STAFF, JUDY HARRIS IS HERE.
SO, UH, TUCKER WILSON, OUR COMMUNICATIONS PERSON IS WALKING IN THE DOOR.
UH, OUR CHIEF SCIENCE OFFICER, LAUREN HOPKINS, IS NOT HERE, BUT YOU'VE ALL SEEN AND HEARD FROM HER.
UH, ASSISTANT DIRECTOR, RANITA MADOO, WE CALL IT, UH, HER AREA PUBLIC HEALTH INFRASTRUCTURE.
BUT BASICALLY IT'S ABOUT QUALITY ASSURANCE AND, AND A LOT OF OTHER OTH OTHER STUFF.
UH, ROGER SEALEY, WHO'S THE ASSISTANT DIRECTOR OF ADMINISTRATIVE SERVICES, UH, CHIEF TECHNOLOGY OFFICER, MARK SEALS, WHO IS HERE, AND I DON'T KNOW, YEAHAND, UH, MARE HORN IS HERE.
SHE'S CURRENTLY OUR, OUR DEPUTY DIRECTOR AND NAOMI AMMAS, UH, UH, COMMUNITY HEALTH SERVICES DIRECTOR.
UH, SHE'S AN ASSISTANT DIRECTOR, BUT SHE'S IN CHARGE OF SPECIAL INITIATIVES AND REALLY, UH, HUMAN SERVICES.
UH, SO THOSE ARE THE PEOPLE WHO ACTUALLY MAKE THE OR OR ORGANIZATION WORK.
MY JOB IS, UH, MAINLY LEADERSHIP, GUIDANCE, CONSULTATION AND, AND WHATEVER.
AND TROUBLESHOOTING, OF COURSE, ESPECIALLY WHEN Y'ALL ASK ME QUESTIONS.
UH, I WANTED TO START BY GIVING YOU, UH, ON THE NEXT SLIDE, UH, UH, THE, THE, THE FINANCE, THE, THE, UH, THE INVESTMENT.
BECAUSE A LOT OF TIMES WHAT YOU'RE SEEING HERE IS REALLY OUR GENERAL FUND AND SPECIAL FUNDS REVENUE, BUT OUR DEPARTMENT IS A A LOT BIGGER THAN THAT.
AND I'LL, I'LL, I'LL GIVE YOU THAT PICTURE LATER ON, BUT I'VE, I'VE ALWAYS SHOWN THE CITY'S NET INVESTMENT IN, IN PUBLIC HEALTH.
BASICALLY, YOU, WHAT YOU SEE, YOU KNOW, IN THE PROPOSED BUDGET IS A $50 MILLION BUDGET.
UH, BUT IN FACT, WE EARN ABOUT $14 MILLION IN REVENUE.
SO THEREFORE, YOUR INVESTMENT, UH, FOR THE FOURTH LARGEST CITY IN THE COUNTRY'S PUBLIC HEALTH DEPARTMENT IS REALLY $35.77 MILLION.
AND OF THAT, ABOUT 6.3 ARE ACTUALLY RESTRICTED ACCOUNTS.
SO THAT LEAVES US, YOU KNOW, ROUGHLY $29.4 MILLION FOR A DIRECT, FOR AN INVESTMENT IN DIRECT SERVICE PROGRAMS. UH, AS IT RELATES TO THE GENERAL FUND.
ON THE NEXT SLIDE, UH, BUDGET AND, UH, FUNCTIONAL SUMMARY THAT REALLY LAYS OUT OUR TOTAL BUDGET.
A LOT OF TIMES I'M ASKED DURING THESE PRESENTATIONS, YOU KNOW, UH, UH, ABOUT OUR TOTAL BUDGET.
SO I JUST WENT ON AND INSERTED OUR TOTAL BUDGET IN, UH, TO THE, THIS PACKAGE.
AND YOU'LL SEE THE GENERAL FUNDS AND THE SPECIAL REVENUE FUNDS, WHICH IS WHAT WE'RE TALKING ABOUT TODAY, BUT ALSO THE AMOUNT OF GRANT FUNDS THAT THAT, THAT WE HAVE.
I KNOW A LOT OF Y'ALL, UH, ARE FAMILIAR WITH THE FACT THAT WE'VE LOST SOME GRANT DOLLARS, BUT LET ME PUT THAT IN CONTEXT FOR YOU.
WE KNEW THAT PROBABLY AROUND NEXT YEAR WE WERE, THOSE DOLLARS WERE GONNA BE OVER ANYHOW.
AND SO REALLY, IT'S REALLY FOR, JUST TO PUT IT IN CONTEXT, IT'S, IT, IT'S, WE, UH, IT'S ABOUT 18, UH, A YEAR TO 18 MONTHS SOONER THAN WE THOUGHT THOSE FUNDS WOULD GO AWAY, BUT WE HAD ALREADY STARTED TO MAKE PREPARATIONS, UH, FOR NOT HAVING THOSE DOLLARS.
REALLY, WHAT TO PUT ALSO, TO PUT IT INTO A GREATER CONTEXT
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IS THAT, UH, WE GOT A LOT OF MONEY DURING COVID, BUT WHAT THE FEDS RECOGNIZED IS THAT THERE HADN'T NOT BEEN MUCH INVESTMENT IN PUBLIC HEALTH INFRASTRUCTURE.AND SO WHEN THE, THE PANDEMIC LITERALLY DIED DOWN A LITTLE BIT, THEY LET US KEEP THOSE FUNDS.
THEY LET US KEEP THOSE FUNDS TO BUILD CAPACITY AND THE VARIOUS FUNCTIONS IN PUBLIC HEALTH.
AND THIS WAS HAPPENING ACROSS, ACROSS THE COUNTRY, FOR INSTANCE, UH, UH, IN, IN IT AND COMMUNICATION, UH, DATA MODERNIZATION AND STRATEGIES TO REACH THE VULNERABLE POPULATIONS.
AND SO THOSE THINGS THAT WERE REALLY CRITICAL TO PUBLIC HEALTH, WE WERE ABLE TO USE THOSE MONIES TO DO THAT.
AND BECAUSE WE HAD THEM A CERTAIN AMOUNT OF TIME, WE DID MAKE SOME PRO PROGRESS IN, IN THOSE AREAS.
IT, IT'S JUST THAT TO MAKE FURTHER PROGRESS, UH, WILL TAKE A, A MUCH LONGER TIME.
UH, THAT'S WHY, ALTHOUGH WE WE'RE SAD ABOUT IT, YOU DON'T SEE US LIKE TOTALLY, YOU KNOW, BEING TOTALLY DISTRAUGHT ABOUT IT.
ON THE NEXT SLIDE, STRATEGIC GUIDANCE AND, AND, AND ALIGNMENT.
UH, REALLY THIS IS JUST A HIGH LEVEL VISUALIZATION OF WHERE I, OUR PRIORITIES, UH, WHERE OUR PROGRAMS, GENERAL PROGRAMS FALL, UH, RELATIVE TO THE, THE, THE MAYOR'S PRIORITIES.
IF YOU LOOK AT THE KEY INITIATIVES I MENTIONED EARLIER WITH SOME OF THOSE DO THE, THE GRANT DOLLARS WE HAD, WE WERE REALLY FOCUSING ON ENHANCED DISEASE SURVEILLANCE.
WE HAVE SPENT A LOT OF TIME ON WORKFORCE DEVELOPMENT.
IF YOU LOOK AT THE TURNOVER IN MY STAFF, MY STAFF, LITTLE PRI PRIOR TO COVID AND DURING COVID, AND IMMEDIATELY AFTER COVID, WE HAVE, UH, UH, STAFF THAT ARE RELATIVELY, RELATIVELY NEW TO THEIR POSITIONS, AND IN SOME CASES NEW TO PUBLIC HEALTH.
AND SO WHAT WE'VE BEEN DOING IN OUR ORGANIZATION IS REALLY DOING A GENERAL OR ORIENTATION TO, UH, INCREASE THE KNOWLEDGE OF WHAT WE DO, WHY WE DO IT AMONGST OUR LEADERSHIP.
WE HAS ALSO BEEN, UH, LOOKING AT, UH, THE PERFORMANCE MEASURES RELATIVE TO EACH ONE OF THOSE PROGRAMS. AND ACTUALLY REFINING THE PERFORMANCE MEASURES, REALLY TRYING TO LOOK AT WAYS TO, UH, INCREASE AND ENHANCE A ACCOUNT ACCOUNTABILITY.
UH, ALSO WE HAVE BEEN INVOLVED IN TRYING MAKE, DOING PROCESS IMPROVEMENTS IN ADMINISTRATIVE SERVICES RELATIVE TO PURCHASING CONTRACT MANAGEMENT, UH, AND, AND BUDGET.
ONE THING THAT YOU, YOU PROBABLY EXPERIENCED WITH US IS THAT, YES, WE HAD A PANDEMIC, BUT AT THE SAME TIME, WE HAD A PANDEMIC.
REMEMBER, IMPACTS, UH, AND, AND MY STAFF HAVE, HAVE ALSO AT THE SAME TIME HAVE, HAVE HAD TO, UH, FOLLOW UP ON TRAVEL RELATED MEASLES CASES AND ALSO MENINGITIS CASES.
AS A MATTER OF FACT, I THINK IT'S ABOUT THREE OR FOUR WEEKS THAT THEY HAVEN'T, UH, REALLY BEEN ACTIVE OVER O OVER THE WEEKEND.
THESE ARE THINGS THAT PEOPLE DO NOT SEE, BUT I, I CAN TELL YOU, UH, STAFF IS ACTIVELY IN, IN INVOLVED IN IT.
AND, BUT WHAT YOU GET OUT OF THAT IS THAT THERE HASN'T BEEN ANY LOCAL TRANSMISSION OF MEASLES BECAUSE THEY WERE REALLY FOLLOWING UP IN CASES.
AND I THINK THE CASE, UH, AT THAT, THAT OCCURRED AT, AT, AT THE AIRPORT, UH, THERE, THERE WERE TENS OF CASES THAT OUR FOLKS HAD TO FOLLOW UP WITH IN CONJUNCTION WITH THE, UH, HEALTH DEPARTMENTS IN, IN THE REGION.
OH, PLANS TO ELIMINATE THE GAP.
OUR DEPARTMENT HAD TO, UH, COME UP WITH A 5%, UH, REDUCTION IN THE BUDGET.
IT PRIMARILY IMPACTED ABOUT 22.5 PEOPLE, UH, POSITIONS, EXCUSE ME.
UH, 7.5 OF THOSE POSITIONS, UH, ARE OUR FEEL, OUR HOPE.
OUR HOPE WAS THAT, I DON'T KNOW WHAT HAPPENS.
SORRY, IT JUST FROZE AND CLOSED OUT.
UH, I THOUGHT THAT ONLY HAPPENED TO ME.
UH, JUDGE, CAN YOU REPEAT THOSE NUMBERS? UH, 22.5 FTAS, BUT 7.5 BEING FILMED.
BUT OUR HOPE WAS THAT, UH, DOING THAT, THAT, THAT, THAT, THAT 60 DAY WONDER, WE WOULD BE ABLE TO FIND POSITIONS FOR THOSE SEVEN POINT 0.5 PEOPLE.
UH, AND ON TOP OF THAT, UH, YOU KNOW, I TALKED ABOUT THE FACT THAT WE HAD LOST, UH, ABOUT 62 MILLION, UH, 42, UH, 40 42 RELATIVE TO OUR IMMUNIZATION GRANT, OUR CRISIS CO-ED GRANT, OUR HEALTH EQUITY, AND OUR ELC UH, UH, GRANT.
AND THE $20 MILLION, UH, THAT WE HAD GOTTEN FROM EPA, UH, RELATIVE TO, UH, THE CANCER CLUSTER.
WE WERE HOPING TO DO SOME VERY POSITIVE THINGS RELATIVE TO THAT.
CAN YOU REPEAT THOSE GRANTS AGAIN, THAT WERE, AND THE TOTAL NUMBERS? AND THE TOTAL NUMBERS? YEAH.
I THINK WE'RE ALL INTERESTED IN THAT.
IT MIGHT BE LATER IN YOUR PRESENTATION, BUT NO, I'LL TELL YOU NOW.
UH, I, I, I KNEW YOU WERE GONNA ASK ME, SO THAT'S WHY.
YEAH, THAT'S WHY'RE WHY I'M GONNA GO AHEAD.
YOU'RE, EVERYBODY WANTS TO KNOW ABOUT IT.
UH, IT'S 62 MILLION AND ALL THAT 42 MILLION I REFER TO EARLIER, THAT REALLY WAS SUPPOSED TO LAST ANOTHER YEAR, YEAR AND A HALF.
BUT, UH, IT, IT ENDED, YOU KNOW, A COUPLE OF MONTHS AGO.
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RELATED TO HEALTH EQUITY CRISIS, COAG IMMUNIZATION, AND, UH, ELC EPIDEMIOLOGY.AND, AND THAT GRANT IS RELATED TO IMPROVEMENTS IN EPIDEMIOLOGY AND, UH, LABORATORY FUNCTIONS.
AND, AND HOW MANY PEOPLE DID WE HAVE PAID FOR WITH THAT GRANT? ACTUALLY, I, I DON'T KNOW, BUT I'LL GET BACK WITH YOU.
AND TELL YOU, TELL YOU THAT WE'RE ANTICIPATING THAT THERE WILL BE SOME CUTS, UH, IN, IN HIV.
WE DON'T KNOW EXACTLY WHAT THEY'RE, THEY'RE GONNA BE.
I MEAN, WE'RE REALLY TAKING A, A, A, WELL, WE'RE TAKING MORE THAN A WAIT AND SEE ATTITUDE.
WE'RE LOOKING, TRYING TO SURVEY THE ENVIRONMENT, SEE EXACTLY WHERE WE ARE.
UH, WHAT WE WILL DO THOUGH, IS GO BACK AND LOOK AT WHAT ARE ESSENTIAL AND CORE SERVICES, AND REALLY HAVE TO FILL THOSE FUNCTIONS SO THAT WE CAN CONTINUE TO O OPERATE OUR, OUR OUR HEALTH DEPARTMENT.
SO 62 MILLION, 40 MILLION TOWARDS WHAT YOU JUST DESCRIBED.
AND THEN THERE, WHAT'S THE REMAINING 22? THE 20 MILLION WAS FOR THE EPA, UH, GRANT.
THAT WE WERE GONNA DO RELATIVE, WE, WE WERE LOOKING AT REALLY AT SOLAR IN THE FIFTH WARD RELATIVE, OKAY.
THE VOLUNTARY MUNICIPAL, UH, EMPLOYEE RETIREMENT PAY PAYOUT OPTION.
UH, ON THAT SLIDE, BASICALLY, YOU, YOU SEE THAT THE TOTAL NUMBER OF PEOPLE THAT WERE ELIGIBLE WAS 245, UH, 83 ACCEPTED.
OF THOSE 39 WERE ACTUALLY GENERAL FUND EMPLOYEES, UH, MAINLY IN VITAL, UH, STATISTICS, CONSUMER HEALTH AND, AND, AND CLINIC AND CLINIC OPERATIONS.
THE NEXT SLIDE, PROPOSED DEPARTMENT RE RE RESTRUCTURE.
UH, I, I HAVE TO SAY THAT FIRST, YOU KNOW, ANY MANAGER WHEN THEY'RE LOOKING AT JUST, OH, WOW, WE HAVE TO GO THROUGH THIS.
BUT THIS IS SOMETHING THAT I THINK WE REALLY, REALLY NEEDED TO DO ANYHOW.
UH, ESPECIALLY, UH, DURING COVID, WE, YOU KNOW, WE DID A LOT OF THINGS ON THE SPOT, YOU KNOW, WE WERE RESPONDING.
SO THIS REALLY PROVIDED AN OPPORTUNITY FOR US TO GO BACK AND, AND LOOK AT OUR ORGANIZATION.
UH, DURING MY EARLIER CAREER, I WAS A MANAGEMENT ANALYST, AND THIS IS ONE OF THE THINGS THAT WE DID IN MARICOPA COUNTY, GOING AROUND TO EVERY COUNTY DEPARTMENT KIND OF DOING THESE KINDS OF ANALYSIS.
AND AS YOU CAN SEE ON THIS SLIDE, WE WEREN'T REALLY THAT BAD OFF.
UH, THE AVERAGE SPAN OF CONTROL WAS 59, UH, 5.996, UH, AND OUR PROPOSED STATE FOR OUR RESTRUCTURE, YOU SEE THAT IT, IT WILL BE EIGHT.
AND, AND THE PERCENTAGE OF, AND SUPERVISORS WAS LESS THAN FOUR.
AND WHEN OUR PROPOSED RESTRUCTURE, IT'S GONNA BE FIVE POINT, UH, 5, 5, 5, 6.
AND LAYERS OF MANAGEMENT WAS SEVEN, WHICH IS USUALLY ACCEPTABLE.
BUT, AND OUR PROPOSED RESTRUCTURE WILL GO DOWN, UH, TO, TO FIVE.
UH, AND, YOU KNOW, THERE ARE POSITIONS AND SITUATIONS WHERE YOU WILL HAVE LESS THAN FOUR, FOR EXAMPLE.
AND, UH, MY BROTHER'S KEEPER PROGRAM, THERE, THERE ARE ONLY TWO PEOPLE THAT ARE IN THAT PROGRAM, SO IT MAKES SENSE.
OUR C TO SUCCEED PROGRAM, WE HIRE SEASONAL OR TEMPORARY STAFF.
UH, AND, AND WE HAVE A SMALL NUMBER OF DEDICATED, YOU KNOW, FULL-TIME EMPLOYEES RELATED TO THAT.
AND SO IN, IN THOSE CASES, IT'S APPROPRIATE ALSO IN A CLINICAL AREA.
YOU WILL HAVE, UH, MID-LEVELS LIKE NURSE PRACTITIONERS WHO ARE ACTUALLY PROVIDERS, BUT THEY HAVE CLERICAL SUPPORT THAT ARE SUPPORTING THEM.
SO THEY MIGHT HAVE ONE OR TWO PEOPLE SUPPORTING THEIR WORK.
I, I WANTED TO POINT THAT OUT, UH, BECAUSE WE'RE STILL AT 5.6, 5.56, BUT WHEN I LOOK AT THE AREAS, UH, IT, IT, IT'S, IT, IT'S PRETTY GOOD AS, AS FAR AS I CAN, CAN SEE AS IT RELATES TO OUR PROPOSED STRUCTURE EXPENDITURES BY PROGRAM, WHICH IS THE, THE, THE NEXT SLIDE.
BASICALLY, I'M GONNA BE COVERING THESE, UH, IN, IN INDIVIDUALLY.
UH, BUT THERE WAS, UM, AN INCREASE IN PERSONNEL DUE TO THE 3.5 SALARY INCREASES.
UH, AND, UH, THERE, THERE WERE SOME CUTS IN, IN SOME OF THE PROGRAMS. AND, AND THERE ARE VACANCIES THAT, UH, ARE IMPACTED FOR 25 THAT WE'RE HOPE HOPING TO FILL INTO POSITIONS.
BUT I'LL GO TO THE REVENUE, UH, BY PROGRAMS NEXT.
AND IN THIS SLIDE, AND I, I'M NOT GONNA READ THE SLIDE TO YOU, BUT ENVIRONMENTAL HEALTH HAD SEVERAL VACANCIES, WHICH CAUSED A DECREASE IN, IN MOST REVENUE CATEGORIES.
BASICALLY, IF YOU'RE NOT ABLE TO CONDUCT AN INSPECTION, YOU DON'T GET THE REVENUE FROM THAT INSPECTION.
UH, WE'RE HOPING TO CATCH UP WITH THAT.
THE, UH, FAMILY, UH, AND HEALTH AND HUMAN SERVICES IS DOWN BECAUSE OF A REDUCTION IN, IN CHARITY CARE.
UH, BASICALLY, UH, WITH, WITH CHARITY CARE, HEALTH DEPARTMENTS, AS WELL AS MENTAL HEALTH ORGANIZATIONS ARE ABLE TO DRAW FROM THAT FUND, UH, BY SUBMITTING A COST REPORT.
AND IN THIS CASE, THERE WERE MORE, UH, MENTAL HEALTH
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AGENCIES AND HEALTH DEPARTMENTS PULLING OUT OF THAT POOL.AND SO WE GOT A, A, A DECREASE IN, IN THAT REVENUE.
UH, ONE OF THE THINGS I'VE BEEN WORKING ON AT THE STATE LEVEL IS ACTUALLY, UH, GET, TRYING TO GET THE STATE TO INCREASE THE POOL.
THE SECOND THING THAT I'VE BEEN TRYING TO DO IS TO GET A DEDICATED POOL FOR HEALTH DEPARTMENTS, BECAUSE THE MENTAL HEALTH AGENCIES ARE TAKING THE, THE, THE LARGEST PORTION OF, OF THOSE DOLLARS.
WHAT I DID FIND OUT IS THAT THE STATE DOES HAVE THE, THE ADMINISTRATIVE AUTHORITY ACTUALLY TO INCREASE THE POOL, WHETHER OR NOT THEY CAN ACTUALLY HAVE A DEDICATED, UH, UH, SET ASIDE FOR PUBLIC HEALTH DEPARTMENTS LIKE WE DID WITH 1115 WAIVER.
I'M, I'M NOT SO SURE ABOUT THAT.
THE NEXT SLIDE REALLY IS PROGRAM ONE, WHICH IS ADMINISTRATIVE SERVICES.
UM, OF THE TWO POINT, EXCUSE ME, 23.6 MILLION ADMINISTRATIVE SERVICES, APPROXIMATELY 6.3 MILLION IS IN RESTRICTED ACCOUNTS.
AND THAT LEAVES ABOUT $17 MILLION TO PROVIDE THE INTERNAL SUPPORT, ADMINISTRATIVE SERVICES SUPPORT TO THE, TO, TO THE PROGRAMS AND SERVICES.
AND, AND THE THING THAT I WANNA POINT OUT WITH, WITH THIS IS THAT IN ADMINISTRATIVE SERVICES, WE'VE ACTUALLY HAD TO AUGMENT, UH, THE ADMINISTRATIVE SERVICES WITH, UH, THE 1115 WAIVER DOLLARS.
BASICALLY, WE'VE USED THE 1115 WAIVER DOLLARS TO, UH, INCREASE OUR CAPACITY AND COMMUNICATIONS AND HUMAN RESOURCES, IT, UH, AND QUALITY ASSURANCE AND COMPLIANCE.
AND ALSO WE'RE FUNDING, UH, LOGISTICAL SUPPORT AND CONTRACT AND, AND PROCURE PROCUREMENT WITH THE 1115 WAIVER DOLLARS.
UH, AND LOGISTICAL SUPPORT, ACTUALLY, IT'S ONE OF THE THINGS THAT I'M REALLY PROUD OF, BECAUSE WE ACTUALLY USE OUR REENTRY FOLKS TO PROVIDE LOGISTICAL SUPPORT TO ALL OUR PROGRAMS AND, AND SERVICES.
YOU KNOW, WE DO A LOT OF WORK IN THE COMMUNITY.
YOU HAVE TO SET UP TENSION, YOU HAVE TO DO STUFF, MOVE THINGS AROUND.
THESE ARE THE PEOPLE THAT ARE, ARE DOING THAT.
SO IT'S ACTUALLY PROVIDING ADMINISTRATIVE SUPPORT, BUT AT THE SAME TIME, IT IS A PROGRAM IN AND OF ITSELF BECAUSE IT'S GETTING PEOPLE BACK TO WORK.
UH, HALF THE, REMEMBER THAT THE 1115 WAIVER DOLLARS THAT ARE ACTUALLY SUPPORTING THESE PROGRAMS AS THE, AND ADMINISTRATIVE SERVICES AS WELL AS IN PROGRAMS AND SERVICES WILL LIKELY RUN OUT IN, IN FIVE YEARS.
NOW, WE WERE GETTING, UH, E EITHER 20 TO $30 MILLION IN THE 1115 AND WAIVER DOLLARS, BUT THAT PROGRAM ENDED THROUGH CHARITY CARE.
WE WERE ABLE TO RECOUP NINE OR $10 MILLION A YEAR, WHICH MEANS THAT THERE'S STILL ABOUT 50% OF THOSE DOLLARS THAT WE NEED TO FIGURE OUT HOW TO RE RE RECOUP.
BUT WE HAVE A COUPLE OF YEARS, UH, TO, TO DO THAT.
ON THE NEXT SLIDE IS ENVIRONMENTAL HEALTH.
UH, BASICALLY YOU UNDERSTAND THAT THESE ARE PRIMARILY REGULATORY SERVICES.
UH, THEY DO GENERATE, UH, REVENUE.
UH, A COUPLE OF YEARS AGO, WE, UH, THERE WAS AN ORDINANCE CREATED SO THAT WE COULD REALLY, UH, SPEND, UH, SPECIAL REVENUE ACROSS THE ENVIRONMENTAL HEALTH PROGRAMS, BECAUSE WE MIGHT HAVE A PERSON THAT'S ACTUALLY, UH, PRIMARILY ASSIGNED TO ONE PROGRAM, BUT BECAUSE THEY, UH, LIKE FOR INSTANCE, UH, A, A CONSUMER HEALTH PERSON THAT INSPECTS RESTAURANTS MIGHT ALSO INSPECT SWIMMING POOLS.
AND SO, UH, THERE, THERE'S ACCESS TO ALL OF THOSE, UH, DOLLARS, UH, UH, BECAUSE OF JUST HOW THE PRO PROGRAM O OPERATES.
ON THE NEXT SLIDE, YOU'LL SEE DISEASE PREVENTION AND CONTROL.
UH, DISEASE PREVENTION AND CONTROL REPRESENT THE HEART AND SOUL OF PUBLIC HEALTH.
UH, PEOPLE OFTENTIMES GET CONFUSED WITH HEALTHCARE, BUT OUR PATIENT FOR DISEASE PREVENTION AND CONTROL IS MUCH BROADER.
INTERVENTIONS TO PROTECT THE BROADER POPULATION MAY INVOLVE INTERVENING WITH INTERVENTIONAL, UH, WITH, WITH INDIVIDUALS.
BUT, YOU KNOW, THE, THE ULTIMATE GOAL IS TO REALLY, UH, KEEP CERTAIN CONDITIONS FROM SPREADING TO THE BROADER, UH, POPULATION.
WE ARE A, THE DESIGNATED ENTITY BY LAW FOR REPORTABLE DISEASES.
UH, MOST OF THE ACTIVITIES OUTSIDE OF OUR CLINICAL ACTIVITIES ARE ACTUALLY FUNDED BY GRANTS.
UH, AND ALMOST ALL OF OUR EPIDEMIOLOGY SERVICES, UH, UH, ARE, ARE, ARE SUPPORTED BY, BY, BY GRANTS.
AND THIS IS ONE OF THE PROGRAMS THAT IS UNIQUELY GOVERNMENTAL PUBLIC HEALTH, BOTH ENVIRONMENTAL HEALTH AND, UH, DISEASE PREVENTION AND CONTROL IS REALLY GOVERNMENTAL PUBLIC HEALTH.
THE NEXT PROGRAM IS REENTRY AND, AND, AND YOUTH VIOLENCE.
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MY BROTHER'S KEEPER ADDRESSES DISPARITIES AND OUTCOMES OF BOYS AND YOUNG MEN OF COLOR.REDIRECT FOCUSES ON JUSTICE INVOLVED YOUTH.
OUR COMMUNITY REENTRY NETWORK INVOLVES, UH, GIVING FORMERLY INCARCERATED INDIVIDUALS A SECOND CHANCE, HOPEFULLY PREVENTING REC RE RECIDIVISM.
UH, THERE ARE NO GENERAL FUNDS THAT ARE, UH, ALLOCATED TO THESE INITIATIVES.
ALL, ALL OF OUR REENTRY AND VIOLENCE PREVENTION INITIATIVES ARE FUNDED BY THE 1115 WAIVER ARE, ARE THE GRANT.
UH, WE'RE PAYING FOR THE MY BROTHER'S KEEPER INFRASTRUCTURE, THE RE REDIRECT PROGRAM, COMMUNITY REENTRY COMMUNITY, UH, ALSO TO GRANT THE, UH, CONTRACTS WITH COMMUNITIES AND SCHOOL XY ZONE, AND THE MBK SYSTEMS OF CARE.
AND OF COURSE, URBAN SCHOLARS, UH, ARE ALL, UH, FUNDED BY THE 1115 WAIVER.
NOW WITH URBAN SCHOLARS, THERE IS A $200,000 MATCH THAT COMES FROM THE SOCIAL JUSTICE LEARNING, UH, IN INSTITUTE FOR THE OPERATION OF THAT PROGRAMS. ALSO RELATED TO THIS, UM, WE'RE MANAGING THE CREDIBLE MESSENGER AND VIOLENCE INTERRUPTION PROGRAMS THAT IS FUNDED BY A A, UH, WHICH ALSO HAVE A TIMEFRAME FOR, FOR, FOR ENDING.
UH, AND AS I ALWAYS SAY, ONCE YOU KNOW, THE 1115 WAIVER AND SPECIAL FUNDING ARE, ARE DEPLETED, IF THE CITY WANTS TO CONTINUE THESE PROGRAMS, WE'LL HAVE TO FIND FUNDING SOURCES FOR 'EM.
UH, MULTI-SERVICE CENTERS, UH, ALL OF YOU'RE F FAMILIAR WITH OUR MULTI-SERVICE CENTERS.
UH, THESE CENTERS PROVIDE COMMUNITY-BASED ACCESS, UH, TO SERVICES, WHICH INCLUDES HEAD START DAYCARE, LIBRARIES, WIC, THE MAYOR'S OFFICES, SPECIAL EVENTS, UH, DIABETES AWARENESS NETWORK AND SERVICES, PROVIDED BY A VARIETY OF COMMUNITY PARTNERS THAT ENHANCE THEIR QUALITY OF LIFE.
UH, THEY ALSO SERVE AS SITES FOR COMMUNITY EVENTS, COMMUNITY MEETINGS, AND VOTING LOCATIONS.
UH, EACH MULTI-SERVICE CENTER HAS EQUIP EXERCISE EQUIPMENT TO, UH, PROMOTE ACCESS TO PHYSICAL ACTIVITIES.
THE $2.7 MILLION PRIMARY SPENT, UH, ON PERSONNEL.
THERE ARE NO FUNDS, NO FUNDING FOR THE PROGRAMS AS ASSOCIATED IN THE MULTI-SERVICE CENTERS.
THE ONLY DIFFERENT, THE ONLY PROGRAM THAT'S FUNDED BY THE JOURNAL FUND IS THE ALE DIABETES AWARENESS NETWORK.
AND THAT ACTUALLY, I THINK WAS FUNDED THROUGH LAST YEAR'S BUDGET, OR THE YEAR BEFORE'S BUDGET, UH, WHEN A LEAF CAME ONLINE, FAMILY HEALTH AND, AND, AND HUMAN SERVICES.
THE, THE, THE NEXT SLIDE, UH, THE GENERAL FUND PRIMARILY SUPPORTS CLIENT ACCESS AND CARE COORDINATION.
UH, THE THREE, UH, CONGREGATE SITES, UH, MEAL SITES, UH, WE BROUGHT IN HOUSE, UH, SEVERAL, SEVERAL YEARS AGO.
UH, I ALSO WANTED TO EMPHASIZE, BECAUSE THIS ALSO THAT WE DO NOT PROVIDE PRIMARY CARE SERVICES, BUT WE EMPHASIZE ACCESS TO CARE.
THAT'S WHY YOU HAVE, UH, PROGRAMS LIKE CLIENT ACCESS AND, AND, AND CARE COORDINATION.
UH, AN EXAMPLE OF HOW WE DO THAT, FOR INSTANCE, WE WORK WITH COVENANT HOUSE.
YOU HAD A LOT OF, UH, KIDS THAT WERE NOT CONNECTED TO HEALTHCARE.
UH, ACTUALLY A FORMER COUNCIL MEMBER, UH, ROBINSON, ACTUALLY INTRODUCED ME TO, UH, UH, THE DR.
HERGENROTHER, WHO WAS, UH, MEDICAL DIRECTOR THERE.
HE'S, HE'S ALSO AT TEXAS CHILDREN.
AND WHAT WE DID WAS HAVE OUR, OUR CLIENT ACCESS PEOPLE WORK WITH, UH, THE COVENANT HEALTH STAFF TO EDUCATE THEM ON WHAT DOCUMENTATION THEY NEEDED TO EITHER GET MEDICAID OR GET ENROLLED IN HARRIS HEALTH.
AND SO NOW WE'RE ENSURING THAT THOSE, UH, YOUNG PEOPLE OVER THERE ACTUALLY HAVE ACCESS TO, TO HEALTH CARE.
THROUGH THAT, WE ALSO DID THE SAME THING FOR, UH, TEXAS CHILDREN, FOR KIDS THAT WERE, UH, AGING OUT OF TREATMENT THERE.
THE NEXT SLIDE IS CHRONIC DISEASE EDUCATION AND WELLNESS.
UH, ALTHOUGH CHRONIC DISEASE IS THE LEADING CAUSE OF MOBILITY, WE HAVE VERY LIMITED AT GENERAL FUNDS OR GRANT FUNDS TO SUPPORT THESE ACTIVITIES.
SO WE'VE INVESTED A SUBSTANTIAL AMOUNT, AS YOU CAN SEE, OF 1115 WAIVER DOLLARS IN, IN THAT.
SO, TO ACTUALLY HAVE SOME LEVEL OF A ACTIVITIES, UH, IN RELATED TO CHRONIC DISEASE.
UH, AS IT RELATES TO, UM, HEALTH EDUCATION.
ONE OF THE THINGS WE, WE, WE REALIZED IS THAT COMMUNICATION AND HEALTH EDUCATION WAS VERY IMPORTANT, BECAUSE THAT WAS SOMETHING THAT WAS QUITE A CHALLENGE DURING COVID.
AND SO WE ARE LOOKING AT HOW WE CAN ENHANCE THOSE FUNCTIONS, UH, SO THAT WE WILL HAVE THAT CAPACITY REGARDLESS OF WHAT GOES ON.
THE NEXT SLIDE, UH, ON 19, WHICH IS, UH, PERSONNEL VERSUS NON-PERSONNEL.
UH, UH, AND THIS YOU CAN SEE, UH, FATS OIL AND GREASE HAS A LARGER, UH, CONTRIBUTION TOWARD EQUIPMENT, VEHICLE PURCHASES, AND CONTRACTS WITH SPECIAL WA WA WASTE VENDORS AND FUND 2002 ARE HEALTH SPECIAL REVENUE.
IT'S USED PRIMARILY FOR CONTRACTS, SUPPLIES, AND EQUIPMENT.
[00:25:01]
TO SEVERAL OUR PROGRAM OPERATIONS, SUCH AS, UH, VITAL STATISTICS, ENVIRONMENTAL HEALTH, UH, UH, VETERAN SERVICES AND ADMINISTRA, UH, MEDICAID ADMINISTRATIVE CLAIMING, UH, TO JUST NAME A FEW.UH, THESE FUNDS ARE RESTRICTED AND ARE SPECIFICALLY DEDICATED AND ARE DEDICATED FOR SPECIFIC HEALTH RELATED PROGRAMS. THE NEXT SLIDE, PERSONNEL VERSUS NON-PERSONNEL RELATIVE TO LABORATORY SWIMMING POOLS AND ESSENTIAL PUBLIC HEALTH.
UH, THESE FUNDS TOO ARE RESTRICTED AND DEDICATED FOR SPECIFIC HEALTH RELATED PROGRAMS BY, UH, THE, THE FUNDERS IN LAB.
IT'S PRIMARILY FOR SUPPLIES AND, AND SWIMMING POOLS FOR PERSONNEL, CONTRACTS AND EQUIPMENT.
AND ESSENTIAL PUBLIC HEALTH IS PRIMARILY PERSONNEL AND CONTRACTS.
THE NEXT ONE, PERSONNEL VERSUS NON PERSONNEL.
UH, OPIOID, AS PREVIOUSLY STATED, UH, WELL, THIS ACTUALLY ADDRESSES OPIOID MISUSE.
THE MAJORITY OF FUNDS ACTUALLY GO TO CONTRACTS AND SERVICES THAT OFFER EVIDENCE-BASED, UH, TREATMENT AND PEER RECOVERY SERVICES.
AND ALSO, THIS IS WHERE WE BUY IT IN NALOXONE FOR THE POLICE DEPARTMENT AND, AND, AND THE FIRE DEPARTMENT.
THE NEXT SLIDE, UH, ILLUSTRATES EXPENDITURES BY FUND.
IT PRETTY JUST HIGHLIGHTS THE EXPENDITURE ACTIVITY FOR OUR GENERAL FUND AND SPECIAL FUNDS.
THE NEXT SLIDE, ACTUALLY, EXPENDITURES BY FUNDS ACTUALLY BREAKS IT DOWN IN THAT YOU CAN LOOK AT THE VARIANCE COMPARES TO GENERAL FUND EXPENDITURES.
REDUCTION IS DUE TO 5% BUDGET CUT HEALTH SPECIAL REVENUE FUND DECREASE IS DUE TO THE IMPACT OF THE VOLUNTARY RETIREMENT OPTION.
THE SWIMMING POOL AND SPECIAL WASTE DECREASES INCLUDE REDUCTION IN PERSONNEL AND PURCHASES OF VEHICLES FOR, FOR THE CURRENT YEAR ESSENTIAL SERVICES CONTINGENCY FUND, WHICH 1115 WAIVER, IT'S USED TO PROVIDE THOSE SERVICES THAT ARE COVERED EARLIER THAT ARE NOT COVERED BY THE GENERAL FUND, SUCH AS MY BROTHER'S KEEPER REENTRY, SEE TO SUCCEED CHRONIC DISEASE AND PUBLIC HEALTH INFRASTRUCTURE.
IT ALSO SUPPORTS IT AND COMMUNICATION.
AND BY THE WAY, THOSE 1115 WAIVER FUNDS, ACTUALLY, I, I THINK SOMEBODY ASKED ME THIS, COVERS ABOUT 179 EMPLOYEES WITHIN OUR DEPARTMENT, 179.
BUT WE'RE OKAY FOR THE NEXT COUPLE, FOR THE NEXT COUPLE OF YEARS.
THIS CHART HIGHLIGHTS THE REVENUE ACTIVITY OF OUR GENERAL FUND AND SPECIAL FUNDS.
THE BREAKDOWN OF EACH FUND WILL BE EXPLAINED ON THE NEXT SLIDE.
UH, THE LAB OPERATION AND MAINTENANCE INCREASES DUE IS DUE TO AN INCREASE IN LAB FEES AND THE INCREASE IN NUMBER OF TESTING.
THE SPECIAL POOLS, POOLS RE REDUCE IS REDUCED DUE TO DECREASE IN POOL REINSPECTION.
THE CENTRAL PUBLIC HEALTH DECREASES DUE TO THE, THE, THE REDUCTION IN CHARITY CARE FUNDING DUE TO THE NUMBER OF PARTICIPANTS, UH, WITHIN THE PROGRAM.
I EXPLAINED THAT LATER, THERE ARE MORE PEOPLE THAT ARE DRAWING FROM THOSE FUNDS, SO THEREFORE, WE'RE, WE'RE GETTING LESS, BUT WE'RE CONTINUING TO ADVOCATE AND, AND WORK FOR ACCESS TO MORE OF THOSE DOLLARS.
THE LAST SLIDE, REVENUE HIGHLIGHTS.
UH, THE GENERAL FUND REVENUE IS CONSISTENT FOR THE MOST PART FROM FY 25 AND THE PROPOSED BUDGET.
UH, AS I MENTIONED EARLIER, WE INCREASED LAB, ALL LAB FEES THIS YEAR TO MORE BE MORE IN LINE WITH WHAT THE STATE CHARGES.
THE LAB AND OPERATION AND MAINTENANCE INCREASE IS DUE TO INCREASING LAB FEES AND NUMBER OF TESTS.
SWIMMING POOLS IS REDUCED DUE TO THE DECREASE IN POOL RE-INSPECTIONS, WHICH IS ACTUALLY PRETTY GOOD BECAUSE THAT MEANS PEOPLE ARE DOING WHAT THEY'RE SUPPOSED TO DO.
AND ESSENTIAL PUBLIC HEALTH DECREASES, AS I SAID EARLIER, UH, DUE TO THE REDUCTION IN CHARITY CARE.
I KNOW I WENT THROUGH A LOT, BUT I'M CERTAINLY OPEN FOR, FOR QUESTIONS.
DARREN IS GONNA ANSWER ALL THE FINANCE QUESTIONS.
PRESENTATION NUMBER 20, DIRECTOR.
UM, WE ARE VERY LUCKY TO HAVE YOU FOR ALL OF THAT.
OH, I DO WANT TO MAKE SURE AND WELCOME PEOPLE WHO JOINED US FROM THE BEGINNING.
COUNCIL MEMBER LETITIA PLUMMER, STAFF FROM COUNCIL MEMBER FROM THE MAYOR PER TIM, MARTHA CASTEX TATUM'S OFFICE, AND FROM JOAQUIN MARTINEZ'S OFFICE AND FROM TARSHA JACKSON'S OFFICE.
WE'LL START WITH QUESTIONS FROM COUNCIL.
COUNCIL MEMBER CAYMAN, I GOT A LOT, SO YOU'LL HAVE TO PUT ME BACK IN Q2.
UH, ONE, I WANNA ACKNOWLEDGE YOUR TEAM, BUT SINCE THIS MAY BE YOUR LAST, I WANNA PERSONALLY RECOGNIZE YOU.
WE HAVE BEEN THROUGH A LOT TOGETHER.
THIS HEALTH DEPARTMENT STOOD UP, I BELIEVE, THE FIRST FREE TESTING AND VACCINATION SITES OF A MAJOR CITY IN THE NATION.
WHEN COVID HIT, UH, WE DIDN'T KNOW HOW TO DO IT, BUT WE FIGURED IT OUT.
AND WE LED THE COUNTRY, WE LED THE COUNTRY WHEN IT CAME TO WASTEWATER
[00:30:01]
TESTING AND RECEIVED AWARDS.AND NOW WE'VE BEEN ABLE TO EXPAND UPON THAT FOR OTHER DISEASES, INCLUDING WHAT WE'RE DEALING WITH NOW WITH MEASLES.
UM, YOU HAVE SEEN THIS DEPARTMENT THROUGH A LOT TO THE POINT WHERE YOU SERVE ON STATE ADVISORY BOARDS AND ARE A TRUSTED MEMBER IN THE MEDICAL COMMUNITY.
SO I WANNA THANK YOU FOR YOUR SERVICE, AND I WANNA THANK YOUR TEAM.
I KNOW NOTHING HAPPENS WITHOUT THE TEAM.
AND AGAIN, WHAT YOU'VE BEEN ABLE TO DO WITH SUCH A, HONESTLY, A SMALL AMOUNT OF MONEY, UH, IS EXTRAORDINARY.
I'M VERY CONCERNED ABOUT THE CUTS THAT WE ARE SEEING.
UM, THERE'S ONLY SO MANY TIMES IN SO MANY DEPARTMENTS, WE CAN SAY WE CAN DO LESS, MORE WITH LESS, RIGHT? THERE'S REAL PERSONNEL IMPACTS, AND I KNOW WE'LL DEAL WITH THE STRUCTURAL, UH, STREAMLINING PROCESSES AND THINGS LIKE THAT.
BUT I, I WANNA MAKE SURE WE'RE ALL AWARE OF HOW MANY PEOPLE WE ACTUALLY ARE LOSING RIGHT NOW.
UM, YOU SAID THE DEPARTMENT IS REDUCING ITS BUDGET BY 5%.
REMIND ME, THIS MAY BE A FINANCE QUESTION.
HOW MUCH IS THAT IN DOLLARS? 3.5.
I SAID IT WAS, UH, WHAT, 22 POSITIONS AND 7.5 WERE ACTUALLY FILLED, BUT WE DO HAVE VACANCIES IN OTHER AREAS THAT WE COULD PROBABLY TRANSFER.
WELL, I THINK IT WAS 2.3 MILLION ON SLIDE SEVEN, BUT WITH VOLUNTARY RETIREMENT, IT'S 3.4.
SO IS THE TOTAL COST EVEN LARGER THAN THAT? CLOSER TO 6 MILLION RIGHT NOW? YEAH, THAT'S TRUE.
AND, UH, HOW MANY HOUSTONIANS ARE SERVED THROUGH THE HEALTH DEPARTMENT EVERY YEAR? OKAY.
YOU KNOW, I GOTTA ANSWER THAT IN LIKE TWO OR THREE DIFFERENT PARTS.
UH,
FOR INSTANCE, OUR AREA AGENCY ON AGING SERVES ALL OF TRAVIS COUNTY.
NO, EXCUSE ME, THAT THAT WAS 20 YEARS AGO.
UH, IF YOU LOOK AT OUR, UM, SEE TO SUCCEED PROGRAM, UH, BECAUSE IT'S ALSO FUNDED THROUGH THE FOUNDATION AND OUTSIDE FUNDS, WE SERVE, UH, ALL OF THE SCHOOL DISTRICTS IN, IN THE AREA.
FOR INSTANCE, WE WILL GO TO CO UH, PASADENA.
UH, WE, UH, WE'VE GONE TO SPRING AND, AND WHATEVER.
SO IT ALL DEPENDS ON, ON, ON THE PROGRAM ITSELF, UH, WITH OUR HIV, UH, EDUCATION PROGRAM, UH, IT, IT, IT IS COUNTYWIDE.
OUR RENTER PROGRAM ACTUALLY DON'T TURN PEOPLE AWAY.
SO YOU COULD COME FROM ANYWHERE WITH, WITHIN THE COUNTY, AND QUITE FRANKLY, EVEN IN ADJACENT COUNTY.
AND WE WILL PROBABLY SERVE YOU.
AND I'LL ASK JUST ONE QUESTION TANGENTIAL TO THAT.
I, I'M GRAPPLING WITH, HOW DO YOU QUANTIFY THE HEALTH IMPACTS THAT YOU HAVE? AND I'LL GET BACK IN QUEUE TO SAY MORE, BUT AGAIN, WHEN WE TALK ABOUT WHAT YOU ALL ARE DOING IN TERMS OF PREVENTION, THERE'S A HUGE COST THAT WE ARE SAVING WITH THAT.
IT'S NOT JUST THE REVENUE GENERATION.
AND I'M, I'M GRAPPLING WITH HOW YOU QUANTIFY THAT.
AND I THINK A LOT OF PEOPLE ARE, TO BE HONEST WITH YOU, BECAUSE IT'S, IT'S HARD TO SAY, YOU KNOW, HOW MUCH IT, HOW MUCH IT WOULD'VE, WELL, IT, IT ALL DEPENDS ON THE SPECIFIC SITUATION.
BUT LIKE, FOR INSTANCE, I MENTIONED, UH, OUR FOLKS HAVING TO DO DOUBLE AND TRIPLE TIME ON THE WEEKEND TO FOLLOW UP ON THE TRAVEL RELATED MEASLES CASE.
IT, IT WOULD BE HARD FOR US TO QUALIFY.
I MEAN, THERE ARE PEOPLE THAT CAN ACTUALLY DO THIS.
HOW MUCH IT WOULD WOULD'VE COST IF THERE WAS ACTUALLY A, A, A TRANSMISSION.
WE'VE HAD A COUPLE OF MENINGITIS CASES.
IF THEY, IF WE HAD NOT DONE THAT AND THERE WAS A TRANSMISSION, UH, THAT WOULD'VE BEEN EXTRAORDINARY AS IT RELATES TO, TO, TO HEALTH COSTS, UM, UH, PROBABLY SOME OF THE EASIER STUFF, AND WE HAVEN'T DONE THIS BECAUSE IT TAKES TIME AND IT TAKES RESOURCES TO DO THIS.
BUT, BUT FOR EXAMPLE, I CAN TELL YOU THAT I, I MENTIONED THE US CONNECTING THE, UH, FOLKS AT COVENANT HOUSE AND AT TEXAS, CHILDREN WHO ARE FALLING OUTTA CARE.
AND THESE WERE IN THEIR SPEC SPECIALTY CLINICS.
THE SPECIALTY CLINICS WAS LIKE IN THE RENAL CLINIC AND IN THE SICKLE CELL CLINIC, I CAN TELL YOU, YOU CAN GO TO HARRIS HEALTH AND SAY, HOW MUCH WOULD IT COST TO ACTUALLY TREAT THIS YOUNG PERSON IF THEY WERE OUTTA CARE FOR SAY, THREE OR FOUR MONTHS? BECAUSE THEY WOULD PROBABLY SHOW UP AT THE HOSPITAL IN CRISIS.
AND THAT WOULD BE A HARD COST THAT YOU COULD, BUT WE HAVEN'T DONE THAT.
I MEANT IN REALITY AND MAY AND, AND I KNOW WE SHOULD INVEST IN IT.
THERE ARE PEOPLE THAT DO THAT.
UH, PEOPLE LOOK AT RETURN ON INVESTMENT, BUT MOST OF THE TIME IN PUBLIC HEALTH, WHAT WE'RE
[00:35:01]
DOING IS LIKE AT, WE'RE, WE'RE JUST MOVING STRAIGHTFORWARD AND REALLY GRINDING TO ACTUALLY DO THE WORK.IT REALLY WELL, YOU HAVE TO REALLY PARTNER WITH, UH, WITH THE EDUCATIONAL INSTITUTIONS AND, AND RESEARCH ORIENTED PEOPLE IN ORDER TO DO THAT.
AND THANK YOU SO MUCH, DIRECTOR.
UM, JUST, YOU'VE BEEN SUCH A GREAT JOB.
I MEAN, I KNOW THE HEALTH DEPARTMENT IS INCREDIBLY DIFFICULT, ESPECIALLY WHEN THE MAJORITY OF THE FUNDING COMES FROM GRANTS.
AND WE GOT THROUGH COVID, YOU GOT US THROUGH COVID, UM, AND ALL OF THE OTHER PIECES OF YOUR TEAM.
THANK YOU SO MUCH FOR ALL OF YOUR HARD WORK, UM, FOR JUST REALLY TRYING TO FIND THE RESOURCES AND SPENDING IT THE RIGHT WAY.
SO I WANT TO ACKNOWLEDGE YOU, AND IT'S BEEN AN HONOR TO BE ABLE TO SERVE WITH YOU THE LAST COUPLE OF YEARS.
UM, I DO HAVE A COUPLE QUESTIONS I'LL GET BACK INTO YOU IF I NEED TO, BASED ON THE TARGETED 84% IMMUNIZATIONS, AND WITH THE SHORTFALL THAT WE'RE SEEING, DO YOU KNOW HOW WE'RE GONNA BE ABLE TO STILL MAINTAIN THAT TARGET OR, UM, WHAT KINDA THE PLANS ARE FOR IMMUNIZATIONS? I, I CAN'T TELL YOU SPECIFICALLY, BUT I CAN TELL YOU ABOUT OUR OVERALL STRATEGY.
WE'RE REALLY ASSESSING THE IMPACT OF ALL THE CHANGES.
WHAT WE WILL DO THOUGH IS PRIORITIZE WHERE WE PUT THE RESOURCES.
I CAN TELL YOU THAT IT, YOU KNOW, I MENTIONED DISEASE CONTROL AND PREVENTION.
I MENTIONED ENVIRONMENTAL HEALTH.
THOSE ARE UNIQUE TO GOVERNMENTAL PUBLIC HEALTH.
AND SO IT WOULD REALLY BE JUST GETTING BACK TO BASICS AND FOCUSING ON THE BASICS.
I HAVE TO TELL YOU THAT, AND MY STAFF, THEY MIGHT LAUGH AT THIS BECAUSE IT IS VERY HARD FOR ME TO PRIORITIZE BECAUSE THERE'S SO MUCH WORK TO BE DONE.
BUT WHILE YOU'RE FOCUSING ON THE BASICS, YOU NEED TO LOOK AT OPPORTUNITIES TO PREVENT TOO.
BECAUSE IF YOU DON'T REALLY, UH, ENGAGE IN SOME LEVEL OF PREVENTION, YOU'RE, YOU'RE NOT GONNA REALLY MAKE, MAKE ANY PROGRESS.
ACTUALLY, ON MOST PUBLIC HEALTH, UH, INTERVIEWS, THEY, THEY ASKED YOU THAT, THAT QUESTION.
THANK YOU, MADAM CHAIR AND THANK YOU DIRECTOR, AND CONGRATULATIONS ON YOUR 20TH YEAR HERE, AT LEAST BUDGET PRESENTATION.
I JUST WANTED TO ASK YOU ABOUT A COUPLE OF, UH, CHANGES THAT, THAT WE NOTED, UH, IN TERMS OF, UH, FTES.
UM, ONE DEALING IN THE FAMILY HEALTH SECTION, WHICH, UH, LOOKS LIKE WE'RE, WE'RE GOING FROM ABOUT 38 FTES TO, TO JUST UNDER 60.
UM, AND THIS, THIS IS ON WHICH SLIDE IS THERE? THIS IS ON, IT'S NOT ON A SLIDE, IT'S ON, UH, PAGE 45 OF THE PUBLIC OR THE HEALTH DEPARTMENT SECTION OF THE BIG BOOK.
DO YOU HAVE THAT WITH 45? NO, HE'S TALKING ABOUT THE BUDGET BOOK, RIGHT? THAT'S RIGHT.
I DON'T HAVE THAT WITH ME, SON.
OKAY, SO, UH, BASIC, YEAH, THE FUND, THE FUND IS, UM, YEAH.
ESSENTIAL PUBLIC HEALTH SERVICES FUND.
AND, AND, UM, CAN YOU, CAN YOU SORT OF WALK US THROUGH WHAT THOSE EMPLOYEES WILL BE DOING? I, I, I HAVE TO KNOW THE PROGRAM.
FAMILY HEALTH PROGRAM, IF THAT HELPS.
YOU KNOW, WHAT, WHICH PART? TALKING ABOUT, UH, AND IT'S PAGE 45 OUT OF THE BIG BOOK.
SO I IT'S THE HEALTH DEPARTMENT CHAPTER.
OH, THE HEALTH DEPARTMENT CHAPTER.
THINK IT'S SECTION SECTION FIVE.
HE'LL FIND IT AND I'LL EXPLAIN IT.
IN, IN THIS FUND, I MEANT, THIS IS OUR 1115 WAIVER PROGRAM.
AND WHAT I EXPLAINED TO YOU IS THAT, THAT, THAT, THAT FUND COVERS A VARIETY OF PROGRAM.
ACTUALLY, WE'RE SUPPLEMENTING THE GENERAL FUND AND SPECIAL REVENUE FUNDS.
UH, I DON'T, UH, WE HAVE, UH, I, I MENTIONED EARLIER THAT FOR INSTANCE, AND I DON'T KNOW THE SPECIFIC PROGRAMS. I KNOW, LIKE THE WAY I LOOK AT IT, FOR INSTANCE, I KNOW THAT I'M PUTTING AN, AN, AN ADDITIONAL MILLION DOLLARS INTO OUR TUBERCULOSIS PROGRAM.
I KNOW THAT WE'RE PUTTING ADDITIONAL 1115 WAIVER DOLLARS INTO IT.
[00:40:01]
WILL HAVE TO PUT MORE 1115 WAIVER DOLLARS INTO IT IN ORDER TO JUST MAINTAIN THE LEVEL OF SERVICES, UH, THAT, THAT WE HAVE.NOW, I KNOW THAT WE, UH, HAVE A CONTINGENCY FUNDS TO, UH, EVEN AUGMENT SOME OF THE CLINICAL SERVICES.
IF, YOU KNOW, WE, IF THEY'RE NEEDED BECAUSE THEY'RE NOT COVERED BY GENERAL FUND OR, OR SPECIAL REVENUE FUNDS.
ALL OF OUR, UH, MY BROTHER'S KEEPERS, UH, DOLLARS ARE COVERED IN THAT FUND.
ALL OF THE REENTRY DOLLARS, UH, WITH THE EXCEPTION OF THE DOLLARS, UH, A GRANT IS COVERED BY THE E 1115 WAIVER.
WE'VE ALSO PUT, UH, DOLLARS INTO OUR, OUR CHRONIC DISEASE PROGRAM, UH, BECAUSE WE HAD NO DOLLARS INTO THAT.
UH, SO WE HAVE, UH, WE, FOR INSTANCE, YOU'LL HAVE COUNSELORS AND NUTRITIONISTS IN OUR DON PROGRAM OUTSIDE OF THE ALE PROGRAM, BECAUSE THAT, THAT WAS COVERED BY THE GENERAL FUND.
SO THOSE ARE, ARE EXAMPLES OF POSITIONS THAT ARE COVERED IN THE 1115 WAIVER.
IS IT ACCURATE TO SAY THAT, THAT THIS INCREASE COMPENSATES FOR LOSSES IN OTHER AREAS THEN? YES.
IN TERMS OF FTES, YOU KNOW, BOTTOM LINE IS, LET, LET ME ANSWER IT ANOTHER WAY THAT I THINK WILL BE MORE ACCURATE.
I'VE USED 1115 WAIVER DOLLARS TO REALLY BUILD THOSE PROGRAMS THAT I MENTIONED, BUT YOU'RE RIGHT, WHERE WE DID NOT HAVE GENERAL FUND REVENUE AND WE DID NOT HAVE SPECIAL, UH, FUND REVENUE TO FILL IN THOSE GAP THOSE GAPS, WHETHER THEY WERE ADMINISTRATIVE SERVICES OR THEIR PROGRAMS AND SERVICES, WE'VE USED 1115 WAIVER DOLLARS TO MAKE ENDS MEET.
I MEAN, THAT'S WHERE YOU GET THE 179 POSITIONS.
THE BOTTOM LINE IS, Y'ALL, MOST OF THE TIMES WITH THE, ESPECIALLY ON THE ADMINISTRATIVE SIDE, THAT'S USUALLY COVERED BY THE GENERAL FUND.
BUT WHEN YOU KNOW YOU HAVE THESE GAPS, YOU, YOU DO WHAT YOU CAN IN ORDER TO MAKE ENDS MEET.
NOW THE EXTENT OF WHICH WE WILL HAVE TO USE THOSE FUNDS TO FILL IN THE GAPS, UH, IN RESPONSE TO WHAT'S GOING ON.
NOW, WHAT YOU WILL SEE IS A SHORTER, UH, LIFESPAN FOR THOSE PROGRAMS THAT ARE TOTALLY FUNDED BY THE 1115 WAIVER.
UH, SIMILAR CHANGE IN TOTAL NUMBER OF FTES, AND THIS IS IN SPECIAL WASTE TRANSPORTATION AND INSPECTION FUND.
UH, GOING FROM ENVIRONMENTAL HEALTH, GOING FROM ABOUT 42 TO 57, AND IF WE'RE IN THE BIG BOOK, IT'S, UH, PAGE 33 OF SECTION FIVE, THE HEALTH DEPARTMENT SECTION.
WHAT, UH, WHAT, WHAT ARE THESE FOLKS DOING IN SPECIAL WASTE? I MEANT BASICALLY
I MEANT THESE ARE, YOU KNOW, WE INSPECT HAULERS, UH, AND, UH, WE, WE MAKE SURE THAT THEIR, THEIR EQUIPMENT IS RIGHT AND, UH, THEY'RE NOT REALLY CAUSING ENVIRONMENTAL CONCERNS.
ACTUALLY, I REMEMBER WHEN I FIRST CAME HERE, THAT WAS LIKE FOREIGN INTO ME AND WE WENT, WE WENT ON A COUPLE OF SPIELS.
SO THAT'S WHAT THAT, THAT THAT PROGRAM IS RESPONSIBLE FOR DOING.
DOES THAT RESULT IN ANY ADDITIONAL REVENUES OR NOT REALLY? YEAH, THAT WE, WE GET FEES FROM FROM, FROM THAT, YEAH.
I, I'LL MOST OF THE ENVIRONMENTAL PROGRAMS, UH, WE, WE DO COLLECT FEES FROM IT.
I NOTICED IN THE SPECIAL REVENUE FUND, THE ENVIRONMENTAL HEALTH SECTION, THERE WAS A, A DECREASE IN GENERAL FUND REVENUES FROM THE GENERAL, YOU KNOW, I GUESS WE WERE PUTTING GENERAL FUND REVENUES AND NOW WE'RE NOT THERE.
ARE THEY TALKING ABOUT TWO, 2 MILLION? ARE YOU TALKING ABOUT THE DEBT SERVICE TRANSFER? YEAH, THE 2.1 MILLION.
THEY'RE, WE'RE NO LONGER DOING THAT.
THAT WAS PART OF THE REDUCTION STRATEGY FOR THE HEALTH DEPARTMENT.
WE'RE NO, THE GENERAL FUND'S NO LONGER SUPPORTING ENVIRONMENTAL HEALTH.
WELL, NO, THAT'S NOT ACCURATE.
UM, OR IT'S JUST A RED WELL, I, LET, LET ME
I DON'T KNOW THAT I WANNA TELL HIM.
UH, BUT IT'S ALL ABOUT, THAT'S WHY I PUT DARREN ON THAT SIDE BECAUSE HE EXPLAINS ALL OF THAT.
BUT ANYHOW, UH, I THINK IT WAS ABOUT, WE HAD ACTUALLY STARTED TO OVERSPEND
[00:45:01]
OUR SPECIAL REP THREE YEARS AGO, OUR SPECIAL REVENUE FUNDS ABOUT THREE YEARS AGO.I MAY, UH, PLEAD TO AN ADMINISTRATION TO, UH, GIVE US THE, THE DOLLARS.
WHAT I REALLY WANTED WAS THE, THE PEOPLE PAID FOR, BUT IT, IT, IT WAS DECIDED THAT WE WOULDN'T GET THAT, BUT WE WOULD GET THE MONEY, WHICH WAS ABOUT $2 MILLION, UH, WHICH HELPED US TO, UH, MAKE, MAKE ENDS MEET WITH THAT.
AND SO WHAT YOU'RE SEEING WITH THAT IS A REMOVAL OF THAT $2 MILLION.
THAT WASN'T BAD FOR A NON-FINANCE PERSON WAS
I KNOW, IT'S JUST, I HAVE TO SAY IT IN MY PLAIN LANGUAGE, NOT IN, THAT'S, THAT'S WHAT WE, WE, THAT, THAT'S WHY APPRECIATE THAT ACCOUNT VERY MUCH.
I'M, I'M NOT AN ACCOUNTANT, I'M A SOCIAL WORKER.
UM, YOU SPOKE ABOUT PREVENTION AND RETURN ON INVESTMENT, AND ONE AREA THAT I THINK WE CAN MAYBE ALL AGREE ON IS AROUND THE MENTAL HEALTH CRISIS THAT IS PERMEATING ACROSS THIS COUNTRY, UM, PARTICULARLY WITH YOUNG PEOPLE AND EVEN MORE SO WITH L-G-B-T-Q YOUTH, THERE ARE ONGOING CONVERSATIONS ABOUT THE ELIMINATION OF THE 9 98 SUICIDE PREVENTION HOTLINE.
WHAT, IF ANY, ROLE DOES THE DEPARTMENT SEE ITSELF PLAYING IN FILLING THAT GAP? I DON'T REALLY SEE THAT WE WOULD PLAY A ROLE IN THAT.
UM, AND, AND JUST FOR CONTEXT, WHEN YOU START TALKING ABOUT MENTAL HEALTH, THAT IS WHERE I GO DEEP BECAUSE I USED TO BE A THERAPIST.
I'VE RUN ALMOST EVERY PROGRAM ON THE MENTAL HEALTH SIDE.
UH, AND I'VE HAD TO PUSH BACK ON MY EMPLOYEES TOO BECAUSE NOT MY EMPLOYEES, MY STAFF, MY LEADERSHIP STAFF.
BECAUSE WHAT THEY'VE TRIED TO PUSH US INTO IS TO REALLY GET INTO THE MENTAL HEALTH BUSINESS.
WE ARE NOT IN THE MENTAL HEALTH BUSINESS.
WHAT I'VE SAID IS, IT IS APPROPRIATE FOR A HEALTH DEPARTMENT TO DO WHAT I WOULD CALL FRONT END STUFF, WHICH WOULD BE, UH, UH, SCREENING AND, UM, MAYBE A SHORT TERM INTERVENTION.
VERY, VERY LIGHT, UH, AND, AND REFERRAL.
I WILL NOT GO INTO THAT BUSINESS BECAUSE IT WILL TAKE A SIGNIFICANT AMOUNT OF, UH, BEHAVIORAL HEALTH EXPERTISE TO EVEN SUPPORT THAT.
AND SO WE'RE NOT GONNA DO MISSION CREEK WITH THAT.
UH, DO I SUPPORT IT? AB AB AB ABSOLUTELY.
BUT, UH, IF I PUT MY MENTAL HEALTH HAT ON, I COULD TELL YOU HOW TO ACTUALLY DO THAT.
BUT THAT MEANS THAT WE WOULD HAVE TO PUT IN THE, THE, THE INFRASTRUCTURE, YOU KNOW, TO, TO MAKE SURE THAT THOSE THERAPEUTIC PERSONNEL ARE ACTUALLY BACKED UP.
BUT PLEASE DON'T INTERPRET THAT TO MEAN THAT I DON'T CARE.
IT'S JUST THAT WE WOULD BE CROSSING THE LINE IN THAT, AND I, AND WE WOULD BE SPENDING A LOT MORE MONEY.
UH, THE POOL THAT I TALKED ABOUT, THE CHARITY CARE POOL, IT IS ACCESSED BY BOTH, UH, THE MENTAL HEALTH CENTERS AND, AND PUBLIC HEALTH.
AND THEY ARE REALLY, UH, ADEPT AT, UH, RE REIMBURSEMENT BECAUSE THEY'VE BEEN DOING IT FOR YEARS.
THE SECOND QUESTION, IF I, IF I HAVE TIME.
EARLIER THIS WEEK, UH, CITY COUNCIL APPROVED THE INTERLOCAL AGREEMENT WITH THE COUNTY AROUND SHARED DATA.
UM, AND, AND BETWEEN THE TWO DEPARTMENTS, AND AT THE SAME TIME, I THINK THAT THERE'S SOME GROWING CONVERSATIONS AROUND, UH, SHARED SERVICES AND, AND CONSOLIDATING THE TWO.
UM, WHAT IS, FROM YOUR PERSPECTIVE, THE POTENTIAL OPPORTUNITIES AND CHALLENGES WITH THAT? I'LL TELL YOU WHAT I'VE BEEN SAYING FOR THE LAST 20 YEARS.
WE'VE HAD MANY DISCUSSIONS ABOUT THIS.
IF OUR POLICY MAKERS WANNA COMBINE DEPARTMENT, THEY NEED TO MAKE THE DECISION TO COMBINE THE DEPARTMENTS AND THEN THE WORK CAN BE DONE.
YOU KNOW, I COULD, IF YOU GO IN MY OFFICE RIGHT NOW, I HAVE THREE BINDERS OF DISCUSSIONS ABOUT COMBINING HEALTH DEPARTMENTS.
NOW I'VE ACTUALLY DONE IT BEFORE IN AUSTIN AND TRAVIS COUNTY.
BUT I THINK THAT THE POLICY DECISION, IF THAT IS WHAT Y'ALL WANT, THE POLICY DECISION NEEDS TO BE MADE.
NOW THAT I'D LOVE TO BE INVOLVED IN IT IF YOU DECIDE TO SUE THAT.
BUT I'M JUST SAYING, SO YOU'RE SAYING YOU'LL STAY FOR, I'M A LITTLE WHILE ORM SAYING IF YOU WANNA DO IT, THAT THAT IS, THAT IS A DECISION FOR POLICY MAKERS TO MAKE.
NOW, IF YOU THINK YOU'RE GONNA SAVE MONEY, FORGET IT BECAUSE YOU'RE NOT, THE ONLY MONEY YOU'RE GONNA SAVE IS MAYBE ON THE ADMINISTRATIVE SIDE.
THE TRUTH IS THAT YOU HAVE TWO MAJOR HEALTH DEPARTMENTS IN THIS COUNTRY THAT ARE UNDERFUNDED.
I MEAN, AND IF YOU THINK BACK, COMBINE IT.
IT IS A LITTLE BIT OF A DIFFERENT ANSWER THAN YOU'VE GIVEN IN THE PAST.
SO THAT'S BECAUSE YOU THOUGHT I WAS AGAINST IT.
COUNCIL MEMBER PLUMMER, AND I REMEMBER THE CALL.
COUNCIL MEMBER CAYMAN, THANK YOU.
UM, AND TO MENTAL HEALTH, HARRIS CENTER DOES INCREDIBLE WORK.
[00:50:01]
THAT WE WORK WITH AND REFER TO THAT, UH, DO INCREDIBLE WORK, BUT POINT WELL TAKEN.UM, JUST TO GO BACK, 'CAUSE AGAIN, I BELIEVE THE HEALTH DEPARTMENT HAS BEEN ONE OF THE DEPARTMENTS VERY HEAVILY HIT BY FEDERAL GRANT CUTS IN PARTICULAR AS OF YET.
UM, JUST A OVERALL GENERAL VIEW.
I KNOW YOU TALKED ABOUT HOW MUCH WE'VE LOST THUS FAR, RIGHT? THE 62 MILLION TOTAL, THE 40 MILLION IN EARLY, EARLIER THAN EXPECTED CUTS, PLUS THE 20 MILLION EPA GRANT RELATED TO THE CANCER CLUSTER, WHICH I, I WANNA PUT AN EMPHASIS ON BECAUSE THAT, THAT'S A HUGE IMPACT, I BELIEVE, UNLESS YOU SAY OTHERWISE.
UM, HOWEVER, OVERALL, WHAT PERCENTAGE OF THE HEALTH DEPARTMENT'S FUNDING IS GRANT BASED? IT'S ABOUT 60.
YEAH, THAT'S 62% ISN'T, I THINK I REMEMBER IT CORRECTLY HERE.
IT DON'T, I'M PRETTY SURE IT'S LIKE 62, RIGHT? YEAH.
BUT THE GRANT FUNDING IS, UH, SO MORE THAN HALF OF THE DEPARTMENT'S BUDGET IS FEDERALLY FUNDED VIA GRANTS.
BUT I SAY FEDERAL FUNDS BECAUSE FEDERAL DOLLARS FLOAT TO THE STATE.
AND THEN WE RECEIVE THOSE DOLLARS TOO.
'CAUSE OF THE REDUCTIONS THAT WE'VE HAD.
IT WAS 67, IT WAS IN THE SIXTIES.
SO, WAIT, BUT I, I CAN TELL YOU THOUGH, I, I USED TO THINK WE WERE DIFFERENT, BUT THEN I DID SOME BENCHMARKING IN OTHER CITIES.
ALL I'M TRYING TO GRAPPLE WITH IS WHAT COULD BE COMING DOWN THE ROAD.
RIGHT? HPD EVEN RELIES HEAVILY ON, ON GRANTS FOR CERTAIN PROGRAMS. SO IT'S NOT A, WE'RE DOING SOMETHING WRONG, IT'S A MM-HMM
WE STILL HAVE 40% OF OUR BUDGET THAT IS CONTIN RELIANT UPON CRITICAL LIFESAVING GRANTS.
UH, DO WE KNOW YET, ARE ANY OF THOSE, THAT 40% WHATEVER'S STILL IN PLACE, HOW MUCH OF THAT MAY BE AT RISK? UM, OR WE DON'T KNOW.
THE, THE THING THAT WE, THE ANSWER IS WE DON'T KNOW SPECIFICALLY.
THE THING THAT I WANT TO KEEP A CLOSE EYE ON IS WHAT'S HAPPENING IN THE AREA OF HIVI THINK IN ONE OF THE SLIDES, I, I, WELL, IN MY TALKING POINTS, I MENTIONED THAT, UH, WE ARE, WE GET ABOUT $12 MILLION FROM THE STATE AND THE FEDS RELATIVE TO HIV.
AND I KNOW THAT IF WE LOSE SIGNIFICANT AMOUNTS OF THOSE DOLLARS, THAT WE WILL HAVE TO BACKFILL SOME WAY.
AND THAT, THAT WAS MY NEXT QUESTION.
AS IT RELATES TO EPIDEMIOLOGY, HOW DO WE CALCULATE THE COST OF A POTENTIAL EPIDEMIC? WE HAVE ONE OF THE MOST POLLUTED CITIES IN THE COUNTRY.
WORST AIR QUALITY THAT TRANSLATES INTO REAL HEALTH COSTS AND CHRONIC DISEASE.
IF HIV PREVENTION FUNDING GOES AWAY, UM, THE WORK WE DO AROUND STD PREVENTION, FOR EXAMPLE, UH, AND THAT BEGINS TO SPREAD AT HIGHER RATES.
WE HAVE THE ANTI-VACCINE AND QUITE FRANKLY, ANTI-SCIENCE PROPAGANDA THAT'S CIRCULATING THE REDUCTION IN SNAP AND THE RELIANCE ON FOOD.
THE FOOD BANKS THEMSELVES, UM, ARE AT RISK RIGHT NOW.
HOW DO WE CALCULATE THOSE COSTS? I, I CAN'T, AT THE MOMENT, I'M AT, WHAT WE'RE DOING IS RIGHT NOW, MY STAFF IS LOOKING AT THE IMPACT OF EVERYTHING THAT'S HAPPENED THUS FAR.
WHAT THEY'RE GONNA PRESENT TO ME IS WHERE ARE THE GAPS IN WHAT THEY SEE AS PRIORITIES? WE HAVE TO MAKE A DECISION ABOUT WHAT, HOW, AND WHAT WE WILL BACKFILL IN ORDER TO ENSURE A CERTAIN AMOUNT, ENSURE THAT THERE'S A GOOD PUBLIC HEALTH FOUNDATION THAT IS IN PLACE HERE IN HOUSTON.
UH, SURPRISINGLY, I'M, I'M NOT NECESSARILY OVERWHELMED BY I, AND PART OF IT, THE REASON IS BECAUSE OF THE PEOPLE THAT ARE SITTING BEHIND ME.
I'M AT, UH, WE, WE WILL FIGURE IT OUT.
UH, UH, I'M NOT SAYING THAT IT'S EASY.
I'M AT, IT IS A TREMENDOUS LIFT, BUT I, I, I JUST BELIEVE YOU HAVE TO DO THE BEST WITH WHAT, WHAT WHAT YOU HAVE.
AND, YOU KNOW, I HAVE SOME OF MY KEY STAFF THAT EVEN CHALLENGED ME ON SOME OF THE THINGS THAT I REALLY WANNA DO, BECAUSE I THINK THERE ARE GOOD THINGS TO DO AND LIKE, WELL STEVEN, THAT AIN'T NECESSARILY, YOU KNOW, CORE, UH, BUT, YOU KNOW, AND A LOT OF TIMES IT IS ON, ON, ON THE PREVENTION SIDE.
SO, UH, WE'LL JUST HAVE TO FIGURE IT OUT.
I MEANT WE'LL HAVE TO FIGURE IT OUT.
DO I NEED TO GO BACK IN QUEUE? YES.
THANK YOU CHAIR AND THANK YOU DIRECTOR FOR ALWAYS BEING SO JUST KIND OF DEFINITIVE AND JUST STAYING IN YOUR LANE.
[00:55:01]
I THINK.SO OFTENTIMES WE JUST ALL WANNA JUST DO EVERYTHING AND IT REALLY DOES TAKE ATTENTION OFF.
AND SO YOU'VE JUST BEEN VERY INTENTIONAL ON JUST STAYING IN THE LANE AND REALLY, UM, CREATING A TRUE DEFINITION OF WHAT THE HEALTH DEPARTMENT'S RESPONSIBILITIES ARE.
AND THAT'S, I KNOW THAT'S CHALLENGING TO DO SOMETIMES, SO I WANTED TO ACKNOWLEDGE YOU FOR THAT.
UM, IN TERMS OF THE 1115 WAIVERS, I KNOW WE'VE BEEN TALKING ABOUT THE LOSING OF THAT MONEY FOR SUCH A LONG TIME AND IT'S SUCH A LARGE INVESTMENT.
IS THERE ANY ADVICE THAT YOU COULD, SINCE THIS IS YOUR LAST BUDGET MEETING,
I KEEP REFERRING TO IT BECAUSE IT'S LIKE WHEN SHE WAS TALKING ABOUT THE PROGRAMS GOING AWAY, YOU'VE ALREADY HAD THIS, YOU'VE ALREADY HAD PROGRAMS GO AWAY.
YEAH, ACTUALLY, YOU KNOW, WE WERE GETTING INITIALLY 30 MILLION BUCKS, THEN IT GOT DOWN TO, UH, 20 I, I HAD STAFF SAID, OH, WE'RE NOT GONNA SPEND ALL OF THAT MONEY.
YOU NEED TO ALRIGHT, COME UP WITH A BUDGET OF ABOUT 12.
I THINK THEY BUSTED IT THOUGH.
UH, AND I'LL, I'LL BE REAL CANDID WITH YOU.
DURING COVID, WE USED COVID RE DOLLARS TO SUPPLANT THE 1115 WAIVER KNOWING THAT WE COULD EXTEND THE LIFESPAN OF THOSE PROGRAMS THAT WE WERE FUNDING WITH THAT.
AND IT'S NO SECRET THAT'S, THAT'S WHAT WE DID.
THAT'S WHAT MY COLLEAGUES DID AROUND THE STATE TO DO THAT.
WE'VE ALREADY TAKEN, I THINK, A MAJOR STEP IN REPLACING THAT.
I TOLD YOU THAT BY, WE REALLY WEREN'T THE STATE ENOUGH SO THAT THEY WOULD GIVE US ACCESS TO THE CHARITY CARE DOLLARS.
WE'VE ALSO BEEN WORKING TO TRY TO INCREASE THE POOL AND I MENTIONED THAT WE ARE WANTED TO GET A SPECIAL SET ASIDE FOR HEALTH DEPARTMENTS, PRIMARILY BECAUSE A LOT OF THE SMALLER HEALTH DEPARTMENTS AND MEDIUM SIZED HEALTH DEPARTMENTS, THEY DON'T HAVE THE CAPACITY TO DO THE COST REPORTS.
AND SO WHAT I'M TRYING TO DO IS TO BUY TIME SO THAT THEY CAN GET THE CAPACITY SO THEY COULD DRAW DOWN MORE MONEY, BECAUSE OF COURSE I'M A PUBLIC HEALTH ADVOCATE IN THE DEPARTMENT.
THE OTHER THING THAT WE'RE LOOKING AT IS HOW CAN WE, UH, GET REIMBURSED FOR SOME OF THE SERVICES THAT WE'RE DOING.
FOR EXAMPLE, UH, A FEW MONTHS AGO, WE CREATED ANOTHER ORGANIZATION, UH, UH, WITH, UH, THROUGH OUR AREA AGENCY ON AGING, PARTNERING WITH E AND OUR HOUSTON HEALTH FOUNDATION.
BASICALLY, WE'RE TRYING TO SEE HOW WE CAN GET A LEVEL OF, WE'RE WORKING WITH A NATIONAL CONSULTANT, SEEING HOW WE CAN GET REIMBURSEMENT FOR SOME OF THE WRAPAROUND SERVICES THAT WE PROVIDE TO SENIORS.
I MEAN, THE MONEY IS ACTUALLY ON THE HEALTHCARE SIDE.
PUBLIC HEALTH HAS HAD A HARD TIME FIGURING OUT HOW TO GET ACCESS TO THAT.
UH, ONE OF THE THINGS THAT I'VE BEEN INVOLVED IN IN THE LAST DECADE OR MORE IS TRYING TO FIGURE THAT OUT AND ACTUALLY WORKING WITH MY COLLEAGUES AROUND THE STATE TRYING TO FIGURE THAT OUT.
AND I, I THINK WE'RE DOING A DECENT JOB, IT'S JUST THAT, YOU KNOW, IT'S A SLOW PROCESS JUST BECAUSE OF THE COMPLICATIONS OR RELATED TO REIMBURSEMENTS, BUT THOSE ARE THE THINGS THAT WE'RE DOING, TRYING TO REALLY FIGURE IT OUT.
I DID WANNA ACKNOWLEDGE EARLIER WE WERE JOINED BY COUNCIL MEMBER JOAQUIN MARTINEZ AND JUST RECENTLY BY VICE CHAIR MARIO CASTILLO.
UM, GOING BACK TO FUNDED POSITIONS, YOU INCLUDED NUMBERS FOR HOW MANY FTES WE'VE EITHER LOST THROUGH VOLUNTARY, UH, RETIREMENT OR OTHER NEEDS.
ONE DOES THAT TO COUNCIL MEMBER RAMIREZ'S POINT.
UM, ARE THE NUMBERS PRESENTED EXCLUSIVE OF THE NUMBERS OF FTES THAT WE'VE SHIFTED OVER UNDER 1115? LIKE HOW DID THOSE NUMBERS BALANCE OUT? THEY'RE EXCLUSIVE.
AND THERE'S ALSO THE GRANT FUNDED POSITIONS THROUGH THE HEALTH DEPARTMENT, IS THAT CORRECT? YES, WE HAVE.
AND THOSE WOULD NOT BE CLASSIFIED AS FTES OR THEY WOULD BE, THEY'RE FTES, BUT THEY'RE GRANT FUNDED FTES.
SO WITH THE GRANT FUNDED FTES THAT WE'VE LOST, THERE HAVE BEEN CUTS RELATED TO THAT.
IS THAT INCLUDED IN THE PERSONNEL THAT HAVE BEEN LOST? NOT ON THE GENERAL SPECIAL FUND SIDE, BUT THAT ONE SLIDE THAT TALKS ABOUT THE BUDGET AND FUNCTIONAL SUMMARIES, IT'S IN THERE.
SO WHEN IT'S UP NOW WE CAN GO BACK TO WHAT NUMBER WAS THAT? WHAT'S THE NUMBER OF FTES THAT HAVE BEEN LOST DUE TO GRANTS THAT YEAH, THAT'S THE QUESTION.
UH, AND WE GOT MORE TO COME, RIGHT? WE GOT MORE TO COME, BUT, UH, IT'S ABOUT 10.
[01:00:01]
SO WE'VE LOST 110 FTES THAT WERE GRANT FUNDED.AND THE POTENTIAL FOR MORE ABOUT DO WE KNOW ABOUT HOW MORE YES, I THINK THAT THAT, THAT THAT'S ACCURATE.
I MEAN, IT, IT'S IN THE BALLPARK, BUT NOW THE, THE 110, BECAUSE IT WAS 80 AND THEN IT WAS 40 SOMETHING.
UH, BUT THAT WAS RELATED TO THOSE GRANTS THAT I SPECIFICALLY TALKED ABOUT.
IT, BUT IT ALSO, AGAIN, IT'S NOT A, IT'S NOT A, UM, WAGGING OF THE FINGER AGAINST THE DEPARTMENT.
IT'S, THIS WAS WORK THAT'S BEING DONE AND NOW EITHER IF WE NEED THAT WORK TO CONTINUE AND THERE'S CRITICAL WORK BEING DONE, CRITICAL WORK, LIFESAVING WORK, SOMEONE ELSE THAT'S STILL ON STAFF IS GONNA HAVE TO TAKE THAT ON AS WELL.
SO IN TERMS OF WHO WE, WE'VE LOST 110 FTES THAT WERE GRANT FUNDED AND WE SAY WE BELIEVE MORE ARE COMING, DO WE HAVE AN AVERAGE, AN ESTIMATE OF HOW MANY THE, THAT WOULD BE? STAFF HAVE DONE SCENARIOS, BUT THEY'RE JUST SCENARIOS WE HAVE.
I, I WOULD LIKE TO KNOW WHAT THOSE SCENARIOS ARE.
I, I DON'T HAVE, THERE'S A SCENARIO FOR HIV, BUT I DON'T, I DON'T HAVE IT.
I MEANT WE, WE CAN LOOK AT IT.
UM, BUT YOU KNOW, THEY, THEY WILL COME AND SAY, OKAY, I NEED 20 FTES FOR THIS.
PART OF MY JOB IS TO LOOK AT, TO REALLY LOOK AT IT CLOSER TO SEE WHETHER OR NOT I, UH, UH, AGREE WITH THAT.
AND THESE ARE ALL AGAIN, ESTIMATES.
BUT I WOULD LIKE, AGAIN, AS WE'RE SITTING AROUND THIS HORSESHOE, I WOULD LIKE THAT INFORMATION.
UH, WE, WE, WE, WE COULD GIVE YOU SCENARIOS.
I MEANT BECAUSE LIKE THE WAY THE GRANT COMES, THEY'RE ASSOCIATED WITH CERTAIN FUNCTIONS.
AND SO THERE ARE CERTAIN, UM, LIKE I MENTIONED, HIV AND SSTD, STIS.
LIKE FOR INSTANCE, THERE'S LIKE THE, THE, THE DISEASE INVESTIGATORS.
UH, I, IF WE SAY THAT THESE POSITIONS ARE AT RISK, AND THIS IS THE CURRENT STAFFING LOAD, I WOULD LOOK AT, YOU KNOW, WHAT, WHAT IS THEIR WORKLOAD, YOU KNOW, UH, WHAT, WHAT, WHAT IS THE DEMAND VERSUS, YOU KNOW, THE CAPACITY FOR INDIVIDUAL PEOPLE AND, AND, AND SEE WHAT WE BELIEVE WOULD BE A MINIMUM, MINIMUM NUMBER OF PEOPLE THAT WE NEED.
UM, I'M ASKING EVERY DEPARTMENT THIS, SOME DEPARTMENTS ARE IMPACTED MORE THAN OTHERS, BUT THE, THE INCREASE IN IN TARIFFS IN TRADE, HAS THAT IMPACTED THE DEPARTMENT AT ALL? I, I HAVEN'T SEEN THAT.
I DON'T KNOW THE ANSWER TO THAT.
WELL, WE'LL SUBMIT THAT QUESTION.
UM, CAN YOU TALK A LITTLE BIT FOR THE PUBLIC'S KNOWLEDGE ABOUT THE CANCER CLUSTER GRANT, THE EPA GRANT, UH, PERTAINING TO FIFTH WARD, WHAT THAT WAS SUPPOSED TO DO, AND ARE WE ABLE TO MAKE UP FOR ANY OF THAT? YES.
UM, REALLY THIS WAS LIKE AN ADDED VALUE, UH, THAT, UH, UH, DR.
UH, HOPKINS, UH, AND HER STAFF PUT TOGETHER A, A GRANT AND WE GOT AN EPA GRANT.
UH, WE KNEW THAT, YOU KNOW, THERE WOULD BE ISSUES REGARDING, UH, REMEDIATION, BUT THE ASSUMPTION WAS THAT THROUGH UP OR WHATEVER, UH, THAT WOULD BE TAKEN CARE OF.
BUT WE WANTED TO DO SOMETHING THAT WAS MORE POSITIVE FOR, FOR THE COMMUNITY.
UH, AND THIS IS THROUGH DISCUSSIONS THAT, UH, WE HAD ACTUALLY IN THE COMMUNITY ITSELF.
AND SO, UH, ONE OF THE THINGS THAT PEOPLE HAD SUGGESTED WAS, YOU KNOW, LOOKING AT, AT, AT SOLAR.
AND SO THERE WAS A, A GRANT OPPORTUNITY FOR SOLAR.
THE DEPARTMENT WROTE IT, BUT IT'S NOT JUST THE CREATION OF SOLAR.
UH, THE, THE THING THAT WE REALLY LIKED WAS THE FACT THAT IT WOULD, UH, ACTUALLY RECRUIT PEOPLE FROM THE COMMUNITY THAT WOULD TRAIN PEOPLE AND, AND, AND, AND SOLAR.
AND ACTUALLY THAT IS HAPPENING, UH, THROUGH, UH, UH, ANOTHER ORGANIZATION VIA ANOTHER GRANT.
AND WHAT WE THOUGHT ABOUT WAS THAT, YOU KNOW, JUST GIVEN THE, THE, THE ECONOMICS, UH, STATUS OF A NUMBER OF FOLKS WITHIN THE ORGANIZATION, IF WE WERE ABLE TO CREATE SOLAR TO MAYBE BUY DOWN UTILITY COSTS FOR THE FOLKS WITHIN THAT, THAT WOULD BE AN ADDED VALUE TOO.
AND SO THAT WAS REALLY THE PLAN.
AND, AND THAT'S WHAT WHAT WE WERE, WERE LOOKING AT NOW.
THERE IS A LOT OF WORK THAT'S COMPLEX, CERTAINLY BEYOND MY INDIVIDUAL CAPACITY TO PUT ALL OF THAT TOGETHER.
AND WE HAD DONE PRELIMINARY WORK, UH, LOOKING AT HOW, HOW THAT COULD BE DONE BECAUSE JUST BECAUSE OF SOME OF THE CHALLENGES WITHIN THE COMMUNITY, WE THOUGHT THAT IT WOULD BE GOOD TO TRY TO BRING SOMETHING
[01:05:01]
THAT'S POSITIVE TO THAT COMMUNITY.UM, WHAT CRITICAL NEEDS ARE NOT BEING FULFILLED WITHIN THIS BUDGET? LIKE, WHAT ARE YOUR WISHLIST ITEMS? THAT WOULD BE HARD TO SAY.
AND THE REASON THAT I SAY THAT IS BECAUSE WE HAVE TO GO BACK AND DO AN ASSESSMENT AND THAT THAT'S ACTUALLY IN PROGRESS.
I DO WANNA THANK Y'ALL AGAIN FROM AIR WORKING WITH Y Y'ALL WORK A LOT WITH DISTRICT OFFICES ON DIFFERENT PROGRAMS. YES.
UM, BUT, YOU KNOW, WORKING WITH US ON THE AIR MONITORS AND LOCAL PARKS, UM, THE FREE PERIOD PRODUCTS AT HEALTH FACILITIES FOR THOSE THAT CAN'T AFFORD THEM, UH, I REALLY WANNA THANK YOU, DIRECTOR AND YOUR TEAM, ESPECIALLY KAMEL AND KA ON THE HEALTH BASED INTERVENTION RELATED TO GUN VIOLENCE.
AND THE, THE INFORMATION AND DATA GATHERING THAT WE ARE DOING, IT WILL BE SOON TO LAUNCH, BUT THAT HAS TAKEN, UH, A LOT OF TIME AND THOUGHT, AND I REALLY APPRECIATE AND COMMEND THE WORK THAT THE HEALTH DEPARTMENT DOES.
YOU MENTIONED, UM, INCREASING REIMBURSEMENTS.
HAVE Y'ALL EXPLORED THE REIMBURSEMENTS THAT COMMUNITY HEALTH WORKERS ARE NOW ALLOWED TO GET, UM, THROUGH THEIR SERVICES? YES, WE HAVE, UH, YOU KNOW, THOSE ARE SPECIFICALLY ALIGNED AROUND MATERNAL AND CHILD HEALTH.
UH, BUT THE ANSWER TO THAT IS YES.
WE REALLY, WE'RE TURNING OVER EVERY STONE THAT WE CAN TO FIGURE OUT HOW TO GET A LEVEL OF RE REIMBURSEMENT.
IT'S A CHALLENGE, BUT ALSO, UH, IT'S, IT'S SOMETHING THAT WE'VE, UH, PUT A LOT OF ENERGY IN AND WE'LL CONTINUE TO PUT A LOT OF ENERGY IN BECAUSE IT IS NOT JUST FOR THE HOUSTON HEALTH DEPARTMENT, IT IS ACTUALLY FOR PUBLIC HEALTH OVERALL.
BECAUSE, AND, AND I THINK THAT WE'VE BEEN TRENDSETTERS IN THAT AREA, ACTUALLY.
I'VE ACTUALLY PRESENTED NATIONALLY ON SOME OF THE STUFF THAT WE'VE DONE, UH, UH, TO, UH, ENHANCED REIMBURSEMENT FIRST WITH THE 1115 WAIVER, WHICH IS PRETTY UNIQUE FOR HEALTH HEALTH DEPARTMENTS AND, AND, AND, YOU KNOW, REALLY LOOKING AT HOW WE CAN, UH, MAXIMIZE THE REIMBURSEMENTS.
UM, I HEARD COUNCIL MEMBER PLUMMER ALLUDE TO THIS BEING POTENTIALLY YOUR LAST BUDGET PRESENTATION.
UM, SO IF IT IS, YOU KNOW, I JUST, WHOEVER IS SITTING THERE NEXT YEAR WILL HAVE SOME VERY BIG SHOES TO FILL AS YOU'VE DONE A FANTASTIC JOB LEADING THE HEALTH DEPARTMENT FOR MANY YEARS AND REALLY PUSHING THE ENVELOPE AROUND WHAT LOCAL HEALTH DEPARTMENTS CAN DO, UH, FOR PUBLIC HEALTH WITH A MORE PROACTIVE APPROACH, UM, GETTING INTO SCHOOLS, SEE TO SUCCEED, ALL OF THESE OTHER THINGS, YOU KNOW.
UM, SO THANK YOU FOR ALL OF YOUR YEARS OF SERVICE TO THE CITY OF HOUSTON.
COMING FROM AN EPIDEMIOLOGIST,
UM, COUNCIL MEMBER CASTILLO, IT'S MY UNDERSTANDING RAY ANDERSON IS RETIRED.
SO WILL THE HEALTH DEPARTMENT BE TAKING ON SOME OF THE CRACKDOWN, HOUSTON CRACKDOWN SITUATION, OR DO YOU KNOW ANYTHING ABOUT THAT? ONLY PERIPHERAL.
I MEAN, Y'ALL ARE ALREADY DOING GOOD WORK ON OPIOID ABATEMENT.
YEAH, SO WE, I ACTUALLY, I'VE BEEN DISCUSSING THAT WITH OUR STAFF.
THERE'S NO MORE PEOPLE IN THE QUEUE.
UM, DARREN, THANK YOU FOR CRUNCHING ALL THE NUMBERS AND, UH, WE'LL LET THE PUBLIC SPEAKERS START.
YEAH, Y'ALL CAN, NO, Y'ALL CAN STEP DOWN.
OH, YOU'RE, YOU'RE, YOU'RE GOOD.
WE'LL BE WORKING WITH YOU ON THAT CONSOLIDATION SITUATION.
UH, MY NAME IS SADA AGAIN, OR, UH, I SERVE AS THE POLICY MANAGER FOR WOODY JUNTOS.
WE, UH, ARE A NONPROFIT, UH, LOCAL TO THE SPRING BRANCH AREA, THOUGH WE DO WORK, UM, ALL ACROSS TEXAS IN TERMS OF ADVOCACY.
A LOT OF THE WORK WE DO ALSO ADDRESSES SOME OF THE ROOT CAUSES AS TO WHY WE HAVE ISSUES IN THE FIRST PLACE.
SO WE SPEAK TO COMMUNITY MEMBERS VERY FREQUENTLY.
WE BRING THEM TO ENGAGE WITH YOU AT THE CITY, COUNTY, STATE LEVELS.
[01:10:01]
I WANTED TO SHARE JUST A RECENT EXPERIENCE THAT WE'VE HAD SINCE THE LAST BUDGET CONVERSATION.WE HAVE ENGAGED WITH THE HEALTH DEPARTMENT A LITTLE BIT MORE.
UH, THEY'VE BEEN, UH, REALLY HELPFUL IN TERMS OF THOUGHT PARTNERSHIP FOR SOME OF THE THINGS THAT WE DO IN THE COMMUNITY, LIKE PUBLIC HEALTH, UM, FOOD, FOOD DISTRIBUTIONS THAT WE DO ON OUR OWN, OR VACCINE EVENTS THAT WE WANT TO PURSUE.
UH, OR EVEN EMERGENCY DISASTER PREPAREDNESS IN LANGUAGE.
UM, WHEREVER THEY CAN, THEY'LL TRY TO HAVE A PRESENCE.
UM, BUT WHAT WE'RE SEEING IS A FLUCTUATION, OBVIOUSLY, IN FEDERAL GRANTS THAT CAN IMPACT, UH, OUTCOMES FOR COMMUNITY MEMBERS.
SO FOR EXAMPLE, IF WE DO, UH, PURSUE A VACCINE EVENT, UM, THERE'S ONLY A CERTAIN THRESHOLD OF TIME THAT WE CAN DO A VACCINE EVENT TO HAVE A LOT OF SUPPORT FROM THE HEALTH DEPARTMENT, RIGHT? OTHERWISE, WE HAVE TO LEAN ON OTHER PARTNER ORGANIZATIONS.
UH, AND SO IT, IT CAN IMPACT THE, THE THROUGHPUT, UM, THE FOLLOW THROUGH AND THE OUTCOMES WHEN SOMETHING LIKE THAT HAPPENS.
AND SO I JUST WANTED TO SHARE THAT.
UH, POINT, GIVEN THE UNPREDICTABILITY OF FUNDS, UM, YOU KNOW, COMMUNITY MEMBERS ARE HOPING THAT THE CITY COUNCIL MEMBERS EXPLORE DIVERSIFIED FUNDING SOURCES, UM, TO ENSURE THAT ESSENTIAL SERVICES REMAIN FUNDED.
UH, THIS COULD INCLUDE SEEKING MORE STATE FUNDING, LOCAL REVENUE GENERATION GENERATION TO REDUCE THE CITY'S DEPENDENCY ON FEDERAL SOURCES AND CREATE MORE SUSTAINABLE FUNDING FOR LONG-TERM PROJECTS.
UM, WE HAVE HEARD A LOT OF CONVERSATION ABOUT POTENTIALLY CONSOLIDATING HEALTH DEPARTMENTS.
UM, ALSO CONSIDER WITH THAT THE ALLOCATION OF TRANSITIONAL FUNDING OR, OR CONTINGENCY RESERVES TO COVER WHAT IT WOULD TAKE FOR LIKE, UH, INTEGRATION COSTS, LEGAL, ADMINISTRATIVE, UM, BETWEEN HEALTH DEPARTMENTS.
AND CONSIDER WHAT A COST BENEFIT ANALYSIS OR PUBLIC SERVICE IMPACT, UH, COULD BE AND HOW THAT COULD BE SHARED WITH COMMUNITY MEMBERS.
UH, FOR TRANSPARENCY, JUST TO SHARE ANY, YOU KNOW, PRELIMINARY FINDINGS OR ASSUMPTIONS, UM, BEFORE SOMETHING LIKE THAT HAPPENS.
UM, COMMUNITY MEMBERS ARE ALSO INTERESTED TO KNOW WHAT THE CITY'S GRANT MANAGEMENT OFFICE OR RELEVANT DEPARTMENTS, UM, ARE DOING, UH, ON PLAYING A ROLE IN THE RISK ASSESSMENT AND SUSTAINABILITY PLANNING FOR FEDERAL GRANT FUNDED PROGRAMS. UM, THAT INFORMATION WOULD PROVE REALLY BENEFICIAL ALONG WITH, UM, GOING THROUGH THE BUDGET AS WELL.
THAT'S A LITTLE BIT, UM, OF A, OF LIKE THE POINTS THAT I WANTED TO MAKE.
WE HAD LIKE 16 QUESTIONS, BUT I THINK I'M GONNA SUBMIT A LOT OF THESE, UH, TO ALL OF YOU.
THANK YOU SARAH, FOR COMING IN.
WE WILL SUBMIT ANY QUESTIONS THAT YOU SEND TO US.
UH, UM, ANY ADDITIONAL PUBLIC SPEAKERS, EITHER ONLINE OR, OH, JACK VALINSKY, THERE YOU ARE.
WE HAVE TO THANK THE DIRECTOR AND THE SENIOR STAFF FOR DOING MAGIC.
BUT IN LIGHT OF WHAT'S GOING ON AT THE NATIONAL LEVEL AND THE STATE LEVEL, HOW COULD WE DEFUND THIS DEPARTMENT? IT'S UNCONSCIONABLE.
HIV AND THROUGH THE MAGIC OF DRUGS, I'M STILL HERE.
FIVE YEARS AGO WHEN COVID CAME, I THOUGHT IF I GOT COVID, I'D PROBABLY BE GONE.
I WOULDN'T BE HERE BOTHERING YOU.
BUT THE HOUSTON HEALTH DEPARTMENT GOT THOSE VACCINES OUT, AND I REMEMBER GETTING THAT EMAIL RIGHT BEFORE CHRISTMAS OF THAT YEAR THAT WE HAD SOME LIMITED SUPPLIES.
AND ALEXIS, YOU HELPED ALEXIS GET MELVIN, GET THAT SHOT.
UM, WE NEED TO PUT MORE MONEY INTO THE HEALTH DEPARTMENT.
WE JUST NEED TO, BECAUSE THEY'RE AT THE GROUND LEVEL OF PEOPLE WHO DON'T HAVE HEALTH INSURANCE.
HOW, YOU KNOW, I CAN'T BELIEVE THIS COUNTRY.
WE'RE THE BEST, SUPPOSEDLY THE BEST COUNTRY IN THE WORLD.
WE DON'T HAVE NATIONAL HEALTH.
SO WE'RE THE STOP GAP HERE IN THE CITY OF SUPPLYING PEOPLE WITH HEALTHCARE.
REALLY APPRECIATE THOSE COMMENTS.
ANY OTHER PUBLIC SPEAKERS, EITHER ONLINE OR IN THE CHAMBER? SEEING NONE, COLLEAGUES WILL TAKE ABOUT A FIVE MINUTE BREAK AND THEN WE WILL HAVE MUNICIPAL COURTS.