Public Health Committee (PHC) meeting Transcript – 6/5/2024 Title: ATXN-1 (24hr) Channel: 1 - ATXN-1 Recorded On: 6/5/2024 6:00:00 AM Original Air Date: 6/5/2024 Transcript Generated by SnapStream ================================== Please note that the following transcript is for reference purposes and does not constitute the official record of actions taken during the meeting. For the official record of actions of the meeting, please refer to the Approved Minutes. [10:00:57 AM] Are we good to go? Wonderful. All right. Hi, everyone. Good morning. I call to order this meeting of our public health committee. The time is 10:01 A.M. On Wednesday, June 5th, 2024. We are here in the city hall board and commissions room. Welcome, everyone, to our June meeting. And a special welcome to our interns for our district two office. Nadia and Bella. Thank you so much for joining us today, so I'm going to go through the agenda. We have a packed committee meeting, joining us today, we have councilmember qadri virtually, hope you're feeling better soon. Councilmember qadri, as well as councilmember Ryan alter, councilmember Velasquez could not be here with us today, so as far as the gender review, we're going to start out with public communications. Then we're going to approve the meeting minutes from the last committee meeting. From there, we will receive a quick briefing from the homeland security emergency management department on heat safety preparedness. We just had a press conference on this. This week. And so it is very timely [10:01:57 AM] week. And so it is very timely for us in this summer heat wave that we are experiencing. And we have about ten minutes for that briefing. Then we will have a briefing on the community health workers hub. We'll have about ten minutes for that briefing and discussion. After that, we'll have David gray join us for a briefing on issues related to homelessness, for that briefing, we have about 20 minutes allotted. Then we will receive a fourth briefing for third. Our third briefing, on the black men's health clinic. And we have about 20 minutes dedicated for that discussion. And finally, our fifth briefing, it will be on the best single source plus collaborative work to, related to the provision of homelessness prevention and rapid rehousing efforts. So like I said, a packed agenda for us today. Any questions or concerns ? All right. So we will start with public communications, Juanita, do we have anyone registered? >> We have one. Sign up. Andy Brower, if you're here. If not, [10:02:58 AM] Brower, if you're here. If not, that's the only speaker. >> All right. Okay, from there, we will now move to the approval of meeting minutes from, April 3rd. Can I get a motion? Council member Ryan alter seconded by councilmember zo qadri, unless there's any objections, we will consider those meeting minutes from April 3rd. Adopted all right, moving right along. We will now welcome director of ageism, Ken snipes, for a very brief update on the city's heat safety and preparedness efforts, as well as our cooling centers. Mr. Snipes, thank you so much for being here with us today. And to talk a little bit about how the city of Austin is preparing for this very hot summer. >> Thank you. Chair, it is a pleasure to be here today. My name is Ken snipes, director of Austin's homeland security and emergency management office, and here today to talk about the current, and ongoing heat [10:03:59 AM] current, and ongoing heat preparations and what we need to be thinking about, as you've already seen, it has been pretty hot already, this year, the first day of summer is June 20th, but we've been well into our summer weather for, over a month now, going back to, may, we know that, already this year, we've had 123, heat related visits to Austin area hospitals in comparison to 2023, we only had 48 of those visits during the same time frame. So more than double almost three times as many visits this year, and that is a result of people taking advantage or being out in the heat, and not necessarily following some of the, the things that we're going to talk about today, in terms of making sure that they're prepared, we want to ask people to continue to hydrate, make sure if you are outside in the weather that you take proper precautions. More information on that can be found [10:04:59 AM] information on that can be found on our on our, regarding the press conference yesterday, June 4th on atx in, we also are tracking trends now that we haven't tracked before, one of those trends that has come out, and seems to be something that we can point to pretty regularly , is that when temperatures or the heat index are above 100 degrees for more than three days in a row, there tends to be an increase or an uptick in the number of heat related illnesses. That is, as a result of the body not having enough time to re-acclimate and cool off before we move forward with the rest of our activities. So again, we're asking people if you are working or even if you are taking advantage of recreational activities when these types of temperatures are, you know, are happening, please be careful and be cautious with respect to relief, city facilities will continue to be available for cooling centers, these include our libraries. Indoor park facilities are also [10:05:59 AM] Indoor park facilities are also available during our normal hours. Cooling centers are meant to be temporary. Temporary reprieve for heat for anyone who may need them, and then to know that when the national weather service issued a heat warning, we will also extend the hours of those facilities, as well. And that concludes my briefing. >> Thank you. And so I'm glad you you touched on when the national weather service issues an excessive heat warning that will be the trigger. And our cities protocol and extending the hours at the libraries and rec centers, which are serving as cooling centers for our vulnerable community members, any can you share with us the extension of hours, what that will look like? >> It varies by facility, and then, generally, or sometimes it's a case by case basis, depending on the nature of the heat, the number of people taking advantage of the facilities and then the location, some of them are driven by, how many staff we can get and what the pivot looks [10:07:03 AM] get and what the pivot looks like when we're asking people to come in, what we're trying to do now and what the teams have been doing is paying much closer attention to the forecast so that we're able to, make those facilities available and get the information out to the public. Earlier and I think last year that was pretty successful on the days that we did extend the hours, and as far as getting the information out earlier, what does that look like as far as outreach to the community to notify them of the cooling centers? >> I know now we have the oasis, which is a newer cooling center that's been stood up. How are we doing the outreach typically, the outreach is happening through many of our regular channels. >> I know at homeland security and emergency management, we help support some of that information on our website. We also point people to either the normal news outlets or agencies as well, or any of the city agencies that are supporting the efforts. They generally host that information. >> Okay, are we using the text messaging service? I know that we did that, during the severe the winter weather, we sent out [10:08:05 AM] the winter weather, we sent out a text message, I believe that is a service that the homeless services office uses to communicate with those experiencing homelessness to communicate that type of information they have used that as a regular tool. >> And my assumption I don't want to speak for, director gray, but I'm assuming that, they will continue to do that going forward. Okay colleagues, any questions? >> I appreciate your work. >> Thank you. And real quick, one last question on my end, for city workers, what is our protocol? I know last year, you know, we had for our public works and transportation staff who are out there, you know, fixing our roads and, you know, out there in the heat, what type of precautions or protocols do we have in place for employees? >> Great question, many of the departments are, putting plans together to increase the number of breaks. They're reminding people to hydrate, I know there were a number of departments last year that shifted some of the work that would typically occur during the hotter, time frames of the day to earlier in the morning, and I know that [10:09:07 AM] the morning, and I know that we're also some shift changes, for some departments as well, that move some of their work to overnight. So departments are paying close attention to this as well and making sure that we're doing what we need to do to protect our staff as well. >> Thank you. Thank you, director snipes, for joining us. All right. We're going to move on to item number two, which is a briefing on the community health workers club hub. Excuse me. Club. It is kind of like a club community health workers hub, and our our lovely aff program supervisor will be joining us. Stephanie Olivares, welcome. Thank you for being here. And, we appreciate the update. >> All right. Good morning, everyone. My name is Stephanie Olivares, and I am one of the program supervisors with the health equity unit at Austin public health. And I wear many hats and under all hats, I get to support community health workers, which is an honor and a privilege. So I'm here to talk [10:10:08 AM] privilege. So I'm here to talk about community health workers in general and the great work we're doing with the hub. And all right, so can I ask who knows what a community health worker is? Or maybe prior to the pandemic, if you knew what a community health worker is one okay. All right. And then pandemic hit and then we know we know. No no no right. All right. So community health workers have been here. I won't go too much into it because it sounds like I'm talking to the right folks here. But, they did start or rather, they've always been here as recognized as volunteers, the city of Austin now is able to recognize it officially as an official title. As of recently, we have community health worker, as a title and a career progression ladder. So they are instrumental. I will say that they are, as one of our community health workers put it, miss Cynthia Washington, is that they are the secret sauce of public health. Okay so they are the trusted messengers, the [10:11:10 AM] the trusted messengers, the gatekeepers, the influencers, they're the ones who got us through the pandemic. Right. So, Austin public health and what it looks like, in Austin, public health, we have a lot of different programs that utilizes the community health worker model and the national association of community health workers. Actually, acknowledged us 190 titles that fall under community health workers. So while these programs have community health workers in title, staff employed, we have a lot of different professions, a lot of different roles that also operate under the spirit of a community health worker, for example, patient navigator, so on and so forth. So here I'm just highlighting that. But please note that the spirit of chw is seen in many different ways, so starting with quality of life, we have a team of three community health workers there. They are paired with public health nurses. They're the ones conducting helping this nurse conduct the screenings. While [10:12:10 AM] conduct the screenings. While the nurses over here waiting for someone to show up, they're out there saying, hey, do you know your numbers? Know come on over, let's talk about it. Let's go get screened. So that's, in a just a community health worker there. They do a lot more than that of course, the maternal infant outreach program, that's one of the programs that I supervise proudly. And that is a team of five community health workers that provide case management, peer support to black moms who are pregnant or have a child under the age of one. And that, of course, is to address the high infant mortality, maternal and mortality rate. And we have reach and reach out. So covid 19 hit, of course, we have arpa money, and one of the great things that came out of it is that we were able to, staff up and be a little bit more efficient in our outreach to reach and reach out is a result of that. So a team of five community health workers, and they conduct street outreach, every day. So that program is, by design, able to have that aff presence in the community and [10:13:10 AM] presence in the community and very instrumental at the very beginning still is, just a shift in focus. Whereas before they had really intense conversations about covid 19 vaccine, now it's turned into, so how are we adapting to life after covid 19? Community health worker hub, is a, that's a designation that we have created and received from the state. We are a certified training site. By forming by being a site, we have formed the community health worker hub. And with that we have the training component to it and the unifying central, community health workers of central Texas, through a coalition. And then we have the training capacity within internal and also with the community to either for those who are new or wanting to become community health workers. And then for those who are hoping to sustain their certification and providing continuing education opportunities there, I'll speak a little bit more on that on the next slide as well. Now we have heart at, that's also another, now transition to grant funding. [10:14:14 AM] now transition to grant funding. But the that team and the heart was still there before, they do a lot of great changes. There are a lot of great work there from system changes to direct, direct care, I guess you could say or direct, outreach and, for example, they have diabetes classes and the magic. And when we talk about carb counting, we're not just talking about, bread or pastas. We're also talking about tortillas. Right. So they make it relevant. They also show like, tostada and an enchilada. You still have the tortillas. So even though it's variety, is it really. So that's the magic in there. And they have other initiatives there where they are able to help communicate what we're hoping to the community health disparity reduction program. So that is the covid 19 education branch, I'd like to call it. So while Arellano rich and reach out are out there talking to folks every day about covid 19 and social determinants of health and connecting to resources, if [10:15:14 AM] connecting to resources, if there's ever a need for more in depth information or education on that, like an employer maybe wants to just learn about more, especially we were seeing that a lot at the very beginning. We'd call on this team, they come and they present on covid 19. So that's one. And efforts again to reduce the disparities that was there prior and then exacerbated during the pandemic. Mobile vaccine program also kind of the same style as quality of life as far as community health workers paired with nurses, with public health nurses, they're mobile. They go to where the community is at. So that's their their jam. There has been very instrumental during the pandemic and still is living to that spirit today at neighborhood services, they also have community health workers in their centers. They're they are. We work hand in hand with them. They a lot of people come to the services like, maybe donations or just other nonprofits. And I feel like they're the ones that know real quick and are able to communicate with us so that we [10:16:15 AM] communicate with us so that we can share the, the, the love or any, any of the resources that come through again. Also you know, utility assistance, food pantry, what have you. And then the refugee clinic. So they do have a community health worker there, there and has different challenges for sure. But still, in the spirit of connecting, people to resources and they do a lot of patient follow up. So they're seeing they're and to adhere to come back for vaccines. And also depending on their, their status, trying to connect them to their appropriate resources and adjust . All right. So current numbers we have, we have nine ftes. Two are general funded and seven grant okay. We have community health worker twos. So again we have community health worker one, two and three. That's the career progression ladder. We have three ftes. They are grant funded and we have one community health worker. Three also grant [10:17:15 AM] health worker. Three also grant funded. Temporaries. We have 11 1111 chw ones and so that's for a total of 24. Again, this is a title, total of 24, in title at a-p-h. I included the, the pay grades in the, in the pay rate because I was asked in a former presentation there. So just so that you can see the, the skill set and how it's compensated as you're, as you move up as the kw3. The biggest difference is that you are a instructor. So you have that instructor capacity. That is an additional certification, to be in a community health worker. Community health worker hub. So like I said, we receive one time funding. It was amazing. It was great because we were able to really catapult into that world of training and being a training site and, and we were able to graduate. Our goal was to graduate 30 and we graduated 32, [10:18:18 AM] graduate 30 and we graduated 32, and it was it was our first cohort. A lot of challenges to it and a lot of great successes to it. We were able to pull through, as always, and 30, I'm gonna say 30 of them were community members, so only two was internal, which is really neat to see. That's talk about building capacity in your community. Right, and then also, we had an additional cohort and that was internal. So we did some changes to the curriculum and did it a pilot internal. And we had seven who became certified. So going into our workforce development and strengthening our infrastructure there, we can only do that or we do that more easily, rather, because we are designated as a certified training site with the state, in addition to the training arm of the community health worker hub, we also have now the coalition, or rather the community health worker alliance of central Texas or chw act, and that is where we convene all [10:19:18 AM] that is where we convene all community health workers of central Texas, miss Stephanie is leads that with us. And, we meet every other month. Right now we have a setup where we have a presenter to come out and speak, either on the resources they have or, or getting collecting feedback from the community health workers. So that's been really neat to see that grow. It is hybrid. I mean, we do in- person at tc and down south or online through zoom and continuing education unit. So that's another great thing that we can do under the designation of being a certified certified training site. So once your community health worker, you do have to maintain ceus, 20 ceus for every two years and there is a lot of different ceus and a lot that are lacking. For example, there might be ceus in maternal health, but not specific to black maternal health, which would be more relevant to my team. So as a training site, we can actually develop those ceus, which is [10:20:19 AM] develop those ceus, which is really great to meet our training needs and also to help with professional development within our instructors. It actually ties into the third one, which is a strategic support, a really neat thing that we've been able to do is across the department, if there is a need for training and we're now, we definitely understand that csvs are the way or the vessel to the community, we we're able to create that training. For example, we partnered with the preparedness team and, our safety person, Albert Ortiz, to be able to create a training for basic safety and doing conducting, outreach door to door. So there are some precautionary things that you should think of, so we created a training for that. That's how we formed our community health worker strike team, which is really a really great model that we're we're trying this year, we're actually in the middle of planning and deploying this weekend, so to do some mosquito abatement. So this [10:21:20 AM] some mosquito abatement. So this is really neat in that we can have community health workers, on standby, or rather, have that skill set and ready to deploy in any, any emergency response or pressing response. So that's a that's an example of that. Yeah. It's really it's really neat. And, in addition for example, we have fast track cities, HIV and they approached us and would like to create a co-create a community, a ceu for us on HIV basic awareness 101. And that's some talent that we have in knowledge that we have in-house. We do have some work in HIV awareness. And so we are creating that right now actually, as we speak, and hope to have that ready to go and invite the community to also be part of that training. So just to give you some ideas, there's some other partners that have also reached out to us to collaborate, on this effort, central health, from central health to national kidney foundation to the, Austin fire department, Austin fire department has recently reached [10:22:21 AM] department has recently reached out to us asking, you know, consulting about outreach, which I'm so happy to, to be that point of person, and to be acknowledged that outreach is not only critical, but there's also a way to conduct outreach and doing your due diligence and reaching out to folks who been in the game is always the best way to go about it. So Austin fire are actually coming to our next coalition meeting to present on their program and also collecting feedback, which is always a good thing to have community feedback for any community program and certification courses. What I spoke on at the very beginning, which is the 160 hour, those are for people who are not community health workers and community health workers. So through the training program, they can certify. We also have helped, so right now we don't have a class, but we've been helping a lot of folks with certifying based on experience, which is great. A lot of people already have the experience. So to be able to provide technical assistance and [10:23:23 AM] provide technical assistance and becoming certified in that way has also been another great benefit from being a how many training, how many certifications have y'all done based on experience? >> Seven wow. Yes. That's great. And how do we market that or promote that to the community. >> Right now it's, on our website, coalition is really has taken on the that presence in the community. So I get calls or emails almost daily on certification, on having the course. And so through that, I'm also able to say, well, we have this. And, if we know of a partner that's providing training, we definitely refer to them, for example, like el Buen samaritano, if they have a space , then we definitely refer and vice versa. So it's through the organic outreach already and for training and then also through the coalition. >> Very good. Thank you miss Olivares. I appreciate the update. As you know, community health workers are near and dear to my heart. And one of my favorite sayings is that our community health workers have a [10:24:24 AM] community health workers have a phd in community, which is why I'm such a strong champion of this program. And I'm pleased to see, a robust support system here at the city. Of course, only two of our community health workers are funded by the city. The rest are either temporary or grant funded. So I would like to see that number, increase and certainly even looking at that, and I'm so glad you provided the pay scale. I mean, just knowing the level of work that our community health workers are doing, I don't think the pay scale that is provided is, is on par to the level of expertise and dedication. In a few questions on my end, how often is the city providing the, the certification Ann courses, we had a cadence of once a year, so the first graduating and then the next provided the second year. This is our third year, we are planning for a fall one. It seems that we have we do better in well, have any evaluation period for any kind of program. Right. So right now we're in [10:25:25 AM] Right. So right now we're in that we're also in the middle of hiring a program coordinator. So right now it's a team of one. Me, and I'm not an instructor nor am I a phd. I'm a proud ally. But right now but we do have instructors within our in our, department, and they were really the ones who got this running. And we could call on them as well. But to stretch them thin again, and also to remove them from the important work that they're doing is, is a concern. So we are hiring for a program coordinator and right now is set up as a one man show, meaning there's going to be some innovation that's going to happen there. We are looking at other curriculums to see something and really airing on the side of creating our own something for Austin, something with an equity lens, to have that. So there's some, some bandwidth that's needed to hear about the creating something customized to Austin. [10:26:25 AM] customized to Austin. >> Because my next question is how what's the intersection between our community health workers and homelessness and outreach services, particularly to our unhoused population? >> Yeah. So, community health workers work in many different areas, right? I can just say from an example, I my dream would be that every effort, every project, every division, unit, program had associated to them from within apps to APD and so on and so forth. Austin energy because anytime you serve the public, you should have a Sade who quite frankly, but they definitely, certainly have the lens just because we have an equity lens. And one way that we have adapted, like the reach in and reach out regrow, that team of community health workers have adapted their swag items to the houseless community, so they planned their outreach in that community and ordered raincoats and socks and pads. And I can't remember what else but they did [10:27:26 AM] remember what else but they did adapt. Those are the three that I do remember. They adapted their swag. So instead of chapstick, they thought a raincoat might be more helpful. So that lens is what is needed to be applied to any program. And that's what we would like to focus on in this training. And we're just not finding that in the in the current existing curriculum, there's just so much more. And it makes sense to have in-house training created by in-house folks from the community is really the best way to go about it. So to be able to, train kids to critically think about within the infrastructure, what can we do? >> Yeah. And I would particularly look at, you know, what more like, how can we build something out regarding our unhoused population and services and outreach, particularly for our unhoused population? I think that's an area of need. The other area of need is around mental health, what are our community health workers doing around mental health? >> Yeah, right now it's continuing education. So we do [10:28:26 AM] continuing education. So we do have continuing education, courses, we have access to UT school of public health, Houston , and they've granted access to their menu of community of continuing education courses. So right now it's in those spurts of either it's a ceu. So now we're a two hour course that we deliver during the year or, or there is a component to it in our existing curriculum, but speaking to having that component of mental health and the house's, community, you know, my idea is to once we have bandwidth to be able to and expertise. So someone with instructional design and someone who's, understands popular education model, for example, once we have that, we're able to bring in these consultants. So these subject matter experts from each division and consult with them as far as what is important for the community to know, what are the different resources, so on and so forth, so that it's truly a collaborative effort and this curriculum is not just an aff effort, which should never be. We, if anything, the pandemic [10:29:28 AM] We, if anything, the pandemic has shown us how stronger we are together. So that's the that's the that's the goal. >> Thank you. Colleagues questions. >> All right. >> Thank you so much. Thank you. >> Okay. I've been informed that our, our speaker has arrived. So if we can have Andy Brower join us to provide public comment. Welcome. >> Hi. And thank you very much. I'm so sorry. Thank you, for allowing me to speak. Sorry for being late. I'm Andy Brower, I'm the neighbors program manager at central presbyterian church downtown. Excuse me. And I've worked in homeless services since about 2018, so I run the day to day outreach program, that we have. And I also co-lead the homeless advocacy project meetings, which used to be the downtown cluster meeting. So we [10:30:29 AM] downtown cluster meeting. So we bring partners together and, try to identify gaps and needs in the community. So I'm here today to talk about homelessness, obviously, and to also, ask for your consideration during the upcoming budget process, to keep a few things in mind. And, one of them is, I guess, three things. One, finding a place to replace the marshaling yard and maintain a 300 bed shelter space, expand or open a new family, expand current family shelter, open a new family shelter and to create a safe outdoor spaces program. And I've , given these policy proposals to your offices before, the reason why I come up with these proposals is, is, really thinking about social determinants of health. And if people do not have a safe place to go and food to eat, they cannot move forward with their health and healing, I went over today. I looked at the pyramid, Maslow's hierarchy of needs and the pyramid. And the bottom is physiological needs. Health, breathing, food, water, shelter, [10:31:30 AM] breathing, food, water, shelter, clothing, sleep. So, I know that not everybody loves the idea of shelter or congregate. Shelter but I think it meets a great need in the community. And I hope that we will continue funding it, it's an immediate way to meet those needs. And also just thinking about what is the minimum that we think the city should do for our homeless citizens, I know we always strive to do more than the minimum, but maybe that's the way we need to look at it. What is our role? What is the minimum? Because right now people can't even access many people cannot access a shelter or do not get crisis intervention. I don't work with families, but I'm a mom of three and I understand when I read these stories every week about families not having shelter, it breaks my heart. Just a few may 13th, we are working with a family who has four children, are currently living in their car. They are already on a waitlist for Salvation Army. May 15th after the family became displaced, the mother missed days of work and her employer terminated her. The son is now living with her in the car. May [10:32:30 AM] living with her in the car. May 17th 61 year old client who's been sleeping outside in her car. All shelters are full. May 21st. She is extremely vulnerable. She cannot walk on her own and uses a knee scooter to get around looking for shelter. I think this should be unacceptable to us, for families, for everyone, but for families. Let's make that our top priority. Let's not. Let's not turn them away. So the proposals I, I gave you, I can certainly provide another one. One is about shelter. And it goes back. It cites reports from 2000 back dating back to 2018 with these recommendations to improve our shelter system, expand it to meet the needs and to coordinate better, you know, at a minimum, let's make sure our highest risk individuals get shelter, the these are ones that the nih weighed in on, again, we can't get expect people to apply for a job until they have some sleep and some stability, the other proposal that I sent in was on creating a safe outdoor spaces program like Denver has. They have eight camp sites [10:33:31 AM] They have eight camp sites around the city, to meet people's needs. It's not ideal again, but it's reality. People are camping throughout their city. They're going to continue camping despite the camping banned, I don't think it's right or fair to tell people to move, throw away their belongings sometimes, and then literally have nowhere for them to go. That's not right. Yeah. Anyway. Thank you very much. And I'm happy to answer any questions about this or after. >> I appreciate you sharing the materials. I just asked my team and they emailed it to or they sent it to me as well. So I, I will review the proposals. Thank you. Okay. >> Thank you very much. >> All right. Colleagues we will move on to our next briefing on issues related to homelessness. Will David gray will be leading this briefing. An update? And this is focused on the marshaling yard emergency shelter update. Welcome. >> Morning, madam chair and council members, David gray, I'm the homeless strategy officer [10:34:33 AM] the homeless strategy officer for the city of Austin. Also joining me today is Gary Pollack. He leads our policy and planning unit, and on days that I'm out, Gary typically serves as acting zo. So I asked him to be here with me today, to help me through this presentation. Thanks, Gary, for being here. Thanks, Tom. >> Good to be here. >> So today we want to give a quick update on the marshaling yard. As many of you know, marshaling yard is a temporary shelter that was established in August of last year, as of, may 1st, we served 755 clients at the marshaling yard. And just as a reminder, our clients who are here get access to a suite of services, including three meals, a day, daily transportation to and from, appointment or frequent locations throughout the city. We have an onsite animal shelter, on site showering facilities, etc, you can see on this slide that our weekly census remains pretty high, on any given night, the shelter is full or nearly full, [10:35:34 AM] shelter is full or nearly full, any beds that are vacant are typically beds that were either holding for people that are street outreach team is going to bring in the next day, maybe a respite bed that we're holding for clients who need that service or an Ada bed, but by and large, the shelter remains full on any given night, this is just a recap of our outcomes, we are working to get updated data since we last met, but when we last met a couple of weeks ago and talked about marshaling yard, we had about a 20% positive exit rate, I believe this has gone up a little bit, but next time we meet to talk about marshaling yard, we'll make sure that we have the updated data and information available for you. The big update that we wanted to present to you today focuses on our plans for winding down the operations at the marshaling yard, so, council members and madam chair, as you might recall, council authorized an extensionof the marshaling yard through the end of March 2025, council also directed us to return and provide a roadmap for [10:36:36 AM] return and provide a roadmap for how we are planning to wind down the shelter, including ways to ensure that we're providing our shelter clients with housing resources, we so the plan that you're going to see and that we're going to talk through in a moment, we'll talk about when we will cease intakes, how we are trying to set up our clients for success. The ultimate goal here is to ensure nobody gets returned to the streets, when possible, we're going to move people into permanent housing or housing opportunity. We might move people into shelter, but we are not going to return anybody to the streets, unless that client decides to reject every opportunity that we give them. And then they, they self-select to return to unsheltered, homelessness. So in terms of the timeline and I'll just touch on this quickly. So currently we're still in normal intake operations. We have not shifted our intake procedures. However, we are modifying how we do our case management delivery, part of the council direction was for [10:37:37 AM] of the council direction was for us to work with endeavors and a local provider to increase local case management at the shelter, and so we've been in conversations with the sunrise navigation center and the endeavor staff to increase the number of sunrise case managers, we've even contemplated having sunrise do all the case management at the marshaling yard and just having endeavors focus on actually maintaining gaining the physical building, and so those conversations are progressing, looking forward to having some real, tangible results from those conversations in the days ahead. Beginning in September is when we're going to shift our operating posture at the marshaling yard, once we get to September 1st, we will limit new intakes, the referrals will focus on clients who have a verified housing resource. Housing resource, in most cases means that the client has a housing voucher, there's a unit that's more or less been identified for that client, and we're just waiting for that unit to become available, oftentimes, our outreach teams will come across clients who are [10:38:38 AM] across clients who are unsheltered, who are able to return to family here in Austin or in other parts of the country. They just need help getting back to their family, so in those cases, when we verified that people have a stable, living place to return to, we want to bring them into the shelter as well, provide them with the diversion support or rapid exit support that they need, and then move those folks into housing. So what we are not going to do after September is provide general access to the shelter to anybody, we're doing this to make sure that we give ourselves the benefit of getting through the summer months, without shifting our operations and shutting down referrals, but also making sure that we have enough time on the back end to get people placed and get people housed. Beginning December 1st. Is when we plan to stop all intakes into the marshaling yard. It really focus on the clients who are in shelter at that time, I should have mentioned that in September we are considering, beginning to [10:39:40 AM] are considering, beginning to ramp down overall capacity at the marshaling yard. We haven't made that determination just yet. We kind of want to see what our clients health looks like once we get to that point, but in December, we could still have 300 beds online. We could also have 200 beds online, time. We just need the benefit of some more time to see what the needs of our clients are once we get there. But anyway, once we get to December, that's when we see salt intakes. And then we're working exclusively on identifying housing or alternative shelter operations for our program participants. Those alternative shelter operations could mean that we're placing clients in bridge shelters or the arch or H street, which are city owned facilities. It could also mean that we're working with our partners at two or at salvation Army or somewhere else, to see if they have availabilities, and if our clients would be a good suit for those communities. And so we're going to give ourselves the benefit of about three, four months to do that work. And then at the end of March is when we will officially close the marshaling yard per council [10:40:40 AM] marshaling yard per council direction and then return the facility back to the convention center, again, I just really want to underscore the point here that our ultimate goal is that no one is returned to unsheltered Ed, and unhoused homelessness, that that is not why we are here. Our goal is to pull people out of an unsheltered environment. Once you're in our care, our sole purpose is to make sure that you get housed, so there will not be a mass exodus of people back into encampments on the streets or in our parks or in creeks or in waterways. And so we would we do welcome feedback from this committee on today's presentation, and then, you know , to the extent that that we're able to we will incorporate that feedback into our ramp down plans, this is the you know, Gary can attest that we spent many hours and many, many meetings thinking through the best way to do this in service of our clients, we think that this timeline optimizes, our utilization of the marshaling [10:41:43 AM] utilization of the marshaling yard for the period that we have. But, of course, we welcome feedback. And with that, madam chair, I'm happy to yield back to you for any questions. >> Yes. I'll kick us off with a couple of questions and then we'll yield to my colleagues. >> And thank you for mentioning that. The marshaling yard is slated to close in March, what how much headway have we made in identifying an alternative site? >> It's been very challenging finding an alternative location. We've been working with the city's real estate department, looking at every, piece of city owned property. We, unfortunately, we have not been able to find a viable location that we think works really well, any city facility that we believe could be converted into shelter currently has another use, vacant land that is available is either in a flood area or it's on the periphery of the city and not really close to city services. We are continuing our quest to look for alternative locations. We're now kind of shifting our focus and looking into the private real estate market. But to date, we have not been able to find a solid alternative for the [10:42:45 AM] solid alternative for the marshaling yard. >> So how confident are is zo that we will find a replacement for the marshaling yard by the end of March? >> We're committed to doing our best to try to find a replacement. We're we're committed to leaving no stone unturned, at this point, though, we have been unsuccessful in that pursuit. >> Okay, colleagues. >> Thank you, pick up a little bit where the chair left off. And I'm curious, as we think about a replacement or. You know, just finding additional shelter capacity. There aren't many 70,000 square foot facilities, set up, like the marshaling yard. But one could argue maybe the marshaling yard is not the ideal setup to begin with. Right. So we have the opportunity here to figure out what is right. I'm curious, as we think about, office space, which typically wouldn't be thought of as any kind of, you know, residential space, but, [10:43:47 AM] know, residential space, but, you know, the marshaling yard itself is just one big open space, right? And an uninhabited office, maybe. Is that same just stacked right, instead of one huge plate you have multiple plates, but that could actually help serve to separate populations. So I'm curious, as we look at now in the private market, is that one option of just basically complete open office space that operates kind of like segments of the marshaling yard? >> It it could be right, it of course, it always comes down to the details of the actual space. But as part of our private market analysis, yes, we have looked at vacant office space, vacant medical offices, vacant warehouses, vacant gyms. I mean, we're we're thinking about all the different types of spaces that could potentially be retrofitted into emergency shelter. >> Okay, well, I, you know, in, in the search for feedback here, the one thing I would really like us to try to do is if we are going to make an investment, [10:44:49 AM] are going to make an investment, make it in something that we acquire, rather than lease, because, you know, if we lease, we end up spending a lot of money at the end of the day, not having an asset. We can reuse. And so that would be the number one thing I would hope that we achieve out of this in our new space, whatever that new space is, you and I have talked a little bit about whether it is, you know, congregate, spring shelter or non-congregate kind of like what they're doing at Esperanza community with these micro shelters. You know, how long, long would it take to stand up a site like this if we did have land available? >> It again, it depends on the style of shelter, some of the spring shelters have gone up very quickly. Those tend to be congregate or semi congregate shelters, but also what we've seen is even in the non- congregate shelter setting, if the land is right and things [10:45:49 AM] if the land is right and things are in the right conditions, those can come up in 7 to 10 months. You might recall, just last week, council gave us the green light to, add $1 million to the other ones. Foundations contract to bring on 100 more shelter beds at camp Esperanza, and in that conversation, you know, we feel like we can get those 100 beds online within the next eight months. And so part of it depends on the zoning for the land and just kind of what that looks like. There's obviously some community engagement that we'd have to do, but then actually pop up the shelter is going to depend on if there's utilities on site or are we bringing in showers and restrooms, like we did to augment some of the operations over at the marshaling yard, but those are all things that we're looking at, you know, as we try to identify a good location that can either lend itself for us to pop something up or retrofit something. And, Gary, did you want to add anything to that, I mean, we've been looking at other cities as well to see what what they've been doing in these scenarios, whether it's like [10:46:49 AM] scenarios, whether it's like parking lots and figuring out how to utilize church parking lots, public parking lots, etc. And there are some options, but I think there's a cost to weigh both with temporary infrastructure versus like, as you said, permanent infrastructure, and, you know, I think nothing's off the table. So we're we're still kind of looking and thinking and kind of trying to learn about what other folks are doing so that we can use those best practices. >> Yeah. And I, you know, we had public testimony here about, you know, Denver's safe outdoor spaces program, which is, you know, essentially a form of sanctioned camping. I'm curious, has that entered the conversation in this analysis? And if you could help kind of highlight, you know, when I first came here, I thought intuitively it seemed like that's so cheap. You buy a piece of land, you say, go camp here. And what's the cost, I have come to learn differently. And so I was hoping you might just talk a little bit about that style of [10:47:50 AM] little bit about that style of providing space for individuals, what costs we have and not, and whether or not that's even a consideration. >> Sure. Gary, do you want to take that one also? >> Sure, I mean, we've not looked thoroughly at it to, to review costs. I know that the model in Denver, and then in Seattle as well, there have been more safe spaces that have popped up, and they're kind of short term. They move from different, different parking lots around the city over time, I think that the capital to, to build the structures is similar to probably what we're seeing at Esperanza, but but, there is definitely flexibility in bringing providers on site and making sure that there's kind of 24 over seven security with portables and other assets. So I think, that's something that we've not gone down the road for just yet, but really just looking at like, what are other folks doing, you know, and looking at things like safe parking, parking lots and especially in California, there's a lot of programs around [10:48:50 AM] there's a lot of programs around safe parking. If folks have operable cars, they can spend the night, have access to showers, that's fairly cheap, but again, they have to have operable cars and, and whatnot. >> But and then I'll just quickly piggyback off of that to say that here in Texas, if we did want to designate an area as a safe and camping area, that's obviously a decision that we would come to you as council to vote and give us some approval on. And we would also have to go to the state of Texas to get approval as well. And so, so far, our focus has been on looking at what's completely in our realm of control, that's an option that's not fully within our realm of control. Okay >> Well, thank you very much. >> Just so I'm clear, getting state approval, if we did want to have a sanctioned campsite, we have to get state approval. >> And they meet only every other year. So we would have to have that approval during the next legislative session. >> I don't know if it's the legislature that grants the approval. I'd have to look into it. It might be a agency that's [10:49:50 AM] it. It might be a agency that's a state agency. Right. But but essentially we would have to do is identify the location in the city that we would want to use, we would obviously do extensive stakeholder engagement around that to let the community know about our intentions, come to council and get your approval. And then whatever the process is that the state has designated, we would have to then shift and follow that procedure before we're able to designate, a location as safe and camping. I will say we are anticipating the supreme court's decision soon on , encampments. It could have come out today. It could come out anytime, in the coming weeks, and as we, as we think about that and kind of the implications of whatever that could have for Austin, that's really kind of recharged us. And looking at the safe and camping option, knowing that we don't have enough shelter beds currently available for everybody who's seeking shelter. >> Thank you. A couple more questions on my end, how soon will we have the data on the success of the sunrise case management, once we get sunrise [10:50:50 AM] management, once we get sunrise more under contract, through our contract with endeavors, they utilize the same hmmis, system as everybody else in our system uses. And so, as soon as they're able to start entering that data, I then go to Gary and his team to pull it up. So it's not that long of a delay, but I do want to be clear that we're still having that conversation with sunrise and endeavors to figure out the best case management resource mix. So we're not there just yet. >> Okay. >> And what are the expected outcomes for clients of the marshaling yard when it closes? If there is not a replacement that is found, again, every client will be offered an opportunity for either housing or shelter, and so if clients have a housing voucher or a housing destination that we can safely place them into, then we will help them transition into that housing. Sometimes that can [10:51:50 AM] that housing. Sometimes that can be a psa unit. I know that we have clients for example, who are on track to lease a unit at pecan gardens when that opens, we have clients who return with loved ones, and we verify that those loved ones exist and that they're willing to take the client in before we divert their. Any client that we cannot place into housing will be offered an opportunity in another city shelter. Now that could have effects on some of our other programs, like the heal initiative, but we are not going to know that until we get a little bit further into the year and we can kind of take a kind of recheck around which of our clients have housing resources and which ones are more likely going to have to transition to another shelter. >> Yeah, because you mentioned in September is when you'll start changing the intake procedures. >> Only accept those who have some sort of, verified housing resource, this will have an impact on the heal initiative and the encampment cleanups to some extent, but we won't know to what extent that impact will [10:52:51 AM] to what extent that impact will be for a while. >> Exactly. Yeah. We're not really going to know until once we get out of summer with that capacity will look like and I would like to clarify, you know, as part of our normal marshaling yard operations, we are helping people get housed. So we're doing the work. We're just going to focus more exclusively on that work and on that clientele once we get to September. Okay >> Any other questions? All right. Thank you. >> Thank you so much, madam chair. Thank you, thank you. >> Okay. So now we're going to move on to item number four, which is a briefing on the black men's health clinic. This would this briefing, what we will be joined by Larry Wallace and doctor Larry Wallace Jr to share an organizational update. And we welcome you all to our public health committee meeting. >> Thank you. Thank you, madam chair. And, the council members, we appreciate the opportunity to come and give you an update, we [10:53:51 AM] come and give you an update, we were here about a year ago, and you acknowledged our work. And we still very much appreciate the support and also the support that we've received through Austin public health, a huge partner in our efforts. And, we just want to say thanks, we celebrated, our two year anniversary, a couple of weeks ago. And so as we look back over our two years of work, we've made tremendous progress. And so people ask why we do what we do next. Slide, please, people ask why we do what we do, we know that, black and brown men have the highest rates of disparities. And among African-American men, the leading causes of death are stroke, cancer, hypertension, all of those that really have a negative impact on men of color. And so the reason we do what we do is because we believe that [10:54:54 AM] do is because we believe that our focused effort allows us to address these issues. And our mission is, is pretty straightforward. And our vision is pretty straightforward, we want to remove those barriers that exist that keep men from accessing care. There are many clinics in Austin, in Travis county, but if you look at the number of men of color that access those services, it's really not at the same level of other folks. And so, we took the time to understand why. And over 46% of black men have had negative experiences when they go to the doctor or, engage the health care system. And so our goal is to really create pathways that are culturally appropriate, that will meet men where they are and at the end of the day, our the reason we do [10:55:54 AM] the day, our the reason we do this work is to save lives. And as we as we lift up men, we lift up their families. And so that's the reason we do it. Our value statement is a life saved is another life that really can continue and contribute, positive. Positive to society and to themselves. Next slide, our three main focuses of work are in the space of mental health and we've learned there's no greater need than mental health. And I'm happy through our partnerships that we have with integral care and community care, we have resources at our clinic, which is located at 6633 highway 290 and, the black men's health clinic in partnership with community care. Community care is our clinical provider. And so as a result of that relationship, we're able to leverage those services. So they bring the clinical staff, the doctors and the nurses, our role [10:56:55 AM] doctors and the nurses, our role is really, ahead of all of that. We do the outreach, we do the engagement, we establish those trusted relationships in order for men to come into care, so our three pillars are mental health. And secondly, physical health. Health screenings are important. And we're really pushing hard in that space because early detection Ann makes a difference. And with men of color, generally there are conditions that people are not aware of and really have not been, let's say, conditioned to really take opportunity in, in advance to address what might be happening with your health. And then the third is social determinants, we can't ignore that, so in our work, we partner with people to help us address things like housing, food insecurity, transportation, economics, jobs. That's a whole body of work that has to be [10:57:55 AM] body of work that has to be addressed as we, employ our holistic approach to addressing the needs of men, I want to really emphasize the fact that we don't try to do what other people are doing. It's not our goal to duplicate, but it's really to, fill that gap that exist, a core principle that we operate from is leverage and collaboration, we don't need to be trying to move into spaces that are already there. We want to make those spaces more effective, especially when it comes publicly funded agencies. And we believe we've done that, we connect with all the major organizations with central health, Austin public health center here, community care is a huge partner. And we even go outside of Travis county in some cases, we're currently, in the process of expanding our reach into pflugerville, into Maner, we've had a conversation with [10:58:58 AM] we've had a conversation with the mayor in Elgin. And so the opportunities to go further with our work are present. I think the most important thing that we can do is establish a value proposition for our work, for people to understand what we do and what it brings to the table and why it's important, critical to continue this work, our next slide. Okay. So I'm going to, turn this over to doctor Wallace, who will talk about, some of our outcomes and results and our structure and how we do our work. >> Absolutely appreciate it. >> Real quick, before I go to the next slide, I hopefully you have in your handouts, our partners and collaborations list is about 16 pages long, and you can see we're here on these three spheres that, Larry Wallace senior spoke about how we're leveraging and we're partnering and engaging with the resources that are available within the community, while at the same time utilizing the funding, and our involvement on that advocacy list that you [11:00:01 AM] that advocacy list that you have, as well, to really get boots on the ground information, as our focus within the collaboration, as you see on this next slide, is really focused on, enhancing the experience. The journey, the pathway, a lot of what we're able to do through the unique mous that we have with all of our partners is more than just a traditional referral. It's more than just, connecting someone. And then you unfortunately have to wait for that individual to come back to you and tell you how that went or, let you know they don't need any further services because we're a clinic and we're able to have business associate agreements and other collaborations with the fqhcs with, the mental health authority, with, local health departments and so forth. We're able to really bridge, in a way, that there has been this ongoing gap, even between providers in their collaborations in local organizations, referring to providers. And as you can see on the slide here, what's [11:01:02 AM] the slide here, what's interesting is it took two years in dialog discussion, going through legal to really establish these joint positions through community care as well as this new joint position, the first one ever for integral care, now located with us as well, we're also what you don't see here is, also in discussions with Seton. We just brought on a health navigator to work directly within Seton to help with referrals from their emergency, ers and so forth. And so hopefully over time, be able to flesh out, a more structured mou as a business associate agreement to be able to do the same thing here. Joint hiring, where we're able to, through the gmhc lens, really focus on that care coordination, navigation, growing the trust back into the system collaboratively, we're also working through discussions of, creating a more formalized mou with Austin public health as well with Austin public health, [11:02:03 AM] well with Austin public health, the team has really been leveraging, and utilizing back and forth between our team and Austin public health when it comes to community events, screenings and know your numbers campaign, as well. This next slide that I think is very significant and of importance. I don't really like to read slides, but I definitely want to read this this statement on the right side that out of over 1400 federally qualified health care clinics and community care, has 29 clinics, is the largest in the nation, bmc is the only black men's health organization with active partnerships with fqhcs. We have a formal business associate agreement with lone star circle care and community care, our physical location off of 6633 highway 290 is identified as one of the 29 clinics under community care, so we're getting ready to go for a joint certification and so forth. And as you can see from there, it says many of the organizations that advance black men's health are not clinics nor [11:03:04 AM] men's health are not clinics nor associated with clinics. Instead the black men's health clinic, unlike most of them, just provide therapy and health education, so again, the way we're partnering this different design of care coordination, navigation is really providing physical, behavioral and social determinants, service services on site and also into the community as well. So, when you look at the target population as well as the secondary population , everything focuses around the care. You can trust that is the focus here. The trust as far as, you're going to be navigated, you're going to be informed of what that journey is going to look like. You're going to be informed of what paperwork and help filling out the paperwork. But at the same time, listening to the individual and what their needs are and getting them coordinated to the right service , for them. And so you see, in this first circle, we're intentionally with our primary clinic client, those that are [11:04:04 AM] clinic client, those that are underserved, underrepresented of, low to no insurance as a target population until often most of the systems in Ralls feel as if I'm poor, I'm getting poor services. And that's the different focus here. We're trying to make it feel as if you shouldn't have to be a vip. You shouldn't have to be a senior senior leader to feel as if you're a person. Ann. And so that's really what we're trying to bring in collaboration with all of our partners, especially where our tax dollars are going into we there's a level of accountability, but in this sense, instead of pointing fingers, it's saying, how can we work collaboratively, and then with that, because of the way we're messaging the way we're branding, that this isn't just for underserved, underrepresented live, even though this is a target population, it's open to everybody. So then we're bringing in the secondary clients, the ones that want to be a part of a focused organization like this for people of color, one that's [11:05:04 AM] people of color, one that's going to provide this more hands on support and assistance, where others that have financial capability, we usually pay for that additional hands on concierge liaison on a quarterly basis. Or in this sense, we're actually being funded to do that for everybody. And so you see here the two tiers, but we're primarily looking and focusing on the funding that is currently going to underserved, underrepresented populations. And how are we helping the system better engage, better provide a service from an expert point that they start using the services that we're funding them for, and then you see the behavioral where behavioral health also connects into what I find interesting on these numbers that I wanted to show to you is, is we're in two years of providing direct services. Last year, you see unduplicated clients. So this does not count engagements recurring visits of clients. But this is unduplicated of last year, and then you can see so far for this [11:06:05 AM] then you can see so far for this year, this is only six months in. We've already hit, about 100% of what we did. Unduplicated clients last year. The biggest difference and biggest change was one year, one not known year two, more known, but we also received more funding and more support, especially through the current contract that expires, this September, through that council approved through Austin public health, and so what you can also see here, which is of interest is even though we're tailored for the most disparaged population, black men is being utilized by both black and brown. It's being utilized utilized by other populations because it's more about the experience and just the name. When you look at the other slide next to that, what I find of interest of highlighting here is the age group. When you do a normal comparison of who integral crashing people's community clinic is seeing and others, they're usually focused [11:07:07 AM] others, they're usually focused for this population that our target population is usually 18 to 24, or it's more higher on the side of 55 and up. Uniquely we are actually hitting into the population that is the population that most frequently does not want to go to the clinic, does not want to see a doctor, and then it becomes the issue when they become older, also when you look at the eligibility, a significant change from self-pay and private pay to this year, from almost 63% to this year, roughly 24% are self-pay and private pay. So a significant shift into reaching our actual target population and what I would really hope you take away from this is what we're doing, even though it's labeled black men's healthcare. And it's for men of color, their immediate families, and those with extenuating circumstance. What we're doing and how we're going about it is really systematic change that improves engagement for [11:08:08 AM] improves engagement for everybody. If we can improve the engagement for the most disparaged, it automatically improves the engagement for everybody else. And then lastly, we're also are working with various academic organizations, we intentionally for year one and part of year two was all about the client engaging with the client, so a lot of the administrative stuff, we've been blessed and fortunate to get a lot of support from the academic organizations, because we know do we either spend a year trying to get administrative sound and have all the right things in place, and then we lose engagement with the community, or do we focus more so on the services, partnerships and collaboration and making sure, we show immediate impact and immediate change to people's health and then work this year and next year to really, more or less structure rise. The best practices is the best scenario cases so we can be able to take [11:09:11 AM] cases so we can be able to take this, as Larry senior stated, to other areas within the city with other other areas within the county, because for us it's more about just give us space. We need funding for a navigator, an outreach person, but we're tying in and connecting to services that are already being funded in the community, and with that being said, this is our board, we intentionally, brought on a board that's health, background experience. In our staff and team is primarily non-health. They come from different industries, they come from different backgrounds, a lot of them, 55% come from, some aspect of unhoused and homelessness, and so they're the ones that are really, looking at the different services and programs that are available through our partners, our collaborators, the messaging that's happening and saying this would never, capture me or the way this is messaged or the [11:10:11 AM] way this is messaged or the pathway through this, is a detractor. And so that's where a lot of the collaboration is happening. That's, that's moving the needle that you're seeing, and with that, I turn the mic over for any questions that you all may have. >> Thank you. Colleagues, any questions? >> I guess I've just one question. I'm trying to look forward for y'all. What what does success look like? Is it, significant growth which would suggest then there's significant need or is it, not that type of growth. And hopefully then we're meeting the needs through kind of the systems in place. And I'm just curious what you see the future for success look like for you. >> So for me, success number one looks like we can measure our result, what's the outcomes? What change are we making? And once we can identify, quantify and be able to state, those changes, it's a journey. And so [11:11:11 AM] changes, it's a journey. And so at what point in the journey can we look and say we made progress, we avoided, er, admissions. We avoided people going into the hospital, we were able to change, the pathway of chronic disease management and had an influence on the health status. So for me, that's success. But beyond that, yes. We've been really approached by many communities, about our work and would like for us to expand. And we're a small team, and we can only go as far as our funding allows. But success is when Ann, folks can look at our organization and say, if you want to reach African American men and Latino men, because over half of our clients are Latino. And so if you want to reach that population, success to me is come to us, we have the data, we have the know how, we've done [11:12:13 AM] have the know how, we've done all the research. You don't have to do it. Rely on us as the agency to make that happen for you. >> You know, for me, it's almost dualistically, right, one definitely tying into what Larry Wallace, senior stated, which is, and we're having this ongoing conversation, even with community care and central health, that what we're focused on as this collaborative effort of improving the system and how it engages, how do you measure the engagement piece, how many touches and so forth to build this trust to where now we have our director of care coordination and navigation. There are certain patients that will not schedule an appointment unless she's on the phone with them, just to give that sense of it's good, right, how do you measure that? Because oftentimes it's being measured by how many people actually show up for an appointment in the no show rate, but what's actually getting them [11:13:14 AM] but what's actually getting them to even come up to experience the first no show rate to actually experience. And go through the process. Most of our individuals are are being enrolled in map for the first time. Some are coming through through different avenues. Our diversion program that we started with Austin echo that year, two, y'all did an amendment for us when those funds went out to carve some funding out for unhoused in client assistance, right. So we're able to bring people in through that door that others are not able to and say, hey, you also have to sign up to be a client and set up a basic assessment of your mental and physical state, we have individuals that are coming through through our barbershop program, where they get $25 off, which is basically the copay they're paying to come see a doctor, and so how do we capture those things of demonstrating this impact in the community, partnering with youth sports organizations, non-school AIDS, where they don't do physicals, they don't do numbers for the [11:14:16 AM] they don't do numbers for the kids. And we're bringing that through a lot with the collaboration with Austin public health and, men's sports areas. We're looking at a discussion with the ymca. Ymca now to bring screenings for their organizations and stuff at the north Austin in the east communities and so forth. So it's one is better being able to capture that, that usually because of the way funding is to fqhcs in the mental health authorities and so forth, are more behinds and seats and no show rates than the engagement, the trust building that we're focusing on behalf of our partners, and then the other piece is now the growth that is happening being asked to come into community first, being asked to, launch our satellite location in pflugerville on the 29th with abundant life church. Being asked to come into those other places but maintain gaining the quality of engagement and hands on time. I don't want to say time consuming [11:15:18 AM] don't want to say time consuming in a negative way, but the time that's needed that we've lost sometimes by going to technical, and more, expecting people to do the research, go to the website, then actually taking the time out to go through these processes with them. That's what we're taking on. And I think to be successful with the natural growth that is happening, more funding is going to be needed for bodies to bring on the bodies. >> Well, thank you very much. Appreciate the work y'all are doing. >> Thank you. >> And just to build off of your comments, you know, one thing I was going to ask about is, is the bmc's work related to our unhoused population. You mentioned that there was some work that y'all did with echo, how are y'all plugged in, or to what extent is outreach done with our unhoused population? And do you foresee any opportunities where we could further integrate bms with our unhoused? >> Several opportunities. Honestly we just had a meeting with doctor Patrick Lee, over at [11:16:19 AM] with doctor Patrick Lee, over at central health CEO last last week, he also mentioned the same thing as well. We'll be doing a follow up with his team in their efforts regarding, that space as well. I'll tell you what we currently have going on in some discussions that have been going on, currently we do have, an individual that basically oversees unhoused and diversion efforts. She's going out into the encampments and so forth. I would say 41 plus individuals have been taken care of, with roughly $32,000 because she's working with other partners and collaborators to bring the cost down, exemption of fees. Individuals are getting plugged into partnerships like goodwill and others, we've done funding of bodies, but we had to pull that back because of funding restrictions, we did fund bodies to be embedded with queer Topia, to be embedded with, hungry hill foundation, we've tried to figure out how we support other organizations like walking by faith ministries and in jail to [11:17:19 AM] faith ministries and in jail to jobs. So more funding in those aspects to bring bodies on. We can intentionally ramp up that. But we also want to for however many bodies we bring on still be able to have a restricted funding account for diversion, for client assistance, because even if someone may be map one, 50 or so forth and they have to play a small, copay, sometimes they still can't even pay that. We've supported in purchasing the glasses. The prescriptions and so forth. And, again, coming out into community first. So that's going to be a new area. So how do we, be able to grow into a dedicated person into those spaces? Right, we've been having the conversations with Austin echo in the collaboration that's going on, and potentially being involved in that effort as that conduit of who's engaging with those individuals on the more day to day basis. So that [11:18:19 AM] more day to day basis. So that way, if there's changes or needs within the physical and the behavioral health, we're there to be able to make those phone calls and say, hey, instead of coming out next week, this individual needs to see you tomorrow. This individual needs to see you today or and whatnot. So there are conversations going on. But like anything else, a lot of it is kind of restricted on funding availability. A lot of it on our end is restricted on being able to bring someone else on. And not have them, be concerned about, job security. >> I mean, I just think it's the, you know, health care services in general is a preventative measure for folks at risk of falling into homelessness. I had one conversation with an unhoused neighbor who talked to me about he needed cataract surgery, was unable to navigate the health care system, didn't get his much needed eye surgery, lost his job as a result of it, lost his house as a result of it, and has been living now, you know, three years in one of our parks. And [11:19:19 AM] years in one of our parks. And so I think that and I and you can count on my continued support for this level of service, the programs that you all offer at bmc, I think it's so important for our community. And I thank you all and appreciate the work that you are doing for our black and brown community, and would like to see further investments in the work that you all are doing. >> So appreciate it. >> Thank you. Colleagues, any further questions? Thank you. Thank okay. Moving, to our final briefing for today's committee meeting. This is a briefing on the best single source plus collaboratives work related to the provision of homelessness prevention and rapid rehousing services. I believe we'll be joined by Joe Katherine Quinn from caritas and Julia Spann from safe alliance for this update. Welcome >> Thank you, we're so pleased to be here, thank you so much for the time on your agenda. We felt like it's been a long time since we've brought an update, and a lot has changed with the [11:20:20 AM] and a lot has changed with the collaboration. And just with, our work in the community in general and thought it was time for an update. So Julia is going to go first. >> Hello and thank you. Hello and thank you. I'm Julia Spann and I'm the CEO of the safe alliance. And I'm the chair of the best single source plus, executive committee. So I'll go back and give a little history. I was just doing the math, and we actually started this collaboration 22 years ago, 23 years ago. Exactly. And our first funder was the city of Austin. That took a risk on four agencies that have joined together to expand greatly. We can go to the next slide, please . So the best single source is a collaboration of 13 community organizations. We have current partners that are funded and some unfunded partners, and [11:21:21 AM] some unfunded partners, and we'll talk a little bit about that as we go through. But you'll see this rich group of funded partners who work together to be able to ensure that folks get housed and that they stay housed. And so when we first started this, the entire purpose was to work with people who are at risk of homelessness. It was a front end prevention program which worked with folks who were finding that they couldn't make their payments for rent or mortgage assistance. We provide them with case management and financial assistance, and we did so at a rate that prevented them from having to go from place to place to place to place to get their needs met in order to stay housed, and the thing that was really different about that, that has been our hallmark throughout the years, is that we're coordinating between us. We're using one, data system. We're using the same forms. [11:22:24 AM] We're using the same forms. We're able to report consistently on the numbers that all of us are achieving, and we're being we're able to show that folks aren't moving from place to place to be able to get help and get their needs met. As we've been able to increase that and the city has been our partner throughout the years, we can't thank you enough for that. There have been major changes and program shifts as we've gone through this, but what we have found is that we have consistently been able to keep people, housed. And when they finish with, best single source plus and the case management piece, which is very intense, the amount of money they need and working with partners to ensure their security and systems that we know that work, it really does keep people from reentering homelessness and, being effective and having the lives that they dream of and wish for. So, Joe. Catherine. [11:23:24 AM] wish for. So, Joe. Catherine. All right. >> Do I control the slides or do you, I can do it. >> Or you. Okay. Is it this this one right here. >> Okay. Thank you, so I want to talk now just about the path that the collaboration has taken through the years and where we find ourselves now, we have, you know, always been attuned to the changes in the community. And one of our values as a collaborative is to be innovative, to be, you know, to evolve with the changes of the community. So that we are always addressing, the needs in effective ways. And you can see there our, you know, our purpose , our vision, our mission. I'm not going to, read all of that to you, but one of the pieces that we engaged, you heard Julia [11:24:26 AM] that we engaged, you heard Julia talk about the very first sort of model of the work that we had in the beginning and in about 2008, 2009, somewhere in there, we started testing the rapid rehousing model, which was a new intervention in the homelessness industry. If you will, and people around the country were getting good results from rapid rehousing. And so we said, why not Austin? And we jumped in and we started learning it. We trained all of our staff and took it from there. And of course, the best training is in the actual doing of it. And because we are, you know, are very good at watching our data using our data to correct and improve what we do. We have developed a really effective rapid rehousing model across the collaboration. The real beauty of the collaboration Ann I would say I want to point this out, is [11:25:27 AM] say I want to point this out, is that you have, all our partners, each of the partners serve different niche populations burns across the community. However all of those niche populations are populations that are more vulnerable to homelessness than the general population. And so the beauty of having the best single source plus tool in your tool chest as an organization, Ann, is that, you know, you're not having to reinvent the wheel here. You've already got something and you have a collaborative of, of fellow professionals supporting you in your efforts. People to bounce things off of. And, just a community that, that, emphasizes excellence and, and perseverance in this work. And so you're not having to send your client with a referral to another organization. You're [11:26:30 AM] another organization. You're able to serve that client within your organization. And when bsw plus first started, not there was only one organization that was really doing housing, and that was caritas. And the other organizations did not have that expertise. And so this was the opportunity to embed that expertise within each of those organizations. And so we were really poised well to do, by the time rapid rehousing, became an evidence based practice, we, we were able to embrace it and have really taken it forward, some of our services are the comprehensive case management, financial assistance and we're we're really, really grateful. Through the years to have had a robust contract with the city of Austin to where we're not having to pay 50% of the rent, we can pay 100% of the rent and we've been able to actually keep up with the cost of rent. And I will say, we can't serve as many [11:27:31 AM] will say, we can't serve as many people as we used to be able to serve because of the cost of rent, but we are still poised to actually take care of 100% of everybody's need, when they come to us in their housing crisis and when we are engaging with them to end their homelessness through rapid rehousing. One of the recent, opportunities and challenges. It's an opportunity and a challenge all in the same space is that since since, the since arpa funding, became a thing and became a resource for the city of Austin and for our community, we're very grateful for that infusion of extra funds after the pandemic, because, as we all know, the pandemic was very damaging across the country, and Austin is no [11:28:33 AM] country, and Austin is no exception to that, at the same time, the arpa funding that came in for people experiencing homelessness and people at risk of homelessness was really only targeted at people already experiencing literal homelessness. And that was when a shift happened in our contract, where we were not able to continue to provide prevent Ann services, when in that very first slide, when you saw unfunded partners, those are partners that are still engaged in our work or in their work and in our collaboration, but they are not directly involved in the collaboration's work anymore because there's not any more funding for prevention, we would love to change that in the future and make the collaborative whole again, with the full complement of services across from prevention all the way to rapid rehousing, and have [11:29:35 AM] way to rapid rehousing, and have both of those components so that we can, do our work the way we used to do it, which is along a comprehensive continuum. One of the, sensitivities, I think, about prevention work is that not every body who needs who's being evicted or needs help with rent and utilities assistance is actually going to enter the homelessness system. But and with bsw plus, we have developed a, a, a, a mechanism. We've developed an assessment tool that actually identifies the folks who, can't pay their rent. They're at risk of eviction, whatever their situation is, their housing instability. We are able to assess that family or that individual and understand if, in fact, they are going to end up homeless and if [11:30:36 AM] going to end up homeless and if that is the case, based on our assessment, then we enroll them in our homelessness prevention program. But we're not just Willy nilly, serving everybody that shows up that says, oh, I can't pay my rent, because that that's about 80% of people who can't pay their rent will not enter the homelessness system. So it's the 20% we're trying to get to. And be sure that that's actually homelessness prevention , you can see the impact that we had in the most recent fiscal, closed fiscal year in 23, we are on target. To, you know, at least meet those those numbers if, if not more. Well, is that it? Last night it is. Okay, so that is the last slide. I thought there was one more for some reason, anyway, go ahead, Julia, I'll just add one piece. >> An example. You might need to turn yours off. I might just add [11:31:37 AM] turn yours off. I might just add an example of how that prevention piece works. So safe alliance, where I work had both prevention dollars and the rapid rehousing dollars. And so we're able to prevent it currently for somebody who's on the back end that's been coming through rapid rehousing, as you all consider budget, budget opportunities, I, I encourage you to think about this prevention side on the front end, the savings to a family, to individuals and to our community of not having people enter the homeless system is enormous. Yes, if you can pay for that on the very at the very beginning. So it saves somebody, we can identify somebody who is going to lose their housing because of domestic violence. And we know that there are years of trauma and the years of all the barriers that they have experienced, because of sexual assault and domestic violence and trafficking in is, will be a long recovery. But if we can [11:32:40 AM] long recovery. But if we can actually help them because at that moment in time they have housing, if we can help them keep that and stay there, we avoid a longer time and such negative health and mental health consequence of living on the streets or being homeless. So to me, it just makes good sense to get ahead of it, it's fiscally responsible. And so being able to have both those pots of money for, to, to help those people who are already unhoused, as well as those who are on the brink of homelessness. And as Joe Catherine says, we've developed a great tool for identifying who is going to be the most most vulnerable. For that makes good sense for our city. I think as a city and a community, we need to have all the tools to identify and assist the people who are in this position. In >> I would just add, one little [11:33:41 AM] >> I would just add, one little fine point to that is when folks are assessed, the one of the key factors that points to someone's vulnerability to fall into homelessness is having experienced homelessness as a child, many of our unfunded partners are partners who serve families with children. And, you know, right now they don't have the tools that they need to do that. Homelessness prevention and it is in all of our interest to prevent so that we're not having to do so much intervention in the years to come. >> Yeah. And thank you for that. And I and that reminded me that we do have, a dedicated fund. It's a voluntary fund through our utility bill that helps with youth homelessness through our school districts. So that might [11:34:42 AM] school districts. So that might be a partner. Y'all might want to consider having conversations with, to the point that you just made colleagues. Any questions? >> I'm I'm a little curious, on some of the data you talked about how how how do you assess your assessment? You know, what is its accuracy rate? Do those individuals assessed go into hmmis. So you see if they pop up or not, like how are we assessing the assessing that is how we developed our tool was by tracking through hmmis, the folks that we didn't help. We continued to track them and, and determined, you know, what percentage of the folks that we didn't help were hitting the homeless system. >> So of those, you know, you said it's about an 80, 20 split, but what is of your you know, if your model says, yes, we think you will become homeless or no, we do not. Are we? Do you think you are I guess experientially, [11:35:42 AM] you are I guess experientially, are we under capturing like are you being extra cautious? And so we see additional people fall in hmmis or the other? Are you being, you know, you think you have it, but we have a few people captured that are maybe, you know, not. And if I'm asking that question properly, I'm just curious how I think I know what you're asking, when we originally developed the tool and we were testing it, our test results were that we were very accurate, you know, and, and we tested it along the way and made tweaks in, in the assessment tool before we got to the final product. And along the way, we were testing to see, how many people were engaging with the homelessness system and what their risk factors were, and are y'all talking to or is there any collaboration with, you know, our, rent support program through Elton? You know, are those individuals that might [11:36:45 AM] those individuals that might need assessing? We should consider assessing if they're coming to an organization like that saying, hey, we can't afford to pay our rent. >> Well, el Buen is not a collaborative partner with bsw plus, not that we wouldn't be open to them becoming one, but, you know, and of course, we would be open to having a referral relationship, you know, be, you know, we want to help all these different places in the, in the community. >> And how is our diversion or, and our diversion, our prevention dollars for do you have enough dollars for everyone? You we don't have any prevention dollars. Okay. So for if you identify what happened, what happened is the arpa dollars came in okay. >> And before the arpa dollars came in, we were using regular city dollars for those prevention funds. The arpa dollars didn't allow for prevention. And I think and I'm I'm going to speak like I know what I'm talking about. And I and I don't, a peek behind the curtain at the city, but I'm assuming that a decision was [11:37:46 AM] assuming that a decision was made somewhere in the city staff that when we got the arpa dollars, we were just going to use those. And no, no city of Austin dollars for the rapid for and just focus on rapid rehousing for this particular collaboration. I won't speak more broadly than our collaboration, but for our collaboration, the regular city dollars went away. >> So for how do y'all pay for the individual? You know, the story you told of someone who you assess and you think they're going to, fall into homelessness ? And so it sounded like there is some and that may be your private funding, but there is funding for keeping them in their home. No, there we are not currently doing that work within the collaboration. >> Okay. Got it. >> We're only doing rapid rehousing. >> What is do you have a cost to like per client of what that would cost to keep, you know, [11:38:46 AM] would cost to keep, you know, to, to pay a certain period of time rent like not today but I can I can get that for you. >> Okay. >> I can send that my last question because you talked about the rapid program. And I know caritas has been very successful with the outcomes as it relates to that program. You know, we've had a lot of discussions about the time length of rapid rehousing, how long it should be available, whether or not the length, now, you know, up to 24 months. Is that because potentially we're putting the wrong clients into rapid rehousing. So I'm curious from your perspective, live and y'all's work, what is the kind of the right level of if we got the right clients into rapid, how long should that program really last? >> Two years. >> Okay. >> It works really well for 24 months, and sometimes people can transition out before 24 months, but 24 months is adequate. If the, the, if the right clients [11:39:47 AM] the, the, if the right clients are referred to rapid rehousing, you know, or paired with rapid rehousing, if someone who is extremely vulnerable and really is more suited for permanent supportive housing, there's really it's really, really difficult for that person to become completely stable with a source of income, a way to pay for their housing in 24 months. Okay >> That's it. Thank you so much. >> Thank you, does the bsw plus share case managers within the collective, or does each organization have a case manager? >> Each organization has their own team of case managers. That works, you want to explain more kind of the structure of the collaboration? >> Because my ultimate question is and that's good to know if each organization has their own case manager about how many clients does each case manager [11:40:48 AM] clients does each case manager serve because it's so scattered site for most of us, a good caseload is about 15 people, point in time. And each one of us has our own caseload. And that comes because we're looking at what is the causative and preventative issue that that really was at the core of somebody's homelessness to begin with. And so for safe, it's been frequently related to trauma and homelessness for somebody else. It, could be other reasons. And so, you know, lifeworks is a partner. Theirs is around youth homelessness. And so all of us have our own needs to be able to help somebody who has become homeless as a result. But we have case management that also addresses those very special issues. And then we all share. So caritas is the sole fiscal agent. Caritas is paying the bills, keratoses paying the [11:41:50 AM] bills, keratoses paying the sending the rent. But the case management happens through each agency and each agency is sending the rent. The rent request to caritas to take care of. So it comes to a really easy way of both tracking outcomes and tracking finances. Very good. It was a good systems improvement, like we were so proud of when we came up with it, because it was the first time in a long time that, that our community took this really systemic look at, what was getting barriers that were getting in folks way and then being able to innovate and continue to improve. That has been good. And responding when our community really needed us to address literal homelessness and knowing that we could do so. >> Yes. >> And remind me. And when did the collaborative commence? >> 23 years? >> 23 years ago. So it was about 2003. >> Very good. >> And, final question. How do how do people get referred to [11:42:52 AM] how do people get referred to bsw plus, we utilize the coordinated entry system. >> Okay, that makes sense. >> I was wondering and all of our data is entered into hmmis except for safe alliance. >> Very good. >> Well, thank you for joining us today. And I also would be interested if y'all could put together a proposal regarding prevention services. I would be interested in taking a look at that. >> Thank you very much. Appreciate your time and attention. Thank you, thank you. >> Okay, colleagues, that is our final briefing for today's committee meeting, the last item on our agenda is just any discussion on future items as proposals. Okay. We will, not have a meeting in July as we will be focused on budget, but we will reconvene in August, thank you, everyone, for your participation and contributions to today's important conversations. If there's no further business or objections, I will adjourn this meeting at [11:43:53 AM] I will adjourn this meeting at 11:43 A.M.