Public Health Committee (PHC) Meeting Transcript – 9/3/2025 Title: ATXN-1 (24hr) Channel: 1 - ATXN-1 Recorded On: 9/3/2025 6:00:00AM Original Air Date: 9/3/2025 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. [10:00:26 AM] hi, everyone. Good morning. Vanessa Fuentes, mayor pro tem, city councilmember for district two and chair of our Austin city council public health committee. We are here in city hall council chambers. It is 10 A.M. On Wednesday, September 3rd, 2025. Welcome everyone to our September public health committee meeting. Thank you all for being here today. Today's agenda is fairly short, which I hope is informative to the council as a whole. As we are on sorry, I'm reading the wrong thing here. So for today's agenda, we are going to have, the committee will discuss the sobering center board of directors. Then we [10:01:03 AM] board of directors. Then we will receive a briefing update on homelessness services for older adults, followed by a briefing update on the status for Austin public health federal grants. Any questions about today's agenda? All right. First, we'll welcome speakers from the community. May the clerk's office please get us started with the first speaker. >> We don't have any speakers today. >> Very good. Thank you. We'll now move on to approval of the previous meeting minutes for item number one. Can I get a motion? Thank you. Motion by vice chair duchen and seconded by council member alter. Any objection to approving the meeting? Minutes from August 6th, 2025, as presented. Okay. Seeing no objections, those meeting minutes stand approved. Next we will actually I'm going to let's do the sobering center item last okay. Great. Thank you. So let's skip that item for now and move to the [10:02:04 AM] for now and move to the briefing on homelessness services for older adults. I'd like to welcome doctor Karen, CEO of family elder care, to provide us a briefing on homelessness services for older adults. Thank you so much for being here with us today. Welcome. And did we have public health staff that would like to also give remarks? No, sorry. Is there anyone else who'd like to provide an update? No. Okay. Just okay. Oh, perfect. Thank you. Thank you. >> Thank you. Good morning, mayor pro tem Fuentes and honorable members of the public health committee. My name is doctor Aaron Alarcon, CEO of family elder care. First and foremost, I want to express my [10:03:04 AM] foremost, I want to express my gratitude for the invitation to present for this committee and the opportunity to share with the community the work that family elder care has been doing for more than 40 years to eradicate homelessness among older adults. And if I may, I start by providing by providing an introduction about family elder care. Next slide please. Our organization was created in 1982 by two visionary social workers that aim to create a resource center for families that decided to be caregivers for the elderly members in their families. Hence the name family elder care. From that small organization, with only a handful of employees now, 43 years later, family elder care is one of the leading voices in service providers in the aging and disability field in the state of Texas. Last year alone, we served more than 16,000 individuals in our community. We have four departments and 12 programs, all of them with the overarching mission to provide to provide services that promote dignity and stability among older adults and adults [10:04:05 AM] among older adults and adults with disabilities. Our commitment to equity and justice does not only apply to our clients, but also to our workforce. We were the first nonprofit organization in Austin that implemented a minimum living wage of $24 an hour, and is currently testing at 36 hour week for our employees in order to promote a healthier work life balance. As some of you know, family elder care is currently building the first lgbtq+ affirming affordable housing community for older adults, which will be our third property and will expand our footprint, which is based on excellence and compassion, advancing our goal of ending homelessness among older adults. Next slide. And speaking of homelessness among older adults, let me share some statistics that I have shared with you all before and that I will continue sharing in whatever opportunity. As these numbers, in my view, show, how neglectful we as a society have been towards marginalized older [10:05:06 AM] been towards marginalized older adults, which are one of the most vulnerable populations. According to the pit acronym for point in count organized but echo, that took place in January of 2025, the number of individuals over the age of 55 experiencing homelessness in central Texas, both sheltered and unsheltered, increased by 70% in two years. This unfortunately matches a trend that older adults are the fastest growing demographic experiencing homelessness in the United States, with numbers projected to triple by 2030. Very alarming, but there's hope. And to talk more about the hope, turning to action, I'm going to let my team share about our four programs that are fighting homelessness among older adults. Start going down as opposed to going up. Let me introduce you to Emily Habermehl, senior director for the supportive services department, who will talk about our service coordination program. [10:06:06 AM] coordination program. >> Hello. My name is Emily. Next slide. I'm the senior director of supportive services, and I'm going to talk about service coordination. At our core, what service coordination does is connect older adults and adults with disabilities residing in low income, affordable housing communities with vital community resources so that they can age in place. Typical tasks of a service coordinator can be something as simple as assisting an older resident with their smartphone all the way to crisis intervention and connecting residents to vital mental health care. Transportation needs. Doctor's appointments. We can help set those up, and essentially, we are the go to for residents at the property who need help. Service coordination services at family elder Gaar family elder care, excuse me, began in 2010. Our service coordinator's office at their assigned properties, making it much easier for residents to obtain assistance. We currently provide service coordination to ten senior low income housing properties and several smaller family properties. Next slide. How [10:07:07 AM] properties. Next slide. How does service coordination help? We have three areas. And I can have some outputs to go with those. First fiscal year 2024 service coordination assisted 1014 residents. Year to date 2025. We have assisted 677 residents to date through service coordination. We've helped 412 residents obtain government benefits such as snap and medicaid, and including utility and rental assistance. We engaged 79 residents and eviction prevention and housing retention services, including assistance with lease renewals and voucher recertifications. We've assisted 57 residents with resolving conflicts that were having with property management. Based on a recent survey, 79% of the residents surveyed are aging in place and 87% report improved Independence and safety. Next slide. I would like to share a [10:08:07 AM] slide. I would like to share a resident success story. Mr. Sanchez, a 70 year old man, lives alone at Lyons gardens. He had to stop working early due to his visual impairment, and this did affect his social security credits and therefore his income was very low. Paying rent was very difficult for him, and this greatly impacted his quality of life, and it put his housing at serious risk. The Lyons gardens service coordinator requested assistance from Mr. Sanchez, optometrist, to obtain certain documents to appeal the social security case and adjust his income to social security disability income, which is much higher. He successfully was able to appeal that case. The residents income increased. The service coordinator also helped him with an application to assist with his electricity bill, and he was also. They also coordinated free meals for him, which again helped his financial situation greatly, and he was able to maintain his housing as a result. Thank you [10:09:09 AM] housing as a result. Thank you so much. And next is dahlia Diaz, housing program manager. >> Thank you. Next slide please. I'm going to go over our rapid rehousing program and our permanent supportive housing programs. Our rapid rehousing program offers short term rental assistance along with wraparound support. Service is designed for individuals who are literally homeless or fleeing domestic violence, and whose income is at or below 200 of the federal poverty level. We take a trauma informed, individualized approach, meaning there are no preconditions to receiving help. Core services include housing identification, financial assistance for rent and move in costs, and case management. Next slide. Many of our clients come to us after experiencing long term homelessness, often living in places not meant for habitation. Some inner emergency shelters with really [10:10:10 AM] emergency shelters with really complex and challenging backgrounds. Once they're enrolled in rapid rehousing, they begin working closely with our case manager team. Through the partnership, they're able to make real progress, moving toward stability, self-sufficiency, and ultimate success. As you will see, there is a picture of an individual who was housed homeless for seven years, received assistance through us, was able to get housing, found a job and secure a vehicle that opened the door for other independents. Next slide. I would like to turn our attention to our permanent supportive housing program. It's a critical part of our continuum of care. Psa is designed for individuals transition out of homelessness who need more intensive, long term support. These services are grounded in the housing first and trauma informed care [10:11:12 AM] first and trauma informed care models, and they focus on helping clients achieve lasting housing stability. Next slide. Currently, our permanent supportive housing programs include downtown Austin community court, pecan gardens, and family eldercare. At our dac project, we offer 46 scattered site efficiency units. They are centrally located near transit. Referrals come directly from dac. At our pecan garden apartment. We have 78 units developed through the Austin motel conversion plan offer an on site case management, wraparound services through service coordination, saw peer support and we have partners like the UT school of nursing and bluebonnet trails with our hud. Psh, federally funded into 2022, offering 37 scattered site units in partnership with central health. It supports individual leaving medical respite to secure [10:12:13 AM] medical respite to secure stable housing during recovery. Ultimately, our goal is to empower clients with tools and support them to to need to maintain housing and build greater employment. Our individuals. Next slide. Please. Provide that intensive case management service. In order to do that, these programs focus on long term stability through personalized service planning, goal setting and developing the skills. Next slide I just wanted to share quickly about one of our stories, our success stories that we received back in 2022. When the client came to us, they were living in a small, windowless apartment. Our case management team was able to find employment, improve the credit up to 740, which is very impressive. And [10:13:14 AM] which is very impressive. And they found a job through goodwill and proudly was able to get a new car and planning for homeownership. We are deeply honored to have walked along them on this journey. On September 13th, we will Marc one year since their peaceful passing. Remember not only their challenges, but also celebrating every step of the remarkable success. As we look at the broader impact of our work, I'd like to share where we are today. So far this year, we've served 112 clients through our permanent supportive housing program, and we're on track to serve over 145 by the end of 2025. About 45% of those individuals we work with have seen an increase in their income, either through employment or by accessing social security benefits. And more than half of those households we support have reported feeling more self-sufficient and experiencing better overall health outcomes. Receiving [10:14:15 AM] health outcomes. Receiving services. These numbers not reflect just outcomes, but the resilience of our clients and the dedication of our team. Up next, we have Shelley Bob Kahn, our financial advocacy program. She's going to share some great work happening in financial advocacy. Okay. >> Next slide. Thank you. Our financial advocacy program provides protection from financial abuse and exploitation. We strive to ensure clients basic needs are met and promote financial security and Independence through management of benefits, housing, advocacy, and coordination with other providers. We assist clients in achieving long term housing stability. Next slide. In 2024, we served 640 clients. I just have some information here about those clients we serve. 358 of those were over the age of 55, 345 of those identified as a racial or ethnic minority, 574 of our clients were under 200% of the federal poverty level, with 450 of those being [10:15:16 AM] level, with 450 of those being under 100% of the federal poverty level. Longevity of current clients. Our service is indefinite. Our clients can be enrolled until they pass away, which is often the reason we close. 32 have been enrolled for less than a year. 1 to 5 have 1 to 5 years is 418 clients, 5 to 10 years is 54 clients, and then ten plus is 30 clients. I believe we have a client who's been enrolled for 26 years, some additional program outputs I wanted to share from 2024. 94% of clients surveyed reported services helps them live independently. 100% of reported clients achieved improved financial stability, and 100% of clients obtained or maintained public benefits. Generally, social security, veterans benefits, medicare, medicaid, snap, etc. So what do these numbers mean and how do our services impact housing? Number one, we ensure they are receiving benefits. Clients often do not have a consistent phone, an address [10:16:17 AM] consistent phone, an address email, ways to be contacted. Some some clients simply don't know how to apply for benefits or renew benefits. So our number one goal is to ensure they are receiving their benefits. We establish a budget, pay bills and distribute appropriate allowance funds to ensure obligations are met, particularly housing costs. We pay about $200,000 in housing expenses monthly with the client's own benefits. We negotiate fee reductions and payment plans. We assist clients with obtaining award letters, id records and other documents needed to obtain and maintain housing. We coordinate housing renewals. Again, a lot of our clients can be tough to reach, so we might link them to the program or the property managers or hakka officers. We advocate for our clients to remain in housing and linked to legal services when needed, if they may be facing possible evictions, and we reduce the need for financial assistance. Everything we pay is with our client's own social security or veterans benefits, so this reduces the need for additional financial assistance outside of [10:17:18 AM] financial assistance outside of that. Okay. The next slide, I have some client success stories I wanted to share. Our first client, Marc, had a notice to vacate. He had not found new housing and had received paperwork that his hakka voucher would be terminated due to not completing renewal paperwork. Once looped in his account, navigator assisted the client in finding new housing when he had less than two weeks before he would be evicted, and helped avoid termination of his hakka voucher by completing the necessary paperwork. The second client, Eric, one of our clients, was incarcerated for almost one year. During that time, we were able to maintain communication, continue services. Upon being released from jail, transportation was arranged by his account navigator. He was given immediate access to his funds to meet his basic needs like food, clothing and hygiene items. His account navigator assisted with a spend down to reduce his assets to under 2000, so he would qualify for medicaid. Mary Lee, icf medicaid coverage. Many individuals that we see referred to us have been recently released from [10:18:18 AM] recently released from incarceration and end up homeless immediately due to lack of supports. By staying connected with our clients, we are able to help them transition and avoid instability following incarceration. And our last client who is pictured here, this is Wanda. She was her daughter, used to be her power of attorney. Her daughter resigned, closed all of her bank accounts with no notice, and then handed everything over to Wanda. She was at risk of losing her housing after this event, due to being unable to manage her finances and to keep up on her bills independently. Family elder care stepped in, secured the benefits into a new bank account, and stabilized the housing situation. The client now has secure housing basic needs met as well as access to her favorite luxuries. Again, she loves makeup and skincare. >> Thank you to my team. Next slide to close, I would like to leave you all with one thought. The four programs that we just presented to you serve collectively more than 900 individuals in 2024. It is possible that most, if not all [10:19:19 AM] possible that most, if not all of these people could have ended up in the streets becoming another statistic if it weren't because of the services that family eldercare provided to them. Thank you for your time. And now we would like to take some questions from the committee. >> Thank you. Thank you for providing this important information. I believe, councilmember Velasquez, you requested this briefing. Would you like to kick us off? Okay, colleagues. Councilmember. Vice chair duchen. >> Thank you. Chair, I just have one question. In the latter portion of the briefing, you touched on that there were 640 clients served, but only about 55% were over 55. Can you speak to the amount of folks that you're serving that? I mean, my understanding is the target group that we're talking about is is older adults. So under what circumstances are you stepping in to help people that don't fit that demographic? [10:20:20 AM] that don't fit that demographic? Sure. >> Are population that we serve. Council member duchen is older adults and individuals with disabilities. So in order to qualify for a service, they must be either older than 55 and or with a disability. >> Got it. Okay. Thank you for clarifying that. >> Of course. >> Councilmember alter. >> I have a couple questions for you. I'm going to start with your rapid rehousing program. Are is that a 12 month or 24 month program? >> It's up to 24 months. >> And how has that experience been for y'all? We've had multiple conversations here about, you know, the appropriateness of the match to rapid and that being leading to a longer stay within the program. Have you all experienced a similar phenomenon where you're, you know, more of your clients are [10:21:20 AM] know, more of your clients are going the full 24 months, and then at the end, kind of facing that cliff of where do they go next? >> Actually during the pause, because of the referral pause, it gave us an opportunity to really assess our clients needs and recreate it. A level of service assessment tool so that we're providing more intensive services. So we're not just doing the minimum of what our contract says. So we're spending that additional time. So because we're providing that weekly, biweekly or even monthly, it's fading off to their being able to be more successful. So we sell we see that transition a lot smoother. >> And given that your clients, many of them either would qualify for social security or SSI. Is it pretty common that people have enough income to [10:22:20 AM] people have enough income to qualify, even if it's very low income housing, but not necessarily needing psa level housing? >> We have spent, I would say probably the second part of the 24 months is rehousing to find more of the affordable. So we see where they're at, getting them off the street, helping support them. And then once they do obtain those benefits, we transition them to a second housing that is more long term for them to sustain. >> Got it. I was also curious, as it relates to your scatter site. Psh. You know, that's something that we have been talking about moving more towards throughout the city's investments. And I wanted to see if you had any comparison of pecan gardens versus your scatter site programs, both in terms of either benefits, challenges. Just if you kind of give us a little bit of your [10:23:20 AM] give us a little bit of your feedback on comparing the two programs, if you were to do that, if you could pull the microphone a little closer. >> Sorry, I would say for our scattered sites, it does give them the flexibility to live throughout the community anywhere. But I think with pecan, it's very intentional. Every when we find our location that we take in mind transportation, what individuals need as far as like living and the accessibility that they have to our staff. Like it's just very impactful because they're they're not having to wait for a day or, or even a week to meet up with the clients. They have access to their case manager if they want to drop in to help them with a quick medical appointment, or walk them up to our UT nursing just to because they fell or something real quick. So that time delay is not there. So [10:24:21 AM] time delay is not there. So that is more impactful and we'll be able to provide services a lot quicker. But I do see the benefits for both sides, just very individual. And I like that we have those options for them. So individuals do come and they really want to just be part of the community and have that option. And some really like that wraparound support and need that structure to help transition from being on the streets for a long time. >> And would you say the outcomes are pretty comparable or. >> Yeah, I would say it's really comparable. It's just really seeing what that individual's preference are and where they see them long term. >> Okay. I think that's the end of my questions. Let me just double check here. Yeah. Well thank you all so much for the important work you're doing. It's an important. You know, I saw I knew we were going to have this briefing today. And I [10:25:22 AM] have this briefing today. And I saw an older gentleman standing on the corner, and it really made me kind of pause and just think about how much more we need to be doing. And, and that while this good work is being done, there's still, as you mentioned, at the top, an unmet need. And so I just I'm glad y'all are there and hopefully we can continue this partnership and address this challenge that we have. So thank you all very much. >> Thank you. Thank you very much. >> Thank you. Council member Velasquez. >> Thank you all so much for, for for coming today and for and for this presentation. I had a couple of and also for your service to the city. It's greatly, greatly appreciated. When you were we were talking about referrals. Where are those predominantly come from. >> Through echo. So we receive all of our rapid referrals through echo except for our dac project. Those referrals come directly from dac, okay. >> And and outside of outside of those referrals. Is there [10:26:24 AM] of those referrals. Is there any other way or or is there any work being done to like id folks that may be on the verge of doing that? And I just think of we have a we have a, a facility in district three, the lady bird, where a lot of older residents reside. And I'm just curious if there is any, any type of intervention there that that helps with folks that may be on the verge of ending up homeless. And just a curiosity to that end, I'm not trying to task y'all with more work right now. >> Yeah, of course, if I may, council member Velasquez for psh and rapid rehousing daily. Right. The referrals come from echo, but for service coordination, we provide services to facilities that we have a service coordinator installed in that facility for financial advocacy. We we take referrals from the community. Unfortunately, right now, because of the decreased funding, we are not able to [10:27:25 AM] funding, we are not able to take referrals, a lot of referrals from the community because, you know, our caseloads are maxed up. But to answer your question about lady bird, family eldercare used to have a person in that facility. But to the best of my knowledge, because of financial reasons, lady bird decided to end our service coordination contract with that facility, which we would be able to. We would love to restart if the facility requested. >> Okay, well, let me know if I can help broker that conversation. I know a few folks over there and a few folks on the board. >> Of course. >> And I did want to add, we actually have clients in our financial advocacy services over at lady bird. Still, yes, we receive referrals from all different agencies in the community. So when it comes to prevention, hopefully preventing homelessness, we do accept referrals for that. And so a lot of times clients refer to us because they haven't been paying their rent for 3 or 4 months and they refer them to us. We get the client enrolled, we get them set up on a payment [10:28:26 AM] we get them set up on a payment plan and then continue making sure that their rent is paid ongoing, as long as the client wants the service. >> Perfect. Thank you so much. And again, thank you all for being here. >> Thank you very much. >> Thank you. And again, just want to appreciate the presentation that you shared with us today. As you all know, I'm a huge champion for our older adults in Austin and was pleased to champion a budget amendment just a few weeks ago around the financial advocacy and literacy support. I mean, I just wholeheartedly believe that case management and navigation services is where it's at, because these systems are complex and navigating multiple systems, whether it's health care or benefits, social security, unfortunately, it is intended that way. And so this type of support is absolutely necessary. So thank you for what y'all do. >> Thank you mayor pro tem. And I just want to piggyback on the on the question that council member alter asked about which option we think that works best, which is pecan gardens in this [10:29:28 AM] which is pecan gardens in this case or scattered sites. I agree with Delia that both have proven to be successful. And when it comes to building a community, when it comes to offering to our clients a home that they can feel comfortable, that they can feel that they want to continue living there. I can say that pecan gardens has definitely been very successful in offering that home. When you walk into pecan gardens, you feel the warmth. You feel the camaraderie among our residents, which in my view is very important and is vital in order for them to stay housed. >> Yes. >> Yes. Councilman Walter. >> That inspired one question. Do y'all partner at all or utilize, like, the wayfinder program with sunrise's utilizing, they have set up a kind of diversion rapid exit [10:30:30 AM] kind of diversion rapid exit program designed for individuals who have some kind of income to end up getting into housing more quickly. And I was curious if that's something that y'all have plugged into with them. >> We do not, but I'm glad you bring that up because family, we are in the process. Actually the the job application, the job ad is already out. We are in the process of acquiring a job training specialist who will help both of our clients and our rapid rehousing clients find employment because at the end of the day, that's what we want to do. We want our residents. We want our clients to be independent. And one primordial part of being independent is to be able to have their own income. So we hope that by acquiring this person, the financial and housing Independence of our clients will increase. >> Very good. [10:31:30 AM] >> Very good. >> Thank you. Of course. >> Thank you so much. >> Thank you. >> Okay, moving on to our next item. This is a briefing on the status of Austin public health federal grants. I'd like to welcome our director, Adrian Sturrup, to join us and provide an update. Colleagues, as you all know, this has been an ever evolving topic for us is understanding the impact that from the federal administration on the services that we provide here in Austin and wanted to make sure that as it changes on a week by week basis, that we are keeping up to date as the public health committee. Welcome and welcome, cassie de Leon. >> Thank you. Yes. Good morning. Adrian Sturrup, director of Austin public health and the ever knowledgeable deputy director, Cassandra de Leon. And so we're going to give you a brief update on what we know and what we're using to plan regarding funding. And I think the conversation now is less about cuts and more about [10:32:32 AM] about cuts and more about uncertainty and instability. And so this first slide shows the grants that we consider to be at risk. If you remember from the presentation that we we did a couple of weeks ago, the list is shorter. So some things have come through off the top of mind. I know the teen pregnancy prevention grant was on here because we hadn't yet heard about the renewal, and that was renewed, and we're able to continue to provide those services. But all of the grants here are contingent upon federal legislation and allocation in the fiscal year 26 budget. These are the contracts that were subject to pauses, mainly because although they were allocated in the fiscal year 25 federal budget because of timing and executive orders and changes at HHS and the CDC, they were subject to some unfortunate pauses and [10:33:34 AM] some unfortunate pauses and restarts. The things that we're watching right now that we have some. And so let me go back. All of these have been renewed as of right now. Many of them have end dates of 2026. However, what happens after that? We have a high level of uncertainty and that will be dependent on on the federal budget. What we're watching right now is the refugee medical services program. We are a subcontractor for uscri right now. Our contract, our funded contract ends on 930. Uscri recently sent us a no cost extension to continue operations through 1231 25. And so the staff put together a shoestring budget to present to the city manager's office, to continue to to get approval, to [10:34:34 AM] continue to to get approval, to continue to provide services using other funds. So right now, we don't have any certainty or promise of reimbursement after 930. So we are we've proposed a budget that supports the physician, as well as one of the individuals that helped our clients fill out the very important paperwork. And we're backfilling some of the clinical services from other areas in the department just to get us through December to see what's going to happen. The other grant that we are unsure of is the whole air monitoring or the biowatch program. We were recently sent a no cost extension to continue those operations through October 31st. What I've asked the staff to do to see what spending availability is left on that [10:35:36 AM] availability is left on that contract, so that we can make a good recommendation to the assistant city manager and city manager's office about whether or not we should accept that. No cost extension. The program used to have three people, and those are the folks that ride around and check the little machines to make sure there's nothing in the air that are going to turn this into teenage mutant ninja turtles. And so we managed to, through the process, place one of those staff persons in there called environmental scientists in another position. We're maintaining two right now. Their employment is scheduled to end on September 19th. And so we're kind of fast tracking that work to get information to the city manager's office about our best recommendation, about whether or not we should accept that no cost extension. All right. Next slide okay. And so this is just a reminder of the grants that have either ended [10:36:36 AM] grants that have either ended or have been reduced. And so if we start at the top we we we talked about the covid 19 immunizations grant that allowed us to do in the field work the move program that provided shots at either jd or other places where folks can't make clinic appointments. It was a $8 million grant with over five years, with an average of a $1.7 million per year spend. And we were supposed to end on 2025, so we knew it was coming. But there was an abrupt cancellation in March. And so that really hindered a lot of the infrastructure that we had to provide continued support not only for covid 19, but when we were dealing with measles and when we're dealing with rsv and the upcoming flu season. And so [10:37:36 AM] the upcoming flu season. And so we're not going to be able to be in places and spaces that the community has come to expect us to be. And we still have our brick and mortar clinics that provide key services. We still have a skeleton team that will be able to support community health fairs and different events, but that capacity is reduced. The other grant that is of note to talk about is our covid 19 epi and epi surveillance and lab capacity. And so this included two ftes and five teams that really supported data modernization for disease reporting from providers, all the cool dashboards that we were able to set up, that information came from that team. Again, that grant was slated to end in July of 2026, but abruptly ended in March of 25. And so trying to figure out how we reposition other resources to continue to provide that real time information that the [10:38:38 AM] real time information that the community has come to appreciate and expect. Another an abrupt ending was our tobacco control grant. And this really focused on tobacco cessation for lgbtq plus communities. And that aligns with the population health data that we're seeing for Travis county. And so you might be familiar with some of the popular campaigns entitled breathe with pride that talked about creating healthy and safe places for that, for those populations to seek treatment and help to kick their nicotine addictions. Our HIV prevention grant was not awarded for fiscal year 25, and so that was a seven member team that got in places in spaces where a lot of other providers don't go because of neighborhood reputations and where they're [10:39:40 AM] reputations and where they're providing HIV and sti screens. They also get gift cards, $5 for meals and other things to help support, in addition to to walk ups. We did see a lot of unhoused individuals and provided those services. And so we are again trying to reimagine how we use some general fund resources to see if we can still, at some level, provide those resources. But as a public health department, we know squarely where we have to be, where no one else is, is in that follow up piece. And so when someone comes to an af clinic for testing, immediately they're getting connected to social work services immediately we're getting that information to about their other partners so that we can do that follow up. So it's bigger than that individual person. We're servicing them as well. But then we're making sure that we're doing good [10:40:41 AM] sure that we're doing good population health control by putting those other factors in place. And so part of it was just acquiescing okay. You know, we're going to have to rely on our community partners and encourage them to be in these places where we used to be, and then encourage them to make sure that they're we're walking in lockstep so that we can provide those social work services. And that very critical disease intervention follow up to make sure that we're controlling spread in communities. The other very important earmark that has ended was the stuff around substance use disorder. And so if you've seen our narcan kits and the ability that we had to partner with ems to to create classes and training for folks at the library, I know director Terrell was very appreciative of that work that we were able to to do for her staff, and just working with our very [10:41:42 AM] just working with our very important partners like Texas harm reduction and others. Charge it to my head, not my heart. Everyone that we work with are important. So just because I didn't name you doesn't mean that you're not. But the ability to have that widespread education and outreach and to support narcan availability when it wasn't readily available from the state. That was an important project for the city. Now, we do have the settlement dollars that we continue to activate in those spaces, but this this $2 million really allowed us to leverage those settlement dollars and stretch them in a way that perhaps other communities haven't been able to. And then the last one that I'll talk about is the earmark for the neighborhood piece project. And that's what really jumpstarted some of our work in community violence interruption. It really helped augment the investments that were made by this council. And so, you know, [10:42:45 AM] this council. And so, you know, this is something that I've, I've talked to doctor Tilman and other people on the national stage about nationally, the impacts to to violence interruption funding and the the effect that's going to have on good health outcomes for communities. So we were thankful to see that in the proposed budget or the approved budget, there is additional funding for those very important projects. The other one that we're we're closely watching because of the recent structural changes at the CDC, is the public health infrastructure grant. And this was like the unicorn of public health funding because it wasn't tied to a specific disease state. It was truly flexible funding that allowed health departments to either augment very important services or to build up key infrastructure. And so we are, you know, keeping our fingers [10:43:46 AM] you know, keeping our fingers crossed. We're working very closely with our project officer to make sure that we're in compliance with any new requirements so that we can maintain that funding. But for now, it's really just a game of wait and see. The department talks regularly with the officials from the state health department, as well as members across the region that are a part of the Texas association of city and county health officials. We are members of the big cities health coalition. So this is something that's being watched locally, regionally and nationally. And I think that's all that I have. Deputy director, is there something about refugee that you wanted to point out that perhaps I may have missed? I think we're good. She thinks we're good. All right. >> Thank you. You know, an innovative tool that, if you wouldn't mind just highlighting online the story map that you all created as a department, because I think that's a really incredible way for us to raise [10:44:46 AM] incredible way for us to raise awareness of the impacts, the funding cuts and the grants that you all have identified that are at risk. What that means for our city. >> I appreciate the opportunity. I'll start and then I'll allow Mr. Leon to to augment. It really was a way just to try to personalize the story. Sometimes we get so caught up in the numbers and we don't it doesn't really translate to what that might mean to a community member. And so that was just our attempt at reminding people that it was more about dollars. It was not only about the staff who, you know. Give of themselves every day, but about the community. That will probably be worse for wear without having these services. I'm going to share one of my favorite stories about that, and then I'll pass it over to Mr. Leon. When we're talking about the refugee clinic, one of the staff said that they were in that day, and a nursing student from one of [10:45:46 AM] a nursing student from one of our local universities came in to do an internship at the clinic. And she went over to the wall. And on the wall was a picture of her family. I can't remember the details, but they had immigrated. And I'll tell you where the place is. I'm I'm sure someone is watching and texting cassie right now. They were from here, but they immigrated from from a country. And one of their first stops in Austin was the refugee clinic. Her mom was a nurse. I believe in the country where they came from, and she was following in her mom's footsteps, and she wanted to come back to the place that helped her family feel like this could be their home. And so that is touching for me. It's something that I carry with me every time I talk about the clinic and what it has meant generationally to people in Austin and Travis county and cassie, I don't know if there's anything else you want to add. >> Yeah. >> I just. >> Wanted to kind of speak. >> To the stability that the [10:46:47 AM] >> To the stability that the funding just jumping all over the place has caused, not just for operations for the city, but for the community. So having this stability and funding and knowing that public health is so heavily reliant on federal and state funding, there's a long standing programs that should be automatic. So when you think about the refugee program, it's a decades old clinic. It's been there as for 30 years. And to have some of the staff have been there their entire career with the city of Austin. And so seeing this change hits in a whole different kind of way. It's not just a job, it's been their life. And so those are the things that we're managing through. And refugees are one example of several programs that seeing them stop. And it triggers a process that we have to to do within the city to be responsible about managing, managing the resources. But it starts to ebb away at the confidence within our community about these these programs that [10:47:49 AM] about these these programs that have been mainstays for a very long time just are not automatic or not there anymore, or the risk that they're not there anymore. And and also the fact that when we had the pauses in federal funding in June that affected our HIV programs and our our biowatch program and our other programs that have been so important, it did create a situation that we've lost those important infrastructure pieces of staff, and we're trying to manage through what is this going to look like in the long term so we can plan, but not having those, not having that real awareness of what that funding is going to be and how stable it is, it just puts us in a space that we're we're trying to plan to do the best that we can for our community with flying, without all the information that we really need to make good programmatic plans. And so we're we're working diligently. I have to really give a big shout out to our staff that have been so [10:48:50 AM] staff that have been so committed and continue to push for our community and push us to say, hey, this is what we have to advocate for. This is what we need to do to to make sure that we're able to stand up for for what's right for the people that we serve. And also what can we do with do more with less because we don't have the resources in-house in the city, doesn't have the resources to shore up the gaps that these these potential funding losses may create. So how can we be creative and innovative in this space to continue to show up, but also know that, I mean, there is there is that local impact because we won't have the same capacity. So we're we're managing through that and then managing with our partners. We're leaning into partners, but their capacity has been affected too. When you think about refugee resettlement, it's not just our refugee clinic. It's all the refugee resettlement partners that are also grappling with these potential funding changes that may really affect the capacity to meet people where they're at. [10:49:51 AM] to meet people where they're at. >> Thank you for that. I mean, we are living in some very troubling times when it comes to public health, especially with all the changes that we're seeing at the CDC level and and its ramifications at the local level, and what that means for our community. You know, I want to dig in on the refugee services clinic because that is an item. And thank you for laying out that incredible story of an individual who was served at the refugee refugee services clinic, came back as an intern. And just that full circle moment that we've had, as in providing that service and a key service, especially as a welcoming city for us to have for our refugees. You know, the if I recall, during budget, the amount that we approved in the budget proposal that was adopted was 1.5 million. Is that correct? Yes. Okay. And to operate the refugee services clinic, it was about or is [10:50:52 AM] clinic, it was about or is about 5 million. Is that correct? For a full year's worth of operations or what would be the operations amount for the clinic. >> So it's a variable. It depends on how many referrals we receive. So the funding is tied specifically to a number of people. So you know, we've operated that clinic on a shoestring of under $1 million. And right now our current funding is 5 million. So it really is the variable is how many referrals are received for refugees to be resettled. So it's tied directly to there's a big tie directly to how many refugees the federal government is allowing into the country, and what Visas are allowed and what their eligibility provides. Noting that there are folks that are resettling, they have a year to work through the process to get their health care needs met through the refugee resettlement program. So there's we're actively providing support to refugees. And I think in when we talked in may when we were grappling with what is this going to look [10:51:54 AM] with what is this going to look like, we had a waitlist of about 400 refugees that referrals that we were managing. And kudos to the clinic because they've been able to power through those referrals and get all of them scheduled and seen with the 930 deadline. >> And how many individuals would you say are on the waitlist today? >> So at this point, we have a very limited waitlist. We're under 50 for our waitlist. And so we're you know, and I think that also what that means is we're trying to make sure that they get their prescreening appointment. So they're scheduling their schedule for the prescreen, which is the first visit. And then the next step is for them to have a physical exam and then any follow up visits. So labs and then also vaccines. And so what we're seeing is from ten 1 to 1231, what we see is our no cost extension would be where we're able to make sure they get their full slate of vaccines, so they're up to date any labs that they need. And then also for us to catch any referrals that may come in between now and in that time, to get people at least manage through what their needs are. >> If I may. Mayor pro tem is the 50 because we were scaling [10:52:55 AM] the 50 because we were scaling down to manage the contract ending, or is the 50 because that's all the demand is. >> So the demand, definitely the demand. We we made a commitment and the staff made a commitment to meet everyone. And so any referrals that we received were managed. We've not turned any referral away at this point. And so we're trying to make sure those get taken care of. We but the demand is definitely dwindled as well. We have not seen the level of referrals that we had that we had seen in the past. And so there's definitely less demand and less referrals that we're seeing daily. >> Right. And so at this point. >> I think there's a couple of factors that might be related to that. And if I'm wrong, you can say in front of these people, I don't mind. I think the first thing is that the insurance that folks are provided has changed dramatically, which has impacted the ability to seek services. And the second thing is the current climate and fear of other opportunities. And before you answer, I do want to [10:53:57 AM] before you answer, I do want to go back to the cost when we priced it out. If using 25 as an example, it was about 175 to 225,000 per month to operate the clinic. So just to give you a number, I'm sorry. >> No. >> No, that's fine. To just refer back to what Adrian was talking about on the on the insurance. There's a special insurance that's allotted for individuals that are being resettled. And it in the past has been a full year that they had access to comfort care. It's a special insurance through the office of refugee resettlement. The current administration adjusted that timeline to where they only have access for four months. And so anyone that's being resettled beginning in may on, they only had four months to get through all of those needs. And so it's a lot for someone who's coming into this country trying to navigate all of the different service things and what they need to do to also make sure that they're taking full advantage of the [10:54:58 AM] full advantage of the healthcare access that they can have. And so that that puts an undue can put an undue cost burden on that population, as well as what Adrian saying, the fear of people not wanting to pursue completing the program because there are situations where those Visas are no longer being honored. And so there's also a risk that the community is, is feeling and there's a risk that do they trust the services that are being provided. >> And so just. >> I'm following the clinic is slated to end by the end of this month. We are in a no cost extension to the end of the year. And you all have our public health professionals here have worked with the city manager and financing the next few months so that we can continue to provide services through the end of this calendar year. >> Yes, ma'am. >> Okay, colleagues? >> Yes, vice chair. >> Thank you. Chair. Sorry, I'll have to run here in a minute. But and I appreciate first of all, the updates. This [10:55:59 AM] first of all, the updates. This is really useful in terms of cataloging what's at risk and what's already been reduced. As you've shared with us prior updates on this. It's a little frustrating because you told a lot of, you know, talked about the story map tool, talked about very personal. Impacts that it's making some of these programs are making to people. My questions are purely financial. They are just trying to figure out how you arrived at the totals on both tables, actually, because I couldn't get to the same totals that you guys got to. Is that because this stuff is like in flux every single day? >> The the the first answer is yes. I would be curious to know what data sources you're using. And like what? >> Oh, I'm just doing the math on what's provided here in the two tables. I can't get to 9.5 million and can't get to 18 million with what's on the list there. [10:57:00 AM] there. >> I will have to go back and look at that. If I'm. Are you 12? 13? Oh yeah. It may it may not be 18. I'll have to go back and look at that, sir. Okay. I apologize if there is a mistake there. >> Okay. I'm just curious. Like, for instance, I didn't know whether, you know, you've got the housing for people with AIDS, the hopwa that's listed three times. I don't know if that's only supposed to be counted once, because it's three separate grants starting at three different times. Anyway. Yeah. I wonder if there's a specific reason that the math works out the way it does. If you could check on that, I'd be grateful. >> I will. I know that the hopwa grant is a squirmy one, which is. Which is why it has the asterisks there, and I do not want to butcher what the explanation is, but I will surely get that from the staff and make sure that the math is right. >> Okay, I'd appreciate that. >> Thank you. Thank you colleagues. Councilmember alter. >> I just have one question, and it's kind of a a holistic question, both based on what's [10:58:02 AM] question, both based on what's happening that you described and where you think your agency is. Do you feel like with, with these cuts and potential cuts, you know, if we were to face another public health crisis tomorrow, are we more prepared, less prepared, just as prepared. Where are we? >> We're definitely more prepared because the the value of lessons learned is there. I believe that we will be able to mobilize and inform much more quickly. But we're back to square one with recruiting, recruiting people, and having to train people and making sure that they're they're up to speed, which is why the the loss with that mobile vaccine team is a hard one to and as a minor of a difference as it may be, to give a shot in a clinic is a very different thing than [10:59:04 AM] is a very different thing than giving a shot in the parking lot of a convenience store, you know? And so we are preparing. What I've said to the team is that we need to become a department of Swiss army knives. We can't afford to have high specialization. We need to be ready to respond and move in any way, shape or form. And so. I have a high level of confidence that we will be able to respond quickly. But the breadth and reach of our response will be limited just because of numbers and the time that it will take to to train people. >> Okay. Thank you very much. >> Thank you. Thank you all for joining us today. >> Thank you so much. >> Thank you. >> Colleagues, before we move into executive session to discuss the sobering center board appointments and applicants, I should say one of the items we have on our agenda [11:00:05 AM] the items we have on our agenda is to discuss any future items for consideration of the committee. Is there any topics you all would like to surface? >> I would love to dive into diversion rapid exit. You know, maybe we could invite. I know sunrise has kind of one of the most extensive programs for their wayfinder program. I know lifeworks has a diversion program as well. And and just curious if, you know, we could have some kind of conversation around this type of intervention and what opportunities gaps might exist. >> Okay. >> Very good. >> That's a great suggestion. Thank you. >> All right. So with that, I'll now move us back to. Our initial item, item number two discussion and possible action on appointments to the sobering center board of directors. And I'd like to take a pause on this item to take this [11:01:05 AM] this item to take this conversation into executive session. Let's see. I believe I need to read pursuant to section 551.074 of the government code, the committee will discuss personnel matters related to item number five, discuss the selection of members of the sobering center board of directors. Is there any objection to going to executive session hearing? None. The committee will now go into executive session. Thank you. [11:10:48 AM] Thank you. We are now out of closed session. In closed session, we discussed the personnel matters related to item number five. Thank you to my colleagues for the great discussion that we had. We decided to move forward and schedule interviews, and that will be with the intention to appoint a member at the October 1st public health committee meeting. All right. Seeing no further business in front of our committee, I want to thank everyone for your contributions, and I will adjourn this committee meeting at 11:11 A.M. On September 3rd. Thank you. The City of Austin's Government Access Channel