Welcome back to this weekly meeting of the Health and Safety Committee with Denver City Council.

Coverage of the Health and Safety Committee starts now.

Good morning, and welcome to the Health and Safety Committee.

My name is Darrell Watson.

I'm honored to serve all of the residents of the Fine District 9, and it is my great honor to be the committee chair for this important uh committee.

Uh this morning we have several action items before us that will be reviewed as a block.

And we have one briefing.

And before we roll into our agenda, let's take a moment to have introductions from city council members.

We have uh two council members online, Councilmember Sawyer and Councilmember Flynn.

We'll turn it over to you for introductions.

Good morning, Amanda Sawyer, District 5.

Good morning, everyone.

Kevin Flynn.

Southwest Denver's District 2.

Councilmember Torres.

Uh good morning, Jamie Torres, West Denver District 3.

And good morning, Mr.

Chair Paul Cash from South Denver District 6.

Thank you all for joining.

We have a briefing today from DDPH.

Wow.

I love the aircraft.

We have a briefing today from DDPHE on a very important discussion on measles updates and immunization.

Thank you so much, Kristen Shu and Alex Vidal for uh presenting.

And we'll turn the floor over to you.

And I think before I say that, thank you, Executive Director Karen McGowan for being here.

And if you have any points you want to make throughout the DDPHE presentation, uh please just wave your hands and we'll have you come forward to uh present.

Turn it over to you.

Mr.

Chair of the Committee, thank you so much, Alex Hudal, Legislative Visa for the department.

Um really appreciate the opportunity to come and talk about our work.

Um the previous chair had uh reached out and requested an update um near the beginning of the school year to talk about our uh measles work and as well as immunization work in our partnership with DPS.

And so I have with me today Kristen Shue and uh the rest of uh the medical operations team that works on immunizations as well in case there are any questions.

Um but I will uh kick it over to Kristen to start to do the presentation, and I will be the key note taker here for the case there are any follow-up that we need to do.

Thank you so much.

Thank you, Chair.

Um, really appreciate all the support we've received from council around our work around measles, and happy to have our DIS, EPI, and EPR folks here with us as well.

Uh it really is collaborative, the effort that we've made, and so we couldn't do it without all of the folks who are in this room and supporting the efforts.

Uh today we just want to share a quick update about where we are with measles and the response, discuss a little bit about vaccination and kind of rules and regulations to help there be some understanding about what our community is.

Our prevention and response strategies.

Uh, this is important just to know where Denver is in terms of our rates and what our efforts are around immunizing our community and how we continue to protect them not only against measles but other communicable disease, and then how public health nursing um and our other colleagues are part of those efforts.

So, so for some national context, uh I think as of today we actually are at 1356 confirmed cases, which is significant compared to previous years.

Uh those 87% of those cases are related to outbreaks, notable outbreaks in Texas and New Mexico, as well as in Kansas, uh, and then international outbreaks in Canada and Mexico.

We have cases across 41 jurisdictions currently throughout the U.S., and we are seeing things slowing down broadly, but there are cases that continue to exist.

For local context, Colorado has done relatively well.

We always knock.

We are super suspicious around T DPHA.

Um we have had 16 cases across Colorado and have been lucky to only have four confirmed cases in Denver.

Part of that you'll see is related to our response.

And the 10 cases that we had broadly were related to uh outbreak.

We're really a tailbreak.

Uh, we did have a travel-related case that went through Denver where several of our cases were originating.

So when we have an inquiry, whether it's coming in through our inbox, whether it's a call to our um duty officer, we our DIS and EPI teams are constantly evaluating and helping us determine what cases are happening and what we need to do in Denver.

So they're conducting disease intervention case investigation, they're confirming systems, symptoms, establishing deadlines, implementing any containment or control measures that they can, and trying to identify additional exposures.

So we may get that we could have a couple of cases in a week.

At the height of this, we've had, you know, many cases every day.

We could have had 10 plus cases a day that they were working to investigate and evaluate.

Once a case is identified, there's a determination about whether there are low or high risk contacts, the level of exposure, any additional contacts that were related, and really addressing risk and what measures for control are needed.

For one case, one individual that is a confirmed case, we could have upwards, I think of we had 200 for a Denver health case.

And when I say Denver Health case, it was someone that went into the emergency room related to an outbreak.

So we had significant numbers of case investigation.

And that's not only the work that we're doing here in Denver, but we are also working with our partners across the state.

So even a case, if a case isn't in Denver, we are actually activated and working broadly across across the state.

For measles response, we did activate our doc.

We had daily coordination calls with partners, a lot of data sharing.

Part of our efforts, which were some of the council briefings that we did, were really we were trying to be prepared, and that is our goal at DDPHE is to be ahead of the game as much as we can.

That's also why we do the immunization work and do the community education and partnerships that we do.

We worked with many partners to not only evaluate what we could do to support them, but to help them determine their readiness and what other resources they need.

And that's something that we're doing all of the time, not just in a response strategy, but definitely part of what we're always thinking about.

And then you were all instrumental.

Council was instrumental in some of our public communication efforts about getting information out to our community about measles and what we needed from them, how to get vaccines, dispelling misinformation, and that continues to be something that's important for us to do, not only around measles, but around vaccines as well.

We are definitely seeing the trend in Colorado that is mirroring what we see across the United States, which vaccination rates are broadly down, especially for kindergartners.

I'll get to that in a minute.

But just to kind of go back to what our response for measles has been, we have assessed approximately 437 individuals.

186 of those were high-risk contacts.

28 were referred for post-exposure prophylaxis, which means we're trying to prevent them from developing the disease, the virus of measles if they've been exposed.

And our nursing team deployed quite flexibly to be able to provide home testing at the request of other jurisdictions and state partners to be able to keep people out of settings that would expose other individuals to provide home testing and to provide that post-exposure prophylaxis.

And we have a very small but mighty team who was doing that.

And then we also did because one of our cases did show up in an emergency room.

So thinking about back to school, which is where we are now, there are lots of immunization and general back-to-school events happening, which we are so glad for.

There are five required vaccines for kindergartners.

Hepatitis B, the diphtheria, tetanus, and protestis vaccine, which prevents protestis is something that we've seen a rise of in our community as well, polio, and rates of those, both of those vaccines are broadly down for our community, as well as MMR.

We are under the goal rate.

We were at 95%, which is what we need for MMR herd immunity a few years ago, meaning the more of us that are vaccinated, the less likely anyone is to get it.

But doesn't mean that we won't get it, even if we're vaccinated.

We can talk about that if we need to.

Colorado is, we have high exemption rates, so we can be anywhere from 3% to eight percent depending on where you're at in Colorado.

In Denver, we're around three to four percent, and usually around 3.4%.

Um, those are both medical and religious exemptions.

We do have a fairly liberal policy, and I don't mean liberal in the sense of politics, but just in that we have a lot of allowance for exemptions, and so we do see a higher rate of them in Colorado.

In general, for across vaccines, we're around 84%, and that's specific for Denver and DPS, but it can fluctuate between 84 and 88 percent.

Um, and that's not what we want.

That's not great, but it's we also can see that that in some of those vaccines we are doing better than we are in others.

So that's part of what we're looking at.

What are we doing about those rates?

Well, the communication is really important.

We are also our team goes out as part of uh a mobile clinic.

We are working with our shelter shelter spaces, um, we are establishing a relationship to have regular community clinics at the library spaces.

They have been an incredible partner for us.

Uh, working with Denver Animal Shelter, the schools DPS and PHIDH have been instrumental in collaborating and coordinating, and we continue to do that on a regular basis.

Um, want to just acknowledge those community partnerships.

It is important that we have uh support from our community partners to provide culturally responsive outreach.

The conversation around vaccine and around communicable disease varies across the population, and not everyone has the same experience or accessibility or willingness to engage with the system, so that is an opportunity for us all to be strategic and to continue to work on how we can engage our community in a meaningful way, and all of that is data driven and evidence based.

So, looking at what do the maps tell us about who's engaging and what do we need to do if they're not that comes into vaccine safety, and there are questions and concerns that a lot of our community members have, and certainly in the environment that we're in right now, those questions are even more prevalent and prominent.

And safety looks like a lot of different things.

It's not just about the vaccine itself, but it's also about trusted healthcare partners, trusted healthcare information, and so continuing to address that is important.

People are turning to different sources than what they have previously turned to, which includes the LPHAs.

Local public health is an increasingly trusted partner, as are our local representatives.

We're seeing that community-level information is more valued than uh some of the higher level or federal information that we used to receive.

And we don't want to discount them, but we also want to recognize it's a whole picture.

So we are looking at all of our organizations, including the American Academy of Pediatrics, the World Health Organization, Immunize.org, these are all trusted reliable sources of vaccine safety, and helping us understand the picture that we're in.

Addressing vaccine hesitancy for whatever reason continues to be important, and not just telling people, hey, if you don't get a vaccine, you're bad, but helping to like to understand why folks may not get vaccines and to make sure that we're taking that into account and providing safety and recommendations for all of our community with that in mind.

Uh those are personalized conversations that we need to have.

And there is certainly a role for the work that is done as part of this committee and with council and the relationships that we have within community to do that, to provide that clear and consistent immunization and vaccination communication and to be able to address concerns in that personalized way.

So continuously combating misinformation, which I'm sure you are all quite familiar in versed in.

Public health nursing is more than immunizations, though that is part of what we do.

We have a critical role in responding to outbreaks and to preventing outbreak from occurring.

We also support assessing records and updating the immunization registry and then delivering all of that vaccination education.

So even if we're not providing directly to an individual their vaccine, making sure that we are providing education not only to individuals but to school systems, to other healthcare partners, to providers, and really anyone who is willing to engage.

So, Chris and I'm going to go.

Yes, sir.

I have to give a lollipop to the mayor or lollipop.

That was not me who did that, so I can find out, but I'm sure I give stickers.

I give stickers.

I come with a whole sticker collection.

Yes.

Next, we can do that at our next meeting.

We can, but you said we should bring vaccines here.

We can do that.

Um so far this year, we've had 41 clinics for our nursing team with 25 different community partners.

We've given 697 vaccines.

Um we expect that we will give over 1,600, which is a 10% increase over last year.

Uh, and that is pretty significant considering we have a smaller team and less consistent resources broadly in the landscape that are happening.

Uh, for measles, we again provided some of that post-exposure prophylaxis.

We did home testing, we delivered quarantine letters to folks.

So again, if you have something that you can't go out and deliver to the rest of the community, we need you to stay home.

And then we also did actually support our Epi and DIS teams, who were extraordinary in the work that they did.

I cannot emphasize that enough.

Uh, but they were able to provide, they needed some search support, so the nurses also supported with that.

We, in addition to the immunization work that we do, we are part of the focus uh team that works in the downtown area.

So we go out and actually are supporting field assessment, making sure that we understand kind of what the medical landscape is and help fill some of those gap spaces.

And we are also now offering uh field delivered therapy to help with the syphilis um increases across Denver and Colorado.

So we're we're doing immunizations, but we're doing a lot more than immunizations for our purposes for measles and for communicable disease immunization and vaccinations.

We need to have continued community engagement.

So any support, any collaboration that we can um that we can have there in terms of identifying community partners who the needs are.

And I will say again, council was really helpful in helping us make connections to community partners uh and to follow up and have clinics in your districts.

So please continue to work with us and send that to us.

It's incredibly valuable.

We need to continue to expand what we can offer, both in having opportunity for access is really the biggest thing.

People need to be able to have it.

Uh there's a barrier for families if they are working.

It's hard for them to get their kiddos to vaccine appointments.

So being able to provide care where families need it is really important.

So we need to be able to continue to expand in that way.

And then the communicable disease planning, which we see has was so instrumental.

We I really truly believe we're we're ready for a measles response, which is why we were able to do it so well and so effectively.

And there are more things than that.

So we need to continue to work in that way, uh, and appreciate your support in those efforts.

I think I think that was the quick and the quick rundown.

I was very prepared, very polished.

We ran through a lot of information there, but we're happy to go to other slides, answer any questions that committee ahead of provide a lot of opportunity for questions and discussion.

Well, absolutely, and then Chris, I just want to say to you and your team, thank you so much.

I mean, this work is so essential, and with such a small team, your impact and collaboration with Denver Health, Noda Health Agencies organizations is so vital.

Uh, the great thing is this is recorded on Channel A.

And so as city council members, we have the ability to push this link out to folks, and so does the DDPHE.

So now you have a virtual kind of talking point for community.

And so I think that is so great that you're here doing this.

Um, we do have uh council members in the queue and I, of course, I want to welcome Council President Sandoval and Council President Pro Tem uh Romero Campbell to our meeting.

Um I always start with the folks who are uh virtual uh first and foremost to make sure we're not missing you.

So, Council Member Sawyer, did you have any questions for Kristen and her team?

Thank you, Mr.

Chair.

Um, and thanks, Kristen, so much for this.

I think it's really interesting information.

Um I'm just curious about the vaccination rates of kindergartners.

I know that Denver Health has been working to um create uh like in-school health communities, um, but they're in our high schools, not our you know, elementary schools, not certainly not in kindergarten.

And I'm wondering if we've had any conversations with them about expanding that or doing something different in order to um see if we can work to get those vaccination rates up since meeting people where they are is the easiest way to do that, and where they are is in kindergarten.

Yes, that's a great question.

Thank you.

Um they actually do do uh they have brought in their ISIP program to address more.

Part of what they've been doing at uh some of the back to school events is getting kids registered.

So they essentially get kids registered ahead of time, and then they can go to the school when the kids are there because they've already had a consent with parents and they can vaccinate them while they're in school.

So they are expanding those efforts.

We also are, we have restructured our monthly meeting, and so we have we meet with them every month to talk about what are the priorities across schools, who's going who's going where?

No, no, you can't.

Uh, who between our team and their team?

What are the priorities and who is tackling what?

So they're absolutely expanding those efforts.

They are working in those communities, and we are we are working closely with them to make sure that we stay on top of the priorities uh and uh expand that work.

They have also uh they are they we are going to work together to expand what we're doing.

And when we talked about needing to offer more services for our team to be able to mimic some of the programming that they do that has worked well, so really in that strategic sharing of lessons learned and and how can we do what we're doing better and continuing to adapt.

So, yes, we are addressing those kindergarten uh and and looking at how we alter our programming, and they are doing the same and working closely with us.

It's fantastic.

My follow-up question was gonna be okay.

If Denver Health is doing this, like what are we doing to help them as well?

And so really appreciate uh, you know, knowing and understanding that a little bit more.

Um, so thank you for that.

And and just last question, then in terms of um both Denver Health work and your work.

Is there anything we can do as council members to help support you to make sure that we're kind of at least broadening awareness, or you know, our capacity is limited in this for sure, but um, but if there's anything we can do to help, I'd love to know what it is.

Yeah, that's a great question.

And I think you have all done it when we made the ask to share information and to help with uh public information in a variety of ways.

You all were ready and willing and did do that, and I think that was very important.

Certainly there are always gonna be questions that are above my pay grade about funding and policy and things like that.

And so I think wherever there can be support and recognize that this is essential work for our community to protect uh our most vulnerable individuals.

Anything that you can do in that space is always helpful, Alex.

Would you add anything?

No, I think that's uh that's a great um thank you for sharing the information that you've been sharing through newsletters that's very important, um, sharing opportunities for us to go out into the community and and uh put on events.

Um, all of that has been very, very helpful.

We'll continue to provide information that you can share with your constituents to continue to get the word out about the need to get vaccinated, where to get vaccinated, how to check your status, all those kinds of things.

And this is a budget question that you might not be able to answer yet, right?

Um is a question about um, you know, confirmation that given that we know that there will be budget cuts uh in 2026, um, is DDPHE working to ensure that these kinds of critical programs remain funded, or you know, is this a conversation we need to have in budget hearings?

And I won't put Krishna on the spot, but I'll I will put the executive director on a spot.

And then you can provide that.

So, executive direct, do you mind uh going to the mic there?

Introducing yourself, and if you can answer the question.

If you can't, uh we'll find out.

Uh, he's good to answer.

Okay, thank you for um meeting me up from here and again, and the director of the department of public health and environment, um this is information that I've shared with my staff many times as we've been contemplating significant budget cuts.

Uh, we're looking at what are core public and essential services first and trying to figure out how we maintain those services or minimally impact them.

Uh, that is a top line strategy for us as we're looking at figuring out where budget savings are going to have to come from and what kind of staff uh are integral to everything that we do as a public health agency.

And I was going to tell you, Kristen, when you get that echo, that's a super power you get from sitting in a super seat.

You lose it once you leave.

So it does not continue.

Councilmember Flynn, I'm wondering if you have any questions.

Thank you, Councilmember Flynn.

Councilmember, Council President Pro Tem, Romero Campbell.

No, no questions for me.

Again, Sawyer asked our councilwoman Sawyer asked my question for reaching out to those pre-K kids in kindergarten.

So thank you.

Councilmember Torres and then Councilmember Cash.

Thank you, Mr.

Chair.

Thank you both so much.

Just trying to understand some of the unvaccinated numbers a little bit more.

You mentioned an exemption, right?

So people who file for an exemption is about three to four percent.

That is not the same number as the unvaccinated at DPS.

So is that gap just kids that haven't had access to the shots that they need?

That's a great question.

Absolutely.

Yes, three to four does not meet the kids that are unvaccinated, and that is truly an access issue.

It can be, there are a lot of different factors that are happening in terms of is it a financial issue, it is a primary care issue, it is a time and energy issue.

Is it a willingness to engage or have ability to engage in a system?

Even though those are required, the reporting is October 15th and January 15th.

So it's also possible that kids can be in school, need those required vaccines, and are not going to get a letter right away because of when the reporting period is.

So the data, we do the best that we can with that picture, but we aren't capturing everything as accurately as we need to.

But there is definitely a difference between our exemption rate.

There is a correlation, though, broadly with high exemption rates in states and low overall vaccination rates or lower vaccination rates.

So we do see that there's a correlation.

Does that end up getting addressed though so that they can register for school?

So we work with DPS and DPS between PHIDH, so Denver Health, DPS, and what we do, we are working closely to try to meet though to address those gaps.

There are ways that kiddos can be in school because you don't want to pull every kiddo that doesn't meet that out.

And some kiddos, it's about why do they not have that current, why are they not meeting that requirement?

Sometimes if they're in an alternate vaccination schedule, it's really about do we have all of the information that we need to understand what's going on in that situation?

And so sometimes we just can't capture that as well.

Some of that we are really, really working on with DPS about how do we clarify and do better data sharing to understand what internal picture they have compared to what we're trying to extrapolate from the outside.

And they have been great.

They're also going through some changes, but we are working closely in um with across CDPHE, not just in terms of vaccinations, about how do we partner better to make sure that we're serving Denver's kids.

Yeah, it'd be interesting if there's a an assessment of that delta by the end of the school year if those kids were either able to be assessed for an exemption if they qualify, or um the shot that could be provided, right?

Yeah.

So that number, because if it's at um a four percent exemption, right, which is like the high end of what you said, there would be more kids unvaccinated.

Um, about 2500 kids unvaccinated without an exemption.

Um, which is still seems like a lot out of 90,000.

It's still quite a lot of kids who are unvaccinated for a variety of reasons.

Um, what we do also measure really directly is when we go into a school, and PHA PHIDH is doing this as well.

Like, what do we see in the change in that population?

Um, some of it is also a little tricky because there are some vaccines like MMR, you need more than one.

So it might change temporarily and look better, and then by the end of the school year, it doesn't look great again, or you see the reverse.

I can tell you that in one of the schools that we worked in regularly last year, we saw the vaccine, the vaccination rate go from 64% to 84%.

Um, we had a pretty significant change in that school.

So we are looking at that really specifically about when we are where are we working and are we effective in what we're doing?

Okay.

Yeah.

Awesome.

Related to DPS protocol, at what point do they contact either Denver Public Health or DDPHE to let you know that they've got a kid with measles or there's been like an outbreak or something?

Gosh, I would love because our DIS and EPI team are they're the ones that are gonna take those calls.

If one of them would be able to like speak to that, I think they would do a better job.

Whoever wants to go forward, I'm gonna pick someone if one of y'all don't get up.

Yeah, and if you don't mind standing at the mic, introduce yourself and kind of your title, and then um uh councilmember Torres can ask a question again.

Hey, yeah, nice to meet you all.

My name's Leslie Warren.

I support our epidemiology unit, and then I'm with my coworker, our kind of counterparts um with Grace Nelson of our D uh Disease Intervention Specialist supervisor.

Yeah.

So just wondering about the protocol for Denver Public Schools, if they have a kid with measles or suspect or something.

That's a great question.

It's definitely as part of the planning piece.

We did a lot of work with them ahead of time.

You know, luckily we work with DPS for communicable disease all year long, not just for measles, but we have a pretty robust system set up with them and all their schools for reporting in, you know, single cases of reportable conditions, outbreaks, things that are routine.

And this, I think we just took the opportunity to kind of enhance and expand that to say, okay, let's like let's take the system we have for reporting, which we do mostly electronically, and then let's kind of expand that so we can do a quicker detection.

So it's kind of it was we had the systems in place, we had the contacts, so but we did have some pretty early conversations with them to say this is specifically what we're looking at when we're looking at measles.

It's you know, a kid walks in with a rash is gonna be a lot different than someone with like actual measles.

So we worked with them to just kind of coordinate what symptoms they're looking out for, what basic procedures they should follow if they if any of the nurses have a kiddo that might have a rash or some since there's any symptoms, get a protocol in place for how to exclude, how to notify public health, how to coordinate with Denver Health if their kids kiddos being evaluated, and then kind of just laid out the process for what we do for contact tracing and explain to them.

We will work with you hand in hand to really break down if we think we have a higher suspicion student, what we're going to be asking for from public health, what we can provide you, and then what that full collaboration looks like from investigation to post-exposure prophylaxis.

Um, we also did a lot of coordination with the DPS, the Denver Health school-based clinics that are located in the DPS schools because they have their own medical director, Dr.

Cheroby, so really getting all the players together to say, okay, if someone walks into a school-based health clinic, this is what's going to unfold.

So I think um, you know, there's always room, and we're just gonna wait and see.

But no, ultimately, we had a pretty good success so far.

Yeah.

Great.

Thank you very much.

Uh, thank you.

Those are all my questions.

Thank you so much.

Uh, Councilmember Torres, Councilmember Cashman.

Thank you, Mr.

Chair.

Thanks for the presentation.

Really is interesting stuff.

With all the good work your small but mighty team is doing to address this context.

It does appear there's a uh healthy sized population of people who are not vaccinated that you would like to see take advantage of that.

I'm wondering uh kind of is our bag of tricks full enough.

Is there something from a state perspective or a local perspective we're not doing that we could be doing that they're doing elsewhere?

I mean, is there a legislation gap?

I think that's a great question, and I don't know that I could specifically speak to a legislation gap.

I mean, I think the exemption is one thing that we do know that has an impact, that is legislative.

The efforts around vaccination are thoughtful and continuous.

We are lucky to in our community have incredible leaders and expertise who really are leading these efforts.

So I don't think that it's a gap of we're not doing something or that there's more to do, but it is a constantly changing landscape that we have to stay flexible and adaptable to.

Uh, so where we see, you know, shifts in our community and what's happening on a day-to-day basis, we have to try to respond the best that we can, and sometimes that works better than others.

Being able to go into schools, being able to bring vaccination clinics to communities does make a difference, and that is something that just still needs more resources.

So some of it, there's it's there's no one answer, unfortunately.

I wish there were, but certainly I think that within our community, we are lucky that we have incredible resources with folks who are really committed and passionate about the work that we're doing and are continuing to look at the question and find new ways to respond.

Thank you for that.

And and under the topic of you you learn something new every day.

Was it varicella?

Yes.

Never heard the word before.

Chicken pox.

I know it.

I'm so sorry.

I learned chicken pox.

And incidentally, I will tell you that you know, one of the things we ran into with measles is that some people were like, Oh, yeah, I had that when I was a kid, and what they meant was chicken pox, not measles.

So, yes, I thank you for uh, but we live in a world of acronyms, we're always explaining, but technical words like that.

No, we don't have much.

Chicken pucks, yeah.

That's all Mr.

Trinity.

Thanks for clarifying that as well because I was searching for it as well.

Is this so yes?

Yeah, very helpful.

Uh councilmember Gonzalez could tier.

Yeah, yeah, thank you.

Um, I will say that um yeah, no, it's been um really helpful to have all of this information, and I wanted to just address something that councilwoman Torres was asking about the collaboration with DPS.

This was something that was brought up on um Councilwoman Sawyer, I think brought it up when we were getting those original briefings with the school city coordinating committee.

So it's like another place, um, thankful for having that committee that meets that we were able to have that conversation there.

We had, I think DDPHE came in and did a presentation and talked about the collaboration that they already had ongoing with DPS, but it was helpful that we were able to like have that conversation there, address it if there were any gaps or things that were needed.

Um, but what was really I think we were grateful for was that that collaboration was already like working and already happening with the nurses um at the schools and things like that.

So it's great because we had that additional checkpoint before like getting it here in this committee, and that was months ago, right?

Months ago, and so I'm glad that we have that committee because we're able to like head off some of those things.

And we did try to pass legislation at the state level around vaccines.

Um, was not passed in I think the way that um some folks were have hoping for like people in the public health space, um, but I think it did open that door for more like data collection and wanting to know who is vaccinated, who is who is not, and and of course, that information is not shared publicly, but at least that's how we are able to access and know the numbers, and I think having conversations where we continue to remember that we are all in this together, and we're not othering someone from the conversation around why they are or are not vaccinated, but to understand um and to continue to come to the data with to look at a bigger picture and try to understand these kinds of questions of what what else do we need to be thinking about and taking into consideration to make sure that we're meeting the needs of our community.

That's it.

Thank you, Councilmember Gonzalez.

Council President Sandoval.

Thank you.

Um thank you for this important information and work.

One thing when we're partnering with DPS for the younger kiddos who aren't, are you partnering with Denver Preschool program?

Um because they are we it they're funded through a sales tax, and so they are that sales tax is administered through the Office of Children's Affairs, and when I was on that board, um, I know that they have great partnerships with all of the um pre-K, everything.

Um, and we're doing when I was on the board, it was during COVID, and so we actually were able to um stand up a pilot program to actually start giving scholarships to three-year-olds because it's you it's only really for four-year-olds, but we were able to introduce so just wondering how that partnership looks like works with because they are doing universal pre-K now, and they're also the funder for Denver preschool program, which is Denver.

So what does that partnership look like?

I think it looks like an opportunity that you just put you just put into my awareness, and thank you very much for that.

I I don't know what's happening with other partners in that space, okay.

But I will look into it and Alex will get back to you to get to share where we go with that.

Their executive director Elsa is um amazing, and she would have the contacts for um mostly in Denver.

But now when they were awarded the universal pre-K when that passed at the state, um they're also the um, they also administer the universal pre-K, those 10 hours for preschool program.

So now they're actually even more statewide because they you go to their you go.

If you want universal pre-K, you go to them, and then you apply through them.

So now they're even broader, and they're really connected obviously to the state through Universal Pre-K and obviously to the Denver, as they're 100% funded for the Denver Preschool program by a sales tax initiative.

So that would be a great opportunity to have a funding partner or a partner where they can fill that space and get get kids even more prepared as they enter into Denver public schools and to that space and even just getting that knowledge that foundation set because oftentimes my kids were recipients of the Denver Preschool program.

So once I was in that program, my it was my daughter.

I automatically didn't have to reapply for my son.

I I had they had I had already been in the program for my son, and so I was already connected as a family with them, and so if you can connect with them very early on, what you'll do is you'll start connecting them early on and get all of the kiddos in that family part of and more education around that, and they're fully bilingual program, have lots of bilingual partners, and are in neighborhoods where you don't really think about preschool.

Like I have a preschool in Northwest Denver that's in a house, like literally a schoolhouse off of Perry, and there's probably six little kiddos there.

So we oftentimes don't have access to those databases, but Denver Preschool Program would because those kiddos still would qualify for the Denver preschool program.

Thank you.

So thank you.

Thank you, Mr.

Chair.

It's awesome.

Thank you so much, Council President.

Um, look around, see if there are any additional questions.

Um seeing none, just one quick um question on communities that we're identified some vaccination reticence from those communities as you engage in communication, or we leveraging language access or any other targeted communication tools schemes that um works within those communities, and if you if you are, can you share a little bit of that?

Yeah, so we provide all of our resources and materials.

One, we have great language access resources via the state, but for DDPHE, we have translated into uh top three languages, and then we have ability to translate into any other needed language when we go into specific communities if it's not something that already exists or that we have.

We have access for all of our events to translators in over 50 languages on the spot that we can actually call and have to make sure that we're getting the right connection.

I think there's I want to clarify.

So, in terms of the vaccine, like the conversation around, so there's being able to provide culturally appropriate care and translation services there, and then there's sort of the how do we engage with conversations, and we we are providing resources to other community partners and really relying on them to share where they are willing and can to help because they are they are trusted members of the community, and we aren't, we're strangers, and we have to build those relationships.

But we are working, I mean, that is one of our number one goals to be to be identifying, and again, you all have been helpful in that space to help us identify community partners who will help us have those conversations and bring people into relationship with us, and then we can provide those resources to them in language translation or culturally sensitive ways.

Well, Kristen and team, thank you for an informative briefing and all of this great information.

And I'm certain that our community members will um receive more information through our newsletters and all the stuff that you're putting out in community.

So thank you so much for the briefing.

We'll transition now to our action items, and um I appreciate your input.

We have an action item of a series of 25, um, 11:30 through 1136 that we're gonna be voting on as a block.

Um Alex Um Bidal and Nick Schorter in about two minutes will transition for your presentation um if you need support and can help you with setting up the uh the presentation, and it'll be a discussion of contracts coming through DDPHEC.

And Nick, as you uh begin to present, uh thanks for reintroducing yourself and Alex as well, and then the floor is yours.

Mr.

Chair members of the committee, Alex Adology of Liaison for the department.

I've got with me Nick Schrader to talk about um some asbestos contracts that provide access to services citywide for agencies across the city.

Um appreciate the opportunity to come and talk about these contracts.

Uh, if members will remember, um, we sent an email a while back that had lots of background and detail.

Um we just wanted to make sure the chair had reached out to make sure that uh members had an opportunity to get a verbal uh discussion about these contracts just to ensure that there weren't any last minute questions before these went to the floor.

Um I will kick us off here by introducing the agenda and then I'll uh send it over to Nick.

So uh just very briefly here, we just have a handful of slides.

Wanted to talk about the need for these services, you know.

What is asbestos abatement and why does the city need to do it?

Um, how do we use these contracts?

How are they uh paid for, and what type the what are the different types of contracts?

Um, and then wanted to talk about the actual resolution request to add value and extend the dates for for these existing contracts.

Um we'll say that uh just as a kind of set the table here about the need for the extensions.

Um the contracts were originally uh competitive bids, so uh RFP uh for a multi-year, you know, five-year contract with multiple vendors.

Um the RFP process is taking quite a bit of time.

We uh briefed the chair earlier this week on it can take up to a year to get uh depending on the on the funding structure and source to get through that process, and so um we had already you know started the RFP process.

I'll let Nick go into the into that if there are questions about that.

Um, but there were some concern that the value the existing value on the contracts might run out or that the we might hit the dates uh the end dates for the existing contracts, and it's very very critical that there not be any gaps in these services.

There are again federal and state requirements that the city has to meet.

And so that's the reason why we're bringing these is to is out of an overabundance of caution to make sure to ensure that there's no no uh gap in in these uh the availability of these services for city agencies.

Um, so with that, I'll kick it over to Nick to talk about asbestos abatement.

Thank you, Alex, and good morning, everyone.

I am uh Nick Schroeder with the environmental quality division within Denver Department of Public Health and Environment.

And the program that I administer solely focuses on city-owned properties and sites, and we also support primarily asbestos, but it really comes down to regulated building materials, and we also have an indoor air quality component for our buildings, and while asbestos is the majority of the work we do, our contracts also have lead-based paint, mold, PCBs, universal waste component.

So there's there's quite a bit that that our contracts support within the city on on a broad scale, which I'll get into in a little bit.

Since asbestos is the main main driver here we'll we'll talk on that.

And you know it it was used quite a bit, and it was a wonder miracle.

You know, it's estimated that it was over 3,500 commercial building products at its peak and when left undisturbed it's fine but it does create a airborne hazard and it's been known it's a carcinogen and so through through the regulations that came through there's federal and and state regulations that we comply with to protect the environment and public health and then also our objectives with managing the city's environmental liability through these contracts and it's not just in the built environment it can also be in soil contaminant subsurface that these contracts serve with regulated asbestos contaminated soil the contracts that we'll get into I'll get into the different types but we're we're kind of bundling all of these between consultants and contractors and then just just as a whole the consultants are the ones that do the inspections the surveys perform the oversight of the remediation work and then when I say a contractor I'm referring to a general abatement contractor are the ones that actually go in and remove the materials in a controlled manner and in the state of Colorado we have specific regulations that cover asbestos for disturbance that the EPA has also delegated CDPHE authority for the the federal regulations and then there's there's a second set that I just mentioned too for subsurface and soil contaminants as well when you're dealing with asbestos contamination in soil and disturb can mean basically anything it's if it's not sitting there and it's getting getting disturbed so it you know it these contracts serve large scale construction projects they serve daily operations in the city for maintenance of our buildings and then they also provide a mechanism for emergency response or spill response or unexpected discovery of a material or a hazard that puts us into this regulatory framework and then you know is a public health concern and an environmental concern.

So just a Mr.

Chair members just to reiterate the point it's really anytime that uh the city touches a property right so for could be for maintenance it could be for remediation it could have been a flood a fire anything that would have again disturbed the the structure and created uh an exposure so put some stuff in in the air that we don't want the public workers anybody else to be exposed to and breathe in.

And these these contracts help us do exactly that from from the front end from the identification of the hazard the quantification like the condition of it to scoping the removal of it and then actually performing the work and then making sure it's removed, handled in a controlled manner packaged and moved and disposed of properly and then while meeting the state and federal regulatory requirements.

It's like I mentioned earlier it's anywhere from small scale short duration work to several month long large scale projects.

And it can vary but between the funding source you know we we do utilize our enterprise fund for this work but there's quite a few different sources that all pull from from this contract and these values the contracts themselves they're not to exceed amount they don't obligate funds to these vendors there's no minimum spend amount on these.

The values have been set and and what we're asking is in part two for a mechanism for the city to have a way to respond to natural disasters or emergencies or large scale fires where there is a public health hazard, there's a concern for the environment, and we hold these contracts so we can use these vendors to respond to it appropriately quickly and still meet our environmental liability objectives and meet our state and federal regulation requirements.

And I just I'll just add another point, Mr.

Chair, that um there's no minimum for these contracts.

So again, they're not to exceed, they don't obligate any funds, and so there's no minimum.

And so having additional value to respond to a catastrophe as some sort of natural disaster that would require a lot of remediation, a lot of these services, it's important for agencies to have access both on an emergency basis and on a planned basis, and so having significant value, having significant uh significant runway for the end of these contracts is really important to make sure that DDP DDPAG can meet these regulatory obligations for the city on behalf of the city.

Any gap in services would create a significant liability for the city on the environmental side.

Thank you.

And we, you know, we bundled the seven contracts that we're looking at, and you know, like I said, the types of contracts that we have are predominantly asbestos consulting firms, which are the consultants, and then the general contractors are general abatement contractors, and these types of vendors are required by regulation when when you're doing this removal and this type of work.

There are set rules and regulations for to have oversight to have trained workers and certified staff doing this type of type of.

Last comment before we switch over to the next slide.

Um these are very specialized services, and so again, it's important to have access to them ahead of time.

So doing an RFP every time the need arises would create significant delays, and particularly for an emergency situation.

And so these contracts are really meant to provide city agencies access to these services on an as needed uh kind of basis, um, because there's not a lot of vendors that that perform these these kinds of services.

So this slide summarizes um what we've put forth, and we've listed our consultants in the top four rows, and then the contractors that we currently have on the bottom three, original value, the amount that we've spent against these contracts, um, as of the end of Q2, the added value ask, and then the current expiration date for these, and the added time for six months across the board.

And I will add that you know, Alex mentioned we are going through the RFP process, and one of the big concerns I had with this was the delays that we were seeing in the RFP process for for new contracts, and some of these vendors were getting close to their their value, and we had also lost a abatement contractor unexpectedly this year that had significant value of their contract remaining that was gonna help us bridge this gap and um because of that, more work is coming on to these three remaining contractors.

And so, um, before we turn over to questions, uh just wanna reiterate again.

We're um I know that the dates, the expiration dates look like they've give us give us enough time, but because there's no minimum expend extending them to the end of the year really doesn't obligate the city to continue with the contracts as soon as the RFPs are done, the vendors are identified, we go through the contracting process, we go through the council process, we get signatures, we get the contracts executed, we can begin to use those contracts, and so these would just uh we would stop using them, but we did want to make sure you can see there's one contract there that's pretty close, and that's as at the end of Q2, so that doesn't include like the last uh month and a half.

Um you can see that uh one of the contractors there is very very close to hitting their hitting their value.

Um, and again, we did unexpectedly lose one contractor that stopped operations in Colorado, just uh without uh giving us a lot of notice, and so that then added pressure on the existing contracts uh on the remaining contracts.

Um, so again, what we're asking for today is approval to move forward with resolution requests to extend dates through the end of next year just to again make sure that there are absolutely no gaps and to add value as we continue to uh engage these services citywide for a whole uh range of activities from maintenance, construction, demolition and emergency response as well.

So, happy to answer any questions.

I appreciate you going through that, Nick.

Thank you so much, Alex and Nick.

Um we do have um council members in the queue.

And I'll start first with council member Flynn, that's online, and then I'll come back to the room to Councilmember Torres.

And actually, I think let me see.

No, sorry, didn't have questions, so I'll go to Councilmember Flynn first, and I'll come back to Councilmember Torres.

Um, the who was the vendor that you say has left the field, and there was uh a lot of capacity remaining in their own call.

How much capacity was left, and who was that?

Uh that was arc abatement, and the parent company decided to close the Colorado branch and and cease their operations, and we had about five days' notice of closure.

Um I can't do their original contract amount and how much was left.

Uh, I'll look up the specifics and Alex can get back to you.

But it it was it was.

Were they one of the major ones?

I know this some of them had five million dollars in capacity, and four of them had only one million.

So I guess that reflects their size.

So, was the one that left?

Did they have a five million or a one million?

I guess that's the basic question.

And then how much was left?

Yeah, okay, I'll clarify.

So the one million contracts are the consultants and so a different type of vendor, and then the five million are the abatement contractors who are labor heavy and and more costly.

Okay, thank you.

Now we're adding three amendments to the seven.

I'm sorry, the uh hundred people.

Seven vendors, we're adding nine and a quarter million dollars in six months.

Uh that's just seems like a lot of scope.

Is it the case?

And correct me if we've not uh reflecting this accurately, but when we issue a contract if it's on call, typically when we issue a contract, we're required to have all the money set aside.

Uh and you can't touch it because you might use it for this contract.

Is that the case with an on-call?

Or would it be the case that if DOTI or some other agency needed this service, but they didn't have in the wastewater enterprise for when they didn't have enough capacity, they just couldn't do the work?

Yes.

So it's kind of sequestered until it's spent for that purpose only.

And what I'm getting at is with the budget uh shortfall that we're facing next year.

I'm wondering about the what is the prudence of locking up nine and a quarter million dollars.

Yes, yeah.

So the funds aren't set aside or allocated of these contract amounts, they're based on the project need, and so each project budget pulls from these contracts independently.

And Nick, if you don't mind facing in just your voice um comes out so folks are in on virtual can hear you, but please uh repeat that again.

Yeah, so the there is no uh appropriation of funds based on these contract values, it's project-based and independent of each department that is pulling against these contracts.

Okay, so it's up to those agencies then if they have the funds to do that work.

And I Mr.

Chair, I thought he'd rather look at my big face.

Oh, well, you know.

I mean, I got the new haircut and everything.

Thank you.

That's all I have.

Thank you, Councilmember Flynn.

You had another question, Nick, that you didn't quite answer.

What was remaining from that contract uh that um that ended so abruptly?

Um, we'll track that down and go track that down.

Okay, that's to committee members before it hits the floor.

Yeah, absolutely.

Thank you so much.

Councilmember Torres.

Thank you, Mr.

Chair.

Um, I might have missed it.

Was that vendor that left a contract or a consultant?

It was a contractor with the five million.

Okay, great.

Um the uh when did the contract originally begin?

We're well we can look up the exact dates on that table.

So it would be around June-ish 2021, I believe.

Okay, and so that we're not exceeding the five year old.

We are with the six months extensions across the board.

Okay, so in doing this, we're exceeding five city attorney's office.

Um, feels like that's appropriate.

Mr.

Chair uh Kelsters uh Torres, yes, the city attorney's office has uh believed drafted a justification and approved the justification for extending these contracts to ensure that again we meet our regulatory uh requirements while we're going through the new RFP process for a new multi-year contract.

Okay, and so the six months is adding to this expiration date, not unilaterally taking them to like December 31st of 2026.

No, it was just six months of their expired at the five year term of each contract, and so that's why they looked a little different in the table, because it's six month extension across the board, just to help us manage this risk that we see with this gap while the new RFP process takes its course.

Super helpful um to understand the um RFP or new F RFP.

When do you expect that to go out?

It hit the street a couple weeks ago, bids are due for both.

We we're running them in parallel concurrently.

Uh previously years these have kind of been offset by about a year.

Um I'm preferred that we just do it at the same time, keep it clean, and bids are currently due on the 21st of this month.

Okay, and um also recognizing that particularly for the contractors, they're close to their original value.

Um, is what we're adding um being conditioned on the same cost rate um that the prior contract was based on.

So we're not paying more for a service now than maybe what what we negotiated four years ago.

We did uh provide them an opportunity to update their rates across the board for consultants and contractors.

Um those were provided in there's not a huge jump, but we also recognize that vendors submitted these pricing this pricing in 2020.

And it's been a good amount of time and just with you know costs of have increased, and so we we did offer them that opportunity.

Okay, I'll just add to that that obviously the RFP process will provide an opportunity to get cut the most competitive rates, um, and I know that we also use the the additional value is based on the capacity of the the contractor, uh the potential need, um, and then also the ability to ask for multiple uh scopes of work for an individual uh call, you know, to do a service, and so that allows us opportunity to again get the best rates possible as needed during these current contracts.

Is it possible to share um uh before the floor like the percentage increase in cost?

Okay.

Um and then um is the spend down that we're doing like typical historically to what we've utilized these contracts for, or are you finding that we're using them more often now than we have in in the past few years?

There has been a bit of an increase depending on various initiatives in the city.

Um, you know, we we did see quite a big jump.

Um and it it does vary, you know, between bond projects that are coming through and just the timing of a bond and and all that.

So there's there's some some drawdowns that that do vary, but so and again, because of the scope the broad scope of the potential use of these again, maintenance, construction, uh demolition, um, but also uh included in this update is the potential for again a catastrophic event that would just be a use up a lot of value suddenly and unexpectedly, you know, some kind of flood, something of that nature.

Um, and so having significant value, even if we're not going to spend it down, having it available is very important for again managing the risk here.

And then we only use these for city owned buildings, city-led projects, things like that.

Do we ever use them for maybe a private property or entity that we expect to be reimbursed or paid back for?

Yes, that can happen.

Um, it's happened a few times under these contracts where there's um whether it's a neglected and derelict building and CPD comes in and takes over or DFT is identified an immediate hazard to life and health.

We we will utilize those contract these contracts to take care of the hazard.

Um so that and that's the a big part of these values and and and the increases is the the what ifs, the environmental what ifs.

And it allows us a mechanism in the city to respond to those things and still be compliant with regulatory requirements and also protect the environment, public health, and and our environmental liability obligations.

Um and this could also be for follow-up.

Um, how long do we have to wait for that cost to be um reimbursed back to the city?

Um, how often is that happening?

Like, you know, for nine and a quarter million being added to almost 16 million originally, like it would be helpful just to know like less than a percent are done on private property that we're trying to be reimbursed for, or something like that might be really helpful.

Okay, thank you.

Thank you, Mr.

Chair.

Thank you, uh Councilmember Torres.

Uh, looking around for any additional comments.

I didn't see anything else virtually.

This is an action item.

We do have quorum.

We'll just need a motion and a second.

Um, this will be on a block uh series of 25, 1130 through 1136.

Do we have a motion?

So we'll move council member Torres, second council president Sandoval.

Any um questions?

Can we do this by acclamation?

Thumbs up.

Get folks on online, the opportunity if they have any questions, seeing none, um, thank you so much, council members.

This will move to the floor.

Thank you, Nick and Alex.

Um, we have four items on consent.

Um, seeing none of those have been pulled off, uh, this meetings adjourn.