Welcome everyone to the um service delivery committee.

I'm Councilmember Tarsha Jackson.

Um I am the chair, and I would like to welcome our vice chair, Mr.

Ramirez.

Councilmember Ramirez, thank you for being here.

Um this meeting is being held in a hybrid mode in person and virtually, and it is open to the public.

The chair is the presiding officer of the committee, and is pretty committee meeting is pre um presented in the chambers according to the provisions of section 551.127 of the Texas government code applicable to the government body that extends into three or more counties.

All of the committee members have the option to participate in person in person or virtually via Microsoft.

And today we will hear presentations from our very own director of the health department on Director Chan.

And Director Chan will share with us just an overview of what the health department does and how they serve our um wonderful city, the city of Houston.

Um we have one person signed up to speak.

If you wanted to speak, you had to sign up by 5 p.m.

If you didn't get the opportunity to sign up, um we have a sign-in sheet that you can um sign up.

So with that being said, we're gonna um have our director come on up and um share the good news of the health department.

It has been an honor, you know, since I've been here on um council working with the health department on various projects.

You guys have been a you know, just the champion on moving our um programs, projects um forward, um, like the Be Successful Initiative and you know, working with our nonprofit organizations to build um to support them and the work that they're doing within our communities.

And so um, this is an opportunity to learn what the health department do.

Everybody, you know, we know you here, but you know, you do a lot of um great things for the city, and so um the table is yours.

Thank you.

Thank you so much, Councilmember Jackson.

Um first off, thank you for inviting me here and for caring to share what the health department does.

Um, this is a little bit of a test for myself because in the nine months that I've been here, I've gotten to learn what we do, and so I'm still learning.

I'm not done with all of my deep dives yet.

I have um one division to go where I'm diving deep into like this morning.

I spent with our WIC program.

I'll be spending it with our triple A program and Incredible Messengers and you know, just a few other programs, but I'll be done certainly within the next couple of months.

Um so how do I ask for the slides to be advanced here?

Just next.

Okay.

All right.

So um just for your awareness, this is the presentation that we put together for new council member orientation.

So it was updated for council member Salinas, and um this actually was a great opportunity for us to just share with everybody to get us back up onto the same page as to what the health department offers now.

Um we are a full service health department.

There are uh 1,222 employees.

Uh last year our operating budget was 179.5 million dollars, of which I'll show you what the grant funding allocation and the general fund was.

Um but really what we do as a health department is truly work within the community to promote health.

And I'm gonna get into public health a little bit more because even as the um assistant dean of a school of public health, I didn't realize what we were doing at the health department in public health, which is could be different depending on uh what city you're looking at.

But we are truly full service.

We provide the um services that a large public health department is supposed to provide, which is fitting because we are the first local health department in the state of Texas, and we um are the largest health department in Texas and one of the largest in the nation.

We are also the second largest department in the U.S.

to achieve public health accreditation.

Um the next slide.

Let's see.

So, of course, you already know this.

We serve all of the residents in Houston, but there are services and Leah and I spoke with the budget committee about how Harris County Public Health and Houston Health Department have services that some of them we provide, some of them they provide for the entire county.

Um, among the services that we provide countywide include our area agency on aging, some of our immunization strategies, and then um our some of the direct funding that we're able to get federally for HIV and STD surveillance.

Uh we do the surveillance for the entire county.

And also 17 surrounding counties, including 17 surrounding counties.

Next slide.

Okay, so what is public health?

This is the definition that you'll see in textbooks, and that you probably know.

You know, we prevent illness, we promote health and wellness, and we try to protect the community from outbreaks and diseases.

The next slide.

And resource allocation for public health has to recognize that the two go hand in hand, and they're not just a mere overlap on a Venn diagram, but they are all encompassing.

And so that is the virtue that we're taking forward into the future at the Houston Health Department, that we encompass an umbrella of everything.

It doesn't mean that we become, you know, a primary care clinic or a medical home, but it is just as much our responsibility to get people connected to that as it is a health care delivery system's responsibility to connect back to us.

Okay, next slide.

So as we go into the legislative session and talks with DSHS and looking at funding mechanisms for the next year, it is important to define what we consider local core services, core local public health services.

And so the um TACA, which is the Texas Association of County and City Health officials, has come up with some talking points that we that align with what health departments are doing.

Not every health department, like you know, in a tiny county, um, well, first off, tiny counties may not even have a health department, but um tiny other cities may not do everything.

We do everything on this list in Houston.

But these are the core services that if we are not able to maintain funding for, whether it is from the federal, state, or local budget, that we're not able to maintain core public health services.

And that includes disease and illness prevention, immunization services, surveillance and treatment, um, reporting, of course, the regulatory services that we're uh statutory supposed to do.

Um, of course, infrastructure, sometimes we forget that we actually have to maintain local offices and a workforce and business functions, um, and then health promotion, including the disease prevention programs that we'll go into a little bit later, and specifically um focusing effort on women and children and seniors, which are huge vulnerable populations.

Um a lot of this work, even with the um the organizations and even with all of the health care dollars that go into health services.

Um they do if we did not exist and if we did not offer those services to the what I call safety net be in being the safety net of the safety net, um the system would the system would fall apart.

And so um those are the services that you know we're able to provide on a large scale that makes us so necessary in the area.

Okay, next slide.

Um, so in addition to the definition of core public health services, in order to maintain accreditation with the public health accreditation board, there are some foundational capabilities that we maintain at the health department.

Um, and which, you know, these are very generic topics: assessment, surveillance, policy development, partnership, accountability, equity, um, emergency preparedness, and then other organizational competencies and communication.

Um, but these are very focused on public health, and that's what we maintain in our whenever we uh discuss workflows and what we're doing, we try to tie them back to foundational capabilities.

Um, go okay, next slide.

This is just a kind of slide of what we do well, and I don't have to explain to y'all because you've been around longer than I have, that these are that I think that you can imagine ways that you've potentially worked with the health department or seen us work with the community in organizing, of course, the big warming center responses, other large events, and um and just the leadership that our members have displayed across policy for local, state, and national level.

Okay, I'll go next.

This is our current organizational structure.

Um actually this will change tomorrow at 5 p.m.

Because Dr.

Peirce, of course, is retiring.

I hope that y'all are coming to his retirement.

But as a uh so Texas statute says that if the director of a health department holds a medical degree, then that person is supposed to be the public health authority.

And so with Dr.

Purse's retirement, I will become the local public health authority.

Um, and then Dr.

White will continue to be the deputy public health authority.

But that's gonna be the only change with Dr.

Purchase's retirement.

So otherwise, we have uh you can see down there we've got seven um, well, really like six uh divisions, and that's my executive team.

The bottom there.

Okay.

So we will talk more about this on May 14th and how this is changing drastically, but I think for the better.

Uh so I think the bottom line for you to take home is that the taxpayer investment in our public health department is 34.7 million dollars.

Um, rendering a benefit of 179.5 million dollars when you count the grant funding that we bring into the community and the special revenue funding that turn that we are able to collect from our um uh billing uh for uncompensated care, which is a small amount for our food inspection services, permitting services that we use to sustain those same services that are a community benefit for safety um, you know, for health safety, um, but also for other programs that um such as our C to Succeed program and some of the services that we have that are not revenue producing or that don't come from the general fund.

All right.

To give you a more of a breakdown of just how heavily funded we are on grants, I gave you a list of overall programming that we do in the department.

I think this is like maybe a key slide for y'all.

Um in red, these are programs that are fully or primarily funded by grant funds.

Blue is what's coming out of the general fund, and green is what is coming out of our um being paid for by either our special funds that are revenue producing, or uh we have a special fund, um, it is fund 20 uh 10, which used to bring in quite a bit of dollars from the Medicaid 1115 waiver program.

And so it was able to carry a lot of the services that were not covered under the general fund or under grant funds, but still provide services to the Houston community.

Since that 1115 waiver fund our waiver program has gone away in Texas, the Medicaid waiver program went away.

Um the uh what we bring back in revenue to that fund is actually uh very much less than what is being sustained on that fund right now.

And we'll talk more about it, like I said, my strategy for the budget session, but um, just to give you a little bit of a super secret overview, I guess.

Um it is if we don't um maintain uh an appropriate revenue fund, that fund will run out within the next two years because of all the services that we're carrying on it in addition to the cuts to the general fund that that we're looking at.

All right, next slide.

Um okay, so some accomplishments, some of which happened while I've been here, some of which have happened before uh I got here, but um just wanted to highlight our areas in environmental health.

We were established as a wastewater center for excellence and actually have received, I believe like nine million dollars in funding for that.

Um, and we are uh we're really leading the effort in public health around wastewater monitoring, and you can do so much with wastewater monitoring nowadays, and um, even from a clinical perspective, it's it's nice to see, okay.

I believe that there's gonna be a flu spike, or I believe there's gonna be some other spike, and we um can even look at trends with opioids and whatnot, um, and other things that can be tested in wastewater.

We performed 14,000 food facility sites in 2025.

And if you'll remember, this was a year when we lost a lot of inspectors to the retirement, as well as not being able to hire into very difficult to fill position.

So in addition to making sure that we're able to address all the needs of your constituents when they come to you and they're like, hey, help us right now.

We we say yes to everyone, we are always there on time.

I think we get everything resolved.

Um at least since I've been here, nothing has ever gone not unresolved within a timely manner.

And we also have been doing the regular inspections, and so it's a Herculean feat for our consumer health and or our food inspection team.

Um our habitability program or our apartment compliance program performed 4,000 complaint investigations in apartments, and so due to their efforts, we have seen improvements in certain in certain apartment complexes, for example, like Life at Jackson Square and others, and the work is ongoing, but we're here for you know, any any um anyone who calls 311 and asks for a uh a or has a complaint within their apartment complex, we send somebody out too.

As far as disease prevention, oh, and let me go back to the environmental health.

So our um our food inspectors, our really mantra in that uh area with restaurants and food trucks is um education over citation.

So the preference is always to educate and help individuals get into compliance without having to do any type of punitive measures.

Um when it is truly a public health hazard, you have to trust us that when we need to shut something down because there's like raw chicken on top of cooked chicken, that's you know, that's what we have to do.

But um, we our inspectors are trained and reminded that we really want to help people make a living and have a good income here in Houston and help them also keep the most vulnerable people you know safe.

So uh just just for your awareness, that's how we train our inspectors is education over citation when possible.

Um for disease prevention control.

So something new that we just started in my time here, and in the idea of um treatment is prevention and prevention is treatment.

Um we started off, or we are starting to offer, we're actually, I think the start date is in May, but we are going to do something called rapid ART, which is rapid anti-retroviral treatment.

Um in the past, when you know, we we get the grant funding to do STI and HIV surveillance, and so we can test an individual and tell them that they have a diagnosis, but then that individual sits with that diagnosis until they're able to see a provider.

Um within the time between when they see us and when they see a provider for treatment, there may be activities that happen and they may be spreading the virus, or um, they are sitting there in limbo with this, you know, death sentence almost, and not these days, but it is a burden, a disease burden that they're carrying.

And so what we have started to do within our own clinics is provide with a new diagnosis treatment that day.

So the individual actually is getting is we are we are seeing in that way treatment as prevention and therefore you know being able to prevent the spread and hopefully end the HIV epidemic.

So the uh, you know, as far as our within disease prevention control back in 2023, um we are the ones who noticed in our surveillance data that there was a large uptick in syphilis.

And um, because of that, we were able to, you know, sound the alarm, deploy um, you know, get state resources, we were able to deploy a lot of our own resources, and within just two years, we've gone below the threshold of outbreak.

Um, and and while syphilis and um congenital syphilis is still a huge concern and a huge disease burden in our region, we are working so closely with providers and um and and trying to improve that still by even just improving the thresholds by for which we look at syphilis.

Um and so, you know, I'm I'm very it's I it's a proud accomplishment of the department.

We created a model where it basically a provider hotline for if you you know you don't know how to read syphilis titers or you don't really know what to do, which I would be one of those providers included as an ER doc.

I'm not like a syphilis or infectious disease expert.

You can call this hotline, and one of our physicians within the disease uh or within our syphilis bureau or excuse me, HIV STI Bureau would walk you through the steps of what next to do.

Um that was such a successful model that the state has adopted it, and DSHS has their own syphilis hotline statewide that we support.

So yeah, um, that's something for us to be really proud of.

Uh a lot of times the successes that we have in our department are what you don't see.

What you didn't notice was a large measles outbreak after we had measles cases in Houston, and that is a testament to our ability to identify, trace, and contain those cases along with our health care providers and the county.

Um so the fact that we don't have a huge measles outbreak in Houston is uh is a testament to public health working.

Um in addition, we finally broke ground on a $13 million laboratory over on Holcomb.

We, you know, the ground, the earth is moving there.

So I know that this is something that the city's been waiting on for many years, and it's finally happening, and we're very proud of that.

Um, that will allow us to expand our services to make our services even quicker and actually to bring in more services.

So we're talking about collaborations with the county, et cetera, um, on providing services at that location.

Okay, next slide.

Um, this is something to be really proud of.

Our immunization bureau, um, they spearheaded uh and they they actually have somebody that goes on campus to all of our HISD schools, and we have a pretty impressive looking tracker of immunization rates, and they've worked very, very well with HISD nurses to uh to partner with them.

And the last year it resulted in 95% of all HISD schools meeting the 95% coverage rate for herd immunity.

Now, um for those of you who like what what does that mean?

Depending on what the disease is, uh herd immunity, meaning the point at which we're not worried about the random unvaccinated person not being or being exposed to getting a disease.

Depending on the disease that we're talking about, it could be anywhere between 80% to 95%.

The highest herd immunity rate of like the key diseases would be measles, which is 95 degree uh 95%.

So for us to have a um a 95% coverage rate and 95% of all HISD schools means that our immunization program is working.

That that was an increase from I believe 83%.

And um, so there are still pockets in schools that are in the red that where we're still trying to increase the immunization rate, but that's why the hard work that they're doing.

Um, but this is just another way of I think showing you just how how effective the programs are, um, especially uh the immunizations program.

Um community reentry and credible messenger, we were able, and this is data from 2022 and 2023, but it hasn't really changed much.

We have a recidivism rate of about 10% compared to the state average of 20%, and that is a testament to how connected our individuals and advocates stay, and our peer counselors stay with the individuals that graduate out of that program.

Um the uh of course the credible messengers program.

I know that there is a credit messengers program in your district, uh, Councilmember Jackson that we support, but we have a credible messenger program that we receive funding through or for our own department.

Um it's amazing.

They get really little funding, but it is a program where nobody really gets turned away.

Um the I uh her name is Robin Osby.

She's the she's the person who really manages the youths in that program, and she has changed their lives.

Like I went to a play that they did, um, uh, and you could tell that they were getting therapy through her group for their trauma because of the way that they were able to address it through these through this play that I went to.

But um individuals will stay in that program for anywhere between three to six months, and um, and really their lives are changed.

They go get licenses, they're able to get jobs and go back to school.

As far as chronic disease, um, we have a program called Dawn, which is Diabetes Awareness and Wellness Network, and it is based on um diabetes education and um like diabetes self management education and diabetes prevention, and those are both programs that are reimbursable.

But within our program, we uh we teach people how to eat healthy healthy, we have give them direct um connection with nurses, with registered dietitians, um uh coaches for exercise lifestyle coaches, and um this is a program that is uh grant funded partially, but um it is our reach into the chronic disease space.

Now, when you think about chronic disease or any like the word chronic disease, it sounds like a medical term and something that maybe a family practice physician or someone in the medical setting should be taking care of.

However, this is another place where I want to remind you the preventionist treatment and treatment as prevention model is that a physician may spend like 15 minutes with an individual.

Our Dawn program is months long.

We are interacting with these individuals to help them with their diabetes or pre-diabetes disease process for months and months and months.

We have a relationship with them, and we're actually helping them meet the goals to where when they see their physician in three months, their hemoglobin A1C is low and they are no longer diabetic.

We have helped individuals stay off and get off of medications through that program.

Um and then, of course, maternal and child health.

I don't have WIC on here, but we had in 2020, or so we are one of four WIC programs in the region that is directly funded by the state, 100% funded by the state.

Uh we saw 216,000 visits through our 14 WIC sites providing lactation nutrition services and actually nutritious foods and benefits to mothers and children.

Um of the individuals that we saw, I think we saw like 16,000 pregnant women, 13,000 infants, um, over 30,000 children under the age of five.

And that was just in one year alone.

Um, and then on here, of course, uh, if y'all don't know about C26 already, it is a program that if it did not exist, there would be 10,000 students of the 40,000 students on the list of students who get screening at their school nurses.

They are told that they are um you know, they have an eyesight problem and they need to go see a doctor, but there's the state gives us an unresolved list, and we target the schools that have high unresolved list numbers, take them on a field trip to our eye clinic in um the West End, or we do the missions on site at on school location, and we see the students screen them for eye problems and give them glasses.

And the uh glasses are all funded through grant funding, um, but we run that through the health department, and one of the missions of the um I guess volunteer missions, voluntold missions of our health department staff is that they actually staff some of these missions.

Um so it is a huge service to the area where that really the um medical community would not be able to otherwise capture if we didn't capture in this type of way.

All right, next slide.

Um in addition, uh you all know that we opened up the our warming centers and we really ran incident command on all of the warming centers.

Those warming centers, eight of the 12 warming centers are staffed, fully staffed and on location at our multi-service centers.

We also provided staffing to the parks department to work in the park sites, um, provided um the logistics for everything, um, and then and so we served 14 over 1,400 clients during the past winter freeze.

Uh if you've been to the A-Leaf Multiservice Center in the past year, it is bustling.

And part of that is the foot traffic that comes through to our Dawn program, the WIC Center, and then the senior services that we have at A Leaf.

And so that is that is the type of model that I want to see in all of our multi-service centers, to be honest.

Um, and then of course, we partnered with Bezos Academy at Denver Harbor for early childhood education through through the Bezos Foundation.

Um so just a recap.

We um, you know, we were originally FAB accredited in 2014, we were re-accredited in 2021, looking into the future.

Our next accreditation process is going on this year, and we will most likely become reaccredited this year in 2026-27.

Um, and we have some really cool projects in mind with um Harris County Public Health, who is also going to be go who is also on cycle like a year ahead of us for re-accreditation so that we can combine the work that we do for re-accreditation to like in our community health assessments and community health improvement plans, we're planning on doing a joint um project for our next accreditation cycle, so that we're just doing one report.

And then something that I can take credit for is uh as of this year, we became an academic health department designated in collaboration with UT Health Houston.

What's different is so UT Health Houston created the academic health department model throughout Texas.

They already had a partnership with Fort Bend County, Travis County, and Dallas County.

What's different is that rather than just being associated or um collaborating with the School of Public Health, the City of Houston is collaborating within all of the schools with the UT Health Houston system, so that we don't have any silos in the type of work that we're doing.

That opens our staff and faculty up to being able to work with researchers and students and faculty across all of UT Health Houston's schools.

Um and we've just become a lot more collaborative.

All right, next slide.

Uh I won't go, I'll let you have all of these for reference, but you know, we have the C to Succeed program.

I can these are some of the six like I told you, this was the um presentation that we did for new council member Salinas.

Um I already talked about CDSOC, we can just skip through that.

Um next slide.

Uh Project Saving Smiles is a dental based, a dental like clinic based mission similar to C to Succeed.

So imagine C to Succeed, but for dentistry, um, which is also another, you know, anytime you have a an issue that really can't be, people aren't able to where transportation or time is a barrier.

Um we decided that teeth and eyes for children are something that just cannot be pushed down the line because they can lead to other diseases and um you know setbacks, and so we um that that's one of those things where we do it similar to the C to Succeed model with very much success.

All right, next.

Um we do have the MBK program housed at our department.

So it exists in our department in a couple of iterations.

So we are the um or the backbone organization for the My Brothers Keeper Houston collaborative model, which encompasses about 200 um organizations uh aimed at um improving social mobility, economic and educational um opportunity for uh young, well, it used to be boys and men of color, but now it's just children of color.

Um we're realizing that it um you know women and our boys and girls are affected and need mentorship.

So uh we we do some of the data collection for the successes that the organizations that um partner within MBK are able to um to report, and then our own um within our own department, we do receive some funding from the MBK um model for a wraparound services like service delivery model where we're providing the wraparound services for these individuals.

Um, next slide.

And then of course I told you about um credible messengers and re-entry, which yeah, I think y'all know about.

Um and then, okay, so something also new that we came up with this year was of course the Safe Watch Dashboard.

If you haven't had the opportunity to check it out already, it has been um a huge undertaking uh that council member Cayman's office helped to get it off the ground, but we work across governmental agencies with level one trauma centers and academic partners to show what the firearm injury patterns are in the um in in the Houston region.

The NIH and a collective from I think University of Michigan came and we presented it to them.

This is just a really awesome model that people are like, how did you get this to happen?

Um that we uh that we maintain at the health department were able to do studies on.

Um I I can't remember who's I I know that other city departments are actually using our um information as well to inform their services as well.

All right next slide um a special project that we are collaborating with Eben Cena, the Health Foundation, UT School of Public Health, we received some common spirit grant funding for that we uh it so we created a an organization or I'm the I'm one of the members of a board of an organization called CATC.

What we do is try and figure out how to generate revenue off of the services that are now billable through um I can't remember what the bill it was but uh community health workers are now able to bill on services but when that became act uh available as a billing mechanism back I think in 2023 it's not like people just still didn't know how to do it.

And so the health department took the lead in learning how to do that.

And so we are at two years from I think being founded and we're at a place where I think we figured it out and we're looking for national grant funding opportunity or federal grant funding opportunities working with the area agency on aging on learning how we can actually operationalize that law and um and teach other organizations how to do it as well.

So next slide and then of course I told you a little bit about our public health our academic public health designation or department designation which while it exists as an academic health department designation with UT Health Houston what's really cool is it's opened up our minds to collaborations across all academic institutions in the area and one of the things that we do within our legal department internally is now whenever we get an MOU in play or a request for an MOU for like a small service we ask ourselves is there something larger that this could be so that the next researcher or the next group that wants to do something collaborative from this school that they can just you know latch on as a scope of work situation rather than having to go through the MOU process all over again.

So making it much easier for the end users to collaborate it it's um yeah that's kind of just that is the whole idea of uh of doing that okay next slide um this is something you may not have heard about but we entered into an agreement with um the entities listed here the Karas County Public Health Harris Health the Harris Center and community health choice in what's called the Harris Collaborative so we are all working together to see if all of these large entities are able to actually move the needle on health outcomes together.

So we just entered into that agreement um in January we had our first kickoff meeting in January and we are going to try and take decisive action together using analytics from Texas Health Connect and PCIC which is now also merged to actually work on uh implementation and outcomes that we can report that you can report on within our area.

All right next and then um very recently which we haven't even pushed out all of the communications on this yet is um Harris County Public Health and the Health Department we know that we all have these dashboards and reports and things that make it very hard for like a researcher like myself to even find the information to understand what it's studying.

And so we decided to take a step or to to take an extra click away for everybody and we put all of our data and reporting on one website.

So now you can go on you can click on the website or you can find it from both of our websites separately but you're like a click away from all of the data that Harris County and the City of Houston report which has made it easier for um researchers community based organizations advocacy organizations and individuals to find information about about them about their areas about their neighborhoods their own demographics and most of them the dashboard you can click through and filter to look for exactly what you need next slide and then this is in the works we entered into what we are looking to and uh there will be some grant funding that we were going to be we we will be applying for this year.

This is something on a large scale that has not does not exist.

But the idea is to collaborate with our health systems here to give people who have a medical, a either acute or chronic medical problem that's that are too sick to actually be um in a shelter or maybe a group home won't take them, um, or they get discharged on a Friday night from the ER and don't have anywhere to go and they but they're not sick enough to um to meet like utilization criteria for admission to the hospital, that they have somewhere to go.

And they don't just go there for the night or as a place for them to just hang out and get shelter, but rather receive wraparound services, receive um you know the the counseling and the care that they need to get them to the to sustainable housing.

Um the idea is that they would be able to stay for the duration of their medical need, and if they have not been able to find sustainable permanent housing by then, whether it's going back home with their families or going to um uh a low-cost living facility or sorry, uh low-cost living um apartment or something that we actually are able to offer them a uh transitional housing.

Um, and so we would be applying for HUD funding through their transitional housing model.

Um okay, next slide.

And then just an update.

Uh we we I meet um quite frequently regarding Union Pacific Railroad.

Um I learned all of this as I joined, but I know this has been going on for 17 years, so maybe y'all can teach me.

But um we're at a place where so um basically we are helping the EPA and um TCEQ uh working with Harris County and then especially a community advisory board to understand exactly where remediation and mitigation of um environmental and potentially cancer related risks with um contamination of the wood uh preserving site or the old woodwork wood preserving work site um in Kashmir Gardens is so um we're just still we're it's a work in progress, but um we'll see where that goes.

So I I don't I don't we don't have a final resolution to that yet.

So that is it, those are kind of those are the big things that you may not have already known or been up caught up to date with in the health department.

Um you can always reach out to me or your staff members.

I'm available 24-7 on my cell phone, and then of course, Pascal is our council liaison.

But um, you know, there's there should be no just one point of communication with us.

So uh if you can't get a hold of me, please reach out to Pascal.

If you can't reach Pascal, please reach out directly to me.

Um so that's it.

Well, thank you.

Thank you, um Dr.

Tran for that presentation.

Um it's exciting to hear all the amazing work that the health department do.

Um want to thank all the the men and women that work at the health department.

I mean, you guys got your hands full, and so I'm really glad you gave this presentation because it it opens it up.

You know, we go in thinking that health departments just do the multi-service centers or um, you know, oversee the the food insecurities, but you guys do a whole lot more, and so um thank you for you know outlining that for us.

Um before we go to questions, I just want to recognize um the council members in chambers, we have council member Martinez, Councilmember Alcorn, and we have council member Ramirez, and then also we have staff from council member pro Town Peck's office, we have Councilmember Thomas, Councilmember Huffman, Castillo, and Councilmember Carter's office.

And so we're gonna go to questions we have first, Councilmember Alcorn.

Thank you, Chair, and thanks for bringing this presentation.

What a breath of fresh air you are.

Thanks.

Thanks for everything you just went through.

That was so comprehensive.

I am music to my ears about all the collaborative work you're doing.

I know when you were first being hired, that's a big priority of mine, and we talked talked a lot about it when I was first elected about doing more with Harris County Public Health, and you sounds like you're doing that.

The data hub, that's exciting, that's been in the works, and then the the collaborative with all of the organizations.

I feel like that's gonna really um really just make us you know a lot stronger working together.

We do so many of the same things.

And um also the transitional housing thing is very interesting.

Um we hear that that's a big, you know, problem and people end up homeless and they're not well enough to get out to an uh a place and it's it's a big mess when they have to leave the hospital.

So I hadn't heard about that.

I'm really excited about your doing that.

And um now that I've built you up so much, uh I'll ask about the I know you your department, you personally and Pascal have helped me out recently with the um food inspections of new buildings, those have gotten kind of backed up.

I've been getting permitting complaints um from every uh for for you know six years now, but really never from the health on the health inspections.

So I'm wondering I mean it's always been something drainage related or or uh something else.

So I'm wondering uh what kind of is uh is happening there.

You said they're hard to hire, are we down inspectors?

Are we um you know, because I l I a lot of times restaurants just can't wait if they're trying to open um for a couple months to get an inspection.

So just tell me a little bit about that.

Yes, to everything you said.

Here's my understanding of it.

So in order to be a registered sanitarian, um, I actually look to see if I could do it myself, but it's kind of a it's like a two-year process where you've got this training and then you have to do um almost like an apprenticeship type of a model.

The health department um does provide that training, okay.

And then because the um historically the work has been harder and the pay less than surrounding areas um or other departments, even we have no we had been doing the training and then those individuals got poached to different places.

Well, that's something we needed to know during the budget season.

Like what what are we paying them and what do they need to be paid?

So very recently, like as of I think the past month or so, we were able to get a salary study done for our environmental health investigators.

And um we sorry I don't have the number, but I we did I'll give I can't.

That's okay.

We um we were able to look at like pay parity across whoever was a who wherever they were able to get the survey results from.

And I believe that we did increase that um going the salary for environmental health investigators.

We still need um support um I think for being able to maintain them.

And uh we I I believe that there's like 12 or more open positions right now in that area, um, out of I like thirty-seven food inspectors for a city with 25,000 restaurants.

That's insane.

Um so part of my um budgeting strategy is because that program does bring in some revenue.

Right.

Um was to realign the revenue with the expenditures so that we could actually reinvest the revenue into the expenditures of that special uh fund.

And I'm sure we probably haven't raised that fee in a long time.

No, and I I think that um so well, so here's the other catch to this was as of um this past legislative session.

Um right, I was gonna ask you about that on the Yeah, yeah.

So um we are uh at least for mobile food units, um, and also I I uh all I think actual restaurants as well.

But we have we used to have a the city ordinance standard was actually higher than standards everywhere else, meaning that if you passed a food inspection here, you were even safer than anywhere else in Texas.

Um but there uh within this recent law um we default back to whatever the state standard is.

And so that's where we're at.

Um now along with that, there is uh at least with our food cap food um trucks, we're no longer the ones who are collecting our permitting fee.

Right.

We are um contracting with the state for a cap or for a m a certain amount from the state to um to be able to do the food inspections on their behalf and they collect the fee.

So we do the food inspections.

We on the mobile just for mobile, just for food trucks.

We do them.

The state pays us something for doing them.

Yeah, they pay us a contract, which is not enough.

Right.

Um, which I do not which our team perceives to not be enough for like half of what we need to get through all of the food inspections for the next year.

Yeah.

Um, and so we're still we're trying to work with them still on that contract.

Yeah, we need to go back to the state again on that, maybe see if there's something.

I'm sure it was just restaurants wanted to what what about regular restaurants?

You you pay a permitting fee to get the you come out there.

Yes, and they pay so they do a pre-inspection, a plan, I think they do a plan review, and then they do a post or like a pre-opening inspection, which the health department does.

We do all this through the Houston Project.

Well, whatever that cost of service is at the better salary, we need to make sure that that's what we're charging.

You know.

Yeah.

Yeah.

And I will, I mean, we it's it's not just like so the county other departments like public works.

I every so often I get notes from them that said somebody's gonna be transferring over there.

Um it's just it's a really hard job.

It's hard, yeah.

Um and but they they we they get it done, and whenever we ask for, you know, a constituent has you guys have helped me.

I have no complaints.

My people are all happy.

You you call, you call Dr.

Treann or Pascal, and man, somebody's out there.

But but it's the first time I've heard that it's taking like a couple months to get on the regular schedule.

The yes, the thing that we need is um I think more investigators and higher salary for in the investigators, and then as far as the fees, I don't know what our constraints are.

I for like I that's not for you to worry about it.

I'm I'm gonna worry about it because we need to make sure and get those get make sure you have the n right number of inspectors.

Thank you.

Thank you.

Um staff from council member Carter's office.

Thank you, Chairwoman, and thank you, Director, for the presentation today.

Um I just wanted to uh talk a little bit about um the My Brothers Keeper initiative.

Um that is something that um Councilmember Carter um expressed some concerns about in 2024, and um we took a look at it again um seeing that it was going to be on the council agenda today.

It wasn't it it was pulled, but um seeing that it's in this presentation today, we just wanted to um bring to light that uh our concerns from 2024, those are still ongoing concerns for our office.

Um we haven't really gotten answers on some of her questions um back from 2024.

So um just want to kind of I guess bring those back to light um in case we could get some answers on those.

I um well I have to go look at the questions.

But I will also say so my brother's keeper is a program that is being funded at like for the work that the health department does is being funded out of the health department's like 1115 waiver fund that is not receiving the funding that it was.

So there's no grant or national funding for my brother's keeper.

And so one of my concerns going into you know the next budget season and even after that in the following years is whether that is sustainable as a health department service without some funding source because our like I told you, our 2010 fund is with clinical services and the things that we have to do with the the reimbursable services that are even able to be reimbursed onto that fund.

We may be running out of money if we're not able to bring in revenue.

So um in order to continue my brothers keeper in the way that it looks now and um you know, for the foreseeable future, we are going to have to identify new funding streams.

Um that is one of those uh cons uh programs of concern that I need to evaluate like how we're gonna maintain it.

Um it is a uh it is a helpful program um or collaborative uh effort to get people on the to the same page, but how sustainable is it on City of Houston funding is really gonna depend on whether we can get some help.

Thank you.

And I do think that's important to look at, and I can just you know reiterate some of her concerns in 2024 as well.

I at that time um there were seven schools that were um utilizing this program, and uh councilmember Carter had reached out to those schools and staff from three of those seven schools uh were unaware that the initiative was even active to begin with and um or that it was still active at that time.

Um and then also at the time um when she spoke with Addicts Middle School, she found that they were running a co-ed version of the program that was um deviating from my brother's keeper's original intent being a program specifically for boys.

So and and now you're you know you're you're bringing to us that it is including girls as well.

So just kind of want to I guess clarify um exactly what is being done with that initiative and making sure that we are actually seeing results.

So um the reason why it was I I asked um for it to be pulled from the agenda actually because I wasn't sure myself what the answers or what you know exactly what that program did and six hundred thousand dollars is um not a small amount of money.

I you know tend to trust that you know there's a good reason for it.

Um, but I wanted to be sure that before it went before council that I could answer personally every question myself that came, you know, with that program.

And so um it is a result of me not having done my deep dive with MBK yet, so I'll take accountability for that.

Um but I uh you know I'm I am going to be looking into it when it comes back when it comes up on my schedule um to to be doing a deep dive and understanding exactly like you know, like you said, what are what is it doing, what's the what is the impact that's measurable that we can report and um how are we going to sustain it?

Thank you.

Appreciate that your council member Martinez.

Thank you, Chairwoman.

Uh Director, um kind of echoing a little bit of what my colleague, Councilman Alc Alcore saying, you there's a lot that you're doing to kind of consolidate, learn it, you know, digest it, and then be able to uh see how you can start right sizing that department.

I had a few questions, and you might not have all the answers right now, which is again I know that there's a lot of work to be done.

Uh but when you start comparing um other major cities in the state, their general fund, how much of that uh in percentage compared to grant funding, how are we?

Are we similar or are we different in some ways?

I know San Antonio they usually focus more on the it's I have a great graph on that that I can share with you from um so our uh I would say that we are similar to other cities in Texas, where we're about two-thirds grant or special revenue funded and like one third uh general fund, and actually less than that for us now.

Um but there like other I want to say Chicago, if you look at their, you can look at where their grant um or federal, state, and local funded, um it's just all over the place.

There's like I think they are mostly federally funded and very they have a very small amount of state and local funding.

We um we do it's it's pretty even um with a lower proportion coming from local funding than state, and then a lower proportion coming from state than federal.

Um I would say that our funding streams are probably more equal when you look at the graphs than other large cities.

Uh and then to that, because we're talking about funding, how are we going to continue to pay this?

And we've definitely had we know that for a long time the city has always seen these challenges when it comes to funding and these real conversations about okay, what is it we're gonna do to make sure MBK gets funded and all these other similar programs?

Uh and then of course this this huge uh uh you know tasks that you want to do with the respite, which I think it's a the respirator and transitional housing, which is a it's definitely shifts us, moving us in the right direction when we're looking at how hardest to house.

Um and I'm 100% supportive of it as we look at funding.

How have we started having more conversations?

Uh I I've said this, I know we've talked about it as well.

So we use what 50 million dollars from the general fund, definitely not enough, but it's similar to what what uh other cities are doing.

How can we start shifting the conversations, start uh really seeing who is that taxing entity within our region or within our area, which is Harris County hospital district.

How do we start having those conversations to have ask those tough uh you know questions of what does that look like?

We recently went through uh a tax rate increase for flood control, knowing that that we needed that when we start looking at the hospital district and identifying maybe even an enterprise fund that is created through that that uh tax rate increase from the hospital district to ensure that we are focusing now on some of these other pro uh projects and programs, specifically when we start looking at uh unhouse community and then the menu of other programs that y'all are doing, stretching the dollars.

Are we want are we moving in that direction a little bit?

I that sounds amazing.

I would love to be able to you know get a piece of whatever existing taxes there are so you know to to fund public health, and that would be um I can't say ideal because I don't know all of the economics behind um you know what would be the unintended consequence or loss from from that, but um something of a model like that would be um ideal, whether it is like a taxing entity or a a taxing district or a um or a percentage that we get of certain fees or violations or something, that would be great.

And if we could have some of that like appropriated to health, whether it is county or city or whatever or state, it just needs we just need more funding in health in public health in general.

Regarding the hospital district, Harris County, Public Health, and Harris Health, work really, really closely with us.

And we um are even talking about what like you know, dreaming together, what a model could potentially look like, um, whether it's actually something that's doable or not.

Um none of us are closed off to the idea of collaborating or aligning or joining more if if it's doable.

That's that's great to hear.

And now before my time expensive sorry, those are the I'm speaking on behalf of people whose governance is different from my own, so I don't want to like say anything out of line, but um, you know, I I can say for myself, like if we could get us all to be one entity, amazing.

It'd be great.

Um I know we did really well this last legislative session to bring back some state dollars.

We know that Texas is lowest, you know, we fund the lowest when it comes to health health care.

Um but it would be great for us to start prioritizing that as a city uh to lead that that conversation for not just Houston, but quite frankly, our neighboring uh cities as well.

So uh it's something that I I'll I'll definitely uh be interested in having more conversations with you and then as we look at like Houston Galveston Area Council and those regions um next year when we start going to Austin.

Uh so um I think it's been said plenty of times relationships are important, so whatever we can do to be helpful.

Per capita funding for public health doesn't actually benefits us, but benefits these small counties and cities even more because they don't have the fundraising for a public health department, and if they were able to have a mechanism for that, I could see public health being able to do more in rural and smaller areas.

Well, thank you for everything you're doing.

I appreciate all the work and you being aggressive on it, and we're here to help the work along.

Thank you.

Thank you, Councilmember.

Um Councilmember Romares.

Thank you, Madam Chair.

Thank you, Dr.

Trant for the presentation.

I really appreciate the energy you bring to the position.

And there's so much uh that the health department does that is good.

So I applaud you and the 1200 employees that that work with you.

Um so just to follow up on on something that um uh staff from Councilmember Carter uh mentioned, you know, we we'd had some concerns in the past as well.

Not that the program isn't well intentioned and all, but but every now and then we see um what we feel are case management contracts that could have better data tracking, you know, so that we can ensure uh performance measures are are being adequately uh met.

And so I I appreciate your taking a closer look at that.

Um I also appreciate your comments about being open to uh perhaps some merging services where we can with uh Harris Health and whatever other agencies you know we might be able to partner with, because there might be efficiencies there that we can achieve that would that would help us make better use of our resources.

Uh I'm excited about a couple of the initiatives you mentioned.

One is the the respite facility.

What um do we do we have any funding for that at this point?

What what does that look like going forward?

So I said I was gonna put it out in the universe and get it hopefully to get it happen.

Um the uh we are in talks with entities for funding funding it right now.

And I, you know, I don't know how much I can actually say right now, but the um the funding for a lease agreement on that transitional facility is earmarked within the health department's special fund budget.

The services themselves are what we need to do fundraising for.

And um that is uh what we're looking to the medical community.

We have the largest medical center in the world with um large medical institutions that have emergency department patients that are discharged to the streets.

And so it would be my call to action to them to become more involved with those services as part of their contribution to the city, um or not the city of Houston, but to the um to the public and um and also um grants grant funding sources.

We uh excuse me, um we are uh going to be going after funding from HUD this year.

Okay.

Well, that all sounds very uh appropriate.

Curious to know are the fundraising efforts being led through our our current homelessness team, or are you a part of that as well?

How's that working?

Uh yeah, the conversations are being um led by I guess our team, you know, Chief Satter White, um Josh Sanders and myself and uh Mike Nichols.

Right.

All right.

Well uh appreciate that.

Also, you mentioned um that uh um you have uh hopes to well we are we're working on a construction of a lab, right?

Correct.

Uh that is being co-funded by HUD.

And um will that you mentioned that lab, I think will serve multiple counties in in our area.

Uh so our our lab already serves multiple counties, serves 17 counties, and sorry, the funding um was COVID era funding from the CDC.

And um the that's gone now, but we were able to use it to actually build the lab.

Um the uh the lab on Holcomb Drive is a lab, like we've always had that.

That's where we do our infectious disease like rabies testing and um tuberculosis, STI is like different diseases and looking for strains of you know, like where these disease families came from or where clusters come from.

Um but we serve as the reference laboratory like this part and as part of the um the a national network of laboratories like emerging infectious disease laboratories that are designated by the CDC that so as a reference laboratory and as the um I guess designated laboratory for infectious disease threats.

But that the 17 county region that we serve, we've been serving.

We're not like it's not a new service.

If um with the growth of the lab, we will be able to expand um our services.

If you if any of y'all want to visit the lab, you'd have to go through like a kind of crazy badging process.

But um, like even I don't have regular access through my badge, but um they have cardboard boxes and like their storage is all out in the hallways because they're utilizing the spaces for actual laboratory work.

And and I suppose the the lab does generate some revenue.

Uh I would have hoped that it could, but we're not like you know, one of those uh diagnostic labs that um charges or bills for it.

I think that that's a model that we could potentially look at, but as a public service, um you'll see that I actually put the lab um onto the general fund, um, the portion of it that's not paid for by the uh what's called the epidemiology lab core services grant um because it is a public health service, like um you're I I don't know how we would bill on the disease surveillance type of work that we do.

Um so for example, how do we find out that a certain strain of Salmonella or candidate um like let's say Salmonella, there's an outbreak or um uh how do we know where to trace that from?

Our laboratory has special equipment to piece out that data and see if that's like a cluster from a certain area or if all of the salmonella, the cases that we're all of a sudden seeing in the ERs, that they're like completely different and not related.

Um but you can't really like bring in revenue from that because it's you know it's a surveillance or it's a disease investigation process.

Um and Salmonelle is just one example, but we do it for all sorts of diseases that um you know we get data from the hospital systems and um from clinics and laboratories themselves so that we can look for patterns and we do that within our lab.

There is a lab, a state lab in Austin, and sometimes the um testing in our region we send to Colorado because there's just so few labs in these networks that do the specialized testing.

All right.

Thank you for that.

You're welcome.

Thank you, Chair.

Come by the chair.

Um Councilmember Huffman's staff.

Uh thank you, Chair, and thank you, Director.

Just one quick question or two quick questions.

The essential public health services fund, is that that fund that you were talking about earlier that's about two years out?

Yeah, that's gonna run out.

And uh just very quickly, what do you see the role of that fund being?

As much as we can, I would love to understand the ways that we're not capturing revenue on services that we're already providing that people are not necessarily paying out of pocket for, but not every patient that we see through the health department doesn't like is uninsured.

But a lot of times um the good thing is that we make it so easy, low barrier to be seen by not, you know, by just providing services whenever they're needed.

Our our providers have a heart of gold and they just don't turn anyone down.

Um the problem with that is we are actually seeing a number of individuals who have insurance that could be billed upon for the same services that a health care system that I would have come from would have billed for the same services.

And so um we are looking at the health department at you know, understanding how we can do that better.

And I see that fund as a place for us to bring in that type of revenue.

The way oh go ahead.

Oh, no, go ahead.

The way that um, you know, giving you foreshadowing for the way that I asked to rearrange the budget is we've put um our clinical services used to sit on the general fund.

Um but uh but the clinical services were the service were the entity that were potentially, if any revenue were bringing in some revenue.

So I have moved them, the expenditures for clinical services over to the special fund um to that fund 2010, because um my understanding of what we collect onto that fund now is charitable care funding, which charitable care is a pot of money that is designated by the state that um is a fixed number.

And so one of the legislative asks would be to actually increase that amount of that charitable care fund.

But as more health departments or entities apply for charitable care funding since um since the 1115 waiver went away, that was their um kind of substitute for it.

The ceiling, there is a ceiling because of there's only one part of money, and so the more people or by people I mean departments or entities that apply, the less percentage of funding any and any one entity would get every year.

And so without the growth of that state fund, that that's where that money that would like that's where that money goes is into the 2010 fund.

So um that what I see that 2010 fund being is a place for us to um try and right size revenue and expenditures for the services that we're able to bill upon.

Got it.

Thank you.

And as you um, you know, go through the contract and and review the um item 19 that was pulled today.

If you could keep our office in the loop uh as well as council member Carter's office, because I know council member Huffman also had some concerns about about this, and so um we would appreciate it.

Yes, I am well, it was because of your call that I looked into it and I was like, what is this?

So let me just pull it until I know what I'm talking about.

Thank you.

All right, thank you very much.

Yeah, thank you.

Um staff from council member Castillo's office.

Uh sorry.

Uh thank you, Chair.

Um I just had a couple questions.

Uh some of them were answered in the presentation and a little bit in the questions from the other council members.

But uh the councilman asked, are there any new and uh any new ways that the two entities of the Houston Health Department and the Harris Public Health Collaboration or Harris Public Health?

Any new collaborations since the previous presentation to council?

And uh what is planned for the future of the potential consolidation of the two entities.

Um so the first way is like we that since our presentation we came up with that dashboard, like the joint um uh reporting initiative.

We uh also produced a health an access to care um report together, like our two entities did that together, and that was um presented to both executive leadership entities and to Harris Health last week or two weeks ago.

Uh we plan to work more on um actually getting uh together as an entity uh as a joint like kind of public health army, if you will, going out in the communities to help um get people uh insured and to help uh to get them on insurance so that they can actually access care.

That was an action item that came out of our access to care, our joint access to care report.

Um looking at uh looking at future collaborations and you know, people use the word consolidation, and I don't know that that may be the model, it may be just alignment of some sort.

I'm open to all of it, but um the we have been having conversations with FQHCs, with hospital districts, with um just individuals uh that um that understand the landscape of how things would work to try and come up with a plan for like is this feasible?

Is this something that you know how what would what would the implications be from a service delivery standpoint from a financial standpoint?

We look back to our model of you know how the county already covers all of the mosquito or vector control for the whole region when they do mosquito spraying, they do it across the whole region.

Um that seems to work really well.

Um the you know, there's still some pain points that we have to work out with, for example, if we have a case of vector control um uh a vector born illness in one in the city of Houston jurisdiction, are we reporting it in a timely manner to the county to you know, so we need to learn what their process is so we can be a good partner.

Um but we are having those conversations like all the time.

Um we I think I reported that we were having already these quarterly meetings.

Um those quarterly meetings have turned into you know, how can we join the things that we're doing, you know, already.

So for example, our tuberculosis programs.

Um we both run tuberculosis programs.

We have clinics in these random locations, and we're very interested in looking at how we can be um how we can uh provide more coverage with the resources that we have.

For example, like there's no reason that a health department clinic should be just down the street from another clinic that somebody could go to.

All right, thank you so much.

Thank you.

Um I have a question about the cancer cluster.

I know you're fairly you know, you're fairly new, even though it don't sound like you knew.

You sound like you've been running the department for quite some time now.

Um but uh you know it says that the Creso plume is currently contained, it's being contained and final um mediation plans are in process.

You you guys are waiting to approve that.

Um however, I know we put five million dollars, set five million dollars aside to relocate folks, and so I know that was stalled.

Um also permits, um, there's no permitting um that's happening in that area unless you know there's some new information that I don't know about.

Um and then of course, no repair, some home repairs in that area is not happened because it is um the CRASO from my understanding and just from you know, just watching from afar, well not afar.

Um, when the recent test, the latest test came in, that's when everything kind of stalled.

Um it sounded like the um elevation levels wasn't as high as um we thought they were gonna be.

And so things just kind of no meetings, no, you know, that was the I think the last meeting was a year ago, um, the advisory meeting.

So I'm just you know curious to know what what's actually happening with that.

So I know uh so the community advisory board did write a letter to us.

Um I was not you know part of that process, but I did um uh I I did review that and cut help come up with rec or help to understand what kind of recommendations they're asking for and if that's feasible or not um for remediation or mitigation.

And um so we are taking that into con all that information into consideration.

I think that what you're referring to is um a an EPA study, or maybe it was yeah, it was an EPA study on the let level of dioxin.

And um the conclusions to that study are actually still pending.

Um there was a you know, there there was a there are different ways that you can look at the science about it, and I think that's where the scientists are still trying to figure out what how what lens they're supposed to be looking at this to that's correct.

Um and so I uh that's where I like I I wish I had more information on that, but I what I don't want to do is say the wrong thing because it's it changes the conversation depending on what level they agree to as like the correct bioavailability level of this dioxin.

Um and there are a lot of other scientific implications, I think that um that there's that uh EPA, you know, these scientific consulting entities, um Pacific and the health department are still trying to wrap their minds around.

Um what I do um know is that there is a permit, I think Union Pacific is um seeking either an amendment or an extension or some kind of permitting process through TCEQ at this time, but I'm not privy to that conversation.

So who can give, I guess provide an update to the community because the last meeting again was last year, May around this time.

Um, you know, so who can give an update so the community know what's actually going on?

I think it's our duty to give an update.

Um, but it's gonna sound a lot like what I'm telling you.

So but I think that we can do that.

Yeah.

I mean, but it's like we're telling them something.

It's like this is where we at um nowhere.

Yeah.

But I think that's better than nothing.

Um I I was not aware that anyone was looking for an update, but if that's the case, I'm happy to get our um you know team together.

EP, I know the EPA had or has an office over at the fifth ward, and we could um, you know, we could can we could have these communications um, you know, in whatever venue that you think is appropriate.

Okay.

All right.

Thank you.

Are there any, I guess there's no more questions.

Thank you so much, Dr.

Director Trand for everything that you do.

Um really appreciate um you taking the time to just go over the health department with everyone so that we can understand and be more aware of the amazing work that um the health department do for the city.

So thank you so much for taking the time to share it with us.

Thank you for your time and thanks for being so attentive.

Yes, that's good.

I know it's easy for me to like be gouged over this stuff, but y'all have been amazing.

Yeah, thanks.

Thank you.

Okay, so we're gonna go to our speakers.

We have one speaker signed up.

Um Mr.

Travis Spowers.

Travis Sowers.

Okay.

So I guess we don't have a speaker set up.

Okay, Travis Bowers is not here.

So with that being said, we're going to wrap up our um service delivery committee meeting at 3 22 p.m.

Thank you all for joining us.

It is adjourned.

Thank you, and the