Nashville Metro Public Health Department Budget Hearing (May 14, 2024)
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Nashville Metro Public Health Department Budget Hearing (May 14, 2024)
The Metro Public Health Department presented its budget requests and provided an overview of recent achievements and ongoing initiatives to the committee on May 14, 2024. Director Dr. Gil Wright led the presentation, followed by questions from council members covering topics such as animal control, community safety programming, family planning services, and behavioral health. No formal votes were taken; the session was informational.
Department Overview and Achievements
- Dr. Wright highlighted the department's mission and team of over 600 workers. Key accomplishments included mitigating a potential meningococcal outbreak, conducting routine restaurant inspections, and serving 22,000 participants in the WIC program.
- The department administered over 4,300 flu shots last season, and the addition of a full-time vaccine clinic coordinator improved access.
- Metro Animal Care and Control celebrated over 1,700 adoptions last year, aided by a new animal behaviorist position.
- Interpreters were moved from grant to local funding, allowing more in-person services.
- The Nashville Strong Babies program, initially targeting high-infant-mortality zip codes, is expanding countywide.
- The department continues to focus on behavioral health, school health nurses, sexual health (including PrEP), and air quality monitoring.
Q&A and Discussion
Animal Care and Control
- Chair Evans asked about making positions more appealing. Dr. Wright noted that last year's salary increases and stable management (citing Director Ashley) have helped; only 6 positions were unfilled, 2 due to recent promotions.
- Regarding spay/neuter capacity, Dr. Wright mentioned adding a second vet and vet techs last year, and recently adjusting the salary range for vets. The department is exploring grants for external spay/neuter clinics.
Community Safety Programming
- Chair Evans and Councilmember Gamble inquired about the transition of community safety from the mayor's office to the health department. Dr. Wright stated that about 90% of contracts are performing well, and the department is hiring approximately 30 staff in the next month or two, funded by a combination of grants (DOJ, opioid, etc.).
- A $1 million unspent cure violence allocation remains with the original oversight group, not yet transferred to the health department. Dr. Wright indicated willingness to proceed if council revisits it.
- The department is considering creating a new bureau for behavioral health and community safety.
- Chair Evans asked about funding for existing community safety organizations under the O'Connell administration; Dr. Wright believed it is included in the budget, but discussions are ongoing.
Family Planning and Clinic Services
- Councilwoman Quinn Evan Siegel asked about family planning services. Dr. Wright clarified they include birth control, preconception care, STD testing, and cancer screenings. The Woodbine clinic has a wait time of several months for appointments; three additional positions were requested to expand capacity. The department is 60% grant-funded.
School Health Nurses
- Councilmember Pepsi asked about school nurse coverage. Dr. Wright stated the goal is a nurse in every school, with some larger schools having multiple nurses. ESSER funds are expiring but will bridge into FY26. The health department supervises nurses hired by Metro Nashville Public Schools through an MOU.
Air Quality and Emissions Testing
- Councilmember Nash and Councilmember Allen inquired about air emissions testing. Dr. Wright confirmed that the program ended, but two engineers continue to monitor air quality. He noted newer vehicles are cleaner. Councilmember Allen requested updated annual reports on the website; Dr. Wright agreed to follow up.
Behavioral Health and Health Care for the Homeless
- Councilmember Huffman asked about the health care for the homeless program (a grant to Neighborhood Health) and the new behavioral health services program. Dr. Wright explained that a clinician now leads behavioral health, and the department aims to place a counselor in each clinic within the next year, also supporting opioid pilot programs.
Syphilis and STI Trends
- Chair asked about rising syphilis cases. Dr. Wright attributed the increase to a shortage of injectable penicillin (due to a tornado damaging storage) and to dating apps making contact tracing difficult. The department is cross-training disease investigators and continuing outreach. Dr. Wright confirmed that current funding is sufficient for education and resources.
Opioid Settlement and Health Equity Bureau
- Dr. Wright mentioned that a proposal for opioid settlement funds will come to council soon. He also noted that the former health equity bureau has been renamed to People and Culture, with a health equity division within it.
Key Outcomes
- No formal decisions or votes were taken; the session was a budget presentation and Q&A.
- Dr. Wright confirmed that Partners in Care and REACH programs are fully funded in the proposed budget (pending council approval).
- The department will provide written answers to council members' questions via email (to Director Darby and Maria) for details on the 30 new positions and grant funding breakdown.
- The $1 million unspent cure violence fund remains with the original oversight group; the health department is prepared to utilize it if reallocated by council.
- The health department is open to meeting individually with council members for further discussion.
Note: No agenda or minutes were available for this meeting; all information is derived from the transcript.
Meeting Transcript
Thank you, Madam Chair. Good afternoon. As stated, I am Dr. Gil Wright. I am the director of Metro Public Health Department. And it's our mission to protect, improve, sustain the health and well-being of all people in Nashville and Davidson County. And with our team of just over 600 dedicated workers, we strive to do that each day. First, we want to thank the committee for our chance to discuss our budget requests today. The plan also included funding to design uh begin design on a new Metro Animal Care and Control Fility. There remains a long way to go on each of these projects, and we look forward to working with council and administration to complete these projects to ultimately help more Nashville's. We're also thankful for the support we've received to transition our clinical operations from paper to electronic health record, process we're currently working through. We understand the need to be patient as we continue to move forward in serving our community, and we remain excited about the future of our work. At the Metro Public Health Department, we love to talk about the things that we have done and accomplished, but even more important is those things that have not happened due to our efforts. Over the past year, a potential many meningiococcal outbreak was mitigated by an immediate response utilizing contract tracing and quick dispension dispens dispensing of medication to contacts. Routine restaurant inspections conducted by our team help prevent uh uh foodborne illnesses, and then services provided by our WIP team ensure fewer families suffer food insecurity, at least during the child's early years, with 22,000 participants across the program. More people are getting a healthy start for their early life. One of the most effective ways to avoid preventable sickness is through childhood immunizations, and our team works to ensure childhood immunizations are accessible to our whole community. Nashville remains at or above the statewide average for nearly all childhood immunizations, according to last year's 24-month-old immunization survey. All these are core parts of the work that the health department does, all of which are often measured by things that do not happen. We appreciate all that council approved for us in last year's budget and have uh some promising results to share. Over the particularly active flu season last year, our team administered over 4,300 flu shots with a focus on ensuring access to those who have historically seen poor access to health care. By adding a full-time community-based vaccine clinic coordinator last year, our team was able to bring vaccines to more people, eliminating potential barriers to health. At Metro Animal Care and Control, the addition of an animal behaviorist has been key in finding the right home for many adoptable animals that otherwise would not have been adopted. With more than 17,000 or 1700 adoptions celebrated over last year, uh we uh appreciate the work that's been done there. Metro's previous budget moved all of our interpreters from grant funding to local funding. This has freed them up to deliver more in-person uh interpretation services, often with a better experience and over-the-phone interpretation services. Our Nashville Strong Babies program, created initially to bring specialized services to specific zip codes where infant mortality was highest, is now expanding countywide as we've seen the need for these services broaden beyond the initial area. As we track data of where services are most needed, we adopt to the need to meet that. With the funding provided in Mayor O'Connell's budget proposal, we'll maintain our diligence to provide or to avoid potential outbreaks. Our areas of focus remain the same as they've always been, working upstream to prevent or reduce future health problems and eliminating barriers to ensure Nashvilleans can live full healthy lives. We'll continue our expansion of behavioral health and mental health services, ensuring we identify and fill gaps that exist in the local community of behavioral health and wellness needs. We expect another year of strong back to school back to class numbers, thanks to a large part by our talented team of school health nurses across Metro schools. Our sexual health center continues to prescribe and supply prep medication to those looking to prevent an HIV AIDS infection while offering affordable testing and treatment for sexually transmitted infections. Our collaboration with mental health co-op, Metro Nashville Public, excuse me, Nashville Metro Nashville Police Department and Nashville Fire Department will continue through the partners in care and the reach programs, and our air pollution team will continue to work closely with the community to ensure our air remains healthy and safe to breathe with reminders of forecast uh air alert days circulated in ways that more Nashvilleans can access. We take our make mission seriously. We'll continue to keep the public's health and wellness front of mind in all decisions we make with the health department have fostered a great respect for much of the work done here at Metro Council, and we look forward to continuing the collaboration. We're looking forward to expanding our operations and offerings more services for the community in coming years. Thank you, Dr. Wright. I'm gonna kick it over to our public health and safety chair, Chair Evans, to see if she has any uh initial questions. Thank you, Chair. I've got, of course, several, as I'm known to do. Um so you can confirm REACH is officially funded for this comp upcoming budget cycle. Yes, ma'am. Okay, awesome. Um and then on Metro Animal Care and Call. So I know we this has like been an ongoing struggle, and I know it's a known struggle in the community too. And so I guess uh, you know, it's not something that's easily done this budget cycle at all because of us needing to remain flat. But what I guess is the vision on making some of those positions more appealing. I know we're uh we're competing a lot, you know, with private vets facilities and that kind of thing.
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