San Antonio Health Committee Meeting - April 7, 2026

The San Antonio Health Committee met on April 7, 2026, at 10:02 AM (CT) to discuss the community health improvement plan (CHIP), trauma-informed care certification, and the economic impact of immigrants in the region. The meeting included public comments, staff presentations, and council member discussions. No formal votes were taken beyond approval of prior minutes.

Consent Calendar

• The committee unanimously approved the minutes from the previous meeting.

Public Comments & Testimony

• Frederick Cochuay (Executive Director, San Antonio Nexus Connection) expressed strong support for the city's investment in community health worker networks and substance use prevention, stating the work is "not a pilot program" but "the next chapter" of San Antonio's commitment.
• Jack Finger voiced opposition to immigration, citing a figure of 21% population growth in the San Antonio metro area over five years. He claimed 90% of asylum seekers miss their court hearings and that 23% of jail inmates are undocumented, arguing immigrants "use hospitals and schools without paying their share."
• Mary Bethesda (Director, Economic Center) supported the trauma-informed care certification program, noting that her organization was chosen to lead certification and that many city organizations have achieved certification. She also provided written public comment on behalf of Elizabeth Lotts of the Bear County Collaboration and Dr. Salazar, who later presented on the community health improvement plan.

Discussion Items

Community Health Improvement Plan (CHIP) – Bejar County

• Dr. Jacob (Metro Health) presented the 2024-2029 CHIP, developed with community partners. The plan focuses on four priority areas: mental/behavioral health, food security, housing stability, and access to care. He highlighted that Metro Health is nationally accredited and that the plan aligns with the city’s previous efforts.
• Metrics from the community health assessment show teen pregnancy decreased from 33 per 1,000 (2019) to 18.3 per 1,000 (2023). Councilmember Alderete Gavito asked about a public dashboard to track progress; Dr. Jacob confirmed a dashboard will be reported in fall 2026 and an annual report in fall 2028.
• Councilmember Mesa González emphasized reducing stigma around mental health and noted a mental health summit in District 7. Councilmember Castillo stressed the link between housing stability and public health, supporting efforts to mitigate evictions and preserve public housing.
• Dr. Jacob acknowledged that the work requires sustained investment and coordination across sectors, with funding from general funds, opioid settlement funds, and Medicaid 1511.

Trauma-Informed Care Certification

• Jesse Higgins (Health Officer) presented on adverse childhood experiences (ACEs) and the city’s trauma-informed care initiative. Data from the 2025 CDC survey shows that 1 in 3 adults in Bexar County reported emotional abuse as children, 1 in 5 reported exposure to mental illness, and 1 in 5 reported sexual abuse. These rates are above state and national averages.
• Six city departments have achieved Level 1 certification (including fire and police, the only such certified departments nationally). An additional 14 departments are in the process. The certification process includes training, team formation, and site visits.
• Councilmember Alderete Gavito asked how to reduce the high ACEs numbers. Higgins replied that trauma-informed practices (e.g., confidential interview spaces for domestic violence cases) are being implemented, and a mentoring program exists within Metro Health.
• Councilmember Castillo inquired about measuring resident experiences post-certification; Higgins noted employee satisfaction surveys show positive feedback, but resident-level impact evaluation is still pending.

Impact of Immigrants on San Antonio’s Economy

• Dr. Jennifer Mada (Office of Compliance, Opportunity & Access) introduced the report, commissioned by the New American Council. Chacey Kramer (State Organizer, American Immigration Council) presented key findings:
  • As of 2022, 344,000 immigrants live in the metro area, 12.7% of the population (below national 14.3% and Texas 17%).
  • Immigrant population grew 7.21% between 2018-2022, a key driver of regional growth.
  • 78.2% of immigrants are in prime working age. In 2023, they contributed $1.2 billion to Social Security and $314 million to Medicare.
  • 24.7% of business owners are immigrants (versus 12.7% of population), generating $791 million in annual income.
  • Immigrants account for 32% of construction, 18.9% of manufacturing, and 15,800 manufacturing jobs preserved.
  • 60% own homes, with $27.1 billion in property value.
  • 2,071 international students contributed $40 million and supported 621 jobs.
• Councilmembers expressed support for the immigrant community. Councilmember Alderete Gavito noted the importance of immigrants in hospitality and manufacturing. Councilmember Castillo emphasized that immigrants contribute more in taxes than they receive in benefits, and that fear of enforcement harms public health and economic productivity.
• Dr. Mada stated the city is developing an immigrant inclusion plan based on these findings, including training for city staff and partnership with local nonprofits. Barriers include lack of awareness of city services and language access, as well as political climate affecting trust.

Key Outcomes

• No formal votes or binding decisions were taken during this meeting; all items were informational or discussion-only.
• The committee received updates on the CHIP, trauma-informed care progress, and the immigrant economic impact report.
• Council members requested a publicly accessible dashboard for CHIP metrics, to be presented in fall 2026.
• Metro Health will continue working with city departments on trauma certification and explore evaluation of resident experiences.
• The Office of Compliance, Opportunity & Access will continue developing the immigrant inclusion plan, using the report’s data.