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2023-068 Public Health Official December 15, 2023 Report No. 2023-068 INFORMAL STAFF REPORT TO MAYOR AND CITY COUNCIL SUBJECT: Public Health Official Position Feasibility BACKGROUND: At the June 6,2023 City Council meeting,Mayor Pro Tern Beck requested staff research and report on the possibility of creating a Public Health Official position within the City of Denton. This report provides the results of Staff research on the feasibility of creating a Public Health Official position to serve as a link by coordinating services between various health care institutions, social service organizations,public safety personnel, and other agencies. DISCUSSION: Staff communicated with Denton County Public Health (DCPH) to document the current relationship between the City of Denton and DCPH which is outlined below. Denton County Public Health promotes and preserves sustainable community health through exceptional education, compassionate care, and quality service. DCPH provides preventive public health services by: • Assuring disease surveillance and working to prevent the spread of disease • Preparing and responding to disasters and assisting communities in recovery efforts • Promoting and encouraging healthy behaviors • Protecting against environmental hazards Denton County Public Health is regulated under Texas Health and Safety Code: Title 2, Subtitle F. Local Regulation of Public Health, Chapter 121. Local Public Health Reorganization Act. Established during the 79th Legislative session (2005), Health Authorities (HA) serve as a critical part of the state's public health system. The Health and Safety Code establishes and defines a Health Authority in Texas as a physician appointed under the provisions of Chapter 121, to administer state and local laws relating to public health within an appointing body's jurisdiction. Health Authorities are considered an officer of the state when performing duties to implement and enforce laws that protect the public's health. Currently DCPH employs 165.5 full time equivalent(FTE)positions and provides the following services at 535 South Loop 288, Denton, TX: December 15, 2023 Report No. 2023-068 O 0 Primary Care Vaccinations Diabetes Case STD Testing Communicable Management and Treatment Disease Response Denton County Public Health (2022) DCPH targeted outreach, collaboration, and marketing efforts in 2022 included*: 478,480 views of HIV 84 community events 65 collaborations with testing info community partners *two-thirds of all services provided within the City of Denton(Dr. Richardson,DCPH Director) Denton County Public Health (2023) Since June 2023, DCPH and/or the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) have provided outreach and clinical services at over 35 events in the City of Denton including: MLK Rec Center Goodwill Quakertown Park Walgreen's UNT TWU NCTC PRIDENTON La Azteca Rubber Gloves Dan's Silverleaf December 15, 2023 Report No. 2023-068 DCPH Collaboration: City of Denton Community Services UNT City of Denton Emergency Management TWU City of Denton Parks and Rec NCTC United Way of Denton County DCPH Coalition Engagement: Denton County Homelessness Leadership Team and Workgroup Denton County Behavioral Health Leadership Team Denton County Homeless Coalition Denton ISD Health Advisory Committee Child Fatality Review Team Community Services Collaboration between community agencies is essential for a holistic, efficient, and effective approach to public health. It ensures that resources are used optimally, that the public receives consistent and comprehensive care, and that agencies are better prepared to address both current and emerging health challenges. Community Services collaborates with residents and local community organizations to foster healthy and safe neighborhoods. By working together, the community tackles complex social issues more effectively, combining various expertise for lasting solutions and using shared data for informed decisions. The figure below shows the current environment specific to essential public health services delivered by Denton County Public Health (DCPH) and those supported by City of Denton grant programs such as the Community Development Grant and American Rescue Plan Act funding for COVID-19 response and recovery. December 15, 2023 Report No. 2023-068 ENVIRONMENTCURRENT TYPES OF SERVICES DENTON COUNTY CITY OF DENTON PUBLIC HEALTH Behavioral Health U GRANTS* Clinics and Services Elf GRANTS* Community Health & Healthy Families EVj & GRANTS* Emergency Preparedness Evi L'U Infectious Diseases E Environment E U Food Safety Health Data LVI Critical Link Er GRANTS* Figure I *City of Denton Grants to Community Human Services Organizations providing related services Health, Social Service, and Public Safety Coordinating Resources and Reducing Waste Making vital links between agencies is crucial for public health.Vital links(Figure 2)that mobilize community collaboration with service providers supporting the medical and mental health needs of the homeless are made in Denton through local coalitions and collective impact projects such as the Denton County Behavioral Health Leadership Team (DCBHLT) and Denton County Homelessness Leadership Team (DCHLT). Denton County 7Homelessness nty Denton County Behavioral Health Leadership Team Leadership Team Public Health Healthy WORKING GROUPS OUPS CommunitiesChild and Famil S stems ` ■ Y Y i NEw gHLT/HLT Housing Coalition ■ Substance Use i CrossCare Homeless Coalition � ■ Suicide Prevention Data i Collaborative ' ■ Data L o HMIs Data&Referral Resource =• • ■ Veterans Findhelp.org Figure 2 Different agencies often have unique resources, expertise, and capacities. Linking these efforts is key to strengthening and enhancing community resources. The programs highlighted below are the newest resources improving the community's holistic approach to public health care. December 15, 2023 Report No. 2023-068 Cross Care Collaborative Behavioral health and housing systems in Denton County overlap in individuals served, but often operate independently of each other. As a result, resources (services and people) in both systems are not utilized as effectively as possible. This collaboration was formed to build a vital link between the health care and homeless response systems to identify opportunities for efficiencies and improved triage and resource planning. Denton County Public Health (DCPH) Mental Health Navigator Program Denton County Public Health (DCPH) recently launched DCPH Links, a mental health referral service for Denton County residents looking for information about mental health community resources. Residents who have questions about where to find mental health services can call or text LINK to 940-349-3000 to reach a Navigator who can help identify mental health resource connections. FindHelp.org Denton County,City of Denton,and City of Lewisville,jointly launched FindHelp Denton County in November 2023. FindHelp Denton County is a one-stop digital shop for finding information about free or reduced-cost services in Denton County. Resources range from medical to rental assistance to employment services. Within the online resource directory, local agencies can list and update their program information in real-time to ensure help seekers have access to reliable information about wraparound supports in our community. Prior to the launch, two information-sharing and training sessions for agencies to learn more about the network, the benefits of joining, and how to get started,were hosted. Environmental Services & Sustainability Environmental Services&Sustainability(ESS),as part of their assigned duties,works with various outside agencies. ESS strives to build strong working relationships as well as have open communication. Mosquito Surveillance and Response Plan (MSRP) ESS manages the mosquito surveillance and response efforts for the City of Denton. This includes working with the University of North Texas (UNT) for mosquito trapping and some analysis. Primary analysis is performed by the Texas Department of State Health Services(DSHS). Denton County is a partner in the overall program as they are the entity who receives human health information regarding disease or illness.Additionally,the City of Denton and Denton County work together to provide an interactive map showing all mosquito trapping locations across the city and the county. December 15, 2023 Report No. 2023-068 Outside Agency Interaction ESS manages several programs that have direct interaction with State and Federal regulatory agencies as well as non-regulatory agencies. • Texas Commission on Environmental Quality(TCEQ)has a regional office in Fort Worth, TX and central offices in Austin, TX. ESS works with TCEQ on air quality, water resources, and enforcement of state regulations. TCEQ's state outdoor air monitoring network has an interactive website with near real time information. Denton Municipal Airport is home to one of TCEQ's air quality monitors. • Texas Department of State Health Services (DSHS)has a regional office in Arlington, TX and central offices in Austin, TX. ESS works with DSHS on asbestos related issues including enforcement.Additionally,as mentioned under the MSRP they provide mosquito laboratory support. • U.S. Environmental Protection Agency (USEPA) has a regional office in Dallas, TX and headquarters in Washington, DC. ESS works with USEPA on air quality,water resources, and enforcement of USEPA regulations. • North Central Texas Council of Governments (NCTCOG) offices are in Arlington, TX. ESS participates on various committees as well as attends various meetings with NCTCOG. NCTCOG is tasked with taking a regional approach to air quality and water resource initiatives. The Dallas-Fort Worth Metroplex is designated non-attainment for ground-level ozone. For Denton to reach attainment, it takes input and efforts by ESS, TCEQ, USEPA and NCTCOG. CONCLUSION: Staff identified numerous areas in which DCPH directly coordinates with the City of Denton on health authority functions. One proposed FTE would be unable to replicate the expansive services currently being offered by DCPH. STAFF CONTACT: Kenneth Hedges Fire Chief Kenneth.hedges&cityofdenton.com (940) 349-8830 REQUESTOR: Mayor Pro Tern Beck STAFF TIME TO COMPLETE REPORT: 10 hours PARTICIPATING DEPARTMENTS: Community Services, Environmental Services and Sustainability, Fire