Ayden Butler, left, an undergraduate student at Harris Middle School, receives a flu shot through Heidi Killough RN.
Bexar County leaders believe their communities were abandoned when San Antonio stepped up its crusade to vaccinate more people against COVID-19 last year.
County officials have taken their own steps to inspire vaccination. They focused on suburban cities and unincorporated spaces that, in their view, had been ignored by the San Antonio Metropolitan Health District, a municipal company that struck a deal with the county to serve the county’s citizens as well.
“We’re getting into this cartel crusade because Metro Health, as the county’s de facto agency, wasn’t giving us adequate resources,” then-Commissioner Trish DeBerry said at a briefing. assembly in August of the Court of Commissioners.
Less than a year later, Bexar County announced it would form a public fitness department as a component of the county-owned college fitness system.
Senior city officials were taken by surprise.
City Manager Erik Walsh said he was surprised by the decision, “especially given the close collaboration with the county over the past two years. “
During the COVID-19 pandemic, the leaders of San Antonio and Bexar County have worked together on several occasions. But the announcement highlighted a failure in communication between the two governments around public health.
Mayor Ron Nirenberg delivers his annual State of the City report at the new Tech Port Center Arena in San Antonio, Texas, Tuesday, April 26, 2022.
Bexar County Judge Nelson Wolff delivers the 2021 State of the County address at the Grand Hyatt Texas Ballroom in downtown San Antonio, Texas, on Oct. 6, 2021.
Some council members are wondering what the county’s new public fitness department will do that Metro Health can’t do.
“I’m very involved in this because I don’t need to see two other agencies overlap and waste taxpayer money,” said Councilman Clayton Perry, who represents District 10 on the Northeast side.
Bexar County is spending $60 million of its federal pandemic relief budget for the Division of Public Health, calling it a “once in a generation” opportunity. The company is in the planmaking phase, but county chiefs say it will complement Metro Health’s work, doubling.
For more than a decade, the city has entered into a so-called interlocal agreement with University Health, Bexar County’s public hospital district, for Metro Health to supply Bexar County citizens who live outside the city limits.
University Health paid the town about $190,000 a year for those services. They have dental health, control of sexually transmitted diseases, tuberculosis control, laboratory services, vaccination and epidemiological surveillance.
Both sides renewed the agreement each year. But this year, it expired on April 1, some time after the county released its plans for the new public fitness department.
Walsh said the city will continue to offer public fitness to citizens of unincorporated spaces as city officials try to negotiate a new agreement with the county.
County spokeswoman Monica Ramos said Bexar County has already resumed many of those provided for in the agreement.
Still, Dr. Bryan Alsip, chief medical officer and executive vice president of University Health, said he doesn’t expect the deal to go away, though changes may be needed.
“It is still mandatory to have an edition of this agreement,” he said.
Prior to the county announcement, city and county officials had talked about updating the agreement to reflect Bexar County’s immediate population growth.
The city of San Antonio has more than 1. 4 million inhabitants. Bexar County has just over 2 million people and nearly 600,000 of them, 29%, live outside the city limits.
The county’s population has grown faster than the city’s, according to the Census Bureau. Bexar County added only about 300,000 citizens between 2010 and 2020, a 17 percent increase. During the same period, the city’s population grew to 107,000, or 8 percent.
“In the next 10 or 20 years, I wouldn’t be surprised to see a million people living outdoors in the city of San Antonio,” said County Judge Nelson Wolff. “We want to prepare for this. “
Metro Health’s service data shows that they are concentrated within the city limits. For example, of the COVID-19 vaccine doses administered by the agency, only 6. 1 percent went to citizens living outside the city limits, according to a city spokesperson. Of the patients seen at Metro Health clinics, about 7% come from out of town.
Ramos said the county is better equipped to succeed in citizens of unincorporated communities, many of whom have limited access to the web and get their data outside the doors of San Antonio’s mainstream media.
“Their desires are a little different and the way they get the data is necessarily the same,” Ramos said. “These things want to be analyzed. “
University Health has stepped up its game to respond to the pandemic, Wolff and Ramos said. Hospitals, nurses and doctors were on the front lines of treating COVID-19 patients, and the county’s fitness formula established a mass vaccination at Wonderland of the Americas Mall that administered more than 500,000 doses.
The city operated a mass vaccination site while driving on the Alamodome. Medical at this location administered more than 226,700 doses. Both closed in March amid a drop in demand for vaccines.
Bexar County’s new public fitness department will do more than just respond to the pandemic. Initially, their work will focus on the essentials: food inspections and authorizations, air quality and containment of hazardous waste.
In addition, University Health plans to examine disparities in public fitness and so-called social determinants of fitness, such as access to education, sufficiently good wages, healthy eating, and living and functioning conditions. To do this, the county will invest in new software. to keep track of fitness data.
Data is also a key component of Metro Health’s new strategic plan. But even when they have the same issues, Alsip said, the city and county can collaborate by sharing data.
County Commissioner Tommy Calvert, representing precinct four in eastern and southeastern Bexar County, envisions a company that addresses epidemic diseases, nutritional and food insecurity, in-person outreach and more.
Metro Health focuses on much of the same. The city also employs network fitness staff it visits to build relationships in neighborhoods.
Perry, the only board member concerned about duplicates.
The same goes for District 3 Councilwoman Phyllis Viagran, who represents the south side.
“I want more transparency from the county,” Viagran said at a council briefing shortly after the new public fitness department was announced. “They are not transparent. They don’t paint with us. We get our data from the news.
She later said she was excited about University Health’s plans, announced last fall, for a new hospital on the south side. This is the same position in which the county’s public fitness department will be based.
Viagran is frustrated that his constituents have to travel more than North Side citizens to access health care. She hopes University Health’s plans for the region will help.
He would also like the city council to have the strength to appoint the university fitness council to facilitate greater communication and collaboration.
Wolff said it’s not up to city and county officials not to ask about new initiatives. The county was not notified when Metro Health announced its new strategic plan this month, Ramos said.
University Health’s Alsip said county officials have collaborated with Metro Health and will continue to do so. He referred to a joint city-county plan in the early 2000s to improve intergovernmental relations. He sees the new fitness department as a way to align additional efforts. .
Mayor Ron Nirenberg agrees.
“Any effort to get local fitness results is welcome,” Nirenberg said. “While we may not know all the main points of this new initiative, there is no explanation as to why it should. . . generates friction. “
Local governments across the country have seized the opportunity to expand public physical activity in light of the pandemic.
Many experts have said that the initial devastation of COVID-19 was partly the result of declining investment in public health. The most productive agencies located to respond lacked resources.
Now, many local leaders say San Antonio’s domain wants to be more prepared for pandemics in the long run.
Justin Rodriguez, Commissioner of County Precinct 2 representing the West Side, said the county’s effort will replace the provision of public fitness services.
“In no way was it something that opposed or disrupted what Metro Health was doing in our community,” Rodriguez said. “It was just expanding beyond resources. “
Calvert said city officials weren’t the only ones surprised by the new public fitness division. He has heard court cases from business leaders and neighborhood association leaders, who have said they need more data and have a chance to give their opinion.
There’s still time for that, Calvert said. He must reexamine the powers the Commissioners Court granted Metro Health in the interlocal settlement.
What will those conversations look like in the future?
“All entities will be at the table,” Calvert said.
megan. stringer@express-news. net