Community Health Assessment to guide changes for future

Hays County Commissioners Court received a community health assessment update from the Hays County Local Health Department in order to give an objective view on the status of the county and where improvement is needed at the regularly scheduled meeting Tuesday.

Hays County Local Health Department Manager Matthew Gonzales gave an executive summary on the community health assessment that was recently completed by the office after seven months of work. He said in Hays County, racial, socioeconomic and geographical health disparities were found. Community Health Improvement Plan, referred to as CHIP,  is the blueprint to address these inequities, and there is a need for a Healthy Hays Coalition. 

Gonzales said the Mobilizing Action Through Planning and Partnerships process was employed and involves the following: visioning, assessments, identification of strategic issues and goal and strategy formulation.

“MAPP is a strategic planning process to achieve health equity for local health departments,” Gonzales said. 

He said the vision statement is as follows: “We envision a healthy Hays County fully committed to equitable access to resources, where all people are thriving and resilient. We are committed to improving the quality of life in Hays County by collaborating to ensure a system of high quality medical and mental health services, education, employment and infrastructure is available to all.”

The first assessment completed was the community status survey in which residents rated their perception of the availability of public transit, 1.9 out of 5, and affordable housing, 2 out of 5, with the lowest score being one and the highest a five. 

“Across the different cities of Hays County, the rankings for public transit or affordable housing change depending on where you were,” Gonzales said.

Gonzales said there was a 12.4% poverty rate as of 2020, which was a 7% decrease from 2019, and there was a 3% unemployment rate. He said the primary care physician to person ratio for the county was 2,343 to one, which was higher than the ratio for the state of Texas and the United States meaning that Hays County has fewer doctors to patients than the state and country. 

Gonzales said 19% of people in the county experience housing problems — overcrowding, high housing costs, lack of kitchen facilities and lack of plumbing facilities — which is 2% higher than the state of Texas. 

“That’s almost one in five families,” Gonzales said. “Eighteen percent of households spent half or more of their income on housing.”

Gonzales said east of I-35, there are fewer community centers, libraries and other community supporting facilities. He said healthcare access is concentrated in the urban areas, and low income areas have reduced access to grocery stores. He said in 2020, 12% of residents experienced food insecurity. 

Gonzales said there are gaps in community partner focus areas such as environmental justice, financial institutions, food service and restaurants, land use planning and development, injury and violence prevention, utilities and cancer.

“Forty-five of our community partners that helped us conduct this community health assessment were invited to take this survey, but only 12 of them completed it, so some of the information here may not be completely accurate,” Gonzales said, adding that because the court recently began a partnership with the Texas Housing Foundation in June, land use planning and development has recently been addressed.

Gonzales said there is currently a steering committee geared at resolving healthcare access issues in the county, and the goal is to transition to a coalition — Healthy Hays Coalition — similar to what Williamson County currently has. 

“We will analyze evidence-based programs and identify improvements to implement by December 2023,” Gonzales said. “We want to look at what’s happening across the county and in the state of Texas. Who operates these county indigent healthcare programs, and how they conduct their application process and how we can improve it.” He added that the coalition would then implement the programs.

Gonzales said the first goal is to improve the Indigent Care Program application process, and the health department will be conducting an audit on it. He said key performance indicators for that program would be the number of training sessions for community partners, number of residents assisted by trained community partners, number of residents screened for eligibility and number of qualified residents enrolled.

According to the Texas Health and Human Services website, the County Indigent Health Care Program helps low-income Texas residents who don’t qualify for other state or federal healthcare programs have access to health care services.

Gonzales said another goal is to assess, develop and sustain a county Medical Reserve Corps to respond to public health urgent needs and emergencies. He said the health department will conduct a readiness assessment to establish an MRC by March 2024, create a strategic plan for implementation by June 2024 and establish partnerships and collaborate with local health care facilities by Sept. 2024. 

According to the U.S. Department of Health and Human Services website, the Medical Reserve Corps network contains various local groups composed of volunteers that focus on emergency preparedness, response and health equity needs.

Gonzales said another goal is to support expansion of the Enhanced ID card Program in San Marcos to other parts of the county. He said the Healthy Hays Coalition would facilitate information sharing about the program with the other cities in the county, including cost, resources, promotional strategies and expected outcomes.

According to the city of San Marcos website, An Enhanced Library Card is a San Marcos Public Library card that has a person’s name, picture and other personal information printed on it. This could possibly be used as a supplement with other documents to prove your identity.

“A lot of the time, our most vulnerable populations can struggle the most by just [not] having a simple identification card. If we can help expand that, we can help them apply for more programs,” Gonzales said. “It can be used for several other things, other than just applications.”

Gonzales said the health department would like to gather new partners to collaborate on transportation solutions. He said the first objective would be to communicate with regional transportation organizations to learn what resources are available.

“Primarily what this would look like is talking to, for instance, CARTS, and seeing what’s being done in the county. What are some things we could possibly collaborate with through our other partner organizations to help them bring better transportation here,” Gonzales said.