Bexar County and University Health today announced plans to establish a Public Health Division within University Health to better promote comprehensive population health objectives that support health equity, acute care, preventive health care, and public health emergency response.
As the only locally owned health system in Bexar County, Level I trauma center for a 22-county area of South Texas, and the region’s academic medical center through its affiliation with UT Health San Antonio, University Health has a deep and long-standing commitment to public health programs and research. Additionally, University Health has long been an essential partner with the city, the county and other health organizations when it comes to responding to natural disaster and public health emergencies.
At the outset of the COVID-19 pandemic University Health stepped into the role of public health when it quickly stood up COVID-19 drive-thru testing for health care workers and first responders, and took a leadership role in providing the community with accurate, timely and evidence-based information on all aspects of the virus. It moved even further into the public health realm on January 4, 2021, when it opened one of the first, largest and most efficient mass COVID-19 vaccination sites in Texas.
“Over the past two years, we have learned a great deal about the important role of public health experts during a worldwide pandemic, and the significant responsibility University Health has to improve the good health of our community in collaboration with the county, the city and other health care providers.” said George B. Hernández Jr., University Health president and CEO.
As an integrated health system, University Health currently promotes the health of our community through preventive care, treatment of illness and injury, and access to compassionate health care services. The new Public Health Division will leverage these strengths, including effective communication, a skilled health care workforce, community partnerships, and a sophisticated technology infrastructure, to improve population health and health equity throughout Bexar County.
“More than ever, the University Health teams have seen how the tracking and analysis of key data points, the rapid mobilization of resources and effective communication efforts work together to help reduce community transmission, hospitalizations and deaths,” said Dr. Bryan Alsip, University Health chief medical officer. “These public health aspects of University Health’s mission are not new; however, we do see opportunity to organize and align these resources under this new Public Health Division to continue to improve our response and coordination to this ongoing public health emergency, and to be best prepared for the next one.”
This division will work in collaboration with key partners, including the San Antonio Metropolitan Health District, Southwest Texas Regional Advisory Council (STRAC), Bexar County, the City of San Antonio, and education and health care organizations, without duplicating services.
Bexar County Judge Nelson W. Wolff said University Health is uniquely positioned to establish this division.
“With more than 9,000 employees, a state-of-the-art hospital, 25 outpatient centers, telemedicine, Hospital at Home, digitizing patient medical records, and acting as the teaching hospital for UT Health, and in the process of building a women’s and children’s hospital, the only one in our area that will open next year,” Wolff said, “they will bring a unique perspective to public health.”
Bexar County Precinct 2 Commissioner Justin Rodriguez said the county will direct up to $60 million of American Rescue Plan Act funds toward the new division.
“We realized that this is a once-in-a-generation opportunity to make transformative, real change in our community,” Rodriguez said. “If we do nothing else with these funds, we have to invest them in a way that transforms the delivery of public health in our community."
The Essential Public Health Services, as defined by the Centers for Disease Control and Prevention (the CDC), will serve as a framework to align existing functions, develop new services and establish priorities. This list, updated in 2020 to be more relevant to today’s environment, describes the activities that communities should do to improve health and remove barriers that result in health inequities. The essential public health services are:
- Assess and monitor population health status, factors that influence health, and community needs and assets
- Investigate, diagnose, and address health problems and hazards affecting the population
- Communicate effectively to inform and educate people about health, factors that influence it, and how to improve it
- Strengthen, support and mobilize communities and partnerships to improve health
- Create, champion, and implement policies, plans and laws that impact health
- Utilize legal and regulatory actions designed to improve and protect the public’s health
- Assure an effective system that enables equitable access to the individual services and care needed to be healthy
- Build and support a diverse and skilled public health workforce
- Improve and innovate public health functions through ongoing evaluation, research, and continuous quality improvement
- Build and maintain a strong organizational infrastructure for public health
The programs and initiatives of University Health Public Health will seek to be innovative, transparent and transformative, particularly in the areas of public health emergency response, addressing health disparities and equity.
Several current community-based initiatives and systems serve as a solid foundation for the new division. University Health’s initial effort will concentrate on restructuring existing public health-related functions in a manner that enhances its commitment to population health and health equity. A few examples of current University Health programs and systems that will develop and sustain public health functions are:
- An existing network of health clinics throughout Bexar County, including specialized clinics like the Teen Clinic, which focuses on the comprehensive health care needs of male and female pre-teens, teens and young adults. In public emergencies, clinic staff work with the County, the City and STRAC to address public health needs.
- A strong pharmacy network of nearly 500 FTEs that dispensed a record one million prescriptions to patients and helped administer more than 600,000 doses of COVID-19 vaccine in 2021
- A robust injury prevention program – including car seat/booster seat education and installation, gunlock distributions, bicycle helmet distributions, Stop the Bleed training, falls prevention, and more
- An existing staff of infection prevention experts and hospital epidemiologists
- A robust IT infrastructure that has achieved Most Wired Level 10 for both hospital and outpatient networks across the community, demonstrating optimal use of information technology. University Health is one of nine organizations to receive a level 10 designation for both hospital and outpatient networks worldwide
- A comprehensive academic laboratory service capable of high-complexity testing, serving more than 60 point-of-care testing locations across Bexar County. Specialized services include an emerging infectious diseases identification lab, the region’s largest hospital-based microbiology lab, and the community’s only in-hospital blood bank, ensuring immediate access to lifesaving blood products in emergencies.
- A strong communication staff that develops and disseminates accurate and accessible health information that is relevant, culturally appropriate, and effectively engages Bexar County residents through social media and mass media channels
- A strong comprehensive grants program – including programs to benefit people with HIV/AIDS, family planning and early cancer detection. In 2021, it received a COVID-19 Vaccine Access Grant from the Health Resources and Services Administration (HRSA) for $1M to provide targeted outreach, education and services to areas with low COVID-19 vaccination rates throughout Bexar, Atascosa, Guadalupe and Wilson Counties
- Trauma-informed care certification and a trauma-informed care institute providing trauma-informed training and technical assistance to other health care organizations in collaboration with the City of San Antonio
- Four school-based health centers – offering walk-in care for students and families, as well as checkups, immunizations and health education services
- Two mobile health units – that provide preventive health, immunization, primary care and mammography services at schools, churches, community centers and businesses across the community
- A Health Fairs Task Force – this team attends community events throughout the year, providing education, immunizations, and preventive health services
The ideal primary location to serve as the administrative, research and clinical services hub for public health is the property University Health recently purchased adjacent to Texas A&M University-San Antonio. University Health has an affiliation with Texas A&M University-San Antonio that supports initiatives related to public health, including collaborations to offer training and practical experiences for undergraduate and graduate students, as well as alignment with the ASPIRE partnership, which develops educational programs and services for school districts in South Bexar County.
Dr. Cynthia Teniente-Matson, President of Texas A&M-San Antonio, said the university will work closely with the new Public Health Division, as well as other community health partners, to create more quality public health education opportunities and further the overall public health mission.
"We talk a lot about collective impact,” Matson said. “This is a critical example that you can point to. You'll be able to touch, you'll be able to see the impact of all of us working together to lift our communities."
University Health has collaborated with nearby higher educational institutions for a number of years. The affiliation agreement with Alamo Colleges started in the 1990s for the purpose of providing clinical training rotations for nurses and allied health professions at University Health sites. Palo Alto, as a junior college, enables students to complete their associates’ level training and potentially transition to the nearby Texas A&M-San Antonio campus to continue their studies at the bachelor’s level. These affiliations complement and feed the developing affiliation with Texas A&M-San Antonio with a pipeline of students interested in relevant studies. Public health-related educational and practical experience areas of study to be offered include public health, community health, rural health, and environmental health. The focus of such programs can be particularly directed to underserved areas of Bexar County.
Work is underway to evaluate the site, space requirements, budget and timeline. Proposed locations for two smaller buildings are currently being identified based on community need, feasibility and ease of access.