Let's dig into some of these issues around the pandemic, around healthcare access, around transportation. What have you seen from your role both in and as a public official and from your past experience as a health professional as EMT? What are you seeing now are some of the biggest issues and barriers that people are having in trying to access healthcare or trying to access resources that can impact their health? Sure. Well, there's this whole long list of social determinants of health, which quite a number of those issues, there is an alignment or an intersection with county government. One of those social determinants of health though is access to transportation. I know that the top three reasons why my constituents need transportation is to get to school, to walk into the doctor. Those are just necessities. There's nothing luxurious about that. But so in Tarrant County, we don't have an integrated transportation system. If a constituent of mine who lives in far southeast Tarrant County, like let's say the Tarrant County portion of Grand Prairie, if they were trying to get to far northwest or to a major employment and commerce node like alliance in northeast and in northwest Tarrant County, I really don't know how long it would take for them to do that if they did not have a car. I've made it a priority of mine to partner with as many organizations in cities to work on transportation programs. For instance, we have a partnership with the Boys & Girls Club, where we find part of their transportation program that will take students from Title 1 schools to after-school programming. We know that that has a huge impact not only on their academic in general overall well-being, but it also helps for the parent or parents who maybe work outside of your traditional eight to five hours or whatever it is. It provides the flexibility. But so that certainly has a huge impact when it comes to delivering healthcare. It came up even particularly with COVID, where we were standing up these drive through testing locations and I said, I have constituents who don't have a car, so I need to make sure whether they are showing up by foot or on a scooter or on a bike or a horse and buggy. I don't care. I don't want them to get turned away from being able to get tested because they're not showing up in a car. That transportation is huge. It's something that we continue to work on and we're actually doing through our Regional Transportation Council is working on an assessment and we implemented various transportation programs to get people across the county for their vaccination appointments at no cost to the recipient. We did the same when it came to elections to make sure that people could access their right to vote. We're having to do all these different one-off programs. Of course, transportation and infrastructure is very expensive. The fact that we have 41 cities in our county, who we want to work with them, but we can't tell them what to do, definitely create some challenges. Yeah. When you're talking about transportation, I imagine that people that aren't from this area, especially people that come from areas where there are very large and connected transportation systems, the question might be, why don't we have one, or if we do have one where is it supposed to come from? I heard you talk about just a lot of really innovative approaches. Sounds like that you're taking on the other of course, have taken to figure out which community or organizations and health and so on. I guess, can you help us explain, whose responsibility is that, and what barriers are there in terms of making that happen? Sure. I think it's a collective responsibility. Interestingly enough, there are three major transportation authorities that touch Tarrant County. There's the [inaudible] and then there's what used to be called the T, now it's called, I've just forgotten the name, but it'll come back to me, and then there's DART, that serves the Dallas County and some of the counties on that side of the metroplex. But all of them require a particular percentage of sales tax which some cities have put before voters and the voter says no, that we don't want a portion of the sales tax to go to that or not. There's that layer of just various governing authorities in municipalities and then also various electorates who depending on if there is a ballot initiative root related to a transportation need on the ballot, they have the opportunity as a taxpayer and more so as a voter to decide whether or not that they are supportive of it. We're even right now having a conversation about a transportation bond for Tarrant County. The last one we had was 2005, 2006. We are working through a process right now to evaluate mostly traditional road projects that we plan to put before the voters in November to get their approval or not on whether or not to fund that. But you have to take into consideration if it'll be our bond that we're proposing would be at no tax rate increase bond, which means that it'll take longer because you'll have to issue debt on a breakup, how you issue that debt to then fund the projects. Then you have some cities. We have a pretty strong mix of small cities and large cities. Large cities have the staffing, the capacity, and the expertise for Bond Program, smaller cities sometimes don't. You have to think of all of that. One of the things that I tried to do was to push our policy to be as progressive as possible in the sense that yes, I know that we need traditional road projects, we always will. However, we also need to be talking about pedestrian projects, that gives the flexibility for communities who may have accessibility issues or if you have students or others who are riding their bikes or different ways that people are getting around, and it's really interesting for me. I'm certainly public transportation, a mass transit supporter and advocate, having grown up in Houston and then in Denver and I came back down to Texas to go to undergrad. It never even dawned on me to research whether or not the city that my school I was in have public transportation. I just assumed that was the thing. It was a huge culture shock for me. I remember asking a dorm member, I mean, my dorm-mate I was like, where's the bus schedule? She was like, "We don't have a bus here," and I was like, "Wait, what?" Okay, no bus, no light rail, but so I think that the expectation that a lot of people have it now they do. I say all the time that the county that we served 10 -15 years ago is not the same county that we're serving now, which means that we have to be willing to do things a bit different. Traditional doesn't mean bad, but it also means that we need to figure out how to make sure that the decisions we're making now serves our community 10, 20, 30 years from now. That's the challenge and the opportunity. Yeah. Now, I'm hearing a lot of conversation about transportation, and it sounds like that is probably going to be one of the biggest factors across the board when it comes to people being accessed healthier like you talked about. Transportation sounds like it impacts a lot of groups. When it comes to accessing healthcare for immigrants or immigrants families that may not have access to different pros of health insurance. Do you see there being any specific issues or barriers that immigrants families experience? Or would you say that it tends to be pretty similar as to that experienced by other groups on the county? I would say it's probably 50/50, I mean, as an example, as the COVID vaccine became more readily available. We saw that there was not equity in who was registering for the vaccine, then who is receiving the vaccine? Then it became a priority for me in our outreach team increasing to stand up sign-up events. Because even though there is a website that was out there and people can go online and register. Again, like I showed earlier, not everyone had digital access or even digital literacy, and we're talking about some of our most vulnerable in our community, particularly older individuals who don't even have an email address which we were able to work around that within our system. But then, even if they are only able to provide their phone number, then what happens if they receive a call about the vaccine? But it's in a language that they don't understand. With our sign-up events, we went to grocery stores, El Rancho Supermercado In East Arlington, and we stood up tables and just talk to people as they were coming in and out of the grocery store to get them signed up or even Asia Times Square, which is a large retail development that is frequented by a lot of folks in the community, but it is geared towards the Asian community or even the international community, based off a very large international grocery store that they have. We went to where the community was, instead of saying, hey, community resource here you figure it out. Unfortunately, government does that quite a bit. But even in that whole conversation about how do we prioritize where to have these events, we had seven sign-up events in [inaudible] throughout [inaudible] We signed up, almost 600 people who perhaps otherwise would not have signed up or maybe, there would have been some barrier to the access to the vaccine. But we prioritized based of this CDC social vulnerability index. I think that was a powerful resource that I will continue to use in guiding how we prioritize some of our efforts, not just with COVID, but even when we're talking about transportation, of course, that's part of the indexes evaluating the access to transportation or race and ethnicity and income and things like that.
