University Health teamed up with Bexar County for this flu vaccine drive in 2020; a new county public health department, approved Tuesday, would increase these types of collaborations.

More than two years into the coronavirus pandemic, Bexar County will establish a new department that consolidates its existing public health-related functions and aims to increase health care access.

The Bexar County Commissioners Court unanimously approved the new Department of Preventative Health and Environmental Services on Tuesday, which is slated to launch later this year using at least $2 million in federal pandemic relief funds.

That money will be used for preventative health services and health education, plus closer coordination with the San Antonio Metropolitan Health District and the University Health Systems’ newly-formed public health division, County Manager David Smith told commissioners.

“I don’t want to duplicate a lot of things that are being done by those two divisions,” Smith said.

The department will include more than a dozen existing county programs and services such as diabetes prevention, opioid overdose prevention, air quality, food and nutrition, animal control, mental and behavioral health, youth asthma control education and hazardous waste containment, he said, so that before the next pandemic, “we can have a more robust, rapid and coordinated response.”

Whoever is sitting in Judge Nelson Wolff’s chair at that time, Smith continued, “will be able to … make one phone call and get things done more quickly.”

The county will hire a public health director to oversee the new department as well as a nutrition specialist and a dietitian to inform what services and messaging are needed across the county, Smith said.

“I can’t tell you how frustrating it was for me for the first few months going through COVID not having information, not having the expertise on staff,” Wolff said.

Commissioner Tommy Calvert (Pct. 4) said he would like to see the department focus on the social determinants of health, such as housing, education, infrastructure and racism.

“The court has not connected the dots yet on how those how those should be driven through the funding of a public health division,” Calvert said.

Once the department is established it can grow and evolve as needed, Smith said.

“This is just a start,” Smith said. “If we need additional resources … we’ll come to you with those requests.”

Smith acknowledged that the county’s current efforts “are not leading to equitable health outcomes,” noting that chronic health issues and deaths from COVID-19 continue to disproportionately impact lower-income neighborhoods.

“I wish as a society, we could just get away from this distinction between physical health and mental health,” he said. “They’re all one package, it’s about wellness, period. And so often one will lead to the other and vice versa. So that will be something to work towards.”

The new department should lead a long-term health education campaign, Wolff said.

“If we could ever get ahead on prevention measures, to try to get there before someone gets really sick with some of these underlying issues, I think we can have a lot of success in saving people,” Wolff said. “There really hasn’t been an aggressive, in my view, that aggressive outreach education program.”

Commissioner Rebeca Clay-Flores (Pct. 1) said the department should develop relationships with local churches and nonprofits, which played a pivotal role in providing information and resources during the pandemic.

“In the middle of a pandemic, it’s too late to build relationships,” she said.

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Iris Dimmick

Senior Reporter Iris Dimmick covers public policy pertaining to social issues, ranging from affordable housing and economic disparity to policing reform and mental health. Contact her at