Though she will not be leading the San Antonio Metropolitan Health District when the budget is finalized, Assistant City Manager Colleen Bridger briefed a Council committee on Friday about the department’s new strategic plan and goals it has set for the next five years.

Among the priorities for the plan is developing a more coordinated approach to mental health services.

Metro Health is in the second year of its four-year strategic plan. The new plan, which Bridger will continue to work on until she hands over leadership responsibilities to incoming Metro Health Director Claude Jacob, has many of the same goals the previous one did but adds more areas for the department to address, Bridger told members of the Community Health and Equity Committee on Friday. 

“Given the pandemic, Metro Health has been revisiting our existing strategic plan and thinking about what we’ve learned from the pandemic and how we can apply those lessons learned to our current strategic plan, perhaps through some expanded focus areas. … And just as a reminder, the guiding principles for this expansion are very much centered around health equity and social justice,” Bridger said.

Bridger originally planned to leave the City last July but delayed her departure after former Metro Health Director Dawn Emerick resigned last June. Bridger previously said her new end date was Jan. 8 but stayed on longer and has continued to coordinate the City’s pandemic response as assistant city manager. She will hand over her Metro Health responsibilities to Jacob when he starts on July 6, Bridger said. She plans to leave the City at the end of July.

“I’ll work between now and [July 6] on what that [plan] funding looks like, and then they’ll put the finishing touches on it as part of the budget process for final approval in September,” Bridger said.

Among recommendations that Metro Health will make for its new budget is hiring a “chief mental health officer” to coordinate mental health initiatives across the city, Bridger said.

“What we recognize is that there are a number of different departments, including the police department, the fire department, department of human services, health department, housing; they all have a little bit of work in the area of mental health,” Bridger said. “But we need one person who can coordinate all of that work throughout the city and connect all of those city pieces to the larger county-run system and program.”

In its 2020-2023 strategic plan, Metro Health pledged to focus on adverse childhood experiences, violence prevention, access to care, and nutrition. While none of those will be ignored going forward, the new strategic plan will add four priorities for Metro Health: mental health, health justice, access to care, and technology and infrastructure. 

“We realized about six months ago that there would be a lot of additional resources being directed to local health departments to address not just the ongoing pandemic response, but also to address some of the outcomes associated with the pandemic and some of the areas around health disparities and social justice that really were brought to light as a result of the pandemic,” Bridger said. “And so … we recognized that there were four basic categories of additional programs, initiatives, and services that kind of added to our existing strategic plan, strengthened it, broadened it, and allowed us to really take advantage of these lessons learned.”

In the category of “health justice”, Metro Health hopes to expand the use of community health workers and create a local food system collaborative that deals with food insecurities. It also aims to put antiracist practices and policies in San Antonio’s health care system and add to existing technological infrastructure to improve infectious disease reporting and investigating under the “access to care” and “technology and infrastructure” umbrellas, respectively.

Councilwoman Shirley Gonzales (D5), who will vacate her seat after new Council members are inaugurated on Tuesday, said she loved that the strategic plan proposed expanding the use of community health workers and highlighted healthy eating.

“I am really supportive of the plan that you have,” Gonzales said. “One of the only concerns is that it’s kind of long, and my sense is that when there’s too many areas of focus, that you can just not get as much accomplished.”

The estimated cost for the strategic plan is between $80 million and $90 million over five years or $16 million to $18 million each year, Bridger said. She added there are no details for how a budget might look, as the plan is still a work in progress.

“We wanted to first check in with you on these priorities before really getting too deep into the details,” Bridger said.

Councilwoman Ana Sandoval (D7), who chairs the Community Health and Equity Committee, thanked Bridger and the rest of the Metro Health team for their work on the plan. She also said she appreciated the fact that the plan would be funded with a “braided funding approach,” as Bridger described it, meaning federal and state grants would supplement funding from the City. 

“As a policymaker, I support that direction entirely,” Sandoval said. “I’ve always felt that if we only relied on grants to execute our preventative health work, we’re at a disadvantage, and we can’t control the good work we can do. And to do that, we really need our own local money.”

Jackie Wang covered local government for the San Antonio Report.