The City of San Antonio Metropolitan Health District (Metro Health) is charged with providing public health services to all residents of San Antonio/Bexar County, Texas. Despite the department’s history of exceptional service, the COVID-19 pandemic exposed gaps in the operation and impact of Metro Health, particularly spotlighting the need for long-term investments in workforce development, public health infrastructure and modernization, data interoperability, capacity building for strategic partnerships, and policy change. Metro Health responded by producing SA Forward, a community-facing blueprint and Metro Health 2.0, an internal strategic plan to support SA Forward and other department initiatives. These are critical plans for building the workforce and infrastructure required to combat future pandemics and threats to public health, and equitably distributing resources across the community. City leaders have increased and rebalanced local investments to initiate and sustain the work encompassed in both, and Metro Health immediately applied available funding to initiatives in progress. Now, the department seeks to accelerate the full implementation of SA Forward and Metro Health 2.0 with funding from the CDC’s Strengthening U.S. Public Health Infrastructure, Workforce and Data Systems grant. These additional resources will enable Metro Health to expand its workforce and foundational capabilities, address immediate needs related to or resulting from the COVID-19 pandemic, better meet future public health needs, and durably address health disparities and inequities.
Metro Health’s primary A1. Workforce strategy is to recruit and hire or sustain a total of 46 public health positions to ensure Metro Health has the right number of people with the right skills in the right places at the right time. Additional planned A1. activities are to support and sustain the public health workforce, train new and existing staff, strengthen workforce planning, systems, processes and policies, and support grant implementation. The primary A2. Foundational Capabilities strategies are to strengthen accountability and performance management, receive PHAB reaccreditation, strengthen organizational competencies in information technology, human resources, financial management, contracting, and procurement, enhance external communications, and strengthen community partnerships and engagement, all through an equity lens.
Significant outcomes will accrue from A1. implementation, including: hiring of a diverse public health staff that mirrors community demographics; achievement of an annual staff retention rate of >90%; more rapid filling of staff vacancies, i.e., 75% of vacant positions filled within 60 days of posting; and staff training on new performance measurement systems and processes to enable organization-wide implementation of Results Based Accountability. A2. outcomes are focused on promoting health equity, and strengthening the organization and its delivery or coordination of essential public health services, including: improvements in human resources, financial management, contracting and procurement systems; mapping community engagement and policy and partnership development activities to better gauge impact; and more targeted allocation of resources to address identified gaps that contribute to health disparities in marginalized communities. Also, Metro Health will continue to provide backbone support to grassroots organizations/partners as a means of enhancing their impact and promoting health equity. In all, these new competencies will advance Metro Health’s efforts to be recognized as a leading, innovative model health department and its quest to attain PHAB reaccreditation in 2024.