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EVERYONE.MY NAME IS VANESSA HUSKY AND I AM PART OF THE HEALTH AND ENVIRONMENT COMMITTEE.
HOWEVER, WE DO HAVE DONNA PAYTON AND SEAN SMITH, UH, ASSISTING US ON THIS COMMITTEE THIS MORNING.
[RESOLUTIONS IN COMMITTEE]
[22269 A RESOLUTION authorizing the County Executive to execute a Participation Agreement with the Missouri Department of Health and Senior Services related to its Summer Food Service program, with costs to be reimbursed to the County.]
READS 2 2 2 6 9, READS A RESOLUTION AUTHORIZING THE COUNTY EXECUTIVE TO EXECUTE A PARTICIPATION AGREEMENT WITH THE MISSOURI DEPARTMENT OF HEALTH AND SENIOR SERVICES RELATED TO HIS SUMMER FOOD SERVICE PROGRAM WOULD CAUSE TO BE REIMBURSED TO THE COUNTY.IS THERE ANYONE HERE TO TESTIFY? THIS ONE SEEMS PRETTY SIMPLE DECISION TO ME, SO I'LL MOVE TO RECOMMENDED ADOPTION.
SO, UH, RESOLUTION NUMBER 2, 2 2 6 9 HAS BEEN ADOPTED.
ANY ONE WOULD BE RECOMMENDED ELSE, ONE TO SAY ANYTHING ELSE? YEAH, AND I THINK THE HELP, WE HAVE A HEARING FROM THE JACKSON COUNTY PUBLIC HEALTH OR WE HAVE A PRESENTATION.
GO AHEAD, SIR, WITH YOUR PRESENTATION.
I'M THE ASSISTANT DIRECTOR AT JACKSON COUNTY PUBLIC HEALTH.
UH, TODAY I AM GOING TO BE TALKING OR, UH, GIVING A BRIEF UPDATE ON, UM, SEXUALLY TRANSMITTED INFECTIONS IN JACKSON COUNTY, STIS.
UH, WE'RE GONNA TALK A LITTLE BIT ABOUT HIGH LEVEL TRENDS, UM, SO WHAT WE'RE SEEING ACROSS JACKSON COUNTY, UM, AND HOW WE ARE RESPONDING, UM, TO THIS PARTICULAR ISSUE.
SO I HAVE A FEW, UM, COPIES OF THE PRESENTATION JUST IN CASE YOU NEED THEM.
I'LL DISTRIBUTE THEM AND THEN WE'LL GET GOING.
UM, I'M WONDERING IF WE CAN ADVANCE THE SLIDE.
UM, EVERYBODY, UM, ACTUALLY, SO WE SENT THEM TO, UM, HEALTH.
UH, SO WE SENT THEM, UH, I THINK IT WAS EARLY IN THE WEEK LAST WEEK, UH, TO IT DIRECTLY.
UM, AND THEN WE ALSO SENT THEM OUT TO THE COMMITTEE.
SOMEONE FROM MY TEAM WILL COME OUT BECAUSE THEY, IT APPEARS THAT THEY DON'T HAVE YOUR SLIDES.
WE CAN, WE CAN JUST, UM, GET STARTED.
I CAN, UH, TALK BRIEFLY THROUGH THE SLIDES THAT ARE IN FRONT OF YOU, AND THEN IF THEY DO APPEAR, UM, WE HAVE SOME GREAT VISUALS THAT, UM, THAT YOU CAN TAKE A PEEK AT.
BUT OTHERWISE WE CAN, WE CAN JUST GO FROM THERE.
SO, UM, SO TO START, WE'RE, WE'RE GONNA START WITH SLIDE TWO IN YOUR PACKET.
UM, UH, TALKING A LITTLE BIT ABOUT WHY THIS MATTERS.
SO, UM, STIS IN GENERAL ARE A GROWING PUBLIC HEALTH THREAT, UM, BOTH HERE IN JACKSON COUNTY AS WELL AS NATIONALLY.
UM, THERE'S A MAP ON THIS SLIDE ON, ON, UH, SLIDE TWO OR PAGE TWO, UM, THAT HIGHLIGHTS, UM, STI RATES BY STATE AND MISSOURI CONSISTENTLY, UH, IS AMONGST THE HIGHER BURDEN, UH, STATES, UM, FROM ACROSS THE COUNTRY WITH ELEVATED RATES COMPARED TO WHAT WE SEE, UH, NATIONALLY, UM, ACROSS THE UNITED STATES.
STI RATES IN GENERAL HAVE INCREASED, UM, OVER THE PAST TWO DECADES, UM, PEAKING IN 2021, UH, WITH MORE THAN 2.5 MILLION REPORTED CASES OF CHLAMYDIA, GONORRHEA, AND SYPHILIS.
AND SO WHILE THERE HAS BEEN A SLIGHT DECLINE SINCE 2021, UH, AND YOU'LL SEE THAT IN THE DATA HERE IN A FEW SLIDES ANYWAYS, UM, WE ARE STILL ABOVE PRE PANDEMIC LEVELS, UM, AND IT REMAINS A SIGNIFICANT ECONOMIC, UM, AND HEALTH BURDEN FROM ACROSS THE UNITED STATES.
SO WE'LL MOVE ON TO SLIDE THREE OR PAGE THREE, EXCUSE ME.
UM, AND I WANNA BRIEFLY CLARIFY WHAT WE MEAN BY STIS AND WHY THEY CAN BE CHALLENGING FROM A PUBLIC HEALTH PERSPECTIVE
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OVERALL.UM, SO WE AT THE HEALTH DEPARTMENT, UM, STIS ARE JUST ONE OF THE MANY COMMUNICABLE DISEASES THAT WE MONITOR.
UM, TRACK, INVESTIGATE, UM, AND TRY TO INTERRUPT CYCLES AROUND.
UM, AND WHAT WE'RE TALKING ABOUT WHEN WE MENTION STIS, WE'RE TALKING ABOUT CHLAMYDIA, GONORRHEA, SYPHILIS, HIV, VIRAL, HEPATITIS, AND EMPO IN SOME CASES.
UM, ONE OF THE MOST IMPORTANT THINGS TO UNDERSTAND ABOUT STIS AND WHY MANY OF THESE INFECTIONS, UM, PERSIST IN OUR COMMUNITIES IS THAT MANY OF THEM DO NOT CAUSE SYMPTOMS, ESPECIALLY IN THEIR EARLY STAGES.
UH, FOR EXAMPLE, THE MAJORITY OF CHLAMYDIA CASES OVERALL ARE ASY ASYMPTOMATIC, AND GONORRHEA IS FREQUENTLY ASYMPTOMATIC AS WELL.
AND SO WHAT THAT MEANS IN PRACTICE, UH, AS YOU CAN ALL IMAGINE, IS THAT INDIVIDUALS CAN CARRY AND TRANSMIT THESE INFECTIONS, UH, WITHOUT REALIZING IT.
UH, SYMPTOMATIC INFECTIONS ARE JUST THE TIP OF THIS ICEBERG, SO TO SPEAK, UH, AND WHAT WE SEE AND WHAT IS REPORTED TO US AS, UM, PUBLIC HEALTH PROFESSIONALS.
SO, UH, ON PAGE FOUR, WE'RE GONNA TALK A LITTLE BIT ABOUT WHAT'S DRIVING SDI TRANSMISSIONS IN JACKSON COUNTY.
HOW ARE THEY EVER DISCOVERED? SO MANY OF THE CASES THAT, UM, WE REPORT IN OUR DATA, UM, ARE NOT REFLECTIVE OF THE TRUE BURDEN OF DISEASE, AND THAT'S TRUE FOR A LOT OF COMMUNICABLE DISEASES.
UM, WE HAVE A GOOD UNDERSTANDING OF COMMUNICABLE DISEASE PREVALENCE WITHIN OUR COMMUNITY BASED ON REPORTED CASES.
SO THOSE ARE OFTEN EITHER, UM, INDIVIDUALS WHO ARE SYMPTOMATIC OR IF THERE'S A SITUATION INVOLVING PARTNERS, RIGHT? SO YOU HAVE AN INDIVIDUAL WHO TESTED POSITIVE AND INFORMS THEIR THEIR PARTNER THAT THEY NEED TO, TO TEST.
WE CAN DETECT ASYMPTOMATIC SPREAD IN THAT SITUATION AS WELL.
BUT FOR A LOT OF PEOPLE, UM, IF, IF YOU DON'T KNOW, UM, IF YOU DON'T HAVE A PARTNER THAT TOLD YOU, OR IF YOU DON'T HAVE, UM, ANY INDICATION THAT YOU COULD HAVE BEEN POTENTIALLY EXPOSED, IF YOU'RE NOT ROUTINELY TESTING, UH, YOU CAN CARRY MANY OF THESE DISEASES, UM, FOR LONG PERIODS OF TIME.
AND VIRAL HEPATITIS, THAT'S A STI, THAT'S SOMETHING THAT WE TRACK.
SO WE HAVE THIS, THIS LARGE BUCKET OF A VARIETY OF DIFFERENT DISEASES THAT WE MONITOR, UM, AT THE HEALTH DEPARTMENT, AND THAT'S ONE OF THE ONES THAT'S INCLUDED WITHIN SOME OF OUR DATA SETS.
CAN CAN I ASK ONE CLARIFYING QUESTION? ABSOLUTELY.
IT'S THE SAME QUESTION I ASK EVERY TIME YOU GUYS COME BEFORE US.
UM, IS THIS DATA THAT YOU'RE PRESENTING ONLY FOR THE PORTION OF JACKSON COUNTY THAT, THAT OUR HEALTH DEPARTMENT IS RESPONSIBLE FOR? OR IS THIS FOR ALL OF JACKSON COUNTY AND, AND CAN WE HAVE THAT BROKEN OUT BECAUSE ABSOLUTELY.
UM, I, I MEAN THE, THAT THE RESPONSE IS VERY DIFFERENT IF, UM, THE PORTION OF THE COUNTY THAT WE FUND FROM A HEALTH OUTCOMES PERSPECTIVE IS IN A DIFFERENT TREND LINE.
AND BY NOT PRESENTING THAT TO US, ANYTIME YOU COME BEFORE US, IT'S, IT'S, IT'S MUDDYING THE WATERS, IN MY OPINION.
UM, I'M, WE, WE ACTUALLY JUST PUT OUT A DATA BRIEF THAT, UM, BREAKS IT DOWN BY KANSAS CITY, EASTERN JACKSON COUNTY AND INDEPENDENCE.
UM, THE REASON THAT WE'RE USING KANSAS JACKSON COUNTY DATA OVERALL IS BECAUSE WE CAN GET, UM, MORE RECENT DATA FOR THE COUNTY AS A WHOLE THAN WE CAN BROKEN APART DATA.
SO, UM, HOW, HOW THIS ALL WORKS, UM, ALL THE REPORTS GO TO THE STATE, UM, THE STATE PROCESSES A LOT OF THIS, THE, THESE DATA, AND THEN THEY WILL PUT OUT AN AGGREGATE AMOUNT FOR LARGE GEOGRAPHICAL AREAS BEFORE THEY PUT OUT THE NUANCED VERSIONS.
AND SO WE HAVE ALL OF THE DATA FOR EASTERN JACKSON COUNTY.
THE TRENDS MIRROR, UM, WHAT WE SEE FOR THE COUNTY AS A WHOLE, EXCEPT FOR H-I-V-H-I-V, UM, IS SIGNIFICANTLY MORE PREVALENT, PREVALENT IN CERTAIN PARTS OF THE COUNTY.
UM, BUT AGAIN, THAT'S, WE DIDN'T MENTION THAT IN THIS PRESENTATION BECAUSE WE'RE FOCUSED.
UM, WE WE'RE TALKING A LOT ABOUT JACKSON, JACKSON COUNTY PUBLIC HEALTH SERVICES.
SO, UH, WE CAN PROVIDE THAT STI BRIEF THAT HAS IT ALL BROKEN DOWN.
UM, UNFORTUNATELY THE DATA'S JUST A LITTLE BIT OLDER, UM, THAN WHAT WE HAVE HERE.
SORRY, GIMME ONE SECOND TO GET BACK IN HERE.
SO, TALKING ABOUT WHAT IS DRIVING STI TRANSMISSION? SO WHEN WE LOOK AT STI TRENDS AT A COMMUNITY LEVEL, THEY'RE DRIVEN BY A FEW CONSISTENT FACTORS OVERALL.
UM, THE FIRST BEING ACCESS TO TESTING, UM, WHETHER PEOPLE CAN BE EASILY SCREENED, UM, AND ROUTINELY SCREENED.
UM, A LOT OF BARRIERS THAT PEOPLE FACE, UM, WITH ACCESS TO TESTING, UH, GOES WELL BEYOND JUST WHETHER THEY CAN ACCESS A PARTICULAR CLINIC OR NOT.
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PARTNERS HAVE COPAYS AND DIFFERENT, UM, FEES THAT ARE IMPOSED THAT MAKE IT, UH, COST PROHIBITIVE TO RECEIVE A SIMPLE TEST.AND THAT'S WHERE A LOT OF OUR PARTNERS WITH KANSAS CITY HEALTH DEPARTMENT, CASEY CARE, SWOPE, UM, OUR OURSELVES AT JACKSON COUNTY PUBLIC HEALTH, UM, PROVIDE ACCESS TO THOSE TESTS AT AN EXTREMELY LOW COST, UM, SO THAT PEOPLE CAN GET, AGAIN, SCREENED REGULARLY, AND WE CAN IDENTIFY THOSE CASES, UH, WELL AHEAD OF WHEN THEY WOULD SHOW UP IN A HOSPITAL OR CLINIC WITH SYMPTOMS. UH, SECONDLY IS TIMELINESS OF TREATMENT.
SO THE LONGER THE GAP BETWEEN INFECTION AND TREATMENT, UH, THE GREATER THE OPPORTUNITY OVERALL FOR, UH, TRANSMISSION.
UM, THE THIRD PIECE IS PARTNER NOTIFICATION AND FOLLOW-UP AS YOU COULD, UM, POSSIBLY IMAGINE.
UM, WE'RE TALKING ABOUT A VERY SENSITIVE TOPIC AND A VERY SENSITIVE SITUATION.
UM, AND WE, IF WE DON'T HAVE THE ABILITY FOR PARTNERS TO NOTIFY OTHER PARTNERS ABOUT A RECENT POSITIVE CASE, UM, THEN WE HAVE THIS, THIS, UH, SCENARIO WHERE TRANSMISSION WILL JUST, UM, SPREAD RAPIDLY ACROSS JACKSON COUNTY.
AND FINALLY, THE BROADER COMMUNITY FACT FACTORS ALSO PLAY, UH, A PART IN ALL OF THIS, UM, ACCESS TO HEALTHCARE, TRANSPORTATION STIGMA.
UM, THEY ALL, UM, FACTOR IN OR INFLUENCE WHETHER PEOPLE ARE ABLE TO ENGAGE WITH SERVICES OVERALL.
SO WHILE INDIVIDUAL DECISIONS, NO DOUBT MATTER, UM, THERE ARE SYSTEMS, SYSTEMS LEVEL CONDITIONS THAT ULTIMATELY SHAPE THE TRENDS THAT WE SEE ACROSS THE POPULATION, AND WE HAVE TO PAY ATTENTION TO THOSE AS WE'RE TALKING ABOUT STIS IN GENERAL.
MOVING ON TO PAGE FIVE, UM, TALKING A LITTLE BIT ABOUT WHAT KEEPS RATES STABLE.
UM, SO NOW THAT WE KNOW WHAT DRIVES TRANSMISSION OVERALL, I DO WANNA HIGHLIGHT BRIEFLY, UH, THE KEY CONDITIONS THAT INFLUENCE WHETHER SDI RATES REMAIN STABLE OR BEGIN TO INCREASE OVERALL.
AND SO AT A COMMUNITY LEVEL, AT A HIGH LEVEL, UM, OUTCOMES ARE DRIVEN BY ACCESS TO TESTING, HOW QUICKLY INDIVIDUALS ARE TREATED, THE ABILITY TO CONDUCT PARTNER FOLLOW UP, ALL OF THOSE THINGS THAT I JUST MENTIONED.
UM, BUT WHEN THESE CONDITIONS ARE CONSISTENT, WE TEND TO SEE EARLIER DETECTION OF INFECTIONS OVERALL.
UM, WE SEE LOWER TRANSMISSION AND WE SEE MORE STABLE, UM, RATES OR TRENDS OVERALL.
UM, THE BIG SPIKE THAT WE SAW IN 2021, UM, A LOT OF WHAT DROVE, UM, UH, THE, THE RATES OVERALL TO STABILIZE WAS DRIVEN BY, AS YOU CAN IMAGINE, ACCESS TO TESTING.
AND AS WE EXITED COVID AND WE HAD MORE RESOURCES TO GET PEOPLE TO, UM, THAT ACCESS, UH, WE BEGAN TO CATCH THINGS EARLIER, UM, AND ULTIMATELY INTERRUPT THOSE CYCLES OF TRANSMISSION.
SO WE'RE GONNA MOVE ON TO PAGE SIX IN YOUR SLIDE DECK, AND WE'RE GONNA START TALKING ABOUT DATA HERE.
UM, AND AGAIN, UM, AS WE MENTIONED, SO THIS IS JACKSON COUNTY AS A WHOLE, UM, BUT THIS IS LOOKING AT RATES OVER TIME.
UM, AND AGAIN, IF WE LOOKED AT EASTERN JACKSON COUNTY, THE RATES FOR THESE THREE IN PARTICULAR, CHLAMYDIA, GONORRHEA, AND SYPHILIS, UM, ARE, ARE VERY, VERY SIMILAR TO WHAT WE'RE SEEING AT A COUNTY LEVEL.
SO, UM, THESE, UH, THESE RATES ARE CASES PER 100,000 PEOPLE.
UM, SO ALL ACROSS ALL THREE INFECTIONS OF CHLAMYDIA, GONORRHEA, AND SYPHILIS, UH, WE SEE A VARIATION OVER TIME, UM, INCLUDING SOME INCREASES THROUGH 22 AND 23.
UM, BUT WE SEE THAT, UM, PRECIPITOUS DECLINE IN 24 AND 25, AND IT IS IMPORTANT TO INTERPRET THESE TRENDS IN CONTEXT.
UM, STI CASE RATES REFLECT NOT ONLY TRANSMISSION IN THE COMMUNITY, BUT ALSO HOW CONSISTENTLY INDIVIDUALS ARE BEING TESTED, DIAGNOSED, AND CONNECTED TO TREATMENT OVERALL.
THAT NEXT SLIDE ON PAGE SEVEN SHOWS THE DISTINCTION.
SO ALTHOUGH WE HAVE SEEN DECLINES IN JACKSON COUNTY OVERALL AND DECLINES IN EASTERN JACKSON COUNTY OVERALL, UM, STI CASE RATES OVERALL IN JACKSON COUNTY COMPARED TO THE STATE OF MISSOURI, UM, ARE CONSISTENTLY HIGHER THAN WHAT WE SEE ACROSS THE STATE.
LOUIS COUNTY, KANSAS CITY, AND ST.
LOUIS COUNTY, UM, OR JACKSON COUNTY AND ST.
LOUIS COUNTY HAVE AMONG THE HIGHEST RATES IN THE STATE OF MISSOURI.
UM, AND SO WHILE BOTH FOLLOW SIMILAR TRENDS OVER TIME, ACCORDING TO THIS GRAPH, UM, THE IMPORTANT POINT IS THAT, UM, JACKSON COUNTY OVERALL HAS CONTINUED TO MAINTAIN A CONSISTENTLY HIGHER BASELINE BURDEN.
UH, AND THAT REMAINS TRUE TO THIS DAY QUESTION OF COURSE.
UM, SO WHEN WE'RE LOOKING AT THESE NUMBERS, ARE WE TAKING INTO CONSIDERATION PERCENTAGE OF POPULATION? OF COURSE.
SO THIS IS, THESE ARE AGE ADJUSTED CASE RATES.
SO, UM, IT'S A RATE PER 100,000 PEOPLE.
SO FOR INSTANCE, IN THE YEAR OF 2025 IN JACKSON COUNTY AS A WHOLE, WE HAD 1032 CASES PER ONE 100,000 PEOPLE IN JACKSON COUNTY.
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SO MOVING ON TO TO PAGE EIGHT.UM, ACROSS AGE GROUPS, STI BURDEN IS HEAVILY CONCENTRATED AMONG ADOLESCENTS AND YOUNG ADULTS IN JACKSON COUNTY, THE HIGHEST RATE IS SEEN IN INDIVIDUALS THAT ARE AGED 19 TO 24 AT NEARLY 4,800 CASES PER 100,000 POPULATION.
UH, WE ALSO SEE ELEVATED RATES AMONGST THOSE WHO ARE AGED 13 TO 18 AFTER AGE 25 RATES DECLINE SHARPLY AND CONTINUE TO DECREASE WITH AGE, WHICH IS A CONSISTENT PATTERN ACROSS ALL THREE MAJOR REPORTABLE INFECTIONS.
AND WHAT THIS TELLS US FROM A PUBLIC HEALTH STANDPOINT IS THAT TRANSMISSION IS NOT EVENLY DISTRIBUTED AMONGST POPULATION GROUPS, AS YOU CAN ALL IMAGINE.
INSTEAD, IT'S HIGHLY CONCENTRATED IN YOUNGER AGE GROUPS WHERE PREVENTION, ROUTINE SCREENING AND EARLY INTERVENTION CAN HAVE THE GREATEST IMPACT OVERALL.
UM, ALL RIGHT, WE'RE, WE'RE MAKING PROGRESS
SO WE, WE CAN TALK A LITTLE BIT ABOUT HOW OUR TEAM IS RESPONDING OVERALL.
SO OUR RESPONSE AT JACKSON COUNTY PUBLIC HEALTH IS CENTERED ON MAINTAINING THE CONDITIONS THAT REDUCE TRANSMISSION, UM, AND SUPPORT EARLY DETECTION.
UH, WE ARE FOCUSED ON EXPANDING ACCESS TO TESTING SO THAT INDIVIDUALS BE, CAN BE SCREENED ROUTINELY AND WITHOUT ANY SORT OF UNNECESSARY BARRIERS.
UM, WE'RE STRENGTHENING THOSE PARTNER SERVICES, UH, WHICH ALLOWS US TO IDENTIFY AND NOTIFY INDIVIDUALS WHO MAY HAVE BEEN EXPOSED AND CONNECT THEM TO THE CARE THAT'S APPROPRIATE FOR THEM.
AND WE'RE ALSO CONTINUING TO TARGET OUTREACH IN COMMUNITIES WHERE THE NEED IS GREATEST WITH AN EMPHASIS ON REDUCING BARRIERS AND INCREASING AWARENESS OVERALL, UM, ACROSS ALL OF THIS WORK, THE, THE, THE WORK IS FOCUSED ON TIMELINESS, UM, BECAUSE HOW QUICKLY WE IDENTIFY AND RESPOND TO AN INFECTION OR A POSITIVE RESULT PLAYS A MAJOR ROLE IN HOW THESE TRENDS DEVELOP, UM, AND THE ULTIMATE OUTCOMES AND RESULTS THAT WE SEE.
LONG TERM QUESTION, OF COURSE.
HOW, WHAT DOES TARGETED COMMUNITY OUTREACH LOOK LIKE? YEAH, SO, UM, FROM THE PREVENTION ASPECT, IT COULD BE INCREASING ACCESS TO, UM, CONDOMS AND OTHER, UM, RESOURCES THAT WOULD ALLOW BARRIERS TO STI TRANSMISSION.
UH, IT COULD INCLUDE, UM, INCREASING ACCESS TO RAPID TESTING SERVICES WITHIN PARTICULAR ZIP CODES OR GEOGRAPHIES OR, UM, SETTINGS.
UM, SO IT'S, AGAIN, MAKING THOSE SERVICES AVAILABLE WHERE PEOPLE ARE IN THE COMMUNITY VERSUS HAVING THEM, YOU KNOW, CONTACT THE HEALTH DEPARTMENT AND COME INTO OUR OFFICE AND LEASE SUMMIT TO REV PROVIDE THOSE SERVICES.
SO WHEN WE DO TARGETED, NOT WE, WHEN YOU GUYS DO TARGETED COMMUNITY OUTREACH, AND I DON'T WANNA SAY WHAT DOES IT LOOK LIKE AGAIN, BECAUSE YOU DID GIVE ME, UH, EXAMPLES OF WHAT COULD BE DONE, BUT HOW ARE WE DOING IT? ARE WE GOING TO, UH, COMMUNITY FAIRS? ARE WE HOLDING FAIRS OURSELVES? HOW ARE WE TAKING, UM, THAT NEED OR THOSE NEEDED RESOURCES INTO THE TARGETED COMMUNITIES? ABSOLUTELY.
IT'S EVERYTHING THAT YOU, YOU MENTIONED.
UM, SO, UH, RECENTLY, WITHIN THE LAST TWO YEARS, UM, WE WERE ABLE TO, UH, OBTAIN A DIS CONTRACT WITH THE STATE OF MISSOURI.
UH, DIS STANDS FOR DISEASE INTERVENTION SPECIALISTS, AND THESE ARE THE INDIVIDUALS THAT ARE ACTUALLY DOING THIS WORK TO INTERVENE AND INTERRUPT TRANSMISSION.
UM, AND A BIG FUNCTION OF THEIR JOB IS BEING OUT AND ABOUT IN THE COMMUNITY.
UM, WHETHER THAT BE COLLECTING SAMPLES FOR TESTING, UH, GOING TO TO, TO BARS AND NIGHTCLUBS TO FIND, FIND PEOPLE, OR TO PROVIDE THEM WITH RESOURCES.
IT'S ACTUALLY GETTING OUT AND ABOUT IN THE COMMUNITY, NOT JUST SITTING BEHIND A DESK AT JACKSON COUNTY PUBLIC HEALTH, UM, TO PROVIDE THOSE PREVENTATIVE SERVICES, BUT ALSO TO, TO INTERRUPT CHAINS OF TRANSMISSION.
WHEN WE HAVE A KNOWN INDIVIDUAL WHO HAS A POSITIVE RESULT, WE'RE TRYING TO TRACK THEM DOWN, FIND THEM SO THAT WE CAN PROVIDE THEM WITH INFORMATION THAT THEY DO HAVE A POSITIVE RESULT.
AND HERE'S SOME RESOURCES FOR TESTING, WHETHER THAT BE AT JACKSON COUNTY PUBLIC HEALTH OR ONE OF OUR PARTNER AGENCIES, UM, ACROSS JACKSON COUNTY TO GET THEM CONNECTED TO CARE.
UM, BUT THEIR, THEIR PRIMARY FUNCTION IS BEING OUT AND ABOUT IN THOSE PRIORITY ZONES OR THOSE PRIORITY AREAS ACROSS JACKSON COUNTY, UM, TO GET PEOPLE ACCESS TO THE RESOURCES THAT THEY NEED WHEREVER THEY ARE IN THIS STAGE, WHETHER WE'RE TALKING ABOUT PREVENTION OR WE'RE TALKING ABOUT A POSITIVE, UM, CASE.
AND IN 2025, DO WE HAVE DATA OR STATISTICS, OUR INFORMATION ON WHERE THEY WENT AND, UM, ESTIMATED OUTCOMES OR PARTICULAR OUTCOMES? DO WE HAVE THAT DATA? YEAH, SO WE HAVE, UM, WE HAVE CASE DATA.
SO, UM, THE, THE STATE SENDS US ALL OF THESE POSITIVE TEST RESULTS THAT ARE, THAT
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ARE SHOWING UP, WHETHER THEY'RE COMING THROUGH OUR CLINIC OR ANOTHER CLINIC FROM ACROSS JACKSON COUNTY.WE ULTIMATELY GET ALL OF THOSE POSITIVE CASE RESULTS.
UM, AND IT'S OUR JOB AS PUBLIC HEALTH TO INVESTIGATE THOSE CASES WITHIN A TIMELY AMOUNT, UM, UH, BASED ON THE, THE COMMUNICABLE DISEASE THAT WE'RE TALKING ABOUT WITHIN THE TIMEFRAME THAT IS SET FOR THAT PARTICULAR DISEASE, UM, AND REPORT BACK THOSE METRICS TO THE STATE.
SO WE HAVE ALL OF THOSE, UH, METRICS AND EVALUATIONS AVAILABLE.
UM, WE ROUTINELY EVALUATE THIS PROGRAM TO SHOW IT'S WORTH TO THE STATE OF MISSOURI.
SO WE CAN PROVIDE ALL OF THAT INFORMATION FOR YOU.
AND I THINK MORE SPECIFICALLY, UM, WHEN THE DESIGNATED PEOPLE GO OUT TO A COMMUNITY EVENT OR THEY GO OUT TO A BAR, THEY HAVE IDENTIFIED A TARGETED AREA AND THEY GO OUT, DO WE KNOW HOW MANY TIMES THEY WENT OUT AND WHERE THEY WENT? ARE YOU TALKING ABOUT A POSITIVE CASE? NO.
I'M TALKING ABOUT THOSE INDIVIDUALS THAT GO OUT.
JUST IN GENERAL, WHERE DO THEY GO? HOW MANY TIMES DO THEY GO IN A, IN 20, HOW MANY TIMES DID THEY GO IN 20, 25? I WANT TO KNOW MORE ABOUT THEIR ACTIVITY BECAUSE IT'S INDICATED THAT THEY TARGET CERTAIN COMMUNITIES.
SO IF THEY'RE GOING TO THESE TARGETED COMMUNITIES, I WANT TO SEE, UM, NOT JUST SO THAT I CAN KNOW WHAT A TARGETED COMMUNITY IS MM-HMM
I JUST WANNA SEE THE ACTIVITY OF THOSE INDIVIDUALS AND HOW EFFECTIVE THAT PROGRAM IS.
AND I KNOW IT'S A GRANT, SO I KNOW THE STATE IS MONITORING THAT MM-HMM
SO I KNOW THAT YOU'RE PROVIDING THEM THAT DATA.
UM, SO, BUT, SO MY QUESTION IS, CAN WE FIND OUT INFORMATION ON THEIR ACTIVITY? ABSOLUTELY.
I, SO I THINK THAT WE CAN PROVIDE MORE DATA GENERALLY, BUT WHAT I WILL ALSO SAY IS THAT THE STATE PROVIDES FUNDING FOR DISEASE INTERVENTION SPECIALISTS.
THEY DO NOT PROVIDE FUNDING FOR PREVENTATIVE SERVICES.
AND SO ANY OF THE PREVENTATIVE SERVICES THAT WE'RE DOING, UH, WE'RE DOING EITHER TAGGED ON TO OTHER GRANTS OR WE'RE DOING THEM AS STAFF, HAVE CAPACITY IN TIME.
UM, PRIOR TO EVEN COVID, UM, YOU KNOW, WE DID NOT HAVE, AGAIN, PRIOR TO COVID, WE WERE NOT AN ACCREDITED PUBLIC HEALTH AGENCY, AND SO WE DIDN'T HAVE COMMUNICABLE DISEASE, UH, INVESTIGATIONS IN THE STI REALM THAT WAS ADDED THROUGH INVESTMENTS OF THIS BODY AFTER, AFTER THE FACT.
AND SO WE'VE BEEN ABLE TO INCREASE THAT CAPACITY TREMENDOUSLY, BUT IT IS STILL, WE'RE NOT ABLE TO PROVIDE PREVENTATIVE SERVICES TO THE LEVEL THAT, UM, KANSAS CITY HEALTH DEPARTMENT IS DOING, FOR INSTANCE.
SO, UM, CONTINUING ON, SO TESTING.
SORRY, WANNA MAKE SURE? OKAY, NEXT SLIDE PLEASE.
SO, UM, TESTING AND TREATMENT, UM, ARE THE FOUNDATIONS OF STI PREVENTION.
SO BECAUSE MANY INFECTIONS ARE ASYMPTOMATIC, THAT ROUTINE TESTING IS THE PRIMARY WAY, AS I MENTIONED BEFORE, THAT WE CAN IDENTIFY CASES AND THAT MAKES, UM, ACCESSIBILITY CRITICAL.
UM, TESTING NEEDS TO BE EASY TO ACCESS, IT NEEDS TO BE TIMELY, IT NEEDS TO BE CONFIDENTIAL.
UH, AND ONCE AN I AN, AN INFECTION IS IDENTIFIED, RAPID LINKAGE TO TREATMENT IS ESSENTIAL.
THE SHORTER THE TIME BETWEEN DIAGNOSIS AND TREATMENT, THE SMALLER THE WINDOW FOR TRANSMISSION OVERALL.
SO, STI TESTING IN GENERAL, AND AGAIN, THIS IS, UH, AGAIN, A FUNCTION OF, UM, THE CONTINUED INVESTMENT THAT'S THIS BODY HAS MADE IN FOUNDATIONAL PUBLIC HEALTH SERVICES.
UM, SO IN 2024, WE CONDUCTED AROUND 398 STI TESTS.
UH, WE HAD VERY LIMITED CAPACITY.
UM, AND IN 2025, THAT NUMBER INCREASED TO 2,266 TESTS REPRESENTING A 470% INCREASE IN TESTING VOLUME.
UM, AND IT IS IMPORTANT TO NOTE THAT THAT IS NOT A FUNCTION OF MARKETING OR PROMOTING THAT PROGRAM THAT IS VERY REAL NEED THAT EXISTED, UM, PARTICULARLY IN EASTERN JACKSON COUNTY, WHERE, UM, ACCESSIBLE ORGANIZATIONS THAT PROVIDE TESTING ARE NOT FREQUENT.
UM, THAT IS A FUNCTION OF INDIVIDUALS COMING TO OUR CLINIC, RECEIVING THOSE, THE, THOSE TESTS, UM, AND TAKING ADVANTAGE OF THE CAPACITY THAT WAS GROWN OVERALL.
UM, A KEY DRIVER OF THIS GROWTH HAS BEEN THE ADDITION OF, UM, AN A PRN NURSE TO OUR TEAM.
THIS HAS ALLOWED US TO MANAGE, UM, A HIGHER VOLUME OF STI PATIENTS OVERALL, UM, INCLUDING MORE COMPLEX CASES WITHIN OUR OWN SYSTEM.
UM, IT ALSO ALLOWED US TO PROVIDE SERVICES THAT GO, UM, WELL BEYOND WHAT MANY LOCAL HEALTH DEPARTMENTS TYPICALLY OFFER, INCLUDING SAME-DAY TREATMENT AND PRESCRIBING MEDICATIONS THAT ARE NOT ALWAYS AVAILABLE THROUGH STANDARD STATE SUPPORTED PROGRAMS. UM, THIS GENERALLY MEANS FASTER DIAGNOSIS, FA FASTER TREATMENT, AND FEWER OPPORTUNITIES FOR ONGOING TRANSMISSION.
THE OTHER TWO FOCUSES ARE, WE ARE UNDERTAKING AS A HEALTH DEPARTMENT INCLUDE PREVENTION TO STOP THE INFECTIONS, UM, FROM EVER HAPPENING, UM, AND
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INVESTIGATIONS, AS I MENTIONED WITH OUR DIS PROGRAM TO PREVENT FURTHER SPREAD OF CURRENT INFECTIONS.SO OUR PREVENTION EFFORTS, AS I MENTIONED, UH, FOCUS ON REDUCING BOTH RISK AND BARRIERS TO CARE.
UM, THIS INCLUDES EDUCATION AND AWARENESS, SO INDIVIDUALS UNDERSTAND WHEN AND HOW TO GET TESTED, AS WELL AS HOW TO REDUCE RISK.
UM, ROUTINE SCREENING, AS I'VE MENTIONED REPEATEDLY IS A KEY PREVENTION STRATEGY, PARTICULARLY BECAUSE MANY OF THESE INFECTIONS DO NOT PRESENT WITH SYMPTOMS. AND REDUCING STIGMA IS VERY IMPORTANT WITHIN THIS PARTICULAR TOPIC.
WHEN INDIVIDUALS FEEL COMFORTABLE ACCESSING TESTING AND TREATMENT, THEY'RE MORE LIKELY TO SEEK CARE EARLIER.
UM, THE OTHER ASPECT TO THIS IS INVESTIGATIONS, WHICH IS ALSO CALLED, UM, PARTNER SERVICES.
UM, WHEN SOMEONE IS DIAGNOSED WITH AN STI, UM, SPECIALLY TRAINED STAFF CONDUCT FOLLOW-UP TO ENSURE THAT THEY'RE CONNECTED TO CARE AND TO IDENTIFY INDIVIDUALS WHO MAY HAVE BEEN EXPOSED, UM, AS YOU CAN POTENTIALLY IMAGINE, IT IS A VERY SENSITIVE TOPIC, UM, TO TALK WITH SOMEONE ABOUT THEIR SEXUAL HISTORY.
AND WE NEED INDIVIDUALS THAT ARE COMPASSIONATE, UM, AND SPECIALLY TRAINED, UM, TO CONDUCT THESE TYPES OF INVESTIGATIONS.
IN THIS INSTANCE, THOSE PARTNERS ARE THEN NOTIFIED CONFIDENTIALLY AND ALSO CONNECTED TO TESTING AND TREATMENT WHERE APPROPRIATE.
SO AS YOU ALL HAVE HEARD, UH, THERE'S, UH, THERE'S A BIG EVENT HAPPENING IN KANSAS CITY THAT WOULD NO IN NO WAY, SHAPE OR FORM INCREASE SEXUAL ACTIVITY, UM, UH, WHATSOEVER.
SO PART OF OUR PREVENTION EFFORTS THIS YEAR INCLUDE PREPARING FOR THE SIGNIFICANCE OF THE WORLD CUP.
UM, AND IN FACT, BECAUSE THE WORLD CUP HAS HAPPENED MANY TIMES, UM, OLYMPICS OLYMPIC TYPE EVENTS HAVE HAPPENED MANY TIMES.
WE HAVE AN UNDERSTANDING THROUGH THE LITERATURE HOW THESE EVENTS IMPACT STI RATES OVERALL.
UM, AND WHAT THE LITERATURE TELLS US IS THAT, UM, ALTHOUGH WE WILL NOT SEE STII RATES INCREASE DURING THE TOURNAMENT, UM, AFTER THE TOURNAMENT, UM, WE WILL SEE A SIGNIFICANT INCREASE IN STI RATES THAT WE NEED TO BE PREPARED FOR.
AND SO, UM, KNOWING THAT, UM, KNOWING THAT EVENTS LIKE THIS BRING INCREASED TRAVEL AND POPULATION MOVEMENT, UM, WE ARE LAUNCHING A CULTURALLY INCLUSIVE AND MULTILINGUAL STI AWARENESS CAMPAIGN, UH, THAT WILL FOCUS ON STATUS AWARENESS AND TESTING.
UH, WE PLAN TO INCREASE ACCESS TO SCREENING, UM, CONDOMS TREATMENT.
UM, OUR STAFF HAVE MADE REALLY POSITIVE CONNECTIONS WITH A, A WHOLE HOST OF DIFFERENT BARS, RESTAURANTS, UM, HOSPITALITY VENUES, UM, ENSURING THAT ACCESS TO CONDOMS ARE, ARE, UM, PREVALENT IN ALL OF THESE LOCATIONS.
UM, WERE EQUIPPING PROVIDERS WITH UPDATED TREATMENT AND REPORTING TOOLS WHILE ALSO ENHANCING, ENHANCING MONITORING FOR RAPID RESPONSE.
UM, THESE PLANS ARE ALL COORDINATED WITH OTHER REGIONAL PARTNERS, INCLUDING OTHER LOCAL HEALTH DEPARTMENTS LIKE KANSAS CITY HEALTH DEPARTMENT, UM, KC CARE, VIVIAN AND A A, A NUMBER OF DIFFERENT ORGANIZATIONS.
AND SO THE GOAL DURING THIS EVENT IS NOT JUST TO RESPOND, UM, BUT TO ANTICIPATE AND MAINTAIN STABLE CONDITIONS EVEN AS THE ENVIRONMENTS CHANGE AND AS POPULATIONS SHIFT DRAMATICALLY OVERALL.
UM, SO TALKING ABOUT WHAT'S WORKING.
SO THERE ARE SEVERAL AREAS WHERE WE'RE SEEING POSITIVE IMPACT IN OUR RESPONSE OVERALL.
UM, EXPANDED TESTING IS HELPING US TO IDENTIFY INFECTIONS EARLIER, WHICH IS CRITICAL FOR REDUCING TRANSMISSION.
IT'S ONE OF THE MOST IMPORTANT ASPECTS OF, UM, OUR EXPANSION OF STI SERVICES.
UM, PARTNER SERVICES CONTINUE TO BE AN EFFECTIVE TOOL FOR REACHING INDIVIDUALS WHO MAY NOT OTHERWISE SEEK CARE OVERALL.
UM, THIS IS A BRAND NEW COMMUNITY CENTERED PROGRAM THAT WE LAUNCHED IN 2025.
UH, WE ADDED DISEASE INTERVENTION SPECIALISTS AND AN STI SUPERVISOR TO OUR STAFF LAST YEAR AS PART OF THIS CONTRACT.
UM, AND THE TEAM LEADING THIS COMMUNITY CENTER PROGRAM ARE THE ONES THAT ARE ACTUALLY DOING THE WORK WHEN IT COMES TO PARTNER SERVICES.
UM, WE'RE ALSO BENEFITING FROM A STRONG PARTNERSHIP WITH COMMUNITY ORGANIZATIONS, UM, SOME HEALTHCARE PROVIDERS AND, UM, ALL OF THESE PARTNERS HELP TO EXTEND THE REACH OF THESE SERVICES OVERALL.
AND SO, DESPITE THIS PROGRESS, THERE ARE ONGOING CHALLENGES, UM, BARRIERS TO HEALTHCARE ACCESS, SUCH AS TRANSPORTATION COSTS, CLINIC AVAILABILITY CAN LIMIT HOW EASILY INDIVIDUALS CAN GET TESTED OR TREATED.
AND AS I MENTIONED, SOMETHING AS SIMPLE AS A COPAY.
A COPAY CAN BE A BARRIER TO RECEIVING, UM, TREATMENT OVERALL.
UH, STIGMA CONTINUES TO DELAY CARE FOR SOME INDIVIDUALS, WHICH INCREASES THE RISK OF TRANSMISSION.
UM, AND THERE ARE ALSO BROADER SYSTEMS CHALLENGES INCLUDING WORKFORCE, UM, CAPACITY AND THE NEED TO MAINTAIN TIMELY RESPONSE CROSSING, UH, A GROWING DEMAND FOR SERVICES.
SO, UH, THERE ARE SEVERAL WAYS THAT THE LEGISLATURE PLAYS AN IMPORTANT ROLE IN SUPPORTING COMMUNITY HEALTH OUTCOMES IN THIS AREA.
UM, AND AS I'VE MENTIONED, UM, YOU'VE
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ALREADY DONE SO IN A VARIETY OF WAYS BY HELPING US TO EXPAND, UM, A FOCUS IN THIS AREA, SUPPORTING ACCESS TO TESTING, PREVENTION RESOURCES AND PUBLIC HEALTH SERVICES OVERALL, UM, TO SEEK TESTING AND THOSE SERVICES EARLIER, UM, CAN HELP PREVENT FUTURE TRANSMISSION OVERALL.UM, ALLOWING US TO STRENGTHEN THOSE PARTNERSHIPS AMONG PUBLIC HEALTH AGENCIES, SCHOOLS, COMMUNITY ORGANIZATIONS, AND OTHER LOCAL STAKEHOLDERS, IMPROVES OUTREACH, EDUCATION AND CONNECTION TO THOSE SERVICES.
UM, AND WHAT I WILL MENTION HERE IS STRATEGIC ACCESS.
UM, THERE'S ONE THING TO, UM, UH, DEPLOYING A WHOLE HOST OF, OF PROGRAMS FROM ACROSS JACKSON COUNTY, UM, TO DOING IT STRATEGICALLY WHERE WE'RE IDENTIFYING WHERE THERE ARE GAPS IN PARTICULAR AREAS OF JACKSON COUNTY.
UM, AND WE'RE SUPPORTING THOSE, UM, STRATEGIC GAPS, UM, RATHER THAN JUST DOING A BLANKET APPROACH.
SO TO CLOSE, I WANT TO BRING THIS BACK TO WHAT IT MEANS FOR COMMUNITIES HERE IN JACKSON COUNTY OVERALL.
UM, STI TRENDS ARE NOT JUST NUMBERS THAT WE TRACK OVERALL.
THESE ARE PEOPLE OBVIOUSLY, AND THEY REFLECT OVERALL HOW WELL OUR COMMUNITY IS ABLE TO ACCESS F FOUNDATIONAL BASIC TESTING TREATMENT AND TIMELY FOLLOW UP.
OVERALL, WHEN THOSE SYSTEMS ARE STRONG AND CONSISTENT, UM, WE SEE THAT EARLIER DETECTION AND MORE STABLE OUTCOMES.
UM, WHEN THERE ARE GAPS IN ACCESS OR DELAYS IN RESPONSE, INFECTIONS SPREAD MORE QUICKLY.
UM, AND WE'RE OFTEN, UM, IDENTIFYING THEM MUCH LATER, UM, AT A MUCH WORSE OUTCOME TO THE INDIVIDUALS WHO, UH, HAVE CONTRACTED THEM.
UM, THESE PATTERNS ULTIMATELY AFFECT FAMILIES, UM, HEALTHCARE SYSTEMS AND COMMUNITY WELLBEING ACROSS OUR COMMUNITIES OVERALL.
UM, AND SO WHEN WE TALK ABOUT SDI TRENDS, WE'RE REALLY TALKING ABOUT HOW WELL OUR LOCAL COMMUNITY SYSTEMS ARE FUNCTIONING TO PROTECT PUBLIC HEALTH IN THIS ARENA.
I'M HAPPY TO ANSWER ANY MORE QUESTIONS THAT YOU MIGHT HAVE.
WELL, THANK YOU FOR PRESENTING.
UH, I THINK THAT THESE ARE IMPORTANT ISSUES THAT THE HEALTH DEPARTMENT IS PRESENTING TO THE LEGISLATURE.
WE'VE GOT ANOTHER COMMITTEE, UH, COMING RIGHT UP AFTER THIS ONE.
SO I'M GOING TO GO AHEAD AND CLOSE OUR COMMITTEE MEETING.
UH, UH, THANK YOU AGAIN FOR COMING AND WE ARE ADJOURNED.