TMC PULSE

t m c » p u l s e | n o v e m b e r 2 0 1 9 16 Q | What about the plans in the longer term to reduce flooding in the region? A | There's a superhuman effort on flood control projects. They are literally decades overdue. We took an independent look at whether these projects could be done any faster. The estimate was it would take 10 to 15 years. We have it firmly at 10 years to get all of them done now. Some we can speed up. All the drainage projects were going to take five years, but now it's going to be three-and-a-half. We're not afraid to ask hard questions of developers. We're requiring them to detain more water—to use more of their land that they've already purchased for deten- tion. We now know what the new rainfall rates are and that if they go with their original plans, they'll end up flooding people downstream. We just gave the county attor- ney's office permission to file suit on flood plain regulation violators. That includes elevation require- ments, fill requirements, detention requirements. They'll basically be able to sue immediately without coming to commissioners court for approval, which helps them to be more effective. We're also working on a project to map flood risk. In a few months to a year, we'll be able to tell folks what the risk is. It's not so much whether they're in the flood plain. It eval- uates risk based on drainage and elevation, so people can know and can make their own decisions. We're doing everything we possibly can and thinking outside the box. Q | Dr. Umair Shah, who leads Harris County Public Health, has talked a lot about the mental health impact of going through repeated flooding. How does the county government, or the community as a whole, address what we've been through the last few years? A | It's traumatizing. To keep get- ting battered by something like this is a recipe to be truly emotionally affected. Part of the way we look at it is we're all first responders in a way. We're trying to help everybody do what they do best and match needs to resources. More broadly, we know we face dire funding limitations from the state in terms of mental health service provision. But we also rec- ognize that if we can do a better job coordinating existing mental health resources, we can better help people. We just passed an item to put the jail in the same medical records systems as everyone else. When you don't have enough funds, the last thing you can do is be inefficient. Right now, our approach on mental health is to stretch every dollar by getting at coordination and efficiencies. Q | Texas is the most uninsured state in the nation. Nearly 18 percent of residents—some 5 million people—have no health insurance. Our state government did not expand Medicaid, so much of this becomes the county's respon- sibility. Here in Harris County, nearly a quarter of the pop- ulation is uninsured. Beyond advocacy, what's the long-term plan? How is this sustainable? A | It's a massive challenge and we're doing it with one hand behind our back because of the refusal to expand health care through Medicaid expansion. The Episcopal Health Foundation did a study that said at least 50 percent of people in Texas have refrained from accessing health care in the last year because they couldn't afford it. You don't want that to be happening. How are we going to solve this problem? We commissioned an investigation that should be done later this year that aims to address precisely this question. We're eagerly awaiting that, especially with regards to health care access on the east side of downtown. The HCA hospital there flooded during Hurricane Harvey, and there are folks who have no Spotlight hospital nearby. From our conversa- tions with private hospitals, there's no interest on their part in opening another one. The other point is about social determinants of health and looking at health holistically. There's really a movement to talk about health and not health care. Once you see people in the hospital—that should be the last resort. The question is, what can we do to be smarter about it? Q | You have a personal connection to the Texas Medical Center, where you once worked. What was your role at the TMC? A | I was working as a medical interpreter. They'll send you to different hospitals. This was around 2014. I was going to UTHealth, Texas Children's Hospital and TIRR Memorial Hermann—all over. I saw several times a mother coming in with a little boy or little girl who has prediabetes because of lack of access to healthy food. I saw the man who can't access dialysis Hidalgo discusses the air quality in east Harris County during a press conference in March 2019, after elevated levels of benzene were detected near a Houston-area petrochemicals storage facility that caught fire. Credit: Godofredo A. Vasquez/Houston Chronicle via AP

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