Commissioner Cook: Health district guides county through pandemic

No one imagined in 1943 when the Williamson County Health Department was established that it later would become a health district, and one day be at the forefront of preserving our public health against a worldwide pandemic.

In 1989, under the Texas Local Public Health Reorganization Act, the county and the cities of Round Rock, Cedar Park, Georgetown and Taylor established the Williamson County and Cities Health District through a cooperative agreement.

The agreement was revised and re-adopted in 1992 and again in 2007, when Liberty Hill and Hutto joined the health district. In 2013, Leander enlisted. Any incorporated city in the county with a population over 15,000 may apply to join.

The Williamson County Board of Health, as the administrative authority for the health district, sets policies to promote and preserve public health and safety. The Williamson County Commissioners Court appoints two directors, while each participating city appoints one board member.

Executive Director Derrick Neal said the health district allows each participating city to customize its own services to better meet the needs of its residents, especially with COVID-19's challenges.

Of the district's 92 full-time employees and eight contractors, roughly 70 perform COVID-related work. Its 58 investigators include 41 epidemiologists, nurses, surge volunteers and staff, six contact tracers and 11 call center volunteers.

There are three types of investigations. An epidemiological investigation occurs when individual cases of possible COVID illness or exposure are reported to the health district. A staff member then calls those individuals and interviews them about their symptoms, where they've been and their close contacts over a specific time.

Contact tracing team members call the person's contacts identified during the epi investigation, informing them they probably were exposed to a COVID-19 case and should stay home for 14 days.

The health district recently transitioned to state contact tracing, which will provide additional resources with the tremendous growth in new cases.

For clusters -- sites with two or more positive cases -- public health staff conduct on-site assessments, offer education, consulting and other services. One or more cases at a long-term care facility, such as a nursing home, is considered a cluster. Wilco EMS and firefighters investigate these clusters and establish safety controls through isolation and testing everyone.

The health district also has run a public testing drive-through at a Georgetown middle school that offered at least 60 tests every weekday from April 30 until it closes July 17. Seven staff members, seven volunteers, five Georgetown firefighters and one Weir firefighter tested people through their car windows as they drove up.

The health district partnered with Austin Public Health to use their online screening and scheduling system for these tests. A $100,000 grant from St. David's Foundation helped fund kits for the Georgetown testing site and pay Austin Public Health. The health district expected to administer about 5,000 tests at the Georgetown site.

At the testing site, volunteers checked people in and performed logistics such as planning, setting up the site, training volunteers and stocking supplies. Others called the elderly to check in on them. The volunteers included school nurses, community members and even former district employees/retirees.

The district has spent over $500,000 for COVID services. A million dollars recently awarded from the state may help the coronavirus operations through December. About 1,000 test kits can cost $100,000 and last 15 to 16 days, depending on the number of tests performed.

While health districts aren't required to conduct testing, state law mandates that they continue investigating and reporting COVID cases because it is a public health crisis.

The National Guard began opening testing sites July 6 in advance of the Georgetown site closing. The Round Rock and Cedar Park Family Emergency Room clinics will continue their free testing for the uninsured, in this great example of public/private partnership, and will bill insurance companies for those insured.

The level of leadership and organization the Williamson County and Cities Health District has shown is evident not only with COVID but through its Public Health Board accreditation. It is only one of five nationally accredited health districts in Texas, and it is applying for its second accreditation to be designated in 2021.

It has shown resiliency, flexibility and adaptability in working with its small numbers of staffing and recruiting, training and accommodating all the volunteers from within county government and from Central Texas.

Terry Cook is county commissioner of Precinct 1, which includes Round Rock, Brushy Creek and Northwest Austin.

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