Friday, May 26, 2017

CD 8 Manny Pelaez

2017 Candidate Questionnaire
2017 Mayoral/City Council Candidates
Health Care Questions
Manny Pelaez, District 8

1.   Despite affecting everyone in this community, "community health and wellness" has not been a big priority at City Hall. "Community health and wellness" had one third of the ranking that "streets" received in community input via SpeakUPSanAntonio. Yet it impacts our well being, workforce, economic development and the prosperity of San Antonio.
What health-related areas do you think deserve increased attention, priority, and local resources, and, if elected, how would you elevate the discussion of these health issues at City Hall and lead effective action to improve health and healthcare in our community?  San Antonio is woefully low on the list of cities that are considered walkable. Except for a small handful of walkable pockets and parks, San Antonio offers very little for citizens who want to bike, walk, jog, and play outside.  Social scientists now know that where a person lives is inextricably tied to how a person lives and that person’s health.  I, and many others, are alarmed at San Antonio’s health problems that have direct relationships to how our city is laid out, developed, and planned. I am particularly alarmed by city planner’s refusal to embrace walkability as a best-practice for future development.  We need city council leadership that is willing to admit something very difficult to admit: That we’ve been doing it all wrong.  If elected I will make walkable communities the topic of a long and difficult discussion with planners, developers, neighborhood associations, the medical community, schools, VIA, and opinion leaders. I will force a long overdue conversation about changing the way we have allowed San Antonio to develop. We can no longer apply the car-centric model of planning and thumb our nose at science. 

2.  Bexar County is the primary source of funding for indigent health care in our area through the Bexar County Hospital District and University Health System. How would you, if elected, promote cooperative efforts to increase services and access to care for the citizens of San Antonio? I am the General Counsel for Family Violence Prevention Services, also known as The Battered Women & Children’s Shelter. I have first hand experience and expertise in delivery of services to vulnerable populations. I also have hands-on experience with creating coalitions between government and private organizations for the purpose of  The county and city governments have done significant work in bringing private institutions to the table to help address problems related to indigence; San Antonio can and must do more. Other cities, such as San Diego and Chicago, invest much more (per capita) in time and money creating opportunities for NGOs, hospitals, medical schools, and private practitioners to leverage their own expertise in helping the communities address problems like diabetes, cancer, infectious disease, alcoholism, child abuse, and mental health.  We must look to those cities that are being bold in this regard and we must not be shy from adopting their strategies.  Also, we must be more demanding of ourselves and hold each other more accountable.  I plan on creating an incentive program so that the city will reward medical students, dental students, and nursing students for their pro-bono community service. My aim would be to inculcate in them a desire to keep serving after they graduate. 

3.  The disparity of health care between our poorest and wealthiest zip codes/districts is quite striking (Bexar County Health Collaborative 2016 report). How would you, if elected, reduce health disparities and improve health outcomes for our lower income communities/citizens? See answer to question #1.  I believe that walkability and transit is also directly related to making it more difficult for people to access resources, go to school, travel to and from work, and traverse the city to visit their doctors.  There is no debate that access to resources and access to school, work, and healthcare are essential to bridging the gap between poverty and thrivability.  A quick look at the poorest neighborhoods in San Antonio reveals to any observer that those neighborhoods were not built or designed with access in mind.  In order to ameliorate our poor citizens' lack of access we must commit ourselves to a transit system that is efficient and sustainable. To that end, I will work with VIA, the Metropolitan Planning Organization, the Advanced Transportation District, the Economic Development Foundation, schools, and the healthcare industry leaders to recommit ourselves to the most basic of principles: That a world-class city seeking to progress and evolve must not leave its vulnerable populations behind.  

4.  San Antonio has a high incidence of obesity and diabetes mellitus and has been ranked as high as second in the nation for obesity in recent years. Past city efforts attempting to improve these rates, such as trying to reduce the prevalence of sugary drinks in our community, have been met with controversy. What ideas do you have to reduce the incidence of these chronic health issues? First, we need city leadership that is willing to face controversy head-on. Effective leadership requires us to be unafraid of critics and those special interests that make money from selling products that imperil our citizens’s health. (eg. smoking in restaurants, vape shops, etc). Second, we know that prohibition and heavy-handed regulations rarely work.  But, we certainly know that incentive programs DO work.  As such, I will push city council to consider tax and fee abatements to restaurants and hotels that demonstrate adoption of healthy menus. I will push our council to adopt tax and fee abatement for large employers that institute healthy lifestyle programs that result in their workforce’s weight loss or achievement of other healthy lifestyle metrics. These are not innovative and unique programs - - they already exist and have proven effective in other cities.

5.  According to the CDC, child abuse and neglect are serious problems that can have lasting harmful effects on its victims. The goal in preventing child abuse and neglect is clear — to stop this violence from happening in the first place. What local policies, resources and efforts will you support to promote safe, stable, nurturing relationships and environments for all children and families? Child abuse, domestic violence, substance abuse, and mental health are enmeshed and should be approached with a no-silos strategy.  I have dedicated my career to domestic violence and child abuse prevention. In my work with the Rape Crisis Center, the Battered Women & Children’s Shelter, the criminal courts system, the jail system, and the Texas Family Violence Council I have come to realize that San Antonio is in the throes of an epidemic of violence and abuse.  Thankfully, our local judges, law enforcement, district attorney, and County leaders have dedicated mountains of resources, time, and effort to address the problem of abuse and violence. But more can be done.  We must bring churches, schools, and doctors to the table. Oftentimes, teachers, doctors, and pastors are the first to see the signs of abuse. City Council must create a network of advocates and watchdogs.  Doctors, teachers, and pastors must be given quick and easy-to-access resources to help them respond to concerns of abuse.  We must also work together to help each other track at-risk citizens to make sure that  someone is always watching and so that they do not get lost because of a lack of interconnectedness between those of us that care.