{"id":1004279,"date":"2026-08-16T11:02:20","date_gmt":"2026-08-16T11:02:20","guid":{"rendered":"https:\/\/www.europesays.com\/us\/1004279\/"},"modified":"2026-08-16T11:02:20","modified_gmt":"2026-08-16T11:02:20","slug":"bexar-county-health-department-at-risk-as-arpa-money-runs-out","status":"publish","type":"post","link":"https:\/\/www.europesays.com\/us\/1004279\/","title":{"rendered":"Bexar County health department at risk as ARPA money runs out"},"content":{"rendered":"

Two years into the COVID-19 pandemic, Bexar County spent millions in federal pandemic relief dollars on public health programs \u2014 with the goal of getting more involved in preventative health, preparing for future pandemics and addressing longstanding health inequities.<\/p>\n

Now, the funds are expiring at the same time the county budget is being squeezed<\/a>, raising uncertainty about the future of the county\u2019s public health department, particularly its newly created Preventative Health Division.<\/p>\n

Created in 2022, the division now operates a $10 million annual budget, including 28 staff positions and programs supporting victims of domestic violence, elder abuse and other public health initiatives, according to a county budget document.\u00a0<\/p>\n

Given the budget picture, some county commissioners are suggesting combining county efforts with University Health\u2019s Public Health Division, which was also established that year with the help of temporary American Rescue Plan Act (ARPA) funding.<\/p>\n

Former Bexar County Judge Nelson Wolff, who championed the project, said in an interview that he wasn\u2019t sure if the county\u2019s preventative health campaigns had been effective \u2014 or what the division had done since he left office.<\/p>\n

\u201cI don\u2019t know whether they\u2019ve done any good with it or not,\u201d he said. \u201cMaybe just another bureaucratic department, as far as I know, and if that\u2019s true, then there\u2019s no need to have it. But if they have done some good things and they can be transferred over to University Hospital, then that ought to be done.\u201d<\/p>\n

Connecting the dots<\/p>\n

The pandemic highlighted longstanding social inequities in Bexar County: poorer ZIP codes with higher rates of diabetes and obesity faced higher death rates<\/a> from COVID-19 compared to more affluent areas.\u00a0<\/p>\n

In 2022, county manager David Smith and Wolff noted their frustrations of not having expertise within county staff that they could rely on during the pandemic.<\/p>\n

\"SanSan Antonio Food Bank volunteers distribute meals in February 2021. Credit: Bonnie Arbittier \/ San Antonio Report<\/p>\n

Preventive health programs, like health education campaigns, vaccine drives, environmental safety and health screenings, had largely been left to the city Metropolitan Health District (Metro Health) and local nonprofits. But these San Antonio-based resources often didn\u2019t reach residents in unincorporated Bexar County.<\/p>\n

With $60 million in ARPA funds set aside to expand public health services in spring 2022, the county had the opportunity to play a larger role in public health and prevention efforts, and the idea was to work closely with University Health, Metro Health and health-focused nonprofits to pursue common goals without duplicating efforts.<\/p>\n

That\u2019s when the county established the Department of Preventative Health and Environmental Services, an umbrella department that absorbed existing county functions like animal control and behavioral health, as well as establishing the brand new Preventative Health Division.\u00a0<\/p>\n

Commissioners also voted to allocate ARPA dollars to University Health, the county-owned hospital system, so it could set up its own Public Health Division, which operates separately from the county.<\/p>\n

Around $2 million in annual funding was approved for the county\u2019s new Preventative Health Division.\u00a0<\/p>\n

But county leaders seemed to be on different pages regarding the focus of their new\u00a0 health division.\u00a0<\/p>\n

Wolff was keen on the division promoting healthy eating and exercise, like requiring restaurants to include calorie and nutrition information on their menus, and running TV ads on the danger of excessive sugar consumption from soft drinks \u2014 efforts he said never made it over the finish line.<\/p>\n

\u201cIt\u2019s been a big critical issue to me for a long time,\u201d Wolff said. \u201cPeople are killing themselves. It\u2019s the tragedy of our community. \u2026 They can so easily help themselves without a major change, but it takes a lot of pushing and a lot of effort.\u201d<\/p>\n

Commissioner Tommy Calvert (Pct. 4) said that he wanted to see the division focus on the social determinants of health such as housing, education, infrastructure, racism and the environment, like pursuing grants to help local businesses reduce greenhouse gas emissions.\u00a0<\/p>\n

\u201cThe court has not connected the dots yet on how those should be driven through the funding of a public health division,\u201d he said at the time.\u00a0<\/p>\n

Smith said the goal was to create a \u201cmore robust, rapid and coordinated response\u201d to the next pandemic by putting existing public health functions under one roof.<\/p>\n

He also cited maps of health inequities in San Antonio \u2014 which largely follow economic and racial lines \u2014 and reducing such inequities as the driving force behind the county\u2019s efforts.<\/p>\n

County leadership said the division would evolve based on input of its new leader, Andrea Guerrero, who oversees the entire Department of Preventative Health and Environmental Services.<\/p>\n

\"\"Bexar County Judge Peter Sakai speaks during a County Budget Town Hall in Precinct 1 at the Harlandale Community Center on June 1. Credit: Amber Esparza \/ San Antonio Report<\/p>\n

Now, the county may have to make cuts to programs and staff in the Preventative Health Division, which has largely relied on ARPA funds.\u00a0<\/p>\n

\u201cWe are now going through a review and analysis of all the ARPA positions, and one of the difficult discussions that will be had in this time period is what positions will remain,\u201d Bexar County Judge Peter Sakai told the Report<\/a> in early July after his budget town hall.<\/p>\n

Aside from those positions, Sakai and the county budget-writers at that event said their finances are overall relatively \u201chealthy\u201d for the time being.<\/p>\n

\u201c[But] Public Health is actually a brand new department that [Wolff] and the previous court created, and we\u2019re having the discussion in regards to what delivery of services we want our public health department to focus on,\u201d Sakai said at the time.<\/p>\n

What the division does today<\/p>\n

Since its inception, the division has expanded beyond its original dietician, nutrition specialist and administrative staff to add a population health data manager, public information officer and more than a dozen domestic violence case managers.\u00a0<\/p>\n

The staff shares office space with other departments in the county\u2019s annex building downtown. The building, at 203 W Nueva Street, was considered for demolition but was instead renovated for $8 million<\/a> in 2022, in part to make space for the new Preventative Health Division.<\/p>\n

\"\"The Bexar County Annex, located at 203 W Nueva Street, was renovated in 2022 for $8 million. Credit: Bria Woods \/ San Antonio Report<\/p>\n

Much of the division\u2019s resources are focused on public safety efforts, which overlap with public health. Its Safety Team Active Response (STAR) program supports victims of domestic abuse with a team of case workers who specialize in domestic violence.\u00a0<\/p>\n

The division also runs a Senior Justice Assessment Center (SJAC), which aims to prevent and intervene in cases of elder abuse, investigating and reviewing cases of abuse, exploitation and neglect of those 65 years and older.<\/p>\n

According to Jennifer Luna, an assistant public information officer with the county\u2019s public health department, the division has also helped fund initiatives for youth and family resilience, healthy eating and exercise, and healthcare access by bringing mobile clinics to the outskirts of San Antonio during the latter half of the pandemic.\u00a0<\/p>\n

It\u2019s not entirely clear how much of the STAR, SJAC and other efforts that fall under the Preventative Health Division still rely on ARPA funding, and whether the programs would need to be axed entirely.\u00a0<\/p>\n

It\u2019s also unclear how much the division is currently involved in more traditional preventative health efforts \u2014 like healthy eating and exercise campaigns, or healthcare access improvements \u2014 that county leaders described as their guiding mission at the outset in 2022.<\/p>\n

The public health director could not be reached for an interview, and Sakai declined to comment further beyond his July remarks. Several county commissioners did not respond to interview requests on the division\u2019s future.<\/p>\n

What happens next?<\/p>\n

During an Aug. 4 Commissioners Court meeting, Commissioners Grant Moody (Pct. 3) and Justin Rodriguez (Pct. 2) suggested to University Health leadership that some of their ARPA-funded preventative health efforts might need to be picked up by its Public Health Division.<\/p>\n

\u201cA public health consolidation between [University Health] and between Bexar County makes a lot of sense,\u201d Moody said. \u201cHow can we streamline that and make it more effective and save taxpayer dollars?\u201d<\/p>\n

University Health\u2019s Public Health Division is housed at the Vida Clinic on the South Side. The division maintains emergency preparedness efforts, school-based health centers, an emerging infectious disease identification lab, HIV\/AIDS outreach, and more.<\/p>\n

\"\"University Health\u2019s Vida Clinic offers urgent care services, primary and specialty care, behavioral health for adults and adolescents, pharmacy, imaging and lab testing to the Southside community. Credit: Amber Esparza \/ San Antonio Report<\/p>\n

\u201cWe are having to make tough decisions here at the county related to the ARPA dollars coming off,\u201d Rodriguez said. \u201cThere are some programs that we established with ARPA dollars specifically in preventative health [and] behavioral health that we\u2019re going to have to figure out a way to put our heads together and continue some of those programs, because they have been impactful.\u201d<\/p>\n

ARPA funds expire at the end of 2026, and county commissioners are expected to discuss the future of the preventative health programs in the coming months.\u00a0<\/p>\n

Wolff reiterated that he wasn\u2019t sure if his efforts had paid off, but that he had hoped to meaningfully expand preventative health in San Antonio and reduce the need for acute care.<\/p>\n

\u201cIt\u2019s the biggest failure that we face as a country and as a local government in terms of trying to address healthcare,\u201d Wolff said. \u201cWe do a great job on acute healthcare, tremendous job, but prevention \u2014 very little resources go to it.\u201d\u00a0<\/p>\n","protected":false},"excerpt":{"rendered":"Two years into the COVID-19 pandemic, Bexar County spent millions in federal pandemic relief dollars on public health…\n","protected":false},"author":3,"featured_media":1004280,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":"","_share_on_mastodon":"0"},"categories":[5133],"tags":[5229,89569,7288,97972,294738,81090,269351,402121,255720,402122,210,244146,60238,402123,881,7202,7203,358,7453,3187,7815,67,586,132,5230,18722,68,2969,7594],"class_list":["post-1004279","post","type-post","status-publish","format-standard","has-post-thumbnail","category-san-antonio","tag-america","tag-american-rescue-plan-act","tag-bexar-county","tag-bexar-county-budget","tag-bexar-county-commisioners-court","tag-bexar-county-judge-peter-sakai","tag-county-health-department","tag-county-manager-david-smith","tag-covid-in-san-antonio","tag-department-of-preventative-health-and-environmental-services","tag-health","tag-judge-nelson-wolff","tag-metro-health","tag-preventative-health","tag-public-health","tag-san-antonio","tag-sanantonio","tag-texas","tag-top-story","tag-tx","tag-typedaily","tag-united-states","tag-united-states-of-america","tag-unitedstates","tag-unitedstatesofamerica","tag-university-health","tag-us","tag-usa","tag-wc-1000-1500"],"share_on_mastodon":{"url":"","error":"Validation failed: Text character limit of 500 exceeded"},"_links":{"self":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts\/1004279","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/comments?post=1004279"}],"version-history":[{"count":0,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts\/1004279\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/media\/1004280"}],"wp:attachment":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/media?parent=1004279"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/categories?post=1004279"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/tags?post=1004279"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}