Safety, Housing, Education & Homelessness Committee - Regular Meeting

Welcome to the safety, housing, education, and homelessness committee of Denver City Council. The safety, housing, education, and homelessness committee begins now.

Good morning, everyone. Welcome to Safety Housing Education and Homelessness Committee. Today is Wednesday, June 4. Thank you everyone for joining. My name is Serrana Gonzalez Gutierrez. I am one of your council members at large and honored to be chair of this committee. We will start with introductions from council members, and then we'll go into what's on today's agenda. So with that said, we'll start over here on my left.

Good morning, Madam Chair. Stacy Gilmore, District 11.

Good morning, Diana Romero Campbell, Southeast Denver, District 4.

And good morning. Paul Cashman, South Denver, District 6.

Good morning. Amanda Sawyer, District 5. Jamie Torres, West Denver, District 3.

Kevin Flynn, Southwest Denver, District 2.

Great. Thank you so much. So we're gonna go ahead and get started. We have a couple of, briefings on the agenda today. Starting us off this morning is the Denver district attorney's office family violence unit. And thanks to, councilman Cashman for, you know, bringing this up as a as an item to come to safety committee just to provide us with information. We have folks joining us today from the DA's office. And so if you all could introduce yourselves, and then you can go ahead and proceed with your presentation. I'll be taking a queue of council members who might have questions. And we'll do questions at the end of your presentation.

Thank you all for having us here. Just very briefly, my name is Kris Curtis, and I'm chief of the Child Victim Unit at the Denver DA's office.

My name is Dani Worley. I have been with the family violence unit for four years, and I'm the child abuse specialist for our office.

Go right ahead.

So, again, thank you. We really appreciate the chance to come and just tell you all what we do today. My understanding is that Danny was invited by Councilman Cashman to just talk about the work we do in what was previously called the Family Violence Unit, which I'll explain. We are here to tell you kind of what we do in the trenches day to day. We're not policy people by any means.

We are in the courtrooms working with victims and families. So that's where we're starting from. We titled this presentation Standing with Survivors just to focus on the victim centered approach that we take in all of our cases, whether domestic violence or child abuse. The victims or survivors are the reason we do this work, and they are the people we're seeking justice for. And that's kind of what we want to guide us through this entire presentation.

I told you basically who I am, what I do. I have been with the office for about thirteen years. I've been mostly focused on family violence type stuff, mostly child crimes pretty much that whole time in various capacities and was chief of the family violence unit for the last year or so until we split it up, as Will explained, and now Child Victim Unit.

So our hope for today is to walk you through what we do and how our office operates specifically within the Family Violence Unit and within these specialized cases. So we're gonna talk with you a little bit about the types of cases that we handle, as well as how we recently split the unit. We're gonna share with you our really unique pre filing processes that we have in Denver, and about our specialist positions, which includes my position. And finally, we'll talk with you about case considerations and trial, some of the nuances of domestic violence and child abuse prosecution, and the things that we're thinking about as we are trying to get our victims ready for trial, as well as as we're walking them through the process. Now, first, what is the Family Violence Unit?

Well, we're not just attorneys. We are a team of people. We have investigators who assist us with follow-up investigation after cases have already been filed. We have investigator technicians who help us obtain useful evidence in our cases, such as getting DNA swabs of a defendant when they're in court. We, of course, have our legal administrative assistants, who do who work in a secretarial function.

And finally, we have our victim advocates who really do everything under the sun to protect our victims and support our victims as they navigate the criminal justice process. The family violence unit exclusively handles felony level crimes, and we handle domestic violence, which really runs the gamut of the types of crimes, which we will talk about later, as well as child abuse. Child abuse includes child physical abuse, child sexual abuse, as well as sexual exploitation of children, which we call colloquially child pornography. At any given moment in time, the family violence unit across our 11 attorneys is handling about 600 cases. This is a heavy caseload, not just in terms of the number of cases, but in terms of the subject matter.

This is really challenging subject matter. And one of the really special things about being part of the FBU team is every attorney wants to be there, which I think is very special.

So I mentioned a couple of times that we just recently split the unit into two units. And by recently, I mean Monday is when we actually did that. But that has been years in the making. It's something that most people I've talked to who have spent time in the family violence unit have felt that this was necessary to truly best serve the victims and families engaged or involved in these different types of crimes. So bottom line, the sticking point has been resources and the inability to just hire more people to handle all these cases.

That hasn't really changed. If anything changed, it's that John Walsh came in and heard our concerns and was willing to reallocate things within the office, which created some pain points elsewhere. But he was committed from the very beginning to improving the family violence unit and ultimately outcomes for victims. So as far as why, why do we do this? Family violence was only those two kinds of crimes were connected by the fact that they tend to be perpetrated by family members in the home.

That's the reality of it. But the cases are very different. And so ultimately, there are distinct skill sets that are needed in order to handle one over the other. In domestic violence context, as Danny will talk about, we're dealing with recanting victims who, you know, a couple days later, they don't want to prosecute anymore. And how do you handle that?

Or they've been dealing with this for years, they're finally ready to come forward versus trying to get a five year old ready to go through the process and testify in a courtroom in front of a a jury full of strangers and the perpetrator. Very different things. And while we can teach those skill sets to both two people, it is not as efficient or effective when you're having to do both simultaneously and jump from one case to another multiple times a day. And so, frankly, just that ability to focus and have whole teams, what Danny just described with the investigators, the VAs, the secretary, we've created these units with devoted investigators, devoted victim advocates just for child crimes, just for domestic violence victims, so that we can all focus more and, really, really build our expertise and skill set and those relationships with victims, that really get us the successful outcomes that we need. The next bit we're going to talk about is the pre filing process.

And this starts with the specialists that we have involved with these units. There are two listed here. One is our child abuse specialist, which is Danny Orly here. And then we have a domestic violence specialist named Victoria Kelly. I think it's worth also noting, though not specifically pertinent here today, that we have a sex assault specialist as well, Bree Beasley, who plays a very similar role.

And all of that is very unique to Denver amongst most jurisdictions. It is not normal to have someone at the front end who is just focused on these cases, who is working with the detectives and with, you know, forensic interviewers and things of that nature in the investigative phase in order to make the best filing decisions at the very front end before a case can even get to court. That gives us consistency in terms of what cases we file on, what sorts of charges we file, whether we're gonna file misdemeanors or felonies, that sort of thing, and provides, essentially a resource to the rest of the office. So whether it's felony or misdemeanor, anybody in our office who gets a child abuse case can go to Danny Worley or anyone in our unit, but Danny's really in the thick of it, and get assistance, get a trial partner, whatever they may need when it's their second week on the job. And suddenly, they have to figure out how to do a child abuse case or something in county court, and same for the domestic violence.

So huge support, huge resource for the office, as well as for our partner agencies. So Danny works closely with the pertinent unit at Denver Police, Clinic for Denver Health, the Denver Children's Advocacy Center, and Department of Human Services, just as an example of the five agencies that are working just on kid cases day in and day out. And then similarly, Ms. Kelly works with DPD, the Rose Andam Center, and other agency partners to improve outcomes on those cases.

So as Chris mentioned, on the child abuse side, we have this multidisciplinary team where we are all coming from our unique perspectives, but we're coming together with a common goal, and that is to protect kids. So that collaboration is really a critical piece, both on the child abuse and on the domestic violence side. And there are a lot of parallels between what Victoria Kelly and what I do. Specifically, being embedded in this location really allows us to have access to the other community partners who are engaged in these cases. That collaboration is so critical because it allows us to look at risks associated with cases with people from different perspectives.

It also allows us to do safety planning and ensure that we are getting immediate assistance to victims. For example, at the Denver SAFE Center, which is where I am embedded, every single morning we have a morning meeting where we talk about the new child abuse or child sex assault cases that came in, and every member of the multidisciplinary team is present. And we check-in on the case, we check-in on the condition of the victim. For example, if the victim's in the hospital, we can get an update from medical on the status of this child. We also do, on both the domestic violence and the child abuse sides, we do case filing reviews and different kinds of triage, where we're looking at cases before or after they are filed to really look at how our teams are working, again, identify risks and patterns, and focus on what we can be doing to improve our responses in these cases.

Additionally, we both have our respective fatality reviews. A big part of being embedded at the SAFE Center means I can work very closely with the Denver Police Department and advise on investigations. Ultimately, it's their investigation. But I'm coming from it with the perspective of a prosecutor that then has to handle the case in court. So I'm thinking about cases backwards from trial.

What kind of evidence could we give a jury in this case to help support the statements of this victim? As Chris mentioned, I'm ultimately responsible for filing decisions on not only FVU or now child victim unit cases, but I actually also file the misdemeanors. And filing can be really straightforward sometimes, but it can also be extremely challenging. And I'll give you an example of something that I've encountered. Sometimes we have cases where we have babies or toddlers who have been injured severely, And we have constellation of injuries that's indicative of non accidental trauma.

But that child cannot tell us what happened. So it's our responsibility as a multidisciplinary team to come together and to put together the puzzle pieces so we can get righteous outcomes for kids even when they can't advocate for themselves. Finally, and really one of my favorite parts is I get to teach, train, and mentor. I get to work with the community. I get to work, teach inside of and outside of the office.

And as Chris mentioned, I do a lot of work with county court attorneys as well who are new to the office. A couple of other nuances as to my position, and Victoria does some of this as well, is search warrants are a very big piece of the job. And one of my responsibilities in working with the Missing and Exploited Persons Unit at the Denver Police Department is making sure that we are vigorously investigating a case while scrupulously upholding a suspect's rights. And that's a fine line to walk sometimes. And so we work together on these search warrants.

I evaluate every search warrant before it is sent to a judge ultimately for their approval. But that also allows me to sometimes respond to the scene with detectives on a search warrant that we may be collaborated on or even respond to an active crime scene. Again, I'm coming at it from my unique perspective as a DA, which may differ from the perspective of other people. Finally, I get to watch things unfold in real time. And that's a pretty cool thing to be able to do.

I get to watch forensic interviews, suspect interviews, witness interviews as they are occurring. And as those interviews are winding down, oftentimes they'll step out of the room and they'll check-in with their other multidisciplinary team partners. An example of how this can be helpful is in a forensic interview, a child may mention briefly, and then he said some stuff that was scary. And maybe the forensic interviewer wasn't able to get to that statement, but one of us caught it and said, hey, that actually might be helpful, knowing exactly what that person said. So that kind of shows how that collaboration can be really helpful to our team.

Just quickly on the this is, handled primarily on our domestic violence side, and a lot of people don't know about this program. One of the big, commitments of Ms. Kelly and her team is this firearm relinquishment program. And we kinda just wanted to have this up there so you could see the stats. She and her devoted investigator do review every single domestic violence case that comes through, which is hundreds, thousands of cases, as you can probably imagine.

And they evaluate it to determine whether relinquishment is appropriate under the statutes that have been passed in somewhat recent past and figure out whether a defendant has potential access to firearms. And so just in the past year, as it says there, there have been almost 200 open investigations under this act, and the relinquishment of a 165 firearms. Bear in mind, those are firearms that were accessible to a domestic violence perpetrator. And so we are talking about high lethality risk. These are situations where victims of even what we might call minor domestic violence are at huge risk of serious injury or death just by the presence of a firearm in the home.

This has been a very successful, very important program.

Next, we're going to talk a little bit about some of the case considerations for domestic violence and child abuse prosecution. Before we jump into that, I wanna give a disclaimer. I tend to default to some gendered language. Oftentimes, I will refer to the perpetrator as he and the victim as she. That's because the vast majority of domestic violence and sexual assault on a child cases are male perpetrators perpetrating on female victims.

But I want to be very clear that anyone can be a perpetrator and anyone can be a victim. But I wanted to provide that caveat before we dive in. So what is domestic violence? Domestic violence isn't just violence or threatened acts of violence. It can actually be any other crime when used for purposes of punishment, retaliation, intimidation, coercion, or control.

I'll give you an example of a case that I had once where the perpetrator and the victim ended their relationship. Victim entered into a new relationship with a new man. And the perpetrator then broke out the windows of the new man's car in retaliation towards his girlfriend. So even though the crime wasn't perpetrated directly against the victim, it was considered a domestic violence crime. But why do people engage in acts of domestic violence?

Really, domestic violence is about power and control. And that can come from a few different places. That can be learned a few different places. It can come from something that a perpetrator learned as a child by what they observed in their home. But it can also come just from a sense of entitlement, that they are entitled to control the acts of their intimate partner. That control can take a lot of different forms, as you can see on this power and control wheel. It can involve economic abuse, which can be things like limiting access to money. It can involve using children. It can involve belittling a victim, making her believe that she has nowhere else to go. And it can also involve intentional isolation of that victim.

Ultimately, domestic violence instills fear that ensures compliance with an offender's wishes. One of the considerations for us as prosecutors as we are approaching a domestic violence case and approaching a domestic violence trial is this cycle of abuse. Domestic violence is cyclical in nature, and it is a cycle of love and fear. And so as we are approaching these cases, we often encounter what might be considered counterintuitive behavior. Why would a victim return to someone who had hurt them in the past?

And it is because of this cycle. After an altercation, they receive an apology that it won't happen again. And as I mentioned before, they may be isolated. They may not have other resources or support. So one of our goals in our office is to ensure that victims have the support and the resources that they need to be able to separate themselves from this cycle.

So as we're approaching trials, one of our considerations for choosing a jury is we want to have a fair and impartial jury. And if a juror is immediately going to write off a victim because of counter intuitive behavior, or someone who thinks, and this is something I've heard before, who thinks domestic disputes belong in the home and law enforcement shouldn't be involved at all, they're probably not going to be the right juror for that case. As we're approaching these cases, we have a very victim centered and trauma informed approach. But we are also very aware of the fact that these cases are dynamic, and sometimes we don't even know if our victim will show for trial. So one of the nuances, as Chris mentioned, there are some very special there are some nuances to domestic violence prosecution that includes handling recantation.

A lot of times, victims say it didn't happen even though we have the victim on scene, bloody and crying to law enforcement, being evaluated to medics and explaining the mechanism of abuse. But we don't judge them because we understand this dynamic. And so having that specialty in domestic violence also allows us to know the evidentiary tools we can use to be able to elicit those prior statements at trial to help support a victim who may not be able to support herself. And we oftentimes use experts to help explain the cycle of violence and why a victim may be recanting to a jury. Domestic violence survivors are incredible, and the amount of courage that it takes to stand in front of a jury as well as in front of one's abuser is unbelievable.

And our goal at the end of the day across the board within our units is to make sure that victims are walking out of the criminal justice process no longer feeling like victims, but feeling like survivors.

I'll jump in to talk about child abuse in general. As Danny said, that's sexual abuse and physical abuse. It also includes things like exploitation, child pornography, as well as neglect type cases. We we talk about dirty house cases where houses are, you know, hoarders that are in such disarray, such horrible conditions, that that constitutes a low level of child abuse. And we'll kind of break those up into two.

I wanna throw in one of my favorite phrases here, and it touches on some of what Danny just said as far as, the family, the home, peep where people learn these sorts of behaviors, is in childhood. It's in the home. And so child protection to me is crime prevention. And so we aren't just dealing with the sex assault or the physical abuse. We are dealing and this is why we have a multiple agency MDT working together to protect and, support children as a whole, as holistically as we possibly can, whether there's a crime involved or not, whether we're filing a case or not.

Because ultimately, whatever crime you choose, whether it's stealing cars, selling drugs, breaking into houses, this is all stuff that is prevented by improving childhood and getting children out of those unsafe, unsupportive environments where they are learning these behaviors or simply failing to learn how to, you know, engage in more socially acceptable behaviors and not having those outlets and resources. So that is the perspective I'm coming from on any child abuse case. It is the, as far as I can tell, the only thing close to, not guaranteed, but, I don't know, like, true crime prevention that we can, do is investing in child protection. So here are some basic stats about child sexual abuse. I don't know if you've all sort of seen these before.

People who haven't tend to be a little shocked. Talking to jurors, we know that it is not common knowledge that this is this common. Certainly, that one in four girls reporting sexual abuse by the age of 18, how many of those are under the age of nine, which is most of them? And, in ninety percent of those cases, the children know they're abusers. Most of the time, we are talking about someone in a position of trust to these children, a parent, a grandparent, a babysitter, a coach, all those sorts of relationships.

These are not stranger perpetrated assaults almost ever. And that is part of the dynamic at play here as well, which I'll talk about when we get sort of more to the case considerations. The other child abuse that we talk about, physical abuse, Danny talked about, you know, babies and toddlers with broken bones or internal injuries, brain hemorrhages, unexplained injuries like that, and then what people think of as physical abuse, the physical beatings that children receive as, you know, supposed discipline or, whatever the however the parent tries to frame that. But we deal with levels of injury all the way from a basic bruise or a belt mark to serious bodily injury and death as part of this unit. It also includes neglect, as I said, the sort of dirty house situation, or also things like perpetrating domestic violence in the presence of your child.

That is psychological abuse at a minimum, and we sometimes do charge a misdemeanor child abuse, count as part of domestic violence cases. And then sexual exploitation of children, typically, it's where, you know, Google or some cloud based service or somebody alerts law enforcement that a certain image has been detected. We investigate. We find that somebody is uploading child pornography, downloading child pornography, has a ton of it on their computer or whatever. So in those cases, we aren't typically working with victims because we don't typically, we aren't able to identify those victims.

But we understand that this is a form of exploitation of children. Those children are victims. They were when these videos or images were taken. And those crimes also tend to be indicators of potential other abuse against children, we so take them very seriously. Paralleling what Danny was saying about domestic violence, when you're talking about a trial, there are just very different dynamics at play.

And talking with the jury is vitally important, just to get a sense of how willing are they to trust the word of a child. What does it mean to them to have a four year old say in explicit sexual terms what an adult did to them? And how do they weigh that against the fact that most of these cases do not have other evidence? There's no video. There's no DNA. It's usually a delayed outcry. I don't know if that stat was up there, but most children who are abused in this way do not tell anybody ever. And if they do, it is delayed by years, sometimes decades. And so by then, we're not gonna get DNA. The child who reports immediately is very rare.

And then it's happening behind closed doors like domestic violence. So, you know, can you convict on the word of a child is my number one question in jury selection. Now that they have to or that that's always enough or that that's all it takes. We still have to prove our case beyond a reasonable doubt. But that is our primary piece of evidence.

So that lack of evidence, or in the case of babies with broken bones, broken ribs, things like that, I mean, you wouldn't believe the number of alternative theories that defense experts come up with for trial to explain all of these individual injuries. And thank goodness we have people like Doctor. Coral Steffi and her team who are part of the Denver Health Clinic, where Danny works every day, who are pediatric specialists, child abuse specialists, and they can come to that trial and be our experts and fight for that kid, which they don't do unless it's medically clear what happened, basically. And so anyone can find an expert to say otherwise. And that's what defense attorneys do.

And that's the sort of fight we have there. Obviously, working with children

I just want to

do a quick time check because we have until 11:15. And I have a few members in the queue for some questions.

Okay. I think just a couple more minutes, and I'm good. I just wanted and this doesn't really take the laboring. You can probably imagine some difficulties in getting a five year old, a nine year old, prepared for testimony. Again, bearing in mind that usually that kid does have to take the stand in the courtroom in front of 12 to 14 strangers in the jury box, a judge in a black robe sitting up high, a bunch of lawyers, and then most importantly, the person who did this to them.

And that is generally someone that they loved and trusted and believed would keep them safe. And so a nine year old testifying in front of her dad about the things that he's been doing to her for the last three years, it it cannot be anything but retraumatizing, and we work as hard as we can to minimize that. And we have tools for that, and that is all about relationship building and trust building. And that is why these cases, like, the numbers are lower for each deputy, but they're still significant because each case takes so much hands on attention from day one to trial, and they mostly go to trial. Nobody wants to admit to any of this.

So we don't get guilty pleas on these cases like you do on other things, drug cases, car cases. So we are preparing for trial from before filing, as Danny said, on these cases more than any other. You know that's probably where we're headed. So just want to say how amazing kids are, as Danny was saying about domestic violence survivors. They are the strength and courage we see in these children is makes me emotional.

It's very powerful. And the families that support them, are to be commended because it is not easy to go through this process at all. But we do what we can for the kids. So, that's what keeps us going. But yeah, there's our contact information, and we're happy to answer any questions. Thank you.

Thank you so much. I do want to welcome Councilman Hines to the meeting. Thanks for joining, our vice chair. And I do want to say, and perhaps I should said this at the beginning, and just knowing that this kind of subject matter can be triggering for folks. I I know we're adults here, but that doesn't mean we all maybe come with a set of experiences, own trauma, things like that. And so thank you for taking the time and approaching it in a way that I think was also very sensitive to any of those kind of facts. So thank you for doing this work. I'm gonna go to council members who are in the queue who have some questions. And we'll start off with Councilman Flynn followed by Councilman Cashman.

Thank you, madam chair, and thank you for the presentation. And, yes, you're right. Somewhat triggering because I had a very unsatisfactory experience years ago with a domestic violence involving a neighbor who crawled over to my porch one night with a ruptured spleen. And after going through all of those steps that you talk about, at the end of the day, the wife said, I'm not gonna cooperate anymore. How I'm wondering of the universe of cases, how often does that happen, and does this approach help reduce the number of folks who back out?

They ended up getting divorced, and they worked it out that way. But it was very unsatisfactory because I went through the interview with the DA, what my testimony would be, etcetera. So I'm wondering, how do

we deal with those cases?

Does it is this approach better?

Your first question being how often does that happen? A lot. So much so that I think at the filing stage for Victoria Kelly, you just assume that's going to happen, and you evaluate your evidence in light of that eventuality.

So I'm sorry to interrupt because I know we have a limited time, so I apologize for that. But what I'm really interested in is, are you able to pursue those cases without cooperation? Sometimes. If you have physical evidence, etcetera.

Right.

Interesting. Okay. And then last question. I have many others, but just to move on. Does this approach result in a range of outcomes? And what are the preferred outcomes? There's no single pathway, I imagine, for every case. So, you know, some may lead to prison. Some may lead to probation. Some may lead to other things. What is there a preferred outcome, or what is the range of outcomes?

I think the range of outcomes could be anything from a dismissal if we identify we can't prove a case to probation to prison. Ultimately, it is very case specific, and we take into consideration the wishes of the victim. Ultimately, it is our decision as prosecutors what to offer in the case, and then it's a question of whether someone who's been accused of a crime wishes to take that offer.

Are there outcomes other than what you just mentioned, you know, some kind of commitment to a program of treatment, rehabilitation, substance misuse might be involved. So everything is on the table.

That usually comes as part of a probation sentence in these cases. Okay. But our our goal, if it's at all feasible, is to get some sort of treatment piece or entirely treatment based sentence until someone shows that that they're beyond that.

Thank you. Thank you, Madam Chair.

Thank you. Councilman Cashman followed by Councilwoman Gilmore.

Thanks, Madam Chair. Dan and Chris, thank you for the presentation. It is, as from our initial discussion when I realized the work that you do, is quite a challenging subject area day to day. Is there you said right now about 600 cases at any given time across your 11 attorneys. Is it kind of a stable landscape from month to month, year to year, or is it seasonal?

Does economic backdrop affect things? I'd always heard that when the Broncos lose, there's a spike in domestic violence the next day. Can you address that in general?

I mean, I personally have seen some fluctuation in the cases. What it's necessarily connected to, I can't say. I will say we have a lot of children, and this really is a testament to, the safety of our schools, but a lot of children talk to school teachers or counselors about what's going on at home. So during the summer, sometimes things may slow down a little bit because we don't have those mandatory reports coming in from schools.

Thank you. Is relinquishment do we have data giving us an idea on if it is, in fact, leading to increased safety? I mean, it would seem logical that it reduces risk to some extent.

I don't have numbers to offer you. But if that's something you're interested in, I'd be happy to follow-up and see if I can get you some numbers. Yeah.

If if that's possible. And I guess what do we need to do? What would dramatically reduce your workload? The the occasion, the frequency of domestic violence, child abuse cases? I mean, if you're king or queen of the world and can pull a lever, what do we do that changes this?

Unsurprisingly, it's a question of resources, right? The split that we just did, we did with the bare minimum of people. Like, we need more people just to handle the cases we're handling right now. We would love to also have specialists dealing with all adult sex assault cases. That's on the horizon, we hope, but we it's just not feasible right now.

So resources for our office, but also for those other partner agencies, you know, Denver Children's Advocacy Center is working on a process right now to try and expand their physical space so that we can have all agencies colocated there, which is a huge project, an expensive project, and will be a huge step forward in that specific process because that collaboration is really what does it, at least in our experience, I think. But it's a big thing. I mean, it's it's daycares. It's preschool. It's health services.

It's social services, right, outside of any crime being reported. It's really all of that. And I think the more we can devote to the welfare of children, really, in any way, is what ultimately reduces our caseloads. Short of reducing the caseloads themselves, we absolutely need to be working on increasing the resources within our office for prosecutors, victim advocates, investigators, just so that each case is handled more closely and with more attention. Last question.

Are our numbers different than other cities? I mean, geographically, what how how are Denver's numbers?

So I don't have exact numbers to provide you with, but I would say Denver's numbers are pretty high. I and I don't know what to attribute that to necessarily. And I think part of it is just being Denver and being a large jurisdiction as well Mhmm. Just in terms of our population.

Someone was just saying, was it Fort Collins finally, like, created a devoted DV unit? And it's one guy. Mhmm. So our numbers are much, much higher than that. But I think compared to Colorado Springs, Boulder, the fact is that Denver just has significantly higher numbers and needs.

Is it Fort Collins or Larimer County?

I guess it would because Yeah. It'd be Larimer County.

Because I I actually that was my first internship out of well, in call while I was in college at CSU was in the domestic violence witness, victim witness unit with the victims advocates

Oh, okay.

In Larimer County DA's office. So I'm just curious.

And I I hopefully I'm

That was a long

time misremembering.

It was like an offhand comment someone just made, so I was just kind of throwing it there. So I could be misstating the location. But I remember it being not like a rural area and just sort of a surprisingly low number. Yeah.

Thank you, madam chair.

Thank you. Councilwoman Gilmore, followed by Pro Tem Romero Campbell.

Thank you,

Madam Chair. Thank you so much for the presentation and the work that you do. And I had a couple of questions. Do you have percentages or I might have missed it. On how many cases do you see that involve alcohol or other substances? Or maybe let's put that. How many involve alcohol and then how many involve alcohol and other substances?

Yeah. I'm gonna say we definitely don't have clear numbers, so this would be mostly anecdotal. I think in the DV context, regularly, something is going I mean, it's not common necessarily for us to get like a blood test or something and really no. But certainly alcohol is a factor. I'm sure that's part of the Bronco game phenomenon as well.

With the kid crimes, maybe yes, maybe no. That's just much more of a I don't know what to call it more of a pathology than a substance induced thing. I mean, certainly you'll see where drinking too much at night happens and then the touching happens, like every night the same way or something like that. And he's always drunk. And maybe that's part of that person's pattern. But I wouldn't say I've ever had the sense that

I guess it's more along the lines of domestic

Okay.

Or child abuse. That way where someone is self medicating, gets blackout drunk, and commits violence. Violence against someone. I know that there's a time lag, but I would be curious because those are some of those generational cycles, especially around on the slide 14. I was just interested that you have domestic violence here.

But on the left hand side, the physical violence piece seems like it all also relates to child abuse as well. And so I just wanted to bring that as an attention because I think especially using male privilege and culturally where males hold a certain place in the household, I think that there's much more that we could do around education for communities. And so what is the outreach and education to prevent some of this? Or does that not fall with you at all and is a different agency?

I don't know. Do you want to speak to that?

So what I will say is in domestic violence cases, probation cases, domestic violence treatment is mandatory for offenders. And I will say that our office is extremely diligent in these cases and ensuring that with offenders specifically, we are kind of triaging the issue. So it may be the mandatory DV treatment, but we ask for probation with substance abuse treatment frequently to really address the root of the problem. As far as the preventative efforts, I mean, I think education is a big piece of it. And I think kind of as I mentioned, my role in the community, Victoria being out in the community and and I think just giving voice to domestic violence.

I think having conversations like these about the prevalence of this in the home can not only empower survivors to come forward, but just gives voice to how prevalent this is.

Yeah. Yeah. I I really appreciate that because, you know, when you mentioned belt, that is definitely one of those things that as a child, and I think it also is layered on with colonization and the Catholic church and religion and all of those pieces as well. And so, you know, just where people don't feel like it's their shame and guilt to carry, that it was something that was done to them and that there's a power in being able to speak truth to that and to empower others to be able to work to get to that space as well. And so thank you, very much for your work. Thank you, madam chair.

Thank

you. Council pro tem Romero Campbell followed by councilman Haines.

Thank you, madam chair, and thank you for the presentation. I think it's a lot to listen to and to think about, but also tremendously beneficial to the folks that you are working with and serving. It made me wonder I know that in DPD District three, the data shows that there is an increase of domestic violence. And I think it's across the city and also, I know specifically in the district, across demographics. Are there PSAs or information, to your point about educating broader public resources that we might be able to promote or send out or have available for folks within our districts?

I mean, I think that's a great question, and I definitely think that's something that we'd be receptive to talking about and figuring out what kind of resources we can be making more publicly available. Do I know of anything offhand? I don't because I am so entrenched in the child abuse world. But I think that's a great idea and would definitely warrant further discussion. Yeah.

That's the sort of thing Victoria Kelly would absolutely be willing to talk with folks about and work on that education piece. I'm certain of that.

I mean, it just it makes me think, you know, simple PSAs, things that are easily understandable. I mean, yesterday, we had a presentation from the Denver animal shelter. Mhmm. And they have easy I think about, you know, your comments about here is easy things that we can share in our newsletters out with community that just, I think, raise awareness, but also give might give people a place that they could turn to or pause and think or know that there are resources available out there.

I think putting even phone numbers just in case a victim sees, like, I could call the Rose Andam Center. I'm not reporting a crime, but there's someone I can call. Yeah. The Children's Advocacy Center, know, things like that, just having those in newsletters. Just something at the bottom, Yeah. Need help? Here's a number, would be something. Because I think a lot of people think, I don't wanna call the police, but I need help. And they don't know what to do.

Yeah. That was all I had. But thank you.

Thank you.

I appreciate the work you do.

Thank you, Madam Chair.

Yeah. And good thing we have our community health assessment folks up next and public health and environment, which I think that is what they live and breathe a lot is PSA stuff, as these are public health issues, right? Next is Councilman Haines.

Thank you, madam chair. Thank you for the presentation and for

all your work. What's the percentage of cases that are filed that are later withdrawn because of complications? Say, for example, the victim chooses not to testify.

I can't give you an exact percentage. I what I can tell you is our DAs do everything in their power when it is a provable case and a case we can prove beyond a reasonable doubt to continue pushing forward for accountability for the abuser, I don't have an exact number. And I think that would be kind of difficult to quantify too.

Well, thank you for the trigger warning. Thank you for you said it was emotional. Thank you for filing cases when they when you know that there's an expectation that some of them will be dropped because someone will choose not to testify. Thank you to the police who show up, who when 911 is called, three out of every four times they arrive, the person who called 911 chooses not to press charges. I mean, it's very stats are stacked against a remedy, but yet we need people who can use humanity to make sure that we hold people accountable.

People are damaged for the rest of their lives because of abuse. And there should be some accountability. Thank

you. Thank you.

I just had a couple of questions, and they might need just follow-up on. I'm particularly I appreciated the slide where you had a bunch of the stats lined up and you looked at ages of kids of when they've experienced abuse. And you said nine and under that had the most cases of children nine and under. I'm particularly interested in the next age group up, like the 10 to 13 year olds, and what their what the stats are for kids of those ages experiencing sexual or physical abuse. And the reason being is because in the state of Colorado and also in the city and county of Denver, the age in which a child can be prosecuted in the juvenile justice system is 10 years old.

And that can be for sex assault, it can be for stealing a car, it can be for a number of things. And you think of a 10 year old that is my son's age now who is in fourth grade or just finished fourth grade in elementary school. And imagining a 10 year old allegedly committing a crime such as sex assault or even stealing a car, to think of that developmental stage for that child. And one of the things you said really stood out for me was that what children might be experiencing in their homes, in their communities, and then how that then plays out later in life for them. And sometimes that later in life could be just a couple years, right, where they may be repeating a cycle of something that has happened to them or learned behaviors that they have experienced.

And so that's something I'm just really interested in as far as the data side of things. And also, if the DA's office and I've worked with the DA's office for several years. I used to work in juvenile justice area and child welfare. I was a caseworker. So I saw a lot of these cases, unfortunately.

So is there any longitudinal data looking at children who've experienced and I know we see this, we call it crossover youth, like kids who have experienced adverse childhood experiences, whether it's physical sexual abuse, and then whether or not they then later become involved in the juvenile justice system and then even further into the adult system. And I think it would be really interesting and helpful for us to see that longitudinal data. And I know that can be very difficult to capture. But I think it also would speak to ways in which we can apply early intervention or even preventative measures. And I'm so glad that we have our community health assessment people coming up next, because I think a lot of these things are aligned.

And I know that's a lot to ask for you to be like, yeah, we have all the answers right now. But I think it's just something maybe for us to start to think about.

Absolutely. And I think this is also why we have a dedicated juvenile unit. And we also do have a dedicated prosecutor who files juvenile cases with a mind towards these things. I can tell you I don't handle juvenile filings, but I think these are all great points. And I've been taking notes. So these are certainly things our office can follow-up on. Fantastic. Yeah, thank you.

Well, thank you again for being here today and providing this and being willing to come and present to us all. I'm sure we may have future conversations or follow ups that we may want to have you all back at some point.

But thank you so much. Thank you for having us.

Thank you all so much.

We're going to take just a minute to transition over with our friends from Department of Public Health and Environment. So please feel free to join us at the table when it's clear. Yes. All of you join us.

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Thank you so much.

Right. Looks like we're all set here. Thank you so much for joining us today. I'm going to have you all introduce yourselves before you jump into your presentation. And then we'll take questions from council members at the end of the presentation. I know that this is like a follow-up from the first presentation. And then I think we're we're gonna have you all back once the report is is ready and all of that stuff. So this is kind of a stop in between, which is great because I think we had a lot of it generated a lot of conversation from that last presentation. So please introduce yourselves and proceed with your presentation.

Thank you so much for having us back.

My name

is Nathan Keffer. I'm the community assessment and improvement planning senior analyst at DDPHE, which means that I serve as the project lead for our community health assessment and community health improvement plan project.

Hello. I'm Agnes Marcos. I am our lead data analyst at DDPHE within our data science team.

Good morning, everyone. Or yeah, still. My name is Katie Andrews. I'm our senior population health epidemiologist on our data science team at DDPHE.

And go right ahead. Great.

Well, yeah, thank you again for having us back. When we were here last earlier on in the spring, we had the opportunity to present a little bit about our community health assessment, our the CHA that we're completing at DDPHE, and present a bit of a status update. Today, we're excited to share that we have some health priorities and findings that have resulted from that community health assessment. The CHA is now published and available publicly. And what we'll do today is a review of the three health priorities that we have landed on that we're gonna focus on for our community health improvement plan over the next five years.

We'll provide an overview of what you are all able to find in the CHA, and so we'll actually dive into it and just show you some of the highlights and some of the findings that we have that we think are important to share. And then we'll talk about what comes next with our five year health improvement plan. We really wanted to start off by, setting the stage for what went into the community health assessment process. This isn't just a report on health in Denver, but it really is capturing the voices and the vision and the wishes and the lived experiences of people living in Denver and the large number of community partners that we worked with on this process. So over the last year and a half that we engaged in our CHA process, we worked with, dozens of community partner organizations, community based organizations, nonprofits, and health care partners.

We talked with a 100 Denver residents across 12 different focus groups, learning what being healthy means for them and what they need to see better health outcomes in their lives. We held two town halls, a third one coming up in Westwood that we're going to hold in Spanish, in July, to help reach wider groups of people and hear what they need for health in their community. We heard from over 2,000 folks in our community health assessment survey. We worked with three advisory boards comprised of, nonprofit organizations, health care organizations, and fellow city and county of Denver departments. Held more than a dozen planning meetings, reviewed, 100 health indicators across 15 publicly available public health data sets, and reviewed 30 of our own public health assessments at DDPHE to pull together what we think is the most comprehensive and community driven health assessment that we've done at DDPHE.

So we're very proud to be able to present some of those findings to you all today. The graphic on the screen shows the community health improvement cycle. I think this is important just to reiterate the cyclical nature of this work. So we're taking findings from public health data sets from community members and what we're hearing from them. We are using those findings and, people's wishes for community health improvement to develop our plan.

We measure health improvement across that plan for five years, and then we restart by, doing another community health assessment cycle. So what progress were we able to make in that five year span? Where did we succeed? Where did maybe we come up short? And we continue that process all over again.

We want to start by talking about our community health assessment findings and specifically the three priorities that we landed on to focus on for for the next five years. These three priorities are access to health care, which includes mental health and behavioral health, safe and affordable housing, and systemic racism. These, three health priorities were selected, by our partners and by community members using a voting process and a recognized prioritization method for public health, improvement planning cycles. They are broad and interdisciplinary in nature. So this allows us to do a lot of work under the umbrella of those three health priority areas.

It allows us to bring in a wide range of collaborators across the city and across sectors. This plan is not DDPHEs to own. We facilitate this community health improvement process, but measurable and actionable health outcomes don't happen without bringing in a wide spectrum of partners. So having these health priorities that are broad, both within our scope and outside of the scope of public health of the public health department allows us to to really make progress over the next five years. We really love this particular quote from one of our focus groups that we held in collaboration with our our friends at DHS, where we heard from a focus group participant that everyone deserves to feel happy and healthy and safe.

And we really feel like this encapsulates the findings from our community health assessment. We're going to provide an overview of each of those three health priority areas, starting with access to health care.

So I'll talk us through our access to health care priority area. And just grounding us in our topic, just one of our focus group participants mentioned that health starts with mental health. And I think that keeps us grounded in the work that we're doing because we know that health goes beyond physical health and mental health as well. So we'll talk through what we looked at for who's affected and where we're finding some of the needs in Denver. So for who is affected, we found that 90, thousand individuals in Denver are uninsured, which feels like a lot, and it is a lot.

So we know that there is a need to have more access to health care across Denver rights. And it's an emerging issue that we're seeing, and we're seeing it rise to the top. And 11 out of our 12 focus groups reported difficulties accessing health care. And this includes quality of treatment. This includes overall access, mental health care access, and lack of culturally responsive care as well.

And then lastly, we saw that access to health care came up in our Thrive in the Mile high survey. When we asked what do you need individually to achieve a healthy life and what your community needs to achieve a healthy life, this came up in both of those questions as our number one response was access to health care. And this was across our in person mail based survey as well as our online survey as well. So we're seeing it across the board coming up as an issue. So where is it affecting Denverites?

We're seeing the highest concentration of uninsured individuals in the Northwest, Northeast, and Southeast regions of Denver. This is also areas where there's a higher concentration of people, of color, people living in poverty, and people living with limited English proficiency.

Our next, top priority area is safe and affordable housing. So this quote, from the youth that I know, it's a place to live. That's something that's very challenging for people to really find for the young people. So we really like this quote because I think when I think of safe and affordable housing, I automatically kind of assume, like, you know, more as, like, families and more but it's affecting our whole population, including our youth. So diving into it similar to what Agnes walked us through.

As you can see, 37% of Denver residents are defined as being housing cost burdened. So that means that definition means that at least 30% of household income is spent on housing. And as you can see, this is much higher than the state and national trends. The Denver line is significantly higher than those other two metrics. And so this is something that's definitely unique to Denver. And people felt that. So I mean, I think that Agnes's 11 out of 12 focus groups is really, really stark. But still here, over half or seven of the 12 focus groups identified concerns with housing cost. And I can break that down a little bit more too in case folks are interested. So housing cost seven focus groups mentioned that.

Unsafe conditions were mentioned in three focus groups. And stability of housing were mentioned in three focus groups. So that's kind of how that played out. And I have more information if anyone's interested about which focus groups brought those up, during their discussions about what they need to be healthy and what challenges they're facing. In that same survey, affordable housing did rank in the top five for both individual and community needs.

So we really saw it in the data, and we heard it from the Denverites that we were able to, learn from in this process that this was definitely a priority. So when we're looking at where, it's not quite as stark as access to health care, but there's still absolute concentrations of where safe and affordable housing needs are unmet. And I won't I'll leave this up because I you know, it's kind of a visual representation. But we did also find that in general, the neighborhoods with the highest proportion of housing cost burden in Denver were also the neighborhoods that had the higher concentrations of people of color, people living in poverty, people with limited English proficiency. So very, very similar to the same social determinants of health that Agnes mentioned.

Our third priority area, systemic racism. So this quote, just in case it's a little small, I'll read it. As a community, being healthy means that your zip code shouldn't determine your health outcomes, life trajectory, and access to clean air, water, food, and green cover. Communities that have been that have historically been redlined are still experienced outsized environmental injustice today. So one reason we really like this quote is we found and heard that all of the issues that we were looking at in the trial really did vary widely across race and ethnicity and also areas where, as we're talking about, people may have been marginalized more systemically.

And that was really across so many different categories that we felt that it really was its own thing, including, environmental injustice. So who was affected? One thing that we looked at, which we thought was really interesting, was life expectancy in Denver across demographic group. So this is if you're born in Denver as a newborn, just statistically how many years can you be expected to live. And when considering race and ethnicity alone, there were some significant differences that we wanted to highlight.

So as you can see, the yellow bar, for all Denverites, the average newborn life expectancy is considered to be 78. And then our highest life expectancy was found to be a little over 84 among our non Hispanic Asian population. And our lowest was found to be 46.8 among our non Hispanic native Hawaiian Pacific Islander and then 62 point six years under our non Hispanic Alaskan American Indian and Alaska Natives. So I personally thought that that spoke really powerfully to even just looking at race ethnicity alone, we have some severe differences in life expectancy and just health overall for our community. Nine out of 12 focus groups raised concerns about discrimination, health disparities, and systematic barriers.

The survey results underscored additional ongoing challenges around equity, discrimination, and the impacts of gentrification specifically. So this is certainly affecting people and is on people's mind, and people recognize these issues as affecting their health and their health opportunities.

So we're in Denver. I'll just caveat this data set is about a decade old and has different methods that Paige's life expectancy dives into, and we're working on updating us. So just know that's coming. But I think it still rings true, and we'll still see it today in our updated data set coming soon, is that systemic racism is seen where people live in Denver. Going back to that Thrive in the My Hives survey quote, it really shouldn't be determined by zip code.

But as an example, we do see a difference between just Hilltop and Globeville. And this is just a stark contrast between someone's life outcomes based on where they live in Denver.

Okay. We wanted to provide a quick overview and walk through of what the community health assessment is. A lot of community health assessments across different public health jurisdictions in The United States are a PDF. We went in a slightly different route, which we're pretty excited about, at least as excited as you can be about a health assessment. So we published ours in the form of a story map.

And so this is a interactive map based dashboard and data driven platform online. So this allows folks to interact with our public health data, we think, in a in a much more engaging way than the traditional CHA. So we're just gonna walk through three of the main sections of this. I'm sure you all have gone through it, in all your free time point by point, but we wanted to, share some of the highlights with you all. And first, Paige is gonna start us off with, a section titled what we heard from Denverites.

Absolutely. And I just wanna give a shout out real quick to our team. So many more folks than just us worked on this, and the amazing graphics that you see. Just are so lucky to work with talented people and just want to give them a shout out too. Okay. So the What We Heard from Denverites section really tries to summarize what we've heard from Denverites. So this is going to look at our survey results, our focus group results across various things, and also dive a little bit deeper into the data. So I just wanted to orient you all to that. This first section describes our different advisory groups that Nathan mentioned earlier. They have been instrumental to this process.

Just for the sake of time, we'll keep moving, but I really encourage you all to just check out who they are and how they contributed because it was really instrumental. This is our Thrive in the Mile high survey. So this is where we heard from over 2,000, Denverites. And this is a great graphic that summarizes just, like, the questions that were used, the methodology, and our responses. And then if you scroll down a little more, thank you, Nathan.

This is kind of our our main summary of the two questions asking about what for the individual, health to thrive and also what they think their community needs to thrive. So you can see how the different categories ranked. Right now, we have it broken out by those who responded to the mailed postcards and those who completed online since they were slightly different populations. We're working on, presenting that in a more intuitive way moving forward. We've gotten some feedback that that was a little a little too data nerdy for everybody, but we think it tells a really interesting story, and it's there's so much alignment between both groups.

So really encourage you all to to look at this if you're interested. Now we get into our focus groups. So this is the list of the the populations we were able to speak with, and it has how many participants in each to get to that one even 100 that we did not plan on, but it's kind of fun. And then if you go down thank you so much. Alright.

This graphic, again, shout out to our team member who put this together. But this really talks about what were the top phrases or topics that came out of each focus group. And then they are color coded according to the social determinants of health in case that's helpful. And so this is kind of like a summary. But as you page through, you can see the actual word clouds that were generated from the transcripts from these discussions with folks.

And you can look at the populations that we met with and what really came up during those sessions. And we just felt there was no better way than to highlight the words that people used themselves and the topics people thought were important. And there are some really interesting stories that emerge that you can look for in that summary table or page through here. Another aspect that we looked at when we were looking at the focus groups was specifically, again, we want to learn how do we change things in the long term, right? So again, coming back to our social determinants of health.

So the focus groups are also those transcripts are transcribed by social determinant of health categories. Like, that's how they were coded. And we have the themes across those different categories that came up for each group summarized here and then broken down by in a in this doughnut chart, again, color coded by social determinants of health with the specific subtopics of each social determinant of health. So as you page through again, you can see the proportionate importance or relevance that each group gave to a topic while discussing what them and their community needs.

Just a quick time check. I have a just a few council members in the queue. This committee goes till noon, so just a time check.

Thank you.

I'll be faster.

I'm sorry if I get too excited. No, no. It's great information. We to go through

it. Definitely. Then, yeah, really quick, this is a summary of all of the public health assessments that have already been done. There's already ongoing community engagement within DDPHE all the time through the various programs that folks do. We wanted to make sure those voices and those priorities were captured as well.

So if you go through these graphics, you can see kind of the the people who are determined to be disproportionately impacted across all programs as well as needs and strengths, found across all those different assessments. And then the last thing is this goes into detail more about the data that was used, and we're still finalizing the the dashboard that will you'll you'll be able to link out of it to it from here, and that'll have all of the indicators that's coming this summer. But it explains a little more. Okay.

The next section are the three health priorities, which we already reviewed with you a little bit at a high level. But in the story map, each health priority is explored a little bit more in-depth. They all follow the same general outline. So which social determinants of health influence health disparities for this particular health priority? We have a brief literature review about why this is important.

Why is access to health care important? Well, obviously, we all need access to medical care, mental health care, behavioral health care. We hear that loudly, through the community stories and voices that we captured, and that's well documented in public health research as well. And so we provide a brief overview of that rationale. We include quotes from community members, some of the statistics that Agnes had shared earlier, populations that are affected, both what we learned through our, qualitative research and what we've seen in the data, and then some additional dashboards and maps.

So each of the three health priority areas follows that same outline and provides additional detail about the justification for why this is important for Denver rights and why this is important for DDPHE. And the final section we wanted to make sure that folks were familiar with were the social determinants of health, which Agnes will share with us.

So we built out some dashboards hoping to capture the comprehensive data that went into the CHA and isn't left out, although they didn't necessarily make a priority area. So we have each social determinant of health, which includes economic stability, education access, quality, health care access and quality, neighborhood and built environment, and social community context. So we have a dashboard built out for each of those social determinants of health. If you can scroll down really fast. I'll just go through one as an example, and then they're all formatted similarly.

But we have a deep dive of our focus group information. So Paige mentioned that we have the data coded and their group by social determinant of health. Well, this gives us an opportunity to dive into each of those subtopics within, for instance, economic stability and see where it came up and which specific focus group and the trends around, those kinda, like, identified topics. And then we also included some salient quotes that we found as well from our focus groups and wanted to highlight the community voice there as well. And then for the next tab, we have some trends over time looking at secondary public health datasets and pulling that in where we can.

So each each social determinant of health will have a trends over time figure, and then some of them will have additional demographic or SOGI kinda like bar charts as well. And then lastly, we have we love our geospatial analysis as well. We have some maps that accompany the social determinants of health as well. And we have different data sets, and you can toggle on and on and deep see different gradients and dive into the data as well. So hopefully, this serves as a one stop shop for our community and Denverites to learn about where the issues are coming up and who's impacted and what we've heard.

And this is replicated for each social determinant of health. So I just sped through that. Please visit it to dive more into it. But I'll talk a little bit about where we're headed in the future. So the work's not over yet.

This is live and, you know, people can interact with it, but we have so much more planned. We'll work on putting together a public health dashboard that will be public facing, and that will involve over a 100 indicators that will include trends over time, map, and demographic SOGI categorizations as well and have that being a living tool and updated in real time when data become available using a lot of those secondary public health data sets. Hopefully, again, a one stop shop for our community and our community members. We'll work on building out those seven additional health profiles. So we focused on our three priority areas, but we'll work on fleshing out the topics that we weren't that weren't selected because I think it's still important to highlight that those issues did come to the surface with our community groups.

And then we'll work on additional analysis. There's always more data. There's always more ways to cut it and dive into it. So we'll keep working on updating that and including that in our CHOP. And then we are kicking off our SHIP, our community health improvement process as well that Nathan is leading, to start building some of the strategic plans and goals around that with our community partners.

I'm gonna skip to that part just in the interest of time. So what comes next? The community health improvement plan is the next step in this process. As Agnes mentioned, the CHA really is just the beginning of this whole process. So we are currently recruiting for community health improvement plan working groups, one working group for each of the three health priorities that community identified they wanted us to work on.

These working groups will be a mixture of city and county of Denver staff, CBO partners, health care organization partners, and importantly, community members to help drive, the action behind health improvement and set goals and strategies and objectives for change over time. We'll make sure that this work aligns with other initiatives. It's already been incorporated in DDPHE's strategic plan, which is currently being formulated. There's alignment with mayoral priorities. I know that there's a lot of interest with, city council and and the issues that you all advocate for.

We plan to publish that chip at the end of this calendar year. So we're happy to come back, this fall and provide a status update or once the chip is published, whichever works best, to present that information to you all. And then the plan is implemented, monitored, evaluated, and revised over a five year period with our community partners. I'll provide just one example because I often get asked, well, what is a chip goal look like? What is gonna be included in this?

So I pulled a couple, and I'm only gonna highlight one of what CHIP goals look like across other jurisdictions. So in Baltimore in 2020, for example, they had a CHIP goal that focused on access to health care and addressed systemic racism by wanting to close the black white gap in infant mortality by ten percent by scaling and sustaining a healthy baby program across the city. So that's an example of what a chip goal could look like. That's going to be at the intersection of health care, public health, community health workers, and community leaders and advocates. So we would like to all, present you all with a call to action to please share the CHA widely with your partners, share it in your newsletters with your constituents.

So this can be a tool for, universal and collaborative health improvement action. We'd like to encourage you to all continue to champion and support community driven change. These priorities were based on data, collected by community members, provided by community members, and selected by community members. And so it's important to continue to advocate to empower those community members as we move forward into the health improvement planning process. This work will need support and partnership from council as well, and so we do appreciate your continued interest, your partnership.

There will be budgetary asks as we move forward if we do want to see change through this process. And so we just wanna thank you again for for your continued interest in this, for invitations for us to to share this with

you as we move forward.

Okay. Thank you.

Thank you. All right. We'll just go straight to council members in the queue. I have Councilwoman Torres followed by Pro Tem Romero Campbell.

Well, thank you. And I could talk with you about this for a longer period of time. So I'll just kind of give my highlights since we've got only about six minutes. When I'd be interested later on to understand where we're at in the spectrum of change around access to health care. Before the Affordable Care Act, I think Colorado was in like the 14 the teens percent of uninsured.

Colorado's dropped below 10. But kind of where are we at? And what are the more sticky populations that cannot seem to get insurance or health care would be really interesting to understand a little bit more about. In terms of housing cost, one of the things that I think we focus overwhelmingly as a city on is visible homelessness and not perhaps people who are housed but are kind of on the cusp of losing that stability or doubled up. And so just wondering a bit more about, I think, actionable things that we might be able to contribute to from our council districts.

Because I'm looking at the housing burden city map. And everyone at this table has a green to dark green neighborhood, which means greater housing burden. And Windsor, Kennedy, every district at the table. And so it isn't just kind of our typical inverted L. So what are some of the things we should be looking at?

Because I think it is a different conversation than visible homelessness that we tend to focus a lot on in the city. So I'd be very interested in that as follow-up. I love the story map. I'm still going through it, so I'd love to circle back with you all. I do think even within neighborhoods, there's nuance within those whole neighborhoods of, like, West Colfax dropped off as a nest neighborhood because it's gentrified, but I still have huge pockets of, low income housing, of, communities who lack access to certain resources.

So there's a story within that that I'd be interested in trying to figure out a way out. And then I would just ask you all, as you're looking at the implementation plan, what are the actionable ways that this can be integrated into other citywide process? So neighborhood planning initiative is one that comes to mind. Participatory budgeting is another one. But for the NPIs, the West Area, we put quality of life first because we wanted to focus on the kinds of things that you talked about, systemic racism affecting over multiple generations, including tree canopy and water quality and air quality, things like that.

So that, I think, is one interesting place to start figuring out how do you and CBD start integrating some of these priorities and gathering feedback from residents. So because it can be an actionable thing that's put into their plan. So, just that. And then where can we find recruitment info for your, improvement plan, stuff would just be another thing.

Yeah. I can send that to, Alex, and then he can connect with Perfect. All of your offices to provide that information. Yeah. And I know just interest of time, yes. Agreed. We're taking notes on all of that. I think those are are great points of feedback. So sorry we don't have time to address them all, but thanks.

That's okay.

Appreciate it. Other actionable thing, I think, is budget. Yes. We were able to get some equity questions added into budget, but these, I think, could also be there in terms of how your cuts will affect these outcomes. Right? That's, I mean, that's the landscape we're looking at this coming year. So okay. You. Thank

you. Council pro tem Romero Campbell.

Thank you, madam chair, and thank you for the presentation. I think too, you've answered some of the questions that I had within the slide deck. Other questions have already been asked. So my action is how do we partner with some of these community conversations using the data? How is how are you looking at what that partnership might be with all of our different council offices to be able to not only go through the story or dashboard.

No. What is it? Map. Story map dashboard. But really having I'm I'm thinking different community conversations to be able to sit with the data, look at it, and think about how residents are engaged with it.

One thing that I was interested in having more information about was the age demographics within the data that's shared. I think that Southeast Denver District 4 represented is also changing and evolving. And so I think there's a more holistic way that we could look at how this what this data means for the district and then actionable items to to get to where we need to be. There is just an anecdote piece of it with Denver Health. We are working to have a health clinic be in Southeast Denver and hopefully be able to respond to a lot of the needs that are there.

So I have a lot more questions about Medicaid and Medicare and who's accessing it if that's reflected in here. But just again, thank you. I look forward to following up specifically on what we can do to have those broader community conversations. So thank you.

Thank you, madam chair. Great.

Last member in the queue, we have Councilwoman Zuider.

Thanks, madam chair. Thanks, you guys. This is really fantastic. Just wanted to ask

about

implementation of this information. Right? This is fantastic information and super useful and helpful. But what I guess I'm waiting to hear is what we are actually going to implement to achieve these goals. And the reason I ask is because, for example, Danica and her team have been doing an amazing job of actually implementing changes in enforcement of health housing policy.

Right? One of the things we have identified that needs to happen is we need to update our minimum habitability standards in the city and county of Denver. But, like, I didn't I didn't hear that Mhmm. From you all in terms of, like, what are we actually doing to address some of these challenges. Right? And I think that's because there are some that are there's not a lot we can do. Mhmm. Right? It's like partnering with the state and with Denver Health to bring health care access to other places. It's not the city of Denver bringing health care access to other places.

Like, we've got wellness win winnie, which is great, but, like, that's not the kind of health care access we're talking about when what these people are talking about. Right? So I just am curious whether you have yet or when we will see the actual concrete items to be implemented to address these.

Yeah. Thanks for the question. So the community health assessment is really the the data collection piece of it, and so it's helping us to formulate and figure out what questions we need to be asking. The part that you're asking about implementation, that is what has started this month essentially and will continue through this calendar year. And so the community health improvement plan that SHIP will answer those questions about what concretely are we able to do as DDPHE across the city with our partner networks, with community advocates and leaders to see measurable change over the next five years, that will be spelled out in the CHIP document, which will be ready at the end of this calendar year.

Okay. Awesome. So we've just started that process right now. And as whatever, you know, counsel would wanna see, we can come back halfway through. We can come back at

the end

of it.

That's the plan.

Yep. That's great. We are happy to talk about this as much as you will all listen to us. So we'll have questions on that. And and to inform how we get there, that is why these three working group groups being interdisciplinary is so important. So that way, we're we're working with Denver Health. We're working with CVOs. We're working with community leaders in your districts, community advocates, residents to help answer that question as broadly as we can and make it realistic because there's a lot of things that's outside of our control to do. There's a lot

to to everyone, especially not with the budget crisis we're looking at right now.

So And there's a lot we can do.

But there's a lot we can do that can move the needle. That's why I'm asking. Yeah. Right? Because, like, a lot of this stuff for big dollar items, we are not going to be able to do maybe in 2027 if we're lucky. Right? So, like but there are concrete things that are low dollar items or $0 items that are, you know, ordinance changes that are policy changes and rules and regs that can move the needle on some of this stuff. And I think as we look at a budget crisis, that's the stuff we have to focus on.

Yeah. Or work that's already being done that we can just highlight through the chip. Right. We're not trying to create additional work for folks, especially in the present moment. But there's already so much being good work that's being done, like Danica and her team that we can reflect in this document and sort of elevate its put a spotlight on it.

Yeah. Okay.

Awesome. Thank you. Great. Thank you. And thank you again for coming to do this check-in. I think it like, as you can hear, council members are very interested in this work, and so we do wanna have you back once the chip is is ready or if there is a step in the or or if there's a time in between, we can discuss that as well. So thank you very much. With that said, we have six items on consent. Those will go through, seeing that nobody's called those off, and we are adjourned.

Thank you.

Thank you, guys.