THE GOING GET READY TO GET
STARTED SOON. CIVIL AND TAKES A
SEAT.
ON.
SO THEY CAN HAVE A LA OF THOSE
AND.
EVERYONE COME UP. HERE.
THEN I GET READY TO START AGAIN.
EVERYONE HAS STRETCHED.
BUT THE BATHROOM BREAK.
ALL RIGHT.
SO WHY THIS IS GONNA BE PART B.
HOWEVER AGENDA. AND WE'RE GONNA
BEGIN WITH THEM. HEALTHCARE
SERVICES.
THIS IS AGAIN THE SUBSECTION
GOING TO FOCUS ON MENTAL HEALTH
SO.
WE HAVE SIX ISSUES OF US START
OFF OF THE FARM HEALTHCARE
SERVICES WHAT WE'RE GONNA DO IS
WHEN IT GETS HERE THE COMMITTEE
MET THE HEALTH OF REVIEW THEN
WE'LL TAKE ON ISSUE TO THE
MENTAL HEALTH SERVICES DIVISION
POLICY IMPLICATION. OLD THEN
TAKE PUBLIC COMMENT ON THOSE TWO
ITEMS TOGETHER AND THERE'S THREE
ISSUES RELATE THE DRUG MEDI CAL.
NAM AS WELL AND THEN WE'LL WE'LL
TAKE PUBLIC COMMENT.
FOR ALL THOSE THREE TOGETHER
SINCE ALL REALLY DRUG MEDI CAL
AND THEN WE HAVE SOME
ADDITIONAL.
AFFIX THE PROPOSALS.
WHICH WERE HERE AND I WILL TAKE
PUBLIC COMMENT ON TOM.
ALL THE PROPOSALS TOGETHER.
AT THE END OF ISSUE SIX ARE
JUST THE PEOPLE KNOW WHEN THE
PUBLIC COMMENT. GOING TO BE SO
BUT THAT.
SAYS WE'RE SORRY YOU SECTION
WILL JUST GO AROUND THE TABLE
EVERYONE SHOULD DO SOME SELVES
THEN WE'LL BEGIN WITH THE
PRESENTATION ON COMMUNAL HOUSE
SELF.
RIGHT JENNIFER CAN ADD DIRECTOR
FOR THE DEPARTMENT OF HEALTH
CARE SERVICES.
BEN JOHNSON ALIJA.
ELENA DEPARTMENT OF FINANCE.
CHRIS COOKED BY MY FINANCE OKAY
AND I HAVE TO SAY DIRECTOR CAN
KNOWING THAT YOU OVERSEE THE
ENTIRE DEPARTMENT YOU'RE HERE
SOLO WITHOUT OTHER STAFF THE
OKAY I'M IMPRESSED ALL RIGHT.
ALL RIGHT.
PLEASE BEGIN I YES SO.
IN OBVIOUSLY IN THE INTEREST OF
TIME ON MENTAL HEALTH AND
SUBSTANCE USE DISORDER.
WERE. HELD IN OPERATED IN US
DIFFERENT DEPARTMENTS WITHIN THE
STATE UP UNTIL ABOUT TWENTY
THIRTEEN AND THEN. THEY WERE
EITHER DISBANDED.
AND BECAME DIFFERENT
DEPARTMENTS LIKE THE DEPARTMENT
OF STATE HOSPITALS OR THE
COMMUNITY MENTAL HEALTH ARE
pCOMPONENTS OF. THE FORMER
DEPARTMENT OF MENTAL HEALTH CAME
WITH INTO OUR DEPARTMENT AS WELL
AS THE FORMER AND DEPARTMENT OF
ALCOHOL AND DRUG PROGRAMS. SO
THEY'RE ALL IN ONE DIVISION
WITHIN OUR DEPARTMENT TODAY.
WE HAVE.
AND YOU WILL HEAR THIS AND THE
IN THE. FUTURE. ITEM THAT WE
HAVE ON TODAY'S AGENDA AROUND
THE BREEDING OF FUNDING THAT WE
TALK ABOUT SO THERE ARE. A
VARIETY OF FUN SOURCES THAT
COUNTIES USE.
TO HELP DELIVER SERVICES IN THE
MIDDLE HEALTH ENVIRONMENT SO
NINETY ONE REALIGNMENT TWO
THOUSAND ELEVEN REALIGNMENT
MENTAL HEALTH SERVICES ACT
FUNDING ON THERE ARE SOME
LIMITED BLOCK DOLLARS FROM. THE
FEDERAL GOVERNMENT AND SAFTEY
FOR MENTAL HEALTH SERVICES
ALMOND OBVIOUSLY STATE GENERAL
FUND ON THE COMPLEXITY AROUND
THE. STATE AND COUNTY FINANCE
SEEN AROUND MENTAL HEALTH AND
SUBSTANCE USE IS ALSO EXTREMELY
BOTH COMPLICATED.
AND WE HAVE TO BE. REALLY KIND
OF CREATIVE IN HOW WE WORK.
TO DELIVER SERVICES OVERSEE
THEM AN APPROPRIATE WAY BUT I
AND I WOULD JUST SAY THAT BACK
IN TWENTY THIRTEEN WE.
ADDED A NEW BENEFIT FOR MILD TO
MODERATE. MENTAL HEALTH SERVICES
THAT IS DELIVERED THROUGH OUR
MEDICAID MANAGED CARE PLANS FOR
INDIVIDUALS EITHER ADULT OR
PEDIATRIC THAT HAVE A SPECIALTY
MENTAL HEALTH SERVICE. THEY.
SEEK CARE DOWN WITH THE COUNTY
MENTAL HEALTH PLAN SO YOU DO
HAVE SOME BIFURCATION THAT WE
ARE I'M INTERESTED IN CONTINUING
TO IMPROVE IN TERMS OF HOW THE
COUNTY MENTAL HEALTH PLANS AND
THE MEDICAL MANAGED. HEALTHCARE
PLANS WORK IN TERMS OF REFERRAL
AND MAKING SURE THAT INDIVIDUALS
GET THE SERVICES THAT THEY NEED.
BUT.
.
JUST WANT TO SAY THERE'S ALSO
SOME CONTINUED WORK IN OUR
DEPARTMENT AROUND INCREASED DATA
MODERNIZATION AND THE BEHAVIORAL
HEALTH AREA WE HAVE A NEW.
OUTCOME SYSTEM CALLED THE
PERFORMANCE OUTCOMES SYSTEM IN
WHICH WE HAVE STARTED TO.
OUR REPORT ON DATA AROUND BOTH
PEDIATRIC AND ADULT POPULATIONS
PENETRATION RATES.
OTHER TYPES OF THINGS THAT
WE'RE HOPING OBVIOUSLY MATURE
THAT DATA AS IT STARTS TO COME
IN AND BETTER FORM. AND THEN.
LASTLY THE BIG AREA OF WORK
AROUNDS MENTAL HEALTH IS ALSO
NOT JUST UNIQUE TO MENTAL HEALTH
AND AS YOU DO IN APARTMENT BUT
TO OUR.
ALL OF OUR MANAGED CARE
DELIVERY SYSTEMS IN RELATION TO
THE FEDERAL MANAGED CARE RULE
AND SO BY JULY ONE THE COUNTY
MENTAL HEALTH PLANS FOR THE
FIRST TIME.
ARE REQUIRED TO HAVE THEIR
NETWORK CERTIFIED BY US AND
SUBMITTED TO THE FEDERAL
GOVERNMENT SO WE HAVE BEEN I'M
RECEIVING THOSE NETWORK FILINGS
FROM. NOT ONLY THE COUNTY MENTAL
HEALTH PLANS BUT OUR MANAGED
CARE PLANS THE STD.
COUNTIES THAT ARE IN THE WAIVER.
AS WELL AS OUR DENTAL MANAGED
CARE PLANS AND SO ALL OF THESE.
ACTIVITIES ARE BOTH LARGE AND
SOME CASES THEY ARE NEW ON TO
THE COUNTY MENTAL HEALTH PLANS
IN PARTICULAR AND SO WE HAVE
BEEN PROVIDING. A GREAT DEAL OF
TECHNICAL ASSISTANCE.
A LOT OF WORK HAS GONE INTO
MAKING IN ON THIS BOTH
SUCCESSFUL BUT ALSO WANTING TO
MAKE SURE THAT WE'RE TRANSPARENT
AND WHAT IT IS THAT WE ARE
EITHER. CERTIFYING TO ARE
PROVIDING TO THE FEDERAL
GOVERNMENT SO WITH THAT I'M
HAPPY TO. TAKE QUESTIONS.
THANK YOU ANY COMES FROM LA
RAIL.
BEN JOHNSON WITH THE LA OUT WE
DON'T HAVE ANY CONCERNS WITH ANY
OF THE BUDGET ITEMS THAT ARE NOT
UNDER THIS SO THE DEPARTMENT OF
HEALTH CARE SERVICES SECTION OF
THE AGENDA SO WE HAVE REVIEWED
IT BUT HAVE NO CONCERNS AT THIS
TIME.
AND IT'S.
ONCE A GREAT QUESTIONS FROM
MEMBERS.
YES US OUR MONEY.
BRIEFLY THANK YOU FOR THAT.
COMPREHENSIVE AND CONCISE
OVERVIEW I DON'T KNOW HOW YOU
KEEP IT ALL STRAIGHT SOMETIMES.
I HOPE YOU DON'T EVER HAVE ANY
DOUBTS ABOUT KEEPING A STRAIGHT.
I'M NOT AT THIS POINT YEAH
THAT'S THE CORRECT ANSWER THANK
YOU. TOM.
MIND YOU KNOW THAT WITH THE
AFFORDABLE CARE ACT BOMB THERE
WERE CERTAIN EXPANSION OF MENTAL
HEALTH BENEFITS.
IS ANY OF THAT THREATENED BY
CURRENT EFFORTS TO.
EITHER CUT BACK OR ELIMINATE THE
AFFORDABLE CARE ACT.
WELL I THINK.
YOU KNOW IN THE NOW SEES THAT
WE DID. LAST YEAR AROUND THE
VARIOUS PROPOSALS THAT CONGRESS
WAS LOOKING AT.
WE ESTIMATED ON THE SIGNIFICANT
FISCAL IMPACT OF WHAT EITHER
REPEAL OR A CAPITA CAP OR A
BLOCK GRANT STRUCTURE WOULD DO.
.
THE UNDERLYING.
FINANCIAL ARRANGEMENTS THAT THE
STATE HAS MADE WITH ITSELF IN
TERMS OF THE COUNTIES OF FUNDING
SHARE THE STATE'S FUNDING SURE
THE RELIANCE ON FEDERAL FUNDS
AROUND THE AFFORDABLE CARE ACT.
TO THE EXTENT THAT ANYTHING OF
THAT NATURE IS EVER EITHER
CONTEMPLATED OUR PASTS.
AT A FEDERAL LEVEL AGAIN.
IN MY YOU KNOW THINKING WE WOULD
HAVE TO KIND OF RE DO THE ENTIRE
PROGRAM AND START FROM THE
GROUND UP YOU HAVE TO REVIEW.
YOU KNOW WHO'S WHO'S PAYING FOR
WHAT YOU KNOW IS A STATE FUNDED
REQUIREMENT IS THAT THE COUNTY
FUNDED REQUIREMENT.
ARE THESE THE POPULATIONS THAT
WE CAN AFFORD TO COVER AND HOW
DO WE COVER THEM IS THIS BENEFIT
PACKAGE THAT E CAN. OFFER AND
WHAT WOULD IT LOOK LIKE I'M ARE
THESE THE RATES THAT WE CAN
AFFORD TO PAY I MEAN IT WOULD.
IT WOULD BE A REALLY
SIGNIFICANT.
REVIEW OF THE ENTIRE PROGRAM
AND OF COURSE YOU KNOW THE
ESTIMATED LOSS ON THE FINANCIAL
SIDE FROM THE FEDERAL
GOVERNMENT.
WOULD BE A REAL GAME CHANGER SO
FOR NOW WE CONTINUE TO DELIVER
THE SERVICES AS THE PROGRAM IS
YOU KNOW LEGALLY AUTHORIZED IN
CONSTITUTED AND.
WHEN WE TALK ABOUT A CD.
ADAM AND A LITTLE BIT I CAN
SHARE JUST KIND OF THE
IMPORTANCE OF WHAT THOSE FEDERAL
FUNDS ARE DOING IN ORDER TO
STRETCH. BUT THE COUNTY
FINANCING AS WELL AS THE STATE
FINANCING TO DELIVER SERVICES
AND HOW IT HOW IMPORTANT AND
IMPACTFUL THAT IS THINKING THAT
CELL PHONE AGAIN I REALIZE YOU
DON'T HAVE A CRYSTAL BALL NONE
OF US DO. BUT AT THIS POINT THE
FEDERAL FUNDING THAT WE ARE.
ELIGIBLE FOR IN THROUGH THE
WAIVER. ARM IS CONSTANT ACT
THANK YOU.
AND I TOO WANT TO THANK YOU FOR
YOUR PRESENTATION I GUESS JUST
PRIMER OBSERVATION ANYTHING ELSE
AS.
THAT YOU KNOW WE HAVE DISEASES
SAID AS A COMPLEX SET OF FUNDING
STREAMS AND OFTENTIMES BUT.
HERE'S IS IS THAT.
THOSE.
BASICALLY WE HAVE FUNDING
STREAMS THAT CERTAIN AMOUNTS OF
MONEY FLOWING THROUGH THEM
WHETHER IT'S YOU KNOW I MAY SAY
SAY WHICH IS BASED ON THE
REVENUE THRIVES FROM NOW ON THE
TAX ON THE. MILLION PLUS PEOPLE.
.
THE NINETY ONE REALIGNMENTS.
YOU IT'S NOT. THERE IT'S IT'S
SOME IT'S NOT NECESSARILY NEED
BASE RIGHT IT'S MORE THIS IS THE
RESOURCES WE HAVE FIGURE OUT HOW
TO OF COURSE ON THE MEDICAL SIDE
AT LEAST IN THEORY WHAT HAPPENS
IS YOU KNOW YOU DO HAVE X.
NUMBER OF PEOPLE WHO HAVE WHO
ARE MEDICARE ALSO THEY. SHOULD.
BUT THE.
BUT THE ACTUAL AMOUNTS.
SO I GUESS SO WHAT I THINK ONE
OF THE THINGS I THINK IS A
LITTLE CHALLENGING AS FOR
EXAMPLE YOU KNOW WE HAVEN'T
EVERY USUALLY WE HAVE LIKE OKAY
WHAT'S THE CASELOAD OR TO THE
BAND OR SOMETHING LIKE THAT AND
WHY AM SEVEN. BUNCH OF NUMBERS
THAT SHOWS HOW MUCH MONEY WE
HAVE BUT I DON'T HAVE THE.
THE DEMAND SIDE OF THAT. IS YOU
KNOW IT IS PART OF THE. IT IS
PART OF THAT AND. AND HAVE YOU
ANY THOUGHTS ABOUT THE ALBUM
WE'RE GOING TO THE NEXT ITEM
WILL BE TALKING ABOUT.
POSSIBLE TATIAN AND WHERE AND
AND AND ACCOUNTABILITY AND
OVERSIGHT SO FORTH IN TERMS OF
HOW DO WE FIGURE OUT LIKE IT IS.
IS THE AMOUNT OF RESOURCES WE
HAVE ARE WHAT WE'RE DOING NOW
MAKING A DIFFERENCE AND IS IT
ENOUGH FOR WHAT THE NEED IS OUT
THERE NOW I. KNOW HERE OF COURSE
THE BUDGET COMMITTEES ALWAYS
LARGER AMOUNT OF MONEY WE HAVE
BUT. AND GENERAL BUT STILL WHERE
HOW CLOSE OR HOW OFTEN ARE WE
FROM FROM THAT SO I DON'T KNOW
IF YOU HAVE ANY. JUST BRIEF
REFLECTIONS ON HOW HOW WITH
MATCHING THOSE TWO UP YOU KNOW.
I THINK THAT'S. A GREAT QUESTION
BUT IT ALSO SPEAKS TO.
KIND OF THE. THE NATURE OF THE
FUNDING ALSO HAS ITS OWN
REQUIREMENTS FOR HOW YOU CAN
SPEND THIS RIGHT SO I'M I DON'T
ENVY THE COUNTIES RIGHT IF YOU
HAVE A POPULATION OF.
PEOPLE SEEKING SPECIAL TO
MENTAL HEALTH SERVICES YOU HAVE
A VARIETY OF DIFFERENT FUNDING
MECHANISMS THAT YOU CAN USE TO
DELIVER SERVICES OF THOSE
INDIVIDUALS BUT THEN YOU ALSO
HAVE DIFFERENT RULES AND
REQUIREMENTS FOR HOW YOU CAN
ACTUALLY DELIVER THE SERVICES I
THINK. THAT I'M SO IT MAKES IT
REALLY HARD FOR US BECAUSE.
THE COUNTIES CAN CHOOSE A
VARIETY OF DIFFERENT WAYS THAT
THEY CAN DELIVER THE SERVICES
THE MHSAA. FUNDING REALLY WAS A
GAME CHANGER FROM THE STANDPOINT
THAT IT. NOT ONLY CAN BE USED TO
AS A MATCH TO DRAW DOWN FEDERAL
DOLLARS BUT IT CAN ALSO PAY FOR
SERVICES THAT ARE NOT OTHERWISE
COVERED BY MEDICAL AND SO. LIKE
THE FULL SERVICE PARTNERSHIP YOU
KNOW THAT IS KIND OF THE DO
WHATEVER IT TAKES TO TAKE CARE
OF THESE INDIVIDUALS THAT'S A
REALLY IMPORTANT.
.
PLACE IN WHICH.
THERE'S A GAP IN THE STATE
OBVIOUSLY ANSWERED THAT THROUGH
AN INITIATIVE PROCESS BUT THEN
YOU KNOW THAT'S WHERE THE COUNTY
ALSO SAVE THIS IS A MEDICAL
INDIVIDUAL I'M GOING TO BUILD
MEDICAL SERVICES UP TO THIS AND
THEN WHEN THIS INDIVIDUAL NEEDS
THAT OTHER TYPE OF SERVICE I'M
GONNA. YOU KNOW BILL UNDER
MHSAA.
DIFFICULT FOR US BECAUSE THE
CLEANING FOR ANY TO SAY DOESN'T
COME THROUGH US RIGHT WE'RE NOT
AUTHORIZING CLAIMS BUT WE
AUTHORIZE AMONG THE MENTAL
HEALTH.
SHORT DOYLE SYSTEM FOR MEDICARE
ALSO. YOU KNOW I THINK WHEN YOU
LOOK AT OUR PERFORMANCE OUTCOMES
SYSTEMS DATA. I THINK THAT.
ADULT POPULATION GETTIN
RECEIVING SPECIALTY MENTAL
HEALTH SERVICES IS SOMEWHERE
BETWEEN FOUR HUNDRED FIFTY FIVE
HUNDRED THOUSAND INDIVIDUAL
STATEWIDE.
I'M NOT SURE WHAT THE CHILDREN
IS OFF THE TOP OF MY HEAD BUT I
MEAN WE'RE HAPPY TO PROVIDE YOU
THAT DATA SO THE POPULATION
ITSELF IS FAIRLY STEADY FROM
YEAR TO YEAR IN TERMS OF WHO IS
ACCESSING SPECIALTY MENTAL
HEALTH SERVICES. AND THEN WHAT'S
IT BEEN INTERESTING AS THE
ADDITION OF THE MILD TO MODERATE
SERVICES ON THE MEDICAL MANAGED
CARE SITE HAS BEEN INCREASING
THE LONGER THAT THE BENEFIT HAS
BEEN IN PLACE THE MORE THAT
PEOPLE KNOW ABOUT IT. PROVIDERS
ARE REFERRING AND OR PEOPLE ARE
CONTINUING TO SEEK. ONGOING
TREATMENT WHICH I THINK IS A
POSITIVE.
ALL RIGHT. AWFUL FLU THAT WAS
ALSO GOOD SEGUE TO I AND NUMBER
TWO WHICH IS ISSUE NUMBER TWO IS
THE MENTAL HEALTH SERVICES
DIVISION OF.
POLICY IMPLEMENTATION I KNOW
THERE'S A BUDGET REQUEST THERE.
HER.
SO THERE ARE THREE REQUESTS
WITHIN A SINGLE REQUEST.
LAST YEAR THERE WAS ON FUNDING
THAT WAS PROVIDED.
FOR IMAGES A PROGRAM MONITORING
SO THIS THE.
LEGISLATURE IN THE
ADMINISTRATION IN THE BUDGET
ACT.
PROVIDED OF HALF A MILLION
DOLLARS.
THROUGH THE A. B. SIXTEEN
TWENTY TWO WHICH WAS THE BUDGET
BILL.
THE POSITIONS WERE NOT
AUTHORIZED TO WE GOT THE MONEY
BUT NOT THE POSITION OF THIS
PROPOSAL IS JUST MERELY TO
ESTABLISH THOSE FOUR POSITIONS.
AND THEN THE OTHER TWO
COMPONENTS OF THIS PROPOSAL OUR
FUNDING TO IMPLEMENT.
EIGHTY FIVE OH ONE BY MR RIDLEY
THOMAS THIS IS FOR.
CRISIS UNITS WITHIN THE PAST
YEAR TEEPEES AND THEN THERE IS
SOME.
EXTERNAL QUALITY REVIEW
ORGANIZATION CONTRACT DOLLARS WE
NEED TO EXPAND OUR EQ RO
CONTRACT IN THE MENTAL HEALTH.
ARENA TO GO AND DO ADDITIONAL
WORK RELATED TO THE MANAGED CARE
ROLE AND SO WE COMBINED ALL OF
THOSE REQUESTS INTO ONE THAT IS
BEFORE YOU TODAY AND THAT
REQUEST FOR THE EXTERNAL
CONTRACTING IS ABOUT. TWO
HUNDRED AND TWENTY TWO AND
TWENTY TWO THOUSAND DOLLARS IN
GENERAL FUNDS WITH MATCHING
FUNDS AS WELL.
OKAY COMES FROM MALAYO. FINANCE.
OKAY QUESTIONS.
IN THE.
AS FAR AS THE.
.
THE EQ ARE OF THE EXTERNAL
QUALITY REVIEW ORGANIZATION.
SO IS THAT TO HELP HER UP.
PROVIDE REPORTS FOR.
THE FEDS AS WELL AS FOR US I
MEAN IT LOOKS LIKE THEY'RE THERE
AND THEY NEED TO GO AND BUY THIS
WHOLE DATA DOESN'T THIS IS
SPECIFIC AROUND.
THE THEY'RE ALREADY DOING WORK
FOR US IN RELATION TO THE
MANAGED CARE ROLE THIS IS FOR
MENTAL HEALTH SERVICES TO MINOR.
NON MINOR DEPENDENCE IN FOSTER
CARE SO WE'RE ADDING THAT
ELEMENT THAT IS IN RELATION TO
CC ARE SO WHEN THE EQ RO IS OUT
IN THE COUNTIES AND PULLING
CHARTS. THERE ARE ADDITIONAL
ELEMENTS THAT WE WILL HAVE THEM
DOING CHART REVIEW ON IT SO THIS
FUNDING IS TO ADDRESS THAT
ADDITIONAL CONTRACTING NEED.
OKAY.
ALL RIGHT AND IN TERMS OF THE
MINERS IN THE HEALTH PLANS I WAS
AS A RESULT OF A B. TWELVE
NINETY ONE.
.
A SHIP THOSE REPORTS ARE COMING
OUT YET.
IT'S FROM THE EQ ARE SO YOU SAID
THIS IS FUNDING REQUESTS FOR
ADDITIONAL WORK BUT THESE TERMS
OF THE WORK THAT THE TWO ARE US
SHOULD BE CURRENTLY DOING.
WE HAVE A BUREAU REPORTS I'M I'M
NOT SURE WHEN THE LAST ONE WAS
ISSUED IF IT'S ON A FISCAL YEAR
BASIS SERVICE ON A CALENDAR YEAR
BASIS BUT I CAN. I CAN CERTAINLY
LOOK AT THE LAST SET OF FEATURE
A CONTRACT. REPORTS THAT WE HAD
FROM THEM OKAY THERE USE THE
MOSTLY FOR OUR OWN INTERNAL.
STATE USE THEIR POSTED PUBLICLY
SHARED PUBLICLY AND I THINK WE
PROVIDE THEM TO THE FEDERAL
GOVERNMENT BUT MORE AS A
COMPLIANCE ISSUE TO JUST TO
DEMONSTRATE THAT WE ARE. BOTH
CONTRACTING WITH ANNE CARO AND
THAT THEY'RE DOING THE WORK THAT
IS REQUIRED UNDER THOSE
CONTRACTS. BUT I THINK ONE OF
THE THINGS AND YOU FOR YEARS
THROUGHOUT THE HEARING IS WE'RE
TRYING TO GET OUR ARMS AROUND.
BE ABLE TO. TERMS OF
ACCOUNTABILITY FOR WHAT'S GOING
ON AT ALL THERE IS MENTAL HEALTH
PLANS AND AND AND BE ABLE TO
ACTUALLY INFORM THE PUBLIC.
WHERE THE DOLLARS ARE GOING AND
AND AND WHAT DIFFERENCE IT'S
MAKING SO?
SO THAT'S WHY AND I NOTE THAT
THE ORIGINAL BILL THAT LED TO
THAT TWENTY SIXTEEN ODDS. TO
SNOWING SPACE GOVERNMENT
SOMETIMES YOU KNOW YOU GET THE
BILL WE GOT THE MONEY THAT SET
OF HEAVY START GAME REPORTS YET.
FROM THE BUREAU AND CERTAINLY
WOULD BE. INTERESTED IN LOOKING
AT THE AT THE RESULTS AND ALSO
IN ITS ASSESSMENT OF THE. HEALTH
OF SERVICE IN TERMS OF OKAY NOW
YOU ARE SAYING GET THE REPORTS
HOW DO YOU FEEL THE PERFORMANCES
IS KNOWN TO HAVE MINIMUM
PERFORMANCE STANDARDS THAT WERE
EXPECTING AND WHAT WE DO FOR.
THE MENTL HEALTH PLANS THAT
AREN'T QUITE MEETING THE
COUNTY'S MIGHT BE A LITTLE
BEHIND YOU WHAT CAN WE DO TO BE
SURE THAT THERE.
WE WE CERTAINLY HAVE THE
TRIBUNAL REVIEWS THAT WE ALSO DO
ON THE COUNTY'S AT THE
DEPARTMENT LEVEL.
AND THE WORLD OF.
QUALITY METRICS IS NOT QUITE
CAUGHT UP ON THE BEHAVIORAL
HEALTH SIDE OF THE WAY IT IS ON
THE MANAGED CARE SIDE THAT
YOU'RE MORE. FAMILIAR WITH AND
SO THE NUMBER OF HE DISCOURSE
AROUND BEHAVIORAL HEALTHCARE
FAIRLY LIMITED THERE IS
DISCUSSION AT THE FEDERAL LEVEL.
AS RECENTLY AS THIS WEEK AROUND
I'M REQUIRING ALL STATES REPORT
ON EVERY SINGLE BEHAVIORAL
HEALTH HE TO SCORE I'M IN THEIR
STATE MEDICAID PROGRAMS AND SO I
THINK THE INTEREST IS NOT ONLY
HERE AT THE STATE. LEVEL BUT
OBVIOUSLY AT THE FEDERAL LEVEL
GIVEN THE IMPORTANCE OF BOTH
BEHAVIORAL HEALTH BUT THEN BOTH
SUBSTANCE USE AND MENTAL HEALTH
ALMOND THE CO OCCURRING
DISORDERS.
ALL RIGHT.
QUESTIONS OKAY OF PUBLIC
COMMENTS ON ISSUES THE OVERVIEW.
HEALTH AND ALSO THE.
BUT REQUEST SO WELCOME.
STRONG SUPPORT FOR THIS
COMMITTEE PROVIDING ADDITIONAL
RESOURCES AND PERSONNEL TO THE
DEPARTMENT OF HEALTH CARE
SERVICES PARTICULARLY IN THE
MENTAL HEALTH SERVICES DIVISION
WHERE THEY'RE VERY MUCH NEEDED
TO ENSURE THAT THE COUNTY MENTAL
HEALTH PLANS HAVE. ACCESS TO
TIMELY AND ACCURATE.
INSTRUCTION AND TO BE ABLE TO
HAVE THEM BE ABLE TO RESPOND TO
THE MANY FEDERAL.
AND STATEWIDE POLICY ISSUES
THAT WE'RE ALL CUT COPING WITH
IN THE MEDICAL SYSTEM THANK YOU.
THANK YOU.
OKAY.
EVERY SALTER ASSOCIATION OF
COMMUNITY SERVICE AGENCIES IT'S
TIME TO TALK ABOUT THE
PERFORMANCE OUTCOMES SYSTEM OR
IS IT COMING LATER.
.
THAT SENTENCE.
I GUESS YEAH YEAH YEAH YEAH YES
YES YES IS NO GOOD.
OUR ASSOCIATION OPPOSES THE HHS
MANDATING THE USE OF THE COUNTS
FOR OUTCOME MEASUREMENT.
AS YOUR COUNTERPART MENTAL
HEALTH AGENCIES IN MONTEREY
COUNTY.
DHS CONTINUES TO IGNORE THE
FINDINGS OF ITS HIRED EXPERTS
FROM UCLA.
WHO DETERMINED THAT ONLY THE PSE
THIRTY FIVE MET ALL ESTABLISHED
CRITERIA ALL THE CANS WAS QUOTE
NOT RECOMMENDED FOR OUTCOME
MEASUREMENT?
BLASTER DTS TOLD THE LEGISLATURE
THAT IT SELECTED THE PSE THIRTY
FIVE. AND THE CANS TO MEASURE
CHILDREN'S MENTAL HEALTH
OUTCOMES QUOTE AFTER A STUDY OF
THE FUNCTIONAL ASSESSMENT TOOLS.
AND A RECOMMENDATION BY UCLA.
THE H. YES LET THE LEGISLATURE
TO BELIEVE THAT UCLA HAD
SUPPORTED THE USE OF THE CANS
FOR THIS PURPOSE. WHEN THE EXACT
OPPOSITE WAS TRUE.
IN FACT YOU STILL I FOUND THE
CANS THAT ONLY FOUR OF NINE
MINIMUM CRITERIA.
EFFECTIVENESS OF CARE. AND NINTH
OF ELEVEN ON SCIENTIFIC
ACCEPTABILITY.
IT ALSO FOUND THAT TWENTY TWO OF
THE THIRTY THREE COUNTIES USING
THE CANS. HAD EXPERIENCED A
PROBLEM WITH THE TOOL WITH OVER
HALF OF THOSE HAVING PROBLEMS
WITH ITS ACCURACY OR
RELIABILITY.
DCS PROJECTED SIXTEEN MILLION
DOLLAR COST FOR MANDATING BOTH
THE CANS AND THE PSE THIRTY
FIVE.
FALLS FAR SHORT. AS BOTH LA IN
ORANGE COUNTY'S ALONE PROJECT
OVER A HUNDRED MILLION DOLLARS
FOR IMPLEMENTING JUST THE CANS.
FINALLY OUR CANS CONCERNS HAVE
BEEN SHARED BY THE CALIFORNIA
BEHAVIORAL HEALTH DIRECTORS
ASSOCIATION. WE URGE YOU TO
OPPOSE THE CANS MANDATE AND
THANK YOU FOR CONSIDERATION
THANK YOU.
YOU MISTER CHAIR AND MEMBERS
FARMER DATING ON BEHALF OF THE
CALIFORNIA STATE ASSOCIATION OF
COUNTIES REPRESENTING ALL FIFTY
EIGHT COUNTIES IN CALIFORNIA. I
AM I WAS UP HERE TO TESTIFY IN
SUPPORT OF ISSUE TO THE.
EMPLOYEE REQUESTS BY DEPARTMENT
HEALTH CARE SERVICES FOR THE
REASONS ALREADY STATED I DO ALSO
WANT TO ADD ON.
OUR SUPPORT FOR THE
IMPLEMENTATION OF THE CANNED
SYSTEM BOTH DH CS AND DS AFTER
IMPLEMENTING THAT SYSTEM AND IT
IS RELATED TO CC ARE AND HOW WE
SHARE INFORMATION ABOUT FOSTER
CHILDREN. SWORD STRONG SUPPORT
AND DH HAS HAD A ROBUST
STAKEHOLDER PROCESS FOR THE CANS
IMPLEMENTATION THANK YOU.
THANK YOU.
WELCOME.
I REMEMBER THIS AFTERNOON ARMY
GENERAL THAT'S WHAT THE
STEINBERG INSTITUTE ARE WE ARE
HERE IN SUPPORT OF SELECTION OF
THE PS AS SEAT THIRTY FIVE AS A
SINGLE TOOL TO BE USED. BASED ON
THE UCLA REPORT FROM AUGUST TWO
THOUSAND SEVENTEEN. THE REPORT
STATED THAT THE PSC THIRTY FIVE
WAS THE ONLY TOOL THAT PASSED
ALL THE MINIMUM CRITERIA THAT
WAS DETERMINED.
TO BE THE BEST SUITED FOR
MONITORING AND THE EFFECTIVENESS
OF THE PUBLICLY FUNDED CHILD
MENTAL HEALTH CARE.
YOU HAVE HEARD. ABOUT CANS AND
WE ARE HERE TO SAY THAT CANCER
IS A GOOD TOOL HOWEVER THECANS.
WAS NOT DESIGNED TO MEASURE
OUTCOMES AND HAS NOT BEEN
VALIDATED FOR THAT USE.
EXAMINING AND REPORTING OUTCOMES
IS A SIGNIFICANT AND ESSENTIAL
UNDERTAKING THAT MUST BE DONE
RIGHT.
WE NEED TO ENSURE THAT FUNDING
IS USED WISELY AND AGAIN BASED
ON THE FINDINGS OF ONE OF OUR
STATE'S MOST HIGHLY REGARDED
UNIVERSITIES UCLA. THERE'S NO
QUESTION THAT THE CANCER WILL
NOT ACHIEVE THE LEGISLATIVE
LEGISLATIVELY MANDATED COAL.
THANK YOU THANK YOU.
WELCOME.
MY NAME IS DAVID HAZARD A MSW
PROGRAM EVALUATOR WITH VICTOR
FAMILY SERVICES WHERE A.
STATEWIDE NONPROFIT CONTRACT
WITH MOST CALIFORNIA COUNTIES.
WE SERVE ROUGHLY SEVEN THOUSAND
CLIENTS AND FAMILIES EACH YEAR
CROSS MENTAL HEALTH WRAPAROUND
FOSTER CARE IN RESIDENTIAL CARE
PROGRAMS.
I'M HERE IN SUPPORT OF THESE THE
CANS WE'VE BEEN USING CANCER
OVER A DECADE. YEAH IT'S FULLY
INTEGRATED CORE COMPONENT OF OUR
PRACTICE FOR SESAME STREET IN
PLANNING AND IT'S NOT COMES TO.
ON A SYSTEM LEVEL OUR COUNTIES
REGULARLY REQUIRE CANS
MEASUREMENTS AT AS CONTRACT
OUTCOME GOALS INCLUDING SAN
BERNADINO SAN JOAQUIN CINEMA AND
HOW MANY COUNTIES.
GRAHAM LEVEL USE THE CANS
INTERNALLY TO IDENTIFY AREAS OF
STRENGTH AND GROWTH AMONG OUR
CLINICAL STAFF AS WELL AS TO
CONTINUOUSLY EVALUATE THE
EFFECTIVENESS OF OUR PROGRAMS.
AND ON AN INDIVIDUAL LEVEL OUR
CLIENTS AND FAMILIES REPORT
LOVING. HOW THE CANS
COMMUNICATES THEIR SUCCESS FOR
THEIR A DECREASE IN FUNCTIONAL
IMPAIRMENT? AND MEETING THEIR
GOALS THANK YOU.
THANK YOU.
WELCOME.
THANK HOUSING KNIFE INSIDE LIKE
A FAMILY OF AGENCIES. CYNIC HAS
ONE OF THE LARGEST MENTAL HEALTH
SERVICE PROVIDERS IN THE STATE
OF CALIFORNIA. WE ARE PROUD TO
BE AN EARLY ADOPTER THE CANS
WHICH WE INTEGRATE INTER AGENCY
WIDE ASSESSMENT TOOL IN TWO
THOUSAND SEVEN. ACCOUNTS
REPRESENTS A WAY TO STANDARDIZE
COMMUNICATION AROUND THE
STRENGTHS AND NEEDS OF CHILDREN
AND FAMILIES AS WELL TO
UNDERSTAND THE AREAS OF GROWTH
FOR DIRECT CARE STAFF AND OUR
PROGRAMS AS A WHOLE. AS A
CLINICIAN AND THE DIRECTOR OF
QUALITY IMPROVEMENT I CAN ATTEST
TO THE IMPORTANCE OF THE CANS
AND BOTH MONITORING TREATMENT
GOALS FOR CLIENTS AND EVALUATING
NOW COMES VERY AGENCY. ABOVE ALL
SENECAS IN SUPPORT OF A SINGLE
CONSISTENT ASSESSMENT TOOL
ACROSS THE STATE. WE SUPPORT THE
STATEWIDE ADOPTION OF THE CANS.
THANK YOU THANK YOU.
WELCOME.
HI EVERYONE.
DOCTOR VARMAS FARMAN CLINICAL
PSYCHOLOGIST AND ASSISTANT
DIRECTOR OF THE CHILDREN YOUTH
FAMILY SYSTEM OF CARE BEHAVIORAL
HEALTH AT THE SAN FRANCISCO
DEPARTMENT OF PUBLIC HEALTH.
THE CITY COUNTY OF SAN FRANCISCO
HAS BEEN SUCCESSFULLY USING THE
CANS FOR ABOUT A DECADE. ACROSS
ALL OF OUR YOUTH AND BEHAVIORAL
HEALTH SERVICES. AND WE SUPPORT
THE IMPLEMENTATION OF THE CANS
ACROSS CALIFORNIA. WE'VE BEEN
DOING INNOVATIVE WORK WITH THE
CANS IN SAN FRANCISCO. MY
DEVELOPING MEANINGFUL OUTCOME
REPORTS ON THE CANS AT THE
SYSTEM PROGRAM AND CLIENT LEVEL
AND ENGAGING PROGRAMS AND
PROVIDERS IN A PROCESS TO
REFLECT ON THEIR DATA THROUGH AN
INITIATIVE CALLED DR. DATA
REFLECTION TO IMPROVE INVITE
ALLIES EFFECTIVENESS WHICH WAS
RECENTLY RECOGNIZED WITH AN
AWARD BY THE SAN FRANCISCO
MAYOR'S OFFICE.
THESE REFLECTIONS HAVE LED THE
SYSTEM AND PROGRAMS IN OUR
SYSTEM TO LINK DATA TO PRACTICE
AND DEVELOP PLANS FOR TRAININGS
AND INTERVENTIONS WE WANT TO
IMPLEMENT TO BETTER SUPPORT THE
FAMILIES IN OUR CARE. ULTIMATELY
NO ONE TOOL IS PERFECT IT IS
ABOUT TRIANGULATED DATA FROM THE
CANS WITH OTHER OUTCOME TOOLS OR
CULTURING CONTEXTUALLY RELEVANT
CLINIC FULL INFORMATION. TO
UNDERSTAND FAMILIES REFLECTING
ON WHAT THIS COLLECTIVE DATA
MEANS AND USING THIS
UNDERSTANDING TO IMPROVE
CLINICAL. PRACTICE AND TREATMENT
OUTCOMES THANK YOU THANK YOU.
HI GOOD AFTERNOON MY NAME IS
SHERRY TO STAND ON THE SENIOR
DIRECTOR OF SOCIAL SERVICES AND
HOW THEIR CHILDREN FAMILY
SERVICES WE DO BOTH BEHAVIORAL
HEALTH. AND SOCIAL SERVICES
THERE I'M HERE TO TALK ABOUT WHY
THE CANS IS IMPORTANT TO ME I
IT'S BEEN IN OUR AGENCY FOR THE
LAST COUPLE OF YEARS AND WE'VE
SINCE SUCCESSFULLY IMPLEMENTED.
THE CANS IS A LIFE TO WHICH HAS
EVOLVED WITH OUR AGENCY AS WE
HAVE EXPANDED OUR PRACTICE IN
SCOPE IN OUR COMMUNITY PRIOR TO
CANCER TREATMENT PLANS CONSISTED
OF GENERIC COOKIE CUTTER ONE
SIZE FITS ALL FORMAT. TODAY WITH
THE CANS OF.
OUR PLANS RESPECT THE UNIQUENESS
OF EACH INDIVIDUAL CHILD AND
FAMILY MEASURING NOT ONLY THEIR
NEEDS BUT ALSO CELEBRATING THEIR
SUCCESSES AS WELL. THIS TOO HAS
ALSO ASSISTED OUR ENTIRE AGENCY
TO RETHINK.
HOW WE LOOK AT OUTCOMES AND
PERFORMANCE IN SUCH A MORE
MEANINGFUL AND? IMPACTFUL
MANNER.
THIS IS A HOLISTIC VALID
RELIABLE AND POWERFUL TOOL. ON
THAT HAS ENHANCED OUR SERVICE TO
OUR COMMUNITY IN WAYS THAT I
CANNOT IMAGINE I HAVE WITNESSED
OUR STAFF BE RE INSPIRED AS THEY
ARE SEING POSITIVE CHANGE. IN
THEIR ONCE VERY HARD TO REACH
YOU. OUR RESEARCH PARENTS ARE
WATCHING THEIR VERY HER CHILDREN
START HEALING AS THEY
PARTICIPATE AS AN INTEGRAL AND
INFORMED MEMBER OF THE CHILD AND
FAMILY TEAM.
I'VE ALSO CELEBRATED WITHOUT
ONCE LABELED NOT ADOPTABLE TEEN
AND FIND THEIR FOREVER HOME TO
ADOPTION AND THAT WAS AFTER WHAT
WE'VE SEEN. EXCITED TO SEE WHERE
THE CANS WILL TAKE US AND I'M
HOPING TO CONTINUE TO WORK WITH
THANK YOU. THANK YOU.
WELCOME SIR BARLOW ON BEHALF OF
THE COUNTY BEHAVIORAL HEALTH
DIRECTORS ASSOCIATION SINCE THE
TIME WE LEARNED THAT THE
DEPARTMENT HAD SELECTED THE CANS
FOR THIS HIGH PERFORMANCE
OUTCOMES SYSTEM. WE ENTERED INTO
SOME PRETTY A ROBUST
CONVERSATIONS ABOUT HOW TO MAKE
THAT A FEASIBLE IMPLEMENTATION
WE'RE VERY PLEASED THAT THEY
WERE AMENABLE TO TO THE
RECOMMENDATIONS WE MADE ONE TO
DELAY THE IMPLEMENTATION TO A
MORE FEASIBLE DATE. AS WELL AS
TO NOT REQUIRE IT TO BE.
ADMINISTERED AS FREQUENTLY AS
ORIGINALLY PROPOSED HOWEVER WE
HAD HOPED THAT FOR SOME COUNTIES
WHO'VE INVESTED SUBSTANTIAL
TAXPAYER DOLLARS INTO AN
ALTERNATIVE ASSESSMENT TO TOOL
AND OUTCOMES SYSTEM FOR CHILDREN
IN THEIR SYSTEM. BUT THOSE
COUNTIES MIGHT BE ABLE TO BE
GIVEN THE OPPORTUNITY TO APPLY
TO THE DEPARTMENT FOR AN
ALTERNATIVE TOOL TO BE USED SO
LONG AS THAT DATA COULD STILL
BE.
INCLUDED IN A STATEWIDE LOOK AT
WHAT COUNTIES ARE DOING THANK
YOU.
THANK YOU WELCOME HI MY NAME IS
JAN CAR THAN US AND I'M A
LICENSED CLINICAL SOCIAL WORKER
FORMER QUALITY IMPROVEMENT
DIRECTOR AND CURRENT
FACILITATOR.
OF THE ALAMEDA COUNTY CANS
PROVIDER COLLABORATIVE.
I AM HERE TODAY TO EXPRESS
STRONG AND UNWAVERING SUPPORT OF
THE CANS AS THE STATE WIDE
OUTCOME EVALUATION TOOL FOR
CHILD WELFARE AND MENTAL HEALTH
SERVICES. IN MY NEARLY TWENTY
YEARS OF MENTAL HEALTH WORK I'VE
NEVER ENCOUNTERED AN OUTCOME
MEASURE. INCREASED EFFICIENCY OF
CARE COORDINATION AND ENHANCED
TREATMENT FOR CHILDREN AND
FAMILIES LIKE THE CANS DOES I
PERSONALLY USE THE CANS FOR OVER
TWELVE YEARS AND I'VE SEEN IT
WORK WONDERS. TOOLS AFFORDABLE
EASY TO UNDERSTAND FOR CHILDREN
AND FAMILIES AND ALIGNS WITH THE
VALUES OF CC ARE THE H. CS AND
CSS. I BELIEVE THE USE OF A
COMMON POOL ACROSS THE CHILD
WELFARE AND MENTAL HEALTH
SYSTEMS IN CALIFORNIA IS
CRITICAL TO ENABLING
TRANSFORMATION IN THE LIVES OF
CHILDREN AND FAMILIES THANK YOU
FOR YOUR TIME. THANK YOU.
THANK YOU WOKE UP WELL FROM THE
CALIFORNIA LINES
OF CHILD AND FAMILY SERVICES.
ALSO A LICENSED AND PRACTICING
CLINICAL PSYCHOLOGIST FOCUSING
ON KIDS AND FAMILIES. I'M AS YOU
CAN TELL FROM THE PEOPLE BEFORE
ME THE DEBATE ABOUT THE CANS IS
CONTINUING THIS I'VE BEEN ON THE
PERFORMANCE OUTCOMES SYSTEM AS A
SUBJECT MATTER EXPERTS SINCE TWO
THOUSAND TWELVE THIS THE SAME
KIND OF CONVERSATION WE'VE HAD
THEIR. EYE WEAR VERY HAPPY THE
DHC HAS HAS FINALLY MADE A
DECISION SO THAT WE CAN MOVE
FORWARD AND ACTUALLY HAVE A
STATEWIDE TOOL. AND AS I AM A
STRONG SUPPORTER OF THE CANS OUR
ORGANIZATION IS VERY HAPPY AND
PLEASED WITH THE DECISION THAT
WAS MADE. I JUST WANT TO TOUCH
ON ONE OTHER THING. WITH
DIRECTOR CAN'T WILL PROBABLY
KNOW WHEN I'M READY TO SAY SO
THE E. IMS.
THE ENTITLEMENT FOR CHILDREN IS
VERY DIFFERENT FROM THE MEDIC
HOW ENTITLEMENT FOR ADULTS AND
LEVEL OF SEVERITY OF NEED IT
DOES NOT ENTER INTO THE
CONVERSATION SO WHEN THE
CONVERSATIONS ABOUT MILD
MODERATE SEVERE. THAT IS NOT TO
THE ENTITLEMENT FOR CHILDREN TO
BE ABLE TO OBTAIN SPECIALLY
MENTAL HEALTH SERVICES IF THEY
HAVE A FUNCTIONAL IMPAIRMENT IT
IS ENTITLEMENT THAT THEY GET THE
SERVICES THEY NEED. IS NOT A
CAPPED ENTITLEMENT THANK YOU.
THANK YOU.
APPRECIATE YOU POINT THAT OUT I
THERE MY NAME IS A DOCTOR KAREN
DRESSER AND I WORK WITH STARS BE
REAL HEALTH GROUP IS THE
DIRECTOR OF RESEARCH AND PROGRAM
PRACTICES I'VE BEEN INVOLVED
WITH. PROGRAM EVALUATION FOR
THIRTY YEARS.
START FAVOR HEALTH GROUP
CURRENTLY USES THE CANS PER OUR
CONTRACTS ACROSS SIX DIFFERENT A
CALIFORNIA COUNTIES INCLUDING
SACRAMENTO. WE SERVE ABOUT
TWENTY THOUSAND CHILDREN YOUTH
AND FAMILIES HERE.
OUR EXPERIENCE IS THAT IT IS
RARELY EFFICIENT AND THAT IT IS.
PREDICTED NOT SATISFACTORY FOR
AN OUTCOME MEASUREMENT TOOL OUR
DIFFICULTIES INCLUDE SECOND
GUESSING ABOUT HOW TO BEST
COMPILE AND INTERPRET THE
RESULTS GIVEN THE KNOWN
PSYCHOMETRIC ISSUES. OF
RELIABILITY AND VALIDITY AS AN
OUTCOME TOOL.
YOU KNOW SAME PEOPLE HAVE BEEN
USING THE CAMPS FOR OUTCOMES AND
PUBLISHED STUDIES USING IT IS
NOT THE SAME AS CARRYING OUT THE
BASIC PSYCHOMETRIC TESTS. OF A
TOOL IN TERMS OF ITS RELIABILITY
AND VALIDITY.
YOU MAY RECALL FROM YOUR HISTORY
LESSONS THAT BEFORE SIXTEEN
HUNDREDS GALLOWAY OWN EVEN
FURTHER BACK TO THE* WRIST
PEOPLE USED ALL SORTS OF TOOLS
AND MEANS. TO SPY THE HORIZON OF
THE KNOWN FLAT UNIVERSE. THE
EARTH BEFORE IT WAS DEMONSTRATED
IN FACT USING SCIENCE TO THIS
SPHERICAL. SO THERE IS
ENTRENCHED CANCELED SCHISM OF
SELF RICHER REFERENTIAL QUALITY
IN THE ARGUMENT THAT BECAUSE IT
IS BEING USED IT IS IN FACT
RELIABLE AND VALID.
OF THE DC HSS OWN STUDY UCLA
SHOWED THAT IT WAS NOT A GOOD
TOOL FOR MEASUREMENT. OF
PERFORMANCE OUTCOMES THANK YOU.
THANK YOU.
WELCOME. AFTERNOON MY NAME IS
DEBBIE MANNERS I'M ALSO A
LICENSED CLINICAL SOCIAL WORKER
AND I'M THE PRESIDENT CEO. THAT
HELP WITH SICK MORE SADDAM
FAMILY SERVICES WERE THE LARGEST
CHILDREN'S MENTAL HEALTH
PROVIDER. IN LOS ANGELES COUNTY
AND WE ALSO HAVE AN SD RTP.
SO I WANT TO MAKE IT CLEAR THAT
OUR ORGANIZATION IS IN SUPPORT
OF THE CANS. AS AN ASSESSMENT
TOOL IN FACT.
WE THINK IT IS A VALUABLE TOOL
IN TERMS OF ASSEMBLING THE CHILD
AND FAMILY TEAM TOGETHER AND
HEARING ALL PERSPECTIVES AROUND
ASSESSMENT PLANNING. BUT WE HAVE
BEEN USING THE CANS FOR MANY
MANY YEARS AS WHAT WAS
CONTRACTED FROM LA COUNTY FOR
RBS AND WRAP AROUND. AND WE
FOUND IT AS AN OUTCOME TOOL TO
BE MEANINGLESS PARTICULARLY IN
WRAPAROUND. AN RBS SO.
THERE'S A LOT OF OPPOSITION.
ABOUT THE USE OF THE CANS AS AN
OUTCOME MEASUREMENT LEADS AND
THERE ARE AT LEAST EIGHT OTHER
COUNTIES BESIDES LOS ANGELES
THAT HAVE EXPRESSED SERIOUS
OBJECTION TO THE CANS. INCLUDING
FRESNO ORANGE CALAVERAS MODERATE
NAPA SAN DIEGO SAN LUIS OBISPO
AND SANTA BARBARA. NAPA WAS HERE
TESTIFYING ON MONDAY THAT THEY
ABANDON THE CANS. I IN TWENTY
FOURTEEN AFTER IMPLEMENTATION
PROBLEMS AND FINDING THAT IT DID
NOT AND. PRODUCE INFORMATION
THAT WAS VALUABLE TO THEM.
SO I JUST REALLY WANT YOU TO BE
SURE THAT YOU MAKE THE RIGHT
DECISION THERE'S A LOT AT STAKE
HERE HUNDREDS OF MILLIONS OF
DOLLARS. HUNDREDS OF LOST
SERVICE TIME AND I WOULD
RECOMMEND. THAT YOU REALLY
CONSIDER NOT MANDATING THIS TOOL
IT'S NOW COULD MEASURE THING.
AND IT'S JUST SO I KNOW WE HAVE
MORE PEOPLE WORK AT.
I DON'T BELIEVE THAT IS IN. THE
BUDGET LANGUAGE.
RIGHT NOW OKAY THIS JUST MIGHT
BE VERY CLEAR AND SELF OKAY YES.
BOOKHAM. GOOD AFTERNOON MY NAME
IS DOCTOR WILLIAM ARROYO I AM
MEDICAL DIRECTOR FOR CHILDREN'S
MENTAL HEALTH SERVICES FOR LA
COUNTY DEPARTMENT ALL HEALTH.
AND ASSISTANT CLINICAL PROFESSOR
AT KICK USC SCHOOL OF MEDICINE.
AND I HAVE SERVED AS A VISOR TO
A NUMBER OF NATIONAL RESEARCH
CENTERS ON CHILDREN'S MENTAL
HEALTH.
ALTHOUGH LOS ANGELES COUNTY
DEPARTMENT OF MENTAL HEALTH IS
SUPPORTIVE OF MEASURING THE
TREATMENT OUTCOMES FOR PERFECT
FOR SERVICES THAT ARE PUBLICLY
FUNDED. LA COUNTY DEPARTMENT OF
MENTAL HEALTH OPPOSES THE D.
EIGHT CCS MANDATE. TO USE THE
CAN FOR THIS PURPOSE.
I WAS A MEMBER OF THE
INDEPENDENT EXPERT PANEL.
CONVENED BY UCLA.
ON BEHALF OF THE EIGHT CCS.
WHICH FOUND THE CANS TO BE. NEAR
THE BOTTOM OF THE ELEVEN TOOLS
THAT WERE REVIEWED.
IN AREAS OF OVERALL UTILITY AND
ITS SCIENTIFIC ACCEPTABILITY FOR
THIS PURPOSE.
THE OSTENSIBLE RATIONAL.
THAT IS GIVEN BY DH CS FOR
SELECTING THE CANS REMAINS
BAFFLING TO OUR DEPARTMENT.
IN ADDITION TO THIS. MANDATE ARE
WE ARE VERY CONCERNED ABOUT HOW
LABOR INTENSIVE ITS USE AS A
WHICH WE BELIEVE WILL DECREASE
THE NUMBER OF. SERVICES THAT WE
CAN PROVIDE TO KAT CLIENTS THAT.
SEEK OUR HELP. THROUGH OUR
DEPARTMENT WE CONSIDERED A MAJOR
ADMINISTRATIVE BURDEN.
IT'S ALREADY BEEN MENTIONED WHAT
THE ECONOMIC IMPACT WOULD BE.
SO I AM ASKING.
DHC HAS TO WITHDRAW THIS
MANDATE THANK YOU THANK YOU.
AGAIN I. WILL TRY TO KEEP THEM
THERE IS AMPLE ARE MY NAME IS
JOHN LINES I'M THE ORIGINAL
DEVELOPER OF THE CANS ON.
AND I JUST WANNA DO A WAY I'M
EXCITED ABOUT THE THE WORK THAT
CALIFORNIA'S DOING THE CANS AS
YOU IT'S A COMING OF METRIC
MEASURE IT SAY. ON ATTEMPTED TO
PERSON CENTERED CARE SO IT'S A
LITTLE BIT DIFFERENT RATES SOME
CONTROVERSY SO.
IT'S NOT PSYCHOMETRIC IT'S
COMING TO METRIC M. SO IT'S SORT
OF LIKE WHEN YOU TAKE A
PSYCHOMETRIC TOOLS.
MEASUREMENT CHARACTERISTIC IS
LIKE COMPARING A. AUTOMOBILE ON
A PLANE.
SO IF YOU TAKE LIKE THE UCLA
STUDY DEAD OF YEARS AGO THE
AUTOMOBILE IF YOU BUY THAT THE
PLANE IS A WELL THAT'S A PRETTY
CRAPPY.
AUTOMOBILE BUT IT'S NOT A PLANE
TO A PLANE CAN GET YOU. WESTERN
FURTHER BECAUSE IT'S DIFFERENT
SO PSYCHOMETRIC THEORY WAS
DEVELOPED BEFORE COMPUTERS
EXISTED.
RIGHT SO YOU KNOW AS YOU KNOW
AND YOU'RE I THINK YOU'RE A
PHYSICIAN THAT'S CLINTON METRICS
AS A WAY THAT PEOPLE MOVED IN
AND OUT MEDICINE AND SO THIS IS
ACTUALLY COMING OUT OF PLANNING
METRICS IS A DIFFERENT WAY OF
THINKING ABOUT INFORMATION. USE
STATEWIDE IN THIRTY SIX
DIFFERENT STATES TOM.
THE FIRST ONE IS IN BAY RALPH
WAS NEW JERSEY HOW THEY HAVE.
CAUSES OF USING THIS APPROACH
THEY'VE EXPANDED THE NUMBER OF
KIDS IN CARE BY.
THREE TIMES WHILE THEY REDUCED
THE NUMBER OF KIDS OUT OF
COMMITTEE BY ONE THIRD. IT
REDUCED THE NUMBER OF DETENTION
CENTERS BY ONE THIRD LIVE CLOSE
OR PSYCHIATRIC HOSPITAL SABAKI.
THANK YOU.
APPRECIATE HAVING THE DESIGNER
HERE. THANK YOU. HELLO I'M DR
CAMEO STANEK I'M A FORMER
ASSOCIATE PROFESSOR AT THE
UNIVERSITY OF MONTANA. AND I WAS
WORKING IN MONTANA AT THE TIME
THAT THE COUNT IS IMPLEMENTED IN
THAT STATE. I'M I'VE TAUGHT IN
THE CANS FOR A NUMBER OF YEARS
AS PART OF MY DOCTORAL LEVEL
CHILD ASSESSMENT CLASS. I'VE
BEEN TRAINED IN IT MYSELF AS
WELL. AND AND I WITNESSED FIRST
HAND SOME OF THE IMPLEMENTATION
CHALLENGES THAT WERE PRESENT
WITH RESPECT TO TRAINING
SUSTAINABILITY TECHNICAL ISSUES
AT THE TIME AND AND SAY TO
MONTANA.
I'M I I THINK IT'S IMPORTANT
MENTION THAT FOR CLINICIANS WHO
NEED SUPPORT IN IN IN
INTEGRATING MEASURES THAT ARE
ALREADY WELL ESTABLISHED AND AS
SIMPLE. FACT MAGICALLY STRONG
PRAGMATIC OUTCOME MEASURES INTO
TREATMENT PLANNING AND CARE
DELIVERY. THE IDEA OF
IMPLEMENTING A TOOL SO BROADLY
STATEWIDE THAT IS AS COMPLEX AS
THE CANS. SEEMS LOGICAL TO ME.
BUT MY OPINION IS ONE OF HIM
AND SO INSTEAD I PULLED A BIT OF
LANGUAGE AND JUST BRIEFLY. FROM
THE ADMINISTRATIVE RULES IN THE
STATE OF MONTANA TWENTY SIXTEEN
WHEN THE KANSAS PULLED. I'M FROM
THEIR MINISTRY OF RULES THE
PUBLIC COMMENTERS AT THAT TIME
REPORTED THAT ITS TOO LENGTHY.
AND THEY DID NOT FIND IT A
USEFUL TOOL FOR INFORMING THE
PRACTICE OR MEASURING OUTCOMES
SO THAT FROM THAT THE MOUTH OF
THE PROVIDERS IN THE STATE WHERE
IT WAS A FIELD IMPLEMENTATION
ULTIMATELY. THAT'S THE STUFF
THAT ALSO DOESN'T GET PUBLISHED
SO WHEN TO ADD THAT TO THE.
PERSPECTIVE THANK YOU THANK YOU.
RIGHT.
OKAY.
IT'S NOT TECHNICALLY ON THE
AGENDA.
AS BAD I REALLY SHOULD
ATTRACTED A WHOLE DEPARTMENT ANY
BRIEF COMMENTS ON. THE FOLLOWING
COMMENT.
THE I THINK IT HAS A AS YOU AS
YOU HEARD FROM PUBLIC TESTIMONY
IT WAS YEARS AND YEARS OF.
DISCUSSIONS AND MEETINGS AND SUB
COMMITTEES.
AN INDEPENDENT EVALUATION A
LITERATURE REVIEW.
I THINK WE ACKNOWLEDGE THAT AND
THERE ARE LOTS OF OPTIONS OUT
THERE.
.
THE UCLA STUDY.
DIDN'T LOVE ANYTHING OTHER THAN
THE PSC THIRTY FIVE WHICH IS THE
PARENT CHECKLISTS IT'S A ONE
PAGE CHECKLIST BUT IT'S ONLY
MEANT TO CAPTURE THE PARENTS
PERSPECTIVE AND. I THINK WHEN WE
SAT AS DEPART AS A DEPARTMENT
AND THEN WE OBVIOUSLY SAT WITH
THE DEPARTMENT OF SOCIAL
SERVICES. AND WE REALLY WANTED
TO CHOOSE SOMETHING THAT
CAPTURED A CLINICAL PERSPECTIVE
WHICH IS HOW WE INTEND TO USE IT
AND THEN ON THE SOCIAL SERVICES
SIDE IT'S MEANT TO CAPTURE THE
CHILD'S FAMILY TEAM PERSPECTIVE
AND SO. ON WE APPRECIATE THAT
THERE ARE DIFFERENCES OF OPINION
BUT WE ALSO THINK THAT IT'S
IMPORTANT THAT WE HAVE. A SINGLE
STATEWIDE TOOL.
WE NEED TO BEGIN AND CAPTURING.
DATA.
AND THEN WE NEED TO JUST KIND
OF MOVE FORWARD AND THEN
OBVIOUSLY TO THE EXTENT THAT THE
DATA IS SHOWING SOMETHING THAT
IS.
NOT MAKING SENSE OR IS NOT
APPEARING TO. BE VALID IN
CERTAIN CASES AND WE OBVIOUSLY
HAVE RESEARCH. SCIENTISTS IN OUR
DEPARTMENT THAT CAN HELP US
DETERMINE WHAT THE NEXT STEPS
ARE BUT DOING NOTHING I'M IS
ALSO NOT AN OPTION.
ALL RIGHT THANK YOU.
OKAY ANY OTHER QUESTIONS ALRIGHT
LET'S MOVE ON TO ISSUE NUMBER
THREE.
DRUG MEDI CAL AND SPECIALTY
MENTAL HEALTH IF WEEKS OF
TREATIES AND ART AND OTHER
HEALTH CENTERS.
CORRECT SO THIS IS.
DEPARTMENT REQUESTS TO
IMPLEMENT THE PROVISIONS OF SB
THREE TWO THREE BY SENATOR
MITCHELL LAST YEAR.
.
IN CASE AS TODAY'S CONVERSATION
AROUND THE COMPLEXITY OF
FINANCING AND PROGRAMS IS NOT.
HARD ENOUGH WE NOW WANT TO.
IMPLEMENT BOTH A CD AND MENTAL
HEALTH SPECIALTY NO HEALTH
SERVICES INTO THE FQHC.
WAY OF DOING CALCULATIONS FOR
RATES SO WE'RE SEEKING.
BOTH POSITIONS AND EXPENDITURE
AUTHORITY.
CAST OVER SEVERAL YEARS.
TO IMPLEMENT THE PROVISIONS OF
THIS BILL.
FIRST AND FOREMOST.
ANY FQHC THAT WANTS TO PROVIDE
THESE SERVICES.
OUR AUDITORS ARE GOING TO NEED
TO BE DOING AND PROCESSING SCOPE
OF SERVICE AND CONTRACT CHANGES
IN HOW WE AFFECT THE RATES.
IF YOU ARE GOING TO BE
PROVIDING SUBSTANCE USE.
TREATMENT SERVICES AS A DRUG
MEDICAL PROVIDER YOU HAVE TO BE
CERTIFIED AS A DRUG MEDICAL
PROVIDER BECAUSE THEIR HIGH RISK
PROVIDER SO WE HAVE STAFF
ALLOCATED FOR THAT. AND THEN.
TO THE EXTENT THAT THEY'RE
PROVIDING US SPECIAL TO MENTAL
HEALTH SERVICES THESE FQHCS ALSO
HAVE TO BE CONTRACTING WITH THE
COUNTY MENTAL HEALTH PLAN. SO.
THE RIGHT IT DOES A REALLY NICE
JOB OF KIND OF SHOWING THE
STAGGERED AMOUNTS AND.
COSTS OVER THE YEARS THAT WE
BELIEVE IT'LL TAKE TO IMPLEMENT
BUT AT THE MOST IMMEDIATE OUT SO
WE'RE LOOKING FOR FIVE POSITIONS
AND EXPENDITURE AUTHORITY OF
ABOUT HALF A MILLION DOLLARS IN
TWENTY EIGHTEEN AND TWENTY
NINETEEN.
THANK YOU. COMES FROM L. L.
FINANCE.
THE ADMINISTRATION CONTINUES TO
SUPPORT THAT THE DEPARTMENT'S
PROPOSAL AND.
AS IT WILL ENSURE OVERSIGHT OF
ANY RATE CHANGES MADE HEARD THE
BELL.
YOU.
QUESTIONS FROM THE MEMBERS NOW
OKAY SO I MOVE ON TO ISSUE
NUMBER FOUR WE'RE GONNA DO ALL
THE DRUG MEDI CAL STUFF FOR
PUBLIC COMMENT SO AFTER ISSUE
NUMBER FIVE WILL HAVE PEOPLE
GIVE PUBLIC COMMENT ON ISSUES
THREE FOUR FIVE SO. ISSUE NUMBER
FOUR IS THE DRUG MEDI CAL
ESTIMATE IN THE OVERVIEW.
GREAT SO.
.
SO WE HAVE TO.
DIFFERENT.
DELIVERY SYSTEMS IN THE STATE
OF CALIFORNIA AS IT PERTAINS TO
DRUG MEDICAL SERVICES SO WE HAVE
COUNTIES THAT HAVE.
ALREADY IMPLEMENTED THE OPTION
AVAILABLE TO THEM UNDER THE
ELEVEN FIFTEEN WAIVER ON WHICH
IS THE SECOND PART OF THIS
AGENDA AND THEN WE HAVE THE
REMAINING COUNTIES THAT ARE
REQUIRED TO PROVIDE DRUG MEDI
CAL SERVICES THERE'S FIVE MAIN
CATEGORIES. AND SO THE CASE
LOAD.
ESTIMATE AN OVERVIEW IN YOUR
AGENDA DOES A REALLY NICE JOB OF
KIND OF LAYING OUT ON THE KINDS
OF SERVICES AND WHAT WE THINK.
THE CHANGES IN THE CASE LOAD
WILL BE AND AS YOU CAN SEE.
WHEN IT BREAKS DOWN BETWEEN THE
FOUR BASE MODALITIES. NARCOTIC
TREATMENT OUTPATIENT DRUG.
IN OUR INTENSIVE OUTPATIENT
TREATMENT IN RESIDENTIAL
TREATMENT. THE CASELOAD CHANGES
ARE EXTREMELY SMALL MEANING THE
CASELOAD IS FAIRLY STABLE WERE
GOING UP IN SOME AREAS BY A
PERCENT SIR YOU KNOW BY TWO
PERCENT AT THE MOST AND SO THAT.
BOTH THE CASELOAD IN THE
EXPENDITURE DATA HAS NOT REALLY
CHANGED SIGNIFICANTLY THE BIGGER
CHANGES ARE IN THE IN THE NEXT.
ITEM AS IT PERTAINS TO THE
WAIVER COUNTIES.
I'M A FAMILIAL.
FINANCE.
OKAY QUESTIONS. AT IT IN TERMS
OF CASES THAT CASE THOSE RATES
STABLE I MEAN HOW HOW. EVERYONE
TALKS ABOUT IT EPIDEMIC WE KNOW
IT CERTAIN PARTS OF CALIFORNIA
AS WELL AS THE MIDWEST AND SO
FORTH SO. ARE WE SEEING ANYTHING
IN THAT RELATIONSHIP AND THE
TERMS OF HITTING OUR DRUG MEDI
CAL PROGRAM.
SO I'M THERE HAVE BEEN SOME
INCREASES BUT THE PLACES IN
WHICH.
THE HIGHEST OPIATE OVERDOSE OR
DEATH RATE ARE IN.
KIND OF YOUR HIGH.
AND RURAL COUNTIES RIGHT SO
THERE ARE CERTAIN COUNTIES.
AND THE DEPARTMENT OF PUBLIC
HEALTH HAS A REALLY FANTASTIC.
OPIOID DASHBOARD THAT YOU CAN
GO AND SEE. THE RATES AND SO WE
WORKED VERY CLOSELY WITH THE
DEPARTMENT OF PUBLIC HEALTH ON
THIS THERE ARE CERTAIN.
OPIOID EITHER OVERDOSE AND
DEATH RATES IN CERTAIN COUNTIES
CERTAIN COUNTIES IN CALIFORNIA
THAT VERY MUCH REFLECTS WHAT IS
HAPPENING IN THE REST OF THE
COUNTRY. AND THEN OVERALL WHEN
YOU TAKE THIS AS AN AGGREGATE
AND AS A STATE OUR RATE IS NOT
AS GREAT AS OTHER. STATES AND SO
IT'S NOT TO SAY THAT.
THE PROBLEM TO IS NOT PRESENT
IN THE STATE OF CALIFORNIA IS
JUST NOT PRESENT AT THE SAME
RATE AND LEVEL AS IT IS IN OTHER
PLACES.
ONE OF THE EXCITING THING IS
NOT PART OF THIS AGENDA BUT WE
RECEIVED. MONEY FROM THE TWENTY
FIRST CENTURY CURES ACT WHICH
WAS. PASSED A COUPLE OF YEARS
AGO IT'S NINETY MILLION DOLLARS
OVER TWO YEARS FOR US TO LOCATE.
AT OUR IT TO IMPLEMENT.
HUB AND SPOKE APPROACH WHICH IS
WHAT A VERMONT IS DOING SO YOU
BASICALLY HAVE US AS. SPECIALTY
EXPERTISE CENTER EITHER NARCOTIC
TREATMENT PROVIDER OR SOME OTHER
EXPERT AND THEY WORK WITH
PROVIDERS OUT IN THE COMMUNITY
TO HELP INCREASE THE NUMBER OF
PROVIDERS THAT ARE WILLING TO DO
INDUCTIONS TO KEEP PEOPLE ON.
MEDICATION ASSISTED TREATMENT
AND SO THOSE MEDICATION UNITS
AND THOSE GRANT DOLLARS HAVE
BEEN GOING OUT TO I THINK
THERE'S ABOUT SIXTEEN TO
SEVENTEEN DIFFERENT AWARD HE'S
ACROSS THE STATE IN. HIGH AREAS
OF OVERDOSE AS WELL AS WE HAVE A
COMPONENT SPECIFICALLY DEDICATED
TO THE NATIVE AMERICAN TRIBAL
POPULATION SO THAT IS SEPARATE
APART FROM WHAT IS HAPPENING AND
I WOULD JUST SAY.
WHEN WE TALK ABOUT DRUG MEDI
CAL IT'S NOT JUST OPIOIDS RIGHT
THERE'S ALCOHOL AND OTHER DRUGS
SO THERE'S A MUCH BROADER RANGE
OF SERVICES AND. ADDICTION
DELIVERY SYSTEM WAIVER.
SO I'M A COUPLE OF A.
ACTUALLY IT SEEMS LIKE A COUPLE
OF YEARS AGO BUT IT WAS PROBABLY
LONGER THAN THAT.
WE RECEIVED AN ELEVEN FIFTEEN
WAIVER AMENDMENT FROM THE
FEDERAL GOVERNMENT TO INSTITUTE
THE FIRST IN THE NATION.
ORGANIZED DELIVERY SYSTEM AS IT
PERTAINS TO SUBSTANCE USE SO
IT'S IT'S EXTREMELY EXCITING IT
HAS BEEN A LOT OF WORK. ON IT IS
THAT.
IT IS I THINK A REALLY
IMPORTANT BENEFIT TO PROVIDE TO
OUR BENEFICIARIES IT RANGES FROM
INPATIENT RESIDENTIAL TREATMENT
SERVICES ALL THE WAY DOWN TO.
OUTPATIENT MEDICATION.
OTHER TYPES OF SOBER LIVING
ENVIRONMENTS IN OTHER TYPES OF
THINGS I'M IT IS ON A COUNTY OPT
IN BASIS SO IT IS NOT MANDATED
THAT THE COUNTIES PARTICIPATE.
BUT WE HAVE ON SEVERAL COUNTIES
OVER THE PAST FEW YEARS THAT
HAVE. IMPLEMENTED. SAN MATEO WAS
THE FIRST FOLLOWED BY RIVERSIDE
SO WE DID HAVE A VERY SMALL
COUNTY AND IN A VERY LARGE
COUNTY.
WE HAVE SEEN.
LOS ANGELES COME ONLINE AS OF
LAST JULY THEY'RE FOLLOWED WITH
WE HAVE MORE IN SAN FRANCISCO.
AND SANTA CLARA SO WE ARE
EXPECTING.
ADDITIONAL COUNTIES I BELIEVE
BY THE END OF THIS FISCAL YEAR
PROJECTING TO HAVE UP TO FORTY
BY THE TIME THE NEXT FISCAL YEAR
CLOSES WE ARE WORKING ON AND
IT'S A. IT'S EVEN MORE
COMPLICATED AND WITH PARTNERSHIP
HEALTH PLAN TO TRY AND IMPLEMENT
THIS ON WITH THE COUNTIES THAT
THEY HAVE WITHIN THEIR OWN
SERVICE AREA WHERE THE PLANE IS
ACTUALLY ADMINISTERING THE
SERVICES BUT.
IT HAS BEEN IT'S A LITTLE BIT
DIFFERENT FROM A GREAT
PERSPECTIVE. I'M WHEN I TALKED
EARLIER ABOUT THE IMPORTANCE OF
THE FEDERAL FUNDING AS IT
PERTAINS TO SUBSTANCE USE JUST
REALLY TO PUT A FINE POINT ON
IT.
ARMS ELEVEN AND A HALF MILLION
DOLLARS IN AUTHORIZED SERVICES
APPROVED UNDER THEIR WAIVER IN
THIS RANGES FROM THAT OUTPATIENT
DRUG SERVICES TO THE
RESIDENTIAL.
ON THE FEDERAL FUNDS. UP AGAINST
THE TOTAL FUNDS OF ELEVEN AND A
HALF MILLION DOLLARS.
FEDERAL FUNDS HAVE BEEN NINE
POINT ONE MILLION.
STATE GENERAL FUND HAS BEEN
ABOUT A MILLION AND A HALF AND
THE COUNTY HAS PROVIDED SEVEN
HUNDRED SIXTY FOUR THOUSAND
DOLLARS.
SO THE SIGNIFICANCE OF WHAT'S.
THE AFFORDABLE CARE ACT BOTH IN
TERMS OF THE MATCHING RATE FOR
THE EXPANSION POPULATION AS WELL
ON AS THE AS THE WAY THAT
THEY'RE USING THOSE FUNDS IS
EXTREMELY IMPORTANT CANNOT BE.
UNDERSTATED.
AND SIMILAR FOR THE OTHER
COUNTIES IN TERMS OF THE UNITS
THAT THEY ARE PROVIDING AS WELL
AS THE FINANCIAL.
BENEFIT FROM THIS ADDITIONAL
MATCHING FEDERAL FUNDS AND SO
WE'RE EXTREMELY EXCITED ABOUT
THE WAIVER IT HAS BEEN A LOT OF
WORK ON EACH COUNTY IS COMING
UP.
AS THEY GET THEIR RATES
APPROVED AS THEIR CONTRACTS GET
APPROVED AS THE FEDERAL
GOVERNMENT IS ALSO DOING
ADDITIONAL OVERSIGHT THERE ALSO
SUBJECT TO THE FEDERAL MANAGED
CARE. RULE REQUIREMENTS THAT IS
ALSO VERY NEW.
BUT WE WE HOLD OUT GREAT.
HOPE FOR FOR WHAT THIS WILL
BRING TO IMPROVING PEOPLE'S
LIVES.
THANK YOU COMES MILIEU. FINANCE
QUESTIONS MANY MEMBERS.
OKAY.
BEFORE WE GO TO PUBLIC COMMENT
THE STAY THERE.
ACTUALLY THERE WAS A QUESTION
THAT CENTER STONE AND I KNOW YOU
HAD TO LEAVE OF US REGARDING.
AND PRICE IT'S MORE UNDER ISSUE
FOR.
THERE IS A.
TURN OVER THE.
YEAH EIGHTY THREE NINETY FIVE
THERE'S A.
TREATMENT FOR SUBSTANCE USE.
ADDING INJECTABLE CALLED WITH A
BIRD VERTEX.
THE DRAW THAT A TRIAL AND
APPARENTLY. YOU CAN. GET PAID
BUT FOR THE TREATMENT BUT YOU
DON'T GET PAID FOR THE.
CAR OF YOU DON'T GET PAID FOR
THE TREATMENT YOU GET PAID FOR
THE RESEARCH AND SO. YOU HAD A
QUESTION ABOUT. THAT PEOPLE
HAVING TROUBLE ACCESSING OUR OUR
OUR.
A TREATMENT WITH UP WITH THIS
STUFF MODALITY AND IF YOU.
I'M I NEVER WEAR THAT ISSUE IN
MEDICARE FEE FOR SERVICE IT'S
PAID THROUGH OUR PHARMACY
BENEFIT IT'S A PHYSICIAN
ADMINISTER DRUGS MEANING THE
PHYSICIAN HAS TO PURCHASE THE
DRUG AND THEN WE REIMBURSE. ONCE
IT HAS BEEN ADMINISTERED.
IN PHARMACY.
CURRENTLY UNDER THE PROVIDER
BILLY MANUAL IT IS LIMITED ONLY
TO.
THE POPULATION THAT HAS BEEN
RELEASED UNDER THE.
REALIGNMENT SO THEY HAVE TO
HAVE BEEN RECENTLY INCARCERATED
AT SAID JAIL POP IT'S LIMITED TO
A JAIL AND PRISON POPULATION.
SO I'M I CAN PROVIDE THE PAGES
AND OUR PROVIDER MANUAL AS TO
HOW THAT DRUG IS ADMINISTERED.
THROUGH THE PHARMACY BENEFIT AND
ORTH AND WE DO COVER IT THROUGH
A PHYSICIAN ADMINISTERED.
BENEFIT AND MEDICAL AND MAY NOT
NECESSARILY BE DOING THE
QUESTION JUSTICE SO I MAY HAVE
ASKED. IF IT'S ALRIGHT HAVE
CENTERS DON'T GET IN TOUCH WITH
THE PARCHMENT AND. BE SURE HE
HAS HIS QUESTION ANSWERED LATE
THAT OKAY NOW APPRECIATE IT
THANK YOU. OKAY NO THE QUESTIONS
ALRIGHT OF PUBLIC COMMENT
PLEASE.
ARMS JR. TOM RENT FREE WITH THE
COUNTY BEHAVIORAL HEALTH
DIRECTORS SO I HAVE A COMMENT ON
ALL THREE OF THESE ISSUES DO I
GET A MINUTE FOR EACH.
I'LL I'LL TELL THEY DEMAND THAT
PREACHES ON ON ISSUE NUMBER
THREE. THE FQHCS ARE WE DO
SUPPORT THAT WE WE WERE ONE OF
THE SUPPORTERS OF SB THREE
TWENTY THREE OUR COUNTIES REALLY
WELCOME FQHCS AS PROVIDERS OF
DRUG MEDI CAL SERVICES UNDER.
THE WAIVER YOU KNOW WE HAVE TO
EXPAND WHERE WE NEED NETWORK
ADEQUACY HEARING FROM HOSPITALS
THAT
THEY HAVE BEEN HAVING A LOT OF
DIFFICULTY. A BILLING AND
CLAIMING FOR THIS BENEFIT AND
VERY FEW OF THEM ARE ARE WILLING
TO DO IT BECAUSE OF ALL THE THE
PROBLEMS WITH BILLING FOR IT SO.
WE DON'T KNOW WHAT THE SNAG IS
BUT IT LOOKS LIKE THIS IS A
BENEFIT ON PAPER THAT'S NOT
REALLY BEING DELIVERED IN
REALITY. DID YOU HAVE A ONE TO
ASK SOMEBODY GOING OKAY AND THEN
ON ISSUE NUMBER FIVE.
WE DO SUPPORT AND APPRECIATE.
THE DEPARTMENTS OF THE
ADMINISTRATION'S.
PUTTING IN STATE GENERAL FUND A
SUBSTANTIAL STATE GENERAL FUND
TO THE ODD ON THE ODS ARE A
WAIVER IMPLEMENTATION FOR THESE
COUNTIES THAT.
IT'S GOING TO DRAW DOWN
SIGNIFICANT FEDERAL FUNDING OF
THE ONE THING WE WOULD ASK IS
THAT.
.
THE UNDER THE CURRENT.
BUDGET PROPOSAL COUNTIES ARE
ABLE TO CLAIM THIS SG OFF. ONLY
FOR NON PERINATAL RESIDENTIAL AN
INTENSIVE OUTPATIENT SERVICES WE
WOULD LIKE TO SEE LANGUAGE THAT
WOULD AUTHORIZE THE USE OF STATE
GENERAL FUND TO COVER. SOME OF
THE NON FEDERAL SHARE OF COSTS
FOR SOME OF THE OTHER ODS
EXPANSION SERVICES SUCH AS CASE
MANAGEMENT AND RECOVERY SUPPORTS
BECAUSE THESE ARE IMPORTANT
SERVICES AS WELL THAT'S IT THANK
YOU. THANK YOU THANK YOU. OKAY.
THANK YOU MISTER CLICKING MISTER
CHAIRMAN CONSUMERS ON BEHALF OF
CALIFORNIA HEALTH PLUS ADVOCATES
I'M IN THE THIRTEEN HUNDRED
COMMUNITY HEALTH CENTERS AND
CLINICS ACROSS CALIFORNIA WE
JUST WANTED TO EXPRESS. OUR
SUPPORT FOR ISSUE NUMBER THREE
AND APPRECIATE THE DEPARTMENT
WORKING WITH US ON SB THREE
TWENTY THREE. LAST YEAR AND LOOK
FORWARD TO THE FULL
IMPLEMENTATION OF THAT BILL
THANK YOU. THANK YOU.
WELCOME. MR CHAIRMAN MEMBERS
ONLY MEASURE OUR BEHALF OF THE
CALIFORNIA ASSOCIATION OF
ALCOHOL AND DRUG PROGRAM
EXECUTIVES AND I'D LIKE TO.
DIRECT MY REMARKS TO ITEM NUMBER
I BELIEVE IT'S FIVE. OTHER HAS
TO DO WITH THE VOLUNTARY DRUG.
WITHDRAWAL MANAGEMENT OTHERWISE
KNOWN AS DETOX OF WE ARE
CONCERNED THAT THE.
AND.
ADVOCATE THAT THE VOLUNTARY. OF
A WITHDRAWAL MANAGEMENT FUNDS
OF.
PROGRAM BE FUNDED FULLY AS.
MY COLLEAGUE HAD MENTIONED. AND
OF WORD OF LOOK FORWARD TO
WORKING WITH THE COMMITTEE IN
THE NEXT COUPLE OF WEEKS TO.
LOOK AT THAT ISSUE ARE WE
THINK-THAT WITHOUT ADDITIONAL
FUNDING
FOR.
AN ADEQUATE FUNDING FOR
VOLUNTARY DETOX THAT IT COULD
LEAD TO HIGHER E. OUR COSTS AND
AN INCREASE IN OVERDOSE
DESTINADA. THE DETOX IS VERY
CRUCIAL SO THANK YOU VERY MUCH
THANK YOU. ALL RIGHT.
THANK YOU.
SO WITH THAT.
.
I THINK WE'RE GOING TO HOLD THE
ITEMS.
OPENED.
AND NOW WE ACTUALLY HAVE TWO SA
COLDER PROPOSALS FOR
PRESENTATION.
THANKS.
THE.
BECAUSE.
OKAY RIGHT FOR SOLACE.
RIGHT SO THE FIRST ONE SO SO THE
TWO TWO STAKEHOLDER PROPOSALS WE
HAVE HERE. ACTION DIRECTOR
MATCHES JUST SURF TO THE SIDE SO
THEY SET UP FRONT.
IT WAS OUR VIEW I STAY OVER HERE
EXHAUSTING WITH FINANCE AND
SCENARIO THAT'S FINE.
I GUESS YOU KNOW WHERE THE
MONEY'S COMING FROM INSIDE.
OKAY SO WE FIRST HAVE A DOCTOR
AMY MULLEN FROM UC DAVIS
REPRESENT CAL A SCEPTER THAT
PROPOSAL TO FUND.
I'M.
WE WILL GO SECOND THAT ALL RIGHT
SO WHILE WE GO THEN WE'LL. HAVE
A.
TOM FREE OF THEIR YEAH OKAY. SO
YOU HAVE THE COUNTY HEALTH
DIRECTOR ASSOCIATION PRESENTING
PROPOSAL TO EXPAND SCREENING
BRIEF INTERVENTION REFERRAL AND
TREATMENT SERVICES AND YOU HAVE
THREE MINUTES THAT SOMETIMES ALL
OF THIS I CAN DO THIS IN THREE
MINUTES THANK YOU DOCTOR PEN.
SO.
IS.
TOM RENT FREE WITH THE COUNTY BE
ABLE HELP DIRECTORS OF WHO WE
ARE BUT THERE ARE PROPOSING THAT
THE LEGISLATURE ALLOCATED TO
FUNDING TO THE TO DIE THE
DEPARTMENT OF HEALTH CARE
SERVICES TO EXPAND. THE MEDI CAL
BENEFIT FOR ADULT ALCOHOL MISUSE
SCREENING AND COUNSELING TO
INCLUDE SCREENING FOR MIS USE OF
OPIOIDS AND OTHER ILLICIT DRUGS.
THE BENEFITS OF ROUTINE
SCREENINGS FOR ALCOHOL MISUSE
ARE WELL DOCUMENTED IT HAS BEEN
WIDELY IMPLEMENTED ACROSS THE
STATE AND SAFETY NET PRIMARY
CARE SETTINGS LIKE PUBLIC
HOSPITALS AND FEDERALLY
QUALIFIED HEALTH CENTERS.
HOWEVER A SCREENING FOR ILLICIT
DRUG USE HAS RECEIVED LESS
ATTENTION. UP EVEN SOLD THE
SUBSTANCE ABUSE MENTAL HEALTH
SERVICES ADMINISTRATION RECENTLY
REPORTED THAT DRUG SCREENING ARE
USING THIS SAME MODEL OF
SCREENING IT'S USED FOR ALCOHOL
WAS ASSOCIATED WITH POSITIVE
OUTCOMES INCLUDING A SEVENTY%
FIVE PERCENT REDUCTION IN
ILLICIT DRUG USE.
THE INTENT OF OUR PROPOSAL IS TO
STRENGTHEN LINKAGES AND REFERRAL
PATHWAYS BETWEEN PRIMARY CARE
AND SPECIALTY SUBSTANCE USE
DISORDER TREATMENT. TO FULLY
CONFRONT THE OPIOID CRISIS THAT
WE'RE NOW. EXPERIENCING THAT'S
CLAIMED THE LIVES OF MORE THAN
TWO THOUSAND CALIFORNIANS LAST
YEAR. OUR STATE'S PUBLICLY
FUNDED HEALTH SYSTEMS MUST
IDENTIFY MORE PEOPLE WITH
SUBSTANCE USE DISORDERS AND
CONNECT THEM TO CARE. WE THINK
IT'S MUCH MORE EFFICIENT COST
EFFECTIVE TO BE ABLE TO
INTERVENE EARLY THROUGH
SCREENING TO SEE IF PEOPLE ARE
IN DANGER OF YOU KNOW OF A
SUBSTANCE USE DISORDER RATHER
THAN WAITING TILL THEIR WAY DOWN
THE LINE AND THEN TRYING YOU
KNOW WHEN KAREN TREATMENT BECOME
MUCH MORE. EXPENSIVE SO WE THINK
THIS IS A GOOD PROPOSAL THANK
YOU.
THANK YOU.
COMES FROM BECAUSE THE STATE
AREA I COMES FROM THE DCS NOW.
ALEJO ANY COMMENTS ON PROPOSAL
FINANCE.
WE HAVEN'T HAD THE OPPORTUNITY
TO REVIEW THE PROPOSAL AND SO WE
DON'T HAVE A POSITION AT THIS
TIME BUT IT.
HAPPY TO PROVIDE TECHNICAL
ASSISTANCE IF YOU DO PURSUE IF
IT'S UP THE LEGISLATURE'S
INTEREST. THANK YOU AND THE
DEPARTMENT HAS PROVIDED AN
ESTIMATE OF OF COST OF I THINK
WAS SOMEWHERE AROUND EIGHT POINT
FOUR MILLION BUT HALF OF THAT'S
GOING TO BE FEDERALLY COULD BE
FEDERALLY MATCHED IF THEY GET
APPROVAL. US SO IT'S WE THINK
IT'S A. RELATIVELY INEXPENSIVE
WAY TO DO A REALLY GOOD A REALLY
GOOD SERVICE. K.. UP PUBLIC
COMMENT ON THIS PROPOSAL. CAN
REALLY TURN ON BEHALF OF
CALIFORNIA PAN ETHNIC HEALTH
NETWORK WE BELIEVE THAT PRIMARY
CARE IS A. PROPER OPPORTUNITY
FOR SCREENING WE SUPPORT THIS
PROPOSAL. THANK YOU.
ALL RIGHT.
THAT A NOTE THANKS SO MUCH FOR
YOUR PRESENTATION ACTUALLY ANY
QUESTIONS ALL RIGHT. THANK YOU
RIGHT CERTAINLY.
AS A PRIMARY CARE DOCTOR STAND.
IT'S REALLY IMPORTANT SHOULD BE
SCREENED FROM ADULT ISSUES.
.
YOUR SPEAKER ON THE WAY OUT.
YES HE'S ON OUR WAY.
NOT SURE WHERE SHE IS BUT I
UNDERSTAND YOU HAVE YEAH WHEN
IT'S OKAY SOMEONE ACTUALLY IF
YOU DON'T MIND I'D.
SO.
.
GIVE YOUR THREE MINUTES.
SO THIS IS THE PROPOSAL TO.
PRESENT A FUND TO FUND A DRUG
AND ALCOHOL COUNSELLORS
EMERGENCY DEPARTMENTS YES THANK
YOU DOCTOR SENATOR MINING TO
MADDEN REPRESENT THE CALIFORNIA
CHAPTER OF THE AMERICAN COLLEGE
OF EMERGENCY PHYSICIANS. IN OUR
BUDGET REQUEST IS FOR ONE TIME
FUNDING OF TWENTY MILLION
DOLLARS TO FIND CERTIFIED DRUG
ALCOHOL COUNSELLORS TO BE
EMBEDDED IN THE EMERGENCY
DEPARTMENT. OUR VISION IS TO
CREATE A GRANT PROGRAM FOR
HOSPITALS TO APPLY FOR FUNDING
TO FIND THIS TYPE OF POSITION
THIS WOULD NOT BE A MANDATE ON
HOSPITALS WOULD BE AN
OPPORTUNITY FOR THEM TO. INCLUDE
THIS INDIVIDUAL IN THE MERCY
DEPARTMENT. IN THE IDEA WAS
THAT.
IT'S A FRUSTRATION EMERGENCY
PHYSICIANS ON A DATE ON A DAILY
BASIS IS THE QUESTION OF HOW DO
WE CONNECT PATIENTS TO THE CARE
THAT THEY REALLY NEED. AS I KNOW
YOU UNDERSTAND OUR JOB IS TO
TREAT THERE ARE MERCHANTS
SITUATION BUT MANY TIMES OUR
UNDERLYING CHRONIC ISSUES. THAT
PATIENTS ARE STRUGGLING WITH
WHICH BRINGS HIM INTO THE MERCY
DEPARTMENT.
SUBSTANCE USE DISORDERS IS IS A
IS A BIG PART OF THAT WHETHER BE
ALCOHOL OR THROUGH A FEW ICE AND
DRUGS. AND WHAT WE SEE OUR
PATIENTS COMING IN WE HELP THEM
WITH THEIR IMMEDIATE CRISIS
EMERGENCY PHYSICIANS DO HAVE
CONVERSATIONS WITH THEM TRYING
TO ENGAGE WITH THEM TO GET THE
HELP THAT THEY NEED ON A LONGER
TERM BASIS. BUT MANY TIMES BY
THE TIME THEY ARE WORKING THE
WAY I THE MERCY DEPART.
THE SUN IS SHINING AND THEY MOVE
ON IN THEIR LIFE UNTIL THEY HIT
THE NEXT CYCLE WITHIN THEIR
ADDICTION AND THEY COME RIGHT
BACK TO US.
UC DAVIS. TOOK AN OPPORTUNITY
THAT WAS PUT FORWARD BY THE UC
OFFICE OF THE PRESIDENT WHERE
THEY MADE SOME GRANT MONIES
AVAILABLE. TO HAVE A CERTIFIED
DRUG AND ALCOHOL COUNSELOR
ACTUALLY BE IN THE EMERGENCY
DEPARTMENT. ARE THIS INDIVIDUAL
UC DAVIS'S NAME IS TOMMY ABOUT
AN OPPORTUNITY TO MEET A NUMBER
OF TIMES ON TOURS AND AND HE'S
DOING AN AMAZING JOB. AND TOMMY
IS SPECIFICALLY TRAINED IN
TALKING TO PEOPLE IN THESE
SITUATIONS ON THE AMOUNT OF TIME
HE SPENDS COULD ANYWHERE FROM
FIFTEEN MINUTES TO THIRTY
MINUTES TO AN HOUR. JUST SITTING
WITH THE PERSON AT THAT POINT
WHEN THEY ARE AT THEIR LOWEST
WHEN THEY COME IN IN THE MERCY
DEPARTMENT COMING OUT OF AN
OPIOID CRISIS THERE REALLY AT
THAT ROCK BOTTOM PLACE. THEY
NEED SOMEONE TO CONNECT WITH THE
SOMEONE TO EMPATHIZE WITH THEM
IN REALLY ENCOURAGE THEM TO GET
THEM INTO THE PROGRAMS THAT THEY
NEED. TOMMY IS COMES FROM THIS
BACKGROUND HIS.
HE'S HAD ITS OWN CHALLENGES IN
THIS WORLD WHO IS FAMILIAR WITH
WHAT THAT IS HE'S ALSO VERY
CONNECTED TO THE COMMUNITY
UNDERSTANDS WHAT SERVICES ARE
AVAILABLE IN THE SACRAMENTO
AREA.
WHETHER IT BE SERVICES ON
THROUGH FAITH BASED TYPE
SITUATIONS WHICH MANY TIMES ARE
MORE APPROPRIATE FOR FOLKS WHO
MAY NOT HAVE THE INCOME TO.
OR THE INSURANCE STATUS TO PAY
FOR THIS TYPE OF A COUNSELING.
SO TOMMY WILL MAKE THAT
CONNECTION HE TELLS A STORY SO
HE LITTLE AGAIN A CAB IN FALL OF
PEOPLE TO THE CENTER TO GET THEM
AND ROLLED. AND HE STAYS
CONNECTED WITH THEM AND SENSE OF
ENCOURAGING THE STAY CONNECTED
TO THE PROGRAMS.
WHEN WE STARTED PULLING BACK THE
DATA ADC DAVIS AND WE SAW THE
RESULTS. JUST LOOKING AT THE
MEDICAL PROGRAM FOR EVERY DOLLAR
THAT WAS.
SPENT ON TOMMY AND HIS SALARY
THE MEDICARE PROGRAM SAVE SEVEN
DOLLARS AND BY THAT WHAT THEY
MEAN IS THAT WHEN YOU SEE DAVIS
LOOKED AT THE COST OF GOING TO
THE EMERGENCY DEPARTMENT IS JUST
THE MERSEY DEPARTMENT IT DIDN'T
INCORPORATE. ANYTHING RELATED
TO.
IMPATIENT BECAUSE THOSE WERE
THE SAVINGS SO LARGELY BASED ON
THE SUCCESS OF THAT PROGRAM
BECAME UP WITH THIS IDEA AND WE
FELT WITH THE STATE BEING IN A
SITUATION WHERE THERE ARE SOME
SURPLUSES. THIS BE NICE
OPPORTUNITY TO DO A ONE TME
FUNDING FOR THIS PURPOSE TO MAKE
IT AVAILABLE TO ALL STOP RIGHT
THERE AND.
.
SEE IF ANYONE HAS ANY QUESTIONS
THANK YOU.
COMMENTS FROM THE BAR
HEALTHCARE SERVICES ON THIS
ALRIGHT ELIA.
FINANCE.
WE DON'T ADD THAT TO THE
ADMINISTRATION DOESN'T HAVE A
POSITION AT THIS TIME BUT WE.
HAVE WORKED WITH YOU IN THE PAST
LOOK FORWARD TO CONTINUING THE
CONVERSATION.
THANK YOU SIR MONEY. THANK YOU
PUT IT IT SOUNDS LIKE.
AGREE.
OPTION FOR PATIENT CRISIS BUT.
BECAUSE BY DEFINITION IS SERVICE
PROVIDED IN THE EMERGENCY ROOM
YOU MENTIONED SOME.
CONNECTIVITY.
BEYOND THE EMERGENCY ROOM TO
HELPING.
IDENTIFY PLACEMENT OPTIONS
ETCETERA. ON. BUT I MENTION. A
CASELOAD FOR ONE PERSON COULD.
GROWING AGAIN. THAT POINT OF
CONTACT IN THE EMERGENCY ROOM
THE PERSON IS PRICED SO
COMPROMISED EVEN.
EVEN AT THE TIME OF DISCHARGE
THEIR STABILIZED BUT MAYBE NOT.
.
OF CLEAR MIND AND IS THERE ANY.
ANY STUDIES THAT SHOW THE
EFFICACY OF.
OF HAVING THAT POINT OF CONTACT
IN AN EMERGENCY ROOM.
I'LL TURN IT OVER TO DR PILOTED
TANK THIS AT THIS.
OKAY.
IT REALLY APPRECIATE IT THERE
ARE STUDIES THAT LOOK AT THE
EFFICACY OF WHAT WE CALL IT
EXPERTS WHICH IS A SCREENING
BRIEF INTERVENTION AND REFERRAL
TO TREATMENT.
IN THE EMERGENCY DEPARTMENTS AND
ACTUALLY WHAT THEY SHOW IS IT'S
MORE EFFECTIVE IN THE EMERGENCY
DEPARTMENT THAN IN A PRIMARY
CARE OFFICE. THAT TO PATIENTS
WHO RECEIVE THAT CONTACT IN THE
EMERGENCY DEPARTMENT ARE MORE
LIKELY TO BE LINKED TO TREATMENT
FROM THE EMERGENCY DEPARTMENT
AND MORE LIKELY TO STAY IN
TREATMENT IF IT'S DONE IN THE
EMERGENCY DEPARTMENT.
IF YOU THINK ABOUT IT. IN THE ER
IS A REALLY VULNERABLE MOMENT
FOR THAT PATIENT AND YOU CAN
REALLY LINK. SORT OF THE
CONSEQUENCES OF WHAT WHAT IS
HAPPENING WITH YOUR SUBSTANCE
USE DSORDER. TO TREATMENT AND
IF WE CAN TAKE ADVANTAGE OF THAT
MOMENT.
IT'S VERY EFFECTIVE.
SO I UNDERSTAND THAT THE THERE
WAS A. THAT WAS ACTUALLY AT UC
DAVIS WE ACTUALLY IMPLEMENTED
THANKS TO THE SURF FEDERAL
GRANTS THAT THERE WAS A SIXTY
PERCENT REDUCTION IN.
REGISTER REALIZATION BY THE
POPULATION OF. PEOPLE CAN YOU
ELABORATE ON THAT A LITTLE SO
YOU'DBETTER GET USED TO DAVIS
WE'VE HAD OUR SUBSTANCE USE
COUNSELOR FOR ABOUT TWO YEARS.
HIS POSITION WAS INITIALLY
FUNDED BY A GRANT.
BUT WE'VE SEEN THE VALUE OF HIS
WORK IN OUR EMERGENCY DEPARTMENT
THAT HE'S NOW A HOSPITAL
EMPLOYEE.
AND WE'VE TRACKED THE ER VISITS
FOR PATIENTS THAT HE'S CONTACTED
PRE INTERVENTION POST
INTERVENTION. AND WE'VE SEN
ABOUT A SIXTY ONE PERCENT
DECREASE IN ER VISITS OVERALL.
AND THAT'S REMARKABLE IF YOU
THINK ABOUT THE POPULATION THAT
WE'VE TARGETED WHICH IS MY A
HIGH UTILIZE OUR POPULATION.
SEVENTY PERCENT OF OUR PATIENTS
ARE COVERED BY MEDICARE. THIRTY
THREE PERCENT ARE HOMELESS AND
THIRTY ONE PERCENT HAVE A CO
OCCURRING PSYCHIATRIC DISORDER.
SO THIS IS A VERY FORMAL PATIENT
POPULATION.
THEY ARE A SET UP FOR HIGH
UTILIZATION AND WE'VE HAD
PATIENTS WHO HAVE YOU KNOW
FIFTEEN VISITS IN THE PRIOR SIX
MONTHS DROP THAT DOWN TO. TWO OR
THREE IN THE FOLLOWING SIX
MONTHS.
THAT THAT'S VERY HELPFUL. ALSO.
UNDERTAKEN SINCE WE HAVE YOU
HERE YOU OVERSEE THE ENTIRE
MEDICAL PROGRAM.
I AS I GUESS A QUESTION TO POSE
TO YOU BECAUSE I ON ONE LEVEL.
WHAT HAPPENS IS THAT?
WE'RE HEARING ABOUT THE
DECREASE IN E. R. UTILIZATION
AND.
YEAH BASICALLY.
YOU SEND ONE DOLLAR HERE YET.
BUT ALSO YOU KNOW ABOUT FUNDING
STREAM SO THE THING IS IS THAT.
SANDRA FIGURE OUT HOW DO WE
TRANSLATE AND TO SAY THIS IN THE
SAVINGS FOR THE STATE.
AND.
BECAUSE I THINK IT IS SAVING
MONEY IT IS IT'S IT'S IT'S
DECREASING UTILIZATION IS GONNA
SAVE MONEY.
BUT I'M ALSO CONCERNED THAT IT
NEVER GOT THAT SAVINGS NEVER
GETS REFLECTED IN THE BUDGET
BECAUSE WHAT HAPPENS IS YOU'LL
SAY WELL YOU KNOW WHAT WE'RE
PAYING FOR THIS ON THIS SITE AND
WHAM AS WE PAID A. FLAT RATE TO
THE MANAGED CARE COMPANY AND GMC
SACRAMENTO OR WHATEVER ELSE AND.
YOU KNOW IF THEY HAVE DECREASED
MUSICIAN IS A PLAN TO KEEP THE
MONEY NOT STATE SO HOW DO WE
MAKE THIS SO MAYBE YOU CAN HELP
ME FIGURE OUT WE HAVE THE
EVIDENCE TO SHOW THAT THIS
DECREASES SPENDING. AND ACTUALLY
DECREASE ANY FOR THE STATE HOW
WOULD WE TRY TO CAPTURE THAT IN
A BUDGET REQUEST.
WELL I THINK M. IT'S
IT'S COMPLICATED FROM THE
STANDPOINT.
IN THIS IS I THINK WHAT HAS
BEEN INTERESTING ABOUT THE
PARTNERSHIP DISCUSSION WITH THE
REAL COUNTIES THAT WOULD LIKE TO
PARTICIPATE THE WAIVER BETTER
LOOKING A PARTNERSHIP TO DO IT.
.
IS THAT IF THE COUNTIES.
.
CONTRIBUTE TO THE TREATMENT OF
INDIVIDUALS WITH SUBSTANCE USE
THE COUNTY IS PUTTING THE MONEY
AND TO TREAT. PEOPLE THAT THE
REQUIRED STATUTORILY ARE
CONSTITUTIONALLY TO TREAT BUT
THE SAVINGS ACCRUE TO THE PLAN.
BECAUSE THE ER USE DROPS THE
OTHER THINGS AND SO I MEAN IT'S
A CLASSIC. CASE THAT WE HAVE IN
A LOT OF DIFFERENT AREAS WHICH
IS HOW DO YOU LINUS INCENTIVES
FOR INVESTMENT SO YOU KNOW.
.
IT'S A HOSPITAL HAS FOUND THAT
THAT'S A SAVINGS.
.
YOU KNOW IS IT THE STATE'S
RESPONSIBILITY TO FIND A
INDIVIDUAL WITHIN THE HOSPITAL
TO ACCRUE SAVINGS TO THE
HOSPITAL BECAUSE THE STATE WANTS
TO THE HOSPITAL SAVINGS RIGHT
SELF THIS CASE IMMUNIZE THE
DECREASE UTILIZATION ALL DEPENDS
ON WHAT THE CONTRACT IS THAT
SIR.
BUT I MEAN GOING TO GO THERE BUT
YES I'M SO IT DEPENDS RIGHT IT
DEPENDS ON A LOT OF THINGS AND
SO I THINK IT'S HARD BECAUSE
DEPENDING ON WHO HAS THE
RESPONSIBILITY FOR WHAT WHAT
PIECE OF THE INDIVIDUAL'S
OVERALL HEALTHCARE. THE
INCENTIVE IS EITHER WITH THEM TO
MAKE AN INVESTMENT TO LOWER THE
COST BECAUSE THEY SEE THE COST.
I'M REDUCTION AND THE WAY WE SET
RATES IF THERE IS A DECREASE IN
UTILIZATION OVERALL ON THE PLAN.
FOR EXAMPLE LIKE THE HEPATITIS
C. DRUGS THAT HAVE COME OUT AND
THE ADDITIONAL.
ONES HAVE COME ON TO MARKET OUR
HABSI PAYMENTS FOR THOSE DRUGS
HAVE DROPPED BECAUSE THE COST IS
DROPPED SO WE DROPPED THE RATE
AS THE COSTS GET LOWERED. BUT ON
SOMETHING LIKE THIS IF YOU'RE
MAKING AN INVESTMENT. DEPENDING
ON WHO'S MAKING THE INVESTMENT
THE SAVINGS MAY NOT ACCRUE TO
THEM AND SO. SO SO I GUESS MY
APPEAL TO YOU.
IS IS THAT.
WE HAVE TO REALIZE IT GETS.
COMPLICATED IN TERMS OF HOW THE
MONEY FLOWS BUT AN END BUDGET
SUBCOMMITTEE SO WHAT HAPPENS IS
THAT WE HAVE TO EVENTUALLY DO
WITH THE MONEY SIDE.
BUT AND I REALIZE FUNDING
STREAMS FLOW IN LOTS OF
DIFFERENT WAYS.
BUT FUN BUT NOT ONLY SO FIRST OF
ALL OF COURSE AND I KNOW YOU
CARE ABOUT THIS TO THIS POSITION
I CARE ABOUT ON THE HUMAN SIDE
THIS IS THE RIGHT THING TO DO
BUT TERMS I THINK ON THE
FINANCIAL SIDE IT'S THE RIGHT
THING TO DO. IN TERMS OF.
THAT'S A SOCIETY OR OVER ON
HEALTHCARE SYSTEM IT'S GOING TO
SAVE MONEY RIGHT I THINK THE
COST IS THAT IF WE CAN ACTUALLY
REDUCE. THE ARE USED BY THAT
MUCH I THINK THE COST OF HIRING
THE PERSON REALIZE THAT BECAUSE
OF HOW WE PAY PEOPLE. WHERE THE
MONEY ACTUALLY GETS CAPTURED
CETERA?
BUT I I THINK THAT.
IT AND AND.
BUT OVERALL I I GUESS MY FEELING
I'M LOOKING OUT OF THE FINANCE
FOLKS TOO BECAUSE WHAT HAPPENS
IS THAT YOU MAY WANT TO SCORE
THIS REQUEST AS A COP AS AN
EXTRA EXPENSE THE BUDGET.
AND MAYBE IN SOME WAYS THAT'S
TRUE BUT I WOULD ALSO SAY THAT
THIS IS GOING TO SAVE US MONEY.
THIS SAVES US MONEY AND THE
SOLACE SAVES US.
YEAH ACTUALLY HELPING PEOPLE SO
I HOPE WHEN WE LOOK AT THIS
PROPOSAL WE WON'T JUST LOOK AS
LG I KNOW WE CAN'T AFFORD
HOWEVER MUCH MONEY IS THIS. TWO
POINT SIX MILLION GENERAL FUND
RIGHT BECAUSE WE'RE ACTUALLY AND
THEN MAYBE WE NEED TO WORK A
LITTLE HARDER FIGURE OUT WE
CAPTURE SOME OF THE SAVINGS TO
MAKE IF THEY WERE SAYING WE
CAN'T QUITE AFFORD IT. HOW WE
CAPTURE SOME OF THOSE SAVINGS
THAT WE CAN'T AFFORD IT BUT IN
THE END I MEAN? BASICALLY WORK
WE'RE GETTING MORE WE'RE WE'RE
ACTUALLY FREE UP RESOURCES FOR
THAT WAY MAYBE.
MAYBE IT'S LIKE A HOSPITAL PLANS
OF WHAT WE ARE FREE MORE UP MORE
RESOURCES TO TAKE CARE OF. OTHER
NEEDS SWITCH THE STATE ALSO PAYS
FOR AND TO ME THAT'S A SAVINGS
ALMOST GOT THROW THAT OUT THERE
I KNOW IT'S COMPLICATED.
AND I TOOK AT THE AGE OF FACT
THAT WE HAVE THE DIRECTOR OF THE
WHOLE DEPARTMENT HERE TO BRING
THIS UP BUT YOU KNOW I. JUST
THAN THE LESS YOU HAVE
COUNTERVAILING DATA TO SHOW THIS
YOU KNOW WHAT THE RESULTS WERE
HAVING THE ART GONNA HAPPEN OR
TIRED TO HAVE IT HAPPEN OTHER
EXAMPLES. BUT THIS IS AN EXAMPLE
TO ME IS WHAT YOU MAKE AN
INVESTMENT WHERE YOU'RE ACTUALLY
GOING TO NOT ONLY HAVE A HUMAN
IMPROVEMENT WHICH OF COURSE WE
ALL WANT BUT ALSO EVEN A FISCAL
ONES WERE BUDGET SUBCOMMITTEE AS
WELL JUST. QUESTIONS WHERE THE
MONEY GETS CAUGHT BUT STILL. I
THINK YOU KNOW.
IT MAKES SENSE TO ME.
THAT'S NOT.
IT COMES LA LA THAT'S SOMETHING
I ALWAYS BRING UP FOR LA TWO CAN
WE LOOK AT THESE THINGS THOUGH.
INVESTMENTS OR SAVINGS REVIEW.
ESTIMATES AND SORT OF THING
THROUGH ANY SORT OF SAVINGS
POTENTIALS BUT THAT I THINK AS
WE'VE NOTED BEFORE SOMETIMES
IT'S NOT THE SAME AND NOT IN THE
BUDGET YEAR WINDOW THAT SAVINGS
ARE GONNA CREW OR AS WE'VE NOTED
THAT COULD CARD AT DIFFERENT
FUNDING STREAMS ARE JUST. A LOT
OF COMPLEXITY BUT THAT HAPPEN TO
THINK THROUGH IT WITH YOU AND
YOUR STAFF K. BUT LET'S LET'S
NOT LET THE COMPLEXITY STOP US
FROM DOING THE RIGHT THING WHEN
WE KNOW THAT ACTUALLY GETS FROM
ATV YEAH AIDS IZZY AND THEY'RE
SOMEWHAT BUT JUST UP IN BETWEEN
BUT. WE KNOW THAT FROM THERE TO
THERE IT'S GONNA. TURN OUT
BETTER. SO OKAY.
THAT.
PUBLIC COMMENT.
KIMBERLY TEN ON BEHALF
CALIFORNIA PANASONIC HEALTH
NETWORK IN SUPPORT OF THIS
PROPOSAL THANK YOU.
I'M READY WITH ACCOUNT TO BE A
REAL HEALTH DIRECTORS THIS THIS
IS A GREAT PROPOSAL TIES IN
EXACTLY WHAT WHAT I WAS TALKING
ABOUT EARLIER ABOUT THE VALUE OF
OUR OF OF EARLY INTERVENTION YOU
KNOW SCREENING. ARE GIVEN THE
INCREASE IN THE NUMBER OF
PATIENTS WERE SEEING IN
EMERGENCY ROOMS THAT ARE THERE
BECAUSE OF A SUBSTANCE USE
DISORDER MAKES PERFECT SENSE TO
HELP. THE COUNSELOR RIGHT THERE
WHERE THEY CAN WHERE THEY CAN
HAVE THE THE.
MAXIMUM A GOOD IMPACT ON THESE
OUT PATIENT SO WE SUPPORT THIS.
THINKING.
ALL. RIGHT SPENCER PATH OF THE
CALIFORNIA MEDICAL ASSOCIATION
IN SPORT. KEEP. THEM A GENERAL
US WITH THE STEINBERG INSTITUTE
ALSO SUPPORT AND WE THINK IT'S A
VERY UNIQUE OPPORTUNITY TO
PROVIDE THIS TYPE OF EARLY
INTERVENTION THANK YOU. THANK
YOU.
OKAY DOUG SERVERS ON BEHALF OF
THE CALIFORNIA PROFESSIONAL
FIREFIGHTERS AND SUPPORT THANK
YOU THANK YOU.
OKAY. ALL RIGHT SO THANK YOU SO
MUCH FOR YOUR PRESENTATION
ACTUALLY AS A MAN I GOT HEAD BUT
I I THINK YOU GOT A CHANCE TO
TALK ABOUT THIS WONDERFUL
PROGRAM AND FISHY MAKING OVER
HERE WE'RE GONNA HOLD. BOTH OF
OUR.
AT THE REQUEST.
HOLD HOLD THEM OPEN I SHOULD
JUST MAKE NOTE BECAUSE IT'S IN
THE NOTES THAT THE.
THE REQUEST FOR CHILDREN
EXPOSED ME VIOLENCE WITH THEM
WAS WITHDRAWN SO THAT'S WHAT WE
DID I HEAR THAT. SO THANK YOU
VERY MUCH.
OKAY SO THE NEXT ITEM IS
ACTUALLY.
FOUR TO SIX OF FORTY FIVE
SUCCESS SO WE HAVE OUR
HEALTHCARE SERVICES THE MENTAL
HEALTH SERVICES OVER SAY
ACCOUNTABILITY COMMISSION.
SO IT'S THE MENTAL HEALTH
SERVICES ACT FISCAL REVERSION
AND PROGRAM ADMINISTRATION.
YES AND I UNDERSTAND THAT.
WE ALSO WILL HAVE.
REPRESENTED FROM THE ESTATE
AUDITOR BECAUSE THERE WAS AN
AUDIT THAT WAS DONE.
AND ACTUALLY.
SO I THINK FOR THIS ITEM BECAUSE
WE'RE GONNA BE DOING THE
OVERSIGHT OF FOR THE. COMMISSION
LATER WORTH LET'S. BEGIN WITH A
BRIEF.
PRESENTATION FROM THE STATE
POTTER ABOUT SOME OF THE.
FINDINGS YET THERE'S GONNA BE
ANOTHER VOTE FULLER HEARING
ABOUT THE AUDIT FINDINGS BUT I
THINK IF THERE'S A. BRIEF
SUMMARY WITH A FOCUS ON
PARTICULARLY THE FISCAL
OVERSIGHT ISSUES VISITS RELATED
MORE SPECIFICALLY THIS BUDGET
SUBCOMMITTEE SO.
SO ACTUALLY PEOPLE ACTUALLY IS
GOING AROUND EVERYONE INTRODUCE
THEMSELVES YOU KNOW WHO'S AROUND
THE TABLE FOR THE SIDE AND FOR
THE RECORD AND THEN WE'LL HAVE
YOU BEGIN ITSELF. BUT.
OKAY SO DOING JOHN BYERS STATE
AUDITOR'S OFFICE THANK YOU.
I'M REQUIRES BERG ON WITH STATE
AUDITORS OFFICE ALSO IN THE
LEGAL DEPARTMENT K..
GOOD AFTERNOON MISTER CHAIR TO
BE DOING THE EXACT ADDRESS AND
I'LL SERVICES OVERSIGHT
ACCOUNTABILITY COMMISSION YOU.
BUT IF I CAN'T DIRECTOR FOR THE
DEPARTMENT OF HEALTH CARE
SERVICES. OKAY. A LAYOFF.
BEN JOHNSON ONLY ON. AIDS
FINANCE RISK UP FROM A FINANCE.
HER FACE APARTMENT A FINANCE.
AND THEN WE HAVE.
KRISTIN BARLOWE ON BEHALF OF THE
COUNTY BE REAL HEALTH DIRECTORS
I THANK YOU ALL RIGHT SO. THANK
YOU MISTER CHAIR MY NAME IS JHN
NICE IN MY NAME'S JOHN BY
REPRESENT AND STATE AUDITOR'S
OFFICE IT WITH ME OUR LEGAL
COUNSEL. IN FEBRUARY TWO
THOUSAND EIGHTEEN WE SHOULD A ON
AND ON HERE SAID THE MENTAL
HEALTH SERVICES ACT BY THE
DEPARTMENT HEALTH CARE SERVICES
AND ALSO THE MENTAL HEALTH.
OVERSIGHT AND ACCOUNTABILITY
COMMISSION. OUR AUDIT CONCLUDED
THESE TWO DEPARTMENTS COULD MORE
EFFECTIVELY OVERSEE THE THE
COUNTY MENTAL HEALTH AGENCIES
USE OF MENTAL HEALTH SERVICES
FIND.
OUR FINDINGS ARE MORE
SIGNIFICANT RELATED TO THE
DEPARTMENT HEALTHCARE SERVICES
PRIMARILY IN TWO AREAS. OF THE
THE OVER THE EFFECT OF GUIDANCE
TO COUNTY SOMEHOW TO SPEND.
SPEND FUNDS AND ALSO THE
OVERSIGHT OF HOW THEIR HOW THEY
COUNTIES ARE USING THOSE FUNDS.
IN THE AGENDA DOES HAVE ALL OF
OUR FINDINGS LISTED IN IT I WANT
TO FOCUS ON TO THAT I THOUGHT
WERE MOST IMPORTANT. PERSON IS
ABOUT REVERSE IN A OF FUNDS.
NOT ONLY HELD REVERTED FINDS
TOTAL TWO HUNDRED THIRTY ONE
MILLION DOLLARS AS OF JUNE TWO
THOUSAND SIXTEEN.
WE ARE CONCERNED BECAUSE
HEALTHCARE SERVICES HAS NOT
DEVELOPED A PROCESS FOR COUNTIES
TO REVERT THOSE FUNDS BACK TO
THIS BACK TO THE STATE. WE KNOW
THAT TO THE LEGISLATURE MADE A
CHANGE IN THE LAW ONE TIME
CHANGE IN LAW AND. IN TWO
THOUSAND SEVENTEEN TO ALLOW
COUNTIES TO KEEP THOSE FUNDS BUT
GOING FORWARD THAT REVERSION
PROCESS STILL NEEDS TO BE PUT IN
PLACE.
HEALTHCARE SERVICES HAS HAD.
BOUGHT A FIVE AND A HALF YEARS
SINCE IT TOOK OVER A
RESPONSIBILITIES A MENTAL HEALTH
SERVICES ACT TO PUT IN PLACE A
REVERSAL PROCESS. HAS NOT DONE
SO WHAT IT TOLD US IS THAT IT
NEEDED TO PUT IN PLACE
REGULATIONS TO. IT TOO AND
FORCES HER VERSION PROCESS
ABOARD WERE CONCERNED THAT THE
DEPARTMENT HAS SOME OF THOSE
REGULATIONS IN PLACE YET.
THE SECOND ISSUE I WANT TO
HIGHLIGHT IS THE AVERAGE LEVEL
RESEARCH FIND SAID THAT THE
COUNTY'S HOLD AS OF JUNE TWO
THOUSAND SIXTEEN. COUNTY SOLD
FIVE HUNDRED THIRTY FIVE MILLION
DOLLARS WORTH OF RESERVE FUNDS.
NOT A RESERVE LEVEL ABOUT FORTY
SEVEN PERCENT. OUR ANALYSIS.
WE WE CONCLUDED THAT THE RESERVE
LEVEL SHOULD BE.
MUCH LOWER ABOUT THIRTY THREE
PERCENT WE THOUGHT THAT WAS
REASONABLE BIG BASED ON. PRIOR
YEAR FLUCTUATIONS IN IN THE MAIL
SERVICES REVENUES.
THE DEPARTMENT'S DISAGREED WITH
THIS FINDING IT HAD A IT
PROPOSES A HIGHER LEVEL BETWEEN
SIXTY FOUR EIGHTY TWO PERCENT AS
A RESERVE LEVEL. WE FILLED OUT
THIS HIGHER LEVEL WOULD WOULD
WOULD TAKE AWAY FINDS THAT WOULD
BE AVAILABLE FOR PROVIDING.
MENTAL HEALTH SERVICES AT THE
LOCAL LEVEL.
WE GOT IN THEM THE THE MENTAL
HEALTH OVERSIGHT AND
ACCOUNTABILITY COMMISSION. WE
FOUND THAT SOME THAT HE WAS MORE
PROACTIVE IN ITS EFFORTS ARE
FINDINGS FOCUSED MAINLY ON
CONTINUES ITS EFFORTS AT HAS
SENT A WAY. FOR EXAMPLE AND
WANNA HIGHLIGHT IS SET TIGHT
COUNTIES TOLD US THEY'RE
STRUGGLING WITH WITH HOW TO
SPEND INNOVATION FUNDS AND HOW
TO GET APPROVAL FOR. THE
PROJECTS BEFORE THE COMMISSION.
AND THE COMMISSION ITSELF AN
UNDERTAKING AN EFFORT TO BETTER.
THE A BETTER EDUCATE THE
COUNTIES AND HELP THEM
UNDERSTAND THE REQUIREMENTS AND
OUR RECOMMENDATION WAS TO
CONTINUE THAT EFFORT UNTIL IT
FOUND THAT. THE COUNTIES WERE
ACTUALLY SPENDING MONEY.
ON A MORE RECENT BASIS. WE ALSO
VISITED THREE COUNTIES. AND.
AND.
WENT TO ALAMEDA COUNTY
RIVERSIDE AND SAN DIEGO COUNTY
AND WE GENERALLY FOUND THESE
COUNTIES WERE.
COMPLAINS APARTMENTS THE MENTAL
HEALTH SERVICES ACT AS FAR AS
GETTING A PLANS APPROVED IN
HAVING A PUBLIC AN OPEN PROCESS
ABOUT IT. AND THAT THEY'RE ALSO
OVERSEEN THE FINDING THAT TIME
THAT THEY'RE PUTTING OUT TO
VARIOUS PROGRAMS.
THAT CONCLUDES MY COMMENTS.
THANK YOU I ASSUME LEGAL COUNSEL
JUST HERE FOR.
IN OTHER WORDS YEAH.
OUR ONLY THE ONLY COMMENT I
WANTED TO MAKE IS WITH RESPECT
TO. THE LEGISLATURES RESPONSE
POSSIBLE RESPONSE TO THE AUDIT
FINDINGS AND RECOMMENDATIONS IS
THAT THE LEGISLATURE COULD THE
BUDGET COMMITTEES COULD
CONSIDER.
BUDGET CONTROL LANGUAGE THAT
WOULD REQUIRE THE DEPARTMENT TO.
.
TO ADOPT OUR RECOMMENDATIONS
DURING THE UPCOMING FISCAL YEAR
OKAY I THANK YOU.
AND I WOULD JUST MAKE NOTE
BEFORE WE MOVE ON TO THE
RESPONSE FROM. THE AGENCY'S
IT'S.
THE OTHER. ONE THE REASONS.
WE AS A LEGISLATURE DID PASS.
ON THE REVERSION WHERE WE SAID
STARVING FOR IS BECAUSE WE HAD
NO ABILITY BECAUSE.
WE DON'T HAVE THE FARM
HEALTHCARE SERVICES AND HAVE THE
INFORMATION FOR US TO GO BACK TO
TO ACTUALLY ENFORCE THE ACT.
WITHOUT THE DATA HOW ARE WE
GOING TO GO AND DO THE REVERSION
WHEN. THE AGENCY IS JUST KEEP
TRACK OF IT DIDN'T HAVE THE DATA
SO THAT'S WHY WE SAID OKAY
MOVING FORWARD BECAUSE THERE'S
NO WAY TO ACTUALLY ENFORCE THE
ACT WE DON'T HAVE THE
INFORMATION THAT WAS NOT
AVAILABLE AND THAT AND AND THAT
WAS ACTUALLY VERY CONCERNING TO
THE SUBCOMMITTEE. SO I DOES NOT
MAKE NOTED THAT YOU DIDN'T
SPECIFICALLY SAY THAT BUT THAT'S
PART OF THE REASON WE ENDED UP
HAVING TO DO THAT THIS IS A TWO
FOLD ISSUE ONE THEY WERE. A
REVERSION PROCESS WASN'T IN
PLACE SO EVEN IF RIGHT
HEALTHCARE SERVICES NEW.
ONE AT THAT THE INFORMATION
KNEW HOW MUCH THEY'RE HOLDING
DIDN'T HAVE THE PROCESS TO DO IT
AND YES ONE OF OUR OTHER
FINDINGS WAS ABOUT TRYING TO
BETTER ENFORCE THE ANNUAL
REPORTING. PROCESS THAT TO THE
COUNTIES ARE NOT FOLLOWING RIGHT
NOW.
ALL RIGHT.
OKAY FOR HEALTHCARE SERVICES.
SURE I KNOW.
THE RESPONSES THAT WE PROVIDED
TO THE STATE AUDITOR AND LIKE.
MOST ARTISTS AND WE AGREE WITH
THE YOU KNOW.
MOST IF NOT ALL OF THE
RECOMMENDATIONS ON IN THIS
PARTICULAR AUDIT THERE WAS A
COUPLE OF PLACES IN WHICH WE DID
NOT DO IT.
AGREE WE HAD EITHER A
DIFFERENCE OF OPINION OR WE HAD
A DIFFERENT STANDARD I KNOW ON
THE RESERVE LEVEL IS CERTAINLY
ONE IN WHICH WE. WE THINK WE
HAVE A DIFFERENT.
BUT WE CERTAINLY AGREED WITH
OTHERS IN TERMS OF THE NEED TO
HAVE.
CLEAR I'M REGULATORY GUIDANCE
OUT TO THE COUNTIES IN TERMS OF
HOW THE REVERSION CALCULATION
WILL BE DONE. ON WHAT THE
PROCESS WILL BE MAKING SURE THAT
THE COUNTIES HAVE AN APPEAL
PROCESS IN PLACE TO THE EXTENT
THAT THEY FEEL WE'VE DONE THE
CALCULATION IN ERROR.
I KNOW THAT ONE OF THE AREAS
THAT WE'VE BEEN TRYING TO WORK
MORE CLOSELY WITH THE COMMISSION
ON IS.
COMMUNICATION BETWEEN THE TWO
OF US IN TERMS OF THE COUNTIES
I'M AS THEY REPORT TO US THEIR
REVENUE AND EXPENDITURE REPORT
SO.
.
SOME COUNTIES ARE BETTER THAN
OTHERS WHEN IT COMES TO
REPORTING THOSE.
WE HAVE CERTAINLY TRIED TO
IMPROVE THE PROCESS BY WHICH THE
COUNTIES GET THAT TEMPLATE AND
THE FORM IN TIME.
AND SAID THERE HAVE BEEN A
MULTITUDE OF EFFORTS TO BOTH
IMPROVE TRANSPARENCY TO INCREASE
THE COMPLIANCE AND THEN
OBVIOUSLY WORKING WITH THE
COMMISSION IN TERMS OF.
ARE THEIR COUNTIES OUT THERE
THAT HAVE.
.
FUNDS THAT DON'T APPEAR TO BE
USED I WOULD. ALSO JUST WANT TO
REMIND THE COMMISSION ARE NOT
THE COMMISSION YOU'RE RIGHT HERE
I'M I WOULD LIKE TO REMIND.
PEOPLE THAT COUNTIES HAVE THREE
YEARS TO SPEND THESE FUNDS SO
JUST BECAUSE THEY TOOK IN AN
AMOUNT. IN A GIVEN FISCAL YEAR
DOESN'T MEAN THAT THEY HAVE TO
SPEND IT IN A FISCAL YEAR THEY
HAVE UP TO THREE YEARS AND SO
THERE ARE SOME. PLACES IN WHICH
PEOPLE SEE MONEY AND THEY SAY OH
YOU HAVEN'T SPENT IT BUT IT
COULD BE THAT THEY ARE HOLDING
IT BECAUSE AS WE'RE DOING COST
RECONCILIATIONS ON THE MEDICAL.
SIDE THERE ARE DISALLOWANCE IS
OR CLAIMS THAT WE COULD COME IN
AND SAY YOU SHOULD NOT HAVE A
CLAIM TO MEDIC HEALTH FUNDING
FOR THAT PARTICULAR SERVICE IT
WASN'T. APPROVED IS NOT
CONSISTENT WITH THE STATE PLAN
WE WOULD DISALLOW THE CLAIM AND
THEN THE COUNTY COULD USE THEIR
IMAGES SAY FUNDS INSTEAD TO BACK
FILL THAT LOSS OF FUNDING. SO
THERE ARE A LOT OF REASONS WHY
COUNTIES HAVE FUNDS EITHER
THEY'RE SAVING THEM FOR
PARTICULAR INITIATIVE THEY MAY
JUST BE HOLDING THEM.
TO USE OUR THEY'RE WAITING FOR
THEIR LOCAL PLANNING PROCESS AND
SO WE ARE ON ENDEAVORING TO TRY
TO YOU BOTH. FACILITATE ON A
TECHNICAL ASSISTANCE BASIS.
GREATER WAYS IN WHICH THE
COUNTIES CAN EXPEND THESE FUNDS
ESPECIALLY.
THE TWO AREAS THAT HAVE BEEN
THE MOST PROBLEMATIC ARE AROUND
PREVENTION AND EARLY
INTERVENTION FUNDING SOURCES AS
WELL AS INNOVATION. FOR
COMMUNITY SUPPORTS AND SERVICES
WHICH IS EIGHTY PERCENT OF THE
MHSAA ALLOCATION WHICH IS THE
BULK OF THE FUNDING THAT THE
COUNTY'S WROTE.
RECEIVE I THINK ONLY.
POINT ZERO THREE PERCENT RIGHT
NOW ACCORDING TO OUR
CALCULATIONS IS SUBJECT TO
REVISION WHICH IS TWO POINT
SEVEN MILLIONDOLLARS. ON IF
AMOUNTS THAT THAT'S ON A
THIRTEEN POINT SIX BILLION
DOLLAR ALLOCATION SO.
THE COUNTIES ARE SPENDING THE
SUMMER YOU KNOW THIS COMMUNITY
SUPPORTS AND SERVICES FINDING
IT'S THE ONES THAT ARE A LITTLE
BIT MORE.
NUANCED AND.
TECHNICAL IN NATURE OR THEY
REQUIRE YOU KNOW AN INNOVATION
PLAN TO BE APPROVED AND SO I
THINK THAT'S WHAT WE'RE
COMMITTED TO I'M WORKING ON. YOU
KNOW THE ODD IT WAS A GOOD I'M
REMINDED THAT WE NEEDED TO.
TAKE A CERTAIN.
YOU KNOW PRIORITY LEVEL ON THE
REGULATIONS WHICH WE WILL
CERTAINLY DO BUT YOU KNOW WERE
COMMITTED TO WORKING THROUGH
THESE ISSUES WITH THE COUNTIES
AS WE AS WE MOVE FORWARD.
THANK YOU MISTER CHAIR TOBY LANE
WITHIN THE HEALTH COMMISSION SO
I WANT TO YOU KNOW THINK THAT
THE AUDIT TEAM FOR THE WORK THAT
THEY DID ON THIS HAS BEEN A LOT
OF TIME WITH THEM.
SHARING LOTS OF INFORMATION AND
I THINK THEY WERE VERY THOROUGH.
AS IDENTIFIED IN THE REPORT
THERE WERE SOME AREAS WHERE THAT
THE AUDITOR BUT ALSO THE
COMMISSION. RECOGNIZED AREAS
WHERE WE CAN IMPROVE.
AS THAT AUDIT STAFF MENTIONED.
ACTUALLY GOING BACK ABOUT A
YEAR YEAR AND A HALF WE'VE BEEN
SITTING DOWN WITH THE COUNTY'S
TALKING WITH THEM ABOUT HOW WE
CAN IMPROVE THE INNOVATION
COMPONENT OF THE ACT. IN
PARTICULAR THERE'S THERE'S BOTH
SORT OF THE PROCESS OF REVIEWING
AND APPROVING COUNTY INNOVATION
PLANS AND THEN THERE'S THE
INTENT OF THE INNOVATION PACE
AND SO WE DID FORM A
SUBCOMMITTEE WE WENT THROUGH AND
CLARIFIED ALL OF THE RULES WE
STREAMLINED. WE HAVE A CHECKLIST
AND AND WE'VE DONE TRAINING FOR
THE COUNTIES TO MOVE THAT
FORWARD AND. I BELIEVE THE
AVERAGE TIME FRAME FOR REVIEW
AND APPROVAL FOLLOWING THE
COUNTY POSTING OTHER PLANETS
AROUND SIXTY SIXTY FIVE DAYS
SOMETHING ALONG THOSE LINES I
DON'T HAVE THAT NUMBER. BUT IT
IS MENTIONED IN THE REPORT.
IN ADDITION TO THAT REALLY
TRYING TO STREAMLINE OUR PROCESS
THAT OUR PROCESS DOESN'T CREATE
A BARRIER TO. COUNTIES INVEST
ANY DOLLARS INNOVATION WE'VE
ALSO STEPPED BACK AND IT'S BEEN
TALKING WITH THE COUNTIES BUT
HOW DO WE ACHIEVE THE GOALS OF
INNOVATION WHICH REALLY ARE
TRANSFORMATIONAL CHANGE.
IN FEBRUARY OF THIS YEAR WE
HOSTED AN INNOVATION SUMMIT IN
PARTNERSHIP WITH THE COUNTIES.
WITH PROVIDERS WITH. A COUNTY
SUPERVISORS CAN BE ABOUT
TRACTORS AND OTHERS. WE BROUGHT
IN. THE TECH SECTOR LEVI STRAUSS
GOOGLE FACEBOOK. LOTS OF
COMPANIES AND REALLY TALK TO
THEM TO SAY HOW CAN YOU HELP US
THINK DIFFERENTLY ABOUT
INNOVATION HOW DO YOU GIVE US A
LITTLE BIT OF THAT. THAT.
INNOVATION DNA INTO THE PUBLIC
SECTOR TO REALLY. LEVERAGE THE
FUNDS THAT THE PUBLIC MAKES
AVAILABLE FOR MENTAL HEALTH
INNOVATION IN WAYS THAT DRIVE
TRANSFORMATIONAL CHANGE. AND WE
WAS A VERY SUCCESSFUL WORKSHOP
DESIGNED EVENT WE'RE NOW
ACTUALLY FOLLOWING UP. AS YOU
SEE IT AS IT WILL COVER THE
GENTLE A BIT LATER WE'RE HOPING
TO BUILD OUT SOME TECHNICAL
ASSISTANCE AND OTHER TOOLS TO
HELP THE COUNTIES. REALLY
LEVERAGE INNOVATION DOLLARS IN
WAYS THAT ARE TRANSFORMATIVE
PART OF WHAT WE HEAR PART OF THE
CHALLENGE. AROUND INNOVATION IS
INNOVATION IS RISKY. AND MANY
COUNTIES ARE RELUCTANT TO INVEST
IN THINGS THAT. THAT THEY'RE
OUTSIDE OF THE COMFORT ZONE AND
PARTLY WHAT WE WANT TO DO IS
BRING IN SUPPORT FROM THEIR
COMMUNITIES. TO HELP THEM BE
MORE SUCCESSFUL WITH INNOVATION
BUT ALSO MITIGATE SOME OF THE
PUSH BACK THAT THEY MIGHT
EXPERIENCE. IN THEIR COMMUNITIES
AROUND USING THESE DOLLARS IN
NON TRADITIONAL WAYS. SO ON SO
ON THE FIRST POINT ABOUT
STRENGTHENING INNOVATION THAT'S
SOMETHING WE'VE BEEN WORKING ON
FOR ABOUT A YEAR YOU HAVE IN
FRONT OF YOU SOME PROPOSALS AND
I'LL TALK ABOUT LATER IN THE
AGENDA.
ON THE ON THE SECOND ISSUE
AROUND.
GATHERING DATA AROUND KEY I IN
LEVERAGING THAT WE AGREE WITH
THE AUDITOR'S FINDINGS.
AND AS PART OF THIS PROCESS WE
HAVE BEEN SITTING DOWN WITH THE
COUNTIES TO TALK WITH THEM ABOUT
THE REPORTING THAT THEY'RE
STARTING TO DO FOR US. THOUGH
THE FIRST LEVEL OF REPORTS FOR
CAME IN DECEMBER I THINK WE'VE
HAD THIRTY SIX COUNTIES. MEET
THAT DEADLINE WE'RE TALKING WITH
THEM WE HELD A WEAPON ARE FORTY
FIVE COUNTIES PARTICIPATED IN
THAT WE'RE FOLLOWING UP. AND AND
THIS IS ABOUT HOW COUNTIES
REPORT INFORMATION ON PERSON
SERVES TO PREVENTION EARLY
INTERVENTION PROGRAMS.
ARE ONLY DISAGREE WITH THE
AUDITOR IS WHETHER WE CAN GET
THERE AS FAST AS THEY LIKE US
TO.
IN PART BECAUSE OF THE DELAYS IN
GETTING THE DATA FROM COUNTIES
AND OUR UNDERSTANDING THAT HOW
WE ANALYZED THOSE DATE IS GOING
TO BE ITERATIVE. IT MAY TAKE US
SOME TIME TO FIGURE OUT HOW TO
MAKE BEST USE OF THE INFORMATION
BECAUSE A VARIATION IN THE
TIMING AND THE DETAIL HAS THIS
INFORMATION FLOWS IN FROM THE
COUNTIES. ON THE THE THIRD ISSUE
THAT THE AUDITORS RAISED IS THAT
DURING OUR FIRST ROUND OF TRIAGE
FUNDING THE COMMISSION BUILT IN
AN EVALUATION REQUIREMENT AT THE
COUNTY LEVEL.
OUR INTENT THERE WAS THAT
RECOGNIZING THAT EVERY COUNTY
PROPOSED A.
SIR CONTRACT DOLLARS THAT LIKE
FRANCE EVERY COUNTY PROPOSED A
GRANT THAT WAS TAILORED TO THE
UNIQUE SITUATION. WE REQUIRED
THAT THE EVALUATION BE TAILORED
TO THEIR APPROACH. THAT MADE IT
A VERY ROBUST IN TERMS OF
HELPING THOSE COUNTIES
UNDERSTAND HOW THEY COULD
IMPROVE BUT IT MADE IT VERY HARD
TO COMPARE. MODOC COUNTY TO LA
COUNTY.
AND SO THE ALTERNATIVE IS FOR US
TO MOVE AWAY FROM A LOCALLY
DRIVEN EVALUATION TO A STAGE OF
AN EVALUATION. AND.
BACK I BELIEVE IN NOVEMBER THE
COMMISSION DIRECTED STAFF TO
MOVE IN THAT DIRECTION.
TRYING TO SHIFT THE ATTENTION
TO OUR ABILITY TO LOOK STATEWIDE
AT THE IMPACT OF TRIAGE AND SO
CONSISTENT WITH THE HONOR OF
RECOMMENDATION. THE COMMISSION
HAS ALREADY. POINTED US TO TO DO
THAT WORK AND IN FACT IN YOUR
AGENDA. ALSO TO EXPLAIN THAT
WERE WE'VE SET ASIDE TEN MILLION
DOLLARS OF THOSE FUNDS ARE
WORKING WITH AN OUTSIDE AT A
COUPLE OF OUTSIDE. EVALUATORS TO
HELP US CRAFT A STATE LEVEL
EVALUATION.
THE DOWNSIDE OF A STATE LEVEL
EVALUATIONS WE LOSE ALL THAT
LOCAL NUANCED INFORMATION HELP
TO HELP SHAPE HOW INDIVIDUAL
COUNTIES OPERATE THEIR PROGRAMS.
THE UPSIDE IS THAT ALLOWS US TO
DO A MUCH BETTER JOB DOING
APPLES TO APPLES COMPARISON
ACROSS THESE DIFFERENT
INVESTMENTS AND SO. WE
APPRECIATE ALL THE WORK THAT THE
AUDITOR DEAD WERE VERY MUCH IN
AGREEMENT WITH. THE
RECOMMENDATIONS THEY HAVE ARE
ONE ISSUE IS CAN WE AS STAFF.
CAN WE WORK AS FAST AS THEY THEY
WANT US TO AND IN THAT REGARD.
IT DEPENDS ON OUR ABILITY TO
COLLABORATE WITH THE COUNTIES
MAKE THAT HAPPEN.
AND.
YOU ARE A.
GOOD AFTERNOON AGAIN KRISTIN
BARLOWE AT THE COUNTY BEHAVIORAL
HEALTH DIRECTORS ASSOCIATION.
LIKE THE OTHERS WHO SPOKE
BEFORE ME WE SUPPORT THE
FINDINGS.
AND REALLY AGREE WITH MANY OF
THE RECOMMENDATIONS THAT WERE
FOUND IN THE STATE AUDIT AND WE
AGREE THAT ADDITIONAL
LEADERSHIP.
IS NEEDED AND IS COMING FROM
THE DEPARTMENT HEALTH CARE
SERVICES AND WE REALLY WELCOME
THAT.
AND LIKE THE MHSAA AUDIT THAT
CAME BEFORE THIS ONE AND THE
COUNTIES THE PARTICIPATED IN
THIS CASE DID VERY WELL AND WERE
FOUND TO HAVE COMPLIED WITH
MHSAA LEGAL REQUIREMENTS
REGARDING HOW THEY'RE SPENDING
THEIR FUNDING.
I THINK WE DO WANT TO MAKE SURE
WE'RE CLEAR.
DESPITE WHAT YOU MIGHT HEAR IN
THE HALLS THE COUNTIES ARE NOT
SITTING ON TWO HUNDRED AND
THIRTY ONE MILLION DOLLARS IN AN
HSA FINDING. JUST LAST YEAR WE
WORK WITH THE LEGISLATURE AND
WITH THIS COMMITTEE IN FACT TO
WRITE THE LANGUAGE OF AB ONE
FOURTEEN TO TAKE CARE OF THE
LOGJAM OF TEN YEARS OF NOT
HAVING REVERSION HAPPENED. SO
JUST IN JANUARY THAT WENT INTO
EFFECT WE HAVE COUNTIES WHO HAVE
THE OPPORTUNITY NOW TO HAVE
THOSE FUNDS COME OUT OF BEING
SEQUESTERED AND TO PUT THOSE
INTO INVESTMENTS IN THE
COMMUNITY. I'M A LOCAL EXAMPLE
HERE IN SACRAMENTO COUNTY.
IS THAT THEY ARE ALREADY IN THE
THIRTY DAY PUBLIC COMMENT
PROCESS I'M WITHIN ABOUT THIRTY
SIX DAYS AFTER THE LOG GOING
INTO A FACT SO THEY'RE VERY
ANXIOUS TO HAVE THOSE DOLLARS GO
INTO THE. HOUSING ISSUES THE
CRISIS SERVICES ELDER WELLNESS
AND VARIETY OF THINGS THAT ARE
NEEDED IN THE COMMUNITY.
WE ARE ITS STRONG SUPPORT OF
THE AUDITORS RECOMMENDATION
THAT.
AS AS MISTER EWING DESCRIBED TO.
IMPROVE GUIDANCE ON THE
APPROVAL PROCESSFOR COUNTIES TO
SUCCESSFULLY GET THOSE
INNOVATION DOLLARS THAT ARE THAT
SEEM TO BE HARDER TO SPEND.
TO HAVE THE LOCAL COMMUNITIES
VIEW OF WHAT'S INNOVATIVE IN THE
COMMISSION'S STAFF AND
COMMISSIONERS YOU WHAT'S
INNOVATIVE FIND A WAY FOR THOSE
THINGS TO MEET IN THE MIDDLE.
AND WE DO AGREE THAT THE
INNOVATION SUMMIT THAT THE OAC
HOSTED WAS A GREAT FOR STAR AND
APPRECIATE THAT THEY REALLY DUG
INTO THE DETAILS THROUGH THEIR
WORK GROUP WOULD LIKE TO SEE
THEM CONTINUE THOSE KINDS OF F..
IT'S BECAUSE DESPITE THOSE
EFFORTS WE STILL HEAR FROM OUR
MEMBERS SOME DIFFICULTIES IN
UNDERSTANDING WHAT THE
EXPECTATION WILL BE SO THAT WHEN
THEY GET THEIR PLAN TO THE
COMMISSION. THAT IT'S SUCCESSFUL
AND THAT IT MEETS BUT STATEWIDE
GOALS BUT ALSO RESPONSE TO WHAT
THEY HEARD FROM THEIR
CONSTITUENTS WHEN THEY DEVELOP
THE ACT WILL COUNTIES ARE
REQUIRED
TO HAVE A PRUDENT RESERVE SO
THAT THEY CAN WEATHER ECONOMIC
DOWNTURNS. THERE'S ACTUALLY A
REQUIREMENT THAT THEY SET A
MINIMUM LEVEL OF ASIDE RATHER
THAN A MAXIMUM LEVEL AND SO AS A
RESULT WE HAVE COUNTIES THAT
VARY FROM HAVING NOTHING PUT IN
RESERVE AND THEY'RE SPENDING
EVERY DOLLAR THEY RECEIVE. TWO
COUNTIES THAT LIKELY HAVE PUT IN
RESERVE MORE THAN EVEN THE
RECOMMENDED AMOUNT.
FRIEND THE MOST.
GENEROUS STANDPOINTS AND SO I
THINK IT IS IMPORTANT THAT WE
TRY TO MITIGATE THAT AND THAT.
ARE FEELING AT THIS POINT ARE
BORED JUST APPROVED US.
.
TO PROPOSE THAT WE SHOULD PUT IN
THE ACT A REQUIREMENT THAT NO
COUNTY CAN PRESERVE. MORE THAN
FIFTY PERCENT OF THEIR PRIOR
YEAR EXPENDITURES PARTICULARLY
IN THE COMMUNITY SERVICES AND
SUPPORTS ARENA INTO A PRUDENT
RESERVE BECAUSE AT THIS POINT
RIGHT NOW WE DO HAVE SOME
COUNTIES WHO ARE PUTTING AWAY
MONEY ON AN ANNUAL BASIS AND IT
DOES BUILD UP. INSTEAD WE WOULD
PROPOSE THAT FIFTY PERCENT BE
FILLED SORT OF LIKE THE
GOVERNOR'S PIGGY BANK.
AND THEN YOU LEAVE THAT ALONE
UNTIL YOU NEED TO START
RESPONDING TO LOCAL ECONOMIC
DOWNTURNS.
FINALLY WE DO UNDERSTAND AND
SUPPORT THE DEPARTMENT'S PLAN TO
WITHHOLD MHSAA FINDS WEN
NECESSARY.
TO.
INSURE THE COUNTIES WHO ARE
SUBSTANTIALLY NEGLIGENT AND
THEIR PART DOING THEIR PART
AROUND REPORTING TO THE STATE
HOW THEY'RE SPENDING THE FUNDS.
BE USED HOWEVER ADAM WE HAVE
BEEN IN DISCUSSIONS WITH THE
DEPARTMENT ABOUT HOW IMPORTANT
IT IS THAT THEY DO THEIR PART AS
WELL. I'M FOR COUNTIES TO BE
ABLE TO SUBMIT REPORTS TIMELY.
AND ACCURATELY WE NEED THEIR
INSTRUCTIONS AND FORMS TO BE
TIMELY AND ACCURATE AND THE
COUNTIES TO CONSIDER THOSE
REPORTS VERY SERIOUSLY THEIR
AUDITABLE DOCUMENTS AND IN FACT
UNDER PENALTY OF PERJURY. THIS
COUNTY'S AUDITOR CONTROLLER MUST
SIGN THOSE BEFORE SENDING THEM
TO THE STATE SO WE HAVE HAD AT
TIMES.
INACCURACIES IN THE INITIAL
VERSION OF THE REPORTS AND FORMS
THE STATE REALLY SAYS ONLY TO
THEN HAVE CORRECTED VERSION
SUBMITTED AND ALL OF THAT SORT
OF HAS THIS DOMINO EFFECT.
SO WE ARE WORKING WITH THE
DEPARTMENT TO TRY TO IDENTIFY
SOME AGREED UPON DATES BY WHICH
THEY HAD RELEASED THEIR
INSTRUCTIONS. THEREFORE REALLY
ALLOWING FOR COUNTIES TO MEET
THAT DECEMBER THIRTY ONE
DEADLINE THAT BEING SAID WE DO
AGREE THERE ARE SOME COUNTIES
THAT ARE MORE OUT OF COMPLIANCE
THAN OTHERS. AND SUPPORT THAT
THE STATE HAS THE AUTHORITY TO
WITHHOLD IMAGES SAY FUNDS AS A
DRIVER I HAD TO GET THOSE
REPORTS IN WHEN NEEDED.
THANK YOU FOR THE OPPORTUNITY
TO ADDRESS THE AUDIT.
THANK YOU QUESTIONS FROM
COMMITTEE MEMBERS CEREMONY YOUR
STANCE THAT MAYBE SOME OF
THOSE ARE WITHIN THE THREE YEAR
PERIOD. MAY OTHERWISE BE
COMMITTED ETCETERA SO I THINK.
COMMUNICATION OF.
THE RULES OF THE GAME IS
CRITICAL.
YEAH PROVIDERS IN MY DISTRICT.
WHO READ THESE HEADLINES IN AT
THE COUNTY LEVEL?
FEEL THAT THEY HAVE UNMET NEEDS
THEY HAVE INNOVATIVE. PROGRAM
DESIGNS THEY HAVE.
HAITIAN COMMUNITY BASED NEEDS.
AND IT'S NOT BEING RELEASED BY
THE COUNTY.
ONE OF MY QUESTIONS HAS ANY
MONEY BEEN. PULLED BACK BY THE
STATE FROM THE REVERSION.
SENDING BONINO.
SO IT EXISTS IN THEORY ONLY AT
THIS POINT THERE'S BEEN NO
FINDING THAT SPAN CLAIM THIS. IS
HELD FROM BEYOND THE THREE YEAR
EXPENDITURE OBLIGATION BEST
CREDIT CHRIS COOK DEPARTMENT
FIND IT SO TECHNICALLY NO MONEY
HAS BEEN.
PULLED BACK FROM THE STATE.
CONVERSATIONS ARE STILL UNDER
WAY AND.
.
ABOUT HOW OLD WILL ADMINISTER
THAT.
WITHHOLD. EASIER.
IS THERE ANY FORECASTS THAT SOME
WILL REVERT TO THE STATE ARM AND
EFFECT IF I CAN CLARIFY.
.
BUT SAY THERE'S NO MONEY HAS
REVERTED THE MODERN ERA. THERE
WAS A POINT IN TIME. WHEN THE
STATE HELD THE FUNDS ALLOCATED
INTO THE COUNTIES. AND THEN
ENFORCE THREE YEAR VERSION AND
SO IF YOU GO BACK TO.
FIVE OR SIX OR SEVEN I THINK OF
SEVEN OR MAYBE A WAY.
WELL STARTED OUT FOR HAS TRIED
SO IN IN IN THE INITIAL YEARS
REVERSION WAS ENFORCED.
AND WHEN THE DEPARTMENT OF
MENTAL HEALTH WAS DISBANDED AND
TRANSITION. THEY HIGHLIGHTED
THAT.
THE REVERSION PROD THE
MECHANISM FOR A VERSION WAS
REALLY DESIGNED IN AN
ENVIRONMENT WHERE THE STATE HELD
THE FUNDS THE COUNTY SUBMITTED
PLANS IN THE STATE FOR LACK OF
BETTER TERMS OF WROTE A CHECK.
AND THE CLOCK STARTED WHEN THE
CHECK WAS GIVEN AND IF THE
COUNTY DIDN'T SPEND THOSE FUNDS
THEY WERE ELIGIBLE FOR MORE
FUNDS AND THEY HAD TO RETURN
THEM.
BECAUSE OF DELAYS IN ALLOCATING
FUNDS TO THE COUNTIES A
LEGISLATURE CHANGED THE RULES
NOW THE FUNDS GO TO THE COUNTIES
AND WHAT WE MIGHT CALL A DIRECT
DEPOSIT MANNER.
AND ABOUT THAT TIME OR SOON
AFTER THAT THE THE
RESPONSIBILITY SHIFTED TO THE
DEPARTMENT OF HEALTH CARE
SERVICES. BUT THE MECHANISM THAT
WAS IN PLACE NO LONGER MATCHED
THE POLICY THAT WAS A DIRECT
DEPOSIT POLICY AND SO THERE WAS
THIS CONFUSION OVER WHEN YOU
START THE CLOCK HOW DO YOU GET
THE MONEY BACK AND SO FORTH. SO
THE STATE HAS A HISTORY OF DOING
HER VERSION BUT THE RULE HAD NOT
HAD NOT BEEN IN FORCE SINCE AWAY
AND SO IN. NINE TWENTY SIXTEEN
THE COMMISSION STARTED ON THIS
PATH AND IN TWENTY SEVENTEEN WE
ISSUED A REPORT TO YOU ON RIVERS
AND IN THIS CHALLENGE AND AND
SUBSEQUENTLY THE AUDIT AND SO. I
THINK YOU KNOW WHAT THE
COMMISSION IS VERY MOTIVATED AT
IT TO TRY TO RESOLVE THIS ISSUE.
BECAUSE OF THE CONCERN THAT YOU
HAVE. AN IDEA AND I WANT TO
CLARIFY THAT.
THAT THERE'S TWO KINDS OF
HEADLINES HERE ONE OF THE
HEADLINES ARE THOSE FUNDS THAT
WERE NOT SPENT WITHIN THE THREE
YEAR TIME FRAME.
AND IN THE LAW REALLY IS USE IT
OR LOSE IT AND THERE IS
FRUSTRATION AT COUNTIES AREN'T
USING IT BUT AREN'T LOSING IT
EITHER.
THE PROBLEM WITH THAT IS THAT
THE COUNTIES ARE ALLOWED TO USE
IT AS AS MISS PARKER SAYS
THERE'S MANY SORT OF SEQUESTERED
BECAUSE OF THE THREAT THAT THE
STATE IF THEY SPEND AT THE STATE
THEN ASK FOR IT BACK THERE SOME
STOCK. ON THE OTHER ISSUE IS THE
LARGE BALANCES OF UNSPENT FUNDS
THAT AREN'T NECESSARILY IN THE
PRUDENT RESERVE. THAT ARE IN THE
BANK AND SO.
WE'VE RECENTLY UPDATED WHAT WE
CALL OUR FISCAL TRANSPARENCY
TOOL THAT DEMONSTRATES CASH ON
HAND AS A PERCENTAGE OF REVENUES
FOR THE YEAR. WE SEE MANY MANY
COUNTIES THAT HAVE FIFTY PERCENT
SIXTY PERCENT IN OTHER WORDS
THEY'VE GOT CASH FLOW THEY'VE
GOT SIX MONTHS MAYBE EIGHT
MONTHS OF CASH ON HAND. OTHER
COUNTIES THAT WILL HAVE MORE TWO
AND A HALF YEARS OF CASH ON
HAND.
AND THE COMMISSION'S CONCERN IS
THAT THE INTENT OF THE LAW WAS
TO INFUSE MORE FUNDS INTO THE
MENTAL HEALTH SYSTEM. WITH THE
RECOGNITION THAT A COUNTY MAY
NOT BE ABLE TO SPEND IT IN THE
THREE YEAR TIME FRAME MANY OF
THIS MONEY COMES IN THE ELEVENTH
MONTH OF THE FISCAL YEAR AND SO
THE ANALOGY IS THAT YOU MAY NOT
SPEND. YOU MAY NOT WANT TO SPEND
YOUR APRIL PYCHECK BY THE END
OF APRIL YOU'LL SPEND IT IN MAY
AND JUNE. IT'S THE IT'S THE
CONCERN THAT THOSE ARE
SIGNIFICANT UNMET NEEDS WHEN
COUNTIES MIGHT HAVE TWO YEARS OF
REVENUE ON HAND THEY BEGIN TO
SPEND THE FIRST YEAR'S MONEY IN
THE THIRTY YEAR TO AVOID THE
REVERSION. BUT THERE'S THIS.
BUMP THIS THIS. HOOTIE THE
DECISION MAKER WHO DECIDES.
IF THEY WERE BOARD OF
SUPERVISORS HAS ULTIMATE
DECISION MAKER UNDER THE UNDER
THE LAW AND PART OF THE
CONVERSATION WE'VE BEEN HAVING
INCLUDE REPORTS OF SUPERVISORS.
IS A LACK OF CLARITY AROUND THE
RULES.
THE LACK OF GUIDANCE IN TERMS
OF.
YOU KNOW WHAT'S APPROPRIATE AND
THEN.
ALSO MECHANISMS TO MAKE SURE
THAT MONEY GETS SPENT IN A
TIMELY WAY.
BOTH BOTH FOR INNOVATION GRANTED
BUT ALSO FOR P. I. ISSUE AS.
PRESUMABLY IN THEORY THERE'S A
MECHANISM. IF MONEY'S REVERT TO
THE STATE. COUNTIES CAN APPLY
FOR THAT BUT IT'S HIS THAT EVER
HAPPENED HIS SIR IN THE EARLIER.
GENERATION NEAR THE GAS IN THE
EARLIER GENERATION OF MONEY WENT
BACK INTO THE STATE FUNDS BUT
THE LAW SAYS IS THESE FUN CHUBBY
RETURNED TO THE STATE FOR
ALLOCATION TO OTHER COUNTIES IN
FUTURE YEARS AND WHAT PROCESS IS
USED. HAD. WHAT'S THE PROCESS
THAT HAS NOT BEEN DEFINED AND NO
PROCESSES AND ABOUT. THINKING
AND DIRECTOR KEN DID YOU HAVE A
COMMENT ON THAT. SO I JUST
WANTED TO CLARIFY SAID THE BILL
THAT THE LEGISLATURE PASSED LAST
YEAR THAT THE GOVERNOR SIGNED.
DEEMS THE. FUNDS THAT WERE
SUBJECT TO REVERSION TO BE
REVERTED BACK TO THE ORIGINAL
COUNTIES IN THE ACCOUNTS FOR
WHICH THEY HAD BEEN. ORIGINALLY
ALLOCATED AND SO WE WILL BE
DOING REVISIONS ON FIFTEEN
SIXTEEN FISCAL YEAR TWENTY YEAR
I'M TWENTY FIFTEEN TWENTY
SIXTEEN STARTING NEXT SPRING. SO
BASICALLY THE COUNTIES NOW HAVE
THAT THREE YEARS SET.
PERIOD FOR THOSE PREVIOUS YEAR
FUNDS AND SO I JUST WANTED TO
MAKE SURE THAT YOU WISH YOU KNOW
CLEAR THAT THE LEGISLATURE KIND
OF HIT THE RESET BUTTON AND WE
WILL BE DOING REVERSION
CALCULATIONS WE HAVE ISSUED.
YOU ALSO IT THROUGH THAT
LEGISLATION GAVE US.
BULLETIN AUTHORITY SO THAT
WHILE WE'RE DOING THE
REGULATIONS WE ACTUALLY CAN DO
IT THROUGH INFORMATIONAL
BULLETIN WHICH HAS SIMILAR
SIMILAR EFFECT.
AND THEN FINANCES THE ONE THAT'S
WHY WAS POINTING WILDLY AT THEM
AS THEY'RE THE ONES THAT
ACTUALLY DO THE METHODOLOGY OF
HOW THE FUNDS ARE DISTRIBUTED
ONCE THE MONEY IS.
RECEIVED INTO THE STTE FUND
THANK YOU AND THEN AND DOING
HERE FROM DEPARTMENT OF FINANCE
BUT.
COUNTIES CAN ALSO EARN INTEREST.
ON THE MONEY.
IS THAT SUBJECT TO REVISION OR
THEY ABLE TO RETAIN THE INTEREST
EARNED IN JUST THAT INTEREST
EARNED HALF TO. BE. APPLIED
TOWARDS IMPLEMENTATION OF THE
GOALS OF THE MENTAL HEALTH
SERVICES ACT.
SO SENATOR THIS IS ANOTHER AREA
THAT WE THAT WE FOUND THERE WAS
NO CLEAR GUIDANCE ON HOW HOW
THAT INTEREST MONEYWAS TO BE
SPENT OR WHETHER IT WOULD BE FOR
REVERTED. FOLLOWING THE MONEY
THAT IT CAME FROM TYPICALLY IT
WOULD ENTER MOST LEGAL
CONSTRUCTS BUT. BUT WITHOUT
GUIDANCE FROM THE FROM THE
DEPARTMENT COUNTY SO LEFT NOT
KNOWING HOW TO SPEND THAT MONEY
AND SOME OF THEM SPEND IT ON A
REGULAR BASIS. SOME OF THEM HOLD
IT AS AN ADDITIONAL RESERVE.
AND WHEN YOU SAY THEY SPEND IT
ON A REGULAR BASIS ARE THEY
SPENDING IT ON. MENTAL HEALTH
SERVICES ACT YES GOALS AND
OBJECTIVES.
YES I AM MISS PARLEY THAT I
THINK THE ISSUE OF INTEREST AND
SHOULD IT BE SUBJECT TO A
REVERSION OR NOT IS ONE WHERE I
THINK WE HAVE AGREED TO DISAGREE
ON SOME LEVEL BECAUSE. THOSE OF
US THAT ARE AT THE TABLE RIGHT
NOW PROBABLY HAVE DIFFERENT
VIEWS ON THAT ON THE COUNTY'S
BELIEVE THAT THEY SHOULD BE ABLE
TO RETAIN.
FUNDS THAT WERE EARNING
INTEREST BECAUSE THEY WERE YOU
KNOW FOR THE PURPOSES THAT THEY
WERE INTENDED IN FACT THE STATE
ADMINISTRATIVE FUNDS.
WHICH I THINK ARE SOMEWHERE IN
THE NEIGHBORHOOD OF A HUNDRED
AND THIRTY MILLION.
PROJECTED IN SEVENTEEN EIGHTEEN
AND ALL OF THE YEARS PRIOR SINCE
TWO THOUSAND AND FOUR THIS ISSUE
OF REVERSION OR INTEREST HAS NOT
EVER APPLIED TO THE STATE ADMIN
FUND SO THE STATE AGENCIES. THAT
ARE RECEIVING.
MHSAA FUNDS ARE ABLE TO JUST
ROLL THOSE OVER FROM ONE YEAR TO
THE NEXT AND CONTINUE TO COLLECT
INTEREST ON THAT. JUST WANTED TO
POINT OUT THERE IS A DISTINCTION
HOW. WE'RE TREATING THOSE FUNDS
FROM HOW WE'RE TREATING THE
LOCAL FUNDS.
THANK YOU IN THE DEPARTMENT OF
FINANCE WANT TO COMMENT ON THAT.
MORE TO THE PROCESS OF BROADLY
OF.
REVERSION WE'RE IN DISCUSSIONS
WITH THE DEPARTMENT AND THE
STATE COMPTROLLER'S OFFICE TO
DETERMINE HOW TO IDENTIFY WITH
COLD AND POTENTIALLY RELEASED
DEPENDING ON THE CIRCUMSTANCE IS
THEIR TIME TABLE TO TRY TO COME
TO SOME AGREEMENT ON THIS.
I THINK YEAH.
I THINK PART OF THE ISSUE IS
IT'S WRAPPED UP IN THE FISCAL
REGULATIONS THAT WE'RE CURRENTLY
WORKING ON. I'M WE HAVE ISSUED.
GUIDANCE TO THE COUNTIES AROUND
INTERESTS AND HOW WE WANT IT TO
BE TREATED AND CLARIFYING THAT
WHICH WERE HAPPY TO PROVIDE TO
THE COMMITTEE.
BUT I THINK THE MECHANICS OF
HOW WE DO THAT IS STILL IN
DISCUSSION AND WE WOULD
OBVIOUSLY BE WORKING WITH THE
COUNTIES AND THE COMMISSION JUST
TO MAKE SURE.
BEFORE IT'S FINALIZED THAT WE
WOULD HAVE CONVERSATIONS ON WITH
IT AND DRIVE TO MAKE SURE THAT
WERE NOT.
DOING. THE WRONG THING IN TERMS
OF IF THERE WAS ANY IF PROFITS
THE HONOR HAVE ANY FOLLOW UP
AFTER COMPLETING YOUR REPORT AND
RECOMMENDATIONS WE DO WEEKLY
FOLLOW UP. AT SIXTY DAYS AFTER
REPORT GOES OUT SIX MONTHS ONE
YEAR AND WE FOLLOW UP ANNUALLY
FOR AT LEAST ABOUT FIVE YEARS.
SO WE HAVE RECEIVED THE
DEPARTMENT'S. INITIAL FALL OF
RESPONSE TO REPORT THAT'S DUE AT
THE END OF THIS MONTH ONE THING
I DO WANT TO YOU WANT TO ADD AS
SUCH AS A MARK CANCEL MR
WEISBERG INDICATED EARLIER IS
THAT. THE THE REGULATORY PROCESS
HAS BEEN HAS BEEN UNDERWAY SINCE
ABOUT TWO THOUSAND SIXTEEN WITH
THE DEPARTMENT BUT IT'S BEEN AND
IT'S KNOWN ABOUT THESE ISSUES
AND IT'S BEEN AN INVENTOR
RESPONSIBLE FOR THE HAPPY
ACCIDENTS TWO THOUSAND TWO TO
TWO THOUSAND TWELVE SORRY.
YOU WERE OUR CONCERN IS THAT IS
THAT THE DEPARTMENT NEEDS TO
NEEDS TO.
WORK EXPEDITIOUSLY ON THESE
REGULATIONS TO GET THEM IN PLACE
WITH THIS IS A LACK OF GUIDANCE.
AT THE AT THE COUNTY LEVEL AND
WE WERE TOLD INITIALLY BY THE
DEPARTMENT'S ON BEFORE I WENT
OUT THAT HE WOULD HAVE THE
REGULATIONS OUT BY JUNE TWO
THOUSAND EIGHTEEN. IN RESPONDING
AS FORMER RESPONSE THEY GOT AT
THE DEPARTMENT MOVE THAT BACK TO
JANUARY TWO THOUSAND NINETEEN
AND SOME OTHER REGULATIONS AND
MOVED OUT FURTHER. SO THAT'S WHY
MR WEISBERG WEISBERG SAID
EARLIER WE'D LIKE TO SEE IS
SOMETHING THAT IS SOMETHING THE
TERMS LIKE BUDGET ACTION.
CONTROLLING WEEDS. DIDN'T SELL
IT APARTMENT TO TRY TO PUT THESE
REGULATIONS IN PLACE BY THE END
OF THIS THIS BUDGET YEAR COMING
UP. THANK YOU AND I APPRECIATE
SOME MAY BE FURTHER FOLLOW UP IN
THERE I'M GAUGE WENT ON THAT. I
RAISED THE CONCERN IN MY
DISTRICT OF PROVIDERS FEELING
THAT THERE'S MONEY THEY COULD BE
USING BUT THERE'S ANOTHER HUGE
CONCERN HERE. AND THAT'S THE WAY
WE DERIVE THE MONEY IS A TAX ON
MILLIONAIRES SWITCH WAS
CONTROVERSY ALL AT THE TIME IT
CONTINUES TO BE RESISTED BY
CERTAIN SECTORS OF SOCIETY.
AND THE WORST THING TO
JEOPARDIZE SWITCHES IN MY VIEW A
VERY IMPORTANT RESOURCE TO
ADDRESS MENTAL HEALTH NEEDS IN
OUR COMMUNITIES.
IF THOSE THAT ARE PAYING.
KING INTO THAT THROUGH THEIR
TAXES.
DON'T HAVE CONFIDENCE THAT
THERE'S GOOD OVERSIGHT THAT
THERE'S CLARITY THAT IS NOT
BEIN USED WE SET OURSELVES UP
FOR PEOPLE GOING BACK TO THE
BALLOT.
IN SAYING LET'S REPEAL THIS
BECAUSE IT'S IT'S BEING. I DON'T
THINK WE'VE HEARD EVIDENCE OF
MISUSE. BUT WE'VE HEARD SOME
EVIDENCE MAY BE OF. UNDER USE OR
LACK OF CLARITY IN TERMS OF WHAT
THOSE RULES ARE BEING ABLE TO
HOLD IT FOR THREE YEARS CENTRIST
SO IT SEEMS LIKE THERE'S A. BOTH
IN INTERNAL.
AUDITING REGULATION PIECE THAT
FITS IN MOTION THERE'S ALSO A
PUBLIC COMMUNICATION PIECE THAT
I THINK IS CRITICAL. BOMB THAT
THE PUBLIC UNDERSTANDS WE NEED
TO BE SHOWING SOME EXAMPLES OF
THE GOOD WORK THIS MONEY'S BEEN
DOING IN OUR COMMUNITIES.
.
MISS PARLEY.
I THINK YOU'RE AT IT MAKING AN
EXCELLENT SEGUE FOR ADAM A
STAKEHOLDER PROPOSAL THAT CBO
CAME WITH THE PRESIDING ABOUT
PRESENTING TO YOU AFTER.
THIS PANEL ENDS WHICH SPEAKS
EXACTLY TO THAT.
THAT WE CAN CHASE THESE DOLLARS
AROUND.
FROM AN ACCOUNTING STANDPOINT
ALL WE WANT BUT REALLY I THINK
FROM THE COUNTY'S PERSPECTIVE
AND MANY OTHERS UNLESS WE CAN
DEMONSTRATE NOT JUST TO THE
MILLIONAIRES BUT TO ALL OF US.
THE VALUE THAT WE'RE PRODUCING
IN THE ACTUAL PEOPLE'S LIVES WHO
WE KNOW ARE BEING IMPACTED BY
THESE FUNDS.
I THINK WILL WILL CERTAINLY SEE
THESE DOLLARS AT RISK NOT JUST
DUE TO THE MILLIONAIRES BUT
OTHERS WHO FEEL LIKE I'M PERHAPS
THERE ARE OTHER BETTER USES. IN
APPRECIATE THAT ALL LOOK FORWARD
TO THAT PRESENTATION I JUST MY
FINAL COMMENT MISTER CHAIRS.
MOM.
IN BUDGET WE DEAL WITH NUMBERS.
WE DEAL WITH ON IT SWEET DEAL
WITH OVERSIGHT.
.
BUT WHAT PEOPLE UNDERSTAND. ARE
THAT THE HUMAN NARRATIVES IN OR
THE METRICS EVEN THAT QUANTIFY
NOT JUST DOLLARS BUT DOLLARS
TRANSLATED. TIM PEOPLE SERVE
CHILDREN SERVED ADULTS SERVED.
SOME. NEW PROGRAMS INITIATED%
BROADER OUT REACH THAT'S WHAT
PEOPLE UNDERSTAND AND I KNOW
THAT SOME OF THAT DATA EXISTS
AND I'LL LOOK FORWARD TO HEARING
IT AT THE APPROPRIATE TIME THANK
YOU MISTER CHAIR. THOUGH THANK
YOU SIR MINING AND APPRECIATE
WHAT YOU SAID AND I JUST NOW.
I FULLY AGREE I MEAN I THINK
THAT ONE OF THE THINGS THAT WE
DON'T WANT TO HAVE HAPPEN IS IS
THAT THERE'S A CRISIS IN PUBLIC
CONFIDENCE AND DAMAGES SAY AND.
ARE AND WHAT WE'RE DOING AND SO.
I APPRECIATE I THINK IT'S.
THE THE PRESENTATION YOU'RE
GOING TO BE MAKING LATER TODAY
ON PROVIDING THAT INPUT FROM THE
BEHAVIORAL HEALTH DIRECTORS CAME
FROM OUR CONVERSATION WE AND I
SAID YOU HAVE A PROPOSAL I WANT
TO SEE IT BECAUSE WE NEED TO BE
ABLE TO GO TELL THE PUBLIC. THAT
THEIR MENTAL HEALTH DOLLARS ARE
MAKING A DIFFERENCE IN THEIR
COMMUNITY.
I KNOW THEY ARE BUT THE THING IS
WE HAVEN'T REALLY BEEN ABLE TO
WE DON'T THE LEVEL ACCOUNT.
YOU KNOW REPORTING
ACCOUNTABILITY THAT WE CAN THEN
TURN TO TELL THE PUBLIC HAS NOT
BEEN THERE SO.
SO I THINK THAT'S REALLY
IMPORTANT THE THE OTHER PIECE IS
IS THAT. I MEAN FRANKLY HERE IN
SACRAMENTO.
pSTEINBERG TO THE AUTHOR OF THIS
AND.
.
PUSHING ON SACRAMENTO COUNTY HAD
TO SAY HOW COME YOU'RE NOT
MOVING THE MONEY.
RIGHT WE HAVE A HOMELESS PROBLEM
WITH MENTAL HEALTH ISSUES.
OKAY WHY IS THE MONEY BEING
MOVED RIGHT AND THEN FIVE
SUDDENLY FINDING OUT IN THE
FRONT PAGE OF THE BE YOU KNOW
THERE'S ALL THIS MONEY SITTING
IN SACRAMENTO COUNTY.
NOW WHETHER YOU THINK THAT'S
FAIR OR NOT. I MEAN AND THEN
FINALLY KELLY SAID OKAY WE'LL
MOVE WILL MOVE THE MONEY AND AND
HELP YOU TRY TO DRESS. AND AND
SO AND IT WASN'T THAT MANY YEARS
AGO.
WHEN I'M BASICALLY WE HEARD
THAT I THINK WAS.
PEOPLE OR SAY TALKING ABOUT NOW
FIRST THEY WERE STARTING OFF BY
SAYING WELL YOU KNOW IT IS THAT
W'RE SPENDING THE MONEY ON YOGA
CLASSES SO FORTH AND I THINK
THAT JANET WAS SIDE THAN AT AT
IT WAS THAT WAS UNFAIR IT
ATTACKED BECAUSE.
BUT WHAT HAPPENED IS THE
UNDERLYING POINT WAS IS THAT.
WELL YOU KNOW WHAT'S THE COUNT
DOWN TO MY YOU KNOW WE STILL
THESE DOLLARS SAY THE MONEY AND
SO WHEN WE HAVE THIS BUT. THEN
WE HAVE THIS HAPPENING AND WE
SAY LOOK THERE'S THIS.
DOWN THE MONEY'S SAYS SITTING
THERE AND THAT'S WHAT IT SOUNDS
LIKE THE PEOPLE AND YET THEY'RE
LOOKING AROUND AND THEY SEE ALL
THESE MENTAL HEALTH NEEDS.
RIGHT.
THEN THAT'S A PROBLEM AND SO I
THINK WE DEFINITELY NEED TO TELL
TIGHT NOTHING'S UP I APPRECIATE
THAT THE FACT THAT YOU KNOW
WERE.
PART OF THE REASON WE'RE DOING
THAT WE'RE FINDING THIS OUT IS
BECAUSE OF THE LEADERSHIP OF OF
OF FOLKS AND AND AND AND HERE.
SAYING THAT OKAY WE NEED TO
HAVE AN AUDIT WE NEED TO FIND
THESE OUT BUT WE ALSO HAVE TO
SHOW THAT WE'RE WE'RE FIXING
THIS. AND.
YOU KNOW I HAVE TO SAY THAT.
KNOW FRANKLY I THINK ONE OF THE
THINGS I'M REALLY CONCERNED
ABOUT IS THE DCS OVERSIGHT OVER
THIS ONE GOT TRANSFER FROM
MENTAL HEALTH TO THAT'S YOU KNOW
WHAT THEY WERE DOING THEY WERE
DOING DIVERGENCE OF I MEAN.
DOING THEIR VERSIONS AS IF THEY
WERE ACTUALLY PAYING ATTENTION
WAS GOING ON AND SO WHAT WE SAW
WAS AFTER TO. SWITCH OVER. KNOWN
AS. PAYING ATTENTION NOW IT
DIDN'T SEEM LIKE IT WAS SO.
I'M NOT SAYING THAT ACTUALLY NO
ONE BUT CLEARLY YOU KNOW WE'RE
HERE AND LIKE WHAT WHAT'S
HAPPENING LAME IT'S A VERSION OF
WHAT WE DON'T HAVE THE NUMBERS
THE ONE WHO'S TRACKING THIS
RIGHT AND THE AUDITORS I KNOW
WHAT THE WHAT THE YOUNG PEOPLE
TRYING TO COLLECT REPORTS INTO.
THE PEOPLE TURNED IN REPORTS ON
TIME WELL DIDN'T SEEM TO MATTER.
AND.
I THINK THAT THE. THAT YOU'VE
ALWAYS BEEN GREAT ABOUT
BEING HERE YOURSELF.
BUT IT DOES SPEAK TO SO. HOW
MANY? WELL WHO'S IN CHARGE IN
THE DEPARTMENT FOR THIS
PARTICULAR PIECE AND HOW MANY
STAFF ARE. ARE ACTUALLY HE
FOUND.
THE SIGN TO WORK ON
ACCOUNTABILITY THAT FOR THE DTS
PART ON ACCOUNTABILITY FOR ALL
THE THINGS THAT THE FARM
HEALTHCARE SERVICES POSSIBLE FOR
TO ASSURE ACCOUNTABILITY AND.
FOR FOR THE MENTAL HEALTH
SERVICES ACT.
YEAH SO IT'S.
IT'S ACTUALLY NOT THAT EASY
BECAUSE IT'S NOT AS A SINGLE
PERSON OR A SINGLE UNIT IS NOT
WHOLLY RESPONSIBLE FOR IMAGES
SAY FUNDING RIGHT SO WE HAVE.
.
I PEOPLE AND SECTIONS ARE ON
UNITS WITHIN THE DEPARTMENT THAT
DO FISCAL WORK FOR THE COUNTIES
BUT ACROSS ALL THE DIFFERENT
FUNDING SOURCES RIGHT SO NOT
ONLY IMAGES SAY FUNDING BUT.
THE SHORT DOYLE AND THE COST
REPORTS THAT ARE ON THE MEDICAL
SIDE THEY MAY DO THE FISCAL
POLICY AND WORK WITH THE
COUNTIES ON FISCAL.
ACCOUNTABILITY ISSUES BUT THEN
OUR AUDITS INVESTIGATIONS
DIVISION MAY ACTUALLY BE
RESPONSIBLE FOR DOING THE
FACADE-AT SO. I'M IT'S NOT
ACTUALLY AS
A CORE GROUP THAT HAS COMPLETE
OWNERSHIP AND SO WE HAVE TO WORK
ACROSS THE DIVISION I THINK WHEN
WE. ABSORBED.
.
THE RESPONSIBILITY I THINK THERE
WAS APPROXIMATELY FIFTEEN ON
EITHER AUTHORIZED POSITIONS ARE
PEOPLE THAT CAME OVER AND SO WE
HAVE.
A UNIT THAT IS DEDICATED TO AN
HSA I'M FROM A POLICY STANDPOINT
TECHNICAL ASSISTANCE.
SUICIDE PREVENTION.
SOME OF THE OTHER AND OBVIOUSLY
THE BILLS THAT THE LEGISLATURE.
PROPOSES AS IT RELATES TO AN HSA
SO THEY MAY HANDLE THE POLICY
ISSUES BUT THEY DON'T DO THE
FISCAL SO.
THERE'S I'M NOT AS MANY PEOPLE
AS YOU WOULD. THINK I'M ACTUALLY
WITHIN THE DEPARTMENT THAT
SPECIALIZE ESPECIALLY IN THE
FISCAL AND COST REPORTING ISSUES
ARE PRETTY TECHNICAL YOU KNOW
AS.
AS MISS PARLEY WOULD SAY YOU
KNOW A SINGLE.
ANNUAL FORM IS A COMPLICATED
EXCEL SPREADSHEET WITH A LOT OF
FORMULAS BUILT INTO IT SO IT'S
NOT SOMETHING THAT WE JUST SAY
YOU KNOW. FILL OUT THESE THREE
PIECES OF IDENTIFYING
INFORMATION AND WE'RE ALL GOOD
SO AND THERE'S ONLY A FEW PEOPLE
THAT HAVE THAT.
EXPERTISE WITHIN THOUGH SO I
CERTAINLY UNDERSTAND ANYONE
LEVERAGE THE EXPERTISE AND KNOW
YOUR DAIY COUNTY THERE'S
MULTIPLE FUNDING STREAMS AND WHY
WOULD YOU HAVE BUT. A GUESS THE.
THERE SHOULD BE PLEASE SOMEONE
RESPONSIBLE FOR THE OVERSIGHT
THEY MAY NOT THAT MADE UP THE
ONLY THING THEY OVERSIGHT OVER I
JUST LIKE THAT LIKE SOMEONE SAID
IF YOU YOU CAN HAVE THE FUTURE
RESPONSIBILITY RIGHT SO I GET
THE SENSE THAT YOU HAVE AUDITORS
AND. OF COURSE THEY'RE NOT JUST
GONNA TESTING I'VE FIXED OR LOOK
AT THE SAME BOOKS ANYWAY OR
SIMILAR BOOKS RIGHT SO THE MILES
A LOOK AT YOU KNOW. THE
DIFFERENT FUNDING STREAMS AND
THIS IS ONE OF THEM. BUT SOME
PLAY I THINK AT SOME PLACES
THERE SOMEONE WHO'S LIKE YOUR
YOUR JOB TO BE SURE ALL THESE
DIFFERENT UNITS ARE ALL DOING
THEIR JOB SO THAT YOU KNOW WE'RE
GETTING REPORTS ON TIME WE'RE
DOING ETCETERA AND YOU MAY ALSO
HAVE SOME OTHER RESPONSIBILITIES
BUT YOU ARE THE. PERSON WHO ARE
TO BE SURE THAT TICK TICK TICK
TICK WE GOT WE'D BE TICKED OFF
ALL THE THINGS REFERRED TO DO
EVERY YEAR. TO KEEP CHARGES THAT
IS THERE ANY ANY OF THE POLICY
IN IT THAT THAT'S YOU OKAY. BYE
FELICIA YOU BEING HERE THAT I
GUESS THE OTHER QUESTION IS IS
THAT HOW MUCH MONEY DOES.
COMES FROM THE ACT BECAUSE THE
DTS TO DO THIS WORK.
ABOUT EIGHT EIGHT AND A HALF
MILLION DOLLARS A YEAR.
OKAY SO THAT'S OKAY SAMI PEOPLE
IS IN A HALF MILLION DOLLARS PAY
FOR.
IT'S NOT GONNA BE A SMALL
NUMBER.
IT'S A NET MILLION THERE'S BOTH
PEOPLE AND THERE'S CONTRACT
DOLLARS SO WE HAVE A CONTRACT
WITH THE CALIFORNIA INSTITUTE OF
BEHAVIORAL HEALTH SERVICES AND I
GET IN THE C. I. BHS ADDRESSES.
A HOUSE SO THAT AN ENTITY.
SOME OF OUR IMAGES SAY DOLLARS
GO TOWARDS THAT CONTRACT WHICH
WORKS WITH THE COUNTIES. ON TO
DO TECHNICAL ASSISTANCE AND TO
DO A LOT OF THE.
KIND OF GRANULAR WORK THAT
WE'VE TALKED ABOUT SO IT'S NOT.
EIGHT AND HALF MILLION DOLLARS
WORTH OF. PEOPLE THAT WE HAVE
WITHIN THE DEPARTMENT HEY THIS
BOOK CONTRACT AND AND PEOPLE
DOLLARS OKAY BECAUSE YOU KNOW
THIS GOES BACK TO SOME OF THE
FINDINGS OF THE AUDITOR RIGHT I
MEAN ITSELF.
SO SOMEONE SHOULD BE TRACKING TO
BE SURE THAT THE REPORTS ARE ON
TIME AND THAT THE REPORT THIS
RIGHT.
IN PRACTICE WE WE AGREE YEAH.
AND IT JUST SAY I'M WE WE HAVE
SOME THE NUMBERS ALSO OPERATE
THE FIFTEEN SIXTEEN FISCAL YEAR
WE WE CALCULATED THAT THERE
THERE WERE THIRTEEN POINT FOUR
FULL TIME EQUIVALENT STAFF SO.
SOME PEOPLE ARE ONLY DOING THIS
FOR PART OF THEIR FUNCTIONS
RIGHT BY MORE PEOPLE INVOLVED IN
IT.
AND AS THE THE DEPARTMENTAL
LEVEL COSTS INCLUDING SALARIES
AND WAGES AND CENTRAL HAD MANY
QUIT AND THAT SORT OF THING WAS
ABOUT TWO POINT EIGHT MILLION.
AND FIVE POINT ONE MILLION WAS
RELATED TO THE.
THE BEHAVIORAL HEALTH SOLUTIONS
CONTRACT THAT YOU MENTIONED AND
THEN THE THE DEPARTMENT ALSO HAS
A CONTRACT WITH YOU SELL A.
WHERE HE RECEIVED MONEY FROM
THAT MENTAL SERVICES ACT IN A
NUMBER OF OTHER SOURCES THE DO
A?
A ONGOING HEALTH SURVEY AND I'M.
IN AND WE JUST SAID WELL AGAIN
WE JUST LOOKED INFORMATIONAL AT
THOSE WITH AN AUDIT THOSE AREAS
BUT THAT'S OUR NEW SCENE IN
WHERE THE PHONINESS.
OKAY AND.
AND SO IT SOUNDS LIKE AND I
DON'T KNOW SO IN TERMS OF THE.
MONEY I MEAN THAT AS SOON AS THE
TWO POINT EIGHT MILLION.
THAT MEANS THAT IT'S BECAUSE OF
SOME OF THE MONEY YET SO COULD.
MAYBE FOR DIFFERENT PURPOSES OF
YOUR DOING A SURVEY OR STUDY OR
INNOVATION CONSULTING WHATEVER
AND THEN THERE'S SOME OF ITS
LIKE DIRECTLY FOR ED HAD BEEN
RIGHT RIGHT TWO POINT EIGHT
MILLION IS OUT OKAY ASKING AN
ADMIN. DEPARTMENT ADMIN COSTS
OKAY AND IT ACTUALLY SO FOR
EXAMPLE WHAT'S THE CONSEQUENCE
OF THE COUNTY DOESN'T TURN AND I
APPRECIATE THE BUREAU DIRECTOR
SAYING THERE SHOULD BE
CONSEQUENCES I MEAN WHAT THE
CONSEQUENCES OF ONE THIS IS THE
DEADLINE FOR TRAINER PORT.
I THINK THAT'S THE PROCESS THAT
WE ARE WORKING ON WHICH WE HAVE
AND WE'VE BEEN PROVIDING TO THE
LEGISLATURE. ON THE SCHEDULE ON
COUNTY BY COUNTY FOR THE REVENUE
AND EXPENDITURE REPORTS IN TERMS
OF WHEN THE COUNTIES HAVE
SUBMITTED THEM OVER THE LAST
SEVERAL FISCAL YEARS AND THEN
WHEN THEY WERE FINALIZED OR
APPROVED AND ACCEPTED. I'M SO
THERE HAS BEEN GREATER
COMPLIANCE.
SINCE THE GREATER IS HOW MUCH A
HUNDRED PERCENT MISSION TO BE A
HUNDRED PERCENT WE'RE NOT QUITE
THERE.
BUT I WOULD SAY THAT'S ALSO
PART OF THE PROCESS THAT WE'RE
WORKING THROUGH WITH FINANCE
WHICH IS OF ACCOUNTING IS NOT
SUBMITTING THE REPORT. OF THE
WHAT'S THE TIME FRAME IS THAT WE
WITHHOLD SOME OF THE IMAGES
ALLOCATION. MAYBE ALL OF IT
UNTIL THEY START WELL I WOULD. I
WOULD JUST SAY.
.
THE REPORT NO MONEY WE ENDEAVOR
AS MUCH AS POSSIBLE TO BE IN A
COOPERATIVE RELATIONSHIP AND I
WOULD ALSO NOT WANT TO WITHHOLD
ALL FUNDS BECAUSE I WOULD WORRY
ABOUT THE RAMIFICATIONS OF WHAT
THAT MEANS FOR SERVICES TO.
PEOPLE IN THE.
IN THE DOWNSTREAM IMPACT BOTH
PROVIDERS AND PEOPLE THAT ARE
RECEIVING SERVICES SO I WOULDN'T
ACTUALLY SAY THAT THAT WOULD BE
OUR FIRST OKAY RECOMMENDATION.
BUT SOMETHING THAT WILL GET THE
ATTENTION HAS DEALT TURN IN THE
REPORT AND THE LONGER IT GOES
THE CONSEQUENCES WILL GET MORE
SEVERE I WOULD SAY SINCE WE'VE
BEEN PROVIDING THAT INFORMATION
TO BOTH THE CESSATION INTO THE
AND TO SEE SACK.
TO THE LEGISLATURE THE REPORTS
HAVE BEEN.
MORE EXPEDITIOUS AND BEING
SUBMITTED THEN ON THE FLIP SIDE
THOUGH THIS GOES BACK TO.
OUR TWO POINT EIGHT MILLION AND
HOW PEOPLE WORKING ON IT. WE
HEARD FROM THE COUNTY HEALTH.
HEALTH DIRECTORS THAT SOMETIMES.
THEY DON'T GET THE RIGHT REPORT
FORM OTHER REPORT FORM IS.
REVISING NOW THEY HAVE TO
RESUBMIT IT AND SO FORTH SO I
MEAN DO YOU HAVE THE
INFRASTRUCTURE TO. TRY TO
MINIMIZE THE BURDEN ON THE AT
LEAST WE CAN GIVE PEOPLE THE
RIGHT REPORTS FOR THEM TO TURN
IN. IT IT'S EASIER SAID THAN
DONE RIGHT SO IT'S BACK TO THE
EXCEL SPREADSHEET THAT I WAS
TALKING ABOUT WITH A LOT OF
FORMULAS BUILTIN SO WE TEST AND.
I'M WITH BOTH OUR PROGRAM AND IT
STAFF HOW WE CAUGHT THERE WAS A
COUPLE OF COUNTY SUBMITTED THEM
WE SAW THE GLITCH. WE FIX THE
ERRORS AND THEN WE MADE SURE
THAT THE REST OF THE COUNTIES WE
NEED MORE PEOPLE. TO DO THIS
WORK SO THAT WE DO IT RIGHT THE
FIRST TIME I WOULD SAY THAT.
WE WENT TO THE EXTENT THAT WE
HAVE A NEED WE WILL ALWAYS WORK
THROUGH THE BUDGET PROCESS TO
IDENTIFY THE RESOURCE AND COME
BEFORE THE LEGISLATURE WITH A
CONCAVE SO I'M HEARING THOUGH
THERE'S A PROBLEM. AND I'M
TRYING TO FIGURE OUT WHAT I
MEAN.
THE SOLUTION TO THIS RIGHT SO.
AND ALSO YOU KNOW OF IT JUST
AGAIN MAKE NOTE THAT.
THERE THERE ARE FINES AND THERE
ARE PEOPLE AND I AND I
UNDERSTAND THAT MAYBE NO ONE'S.
I MEAN I I THINK WOULD BE GOOD
TO HAVE SOMEONE TO AT LEAST AS
THE POINT PERSON WHOSE RESEARCH
I MEAN. RESPONSIBLE I MEAN ASIDE
FROM YOUR VERY BUSY AND YOU HAVE
A LOT OF THINGS AND BELIEVE ME
WE HAVE YOU HERE FOR A LOT OF
DIFFERENT THINGS SO. IT'S ALL
YOU SAID IT'S YOU LIKE OKAY WELL
THAT'S GOOD AND THAT'S BAD
THAT'S GOOD BECAUSE EUROPE BUT
THE BAD PART IS THAT THIS IS
OBVIOUSLY GOING TO BE ONE SMALL
THING AND ALL THE THINGS
YOU-HAVE TO DO AND THIS AND AT A
CERTAIN LEVEL.
NOW MAYBE THERE SHOULD BE
SOMEONE WHOSE JOB IS TO BE SURE
ALL THE BOXES ARE TICKED OFF
BECAUSE THAT'S PROBABLY A
LITTLE.
BELOW YOUR PAY GRADE I THINK ARE
AT A MEAT IS IS THAT. THEY'RE
DOING RIGHT NOW. I WANT THEM
BACK TO THE DEPARTMENT DOING
THAT SO THAT'S WHY I'M HERE AND.
THIS I MEAN WE HAVE SOME REALLY.
YET NONE OF IT IF YOU HAVE
INCREDIBLE PEOPLE WORKING THERE
BUT THE THING IS IS THAT I'M
ALSO SAYING THAT MAYBE THERE
SHOULD BE SOMEONE WHO'S.
JOB IS TO SAY YOU KNOW WHAT.
I AM I AM THE PERSON WHO CUTS TO
LOOK ACROSS ALL THE DIFFERENT
PEOPLE WE HAVE THE OUT OF PEOPLE
BLAH BLAH WHO OF COURSE GONNA DO
MULTIPLE THINGS IN THERE AND YOU
KNOW LET'S THERE'S LOTS OF
DIFFERENT BIRO BUT. I'M THE ONE
WHO'S GONNA BE SURE THAT ON ALL
THE IMAGE A SET MHSAA STUFF I'M
SURE TO SOMEONE WHO ALSO WHEN
CMS WANTS TO TALK TO THEY DON'T
WANT TO TALK TO FIVE DIFFERENT
PEOPLE AS TO WHO'S THE PERSON I
TALKED TO THEM BOTH. COULD RIGHT
NOW EVERYBODY ELSE THAT WE
COMMUNICATE WITH WHEN IT COMES
TO THIS PARTICULAR WAIVER OR
SOMETHING ISSUE OR SOMETHING
LIKE THAT RIGHT SO. ANY AT
CERTAIN LEVEL. I GUESS YOU KNOW
ADMINISTRATIVELY.
ANY AND YOU KNOW YOU HAVE A
BETTER MANAGER AND I AM SO.
I'M SO I'M NOT TRYING TO.
DICTATE HOW TO RUN THE
DEPARTMENT BUT I I JUST WANT TO
BE SURE WE DON'T I MEAN WE THIS.
THIS BECOMES ACTIVE PUBLIC
CONFIDENCE RIGHT AND.
I THINK THIS SOMEHOW NEEDS TO
BE A HIGHER PRIORITY LEVEL AT
THE AT LEAST AT THIS PHASE
BECAUSE WE'RE GETTING A LOT OF
MAYBES WERE WORKING OUT AND SO
FORTH AND THAT'S BECAUSE NO ONE
YOU KNOW. AND THAT'S ON THE
HEELS OF WE FOUND THAT ALL THESE
PROBLEMS AND FOR NOT JUST THE
YEAR BUT FOR YEARS AND AGAIN
EVEN BEFORE YOU BECAME DIRECTOR.
IT SEEMS LIKE.
THIS WASN'T A LOT OF TENSION AND
ACTUALLY ONCE PEOPLE START
LOOKING AT IT THINGS THAT LOOKS
SO GOOD SO NOW WE'RE TRYING TO
GET THIS THING FIXED AND I
APPRECIATE YOU'RE HERE AND
YOU'RE TRYING TO FIX FIX IT. BUT
NOW. OKAY YOU HAD SOMETHING.
ONLY TO OFFER A FEW VERY
CONCRETE SUGGESTIONS THAT OUR
ASSOCIATION VERY MUCH SUPPORTS
AND THESE ARE NOT NECESSARILY
NEW IDEAS.
EVA WE WE CERTAINLY.
YOU'LL SEE ME HIGHTAIL IT BACK
TO THE MICROPHONE REALLY ANYTIME
THAT THE DEPARTMENT IS ASKING
FOR YOU ALL TO APPROVE POSITIONS
MENTAL HEALTH AND AS YOU DO
DIVISION AREA IT IS OUR BELIEF.
THAT THEY DO NEED ADDITIONAL
PERSONNEL AND TO ASSIST THE THE
DEPARTMENT WITH BEING ABLE TO
MANAGE THE COMPLEX ARENA
INCLUDING THE MINIMAL SERVICES
ACT ARENA. ON BUT SECONDLY WE
pSPONSORING A BILL THAT SENATOR
MORLOCK IS OFFERING RELATED TO
THESE ARE YOUR REPORTS THESE
EXCEL SPREADSHEETS WHICH IT
SEEMS YEAR TO YEAR CHANGE.
INCLUDING THE INSTRUCTIONS FOR
HOW TO COMPLETE THEM WHICH YOU
KNOW AND THAT CREATES THIS
DOMINO EFFECT OF DELAY AND SO
OUR HOPE WOULD BE THAT AT THE
VERY LEAST THAT REPORT. BE
ESTABLISHED AND.
COMPLIANCE WITH.
GOVERNOR GENERALLY ACCEPTED
ACCOUNTING PRINCIPLES OR GAAP
STANDARDS BUT THIRDLY I'M A MORE
IDEAL SOLUTION AND MORE ELEGANT
SOLUTION EVEN THOUGH IT WOULD BE
HARD.
WOULD BE TO COMBINE THE TWO
REPORTS THAT COUNTY MENTAL
HEALTH DEPARTMENTS ARE REQUIRED
TO PROVIDE EVERY YEAR ON
DECEMBER THIRTY FIRST WE HAVE A
MEDIC CAL SPECIALTY MENTAL
HEALTH COST REPORT. AND IN AN
HSA REVENUE AND EXPENDITURE
REPORT INFORMATION ON BOTH OF
THOSE ACTUALLY HAS INNER WE
INTERWOVEN I'M COMPLEXITY AND
YOU KINDA NEED THE COST REPORT
TO COMPLETE YOUR MENTAL HEALTH
SERVICES ACT REPORT. WE ACTUALLY
WOULD LIKE TO SEE AN EFFORT
UNDERTAKEN WITH THE DEPARTMENT
IN COUNTIES INCLUDING THE AWAY
SEE WHO ALWAYS SEE WHO ALSO
WANTS TO SEE THIS INFORMATION.
TO COMBINE THEM INTO ONE REPORT
WHERE COUNTIES ARE REALLY BEING
ACCOUNTABLE TO WHAT THEY SPENT
FROM THE VARIETY OF.
FUNDING SOURCES TO DELIVER ON
THEIR MEDICAL AND MENTAL HEALTH
SERVICES ACT RESPONSIBILITIES.
SHE CHECKED WONDERED IF MISTER
EWING HEADACHE I MEAN TERMS OF
BECAUSE WE ARE DEPENDENT ON THE
EIGHT CS FOR ADMINISTERING THIS
IN MANY WAYS I MEAN YOU'RE THE
OVERSIGHT THE THE OVERSIGHT PART
BUT
DOESN'T ACTUALLY HAVE TO.
DO ALL THE SPREADSHEETS.
AND I APPRECIATE THAT JENNIFER
GET TO THE SPREAD SHEETS AS HE.
WELL YOU KNOW THE COMMISSION.
WE ARE CONCERNED ABOUT DUPLICATE
REPORTING REQUIREMENTS RIGHTS
WERE CONCERNED ABOUT THE OUR
ABILITY TO TELL THE PUBLIC A
CLEAR AND COMPELLING STORY ABOUT
THE DOLLARS PART OF THE
CHALLENGE. IS NOT JUST THE IMAGE
OF STATE DOLLARS DAMAGES SAY IS
TWO BILLION DOLLARS A YEAR
ROUGHLY. IN A IN A COMMUNITY
MENTAL HEALTH SYSTEM THAT'S
RUNNING ABOUT SEVEN BILLION
DOLLARS A YEAR IN SOME COUNTIES
IT'S FIFTY PERCENT OF YOUR
BUDGET IN OTHER COUNTIES IS
OBVIOUSLY LESS.
AND THE IMAGE IS A IS A IS A
FIRST PIECE THAN WE ARE TRYING
TO UNDERSTAND THE COST REPORTS
IN ORDER TO UNDERSTAND. WHAT
WE'RE REALLY TRYING TO DO I
SHOULD SAY IN TERMS OF WHAT WE
CALL A FISCAL TRANSPARENCY TOOL
IS TO LET THE PUBLIC KNOW? HOW
MUCH MONEY IS COMING IN WHAT HAS
BEEN SPENT ON WHAT'S IN THE BANK
BECAUSE THE MEDICAL SERVICES ACT
REQUIRES A COMMUNITY PLANNING%
PROCESS VERY HARD TO PARTICIPATE
IF YOU DON'T KNOW? WHAT THE
OPTIONS ARE THE MONEY AS A PIECE
OF THAT CONVERSATION AND WE HAVE
THREE PIECES THE SECOND PIECE IS
SERVICES AND I'LL TALK ABOUT
THIS LATER IN THE GENDER? AND
THE THIRD PIECE IS OUTCOMES AND
AS OUR STRATEGY THERE IS TO
CREATE PUBLIC ACCOUNTABILITY BY
EMPOWERING COMMUNITIES BECAUSE
THEY KNOW THEIR COUNTIES BETTER
THAN WE DO. TO TO REALLY ENGAGE
AND AND AND COMMUNICATE WITH
THEIR BOARD OF SUPERVISORS HAS
HAPPENED HERE AS YOU POINTED OUT
IN SACRAMENTO COUNTY.
WE'RE NOT WE DON'T HAVE A
POSITION YET ON YOU KNOW WHETHER
AND HOW TO MERGE THE COST
REPORTS.
BUT WE DO WANT TO GET TO THE
POINT WHERE WE DON'T HAVE TO
SETTLE THIS INFORMATION IN SUCH
A WAY THAT YOU HAVE TO HAVE A
PHD IN HOW FAR IF I DIDN'T. HAVE
ROOM TO PUT
THIS ON THE TABLE I'M IN A WHILE
THE DEPARTMENT OF FINANCE
HEALTHCARE SERVICES AND THEY'VE
BEEN VERY GRACIOUS AND WORKING
WITH US. BEGIN TO. REFINE AND
IMPROVE THE PROCESS IN TERMS OF
REPORTING AND THE TIME FRAMES
AND THE MECHANICS OF REVERSION.
THE COMMISSION ALSO HAS
SUGGESTED TO THE LEGISLATURE
THAT YOU MIGHT WANT TO THINK
ABOUT THE ISSUE OF DEFINING THIS
THIS NOTION OF THESE REFERRED TO
FIND TO BE RETURNED TO OTHER
COUNTIES. IN FUTURE YEARS PRIDE
THAT THAT SAID THAT IT HAS.
THE WAY THAT THE STATE
ADMINISTERED THAT IN THE EARLY
DAYS WAS AT A TIME WHERE THE
STATE HELD THE FUNDS AND
APPROVED PLANNING AND ISSUED
CHECKS. AND SO THE STATE HAD A
ROLE IN MAKING SURE THAT THERE
WAS SOME CONTINUITY THERE.
AND SO THE. FIRE UNDERSTANDING
FOR THE DEPARTMENT OF FINANCE IS
THAT THE DEFAULT IS TO SIMPLY
RETURN THE MONEY TO FINANCE GETS
DISTRIBUTED UNDER THE
DISTRIBUTION FORMULA. AND EIGHTY
ONE FOURTEEN LAST YEAR DID
REQUIRE A THE PRESERVATION THAT
IF ADOLLAR WAS AN INNOVATION
DOLLAR HAD TO STAND ON A
VACATION IF THE DOLLAR WAS A
PREVENTION DOLLAR HAD TO STAND
PREVENTION. WITH THE COMMISSION
AND RECOMMENDED IS THAT THE
LEGISLATURE ESTABLISHED A
REVERSION FIND FOR THREE REASONS
ONE IS FOR TRANSPARENCY. RIGHT
FOR THE STATE TO REPORT OUT
THROUGH THIS STANDARDIZED
REPORTING THAT THE DEPARTMENT OF
FINANCE DOES. ON MONEY THAT IS
IN THIS FUN AND IT WOULD ENHANCE
UNDERSTANDING IT AROUND WHETHER
NOT MONEY IS BEING RECORDED OR
NOT REVERTED. THE SECOND IS TO
INCREASE THE INCENTIVES FOR
COUNTIES TO SPEND THE MONEY
QUICKLY WE ARE HOPE WOULD BE
THERE'S NO MONEY IN THAT
REVERSION FIND BECAUSE NOMINEES
REVERTING TO THAT'S THE INTENT.
BUT IF THERE ARE FUNDS THEY'RE
THE THIRD PIECE WOULD BE ABLE TO
GIVE PURPOSE TO THOSE FUNDS
RETURN THE MONEY TO THE
COUNTIES.
AS IS REQUIRED BY THE BECAUSE
THIS IS WHAT THE FUND ORIGINALLY
FOR BUT DO IT IN A PURPOSEFUL
WAY IN OUR OUR CONCERN IS THAT
SMALL AMOUNTS OF MONEY WILL BE
DISTRIBUTED TO SO MANY LITTLE
SMALL POTS AT MONO COUNTY WOULD
GET SEVENTY THREE CENTS AN
INNOVATION DOLLARS. TO THEIR
VERSION BECAUSE IT'LL JUST BE
PLANTED IN THE LARGER POT. AND
WE'VE REALLY BEEN WORKING TO TRY
TO BRING MORE COLLABORATIVE
OPPORTUNITIES TO THE COUNTIES
ALONG THE LINES OF THE WORK
WE'RE DOING ON INNOVATION BUT
ALSO IN TERMS OF SOME OF THE
GRANT DOLLARS AND WE HOPE IN
THE.
P. I. PROGRAM SO WELL THE WELL
THE ADMINISTRATION WORKS YEAH.
YEAH AMONG OTHER ISSUES OF OF C.
WE TOUCHED ON THE.
THE I GUESS RESERVE AND I KNOW
THERE'S DIFFERENT COMMENTS ABOUT
THAT.
CERTAINLY PEOPLE THIS
CHRISTOPHER REASONS FOR PEOPLE
HAVING DIFFERENT SIZE RESERVES
ITS OUTER.
AT AT THINGS THAT YOU KNOW
TRYING TO PICK A NUMBER OUT OF
THE YEAR BUT. PERHAPS MAYBE ONE
OTHER THING TO THINK ABOUT IS
WHATEVER WE SET THE RESERVE
LEVEL ESPECIALLY IF IT'S AN
AGAIN THIS IS ABOUT PUBLIC OUT
BUT IF YOU THINK YOU JUST HAVE A
BUNCH OF MONEY SAY AROUND. MAYBE
THE RESERVE NEEDS TO CERTAIN IF
IT'S ABOVE A CERTAIN AMOUNT YOU
NEED TO SENSUALLY SAY WELL WHY
DO YOU HOLD OUT YOU KNOW YOU
SAVE YET OUT FOR NOT JUST LIKE
SAVING UP FOR A RAINY DAY I MEAN
I MEAN WE WOULD WE DO SAFE RAINY
DAYS TOO. BUT ALSO LIKE OKAY
FINE WE'RE TRYING WE'RE WE'RE IN
THE MIDDLE OF DOING A PLANNING
PROJECTS SO THIS IS ACTUALLY MY
BODY THAT'S BEING DEDICATED
TOWARDS. AND WE JUST HAVEN'T PUT
THE PLAN TOGETHER INSTEAD OF
JUST LIKE WHAT WE HAVE A BUNCH
OF MONEY AND WERE JUST HANG IT
WILL WE'RE NOT SURE WHAT WE CAN
DO WITH THAT WE WERE JUST
WORRIED WE MIGHT NEED WE MIGHT
USE IT FOR SOMETHING BUT. MAYBE
HAVING SOME OF THAT CERTAIN
SOURCE OF FUNDING BUT I THINK
THAT IS ALSO AT CERTAIN POINTS
PEOPLE LIKE IT RESERVES IS
YOU'RE NOT SPENDING THE MONEY.
AND WE HAVE ALL THESE NEEDS SO.
YOU KNOW WHAT'S GOING ON.
ALL RIGHT.
OKAY WITH THAT.
.
SO ONE OF THE OTHER THINGS IS
THAT.
WE WANNA DEFINITELY FOLLOW UP
ON A LOT OF THE THINGS I MEAN
I'VE HAD CONVERSATIONS ABOUT
DOING A OFF. A OVERSIGHT HEARING
ON MENTAL HEALTH THE COUNTLESS I
THINK ADMINISTRATION AND
ACCOUNTABILITY US THAT BECAUSE
I'M SURE WE'RE NOT GONNA FINISH
TACKLING ALL THAT TODAY. AND.
OR IN THIS BUDGET SO BECAUSE I
THINK THIS IS AN ISSUE THAT. IS
OF CONSIDERABLE CONCERN.
SO THAT I WOULD THINK THE
AUDITOR I KNOW THERE'S GOING TO
BE A G. LECTURING TO GO MUCH
MORE DEATHS IN THIS HEARING SO
MAYBE MORE DISCUSSION. AND YES
AS I APPRECIATE YOU SPENDING
SOMETIME HERE IN OUR BUDGET
SUBCOMMITTEE PRESENTING THAT
SOME OF THE KEY FINDINGS RELATED
TO OUR BUDGET SUBCOMMITTEE THANK
YOU THANK YOU FOR HAVING US
HERE.
OKAY SO THE NEXT.
IS ACTUALLY NOT A.
OKAY.
OKAY YES WE DO HAVE A JOB
RELATED TO THIS WE HAVE A
STAKEHOLDER PROPOSAL FOR.
EVALUATION AS IT WAS AT THIS
OKAY YES SO.
.
RIGHT SHIPS.
REMINDING ME.
AS I KNOW WE'RE HAVING A. FOR
THE JOB THAT WAS FALLING.
GOOD EVENING MR MEMBERS ROB
LANGUAGE CBH TA.
I DON'T KNOW HOW YOU'D LIKE TO
GO ABOUT THIS WOULD YOU LIKE ME
TO REFER TO OUR LETTER THAN OURS
US.
SO ACTUALLY WANT YOU. TO HAVE
THREE MINUTE PROPOSAL OF.
YOU OF. THE.
.
SAFEWAY VALUE IF YOUR PROPOSAL
AND I THINK YOU SAID YOU THERE'S
A LETTER.
BY THE ASSOCIATION SENT YOU A
LETTER YES.
YES YES SO OUR SIBLINGS USUALLY
AFTER OUR CONVERSATION.
WOULD LIKE TO SEE A ROBUST AND
THOROUGH EVALUATION OF THE
MENTAL SERVICES ACT ON THERE ARE
FOUR MAJOR COMPONENTS THAT I'LL
COVER IN LESS THAN THREE MINUTES
OF FLIGHT. TIME WE WOULD LIKE TO
SEE THE.
.
LIKE TO SEE THE THE ORIGINAL
LANGUAGE AND THE EVALUATION
BOZELL.
ACTUALLY. PUT INTO A BUDGET
CHANGE PROPOSAL ON WOULD LIKE
FOR IT TO BE DONE AND.
DONE BY NONPROFIT RESEARCH
INSTITUTION THAT IS EXPERIENCE
AND EXPERTISE NECESSARY TO DO
THIS.
WE WOULD LIKE IT TO BE. DONE BY
IN OUR ORGANIZATION.
.
PART OF ME.
WE ALSO WOULD LIKE TO RESEARCH
AND IS A DEVELOPER PROPOSED
METHODOLOGY FOR IMPLEMENTING A
RIGOROUS AND STATEWIDE
EVALUATION SYSTEM FOR ALL IMAGES
SAY EXPENDITURES ON THE SEVEN
THAT ARE LISTED IN THE ACTED
DISTANTLY. FOR THE STATE
ADMINISTRATIVE EXPENDITURES AND
HSA HOUSING.
AND ALSO WE WOULD LIKE TO HAVE
THE.
QUALITIES MY NOTES ARE NOT WITH
ME.
THE BODIES AND WE WE JUST WOULD
LIKE TO HAVE A ROBUST EVALUATION
AND ACT ON.
OKAY.
RIGHT SO.
THANK YOU.
AND AND I THINK THAT ONE OF THE
THINGS WE HAD DISCUSSED WAS
ACTUALLY. I MEAN CERTAINLY DOES
THEFAA TO SAY PART BUT ACTUALLY
WE WERE LOOKING AT. HER THE
MORE.
BROADLY SO. WE HAVE MULTIPLE
STREAMS OF FUNNY EMPHASIS WAS
ONLY ONE MAJOR ONE THE OTHER
ONES ON THE MEDICAL SIDE. AND I
THINK WHAT ONE SEES HOW
EVERYTHING KIND OF CAME
TOGETHER.
AS WELL AND WE HEARD SOME
TESTIMONY READY ABOUT HOW THE
OKAY YEAH WE PUT BILL THAT CAL
TURNS OUT THAT DOESN'T AND MAKES
A SAVE MONEY FROM THE COUNTY
COMES FACE SO. BUT THEN BE ABLE
TO TELL THE FULL STORY ABOUT HOW
WE'RE ADDRESSING MENTAL HEALTH.
AND COURSE TO BE EVER HELD
DIRECTORS YOU KNOW YOU'RE NOT
JUST SEEING THE INMATES SAY PART
OF THE COUNTY ALSO SEEN THE
OTHER PARTS AND WE WANT TO BE
ABLE TO.
REALLY BE ABLE TO TELL THE
PUBLIC THE STORY OF WHAT WE'RE
DOING BOTH THE CROSS STRAIT AND
AND AN INDIVIDUAL COUNTIES AS
WELL SO I THINK I HAVE AND I
REMEMBER THE LETTER THAT'S WHAT
WE WERE REALLY TRYING TO ADDRESS
THAT.
SO.
OKAY.
AND.
ACTUALLY WE CAN GET WE CAN WE
CAN GET COMMITTEE MEMBERS THE
COPY THE LETTER YES.
OKAY ALL RIGHT VOTE THOUGH THANK
YOU FOR.
THEY'VE ALL RIGHT.
ANY OTHER QUESTIONS FROM
COMMITTEE MEMBERS ARE RIGHT
PUBLIC COMMENT AND.
ON ON THIS ON ON THE AUDIT AND
EVALUATION.
SO.
GOOD EVENING CHAIR.
WELL SENATOR MINING JUST LEFT MY
NAME IS DURING THE WISE MAN I AM
WITH THE CALIFORNIA BEHAVIOR
HEALTH PLANNING COUNCIL WE ARE
VERY MUCH IN SUPPORT OF THE
EVALUATION PROPOSAL. THAT
COUNSEL HAS LONG REQUESTED AN
OUTCOME EVALUATION OF THE ENTIRE
PUBLIC BEHAVIORAL HEALTH SYSTEM
SO THIS IS VERY MUCH IN LINE
WITH THAT AND WE ARE ACTUALLY.
DESIRING TO WORK WITH ALL
STAKEHOLDERS INVOLVED WITH THIS
PROCESS THANK YOU. THANK YOU.
GOOD EVENING ODD CHAIRMAN AND
COMMITTEE MEMBERS.
MY NAME IS JAKE HOW CAN I AM
WITH THE CALIFORNIA COUNCIL OF
COMMUNITY. HEALTH AGENCIES. WALL
CBJ HAS NOT TAKEN A FORMAL
POSITION ON THIS PROPOSAL.
WE DO SUPPORT THE CONCEPT OF
EVALUATING THE MHSAA FUNDS AND
WE DO LOOK FORWARD TO WORKING
WITH CB HDA ON THE SPECIFICS OF
THIS PROPOSAL THANK YOU. THANK
YOU.
I SEE NO OTHER PUBLIC COMMENT IT
IS.
FOR BOTH THE.
FOR BOTH MISTER EWING AND
DIRECTOR CAN WHEN THE THINGS
THAT WE WANT TO DO IS.
SEE WHETHER WE CAN DEVELOP A
MORE ROBUST SYSTEM OF.
OF ACCOUNTABILITY OF.
.
IT'S ACTUALLY EVALUATION AND.
SO WELL APPRECIATED THE BUREAU
OF. LABOR HEALTH DIRECTOR SAID
THEY HAVE HAD SOME IDEAS ARE
PLANNED FOR DOING THAT.
ALTHOUGH WHAT WE'D LIKE TO DO
SEE WORKING CAJUN A. AN IN
SERVICE OR PROCESS TO SEE
WHETHER WE CAN DEVOTE AND I KNOW
THAT FOR EXAMPLE YOU KNOW THE
PART OUT ON MEDICAL SITES GOT
REPORTERS CMS AND. ASKING FOR
MORE AND I KNOW THAT.
AND IT'S A YEAH WE WENT SO SEE
WHAT WE CAN SORT OF PUT THINGS
TOGETHER AND.
SEE IF THERE'S A WAY WE CAN
DEVELOP A AT A STRONGER RIGHT
ACCOUNTABILITY IN REPORTING
SYSTEM THAT ALLOWS. THE PUBLIC
TO HAVE A BETTER IDEA ABOUT
WHERE THEIR MENTAL HEALTH
DOLLARS ARE GOING CERTAINLY SEEN
VARIOUS BILLS AND AFTER THAT I
HAVE A BILL AS WELL TO SET SOME
MENTAL HEALTH PRIORITIES AND
MAKES ITS OTHERS. BECAUSE I
THINK. WE SEE MENTAL HEALTH
ISSUES OUT IN OUR COMMUNITY
RIGHT. AND. AND.
BLEW IT AND I THINK PEOPLE ARE
LOOKING TO SAY OKAY WHAT KIND OF
WHERE ARE WE NOW WHAT KIND OF
PROGRESS TO READ MAKING ON THOSE
AND WHERE ARE WE PUTTING OUR
RESOURCES. AT US AND THAT IS.
THE ALL NON MANDATED AMBITIOUS
A STATE ADMINISTRATIVE
EXPENDITURES BE FROZEN.
INTEL THIS.
METHODOLOGIES BEEN IMPLEMENTED
THERE A LOT OF STATE DEPARTMENTS
THAT RECEIVE MHSAA ADMIN CAP
DOLLARS FOR SERVICES AND SO.
YEAH WE WOULD NOT LIKE TO SEE
THOSE FROZEN OKAY. ALL RIGHT
WELL I THINK WE'RE LOOKING AT
TRYING TO FIGURE OUT HOW TO
ACTUALLY COMES FROM OHIO.
ALRIGHT SO I THINK THE I THINK
THE THRUST OF IT IS REALLY MORE
ABOUT.
LET'S ESTABLISH A.
A MORE BROAD BASED SYSTEM OF.
AND TRYING TO AGAIN MINIMIZE%
DUPLICATION WITH OTHER REPORTING
BUT HOW HOW DO WE HOW DO WE TELL
THE STORY RIGHT.
OF WHAT'S GOING ON OKAY. ALL
RIGHT SO THANK YOU AS SO WITH
THAT LET'S SAY GO AHEAD AND MOVE
ON TO THE OVERVIEW THE MENTAL
HEALTH. SERVICES OVER ST
CASUALLY COMMISSION. SO I KNOW
WE TALKED A LOT ABOUT IT BUT.
THANK YOU MISTER CHAIR CENTER
MINING PURSE AT THE TIME.
.
YOU KNOW.
VERY QUICKLY I WOULD SAY THAT WE
THINK OF THE COMMISSION WANNA
THINK ABOUT COMMISSIONS OR SORT
OF A GRAND JURY STILL OF A GRAND
JURY FOR MENTAL HEALTH. AND YOU
KNOW WE ARE NOT DENSE MANY
AGENCY CLEARLY IT APART AND
HEALTHCARE SERVICES IS THE
STATE'S LEAD AGENCY FOR MENTAL
HEALTH. WHEAT BUT BUT WE DO HAVE
A RANGE OF PROGRAMS THROUGH THE
DIRECTION THAT THE LEGISLATURE
AND THE GOVERNOR HAVE GIVEN OVER
THE LAST FEW YEARS. AM I
MENTIONED A LITTLE BIT ABOUT
INNOVATION I WANT TO SET THAT
ASIDE BECAUSE OF THE THE THE THE
NEXT ITEM ON THE AGENDA. WE
ISSUE TRIAGE GRANTS TO THE
COUNTIES WE THINK OF THESE AS
INCENTIVE DOLLARS THAT REALLY
BEGIN TO. HELP MOVE THAT
COUNTIES A CERTAIN DIRECTION SO
CURRENTLY WE ARE IN AN OPEN
PROCUREMENT AND WE'VE WE'VE SET
ASIDE THIRTY MILLION DOLLAR
SPECIFIC TO SCHOOL COUNTY.
COLLABORATIVE'S IN PART BECAUSE
TRIESTE DOLLARS ARE FOCUSED
AROUND CRISIS. AND RESEARCH THAT
WE'VE DONE IS FOUND THAT
CHILDREN ARE MORE LIKELY OR VERY
LIKELY TO PRESENT CRISIS AND
SCHOOL BASED ENVIRONMENTS. AND
WE HEAR STORIES OF CHILDREN THAT
ARE HANDCUFFED AND PUT INTO
TROLL CARS TO BE TAKEN TO
HOSPITALS AS A CRISIS RESPONSE
AND SO WE SEE TRIAGE DOLLARS AS
WAYS TO INCENTIVIZE THE KINDS OF
COLLABORATION THE APPROACHES.
THAT ARE THAT ARE CONSISTENT
WITH RECOVERY AND WELLNESS THAT
ARE THAT THE BEDROCK OF THE ACT.
WE DO SOME OTHER THINGS TO DO
THIS POLICY PROJECTS ONE OF
WHICH WAS FOR VERSION WE DID A
REPORT RECENTLY ON THE
CHALLENGES OF REDUCING THE
NUMBER MENTAL HEALTH CONSUMERS.
INVOLVED WITH THE CRIMINAL
JUSTICE SYSTEM WE CURRENTLY HAVE
ABOUT A MINUTE HEALTH IN THE
SCHOOLS AND YOU'VE GIVEN US
DIRECTION LAST YEAR. TO DRAFT A
SUICIDE PREVENTION PLAN FOR THE
STATE.
I MENTIONED EARLIER THAT WE HAVE
THIS THIS EFFORT WE CALL IT OUR
TRANSPARENCY WORK THE FIRST
PIECE IS THE DOLLARS THE SECOND
PIECE IS THE SERVICES. AND
INCLUDED IN THE SERVICES IS
UNDERSTANDING HIS GETTING
SERVICES AND THE THIRD PIECES
OUTCOME SO CONSISTENT WITH THE
COMMENT. THAT WE'RE STARTING
WITH THE KEY METRICS THAT ARE
IDENTIFIED IN THE ACT ONE OF
WHICH IS TRUE THIS CRIMINAL
JUSTICE INVOLVEMENT SO WE'RE
ACTIVELY WORKING TELLING MENTAL
HEALTH DATA. AND DEPARTMENT OF
JUSTICE DATA SO WE CAN ACTUALLY
MAP CRIMINAL JUSTICE INVOLVEMENT
AND AND THE PURPOSE IS. BOTH
OVERSIGHT BUT ALSO TO REALLY
DRIVE UNDERSTANDING OF WHAT
WORKS AND FOR WHOM AND WHAT
ENVIRONMENTS. WERE WORKING WITH
THE DEPARTMENT EDUCATION TO SEE
IF WE CAN DEVELOP SIMLAR
STRATEGIES BECAUSE ONE OF THE
GOALS OF THE ACCESS FOR DISCO
FAILURE. LAST YEAR YOU. AUTHORED
YOU APPROVED A BILL THAT THE
GOVERNOR SIGNED TO GIVE US
ACCESS TO EDT EDT DATA ONE OF
THE GOALS FOR THIS UNEMPLOYMENT.
SO WE'RE DOING A NUMBER OF
THINGS ALREADY TO BEGIN TO
MONITOR OUTCOMES OUR PERSPECTIVE
IS THIS THAT WE HAVE THE DATA.
IN MANY CASES BUT WE ALSO HAVE A
VERY FRAGMENTED SYSTEM DATA
COMES FROM MULTIPLE SOURCES
THERE ISN'T AGREEMENT.
THE COMMISSION HAS A ROLE TO
PLANNING COUNCIL HAS A ROLE THAT
PART HEALTHCARE SERVICES HAS THE
PRIMARY ROLE. IN TERMS OF
IDENTIFYING KEY METRICS FOR
OUTCOMES AND WE HAVE A NUMBER OF
CHALLENGES IN TERMS OUR DATA
SYSTEMS.
THE THE THE OTHER BIT OF GOOD
NEWS IS IN THE WORK THAT WE'VE
BEEN DOING WITH THE PRIVATE
SECTOR IN THE TECHNOLOGY SECTOR
IS THERE'S BEEN A LOT OF OFFERS
FOR ASSISTANCE IN UNDERSTANDING
HOW YOU CAN TAKE. OLDER LEGACY
SYSTEMS AND REALLY TRANSFORM
THEM FOR EFFICIENTLY WE DON'T
HAVE TO BUILD NEW SYSTEMS BUT
DRAW THE DATA OUT OF THEM TO DO
THIS KIND OF LINKING AND AND SO
WE'VE WE'VE HAD LOTS OF
COLLABORATION AND INTEREST. FROM
A RANGE OF PARTNERS IN THE
FOUNDATION COMMUNITY AND
ELSEWHERE THAT AGREED THAT WE
HAVE TO DO A BETTER JOB. HELPING
THE PUBLIC UNDERSTAND THIS THE
SYSTEM WE HAVE WHO IT'S SERVING
HOW WELL IT'S SERVING THEM AND
THE OUTCOMES THAT ARE ACHIEVED.
I I JUST FOR FOR CONTEXT IN
TERMS OF THIS DISCUSSION THE
VAST MAJORITY OF THEM INTO THE
FUNDS ARE BEING SPENT.
ABSOLUTELY COUNTY REPORTING IS
IMPROVING DRAMATICALLY WHEN WE
FIRST AT OUR VERSION WORKED
THERE WAS ABOUT A FORTY FIVE OR
FIFTY PERCENT REPORTING RATES
NOW UP TO ABOUT A NINETY FIVE
PERCENT IT'S. REPORTING IT'S
BETTER IT'S FASTER RIGHT SO
WE'RE MOVING IN THAT DIRECTION
ONE OF THE OTHER ISSUES ONE OF
THE THINGS WE DO IS WE
ADMINISTER STAKEHOLDER CONTRACT
DOLLARS AND SO ON OVER THE LAST
COUPLE OF YEARS. YOU'VE ENHANCE
THOSE FUNDS THESE ARE FUNDS THAT
WE MAKE AVAILABLE TO NONPROFIT
ORGANIZATIONS TO DO MENTAL
HEALTH ADVOCACY ON BEHALF OF
DIFFERENT CATEGORIES CHILDREN
USE. VETERANS.
NO HEALTH CONSUMERS FAMILIES THE
LGBTQ POPULATION AND EFFORTS TO
REDUCE DISPARITIES AND SO ONE OF
THE ITEMS ON THE AGENDA TODAY IS
TO ADD SOME FUNDING FOR THAT. UP
SO YOU KNOW WE WE WE DO A NUMBER
OF THINGS WERE VERY ACTIVE WE'RE
IN THE COMMUNITY QUITE A LOT
MOST OF OUR WORK IS ACTUALLY
LISTENING TO WHAT'S HAPPENING IN
THE COMMUNITY. WORKING WITH THE
COUNTIES AROUND INNOVATION AND
THE LAST THING I WOULD SAY IS
REALLY TRYING TO HELP THEM GET
TO OR TO A APPOINTED SUCCESS.
THROUGH A TECHNICAL ASSISTANCE
STRATEGY SOME OF THAT WE CAN DO
WITH THE RESOURCES THAT WE HAVE
SOME OF THAT WE'RE TRYING TO
BRING IN OTHER RESOURCES AND
AGAIN MOST OF THE TEN ITEMS. OF
IT DOWN THE ROAD. AND BUT ARE IN
OUR INTENT TO REALLY IS TO.
TO HAVE TO BREAK THE ICE IN IN
TERMS OF THE TRANSFORMATIONAL
CHANGE THAT IS THE INTENT OF THE
KNOW HOW SERVICES ACT. AND I
THINK YOUR POINT IS NOT JUST AN
A HOLE SERVICES ACT DOLLARS.
IS THE DOLLARS ARE IMPORTANT BUT
IT'S THE BROADER POLICY THAT IS
SUPPOSED TO REALLY SHAPE THE
ENTIRE MENTAL HEALTH SYSTEM NOT
JUST THOSE PROGRAMS THAT ARE
FUNDED WITH AN IMAGE AS A
DOLLAR.
ANY COMMENTS ON EVERY FAMILIAR
THOUGH FROM FINANCE. OKAY.
QUESTIONS MADE ALL RIGHT SO WE
DO HAVE A STAKEHOLDER PROPOSAL
GONNA GO ASK A COMMISSION FROM
THE CALIFORNIA PAN ETHNIC.
HEALTH NETWORK INTEREST FOR
GOING OVER THE CALIFORNIA
IMMIGRANT POLICY CENTER.
BOZELL'S TAKE AEROBICS CONTRACTS
FROM AN ADULT ISSUES AMONG
IMMIGRANTS AND REFUGEES. BREVITY
IS APPRECIATED NO MORE IN THREE
MINUTES THOUGH. COLLECTIVE BOTH
TOGETHER.
SO MR MEMBERS CAN REALLY KIND OF
THE CALIFORNIA PAN ETHNIC HEALTH
NETWORK.
I'M HERE ON BEHALF OF SEA PEN
AND US UPC TO REQUEST A A SIX
HUNDRED SEVENTY THOUSAND.
DOLLARS TO GO TOWARDS CREATING A
CONTRACT FOR SICKLE ADVOCACY ON
BEHALF OF IMMIGRANT REFUGEES I
JUST WANTED TO CLARIFY THAT.
WE'RE ASKING FOR SIX HUNDRED
SEVENTY THOUSAND I THINK THERE'S
SOME CONFUSION ABOUT. THE DOLLAR
AMOUNT BECAUSE AS BEEN COUPLED
WITH SOME OTHER ASPECT THAT
THAT'S JUST TO BE CLEAR ON THAT
IN THAT NOW SAYS IT.
INCORRECTLY. STATED THE AMOUNT.
ABOUT HALF THE IT'S HALF THE
AMOUNT. OF THE AS THE DIRECTOR
SPOKE TO EARLIER THE MEDICAL
SERVICES ACT REQUIRES A PORTION
OF FUNDS BE USED TO ENSURE
STAKEHOLDERS ABLE TO PARTICIPATE
IN CRITICAL PUBLIC PROCESSES
CONCERNING. PUBLIC MENTAL HEALTH
CARE AND THE OAC HAS
HISTORICALLY FOR FILL THIS
MANDATE BY PROVIDING STAKEHOLDER
ADVOCACY CONTRACTS TO SPECIFIC
POPULATIONS IN THE PAST.
ALLOCATED ADDITIONAL FUNDS TO
SUPPORT A DIVERSE ETHNIC
COMMUNITIES VETERANS ALL PRETTY
COMMUNITIES.
SIMILARLY IT'S CRITICAL THAT
IMMIGRANT REFUGEE CAMP.
CALIFORNIANS HAVE
REPRESENTATION IN THE MENTAL
HEALTH SYSTEM.
WE ARE IN A CRITICAL TIME FOR
IMMIGRANTS ANDREFUGEES FROM
TRAVEL BANS TARGETING MUSLIM
IMMIGRANTS TO RESCINDING
PROTECTIONS FOR DACA RECIPIENTS.
AND I'M PRESIDENT IMMIGRATION
ENFORCEMENT AND WHETHER YOU ARE
DIRECTLY IMPACTED BY THESE
ACTIONS HAVE A FAN OF FAMILY
MEMBER FRIEND. OR OR JUST A
MEMBER OF THE COMMUNITY THERE'S
A REAL SENSE THAT YOU'RE JUST
NOT WELCOME HERE AND THAT PUTS.
PEOPLE ON EDGE AND THAT'S BEEN A
INTENTIONAL TACTIC OF THIS
ADMINISTRATION AND THAT CAUSES A
TREMENDOUS AMOUNT OF OF STRESS
AND A HOST OF MENTAL HEALTH.
CONDITIONS RELATED TO THAT.
REJECT THIS THIS NOTION OF OF
NON INCLUSION AND WE AS A STATE
HAVE.
AND THAT'S NEVER A A LEVEL OF
PROTECTIONS FOR OUR IMMIGRANTS
THROUGH A NUMBER OF OTHER STATE
LAW AND THIS PROPOSAL WOULD
BUILD ON THAT ENSURING
IMMIGRANTS HAVE A SEAT AT THE
TABLE. WE URGE YOU TO ADOPT THIS
PROPOSAL THANK YOU.
GOOD EVENING I'M MISTER CHAIR
AND US SENATOR MINING I MY NAME
IS CHRIS KELLY ON A LEGISLATIVE
ADVOCATE FOR THE CALIFORNIA GOOD
POLICY CENTER.
INSTRUCTS PART OF THIS APP
PROPOSED INVESTMENT.
IMMIGRANT AND REFUGEE
COMMUNITIES HAVE FACED LONG
STANDING BERRIES TO EDUCATIONAL
ATTAINMENT ECONOMIC
OPPORTUNITIES AND ACCESS TO
SOCIAL SERVICES AND. HEALTH CARE
GIVEN THE DRAMATIC AND OFTEN
VIOLENT MIGRATORY EXPERIENCE IS
COUPLED WITH THE MISCONCEPTIONS
OF RECEIVING HEALTH SERVICES THE
PHYSICAL AND MENTAL WELL BEING
OF IMMIGRANTS AND REFUGEES ARE
PARTICULARLY AT RISK. OFFER MANY
IT'S LIKELY THAT MENTAL HEALTH
ISSUES EXPERIENCE BEFORE AND
AFTER THEY ARRIVED. UNDIAGNOSED
AND UNTREATED FOR YEARS. LAST
YEAR ICE DEPORTED THIRTY SEVEN
PERCENT MORE PEOPLE LIVING IN
THE US SENATE IN TWO THOUSAND
AND SIXTEEN.
A RECENT SURVEY THAT CIBC
HELPED CONDUCT ABOUT ONE HUNDRED
FIFTY ONE HEALTH CARE PROVIDERS
ACROSS CALIFORNIA UNDERSCORED
THE REALITY THAT IMMIGRANT
FAMILIES ARE INCREASINGLY
FEARFUL OF ENROLLING IN PUBLIC
HEALTH PROGRAMS. I'M DUE TO
AGGRESSIVE DEPORTATION ACTIONS
BY THE FEDERAL GOVERNMENT.
LAST YEAR CIBC ALSO I HEARD
FROM NUMEROUS REFUGEES
STAKEHOLDERS ABOUT THE
CHALLENGES AN URGENT NEEDS OF
THE ROW REFUGEE. COMMUNITY HERE
IN THE STATE.
CULTURAL AND LINGUISTIC
BARRIERS TO MENTAL HEALTH
SERVICES AND LACK OF MEDICALLY
TRAINED MENTAL HEALTH
PROFESSIONALS ARE AT THE TOP OF
THE LIST.
WHILE THE FEDERAL MINISTRATION
LEASHES ANTI IMMIGRANT POLICIES
AND SYSTEMICALLY UNDERMINES US
REFUGEE RESETTLEMENT AS WE KNOW
IT. WE MUST STILL FIGHT TO
PROTECT THE HEALTH OF OUR STATE.
WE URGE THE LEGISLATURE TO MAKE
THIS INVESTMENT SO THAT MENTAL
HEALTH. NEEDS OF IMMIGRANTS AND
REFUGEES WHO CALL CALIFORNIA
HOME ARE INTENTIONALLY
REPRESENTED IN THESE CRITICAL
DISCUSSIONS REGARDING
CALIFORNIA'S MENTAL HEALTH
SYSTEM THANK YOU.
OKAY THANK YOU.
COMMENTS FROM THE COMMISSION.
THANK YOU. MISTER CHAIR SO YOU
KNOW SOMETIMES WE LIKE
PARTNERING WITH NON PROFITS
BECAUSE THEY'RE THEY THEY CAN BE
FASTER AND BETTER. AND IN THIS
INSTANCE BECAUSE AN OMISSION
OVERSIGHT ON OUR PART WE HAD
INTENDED TO PUT THIS PROPOSAL
AND TWO OTHER PROPOSALS ON YOUR
AGENDA AND IT DIDN'T GET IN
THERE AND SO MY APOLOGIES FOR
THAT. THE COMMISSION IS VERY
MUCH IN SUPPORT OF THIS PROPOSAL
AND WE'VE HEARD. A NUMBER OF
STORIES OF COMMUNITY GROUPS HAVE
COME TO US AND TALKED ABOUT THE
CHALLENGES THAT THAT ARE FACING
OUR IMMIGRANT REFUGEE
POPULATIONS AND THEY'RE NOT
GETTING THE RIGHT KINDS OF.
ACCESS AND SERVICES AND SO WE
SEE THIS AS AN OPPORTUNITY TO
HAVE TO LEVERAGE THE EXPERTISE
OF THE ADVOCACY AND NONPROFIT
COMMUNITY TO REALLY BRING THAT
MESSAGE NOT JUST TO THE STATE
MUST APPLY TO THE COUNTIES. THE
IT SIMILARLY THE REASON OF THAT
THE DOLLAR FIGURES BECAUSE THERE
WAS A SECOND PROPOSAL WHICH WAS
AN AN ADDITIONAL SIX HUNDRED AND
SEVENTY TWO THE SAME KIND OF
WORK TO REDUCE CRIMINAL JUSTICE
INVOLVEMENT. AND SO THE
COMMISSION ALSO HAS TAKEN A VOTE
TO SUPPORT THAT AND SO WE TALK
TO YOUR STAFF ABOUT POSSIBLY
PUTTING ON THAT AGENDA AT A
LATER DATE. YEAH EXCELLENT OKAY.
LEO INCUMBENTS FINANCE ONCE.
THE ADMINISTRATION DOESN'T HAVE
A POSITION ON THIS PROPOSAL BUT
IF IT'S A LEGISLATIVE PRIORITY
WILL BE HAPPY TO OFFER TECHNICAL
ASSISTANCE. ALRIGHT.
THAT'S OUR MONEY THANK YOU
MISTER CHAIR I JUST WANT TO
THANK THE ADVOCATES THE
COMMISSION FOR. PULLING TOGETHER
ON THIS.
.
WE'RE LIVING IN. UNCHARTED
WATERS IN THIS PARTICULAR.
COMMUNITIES THEY'RE TAKING THE
BRUNT OF IT SO I JUST WANT TO
THANK YOU FOR YOUR ADVOCACY HERE
TODAY THINKING.
RIGHT. AGAIN THANK YOU SO MUCH
FOR BEING HERE.
AND.
FREE SHEET THE THE PRESIDENT
WHAT WE GET IS GOING WE HAVE ONE
OTHER ITEM AND THEN WE'LL GET
TAKE PUBLIC COMMENT BOTH OF
THOSE SO YOU DON'T MIND. THE
CONCEPT THOUGH BECAUSE IT'S.
SO ISSUE NUMBER TWOS COUNTY
MENTAL HEALTH INNOVATION
PLANNING IT'S ALSO RELATED TO
THE COMMISSION.
AND THEN WE'LL TAKE PUBLIC
COMMENT ON BOTH THE OVERVIEW AND
DISABLED FALLS WHEN THIS.
THANK YOU MISTER CHAIR AND
CENTER MINING I I KNOW YOU'RE
PRESSED FOR TIME AM I I THINK
YOU SAID YOUR HOPE WAS TO STAY
AT LEAST UNTIL EIGHT SO FALL AT
A LOSS OF CONSCIOUSNESS IF I
DON'T MIND BEING HERE WE DO HAVE
PEOPLE BEEN WAITING A LONG TIME.
TO PRESENT THEIR ISSUE THAT
TOWARD THE END SO YEAH SO THAT
THE COMMISSION IS PROPOSING IN
IT IT THEM AN INVESTMENT OF FIVE
HUNDRED FIVE MILLION DOLLARS OF
STATE ADMINISTRATIVE AND TO SAY
FUNDS TO SUPPORT.
ASSESS FOR. WHAT WE CALL AN
INNOVATION INCUBATOR AND THE
PROPOSAL IS REALLY TO BRING
TOGETHER THE COUNTIES AROUND
STRATEGIC COLLABORATION
OPPORTUNITIES? TO ENHANCE THE
TECHNICAL ASSISTANCE AVAILABLE
TO THEM SO THEY CAN BETTER
LEVERAGE THEIR INNOVATION FUNDS.
TO ENSURE THAT THERE'S A ROBUST
EVALUATION BUILT IN THE DESIGN
OF THESE PROJECTS AND THEN
REALLY TO SUPPORT COLLECTIVE
LEARNING. IN THE PROPOSAL IS
THAT THESE FUNDS WOULD BE USED
TO LAUNCH. WHAT WILL PROBABLY BE
A NONPROFIT THAT WOULD ACTUALLY
BE A SERVICE PROVIDER TO THE
COUNTIES? THE THIS THE PROPOSAL
IS TO TWO POINT FIVE MILLION
DOLLARS. TWICE ACROSS TO FIVE
MILLION ACROSS TWO FISCAL YEARS
WITH THE INTENT OF THIS IS START
UP MONEY.
THE COMMISSION IS WORKING WITH
THE COUNTY IS TO IDENTIFY WAYS
IN WHICH THE COUNTIES COULD THEN
USE THEIR EXISTING FUNDS TO FUND
THE INCUBATOR OVER TIME SO WE
SEE THIS AS A MARKET TEST. IS
THAT THAT THE STATE WOULD
ACTUALLY LAUNCH THIS BUT THEN
THE COUNTY SHOULD FIND AN ON
GOING BASIS TO THE EXTENT THAT
IS ACTUALLY HELPING THEM BETTER
UTILIZE THEIR INNOVATION FUNDS.
IN WORKING WITH THE
ADMINISTRATION. CONSISTENT WITH
THE BROADER PROPOSAL THAT'S ON
YOUR AGENDA IS THE INTENT IS
THAT THE INCUBATOR WOULD FOCUS
ON. REDUCING THE ICED TEA
POPULATION WERE VERY SUPPORTIVE
OF THAT PROPOSAL WE THINK AND
THAT'S CONSISTENT WITH THE WORK
THAT WE'VE DONE AND REDUCING
CRIMINAL JUSTICE INVOLVEMENT
INTO IT IS ONE OF THE GOALS OF
THE ACT. AND ALL AND ALL I'LL
SAY THAT BECAUSE I WAS GONNA
COME UP LATER. IN THE AGENDA IS
THE COMMISSION SUBSEQUENT TO
THIS ASKED US TO ALSO. BRING TO
THE IDEA OF AN ADDITIONAL
pMILLION DOLLARS TO FOCUS ON THE
NEEDS OF CHILDREN. PARTICULARLY
GIVEN THE WORK THAT.
THAT WE'VE SEEN AROUND ADVERSE
CHILDHOOD EXPERIENCES THAT WE
WANT TO MAKE SURE THAT WE ARE
DOING A COMPARABLE JOB IN TERMS
OF LEVERAGING THE INNOVATION
DOLLARS. TO REALLY UNDERSTAND
HOW WE CAN IMPROVE ACCESS TO
PREVENTION AND EARLY
INTERVENTION STRATEGIES FOR OUR
YOUNGEST RESIDENTS WHO WHO OFTEN
ALSO STRUGGLE WE KNOW THE
RESEARCH SHOWS. THAT SOME OF THE
MOST SEVERE ILLNESSES AND AT
EIGHT OO.
.
HAPPEN IN IT IT THE EARLIER AGES
OF OUR OF OUR YOUTH TEENAGERS
YOUNG ADULTS AND SO. SO THAT'S
NOT ON THE AGENDA TODAY BUT I
WANT TO PUT A PLACE HOLDER HERE
THAT WILL WORK WITH YOUR STAFF
TO TO FLESH THAT OUT A LITTLE
MORE FULLY.
THANK YOU.
CONCILIO NO FINANCE.
BUT WHILE THESE FUNDS ARE
SEPARATE FROM THE DEPARTMENT OF
STATE HOSPITALS. IST DIVERSION
PROPOSAL WE WE REALLY VIEW THIS.
COMPONENT AS BEING KEY TO THE
SUCCESS AND ALSO THE WAY IT BY
USING THEIR MHSAA RICK
INNOVATION DOLLARS TO.
AS A COUNTY IS A COUNTY MATCH
TO THAT INNOVATION ART. ICED TEA
DIVERSION PROPOSAL THANK YOU ALL
RIGHT QUESTIONS FROM MEMBERS.
OKAY SO WE'RE GONNA TAKE PUBLIC
COMMENT ON IT AND NOW IF YOU
WANT I CAN KIND OF THE ICE TEA
WERE ACTUALLY THE NEXT SECTION
WILL BE ALL ABOUT ISPS OF YOU
HOLD THAT TO ACTUALLY HAVE THE
ICE TEA DISCUSSION. BUT IF YOU
HAVE COMMENTS ON THE RESTS ON
THE CUT ANY MENTAL HEALTH
INNOVATION PLANNING THE
STAKEHOLDER PULLS OF REFUGEES
THAT MADE TO SAY OVERALL.
PLEASE COME UP AND.
MR CHECKER CHILD DISABILITY
RIGHTS CALIFORNIA WE SUPPORT THE
EARLIER PROPOSAL THAT WAS
PRESENTED WILL SAVE OUR COMMENTS
ON THE ISP FOR THE NEXT DAY I.
DO YOU.
HELENA THOUSAND TEACHERS FOR
HEALTHY KIDS SINCE YOU BROUGHT
UP THE INCUBATOR PROPOSAL FOR
CHILDREN AS WELL AS FOR. THE.
THE OTHER POPULATION WE WANT TO
SUPPORT THAT YOU DO SOMETHING ON
ON THE CHILDREN SIDE WE KNOW
THAT SEVENTY FIVE PERCENT OF
MENTAL ILLNESS. OCCURS BEFORE
THE AGE OF TWENTY FOUR AND FIFTY
PERCENT BEFORE THE AGE OF
FOURTEEN THERE BEEN SOME
EXCELLENT HEARINGS AND MEETINGS
THAT THE. COMMISSION IS HELD AND
I REALLY THINK THIS WOULD BE
HELPFUL TO COME UP WITH THOSE
INNOVATIVE IDEAS TO THE SINK
BITTER PROPOSAL THANK YOU. THANK
YOU.
WELCOME.
THE GENERAL US WITH THE
STEINBERG INSTITUTE. IN STRONG
SUPPORT OF THE TECHNICAL SUPPORT
DOLLARS FOR COMPANIES FOR THEIR
INNOVATION PROGRAMS. ARMED AND
ALSO IN STRONG SUPPORT OF THE
REFUGEES STAKEHOLDER ADVOCACY
PROGRAMS AND THINK VERY MUCH.
THANK YOU.
ALL RIGHT.
THANK YOU SO MUCH OKAY SO THE
NEXT ITEM IS ACTUALLY ANOTHER
LARGE ONE.
OF.
I AM GONNA HOLD WHICH WILL HOLD
THOSE TWO PROPOSALS OPENED.
REVISE AND SO.
WE'RE NOW GOING TO MOVE FORWARD
TO.
THEIR SECTION ISSUE NUMBER ONE
INCOMPETENT STAND TRIAL
POPULATION THE OVERVIEWS FO WE
NEED DEPARTMENT STATE HOSPITALS
AND WE HAVE MISSIONARY UP HERE
SO WELL FIRST DO SAID DO THE
ROUND OF INTRODUCTIONS SINCE WE
HAVE NEW FOLKS EMILIO FINANCE.
FOR THE RECORD AND THEN.
.
AND SEE HERE.
AND SO WHAT WE'LL DO IS.
WE'RE GOING TO HEAR BOTH ISSUE
ONE THEN TWO THEN THEY'LL TAKE
PUBLIC COMMENT BECAUSE OF BOTH
RELATED TO HIGHEST T.. SO.
SO FIRST FOR THE RECORD OF
IMAGES AND THE ADDED INTRODUCE
THEMSELVES AGENCIES FIRST.
I STEPHANIE CLINTON AND CHIEF
DEPUTY DIRECTOR FOR THE
DEPARTMENT OF STATE HOSPITALS
KEEP. BACK GARBER DEPUTY
DIRECTOR FORENSIC SERVICES
DEPARTMENT THAT HOSPITAL IN IT
WERE BURTON MEDICAL DIRECTOR
DEPARTMENT STATE HEALTH.
TO SORT OF WORK LEGISLATIVE
ANALYST.
AND JONATHAN PETERSON
LEGISLATIVE ANALYSTS. FINANCE
OKAY WELL. ARE IN THE FINANCE.
OKAY HUMPHRIES DEPARTMENT OF
FINANCE.
CHRIS COOK BY MY FINANCE I GUESS
FOR THE RECORD USUALLY HEALING
WITH THE MEDICAL SERVICES OVER
TEN KIND OF THE COMMISSION OKAY
THANK YOU ALL RIGHT OF YOU. IF
YOU CAN BEGIN. ON THE ROOF.
SURE THERE WERE.
SEVERAL OF THEM. AT QUESTIONS
ON THE AGENDA AND SO I THOUGHT I
WOULD START WITH THE OVERVIEW
FIRST AND KIND OF WEED IN THE
ANSWERS TO THE OTHER ONES AND
THEN GET INTO THE PROPOSALS.
JUROR ANYA AND STRAIGHT STICK TO
THE HIGHLIGHTS WE HAVE A WELL
WRITTEN SO YOU DON'T NEED VERY
EARLY EVERYTHING IN THAT WRITTEN
COMMENT. CERTAINLY WELL SO JUST
TO AND KIND OF GIVE A BRIEF
OVERVIEW ABOUT THE KIND OF THE
HISTORY OF OF THE CHALLENGES
THAT WE FACE WITH INCOMPETENT TO
STAND TRIAL POPULATIONS OF THE
DEPARTMENT OF STATE HOSPITALS.
AND WE BEGAN TO IT AM
EXPERIENCING A GROWTH IN OUR
WEIGHTLESS BACK IN TWO THOUSAND
AND THIRTEEN. AND I WON'T GO
INTO WHO I GUESS HE'S ALREADY
THE GENDER THEY DID AND THAT
JUSTICE I WILL SAY THAT.
TIME.
THE I AM BUT WHEN I IS HE'S ARE
COMMITTED TO THE DEPARTMENT OF
STATE HOSPITALS AND IT'S THE
FELONY I GUESS HE'S THE KIND OF
THE DEPARTMENT OF STATE
HOSPITALS. THEY'RE PROVIDED BOTH
MENTAL HEALTH AND MEDICAL
SERVICES THEM WITH THE GOAL OF
RESTORING THEIR COMPETENCY
EXPEDITIOUSLY EXPEDITIOUSLY AND
ENABLING THEM TO STAND TRIAL.
TIME WE THE TREATMENT REALLY IS
AROUND CONTINUAL ASSESSMENT
IDENTIFIED IDENTIFICATION OF THE
BARRIER TO CON COMPETENCY AND
THEN PROVIDING THE TREATMENT TO
ADDRESS THAT BARRIER.
THE MAXIMUM COMMITMENT TIME FOR
AN ICED TEA IN THE DEPARTMENTS
OF HOSPITALS IS THREE YEARS.
AND.
OR THE MAXIMUM TERM OF THE
PRINCE AND THE IMPRISONMENT FOR
THE MOST SERIOUS CHARGE I JUST
TO GIVE YOU A SENSE OF THE
NUMBER THAT WE SERVE IN THE
STATE HOSPITALS WE SERVE AN
AVERAGE DAILY CENSUS OF.
ABOUT FIFTEEN HUNDRED AND
TWENTY FIVE BACK IN TWO THOUSAND
SIXTEEN SOMETHING THAT WAS OUR
AVERAGE DAILY CENSUS I'M FOR
ISPS. LAST YEAR WE SERVED OVER
FORTY SIX HUNDRED IDEAS TO USE
THEM. AND THEY HAD AN AVERAGE
LENGTH OF STAY IN THE STATE
HOSPITALS OF A HUNDRED AND SIXTY
FOUR DAYS.
BEEN OUR JOB BASE COMPETENCY
TREATMENT PROGRAMS WE HAD A
HUNDRED AND FORTY ONE LAST YEARS
OR EVEN AVERAGE DAILY SOME SENSE
THAT WE SERVED TOTAL OF SEVEN
HUNDRED AND TWENTY NINE. AND THE
JOB BASE COMES TREATMENT
PROGRAMS HAVE ASHORTER LENGTH
OF STAY THERE AT SIXTY DAYS AND
THAT IS BY DESIGN. AND WE TREAT
THE INDIVIDUALS IN THOSE
PROGRAMS THAT WE THINK CAN
RESTORE QUICKLY. AND IF THEY
DON'T RESTORE WITH IN AND THE
SIXTY DAYS AND THEY'RE
TRANSFERRED INTO A STATE
HOSPITAL SO THEY'RE NOT SPENDING
EXTEND EXTENDED AMOUNT OF TIME
IN JAIL.
AS OF APRIL NINETEENTH WE HAD
NINE HUNDRED AND SEVENTY TWO
HIGHEST HE'S ON OUR WAITLIST
PENDING PLACEMENT TO THE STATE
HOSPITALS OR JOB BASE.
TREATMENT PROGRAM LOOKING BACK
JUST TO TWO THOUSAND AND FIFTEEN
WE HAD ONLY THREE HUNDRED AND
EIGHT SO IT'S GROWN
SUBSTANTIALLY OVER TIME. AND
IT'S IMPORTANT AT THAT SITE LIKE
A STATIC NUMBER THE WEIGHTLESS
IS CONSTANTLY TURNING.
AND THE.
INCREASE AND.
ICED TEA REFERRALS IS ACTUALLY
A NATIONAL TREND IT'S NOT JUST
SOMETHING THAT WE'RE FACING HERE
IN CALIFORNIA. THERE HAVE BEEN.
LITIGATION NIGHT NATIONWIDE ON
THE SUBJECT AND THE TIMELINESS
OF ADMISSIONS. SO AND WE'VE
ADDRESSED THE ISSUE IN THREE
DIFFERENT WAYS FOCUSING ON
CAPACITY SYSTEM.
EFFICIENCIES AND DEMAND WE'VE
OPENED OVER FOUR HUNDRED BED
SUITE I'M IN THE STATE HOSPITALS
OVER THE LAST SEVERAL YEARS WE
HAVE INCREASED OUR JOB BASE
COMPETENCY TREATMENT PROGRAM
SUBSTANTIALLY. AND WE'VE HAD.
WE'VE IMPROVED OUR SYSTEM TRY
AND REDUCE OUR LIVES ARE LIKE
THE STATE TO ENSURE THAT WORK
THAT WE ARE ABLE TO USE OUR BEST
AS EFFICIENTLY AS POSSIBLE. AND
BUT DESPITE ALL THESE EFFORTS WE
CONTINUE TO EXPAND EXPERIENCE A
WAIT LIST.
INCREASE BECAUSE THE COUNTY
REFERRALS ARE. OUTPACING OUR
ABILITY TO GROW THE SYSTEM. SO
FROM THAT WE STARTED LOOKING AT
THE DEMAND SIDE.
AND.
TRYING TO SEE WHAT WE CAN DO TO
TO ADDRESS THE ISSUE FROM THAT
FROM THAT SIDE AND.
AGAIN IT'S A NATIONAL ISSUE
YOU'D ASKED ABOUT KIND OF WHAT
IS DRIVING THE DEMAND LOOKING AT
THE NATIONAL DATA. AND REALLY
IT'S YOU KNOW IT'S THERE THERE
DEMONSTRATED NATIONAL DATA
DEMONSTRATES THAT THERE IS A
LARGE INCREASE OVER TIME AND I
ESTEEM PATIENTS I'M COMMITTED TO
STAY HOSPITALS ACROSS THE
NATION.
ON THE DATA IN CAPE INDICATES AN
APPROXIMATE RISE OF OVER SEVENTY
PERCENT IN THE LAST TWENTY
YEARS.
THE EXACT CAUSE THOUGH HAS BEEN
DIFFICULT TO PROVE.
BUT THE THE DATA IT DOES
SUGGEST A CORRELATION BETWEEN.
WITHIN RECENT NOW.
EVERY SESSION. WHEN LOOKING AT
COMMON COMPARED IT TO MEDICAL
DATA DID
NOT ACCESS THEIR MEDICAL
REIMBURSABLE MENTAL HEALTH
SERVICES IN THE SIX MONTHS PRIOR
TO THE RAP TO THE ARRESTS. SO WE
HAD I'M SEVERAL PROPOSALS THIS
YEAR.
FOR CAPACITY SOLUTIONS AND WE
ARE PROPOSING.
TO ADD TWO HUNDRED AND THIRTY
SIX OR CONVERT I'M TWO HUNDRED
THIRTY SIX BEDS AT THE
METROPOLITAN STATE HOSPITAL. AND
WE'VE HAD A SERIES OF PROPOSALS
OVER THE LAST YEAR THAT SEVERAL
YEARS STARTING WITH A CAPITAL
OUTLAY PROJECT TO BUILD SECURITY
INFRASTRUCTURE AROUND AN
EXISTING PATIENT BUILDING. LAST
YEAR WAS THE FUNDING TO BEGIN TO
PREPARE TO CONVERT THOSE BY
MOVING THE EXISTING I'M SIMPLY
COMMITTED PATIENTS OUT TO
ANOTHER BUILDING. AND THEN WE'RE
NOW ASKING FOR THAT I'M. THE
ONLY ANY AND I'M STOPPING TO BE
ABLE TO ACTIVATE THE UNITS AND
THEN THOSE BEDS. AND WE ALSO
HAVE A REQUEST FOR THE
ASSOCIATED.
PATIENT AT LEE ANNE.
NEWS OR CUT COSTS THAT ARE
DRIVEN BY AGE AND THE PATIENTS
LIKE FOOD AND.
CLOTHING THOSE KIND OF THINGS
AND THEN WE ALSO HAD.
A REQUEST FOR COALINGA STATE
HOSPITAL INCREASING BED CAPACITY
AT I S. T. SO WE NEEDED TO
ENSURE
THAT WE HAVE ENOUGH BEDS FOR ALL
OF OUR PATIENTS. AND THEN
FINALLY WE HAVE.
TWO PROPOSALS RELATED TO.
CONTRACTED CAPACITY AND THAT'S
WITH THE GM JOVIS COMES AS A
TREATMENT PROGRAM EXPANSION. AND
WE HAVE BEEN YOU KNOW IT'S BEEN
MENTIONED WE HAVE X. ADAM. BEEN
A GROWING OUR OUR JOB IS COME TO
SEEK TREATMENT PROGRAMS AS PART
OF THE SOLUTION WE HAVE A NUMBER
OF COUNTIES THAT ARE AND. THAT
WE ARE PROPOSING TO BRING ONLINE
OVER THE NEXT YEAR AND THEN WE
HAVE THE CURRENT.
PROPOSAL AND THAT'S REALLY A
CURRENT YOUR SAVINGS THAT'S
ACTUALLY GETTING READY TO
ACTIVATE THEM THIS MONTH AND SO
THERE WAS SOME DELAYS AND NOT
ACTIVATION.
TAKE ANY QUESTIONS.
YOU.
ANY COMMENTS FROM.
AM. I THINK I THINK I WOULD I
WOULD BE REMISS IN MY. NOMINAL
HEALTH GRAND JURY ROLL IF I
DIDN'T.
AND POINT OUT THAT ONE OF THE
THINGS THAT THAT THE COMMISSION
IS REALLY FOCUSES ON IS THE
LANGUAGE THAT WE USE.
AND ONE OF MY COMMISSIONERS HAS
A CHILD AT ONE OF THE STATE
HOSPITALS AND I THINK SHE WOULD
BE HORRIFIED.
IF WE HEARD REFERRED TO HER
CHILD IS AN I. S. T..
AS OPPOSED TO A CONSUMER WITH
IMAGES AS A PATIENT SO.
IN INSTEAD OF RECOGNIZING THAT
WE'RE ACTUALLY TALKING ABOUT
PEOPLE WHO ARE STAYING WITH
MENTAL HEALTH NEEDS KNOW THE
HOPE WOULD BE THAT TO
UNDERSTAND.
THAT YOU KNOW THESE ACTUALLY OUR
MENTAL HEALTH CONSUMERS. SO AND
AND AND AND THAT'S A THAT'S A
CHANGE AND WE HAVE THAT
CONVERSATION WITH THE WITH THE
MEDIA ALL THE TIME AND IT'S IT
BUT IT'S A REALLY IMPORTANT
SHIFT.
PART OF WHAT REALLY SURPRISES
THE COMMISSION IN TERMS OF SOME
OF THE DATA IS THE FACT THAT
MANY OF THESE FOLKS ARE ON
CHILDREN HOMELESS HALF OF THEM
IN THAT THEY'VE BEEN ARRESTED
MULTIPLE MULTIPLE TIMES.
AND SO I I THINK WE'RE WE'RE
VERY SUPPORTIVE OF THE IDEA OF
REALLY TRYING TO IMPROVE OUR
STRATEGIES TO REDUCE THE THE
NUMBER OF FOLKS.
WHO DO END UP BEING DECLARED
INCOMPETENT TO STAND TRIAL AND
OUR?
YOU KNOW ON A WAIT LIST RIGHT
BECAUSE OF THE CHALLENGES OF
SERVING THEM IN A COMMUNITY
ENVIRONMENT. YET AMOUNT OF TIME
IT TAKES TO ACTUALLY GET THEM
THE SERVICES THEY NEED BUT ALSO
TO UNDERSTAND THAT THE SERVICES
THEY NEED. MAY VERY MUCH BE
ASSOCIATED NOT JUST WITH THE
UNDERLYING MENTAL ILLNESS BUT
WITH THE LACK OF HOUSING THE
LACK OF OTHER SERVICES AND
SUPPORTS THAT HELP THEM. BE
SUCCESSFUL AS INDIVIDUAL MEMBERS
OF OUR COMMUNITIES SO I THINK
YOU KNOW WE'RE WE'RE VERY
INTERESTED IN ENGAGING IN
PARTNERING WITH THE DEPARTMENT
AND REALLY WANT TO UNDERSTAND
HOW TO MAKE THIS WORK.
OKAY THANK YOU.
ACTUALLY IN THE MEDIA. ACCOUNTS
FROM OHIO.
THANK YOU MISTER CHAIR AND
MEMBERS I WE HAD ONE
RECOMMENDATION ON THE OVERALL
ICED TEA OVERVIEW AND THEN SOME
RECOMMENDATIONS ON THE CAPACITY
PROPOSALS THAT WERE MENTIONED.
FIRST WE WANTED TO NOTE THAT THE
ICE TEA WAIT LIST AS IS
CURRENTLY DEFINED THAT NINE
HUNDRED SEVENTY TWO NUMBER.
REALLY COMPOSES TWO GROUPS OF
PEOPLE PEOPLE WHO ARE TRULY
WAITING FOR A BED TO BECOME
AVAILABLE BECAUSE THERE IS NOT
ANY CAPACITY. AND ANOTHER GROUP
ALBEIT A SMALLER GROUP ARE
PEOPLE WHO ARE BEING PROCESS TO
IDENTIFY THE APPROPRIATE PLACE
TO TREAT THEM. SO EVEN IF THERE
IS ADDITIONAL CAPACITY THAT'S
ADDED TO THE SYSTEM THE PEOPLE
WHO ARE BEING PROCESS TO
DETERMINE WHERE THEY SHOULD BE
TREATED WILL STILL BE ON THE
WAIT LIST FOR SOME PERIOD OF
TIME. SO WE RECOMMEND IS THAT
THE LEGISLATURE. DEFINED THE
WAIT LIST ACCORDING TO. WHAT IT
CONSIDERS TO BE AN APPROPRIATE
TIME SOMEONE SHOULD BE WAITING
AND WHAT IS APPROPRIATE MEASURE
OF WHEN SOMEONE IS ON THE WAIT
LIST VERSUS JUST BEING A PROCESS
FOR TREATMENT?
WE RECOMMEND WE SUGGEST ONE
OPTION IS A SIX WEEK WAIT
WAITING LIST WHICH WOULD BE
WHICH IS ACCORDING THE
DEPARTMENT KIND OF A HIGHER
ESTIMATE FOR HOW LONG IT TAKES
FOR THEM TO PROCESS SOMEONE. TO
MAKE SURE THAT THEY'RE READY TO
BE PLACED IN A TREATMENT
FACILITY.
AND AFTER THE LEGISLATURE
DEFINES A WAIT LIST AND THE
DEPARTMENT IT WOULD WE WOULD
ALSO RECOMMEND ADOPTING BUDGET
TRAILER RIG LEGISLATION FOR THEM
TO REPORT ON A WEEKLY BASIS AS
THEY DO WITH THE CURRENT
WAITLIST.
ONCE THE LEGISLATURE HASDEFINED
THIS WAIT LIST WILL BE IN A MUCH
BETTER POSITION TO DETERMINE HOW
MANY ADDITIONAL BEDS ARE NEEDED
TO REDUCE OR ELIMINATE. ALL THAT
WEIGHT LAST.
IF THE LEGISLATURE TO FIND THE
WAIT LIST.
ACCORDING TO THE SIX WEEK PERIOD
IT WE WE ESTIMATE THAT THE WAIT
LIST WOULD BE ABOUT FEW A FEW
HUNDRED PEOPLE LOWER THAN IT IS
NOW. OBVIOUSLY THERE WOULD STILL
BE NINE HUNDRED AND SEVENTY TWO
PEOPLE BUT THE NUMBER READY TO
BE TRANSFERRED WOULD BE LOWER
THAN THAT.
A LARGE PORTION OF THIS NEED WE
THINK COULD BE MET WITH THE GEL
BASED COMPETENCY TREATMENT
EXPANSION THAT THE DEPARTMENT
MENTIONED AND THE LA COUNTY
PROGRAM WHICH WE HAVE SOME
SPECIFIC RECOMMENDATIONS FOR A
HOLD FOR THE. NEXT ITEM.
TO DRESS THEN THAT WOULD ADD
ABOUT TWO HUNDRED FIFTY SIX BEDS
TO DRESS THE ADDITIONAL NEED FOR
BEDS WE RECOMMEND THE DEPARTMENT
ACTIVATED. TWO OF THE UNITS AT
THE DEPARTMENT SEE HOSPITALS TO
FACILITY METROPOLITAN IN
NORWALK.
THE REMAINING UNITS WOULD BE
AVAILABLE BEYOND THE TWO UNITS
WE RECOMMEND ACTIVATING IN CASE
WE WERE NOT ABLE TO SERVICE THE
WAIT LIST AS ANTICIPATED WITH
THOSE TWO UNITS AND THE. OTHER
PROGRAMS MENTIONED.
OR IF THE WEIGHTLESS CHANGES
BETWEEN NOW AND MAY REVISION
WHEN WE GET UPDATED INFORMATION.
ON THE JOB BASE COMPETENCY
TREATMENT PROGRAMS WE WOULD KNOW
THAT.
THE DEPARTMENT WE WOULD
RECOMMEND THAT THE LEGISLATURE
DIRECTED APARTMENT TO REPORT ON
ITS PROGRESS TOWARD IDENTIFYING
COUNTIES TO OPERATE THE
PROGRAMS.
AND OF HOW THOSE NEGOTIATIONS
ARE PROGRESSING TO MAKE SURE
THAT THOSE FACILITIES CAN BE
ACTIVATED ACCORDING TO SCHEDULE.
AND FINALLY ON THE INCREASED
CAPACITY AT THE ESTATE COALINGA.
WE WOULD NOTE THAT WE RECOMMEND
APPROVING THE FUNDING FOR THE
STAFF AND POSITION MISSED THE
POSITIONS.
BECAUSE IT WOULD ALLOW THE
DOCTOR APARTMENT OPERATE THESE
BEDS CONSISTENT HOW IT OPERATES
OTHER BEDS FOR MENTALLY
DISORDERED OFFENDERS WE WOULD
JUST NOTE THAT THE DEPARTMENT IS
CURRENTLY UNDERGOING A STAFFING
STUDY THE FIRST PHASE WAS
SUPPOSED TO BE RELEASED. FALL
TWENTY SEVENTEEN IT HAS NOT BEEN
RELEASED YET.
THIS STABBING STUDY WOULD
HOPEFULLY HELP THE LEGISLATURE
DETERMINE WHETHER THAT ALL
STAFFING AT THE DEPARTMENT IS
APPROPRIATE AND WHETHER BUDGET
CHANGES. IN STAFFING CHANGES ARE
NEEDED SO WHAT WE RECOMMEND TO
ENSURE THAT THE LEGISLATURE HAS
THIS INFORMATION IN TIME TO MAKE
THOSE DECISIONS. THAT IT
APPROVED PROVISIONAL LANGUAGE
REQUIRING THE DEPARTMENT TO
PROVIDE THAT STAFFING STUDY IT
HAS TWO PHASES.
BY JANUARY TEN TWENTY NINETEEN
IT WOULD GIVE THE DEPARTMENT ONE
MORE YEAR AND THEN ALLOW IT TO
BE CONSIDERED IN THE FOLLOWING
BUDGET PROCESS.
THANK YOU THANK YOU.
FINANCE.
YEAH JUST TWO COMMENTS IN
REGARDS TO THEIR LEOS.
STATEMENT.
ONE ON THE GBC T..
ACTIVATION YOU KNOW FNANCE
SHARES SIMILAR CONCERNS AND AND
WE RECOGNIZE THAT WE HAVE BEEN
EXPANDING JB CITY CONTRACTS.
WITH COUNTIES IN IN THE RECENT
YEARS AND SO SIMILARLY TO PAST
YEARS.
THE. FINANCE THEIR THE
ADMINISTRATION IS INCLUDED A
PROVISIONAL LANGUAGE. TO.
ALLOW.
.
THAT NOTIFICATION TO GO OUT TO
THE LEGISLATURE UPON ACTIVATION
ACTIVATING.
A LAW THAT ALL THOSE CONTRACTS
AND. AT THE TIME THAT THEY REACH
AN AGREEMENT WITH THOSE COUNTY
SO WHILE IT DIDN'T THAT THEY
ESTIMATE. FROM THE DEPARTMENT
DIDN'T EXPLICITLY CALL OUT THOSE
COUNTIES BECAUSE THEY'RE STILL
UNDERGOING A. CONTRACT
NEGOTIATIONS AND THEY ARE MADE
PUBLIC UNTIL IT'S.
PROVE THEIR BOARD OF
SUPERVISORS WE HAVE ADDED IT
INCLUDED.
A MECHANISM TO NOTIFY THE
LEGISLATURE OF THOSE
ACTIVATIONS.
AND THEN FURTHER OUT OF ANOTHER
POINT ON THE STAFFING STUDY.
AS NOTED BY THE ALITO THEM THAT
THE STAFFING STUDY WAS.
BEGAN A FEW YEARS BACK.
ALTHOUGH THE THE THE DEPARTMENT
HAS NEVER RECEIVED RESOURCES TO
DO THE STAFFING STUDY IT'S A
HUGE UNDERTAKING BY THE
DEPARTMENT TO ESSENTIALLY
EXAMINE THEIR WHOLE
INFRASTRUCTURE OF. ALL THEIR
EYES THEIR STAFF AND ALL THE
FACILITIES AND SO GIVEN THE.
THE CURREN EFFORTS WITH THE
DEPARTMENT OF FINANCE'S MISSION
BASED REVIEW TEAM THEY'VE BEEN
TEAMING UP WITH THE DEPARTMENT
OF STATE HOSPITALS TO REALLY
TAKE A GOOD. LOOK AT ALL THE
RESOURCES THEY HAVE AND SOLD
THAT EFFORT IS IS UNDER WAY BUT
JUST WANTED KNOWLEDGE THAT
THEY'VE BEEN DOING IT WHAT THAT
UTILIZING EXISTING RESOURCES.
AND ALSO.
.
BUT THOSE THOSE SAME PEOPLE ARE
THE ONES THAT. ARE THE ONES THAT
PRODUCE THEIR ESTIMATE AND DO
ALL KINDS OF OTHER WORK FOR THE
DEPARTMENT AS WELL.
GIVE HER MONEY.
THANK YOU MISTER CHAIR I OWNED
IT IT SEEMS LIKE WITH THIS. NINE
HUNDRED SEVENTY TWO WAIT LIST
WE'VE HAD SOME ILLUSTRATION OF.
THAT BREAK DOWN BUT.
IS IT FAIR TO SAY. VAST MAJORITY
OF THEM ARE BEING HELD IN COUNTY
JAIL FACILITIES.
YES THAT'S CORRECT ENDING PLATE
WHEN THEY'RE PENDING PLACEMENT
THEY ARE I'M WAITING IN THE
COUNTY JAIL AND I KNOW PART OF
THE BUDGET PROPOSAL IS TO EXPAND
ON.
THOSE SERVICES JAIL BASED ON
COMPETENCY. TREATMENT BUT WHAT'S
REQUIRED THEM. IT'S NOT JUST
MORE CELLS YOU NEED SPECIAL
PERSONAL.
DEVOTED IS THE COST PRIMARILY
PERSONAL IS IT IS IT ACTUAL
HOUSING AREA IS THAT SPACE HAD
IS THIS PROPOSAL BREAKDOWN
BETWEEN. QUALIFIED PERSONNEL. IN
BY QUALIFIED PERSONNEL AND I'M
CURIOUS.
WHAT IS QUALIFIED PERSONNEL
BECAUSE?
OUR COUNTY JAILS ARE BEING
TURNED INTO MENTAL HEALTH CARE
ACILITIES BUT MANY OF THE
PERSONNEL THERE AREN'T TRAINED.
IN THE.
THEY TREAT.
IN ME INSUBORDINATION.
PROBLEMS.
OFTEN WITH FORCE.
SO HELP ME UNDERSTAND.
WHAT PARTICULAR TRAINING IS
REQUIRED OR OR WHAT QUALIFIES A
COUNTY JAIL TO SERVE THIS
PURPOSE?
AND THAT'S A REALLY GOOD
QUESTION I MEAN DEFINITELY AT
ONE OF THE CONCERNS AND THE
REASON WHY WE ARE WORKING SO
FEVERISHLY TO ACTIVATE THEM. BED
CAPACITY AND.
WOULD REDUCE THE WAIT TIMES AS
WE RECOGNIZE THAT WHEN SOMEBODY
IS ADD THERE'S TWO ISSUES ONE
THAT THEY'RE NOT GETTING TIMELY
RESTORATION SERVICES IN ORDER TO
GET THEM TO HAVE. MEET THEIR
CONSTITUTIONAL RIGHTS TO DUE
PROCESS.
BUT SECONDLY IS THAT YOU KNOW
THERE'S VARYING DEGREE. LEVELS
OF MENTAL HEALTH TREATMENT IN
THE IN THE COUNTY JAILS.
AND SO AS OUR GOAL IS ALWAYS TO
TRY TO GET THEM IN AS QUICKLY AS
POSSIBLE WE I HAVE WITH ME MATT
GARBER WHO IS OUR DIRECTOR OF
FORENSIC SERVICES AND THEY
OVERSEE ALL OF THE CONTRACTING
WITH A THAT THE COUNTY I'M
JAILS.
AND THE SHERIFF'S TOO AND HIDDEN
I'M GONNA ASK HIM TO TELL YOU
ABOUT WHAT THOSE PROGRAMS LOOK
LIKE I AM. THE BIG DIFFER
BETWEEN OUR LARGER PROGRAMS
VERSES ARE SMALLER PROGRAMS AND
KIND OF AND THE SERVICES THAT
ARE PROVIDED IN WHO'S PROVIDING
THOSE SERVICES IN THE JAIL. MAN
IF YOU WOULD LIKE TO THANK YOU
SO.
WHAT WE DO IN OUR JAIL BASED
PROGRAMS
AND WE'LL HAVE A PSYCHIATRIST
THAT WILL COME IN AND?
PRESCRIBE APPROPRIATE
MEDICATIONS AS AT WORK IN RURAL
AREAS.
RIGHT NOW WHAT WE HAVE IS.
ARE SMALLER PROGRAMS ARE IN.
CINEMA COUNTY IN STANISLAUS
COUNTY SO WE'VE WORKED WITH
THEY'VE BEEN ABLE TO PROVIDE
FIND CONTRACTORS THAT WERE ABLE
TO.
BASICALLY. FIND APPROPRIATE
STAFFING TO. FILL THOSE
POSITIONS SO.
IT'S WORKED OUT VERY WELL AND
WE ALSO.
ENSURE THAT ANY DEPUTIES THAT
ARE.
PART OF THE PROGRAM THAT
PROVIDE THE CUSTODY SERVICES ARE
TRAINED IN OUR VOLUNTEERS IN
OUR.
WORKING CLOSELY WITH THE
TREATMENT STAFF TO PROVIDE AN
APPROPRIATE MILIEU TREATMENT FOR
THOSE PATIENTS ARE YOU AWARE OF
ANY SUPPORT IN SAN LUIS OBISPO
COUNTY.
WE ACTUALLY ARE WORKING WITH
THEM WE MET WITH THEM IN PERSON
LAST WEEK SO WE'VE BEEN.
DISCUSSING WITH THEM OPTIONS FOR
WHAT MIGHT BE AN APPROPRIATE
SETTING FOR THEM WITHIN EITHER
THEIR EXISTING JAIL ARE LOOKING.
THROUGHOUT THE COUNTY AS FAR AS
ONE OF MY FAMILIAR WITH THE
HOLLAND CASE IN TENNIS OBISPO
COUNTY.
SCHIZOPHRENIC MAIL HELD FORTY
SIX HOURS IN RESTRAINTS YET AND
HE DIED FROM A RECENT THIRD
THEY'RE LOOKING TO WORK WITH US
ON ON THE OPTION OPTIONS AND
OPPORTUNITIES.
IS TO IS TO WORK TOWARDS.
FINDING A BETTER SOLUTION FOR
PROVIDING THE SERVICES BOUT
COUNTIES THAT AREN'T REACHING
OUT TO YOU.
BUT DON'T HAVE THE CAPACITY ARE
YOU DOING ANY AFFIRMATIVE
OUTREACH YES WE ACTUALLY HAVE
REACHED OUT TO.
I WOULD SAY ALMOST EVERY COUNTY
IN THE STATE IF NOT EVERY COUNTY
WHAT WE'RE WORKING ON IS.
LOOKING AT SMALLER COUNTIES
ESPECIALLY BEING ABLE TO FIND
WAYS THAT WE CAN IMPLEMENT A
SMALL COUNTY MODEL WHICH IS
WHERE WE DON'T NECESSARILY HAVE.
A LARGE SECTION OF JAIL BEDS.
CARVED OUT BUT WERE WE WORK IN.
WITH THEIR EXISTING STAFF TO
AUGMENT THEIR TIME SO WE CAN
PROVIDE INDIVIDUAL ONE ON ONE
TREATMENT. IN THE INTEREST OF
TIME I WON'T BELABOR IT BUT WE
HAVE. I WOULD DESCRIBE A CRISIS
WE'VE HAD TWELVE DEATHS. IN SAN
LUIS OBISPO COUNTY JAIL SINCE
TWENTY TWELVE I CAN'T SAY THEY
WERE WRONG.
S. I. S. T..
PATIENTS. FOR INMATES.
BUT IT'S A CRISIS WE'RE ASKING
OUR COUNTY JAIL FACILITIES. TO
TREAT PEOPLE WITH SERIOUS MENTAL
ILLNESS WHO MAY NOT. BE DIVERTED
IS AN I. S. TEENS THEY MAYBE
HAVEN'T EVEN REACH THAT POINT.
THEY MAY BE.
THEY'VE JUST BEEN DETAINED SO I
I JUST THINK WE NEED TO PUT A
SPOTLIGHT ON THIS IT'S IT'S A
FUNDAMENTAL HUMAN RIGHTS ISSUE
OF PEOPLE BEING.
DID IN RESTRAINTS ON TONIGHT
FOOD DENIED ACCESS TO MEDICAL
CARE.
THIS ONE INDIVIDUAL HOOD WAS PUT
OVER HIS HEAD HE WAS STRIPPED
NAKED IN A CONCRETE ROOM. AND
TIED TO A CHAIR FOR FORTY SIX
HOURS. WHEN HE WAS CUT LOOSE HE
DIED FROM. EMBOLISM ON.
ATTRIBUTED TO BEING HELD IN A
CHAIR WITH THE RESTRAINTS FORTY
SIX HOURS.
THAT'S THAT'S TWO DAYS.
SO.
I JUST FEEL OBLIGATED TO
UNDERSCORE.
THIS CRISIS IS REAL AND IT'S
AFFECTING FAMILIES. ARM IN A
BROAD BROAD SEGMENT OF THE
POPULATION.
IT'S BEING HELD IN COUNTY JAILS.
I WON'T STOP THERE.
NO THANK YOU.
ALRIGHT WELL THAT'S THE.
WHEN WE. MOVE ON TO THE.
ISSUE NUMBER TWO WHICH SIZED
VERSION PROPOSALS AND THEN WE'LL
TAKE PUBLIC COMMENT ABOUT THE
ISSUE ONE AND TWO AT THE. AFTER
WE CONCLUDE THIS.
SO.
THE SERVICE WASN'T.
WELL WHAT DO YOU WANT ME TO
START.
HAPPY TO. HAVE.
MISTER CHAIR SO THE PROPOSAL
THAT THE THAT THE FIVE MILLION
DOLLARS THAT IS INCLUDED IN THIS
FOR THE COMMISSION REALLY WAS
THE ISSUE THAT WAS ON THE
EARLIER AGENDA ITEM. WELL AGAIN
THAT WAS THIS IS OKAY SO THIS
THIS IS THE TIME OUR HEALTH
TREATMENT VERSE OF THE DS A
CHESS REPORTS. REPRESENTS A
CLASS TWO NIGHTS AS PART OF IT
WAS IN PART IT'S REALLY GENTLE
FUN SO IT'S AT THIS WRITING
THOSE S ADMINISTRATION WAS
ABOUT IN THIS PROPOSAL AND THE
COMMISSION WAS. INTERESTED IN
REALLY STRENGTHENING
OPPORTUNITIES TO USE MOUTH
INNOVATION DOLLARS TO REDUCE
CRIMINAL JUSTICE INVOLVEMENT IN
THE RIGHT WOULD ADMINISTRATION
IS PROPOSING TO MARRY THESE TWO
PROPOSALS. AWAY WE REALLY SEE
THE OPPORTUNITY TREMENDOUS
OPPORTUNITY. TO BETTER DEPLOY
MHSAA AND OTHER MENTAL HEALTH
SERVICES DOLLARS TO REDUCE
UNEMPLOYMENT IT'S ACTUALLY ONE
OF THE EXPLICIT GOALS IN THE ACT
IS TO INVEST IN MENTAL HEALTH
STRATEGIES THAT ACTUALLY PREVENT
THE INITIAL. CRIMINAL JUSTICE
INVOLVEMENT THE WORK THAT WE'VE
DONE HAS FOUND THAT THE PRIMARY
OPPORTUNITY THE MOST COST
EFFECTIVE OPPORTUNITY IS TO
REALLY DO THAT THROUGH COMMUNITY
BASED SERVICES TO INVESTMENTS IN
FULL SERVICE PARTNERSHIPS.
WE'D LIKE TO UNDERSTAND WHY. WE
DON'T HAVE AS MANY FORENSIC FULL
SERVICE PARTNERSHIPS AS
ALTERNATIVES TO THE ORIGINAL LAW
ENFORCEMENT INVOLVEMENT. AND
WE'VE BEEN TALKING TO FOLKS
NATIONALLY AROUND STRATEGIES TO
DO THAT AND SO THE PEACE THAT
THIS TINY PIECE THAT WE HAVE
THIS BROADER PROPOSAL TO PROVIDE
A COMMUNITY STRATEGY
PARTICULARLY RECOGNIZING. THE
SIGNIFICANT PERCENTAGE OF THE
POPULATION THAT IS NOT GETTING
MAIL HOW SERVICES PRIOR TO A
FELONY ARREST. THAT WERE
INVOLVED WITH THE CRIMINAL
JUSTICE SYSTEM MULTIPLE TIMES
PRIOR TO THE FELONY ARREST AND I
THINK THE FIGURE WAS SEVENTIES
FORTY SEVEN PERCENT THAT ARE NOT
HOUSED. AND SO WE SEE AN
OPPORTUNITY TO BETTER LEVERAGE
HOUSING DOLLARS BETTER LEVERAGE
IMAGE IS SAYING AND REALIGNMENT.
TO REALLY STRENGTHEN THE
PREVENTION OPPORTUNITIES SO THAT
WE DON'T HAVE THE NUMBERS
FLOWING INTO THE SYSTEM IN THE
FIRST PLACE OKAY AND SO I
UNDERSTAND THIS IS PART YOU HAVE
THE STATE COUNTY PARTNERSHIPS
FOR DIVERSION AND THE LA. COUNTY
MENTAL HEALTH TREATMENT PIECE
YET DID YOU WANT ME TO KIND OF
AND DISCUSSES PROPOSALS AND THEN
ADDRESS THE QUESTIONS.
ESPECIALLY. YES SO I WANT TO
ACTUALLY WATCH JUST GO AHEAD AND
THE WILD ONE THE QUESTIONS A
BRIEF OVERVIEW OF THE THREE WE
ALREADY HEARD FROM THE MOUTH OF
THAT WE HAVE THE OTHER TWO SEVEN
BRIEF. AND THEN.
AND AND OTHER QUESTIONS YES
BRIEF THOUGH AND FOR THE
INCOMPETENT TO STAND TRIAL
DIVERSION PROGRAM OF IT YOU KNOW
AS WE MENTIONED WE STARTED
LOOKING AT AND WE WE DEALT WITH
THE CAPACITY AND THE.
SYSTEMS IMPROVEMENT AND NOW
THIS IS LOOKING TOWARDS THE
DEMAND SIDE AND HOW DO WE ON
SOMEONE AND THE FUNDING THAT WE
PROPOSE
CAN BE USED FOR EITHER PRE
BOOKING AND OR POSE FOR BOOKING
AND DIVERSION PROGRAMS THAT
PROVIDE EVIDENCE BASED COMMUNITY
MENTAL HEALTH TREATMENT AND
NECESSARY SUPPORTS FOR THESE.
INDIVIDUALS.
.
OUR TARGET.
WE HOPE THAT THIS PROGRAM WILL
TARGET INDIVIDUALS WHERE THERE
IS A NEXUS BETWEEN THE SERIOUS
MENTAL ILLNESS AND THE ALLEGED
CRIMINAL ACTIVITY.
WHERE THERE'S SIGNIFICANT
EVIDENCE OF SERIOUS MEANT A
MENTAL ILLNESS AT THE TIME OF
THE ALLEGED CRIME OR THE CRIME
IS DRIVEN BY CONDITIONS OF
HOMELESSNESS? AND DO THAT THE
INDIVIDUAL CAN BE SAFELY TREATED
IN THE COMMUNITY AND THERE IS A
WE HAVE PROPOSED A. MINUTE AT A
MINIMUM EXCUSE ME A COUNTY MATCH
OF TWENTY PERCENT AND THE GOAL
IS TO TARGET A MINIMUM REDUCTION
OF A TWENTY PERCENT.
OF ICE TEA REFERRALS TO DS AGE
AND THE OF THE AMOUNT PROPOSED
NINETY NINE POINT FIVE MILLION
WOULD BE FOUR COUNTIES FOR ABOUT
TO SEVEN HUNDRED PLACEMENTS IN
DIVERSION PROGRAMS. AND WE ARE
FOCUSED ON PRIMARILY ON THE TOP
FIFTEEN COUNTIES THAT REFER THEM
AT THE GREATEST NUMBER OF INCOME
TO STAND TRIAL PATIENTS TO THE
HOSPITAL. AND.
TO SAY HOSPITALS AND THEN WE
HAVE SET ASIDE EIGHT POINT FIVE
MILLION FOR OTHER COUNTIES TO
GIVE THEM THE OPPORTUNITY FOR
SMALL COUNTIES TO PARTICIPATE.
MORE FOR COUNTIES TO. TO.
COLLABORATE AND AND COME IN
WITH A PROPOSAL.
THE PROGRAM WE DO HAVE WE HAVE
REQUESTED IT.
SOME SUPPORT WHAT PROPORTION OF
THE FOLKS.
THAT YOU TALKED ABOUT FOR WHO
ARE CURRENTLY PATIENTS WHO ARE.
AND I SEE I KNOW CYCLE THROUGH I
MEAN I'VE READ WHAT PERCENTAGE
OF THE.
THEY SHOULD HAVE TO. YEAH SORT
OF FIT THIS TARGET I MEAN I WE
ESTIMATE ABOUT TWENTY PERCENT OF
OUR POPULATION THAT'S ABOUT
TWENTY PERCENT OKAY. OKAY THANK
YOU BUT WE WE WE WE DO ESTIMATE
THAT THERE'S PLENTY TO FILL
THESE SEVEN HUNDRED OKAY. THAT'S
ABOUT TWENTY PERCENT OKAY. WHEN
TIME SO THE FIRST QUESTION IS
AROUND WHETHER I AM WE HAD BEEN
WORKING WITH JAFFA. AND WE
APPRECIATE THIS A AND A IN OUR
PRE HEARING THAT WE HAD THAT AND
THE OPPORTUNITY TO REACH OUT AND
HAVE A CONVERSATION SINCE AND
WITH JAVA WE CONTINUE TO WORK
WITH THEM TIME TO LEARN MORE
ABOUT EACH OF OUR RESPECTIVE
PROGRAMS AND HOW. WE AND ME AT
WHERE THERE MIGHT BE
OPPORTUNITIES TO COORDINATE AND
THESE THESE TWO FINDING TOOLS.
.
WE HAVE ON THE NEXT QUESTION ARE
THESE ONE TIME EXPENDITURES OR
FOR AN ONGOING PROGRAM AND THE
GOVERNORS FOR PUT THEM PROPOSAL
IS
.
THE FOURTH QUESTION.
V.. WEATHER.
SEE WE HAVE A DSA TOLD COUNTIES
ACCOUNTABLE FOR MEETING THE
OBJECTIVES. TO THE PRIMARY GOAL
OF THE PROGRAM IS TO DIVERT
INDIVIDUALS WITH SERIOUS MENTAL
ILLNESS FROM THE CRIMINAL
JUSTICE SYSTEM. I'M AND PROVIDE
THE MENTAL HEALTH TREATMENT WITH
THE ADDED BENEFIT OF REDUCING
THE INCOMPETENT TO STAND TRIAL
REFERRALS TO THE STATE HOSPITAL.
AND YOU KNOW. THE WAY WE
DESIGNED THE PROGRAMS PROVIDE
MAXIMUM FLEXIBILITY TO THE
COUNTY SO WE WILL HAVE.
DIFFERENT TYPES OF PROPOSALS
COMING IN FROM THE COUNTIES AND
WHEN ONE COUNTY.
LOOKS LIKE WE'LL LOOK VERY
DIFFERENT THAN WHAT THE OTHER
COUNTIES.
ALL LOOK LIKE SAID THE GOALS OF
EACH PROGRAM WILL VERY.
WE DO AND PLAN TO CONTRACT WITH
THESE COUNTIES. AND SO THERE
WILL BE A SCOPE OF WORK WE WILL
BE MONITORING THAT SCOPE OF
WORK.
AND THAT TO DISCOUNT AND THE
COUNTIES WILL BE REQUIRED TO
REPORT OUTCOMES AND DATA TO THE
DEPARTMENT OF STATE HOSPITALS.
ON THE NEXT QUESTION.
.
WELL THESE ARE THE MOTHERS
PROGRAM HAVE THE ADDITIONAL
BENEFIT OF DIVERTING INDIVIDUALS
FROM A CAR SERRATION IN COUNTY
JAILS YES DEFINITELY.
INDIVIDUALS ARE WILL BE
DIVERTED FROM THE CRIMINAL
JUSTICE SYSTEM AND.
AND ULTIMATELY IF THEY'RE
SUCCESSFUL IN THE PROGRAM EITHER
HAVE THEIR CHARGES MITIGATED OR
OR I'M REDUCED SO THEY WILL BE
IN IT DIVERTED FROM THE CRIMINAL
JUSTICE SYSTEM. AND THE NEXT
QUESTION WHAT EXPERTS TEASES
DEPARTMENT STATE HOSPITALS
POSSESS ALLOW US TO EFFECTIVELY.
IDENTIFIES BEST PRACTICE FOR
COMMUNITY BASED DIVERSION
PROGRAMS AT THE COUNTY LEVEL
OVERSAW WE UNDERSTAND ARE
POPULATED BY THE OUR PATIENTS
AND OUR POPULATION THAT WE SERVE
I'M VERY WELL AND SO. AND THAT
WILL DEFINITELY HELP US FIRST
FALL IN IN IN THE DISCUSSIONS
WITH THE COUNTIES AND AND AND
WHO THEY WERE TRYING TO DESIGN
THESE PROGRAMS TO SERVE.
WE WILL BE WORKING WITH COUNTIES
TO LEVERAGE THEIR EXISTING
COMMUNITY BASED PROGRAMS TO
PROVIDE DIVERSIONS AND.
PROGRAMS IN LINE WITH THE
SCHOOLS. AND WE HAVE BEEN
WORKING TO GAIN EXPERTISE. IN
THAT AREA OF JAIL DIVERSION I'M
CONDUCTING COUNTY VISITS I'M
LEARNING WHAT PROGRAMS ALREADY
EXIST IN THE COUNTY
UNDERSTANDING THE PROGRAM
INFRASTRUCTURE. AND REVIEWING A
BEST PRACTICES FROM AROUND THE
COUNTRY. AND WE EXPECT TO HIRE
ONE OF THE POSITIONS THAT WE
REQUESTED IS CHIEF.
PSYCHOLOGISTS WHO EXPECT TO
HIRE A JAIL DIVERSION SOMEBODY
THAT'S VERY YOU KNOW IT AND
KNOWLEDGEABLE IN THIS AREA.
ADDITIONALLY WE ALSO HAVE AN
EXISTING RELATIONSHIPS WITH MANY
OF THE COUNTY PARTNERS THAT ARE.
GOING TO ME I NEEDED TO COME
TOGETHER TO THE TABLE IN ORDER
TO HAVE A SUCCESSFUL DIVERSION
PROGRAM FOR THESE INDIVIDUALS.
AND AND THESE ARE THE SAME
PARTNERS WE'VE BEEN WORKING ON
AND STUFF LIKE THAT ESTABLISHING
OUR JOB BASE COMPETENCY
TREATMENT PROGRAM AND AND AND
HAVING VERY SUCCESSFUL AND.
PROGRAMS OPERATING COUNTIES.
THE HAPPY TO ANSWER ANY
QUESTIONS. THANK YOU ALLEY OF
COMMENTS.
THANK YOU MISTER CHAIR SO
SPECIFIC TO THE ICY DIVERSION
PROPOSAL AND WE FIND THAT THE
CONCEPT OF ICY DIVERSION FOR THE
REASONS THAT APARTMENT MENTIONED
DOES MAKE SENSE HOWEVER.
WE RECOMMEND REJECTING THE
GOVERNOR'S PROPOSAL AS IT WE WE
DIDN'T FIND THAT ITS STRUCTURE
WELL STRUCTURED TO ACHIEVE THE
BENEFITS OF REDUCING ICED TEA
REFERRALS. MIND AND DIVERTING
PEOPLE OUT OF THE SYSTEM AND
THIS IS FOR THREE PRIMARY
REASONS. THE FIRST BEING THAT
THE KEY PROGRAM DETAILS ARE
UNCLEAR SUCH AS HOW MUCH FUNDING
WILL BE PROVIDED TO WHICH
COUNTIES AND WHAT SPECIFIC
PROGRAMS WILL BE PROVIDED.
SECOND THE COUNTY INCENTIVES ARE
UNCLEAR.
SUCH AS WHETHER COUNTIES WOULD
BE INTERESTED IN PROVIDING THESE
SERVICES GIVEN THAT THEY ARE
REQUIRED TO PROVIDE A MATCHING
FUNDING WHILE THE TREATMENT OF
FELONY ICED TEA PATIENCE. IS A
STATE RESPONSIBILITY. AND THIRD
THE IMPACT OF THE PROPOSAL WILL
LIKELY BE MINIMAL BECAUSE IT
WILL TAKE TIME FOR THESE COUNTY
DIVERSION PROGRAMS. A TO TAKE
ROOT AND BECOME EFFECTIVE THE
FUNDING HOWEVER IS ONE TIME IN
NATURE ALTHOUGH CAN BE USED OVER
A THREE YEAR PERIOD. BUT WE ALSO
THE PROPOSAL DOESN'T INCLUDE A
MEETING FOR EVALUATION OF THE
PROGRAMS TO REALLY PINPOINT
WHICH STRATEGIES WERE MOST
EFFECTIVE.
SO AS AN ALTERNATIVE WE
RECOMMEND THE LEGISLATURE
DIRECTED APARTMENT TO WORK WITH
COUNTIES TO DEVELOP SPECIFIC
ICED TEA DIVERSION PROGRAMS THAT
THE LEGISLATURE COULD CONSIDER
FUNDING EITHER IN TWENTY
EIGHTEEN NINETEEN OR BEYOND. AND
WITH THESE.
PROPOSALS THAT THEY WOULD
IDENTIFY A SPECIFIC PROGRAMS
THAT WOULD BE PROVIDED THE
NUMBER OF PATIENTS THAT WOULD BE
SERVED AND A PLAN TO EVALUATE
THE EFFECTIVENESS OF THOSE
PROGRAMS.
AND IF THE LEGISLATURE CHOSE TO
APPROVE SOME OF THESE PROPOSALS
WE WOULD RECOMMEND THAT IT
PROVIDE FUNDING ON A MULTI YEAR
LIMITED TERM BASIS TO EVALUATE
WHAT WORKS. IF A PROGRAM IS
PARTICULARLY SUCCESSFUL THE
LEGISLATURE COULD THEN CONSIDER
WHETHER TO PROVIDE ONGOING
FUNDING.
FINANCE.
PICTURE OF.
SO THIS PROPOSAL AND IT MAY HAVE
BEEN SAID BY THE DEPARTMENT.
IT'S ALWAYS INTENDED TO TO
PROVIDE COUNTIES FLEXIBILITY AND
SO THERE ARE SOME ASPECTS OF
THIS THEY ARE INTENTIONALLY
VAGUE.
IN THAT THAT. IT ALLOWS THE
COUNTIES TO. BEGIN PROVIDING THE
SERVICE ALMOST IMMEDIATELY
BECAUSE A LOT OF THESE COUNTIES
THAT HAVE THE HIGHEST HE
REFERRALS. MATE OR DO IN SOME
CASES HAVE.
DIVERSION PROGRAMS IN PLACE
CURRENTLY AND SO. BE.
WE WANTED TO PROVIDE WE WANTED
THE LANGUAGE TO BE OPEN AND THAT
THE COUNTIES HAVE THE
FLEXIBILITY TO. USE THIS FINDING
TO START THE SERVICES QUICKLY.
IMMEDIATELY WITHIN THAT THREE
YEAR PERIOD TIP TO CONTINUE AND
TO BUILD UPON EXISTING RESOURCES
THAT THEY CURRENTLY HAVE.
AND AND SO.
.
FOR A LONG TERM NATURE OF THIS
AND WHAT HAPPENS AFTER THE THREE
YEARS IS AND THAT'S WHERE WE SEE
THE COMPANION PIECE FROM. THE
MENTAL HEALTH SERVICES OVERSIGHT
COMMISSION AND THAT.
ONLY THEN WILL BE INCENTIVIZED
TO USE THIS PLANNING PROCESS TO
THINK INNOVATIVELY AND HOW THEY
APPROACH.
THEM TO PROVIDE THESE NEEDS IN
THE COMMUNITY. AND SO.
THROUGH THEIR THAT PROCESS THE
ABILITY TO LEVERAGE THEIR MHSAA
DOLLARS TODAY AND THINK OF OTHER
STRATEGIC WAYS TO ADDRESS THIS
POPULATION THE COMMUNITY.
LONG TERM.
THANK YOU QUESTIONS FROM THE
MEMBERS. OKAY SO.
SOME I'M I'M IN A PRETTY SHADE
THOUGH AS PRESENTATION BECAUSE I
DID HAVE SOME THERE'S SOME
VAGARIES AND THEY GET. SO SO I'M
HEARING. FROM FROM FINANCES THAT
SO ON ONE HAND WE'RE GOING TO
LOCK PEOPLE START UP QUICKLY EAT
SO I ASSUME WHAT THAT MEANS IS
SCALING UP SOME EXISTING
DIVERSION PROGRAM THEY HAVE
RIGHT.
AND THEN WE ALSO HAVE A
PLANNING PROCESS TO COME UP WITH
NEW INNOVATIVE WAY THAT'S GONNA
TAKE MORE TIME BECAUSE CLEARLY
THERE SO SO I ASSUME THIS MY
SINCE ITS THREE YEAR FIXED IT'S
REALLY MORE ABOUT SCALING UP AT
LEAST INITIALLY BECAUSE BY THE
TIME YOU GET THE RESULTS. YOU
PROBABLY THE THIRD YEAR BY TIME
YOU SAY YOU KNOW.
YOU BRING PEOPLE TOGETHER YOU
TALK YOU HAVE A PLAN WE CAN
IMPLEMENT.
THAT'S PROBABLY AT LEAST A YEAR.
RIGHT. CONCRETE OKAY THAT IS NOT
TO. OKAY THAT IS SO. SO ONE OF
THE GOALS I SEE HERE IS
REDUCTION OF THIRTY.
THIRTY PERCENT THIRTY PERCENT
CURRENT ICY REFERRALS WILL BE
DIVERTED RIGHT.
IS.
.
SO SINCE MORE PRIVATE TALK ABOUT
PEOPLE STARTING BRAND NEW
PROGRAMS BUT EXPANDING EXISTING.
I'VE HEARD OF YOU GUYS GO PICK
IF YOU'RE GONNA STRICTLY RAMP UP
FOR I MEAN IT'S PROBABLY NOT
STARTING FROM SCRATCH YOU
PROBABLY SCALING UP SOMETHING
YOU'RE DOING EVEN SCALING UP
TAKES TIME AND MONEY. AS THEIR
STANDARD THAT YOU HAVE TO SHOW
YOUR EXISTING PROGRAM AT LEAST
THE BEFORE THE SKILLED UP AT
LEAST THIRTY PERCENT SO THAT WE
KNOW WILL GET THE THIRTY PERCENT
AT LEAST HAVE A SHOT AT DOING
IT.
LABS YOUR EXISTING PROGRAM. GETS
TEN PERCENT BUT THAT STILL BE
SOMETHING YOU'D SAY WE PUT MONEY
THE SCALE UP BECAUSE IT'S
UNLIKELY IS GONNA DO BETTER WHEN
YOU SCALE IT UP IT'S MORE LIKELY
IT'S GOING TO GO DOWN A LITTLE
BIT. BUT HOPEFULLY CAN STAY THE
SAME I MEAN I'M JUST TRYING TO
GET. I APPRECIATE THE GOAL OF
THIRTY PERCENT BUT I'M TRYING TO
FIGURE OUT LIKE WHAT'S THE
STANDARD BY WHICH YOU CAN DECIDE
WHAT GETS FUNDED SO THAT WE
ACTUALLY HAD OUR GOAL.
SO AM I YOU MANY OF THE COUNTIES
HAVE AN EXISTING PROGRAMS THAT
MAY NOT BE TARGETING THIS
POPULATION SPECIFICALLY SO OUR
GOAL IS TO PROVIDE FUNDING TO
HELP. AND PROVIDE THE NECESSARY
EITHER SPORTS WRITER STANDARD BY
US LEVEL SUCCESS OF THOSE
EXISTING PROGRAMS AND YOU HAVE
US TO SET A GOAL OF THIRTY
PERCENT HERE IN YOUR PROPOSAL
SO.
I PRESUME THAT.
THE EXISTING PROGRAM THESE HAVE
DEMONSTRATED I MEAN THAT THEY
HAVE HIT A CERTAIN LEVEL OF
SUCCESS BEFORE WE PUT MORE STATE
MONEY INTO IT.
I THINK NOT BE LOOKING AT WHEN
WE MEET MAINLY AND WHEN WE WORK
WITH THE COUNTIES TO UNDERSTAND
THEIR EXISTING PROGRAMS THAT
WOULD BE LEARNING. HOW THEY HAVE
BEEN SUCCESSFUL SO THAT AND WE
CAN ENSURE THAT THE MONEY THAT
WE WOULD BE INVESTING WOULD BE
GOING TO I'M PROGRAMS THAT? HAVE
BEEN DEMONSTRATING THAT THEY
HAVE BEEN AND SUCCESSES THIRTY
PERCENT AT LEAST RIGHT. OLD
THIRTY PERCENT THAT THIRD
PROGRAMS MAY NOT CURRENTLY BE
TARGETING AND THE INCOMING
DISTINTA POPULATION SO. OKAY IT
WOULD BE DIFFICULT TO EXPECT
THEM TO HAVE ALREADY BE
DIVERTING THIRTY WELL WELL I
MEAN IT OKAY YOU CAN TAKE THE
RESULTS AND. I MEAN AT THE END.
I'M JUST TRYING TO GET AT WHAT
THE STANDARD BECAUSE WE SET A
GOAL HERE OF THIRTY PERCENT.
BUT THE STANDARD IS FOR
EVALUATING WHETHER WE'RE GOING
TO PUT ADDITIONAL STATE MONIES
INTO. WELL PRIVATE SO I COULD BE
AN EXISTING PROGRAM MAYBE NOT
DIRECTLY RELATE TO DIVERSION BUT
THAT WOULD YOU EXPECT TO
REASONABLY RESULTS IN A IS THAT
THE EXPECTATION AND THE AND THE
PERCENTAGE.
WAS AROUND AT SEVEN HUNDRED OUT
THAT WAS A PERCENTAGE OF THE
EXISTING REFERRALS TO THE END
AND DANIEL REFERRALS TO THE
DEPARTMENT THE HOSPITAL SAID
THAT GOAL WAS SET AS A. IF WE'RE
GOING TO TAKE SEVEN HUNDRED OUT
OF THE STATE HOSPITAL REFERRAL
POT THEN THAT WOULD BE TV'S A
THIRTY PERCENT REDUCTION OF THE
OF DOT POT THAT WAS COMING AND.
SO THAT'S KIND OF WHERE THAT
NUMBER RIGHT SO WELL. SO SO THE
BY HE UNDERSTAND WHAT I'M ASKING
RIGHT BECAUSE YOUR GOAL IS
THIRTY PERCENT IN ORDER TO HIT
YOUR GOAL THEN.
YOU NEED TO FUND PROGRAMS FOR
YOU RESOLVE EXPECT I'LL BE
THIRTY PERCENT OR BETTER
OTHERWISE YOU'RE NOT GONNA HIT
YOUR GOAL AND YOU'RE NOT GONNA
GET TO RETURN YOUR SEEKING.
CORRECT BREATH PRACTICE SO I
MEAN IS YOU ARE TRYING TO VALLEY
WHICH PROGRAMS YOU GONNA TAKE
FOR THE AND I DO THINK AND
EVALUATIONS IMPORTANT BECAUSE WE
DON'T KNOW WHAT REALLY HAPPENED
UNTIL WE ACTUALLY EVALUATE SO IS
THERE AN INTENTION TO INCLUDE
EVALUATION COMPONENT. TO THIS
FUNDING.
BUT WE HAVE THEM OUT CUTS WE DO
HAVE OUTCOMES AND DATA THAT I'M
REQUIRED TO BE REPORTED TO US AS
WELL AS A CONTRACT.
WITH.
PROPOSE FOR WHICH THE UC DAVIS
ARCS GIVING WITH A YOU SEE.
IN ORDER TO AND LOOK AT SOME
COMPONENTS OF IT.
OKAY NOW IBM IS SO SOMEONE
THINGS SO THEY ACTUALLY THE
OTHER QUESTION I HAVE IS.
IT ASSUMING WE HIT THE THIRTY
PERCENT WHAT IS THE DESERT
INSISTS.
WHAT'S ANTICIPATED NETS. A
REDUCTION IN COSTS IS THAT WE
HAVE WE'RE GONNA PUT IN. WAS A
HUNDRED AND.
FOURTEEN POINT EIGHT. YOU KNOW
MILLION I APPRECIATE THE
GOVERNOR MAKING THIS VEST AND I
ACTUALLY THINK IT'S AN IMPORTANT
INVESTMENT RIGHT. AND THAT WE
SHOULD BE DOING THIS SO I MEAN
THAT'S NOT THE ISSUE I JUST
WANNA BE SURE SPENDING THE MONEY
WISELY CELEBS AND THAT'S THE
GOOD I LIKE WHAT YOU WOULD FAVOR
TARGETING HERE.
SO.
.
AGAIN THIS IS BY THE COMMITTEE
AND I ALWAYS LIKE TO TALK ABOUT
SAVINGS AND SO OFTEN I HAVE
ADVOCATES ARE SAYING BUT
ACTUALLY DOES GOVERNMENTS
BECAUSE I LIKE TO HAVE THE SAME.
BY THE SAME STANDARD I EXPECT WE
SHOULD SAVE SOME MONEY HERE YOU
KNOW SO WE'RE GONNA HAVE A.
SPEND SOME MONEY BUT WE'RE ALSO
GONNA SAVE MONEY BECAUSE WE CAN
ACTUALLY DIVERSE THIRTY PERCENT
THAT PROBABLY IS GONNA SAVE THE
STATE SOME MONEY SO HOW MUCH
MONEY DO EXPECT IT'LL SAVE IF WE
DIVERT OUR THIRTY PERCENT. WELL
I DON'T THINK THERE'S ANY
ANTICIPATED SAVINGS IN THIS
PROPOSAL GIVEN THAT THERE'S
THERE IS A WAIT LIST. THERE WAS
A WAIT LIST OF INDIVIDUALS
WAITING TO GET INTO STATE
HOSPITALS. AND SO I THINK THE
INTENT THE INTENTION IS TO
DIVERT THESE INDIVIDUALS WHO
WOULD HAVE OTHERWISE CONTINUE TO
CYCLE THROUGH SAY HOSPITALS BUT
JUST AS MANY AS THEY'RE
DIVERTING THERE'S OTHERS THAT
ARE STILL CONTINUING TO COME
AND.
SEE YOU KNOW YES AND WE GOTTA
GET CREDIT REALIZE WE GOT IT
BEFORE. I DID MS APOLOGIES AT AS
WE NOTED BEFORE THERE ARE A LOT
OF INDIVIDUALS WAITING TO GET IN
THE STATE HOSPITALS SO THIS IS
ONE OF THE STRATEGIC WAYS TO
AVOID CAN'T MORE INDIVIDUALS CUT
CYCLING IN WHILE THEY CONTINUE
THIS ARE THE ONES THAT ARE STILL
WAITING.
OKAY SO FROM MY SAVINGS
PERSPECTIVE YOU'RE STILL
CONTINUING TO HAVE INDIVIDUALS
REFERRED AND TREATED IN STATE
HOSPITALS IT'S NOT LIKE WE'RE
VACATING A BAD. GUY JUST
PIGGYBACK ON THE OUT OF THE WAY
THIS IS ALSO CONTINUING TO GROW
SO RIGHT. DOUBT CERTAINLY DIE
ENTERED THEIR DAD I HOPING THAT.
.
AT LEAST WE COULD REDUCE FUTURE
ILL AND EXPANSIONS BECAUSE IF WE
DON'T DO ANYTHING AND IT'S I
APPRECIATE THE GOVERNOR PLAYING
THIS MONEY AND.
RIGHT PROBABLY WE ARE GONNA MEAN
WE ARE OPENING UP MORE BAD DEBT
OF SORTS RIGHT I MEAN YOU HAVE
WE JUST TALKED ABOUT YOUR
ACTIVATING VARIOUS BEDS OF
DIFFERENT THINGS TO TRY TO DEAL
WITH BUT THIS. ISSUE TOO SO
MAYBE IT'S.
REDUCTION IN.
OTHER ACTIVITIES CELL. OKAY.
OKAY SO YES PUBLIC COMMENT.
SO IT'S ARE WE HAVE A
STAKEHOLDER PROPOSAL.
HERE'S A PRESIDENT COME ON UP
HERE COME ON UP HERE SO WE DO
HAVE A STAKE OUT A PROPOSAL.
YES SORRY I APOLOGIZE AND YOU
YOU ACTUALLY GET YOUR YOU GET
YOU DON'T HAVE TO USE ALL OF IT
YOUR THREE MINUTES I WILL I
WILL.
ENDEAVOR NOT TO USE ALL OF IT SO
MY NAME IS MELINDA BLAKE I'M A
FELLOW AT STANFORD AT STANFORD
LAW SCHOOL I AM HERE ON BEHALF
OF THE N. DOUBLE ACP LEGAL
DEFENSE FUND IS OUR CLIENTS GET
THE LEGALITIES OUT OF THE WAY.
I'M WE HAVE A PROPOSAL TO
ACTUALLY ADDRESS SOME OF THE
CONCERNS THAT WERE DISCUSSED
HERE AT THE TABLE NAMELY HOW TO
PROPERLY INCENTIVIZE COUNTIES TO
PARTICIPATE IN THIS TYPE OF
PROGRAM. HOW TO ENSURE CONTINUED
LONG TERM FUNDING TO ALLOW FOR A
LONGER TERM PLANNING AND THAT WE
HAVE THE MAGIC SOLUTION?
IT'S OWNED AND A CURRENT BILL
SB ONE FORTY TWO WHICH PASSED
OUT OF THIS HOUSE LAST YEAR AND
IS CURRENTLY SITTING AND
ASSEMBLY PUBLIC SAFETY.
BASICALLY WHAT IT DOES IS IT
TAKES A LOT FOR EVERY COUNTY
THAT REDUCES THE NUMBER OF
PEOPLE THAT ARE COMMITTED TO
STATE CUSTODY SO THAT COULD
EITHER BE. A MENTAL HEALTH
DELIVERY SYSTEM AND CDC ARE
STATE HOSPITALS EITHER BY.
INCOMPETENT STAND TRIAL OR
NOT GUILTY BY REASON OF INSANITY
AT THE AT. THE A PORTION OF THE
SAVINGS WILL BE SENT BACK TO THE
COUNTY TO INVEST IN COMMUNITY
BASED. ON SERVICES TO.
BASICALLY PROVIDE THE DIVERSION
THAT WE'RE TALKING ABOUT HERE SO
DO A COUPLE DIFFERENT THINGS
FIRST OF ALL IT WOULD AVOIDED
THE ISSUE OF OF COUNTIES BEING
ABLE TO PLAN IT FORWARD IN THE
FUTURE WHY WOULD I. WILL IT'S
FULL OF A PROGRAM THAT CAN BE
DONE BY THE FUNDING TO MAKE ON
THREE YEARS FROM NOW NUMBER ONE.
NUMBER TWO ALSO AVOIDS THE WATER
BALLOON ISSUE RIGHT SO WE'RE ALL
WE'RE TALKING ABOUT THESE LIKE
THEY'RE DISCRETE GROUPS OF
PEOPLE BUT THEY'RE REALLY ALL
THE SAME POPULATION THING IS
THAT WE WANT TO REDUCE
THE THREAT AND THE THE CENTER
RIGHT NOW THE COUNTIES HAVE
WHICH IS BASICALLY TO. GET THEM
OFF OF THEIR PAYROLL AND SEND
THEM TO THE STATE. RIGHT SERVICE
SAYS WITH AT LEAST TAKES AWAY
THAT INCENTIVE AT THE VERY LEAST
BUT WE THINK THAT WHAT IT'LL DO
IS BUILD CAPACITY FOR. COMMUNITY
BASED MENTAL HEALTH SERVICES
THAT WILL HELP ALL OF THESE
POPULATIONS. AVOID FUTURE CRIMES
WELL WHICH IS ALSO GOOD FOR
PUBLIC SAFETY GENERALLY AND.
AND ENSURE LONG TERM FUNDING
FOR THIS TYPE OF PROGRAM THOUGH
LESS THAN THREE MINUTES HAPPY TO
ANSWER QUESTIONS THANK YOU FOR
YOUR CONSIDERATION.
THANK YOU COMMISSION STATE
HOSPITALS WITH.
ANY COMMENTS.
OKAY ALRIGHT SELF. RIGHT AWAY
OF.
FINANCE.
OKAY.
ALL RIGHT.
I'M SURE WE'LL OF.
AS A NATION ALRIGHT. WITH THAT
PUBLIC COMMENT.
THANK YOU MR MEMBERS COULD BE
PRESIDING YOU WITH THE
CALIFORNIA ASSOCIATION OF
PSYCHIATRIC TECHNICIANS. ON
ISSUE ONE OF THE METROPOLITAN
STATE HOSPITAL SECURE BED
CAPACITY INCREASED.
THIS INCREASE.
IN POSITIONS AT METRO IS WHOLLY
APPROPRIATE AS THE TYPE OF
PATIENT THAT WILL BE HOUSED IN
THESE NEW UNITS.
THAT WILL REQUIRE STABILIZATION
RESTORATION TREATMENT ICE TEAS
THAT ARE REFERRED HER FACILITIES
WELL KNOWN FOR BEING THE MOST
ASSAULT OF PATIENTS.
THESE HIGH NICULAE LEVELS WILL
DEFINITELY NEED STAFFING. SAME
GOES WITH COALINGA AND THEN
SPEAKING ON BEHALF OF THE SAFETY
NOW COALITION WHICH REPRESENTS.
CAPPED THE YOU KNOW IT YOU A P.
D. S. WE TWENTY SIX TWENTY.
AS HERE YOU SEE A SILLY SO.
.
WE'RE GLAD TO SEE THAT THE
DEPARTMENT IS LOOKING AT NEW AND
CREATIVE WAYS TO ADDRESS
CAPACITY ISSUES THAT HAVE LONG
PLAGUED THE STATE HOSPITAL
SYSTEM.
FOR TOO LONG.
IT IS BEEN THE POSITION OF THE
ADMINISTRATION THAT WILL NOT
GROW OUR WAY OUT OF THIS
CAPACITY PROBLEM. HOWEVER IF YOU
LOOK AT THE AGE OF THE
FACILITIES BEING USED YOU'LL
FIND THAT COALINGA AND
ATASCADERO STATE HOSPITAL AND
ATASCADERO IN THIS MORNING
SISTER BECAUSE BILL NINETEEN
FIFTY FOUR.
I'VE NOT BEEN YOU KNOW THAT THE
NEWEST ONE WAS NINETEEN FIFTY
FOUR IF YOU TAKE COMING OUT OF
IT.
THEY WERE NOT DESIGNED TO.
DEAL WITH PATIENTS WITH CRIMINAL
HISTORY.
SO.
WE NEED TO REALLY LOOK AT HOW
WE'RE DEALING WITH OUR OUR OUR
PATIENT PROBLEM AND I SEE
PROBLEMS YOU JUST HEARD FROM
EVERYBODY SAYING THAT. ALL THESE
MEASURES ARE STOPGAP MEASURES ON
THE GROWING ICE TEA ISSUE YOU'RE
GOING TO LOOK AT INVESTING
YOU'RE GONNA HAVE TO COME TO THE
CONCLUSION THAT THESE ARE ALL
BAND AID APPROACHES. TO DEALING
WITH THE GROWING ISP PROBLEM AND
THAT MEANS YOU HAVE TO INVEST IN
BUILDING A NEW FACILITY.
THANK YOU.
OKAY. THANK YOU MISTER CHAIR AND
MEMBERS FOR MCDADE TANG AGAIN ON
BEHALF OF THE CALIFORNIA STATE
ASSOCIATION OF COUNTIES AS WELL
AS THE COUNTY BEHAVIORAL HEALTH
DIRECTORS ASSOCIATION WE ARE
STRONGLY SUPPORTIVE OF THE
GOVERNOR'S PROPOSAL. AND DO.
ALSO SHARE THE CONCERNS ABOUT
TRYING TO FLUSH IT OUT AND SEE
HOW IT COULD WORK WE'RE WORKING
WITH OUR COUNTY AFFILIATES AND
STAKE HOLDERS AS WELL AS.
EVERYBODY AT THE TABLE WE
p BUT WE WE DO WANT TO MISS THIS
OPPORTUNITY TO DEVELOP SOMETHING
THAT MAY DIVERT FOLKS FROM THE
HIGHEST MOST RESTRICTS
RESTRICTIVE FORM OF CARE SO
THANK YOU.
WELCOME TO OUR MEMBERS TO WIN
FOR SOME HAVE THE URBAN COUNTIES
OF CALIFORNIA I'M ALSO IN
SUPPORT OF THE HUNDRED MILLION
FOR.
DIVERSION FOR COUNTIES ON WE
HAVE BEEN PART OF THE
STAKEHOLDER PROCESS AND MEETING
WITH THE DEPARTMENT WILL PREACH
THEM. DURING THE DATA ON WHO THE
POPULATION IS WHO ARE THE
HIGHEST POPULATION THE CV
CURRENT INTO THE JAILS ARE OR
WHO WE SEE IN OUR SYSTEMS.
WE ARE STILL EVALUATING ON THAT
PROPOSAL AND TRYING TO COME UP
WITH ON. SOMETHING THAT WILL
WORK HOPEFULLY USING AN EXISTING
PROGRAMS THAT CARRIES ALREADY
HAVE SO WE DON'T HAVE A I'LL
SPEND A LOT OF MONEY ON THE
BUILD UP OF THOSE PROGRAMS. BUT.
AND THEN ALSO DRESSING IN
TRYING TO ADDRESS THE ISSUE OF
THE BAD SITUATION PRESENTS
THAT'S THE BIG ISSUE FOR
COUNTIES RIGHT NOW AS WE DON'T
HAVE ENOUGH BEDS. EVEN IF WE
WANTED TO DIVERT THANK YOU.
THANK YOU WELCOME. GOOD
AFTERNOON MISTER CHAIRMAN BURST
ELIZABETH ESPINOSA HERE THIS
EVENING ON BEHALF OF THE BOARD
OF SUPERVISORS THE COUNTY OF
RIVERSIDE. THIS IS AN ISSUE TO
THE ICE TEA DIVERSION PROVOKE
PROPOSAL A COUNTY RIVERSIDE IS
AMONG THE TOP FIFTEEN AND
REFERRALS TO THE DEPARTMENT
STATE HOSPITALS. A REGRETTABLY
THERE ALSO FIFTY SEVEN FIFTY
EIGHT IN TERMS OF THE MENTAL
HEALTH AND HEALTH RESOURCES THAT
THEY RECEIVE IN THE STATE SO
THEY'VE REALLY BEEN UNABLE AT
THIS POINT TO DEVELOP THE ROBOTS
KIND OF. CONTINUUM OF SERVICES
ON THE MENTAL HEALTH SIDE THAT
THEY MIGHT LIKE TO SEE HOW THEY
VIEW THE GOVERNOR'S PROPOSAL AS
AN OPPORTUNITY. TO SECURE SOME
RESOURCES TO INVEST AND DIVERTED
TREAT THOSE WERE MOST VULNERABLE
IN OUR SOCIETY UNDERSTANDING
SOME OF THE DETAILS NEED TO BE
WORKED OUT BUT THEY AREN'T
SUPPORT THANK YOU.
THANK YOU.
WELCOME MISTER CHAIR KIRK CHILD
DISABILITY RIGHTS CALIFORNIA AND
WE TOO ARE VERY APPRECIATIVE
THAT THE ADMINISTRATION IS
RECOGNIZING THE NEED FOR SOME
ADDITIONAL RESOURCES.
WE WOULD HAVE A COUPLE OF
COMMENTS AND I THINK ONE SENATOR
MINING TO. THAT YOUR POINTS OR
IS THAT YOU'RE MAKING ON JAIL
BASED COMPETENCY PROGRAMS WE
HAVEN'T SEEN THAT THOSE ARE
REALLY THE ANSWER FOR ALL OF US
I I THINK THE LACK OF
PREPARATION AND THE THE
RESOURCES THAT ARE NEEDED
LOCALLY. TO MAKE THOSE.
SUCCESSFUL THEY CONTINUE I
THINK TO PROPOSE ARE POSE RISKS.
TO THE ADMINISTRATION'S.
PROPOSAL ON. THE DIVERSION I I
THINK YOU'VE HEARD OF FOR ABOUT
THAT THERE THIS WOULD BE AN
EFFORT TO TRY AND EXPAND WHAT IS
ALREADY EXISTING RESOURCES WE
WOULD SUGGEST PERHAPS A
DIFFERENT APPROACH NOW.
WITH A LIMITED AMOUNT OF A
HUNDRED MILLION DOLLARS OVER.
THREE YEARS
THAT THAT WOULD NOT DO WHAT WE
NEED TO DO WHAT WOULD IT WOULD
MOSTLY BE. THE DIVERSION OF
MISTER MINUTES WE THINK NOW IS
THE TIME TO REALLY START DOING
THE TOUGH WORK AND LOOKING AT
THE VACATING THE PADS IN THE
FELONIES.
AND FELONS IN SO LOOKING NOW TO
WHAT WOULD BE COMMUNITY BASED
PROGRAMS AND SO WITH THREE
YEARS.
OF THIS THESE DOLLARS WE THINK
THAT YOU COULD ACTUALLY START
LOOKING AT ARE WHAT ARE THE
OTHER THE MORE DIFFICULT.
PROBLEMS TO SOLVE WITH THIS
COMMUNITY AND START LOOKING AT
THE. THE.
FELONIES AND DOING SOME ROVER
ROBUST EVALUATION OF THOSE
PROGRAMS SO AT THE END OF THAT
THREE YEARS WERE READY TO MOVE
BEYOND.
THE CURRENT PROPOSALS THAT
WE'VE BEEN LOOKING AT THANK YOU.
OKAY ANY OTHER QUESTIONS.
RIGHT WELL I WOULD JUST SAY.
THAT.
I AGREE WITH HALEY OF WE DO WE I
THINK WE NEED TO REALIZE THAT
YOU'RE SAYING WE'RE STILL
WORKING GUYS I THINK THERE NEEDS
TO BE SOME MORE SPECIFICS IN
TERMS OF THE STANDARDS FOR WHAT
KIND OF. PROGRAMS WILL BE
FUNDING WITH THIS MONEY YOU KNOW
WHAT. YOU KNOW YET YOU SET OUT A
GOAL HERE WELL THEN HOW WE KNOW
WE'RE GOING TO GET TOWARD THAT
GOAL I MEAN WHAT.
I THINK CERTAINLY AN EVALUATION
IS REALLY IMPORTANT AND I I
ALSO.
APPRECIATE THAT NO ONE TIME OKAY
WITH A DO A HUNDRED MILLION OVER
THREE YEARS BUT I'M NOT SURE
THAT WE CAN BE VERY SUCCESSFUL
YOU GO TO A COUNTY AND WE SAY WE
GET THREE EARS OF MONEY AND
AFTER THAT YOU JUST GOTTA FIND
COUNTY MONEY FOR THAT WE'VE. GOT
TO BUILD IN SOME SORT OF IT'S
NOT STATE DOLLARS SOME SORT OF
COMPONENT TO THIS WHERE YOU WORK
AT THE COUNTY TO HELP THEM. DO A
SUSTAINABILITY PLAN LOOKING AT
ALL THE VARIOUS YOU KNOW FUNDING
STREAMS COMPLICATED WE'VE HEARD
ABOUT FUNDING STREAMS BUT HOW DO
YOU. HOW DO YOU BASICALLY TAKE A
PROGRAM THAT HOPEFULLY THIS
MONEY CAN LAUNCH THEN YOU CAN
MAKE A CASE FOR LIKE OKAY NOW I
CAN DRAW DOWN SOME MORE OR MAYBE
MAIL MEDICAID DOLLARS BECAUSE
THAT WE CAN? FIGURE THAT OUT OR
SOME IS A IT SO THAT THERE IS A.
I'M GOING FUNDING STREAM THAT'S
BEYOND JUST SIMPLY WELL GUESS
WHAT WE GIVE YOU THREE YEARS THE
MONEY AND THEN YOU'RE ON YOUR
OWN AND YOU FIGURE THAT OUT
BECAUSE I HAVE A FEELING THAT
PEOPLE LOOK AT THAT AND THEY'RE
NOT TO BE SO EXCITED TO PICK UP.
ON THAT. SO.
I'D URGE YOU TO FIGURE THAT OUT
BEFORE YOU COME BACK TO US AND
MAY AND TELL US EXACTLY WHAT YOU
WANT US TO TRY TO FIND. THEM ALL
RIGHT.
OKAY LET ME ALSO ALRIGHT THANK
YOU.
SO.
.
WE GET. UP AND WE'RE GOING TO
HOLD THIS ITEM OPENED SO WE'RE
LOOKING FOR THOSE DETAILS.
RIGHT.
AND I DO APPRECIATE THE
INVESTMENT THAT THE MENTAL
HEALTH OFFICIALS PUTTING INTO
PARTNERSHIPS ALRIGHT DEPARTMENT
OF STATE HOSPITAL SO WHAT WE CAN
DO HERE IS THAT WE HAVE AN
OVERVIEW AND WE'RE GONNA HEAR
ALL THE DIFFERENT ITEMS THAT
RELATED TO THAT AND THEN WE'LL.
TAKE PUBLIC COMMENT ON THE WHOLE
CATEGORY. SO AGAIN.
.
NOT JUST THE HIGHLIGHTS ON THE
OVERVIEW. OF ISSUE NUMBER ONE.
QUEUE AND ACTUALLY WE STILL HAVE
THE SAME PLAYERS AROUND THE
TABLE DON'T NEED. A OKAY ONLY I
INTRODUCE YOURSELF.
GOOD EVENING KAREN AND SENATOR
MOANING MY NAME IS PAMELA AND
THE DIRECTOR FROM THE DEPARTMENT
STATE HOSPITALS. AND I AM GOING
TO PROVIDE THE OVERVIEW THINKING
AND.
SO I WON'T GO INTO TOO MUCH
DETAIL BECAUSE THERE'S SOME
QUITE A BIT OF INFORMATION AND
THAT THE. I'M DOCUMENTS THAT WE
HAVE HERE. DEPARTMENT SAY
HOSPITALS WAS ESTABLISHED AND
JULY FIRST TWO THOUSAND TWELVE
IT WAS TO MANAGE AND OPERATE THE
STATE HOSPITAL SYSTEM FOR
MENTALLY ILL PATIENTS OF
CALIFORNIA.
WE CURRENTLY HAVE FIVE STATE
HOSPITALS THROUGHOUT CALIFORNIA
ONE IS IN THE NORTHERN PART OF
CALIFORNIA TO CENTRAL INTO
SOUTHERN. NAPA STATE HOSPITALS
ARE NORTHERN KALANGA AND
ATASCADERO OR IN THE CENTRAL
PART OF CALIFORNIA. METRO AND
PATTON ARE DOWN IN THE SOUTHERN.
WE ALSO HAVE A CONDITIONAL
RELEASE PROGRAM. WE REFER TO
CONRAD BITS ARE OUTPATIENT
PROGRAM WE CURRENTLY HAVE OVER
SIX HUNDRED PATIENTS IN
OUTPATIENT PROGRAM. AND HEARD A
LITTLE BIT ABOUT OUR JOB BASE
COMPANY TO PROGRAM WHICH IS
EXPANDED FROM FORTY BEDS AS A
PILOT PROGRAM TO WELL OVER TWO
HUNDRED BEDS NOW.
ALL OUR PATIENTS THAT ARE
COMMITTED TO THE DEPARTMENTS THE
HOSPITALS ARE COMMITTED THROUGH
EITHER THE COURTS THROUGH A
COURT ORDER. THROUGH THE
DEPARTMENT OF CORRECTIONS ON
THROUGH THE ARMY AND IN THE HILL
OR CIVIL PATIENTS THAT ARE
THROUGH THE CONSERVATIVE
PROCESS.
THE PEOPLE THAT WE SERVE IT ON
OVER THE PAST TWENTY TWENTY FIVE
YEARS THE DEPARTMENT'S
POPULATION DEMOGRAPHICS HAS
SHIFTED FROM PRIMARILY CIVIL.
CIVIL COURT COMMITMENTS TO
FRIENDS OF POPULATION REAPER
REFERRED THROUGH THE CRIMINAL
COURT SYSTEM.
SO AS WE SAID TODAY WE HAVE
ABOUT NINETY ONE PERCENT OF OUR
PATIENT POPULATION IS FORENSIC
WHICH INCLUDES ARE NOT GUILTY BY
REASON OF INSANITY. PATIENTS ARE
INCOMPETENT STAND TRIAL PATIENTS
SEXUAL VIOLENT PREDATORS ARE
MENTALLY DISORDERED OFFENDERS
AND ARE MENTALLY ILL PRISONERS
REFERRED TO AS A COMMON
POPULATION.
OUR CIVIL ON POPULATION WHICH IS
ABOUT NINE PERCENT IS THE LPS
LETTERMAN PETRA SHORT CONCERT BY
THE COUNTIES.
WE LOOK AT OUR POPULATION THAT
AND WE HAVE TWO TYPES OF LINKS
STAYS WITH THE SHORT TERM WHICH
ARE THE INCUMBENT STAND TRIAL.
ADVERSELY THIS DAY IS ABOUT A
HUNDRED SIXTY FOUR DAYS AND THAT
ARE MENTALLY ILL PRISONERS WHICH
WE SERVE ABOUT SIX TO SEVEN
MONTHS NOW WE RETURN THEM BACK
TO THE DEPARTMENT OF
CORRECTIONS.
OUR LONG TERM POPULATIONS WHICH
HAVE A MUCH LONGER LENGTH OF
STAY. ARE NOT GUILTY BY REASON
OF INSANITY SEXUAL PREDATORS
MENTALLY DISORDERED OFFENDERS
ENTER LPS POPULATION.
YOU TALKED ABOUT WHAT KIND OF
TREATMENT PROGRAMS THAT WE HAVE
IN IN OUR DEPARTMENT YOU'RE ONE
OF THE QUESTIONS.
WE HAVE INPATIENT OUTPATIENT OUR
DATABASE PROGRAMS AND WE HAVE A
PROPOSED.
ASSESSMENT EVALUATION
STABILIZED CENTER THAT'S COMING
UP IN KERN COUNTY AND THEN YOU
HEARD ABOUT THE DIVERSION
PROGRAMS WITH HER IN THE FUTURE
IN THIS OR PROPOSE.
OUR IMPATIENCE SENSES IS
APPROXIMATELY IN SIXTEEN
SEVENTEEN WITH APPROXIMATELY
SEVEN THOUSAND. AND WE SERVE IN
THE SEVEN THOUSAND.
SENSES WE SERVE ABOUT THIRTEEN
THOUSAND MENTALLY ILL PATIENTS
EVERY YEAR.
OUR HELP PATIENTS SENSES IS A
LITTLE BIT OVER SIX HUNDRED. AND
WE THOSE ARE ALSO ANY GIVEN DAY
WE HAVE SIX CENTER BUT THEY COME
IN AND THEY'RE ADMITTED AND
THEY'RE DISCHARGED.
JVC WE HAVE OVER TWO HUNDRED
BEDS. CURRENTLY.
WE PROVIDE CLINICAL TREATMENT
WHICH INCLUDES MEDICAL MENTAL
HEALTH AND DENTAL.
WE ALSO HAVE DRIVEN PATHWAYS
WHICH WE ARE CLINICAL FOLKS AND
LOOK AT. THE OTHER TWO THE
PATHWAYS WHICH ARE SPECIFIC TO
EACH PAGE PATIENT AND THE REASON
THAT THEY'RE THERE. AND OUR GOAL
IS ALWAYS TO SUCCESSFULLY
DISCHARGE THEM EITHER BACK INTO
THE GEL SETTING SO THEY GO
THROUGH DUE PROCESS BACK TO CDC
ARE SO THEY CAN FINISH THEIR.
TERM THERE OR BACK TO THE
COMMUNITY AND BE SAFELY PLACED
IN THE COMMUNITY.
WE HAVE A OUR TREATMENT IS MULTI
DISCIPLINARY TEAMS WE HAVE
PHYSICIANS PSYCHIATRISTS
PSYCHOLOGISTS CLINICAL SOCIAL
WORKERS REHAB THERAPISTS NURSES
WHICH INCLUDES LIKE TAX AND
REGISTERED NURSES.
SOME OF THE SIGNIFICANT
ORGANIZATIONAL CHANGES YOU HEARD
WE ESTABLISHED IN TWO THOUSAND
TWELVE FROM THE PRIOR DEPARTMENT
AMOUNT HALL. WHICH ALLOWED US TO
HAVE A LITTLE BIT MORE FOCUSED
ON THE STATE HOSPITALS AND
PATIENTS WE SERVE AND HAVE A
BROAD MAN RESOURCES.
OUR GOALS WITH THEM AT THAT
POINT OUR SAFETY FOR OUR
PATIENTS AND OUR STAFF.
OUR TREATMENT THAT WE PROVIDE WE
WANT TO HAVE THE STATE OF THE
ART TREATMENT ALWAYS LOOKING AT
NEW WAYS TO TREAT A PATIENT THE
BEST WAY TO TREAT HIM. AND BE
RESPONSIBLE DEPARTMENT TO ALL OF
THEIR STAKEHOLDERS AND OUR
TAXPAYERS.
WE FOCUS IN ON BECOMING AN
ENTERPRISE AT THAT POINT TIME WE
WERE FIVE INDEPENDENT HOSPITALS
WE'RE NOW COLLAPSING AND WORKING
AS AN ENTERPRISE ORGANIZATION.
WITH THAT WE CAN LEVERAGE
OPPORTUNE OPPORTUNITIES TOWARD
DEFICIENCIES WHERE LET
LEVERAGING OUR RESOURCES OUR
SYSTEMS AND OUR BEST PACK
PRACTICES THROUGHOUT OUR SYSTEM.
DURING THAT TIME WE ALSO.
FOCUSED ON ESTABLISHING A
CLINICAL OPERATIONS DIVISION
THIS WAS TO EMBRACE INCORPORATE
ALL DISCIPLINES AND POLICY
DEVELOPMENT AND DECISION MAKING
PROCESS.
AND FINALLY. WE'RE FOCUSING AS
MISS CLINTON AND TALKED ABOUT
WAS BEYOND THAT. YOU KNOW WE
HEAR ABOUT CAPACITY WERE HERE
EACH AND EVERY YEAR TALKING
ABOUT OUR CAPACITY IN AND ARE
WEIGHTLESS.
BUT WHAT WE'VE LEARNED IS
CAPACITY JUST ONE PART OF
OBSERVING THE MENTALLY ILL
POPULATION WE HAVE TO UNDERSTAND
THE DEMAND OF HIS COMING IN AND
HOW TO BETTER SERVE THEM AND HOW
DO WE DIVERT THEM OUT OF OUR
SYSTEM.
AS YOU HEARD ALSO. IS THE
HOSPITALS THAT'S A LAST RESORT
FOR A MENTALLY ILL PERSON IN
CALIFORNIA. SO OUR GOAL IS TO
REALLY HOW DO WE BEST STEER THEM
OFF PRIOR TO COMING INTO THE
STATE HOSPITALS HOW DO WE WORK
WITH THE COMMUNITIES HAD WE WORK
WITH OUR GEL PARTNERS TO KEEP
THEM OUT OF THE CRIMINAL JUSTICE
SYSTEM. HOW TO KEEP IT OUT OF
THE COURT SYSTEM WHAT'S BEST FOR
THE PATIENT?
SO WE'RE REALLY FOCUSING IN AN A
AND A SOB HEARD A LITTLE BIT
ABOUT THE DIVERSION PROGRAM. AND
THE STATE'S RESPONSIBILITY IS
FELONY ISPS HOWEVER THIS
DIVERSION PART PROGRAM TO ME
REACHES A LITTLE BIT BEYOND
THAT.
WE'RE TALKING ABOUT A PATIENT
WE'RE TALKING ABOUT A PERSON.
WE'RE TALKING ABOUT GETTING THEM
SERVICES PRIOR.
MORE THAN JUST RESTORATION.
TRY TO GET THEM CONNECTED BACK
INTO THE COMMUNITIES WHERE THEY
LEAD GIVEN CASE MANAGERS GET ON
PEOPLE GET IMAGE SERVICES
WHETHER IT'S FEDERAL OR OR OTHER
SERVICES THAT ARE THERE. AND GET
THEM STABILIZED IN THEIR OWN
COMMUNITY SO THEY CAN BETTER
SERVE THEIR COMMUNITY SO I
PERSON LOOK AT THE DIVERSION IS
A LITTLE BIT MORE THAN THE
STATE'S RESPONSIBILITY
CONNECTING THEM BACK INTO THE
CAR. THE COUNTY TO BE PRODUCTIVE
AND HELP OUR JAIL PARTNERS TO
HELP OUR COURTS AND HELP THE
PEOPLE THE FAMILIES OF THESE
PATIENTS.
WE ALSO HAVE A RESPONSIBILITY OF
OUR SYSTEMS AND WHAT WE'VE DONE
IS AS WE BEGIN THE DEPARTMENTS
THE HOSPITALS LOOKED AT HOW CAN
WE BETTER. BE MORE EFFICIENT
WITH THE DOLLARS THAT WE ARE
THAT WE HAPPEN TO THE PATIENTS
THAT WE SERVE. SO WE LOOK AT HOW
DO WE DO OUR BEST OUR BUSINESS
BETTER WE'RE CENTRALIZING WE'RE
GOING TO REGULATION PROCESS. AND
WE'RE TRYING TO EVEN OUT. OF THE
THE TREATMENT THAT WE SIR WITH
ALL OUR OUR POPULATIONS IN A
MATTER WHAT HOSPITAL HE LANDED
YOU'RE GETTING THE SAME GOOD
SERVICE.
ANOTHER SIGNIFICANT CHANGE THAT
OUR DEPARTMENT UNDERWENT WAS
JULY ONE OF TWO THOUSAND
SEVENTEEN WAYS TO MANAGE THREE
PSYCHIATRIC PROGRAMS WITH THE
DEPARTMENT OF CORRECTIONS WE DID
THAT FOR MANY MANY YEARS.
AND THEY HAD STARTED BRINGING ON
AN EMBRACING AND AND BUILDING UP
THEIR MENTAL HEALTH SERVICES IN
THEIR IN THEIR PRESENCE AND THEY
WERE AT A POINT WHERE THEY'RE
READY TO TAKE ON THE INPATIENT
PROGRAMS THAT WE WERE RUNNING
FOR INSIDE THEIR PRESENCE. JULY
WHEN WE TRANSFER THAT
RESPONSIBILITY BACK TO THE
DEPARTMENT OF CORRECTIONS AND
I'M PLEASED TO SAY THAT THEY'RE
DOING A VERY VERY GOOD JOB.
SO THAT'S KIND OF WHO WE ARE AND
THAT'S IN A NUTSHELL AND. AND.
ANY QUESTIONS GREAT THANK YOU.
ANY ERA COMES FROM THE LIVE OAK
FINANCE IT. CEREMONY.
THANK YOU I KNOW THAT WAS AN
OVERVIEW AND A LOT OF OUR FOCUS
TODAY IS ON.
CAPACITY EMBEDS IN KEEPING PACE
WITH NEED.
TOM WE DID HEAR THAT ATASCADERO
WAS BUILT IN NINETEEN FIFTY
FOUR.
WHAT?
WHAT PROGRAMS YOU HAVE TO
EVALUATE INFRASTRUCTURE NEEDS
HANDS SAFETY?
WELL WHAT WE DEFINITELY ARE
LOOKING AT OUR INFRASTRUCTURE
WERE EVALUATING EACH ONE OF OUR
HOSPITALS AND WERE LOOKING AT
THAT THAT.
THE SAFETY FOR OUR STAFF AND FOR
PATIENTS YOU'LL HEAR A LITTLE
BIT MORE ABOUT OUR PERSONAL
DRESS.
ALARM SYSTEM THAT WE HAVE.
IMPLEMENTED SUCCESSFULLY IN
pEVERYONE OF OUR HOSPITAL SO
WE'RE LOOKING AT HOW DO WE
RESPOND QUICKER FOR STAFF AND
FOR PATIENTS BECAUSE THAT COULD
BE MEDICAL AS WELL.
AND WE ALSO YOU'LL HEAR A LITTLE
BIT MORE ABOUT OUR ENHANCED
TREATMENT PROGRAM AND THAT IS
WERE RECONSTRUCTING SOME UNITS
AT ATASCADERO AND ALSO A PATENT
FOR FEMALE POPULATIONS AND IT'S
TO BETTER SERVE. SOME OF THOSE
MORE VIOLENT PATIENTS THAT WE
GET IN OUR HOSPITALS. AND GIVES
US THE TREATMENT ENVIRONMENT
THAT ARE CLINICIANS CAN REALLY
SAFELY TREAT THOSE PATIENTS
AGAIN WE FEEL THAT THOSE
PATIENTS DESERVE THE TREATMENT.
BETTER STAFF HAVE TO BE ABLE TO.
SAFELY TREAT THEM AS WELL SO
IT'S FOR SAFETY OF OUR STAFF AND
THEIR PEERS THE PATIENT'S PEERS.
THAT WERE WERE LOOKING AT THAT
TYPE OF ENVIRONMENT. THANK YOU I
WON'T BELABOR THIS BUT I I DO.
SO MUCH OF THE FOCUS WE'RE
TALKING ABOUT IS.
.
GARTNER PROVIDER SAFETY IN
PATIENT SAFETY. ARM ALARM
SYSTEMS ETCETERA BUT. SOME OF
THAT ANTIQUATED INFRASTRUCTURE
ARE THERE RISKS OF.
POWER FAILURES SEWAGE FAILURES
ON FIRE.
THE NEED FOR MASS EVACUATION DO
HAVE CONTINGENCY PLANS IF YOU
HAVE TO EVACUATE THE FACILITY.
YES.
WE HATE WE I'M DEFINITELY ARE
LOOKING AT. THE MAINTENANCE OF
ALL OF OUR FACILITIES AND WE
EVER HAVE UNDERGO AND.
HELLO ELECTRICAL ROOFING AND
THOSE KIND OF SAFETY FEATURES
EARTHQUAKE SAFETY FEATURES AND
WE HAVE OUR PREVENTATIVE
MAINTENANCE PLAN THAT WE PUT
FORWARD EVERY YEAR WE DO SOME OF
THOSE.
.
LIFE AND FIRE SAFETY AND REPAIRS
ON ON OUR FACILITIES EVACUATION
IS KIND OF HARD IN A SENSE
BECAUSE WE HAVE EACH WON OUR
HOSPITALS HAVE ANYWHERE FROM
NINE HUNDRED.
TWO THIRTEEN HUNDRED PATIENTS
AND WHERE DO YOU TAKE THEM. SO
FOR EXAMPLE IN OUR IN OUR NOW
BUT. WE.
WENT INTO AN EMERGENCY
OPERATION WHERE WE HAD OUR NAPA
FIRES THIS LAST YEAR. AND AND WE
PARTNER WITH THAT THE OFFICE OF
EMERGENCY SERVICES WITH OUR OUR
SISTER DEPARTMENT AND CALIFORNIA
DEPARTMENT OF CORRECTIONS.
WHO?
?
AND WE WOULD PRESET.
HOW DO WE EVACUATE THEM SO THAT
WAS A KIND OF A GOOD TEST AND A
SENSE OF HOW DO YOU EVACUATE NOW
BUT WE ALSO HAVE TO REMEMBER
THAT? OUR FACILITIES.
OUR FIRE PROOF WE PREFER TO
SHELTER IN PLACE AND MOST OF
THEM MOVING THE MENTALLY ILL
PATIENTS IS VERY.
.
LABOR AND INTENSIVE ON THE
PATIENT THEMSELVES. SO WE WE TRY
TO BE AS SELF SUFFICIENT EACH
ONE OF OUR FACILITIES TO SHELTER
IN PLACE FOR ALL OF THOSE
REASONS. SO THAT WE DO HAVE
EMERGENCY PREPAREDNESS PLANS FOR
EACH ONE OF THE FACILITIES THANK
YOU THANK YOU.
THANK YOU.
IN MUCH OKAY SO WHEN WE GO AHEAD
AND MOVE ON TO ISSUE NUMBER TWO
UNIFIED HOSPO COMMUNICATIONS
PUBLIC ADDRESS SYSTEM FACE TO.
THE.
I THINK YOU.
AS IF YOU WANT TO INTRODUCE
YOURSELF FOR THE RECORD GOOD
EVENING MISTER CHAIR AND MEMBERS
I'M RAIJIN SEARS CHIEF
INFORMATION OFFICER FOR THE
DEPARTMENT OF STATE HOSPITALS.
WE'RE REQUESTING THREE HUNDRED
FIFTY NINE THOUSAND AND TWO FOR
TWO FULL TIME POSITIONS IN
FISCAL YEAR EIGHTEEN NINETEEN.
FOUR POINT SIX MILLION IN FISCAL
YEAR NINETEEN TWENTY. SEVEN
POINT SEVEN MILLION IN FISCAL
YEAR TWENTY TWENTY ONE.
AND THREE POINT SEVEN IN OUT
YEARS. TO SUPPORT THE ONGOING
COSTS FOR UNIFIED HOSPITAL
COMMUNICATIONS PUBLIC ADDRESS
PHASE ONE.
WHICH IS AT PATTON AND KALANGA
AND ADDITIONALLY WE'RE
REQUESTING. TO FUND THE
IMPLEMENTATION OF PHASE TWO OF
THE REMAINING THREE HOSPITALS.
PSH.
I AM THE PROPOSED SOLUTION
PROVIDES THE ESTATE WITH A
COMPREHENSIVE AND RELIABLE
NETWORK BASED PA SYSTEM THE
SYSTEM INTEGRATES INTO REPLACES
THE EXISTING PA SYSTEM. AND
SUPPORTING NETWORK IT PROVIDES
FULL CAMPUS COVERAGE.
WE'LL NOTIFY STAFF OF THE VENTS
IN REAL TIME DURING EMERGENCY
SITUATIONS PROVIDES TWO WAY
COMMUNICATION BETWEEN THE PUBLIC
ADDRESS SYSTEM MANY KEY AREAS
LIKE THE NURSES STATION BACK TO
THE HOSPITAL POLICE.
HAS ANNOUNCEMENTS TARGETED TO
SPECIFIC CAMPUS LOCATIONS TO
PREVENT DISRUPTION.
AND THE SYSTEM ALLOWS MESSAGE
PRIORITIZATION TO PREVENT
CONCURRENT MESSAGE DELIVERY AND
THE SYSTEM WILL INTEGRATE WITH
OUR. PERSONAL DOURESSEAUX ALARM
SYSTEM.
AS A RESULT THE PUBLIC ADDRESS
SYSTEM WILL INCREASE WORKER AND
PATIENT SAFETY.
THE FIRST PHASE OF
IMPLEMENTATION TAKES PLACE IN
MARCH TWO THOUSAND EIGHTEEN AND
COMPLETED IN JUNE TWO THOUSAND
EIGHTEEN. WE'VE ACTUALLY GOT A
HUNDRED PERCENT OF THE SPEAKER'S
IMPLEMENTED AT COALINGA AND
ABOUT SEVENTY PERCENT PATTON
RIGHT NOW.
DS AGE METROPOLITAN WILL
IMPLEMENT MARCH TWENTY TWENTY
ONE ATASCADERO TWENTY TWENTY ONE
AND NOW BUT IN JUNE OF TWENTY
TWENTY TWO. WITH POST
IMPLEMENTATION EVALUATION REPORT
JANUARY TWENTY TWENTY FOUR AFTER
SYSTEM STABILIZATION.
DID YOU HAVE ANY QUESTIONS THANK
YOU EARLIER COMMENTS FINANCE.
THIS SYSTEM AUGMENTS THE.
PERSONAL DURESS ALARM SYSTEM
WHICH WILL BE DISCUSSED LOCATED
DOWN THE ROAD THAT.
WE'RE IN SUPPORT OF IT BECAUSE
IT HELPS WITH THE SAFETY LEVEL
AT THIS HOSPITAL. THANK YOU.
SHINJI MAKES ALL RIGHT ONLY MOVE
ON TO ISSUE NUMBER THREE WHICH
IS THE ON GOING COSTS FOR
PERSONAL INTERESTS ALARM SYSTEM.
OKAY.
WE'RE REQUESTING TWO POINT SEVEN
MILLION IN FISCAL YEAR EIGHTEEN
NINETEEN IN OUT YEARS TO
INCREASE EXPENSES ASSOCIATED
WITH REFRESHING THE PERSONAL
DRESS ALARM SYSTEM EQUIPMENT.
IN OCTOBER TWENTY TEN A PATIENT
ON STAFF ASSAULT RESULTED IN THE
DEATH RAISING SERIOUS CONCERNS
REGARDING SECURITY AND SAFETY AT
DS EDGE HOSPITALS.
TO ADDRESS THIS TRAGEDY STARTING
IN TENTY TWO. TWENTY TWELVE DSA
SUCCESSFULLY DEPLOYED PERSONAL
DRESS ALARM SYSTEM APPLICATION.
THE SYSTEM IS USED SUCCESSFULLY
ON A DAILY BASIS TO ALERT
HOSPITAL POLICE AND OTHER NEARBY
EMPLOYEES WHEN I DRESS INCIDENT
OCCURS.
PREVIOUSLY APPROVED PROJECT
FUNDING PAYS FOR THE SOFTWARE
AND HARDWARE SUPPORT. THIS
PROPOSAL WILL ALLOW DS AGE TO
REFRESH THE PERSONAL DRESS ALARM
SYSTEM HARDWARE.
YES AGES UNABLE TO INTERNALLY
FUND MAINTENANCE FOR THESE
CRITICAL LIFE AND SAFETY SYSTEMS
WITHOUT AN ADDITIONAL BUDGET
ALLOCATION. IF THE DEVICES ARE
NOT REPLACED THE SYSTEM MAY
BECOME UNRELIABLE AND SAY STAFF
AND PATIENT SAFETY MAY BECOME
JEOPARDIZED.
THANK YOU. LAYOFF COMMENTS
FINANCE WINS QUESTIONS COULD BE
MEMBERS.
OKAY WELL WE DEFINITELY NEEDS I
MEAN. JUST NEED TO KEEP THESE
THINGS UP TO DATE RAPE IT'S NOT
JUST I MEAN WE ALWAYS TALK
ABOUT.
BY BIG SYSTEM BUT THIS
MAINTENANCE RIGHT OUT OKAY. ALL
RIGHT.
IT'S GOT THE SERVER COSTS OKAY
ISSUE FOR INFORMATION SECURITY
PROGRAM EXPANSION YEP WE'RE
REQUESTING THREE POINT ONE
MILLION AND TWO FULL TIME
POSITIONS IN FISCAL YEAR
EIGHTEEN NINETEEN AND ONE POINT
SEVEN MILLION OUT YEARS ALLOWING
THE DEPARTMENT TO READ MEDIATE
SECURITY ASSESSMENT FIND IAN'S.
LAST FISCAL YEAR DSA TO PERFORM
TO SECURITY ASSESSMENTS IN
COMPLIANCE WITH THE GOVERNMENT
CODE SECTION ONE ONE FIVE FOUR
NINE POINT THREE.
AND THE STATE ADMINISTRATIVE
MANUAL SECTION FIFTY THREE
HUNDRED AND THE HEALTH INSURANCE
PORTABILITY AND ACCOUNTABILITY
ACT SECURITY COMPLIANCY.
THESE ASSESSMENTS IDENTIFIED
SIMILAR FINDINGS CRITICAL TO THE
PROJECT PROTECTION OF DEUS H.
INFORMATION.
TO MITIGATE THESE FINDINGS WERE
REQUESTING SUPPORT TO IMPLEMENT
AN INVENTORY AND ASSET
MANAGEMENT SOLUTION.
TWENTY FOUR BY SEVEN SECURITY
MONITORING ACROSS THE
ENTERPRISE.
ON PREMISE ROAD DEVICEDETECTION
PAIRED WITH MORE CLOUD SECURITY
SOLUTIONS TO LIMIT ACCESS TO
AUTHORIZE DEVICES.
SECURE CODE REVIEWS SOLUTIONS
APPLICATION PENETRATION TESTING
IN AND THEN TRAINING FOR OUR
APPLICATION DEVELOPERS.
AS A RESULT OF THIS PROJECT DID
A STAGE WILL BE ABLE TO HELP
PROTECT OUR INFORMATION. ASSETS
AGAINST EMERGING THREATS AS WELL
AS THE CHIEF THE COMPLIANCY
NECESSARY TO AVOID POTENTIAL
SANCTIONS. ARE PROJECT KICK OFF
FROM PROCUREMENT WOULD BEGIN IN
JULY TWO THOUSAND EIGHTEEN.
SUPPORTING SYSTEM IMPLEMENTATION
WOULD BEGIN IN JANUARY TWO
THOUSAND NINETEEN AN ONGOING
PROGRAM MAINTENANCE AND EARLY
TWENTY NINETEEN.
OKAY THANK YOU OIL.
FINANCE.
COMMITTEE MEMBERS. OKAY ALL
RIGHT WELL CYBERSECURITY GOOD.
HOW EXOTIC HEALTH RECORDS
PLANNING THEY WERE REALLY
EXCITED ABOUT THIS PROJECT?
SUPER EXCITED.
REQUESTING ONE POINT TWO MILLION
AND FOUR TIME FULL TIME TO THE
FOR FULL TIME POSITIONS IN
FISCAL YEAR EIGHTEEN NINETEEN.
AND SEVEN HUNDRED THIRTEEN IN
FISCAL YEAR NINETEEN TWENTY TO
PREPARE FOR THE ELECTRONIC
HEALTH RECORD.
INDIA'S AGE HAS COMPLETED
BUSINESS ANALYSIS THE
ALTERNATIVE ANALYSIS IN PROGRESS
IT WILL SOON AFTER INCREASED
FOCUS ON ORGANIZATIONAL
READINESS EFFORTS.
GIVEN THE SIZE OF A COST AND
COMPLEX SCOPE OF THE ELECTRONIC
HEALTH RECORD THIS PROPOSAL
FOCUSES ON SOLUTION DEVELOPMENT.
PROCUREMENT AND PROJECT
READINESS FOR DEPLOYMENT OF A
PRIMARY CARE SOLUTION IN
INTEGRATING IT WITH OUR INTERNAL
FORENSIC BEHAVIORAL HEALTH
SYSTEM.
DS AGE HAS MADE GREAT PROGRESS
TOWARDS CONSOLIDATING AND
DEVELOPING ENTERPRISE CLINICAL
BUSINESS PROCESSES. AFTER THESE
KEY READINESS ACTIVITIES THE
NEXT STEP IS PROVIDING THEM WITH
THE TOOL TO EFFECTIVELY
IMPLEMENT THE REFINED PROCESSES.
THE PROJECT WILL ALLOW DS EIGHT
HOSPITALS TO TREAT PATIENTS TO
BE A UNIFIED PATIENT RECORD.
ENABLING ALL PATIENT CARE DATA
TO BE ANALYZED TOGETHER TO
IMPROVE INDIVIDUAL TREATMENT
SYSTEM DECISION MAKING.
THE REGISTRATION PROCESS FOR
PATIENTS AND STAFF IN PRE
PHARMACY SERVICES FOR PATIENTS
WHILE ALLOWING HIS AGE TO COME
INTO COMPLIANCE WITH STATE AND
FEDERAL REGULATIONS.
PERMITS BETTER ACCURACY OF
PATIENT COST OF CARE AND
IMPROVES THE QUALITY AND
EFFICIENCY OF PRIMARY MEDICAL
CARE FOR BOTH PATIENTS AND
HEALTHCARE PROVIDERS.
OUR STREET STAGE THREE SOLUTION
DEVELOPMENT KICKOFF BEGINS IN
JULY TWO TWENTY EIGHTEEN
APPROVAL STAGE THREE SOLUTION
DEVELOPMENT JUNE TWO THOUSAND
NINETEEN. AND THEN APPROVAL
STAGE FOR PROJECT PROJECT
READINESS AND APPROVAL FOR
CONTRACT AWARDED IN JUNE OF
TWENTY TWENTY.
YEAH.
FINANCE.
I JUST WANT TO POINT OUT THAT
THIS IS THE PLANNING STAGES AND
A AND A PROJECT APPROVAL PROCESS
AND NOT. IMPLEMENTATION
COMMITTEE OKAY.
YES US OUR MONEY.
YES SOME OF THE SAME MAKE SENSE
MOVING FORWARD PARTICULARLY WITH
THESE PATIENTS ABILITY TO
MAINTAIN MEDICATION.
PAGE FIFTY FOUR.
ON BILLING REDUCE THE NUMBER OF
MEDICARE CLAIMS RETURNED WITH
THEIRS TO LESS THAN TWENTY FIVE
PERCENT DOES THAT MEAN TWENTY
FOUR PERCENT ERROR RATE IS
ACCEPTABLE.
SHOULD THE TARGET BE WAY LESS
THAN TWENTY FIVE PERCENT.
THAT MEANS WE DON'T GET.
THE REIMBURSEMENT.
OUR OUR BILLING SPECIALIST HERE
UP TO UNDERSTAND AND BE AS THE
MECHANICS OF THAT I KNOW THE
MEDICARE BILLING PROCESS IS
EXTREMELY. COMPLEX AND CURRENTLY
WE HAVE A VERY HIGH ERROR RATE.
SO REDUCING TO TWENTY FIVE
PERCENT AND IT WOULD BE A
SUBSTANTIAL IMPROVEMENT OVER
WHERE WE'RE AT TODAY BUT WE
CERTAINLY AND WOULD BE WORKING
TOWARDS. ENSURING THAT WE GOT
I'M AS AS MUCH MEDICARE BILLING
I'M. AT A COMPLETE SUCCESSFULLY
AS POSSIBLE.
AND. SOME OF THESE BUILDINGS ARE
ACTUALLY DIED DOUBLE BILLING
AND.
SO IT COULD BE A I MISSED THE
FIRST PART THEY'RE NOT SOME OF
THESE BILLING ERRORS ARE
ACTUALLY DOUBLE BILLING AND I'M
SO IT'S NOT NECESSARILY A BLACK
BUT.
WE'LL REVIEW SOME ANOTHER WAY TO
SAY THAT IS THAT WE ARE GETTING
THE REIMBURSEMENT.
FROM ONE BUILDING AND IT'S
DENIED ON ANOTHER BECAUSE IT'S A
DUPLICATE. EIGHTY YEAH
DUPLICATED WOULD BE.
SHE WILL BE GOING DOWN WITH THE
SYSTEM.
GOOD EVENING LOU BALANCE OF THE
US ADMIN DEPUTY DIRECOR FOR THE
DEPARTMENT OF STATE HOSPITALS
AND THANK YOU FOR THE
OPPORTUNITY TO SPEAK TO YOUR
QUESTION. WITH RESPECT TO
REDUCING.
RATES AND ARGUE BILLING SYSTEM
SO AS OUR CHIEF DEPUTY DIRECTOR
CONDEMNED AND NOTED HOW WE DO
HAVE AN ANTIQUATED SYSTEM WE IN
FACT BORROW. AND OR LEVERAGE DDS
AS THE DEPARTMENT OF
DEVELOPMENTAL SERVICES COST
RECOVERY SYSTEM. THAT IS AN
ANTIQUATED SYSTEM THAT HAS BEEN
AROUND SINCE THE NINETEEN
SEVENTIES. SO WITH EHR WE HAVE
THE OPPORTUNITY TO REALLY
LEVERAGE OF MORE MODERN BUILDING
PRACTICES WHAT THAT MEANS IS
THAT WITH EACH CHARLIE WOULD
HAVE THE OPPORTUNITY. TO WORK OF
THAT MUCH MORE COLLABORATIVELY
AND FROM A DETAIL ORIENTED
PERSPECTIVE WITH OUR CLINICIANS
SO THAT WHEN THEY ARE IN PUTTING
PPN PHYSICIAN PROGRESS NOTES.
WHICH IS THE THE DIAGNOSIS THE
SYMPTOMS AT CETERA THAT THEY'RE
ALSO WORKING WITH OUR H. I. M.
D. WHICH IS OUR IT TEAM THAT
WORKS ON MEDICAL CODING. TO BE
ABLE TO THEN USE THE APPROPRIATE
ICD TEN CODES UNDER TO EVER USE
THE APPROPRIATE CODING SO THAT
WHEN WE'RE SUBMITTING. OUR OF
OUR BUILDING TO CMS THAT WE HAVE
A REDUCTION IN RATES CERTAINLY A
WE AGREE WITH YOU THAT THE ERROR
RATE SHOULD BE LOWER THAN THAT.
OF WHAT WE HEAR THAT IT'S A PART
OF A PHASED APPROACH SINCE
BILLING IS ISN'T JUST THE
INITIAL TRANSACTIONS OF DOLLARS
IT'S A MUCH MORE COMPLICATED
PROCESS. WILL THINK YOU VERY
MUCH AND I JUST WANNA MAKE SURE
YOU DID GET A CHANCE TO TESTIFY
TO.
YOU DID VERY WELL STILL LOOKING
FORWARD WELL WE MAY DO IT FOR A
LONG TIME.
I HAVE NO FURTHER DURATION PARTS
AND I'VE
ACTUALLY BEEN INVOLVED IN TWO
EHR IMPLEMENTATIONS. SO I GUESS.
AND I UNDERSTAND THAT THE
INITIAL THESE CURRENTLY ESTIMATE
FOR THE PROJECT REPORTS ABOUT
THREE HUNDRED EIGHTY SIX MILLION
IS ACTUALLY WE DON'T KNOW WHAT
THE COST IS UNTIL AFTER WE
LEAVE.
THE STAGE TO WHICH WE'RE IN
RIGHT NOW. WE'VE HAD IN OUR IF I
GO OUT AND WE'RE CURRENTLY DOING
DEMOS WITH FIVE DIFFERENT ENTERS
FROM NOT OR IF I SO WE REALLY
THAT THREE HUNDRED EIGHTY SIX
MILLION WAS ACTUALLY THE S. PR
COSTS FOR OUR. CCHS CC CSS
IMPLEMENTATION.
SO I THINK THAT IS YOUR MOVING
FORWARD AND I KNOW DEPARTMENT
TECHNOLOGIES FOR THIS I ALWAYS
SAY THAT THE. REAL COST OF EHR
IMPLEMENTATION IS NOT THE
SOFTWARE. IT'S ACTUALLY THE
PEOPLE RIGHT BECAUSE IT'S AN
INTERFACE BETWEEN SOFTWARE AND
PEOPLE AND THE TIME IT TAKES TO
TRAIN PEOPLE TO DO IT RIGHT
THAT'S PART OF THE AIR ISSUE
RIGHT. IN TO TEACH PEOPLE HOW TO
ADD DATA ENTRY AT CENTER AND
HAVING BEEN IN THAT PARK AND
GETTING THEIR BUY IN. AND AND
THAT AND.
AND SO ANNEX STEVE IT FAILURES
THAT I SEE HAPPENING IN THE
STATES BECAUSE WHAT HAPPENS IS
PEOPLE TRY TO TAKE ON A BIG
PROJECT IN DON'T GET BY AND FOR
THE PEOPLE WHO ACTUALLY HAVE TO
USE THE SYSTEM. RIGHT SO IT'S
NOT JUST THE ADMINISTRATOR IS
MAKING A FINANCIAL DECISION
WE'RE GONNA PICK THIS EHR BUT
THE PEOPLE ACTUALLY HAVE TO USE
IT SO. I JUST. PUT THAT OUT
THERE BECAUSE I DON'T KNOW WHO'S
BECOME THE CHAIR BUDGETS OF
THREE FOR YOU FINALLY COME AND
ASK FOR THE SYSTEM ITSELF.
BUT.
YOU KNOW I THINK.
I WANT I WANT YOUR
IMPLEMENTATION BE ONE THE LIKE
QUITE ONES WE NEVER SEE IN THE
NEWS BECAUSE IT JUST WENT SO
SMOOTHLY AND EVERYONE'S HAPPY
ABOUT IT AND WE'RE ALL GOOD ON
THAT SO WHAT THAT.
ANY OTHER QUESTIONS.
I HOPE WE. WILL MAKE THAT
HAPPEN.
ALL RIGHT OKAY SO.
AND NO OTHER COMMENTS THEN UP
PUBLIC COMMENT ON ANY ITEMS.
UNDER STATE HOSPITALS.
WHILE BUT WE LOOK FORWARD TO
HOPEFULLY MOVING FOR OTHERS
AFTER MAY REVISE AND WITH THAT
WE'VE COMPLETED OUR AGENDA AND
THE THIS.
HEARING OF THE BALANCED BUDGET
FISCAL REVIEW SUBCOMMITTEE
NUMBER THREE ON HEALTH AND HUMAN
SERVICES IS NOW ADJOURNED AND
ALI. LOST.
IF YOU